My new doctor said something the other week that made me think. After seeing a sample food log, he commented that I wasn’t getting enough protein in the morning and was eating too much at night. For example, I would have 2 eggs in the morning (12g) and 10 oz of steak for dinner (70g). My first response was “What’s the big deal? It all adds up to the right amount by the end of the day.” … But do the day’s totals really matter to your body?

The body is constantly using nutrients, e.g. fat, protein and glucose, etc. It doesn’t wait until the end of the day when everything is totaled up, a deficit is noted and any shortage is made up from storage.

Instead, fat is always flowing out of your fat cells into your blood (or coming in from food) making itself available to be used and then moving back into your fat cells. Similarly glucose circulates in your blood, coming in from many sources (food, stored glycogen, gluconeogenesis) and can be restored if unused (though this is broken in diabetics). The same is true for many micronutrients, e.g. vitamin C. So where is protein stored?

Here’s the rub, there is no inert storage form of protein; it is used to build muscle, bones and organs. Your tissues are continually breaking down its protein into amino acids. From there they can either reuse those amino acids to rebuild what was just broken down, they can take even more amino acids from your blood and build bigger or they can release those amino acids back into your blood for other organs to use. And any excess protein? It doesn’t magically cause your muscles to get bigger or your bones stronger. Once your body has used as much as it needs, the rest is usually converted to glycogen (a form of stored glucose).

Keeping this in mind, when I eat a protein-light breakfast, a moderate lunch and go all out at dinner, what does that look like to my body?

• In the morning, I have been fasting for 12 hours, I’m already pretty low on amino acids and since I didn’t get much for breakfast, my cells are most likely to give up protein (for the sake of more important organs like the heart).
• At lunch I get a good dose of protein, raising my amino acids levels and enabling my cells to use them to rebuild and retain protein.
• Now for dinner, I have my mega-steak (yum!).  I get a huge influx of amino acids and my cells can use as much protein as they need to rebuild. But they only need so much, and the excess isn’t stored as protein. Instead my liver helpfully saves it for a rainy day as … glycogen. Which can then be used later to raise my blood sugar.

My day’s total protein was right on target but now not only am I losing muscle and bone mass but my fasting blood sugar is getting higher! After all I’m giving my liver plenty of ammo every night with that excess protein. So while it all looked good on paper, my carefully planned meals weren’t having the effect that I had hoped for…

So from now on, I’m saving that extra steak at dinner and eating it at breakfast. Yup, with advice like this, the new doctor should work out just fine.

Afterthoughts

• I don’t have solid references or citations for this stuff. It’s what I learned from my doctor, so if it is incorrect or you have some good references, please let me know!
• Though I’m focusing on protein, there are equally good reasons for splitting all of your nutrients evenly across your meals. Especially if you are diabetic, you should avoid lumping all your carbs into a single meal.
• If you are eating very low-carb, your body will also use protein and convert it into glucose for your brain, via gluconeogenesis. This is why it’s very important to get adequate protein from your food. If you don’t your brain will win every time and you will lose lean body mass.

Check out How Much Protein Should You Eat? for information on how to calculate out how much protein you need.

What does the Primal Crazy Cat Lady’s kitties diet look like? I call it Catkins (Atkins for Cats), The Paleo Pet Solution or the Primal Kitty Diet. As I have learned more about my own health and the effect of nutrition, like the crazy cat lady I am, I’m putting the cats on their own ancestral diets too. When two of my cats became obese, besides feeling like a failure (it’s not like they are sneaking out to McDonald’s) and being terrified that they would develop diabetes (can you imagine holding down a 16lb Maine Coone to test his blood sugar and inject insulin?) I made the mental transition of applying some of my new found knowledge to my cats.

Cats are carnivores, they eat small rodents, birds and maybe some fish in the wild, so why was I feeding them dry kibble? Granted it was expensive, organic kibble but across the board all kibble is basically the same thing: carbohydrates. Last time I checked, field mouse is pretty low in carbs. The cheap stuff uses mystery “by-products” and the expensive stuff uses more consumer friendly filler like potato starch or rice but it’s really all the same. The carbohydrates is the essential ingredient, without it kibble couldn’t exist.

It really came down to this: I was sacrificing my cats’ health for the convenience of leaving out a bowl of kibble all day. My cats are my children and thinking about it this way was the uncomfortable motivation I needed to try something else.

My cats diet has been a long slow de-evolution:

1. I instantly rejected the standard affordable cat food brands. The more expensive stuff must be better for them, right?
2. Very early on I switched them to grain-free kibble, because the littlest one had unspeakable gas which was fixed by going grain-free.
3. Then when the boys starting packing on the pounds, I tried low-calorie kibble (I didn’t know better). They actually liked this kibble more than the old but gained even more weight on it! Turns out that there is less protein and fat in low-calorie kibble, so I had unintentionally just put them on the standard low-fat high-carb diet that had failed for me.
4. A few months ago, I switched them to the highest protein kibble available. It was a herculean task finding, high protein, grain-free, low-GI, kibble and ultimately a waste of time because again they did not lose weight.
5. Currently they are on 95% protein wet food. It’s mostly meat with a bit of carrots and whatnot as well. I tried the 100% canned food but after years of feeding them kibble, I had created “kitty carb addicts” who had no clue what cats were supposed to eat.

So far they have both lost some weight, at a safe pace. However I’m still not satisfied because a) there is still more kitty chub to lose and b) quality wet food is an expensive pain in the ass. If it were just the expense maybe I wouldn’t care. However the portion size isn’t right, so I always have leftovers in the refrigerator, each cat likes something different and Big Red usually neglects to tell me before I open the tin that “he’s not feeling like duck today”. It’s a lot of work, epensive and ends up being very wasteful.

Crazy cat lady that I am, I’m now considering making my own cat food. Why pay $1.30 for 3 oz of “pet grade” meat when I could buy human grade for $1/lb and cut it myself? As long as I made sure to get the right mix of essential nutrients (like taurine) then it should be safe. Which actually isn’t difficult because wonder of wonders, if you feed them the entire animal (not just the muscle meat) then all the essential nutrients are pretty well taken care of.

Which if you think about it, is the final step in the de-evolution of my cats’ diet. From highly processed grains to whole animal. Short of setting them free to chase mice and birds, feeding them fresh meat and organs is their ancestral diet, though that wasn’t my intention starting out.

Let’s say you buy into the idea that eating low-carb can be a good idea for diabetics or the overweight. You agree that carbohydrates raise blood sugar, so in order to keep it under control, you restrict until your blood sugar looks good. You also agree that insulin can cause your body to hold onto fat, so to help lose weight, you restrict until you are happy with your weight. Is that the end of the story? You may eat as many carbohydrates as you desire and can “get away with”?

As I learn more about glucose metabolism, my answer is that even if I can “get away” with X carbohydrates, in the larger picture (beyond blood sugar and fat tires) my health still suffers. Even if I could eat 100g a day (which I can’t), I wouldn’t. Here’s why:

I eat my 100g (yum!) and my blood sugar magically stays rock steady at 85 because my body made enough insulin to cover it. Yay for me, right? Wrong. Since I am insulin resistant, that means that it took a LOT of insulin to achieve that. After reading Gary Taubes books, Good Calories Bad Calories and Why We Get Fat, I understand that insulin plays a major role in keeping fat locked away in my cells. So that higher insulin hurts my weight loss and prevents me from using fat for energy, making me feel tired and probably hungry.

But what if I have already hit my target weight and the extra carbs aren’t causing me to gain weight. Surely it’s okay then, right? Wrong again. This is where it gets frustrating. I can measure my blood sugar, I can hop on a scale and the consequences of my carb consumption are right there in my face. It is unavoidable, it is motivating but unfortunately not all effects are so easily measured. Many diseases have been associated with glucose metabolism and while you may “get away with” extra carbohydrates in the short term, I am arguing that you aren’t doing your health any favors in the long term.

Now going back to the amount of carbs I ate, even if my blood sugar and weight remained steady, my body still metabolized that glucose. When glucose is metabolized, it creates by-products such as methylgyoxal (MG). MG is one of the molecules that create AGEs (Advanced Glycation End-Products). Just as the name implies, AGEs contribute to aging. They react with the cells in your body and cause all sorts of damage: from wrinkles and age spots to systemic inflammation, diabetes, heart disease, Alzheimer’s, kidney disease and more.

My understanding is that every molecule of glucose I consume contributes a little bit more to my eventual demise. Is glucose (carbohydrates) the alpha and the omega of aging and disease? No. Life is more complicated that that. However, it is one piece of the puzzle and whether you can “get away with it” or not, is something to be considered if you care for your health.

I am working on an article which backs up my assertions with SCIENCE! but for the moment, here is a sampling of citations to show that I’m not a whack job with a blog and an unsubstantiated vendetta against carbohydrates. At the very least I am a whack job with sources! :) If you are interested in more, I pulled these citations from Dr. Ron Rosedale’s incredible post on Jimmy Moore’s blog. The page is very long, so search for the word “Rosedale” and start reading from there.

1. There is no “safe” blood sugar threshold

   Is there a glycemic threshold for mortality risk? Diabetes Care May 1999 vol. 22 no. 5 696-699 “…the lowest observed death rates were in the intervals centered on 5.5 mmol/l  [99mg/dl] for fasting glucose and 5.0 mmol/l [90 mg/dl] for 2-h glucose. CONCLUSIONS: In the Paris Prospective Study, there were no clear thresholds for fasting or 2-h glucose concentrations above which mortality sharply increased; in the upper levels of the glucose distributions, the risk of death progressively increased with increasing fasting and 2-h glucose concentrations.”

2. Glucose promotes the effects of aging

   Pro-Aging Effects of Glucose Signaling through a G Protein-Coupled Glucose Receptor in Fission Yeast PLoS Genetics, March 2009 | Volume 5 | Issue 3 “…excess of glucose has been associated with several diseases, including diabetes and the less understood process of aging. On the contrary, limiting glucose (i.e., calorie restriction) slows aging and age-related diseases in most species…The pro-aging effect of glucose signaling on life span correlated with an increase in reactive oxygen species and a decrease in oxidative stress resistance and respiration rate. Likewise, the anti-aging effect of both calorie restriction and the Dgit3 mutation was accompanied by increased respiration and lower reactive oxygen species production.”

3. Glucose is the preferred food of cancer

   Glucose restriction can extend normal cell lifespan and impair precancerous cell growth through epigenetic control of hTERT and p16 expression. FASEB, December 17, 2009 “Cancer cells metabolize glucose at elevated rates and have a higher sensitivity to glucose reduction…The altered gene expression was partly due to glucose restriction-induced DNA methylation changes…Collectively, these results provide new insights into the epigenetic mechanisms of a nutrient control strategy that may contribute to cancer therapy as well as antiaging approaches.”

Supplementation is a sticky subject for me. On one hand, I shy away from supplements, especially herbal, because they often seem like snake oil. On the other, I see studies like the one below which really tempt me to try one out on myself.

Effect of L-carnitine on the hepatic transcript profile in piglets as animal model (full text)

In this case L-carnitine affected the gene expression of several key genes in the liver. It up-regulated genes associated with glucose and fatty acid uptake and down-regulated gluconeogenesis. In short, it turned on genes that use up glucose and fat and turned off genes that convert protein into glucose.

Sounds like a great supplement for a diabetic, no? And that’s where the quandary sets in. You shouldn’t just randomly take supplements based on a single study (in pigs no less).

So how do you decide that it’s even worth considering taking a supplement? 10 studies? A double blind randomized study in humans? Even if the results look good, you need to understand what the supplement is, how it works, is one deficient or just supplementing, possible negative effects, the dose, etc. Lets say that you decide to give it a shot and become “an experiment of one”. You still need to monitor the results and figure out if it’s helping, hurting or seemingly not making any difference. Unless you are running blood tests, all you have to go on is how you feel (which is arguably the best data point anyway). It’s not as simple of a choice as it initially appears!

So will I try this shiny new supplement? Maybe but first I’ll spend at least a month or two reading more studies, reviewing other people’s experiences and generally dithering. Dithering… it’s what I do best. :)

It’s my opinion that the majority of what you hear about cholesterol from the major news outlets is a load of crap. If I hear one more person call HDL the “good cholesterol” and LDL “bad cholesterol”, I may hurt someone. :) It’s an outdated, oversimplified view of cholesterol and heart disease that has been thoroughly disproved. Unfortunately, it may take family physicians and the nightly news another decade to acknowledge that!

So why do I think this? Is it just because I want to feel better about my current diet? Hoping that in saving myself from diabetes I’m not just going to kill myself with heart disease? Well I’d like to think I’m not that self-delusional but you never know. No! I used to buy into the lipid hypothesis but as I’ve delved deeper into understand exactly what is HDL and LDL and the latest theories on what causes heart disease, I’ve come to see that the majority of people are operating on stale data.

In an effort to once again regurgitate other people’s thoughts so that I can understand it better, I’ve added two articles to my main site.

Bio 101: HDL and LDL – This should be devoid of controversial ideas, simply going over at a high level what all these terms are when people discuss cholesterol.

Cholesterol and Heart Disease – My attempt at deductive reasoning, starting with the definition of LDL, touching on the effects of diet on LDL composition and the implications for heart disease.

Consider this “ammunition” the next time your doctor insists that your LDL is too high or that a low-carb diet will raise your triglycerides. He may not listen but at least you’ll feel more confident telling him that he needs to hit the books.