Toxic!

There hasn't been much buzz about this year's LC Cruise, but a couple of days ago, a tweet from the presentation of one Dr. Dwight Lundell made a little splash on Twitter and FB.  

The most toxic chemical in the human diet is GLUCOSE. -Dr. @dwightlundell #sugarkills #LCCruise13
— Dietitian Cassie, RD (@dietitiancassie) May 7, 2013

This spurned a side conversation into which someone going by the handle @liberrocky  that is best begun here:

MT @carbsane: @kateinaustin @dietitiancassie These are irresponsible & dangerous claims. If KETONES were toxic our bodies wouldn't make em!
— liberrocky (@liberrocky) May 8, 2013

That conversation reminded me of why I should never discuss science on Twitter.  It is so very NOT suited towards any sort of meaningful conversation, especially if more than two people are involved due to character limits.  So I stated yesterday that I would take this to my blog ... it seems appropriate given that I had just blogged on this very topic recently:  An American Justice System for Food ~ Part I Intro and Carbs in General.  The LC line on carbs is that they basically all turn to "sugar" (glucose) in our bodies and since diabetes (hyperglycemia) is associated with all manner of deleterious health consequences, dietary carbohydrate is toxic!  Such is the unequivocal message from the controversial* Dr. Dwight Lundell.   (*see here, here and here, that last link is to a discussion on PaleoHacks with many more links and opinions on both sides for anyone interested)

For those not familiar with Dietitian Cassie, she is Jimmy Moore's new co-host on his Low Carb Conversations podcast.  I've always thought that a strange fit, given as she's a self-described Semi-Vegetarian and an endurance runner, but whatever.  It is disheartening to see a trained dietitian, however, write something like this:  (from that link)

I was consuming a diet of mostly carbohydrates and unhealthy fats—mostly in the form of sugar, chemicals and processed food. Instead of eating an alternative protein to replace the meat I was intentionally omitting from meals, I simply cut it out.  At the time, I’d read a few misleading research studies on the negative health effects associated with overconsumption of protein.   In response to this, I didn’t think it would be a problem to cut the meat out entirely.   A few times per week, I would eat fish or eggs but never made it a point to include quality protein in my daily routine.   Besides, I’d heard that Americans tend to consume more than enough protein without even trying.   I figured I was consuming enough protein by including soy milk, yogurt and cheese-based meals in my daily routine.  Although I didn’t have symptoms of a deficiency, I doubt I was getting enough protein.   I was constantly hungry, which caused me to continually graze on carbohydrates.  When I decided to become a vegetarian, I was still buying into the “fat-phobia” myth, which meant I was eating foods loaded with chemicals, such as light yogurt, skinny lattes and—I shudder to even think this—the occasional diet soda.   After years of my own research on the topic and reading the findings of well-respected nutrition experts such as Gary Taubes, Marion Nestle and Jimmy Moore, my life as a vegetarian looks much different (and healthier!) than it did back then.

Emphasis mine,  Marion Nestle being the only nutrition expert amongst the three, and Jimmy Moore would not even describe himself as a nutrition expert!  So here you have a registered, licensed dietitian who didn't construct her own diet properly based on her formal training, yet considers a journalist who didn't even include dietary advice in his seminal work or lectures a nutrition expert?  I'm sorry but I am very baffled by this.  I remember reading information on the topic of vegetarianism informally in my teens, and I've known how crucial it is for those who avoid animal proteins to select foods to consume enough complete protein for a very long time.  So... baffled ... OK, back to the topic at hand.  The Toxic Tweet was preceded by the tweets screenshot above (I believe they are most recent on top), and I think it would be a fair read to consider Cassie a fan in agreement with Lundell's message.   So considering that these tweets are even made at all, the tweet that set off the conversations on social media was one that Cassie seemed to deem important information and was not really under character limits to relate accurately.  

Dr. Lundell identified GLUCOSE as *the* most toxic dietary *chemical*, and Cassie all-capped glucose and attached the hashtag #sugarkills.  I'm adding the following emphases:

• The use of "the" as in singular, versus using "a" or "one of the" indicating plural.
• Use of the term "chemical" as if glucose is akin to consuming cyanide or something.  Yes, all of our food is ultimately chemical compounds, but referring to it as such in this selective manner is needless hyperbole.
• Dietary:  This is important to the ensuing discussion on Twitter, because there is a big difference between an ingested toxin and endogenous metabolic toxicity.  This is the primary topic I wish to expand upon and clarify.

OK ... so I have already outlined my issue with the use of the term toxic.  If I had my druthers, it would be eliminated from the vernacular in the health/nutrition realm and be reserved for true toxins -- e.g. substances that when ingested in small, feasible or intentional excess are truly harmful to the human being.   By this definition, there are few if any foods that are toxic, and certainly none of the traditional human foods derived from nature can be considered toxic.  

Glucose most certainly CANNOT be considered remotely toxic on that basis.  There are qualifiers to my response on Twitter, but for the most part it is a fair defense of glucose to say that if it were toxic, the human body wouldn't make it!  But I'd like to take this opportunity to flesh that out a bit, in conjunction with my recent blog post, and I'd also refer you to some thoughts I outlined here:  Nutritional Idiotosis  (no, I won't change the language there, as anyone eating 80+% fat for reasons other than epilepsy or neural afflictions is engaging in an idiotic pursuit.)  The bottom line?  Our bodies go to great lengths to maintain a minimum level of only a few things ... glucose is prime among those.   If your blood sugar level falls too low, you die.  It is just that simple.  From the T1 diabetics I've known and spoken with, this is the concern underlying conservative BG regulation -- it is better to err on the side of hyperglycemia than to risk the hypo. Modern technologies are making this a less necessary trade off.   Yes, chronic hyperglycemia can have progressive toxic impact on  your cells and organs, but out of control blood glucose is not the result of consuming a lot of glucose, it is form profound and improperly treated metabolic dysregulation leading to unchecked endogenous glucose production by the liver -- including failure to shut it down after glucose has been consumed.   Our bodies have such an important need for glucose that it is an "always on" process regulated by suppression.   

Couple this with the fact that if there is an LD-50 for ingesting glucose, it must be pretty darned high or even a corrupt medical establishment wouldn't routinely submit pregnant women to 50-100g bolus doses of glucose.  (I'm aware and open to the controversies over gestational diabetes and the OGTT, but fears over toxicity for a one-time or even a few times test are not among my concerns, those are misplaced).  

So liberrocky took my comment and ran with it with the analogy to ketones.  Ketones can't be toxic because the body makes them.  Tis true.  But it IS ketones -- the excessive production thereof -- that is understood without controversy to be the "toxic" culprit in untreated diabetes (T1) which leads to ketoacidosis.  While we always have some nominal level of ketones in our body, unlike glucose, we don't have any physiological need for them.  Our bodies produce them to replace some of the need for glucose in order to spare protein -- protein (certain amino acids specifically) being a significant substrate for gluconeogenesis (that cannot be sustained on glycerol from fats and other sources alone).   Ketone production is increased in the progression of carbohydrate depletion, also known as "starvation" with the specific purpose to spare protein that might otherwise need to be broken down to provide glucose.  

As I stated in my last discussion of ketosis, I think it is telling, and downright intuitive, that if ketosis were some preferred or desired metabolic state, our bodies would not come out of that state so easily.  Folks limiting protein intake to force ketosis after their bodies adapt to biologically zero carb diets are forcing their bodies into a state they'd rather not be in.  While non-diabetic ketone levels are not toxic (long term effects are unknown, but let's limit it to acute toxicity) in disease where dose makes the poison, they most certainly are.  Then let's look at the notion of dietary ketones.  We really don't have such a thing, though the LD50 for acetone does appear to be a bit higher than one might expect.  Still I wouldn't suggest anyone run out to their local home improvement or beauty supply store to buy the pure stuff and swig it with dinner.  I couldn't find anything for beta hydroxybutyrate or acetoacetic acid but that's irrelevant anyway as I know no dietary source of either.  On Twitter I mentioned an MCT experiment, however, because this is the one thing (and these are the shortest MCT's comprising  less than 10% of CO fatty acids).  As such, MCT is rapidly absorbed and metabolized to ketones by the liver -- it can also cause severe gastric distress, and I would contend unlike an equivalent amount of corn or olive oil, butter or cream.    Still, I would not term MCT's as toxic, though I would use them as an example where overdoing it can elicit a sickened response.   Many use celiacs as evidence that "Wheat is Murder" or blame fructose for every malady under the sun.  Yet a far greater proportion of the population would be sickened by consuming some MCT than would be by consuming wheat or even a pound of sugar in a sitting.

Now I'm not sure if he was just trying being cute (I presume this is a he from the avatar) with the rest of the exchange, but here is where I lose patience with Twitters limits and people like liberrocky.  He took umbrage with my discussion on ketones and then stated that ketones are the fuel we use when we sleep.  It's funny that none of the medical books or even the low carb diet books make mention of this, because under normal circumstances, while ketone production may rise overnight = short term fast, it is clearly fatty acids the "normal" person is primarily burning overnight in the postabsorptive state.  Somehow responding to his tweet got twisted into me not knowing that ketones were produced at all overnight?  Sigh.   I see just now on Twitter that he's trying to draw Robb into this so ...

EDIT/UPDATE:  Liberrocky responded in comments here and apparently it was Robb Wolf who inserted himself into the Twitter exchange.  So as I did in comments, I apologize to liberrocky for blaming him or accusing him of pot-stirring.  He did not do that.  I did not see Robb's tweet, however, because he had blocked me long ago, though perhaps it was because I blocked him recently.  I thought it quite strange on Thursday when I got notice that Robb Wolf had followed me on Twitter.  Here I thought he had given his solemn word to go on Jimmy Moore's "silly ass" cruise and would be soaking up the rays or brushing up his presentation.  It really boggles the mind why he would want to provoke me here .... well, perhaps not.  What better way to avoid answering simple questions like 'what diet are the law enforcement personnel eating in your study' or to go back on your word than to create a false controversy and point fingers at an easy target.  In any case, as I said in comments, I think Robb would do better to brush up on his basic knowledge rather than insinuating that mine is lacking.

I'll issue an open challenge to any of these folks who are denigrating my knowledge and intellect out there in the community -- be it under their real names or cowardly hiding behind the skirts of a stalker.   I am willing to debate any of you on any issue discussed here on this blog.  I'm happy to do it on "your turf" so long as I am given equal copyrights/control over dissemination of the content and any profits are donated to a mutually agreed upon charity.

END EDIT

So, where does this leave us?  I guess what I would like to see is a little more responsibility on the part of folks making claims and painting foods as toxic.  It does not serve the purpose of moving the dialog forward, and it sure as heck isn't ever going to help gain mainstream acceptance.  If anything it will do the opposite.  We do not need to go back to the paleolithic to find healthy human cultures, and many, many of these consume far closer to the 80-10-10 C-F-P ratios promoted by some than the few (if any) who consume 20-65-15 or even more extreme presumably paleo ratios of macronutrients.  Folks can argue over the quality of those carbs, and to a degree there is merit to these arguments, but no human is getting 80% of their energy from "carbs" from green leafy veggies and low sugar fruits.  Somewhere along the line these diets included significant levels of starch (glucose) and/or sugar (glucose, fructose and sucrose) that were directly digestible for energy by the person (added nutrition from gut fermentation may well have been a bit higher, but not more than 10% in any extrapolation I've seen).   You can't support life on low starch low sugar veggie "carbs" ... and the burden of proof is on those who advocate fat rich diets over carbs to prove their case.

In the face of such incontrovertible evidence, declaring glucose toxic IS horribly irresponsible and damaging to the credibility of a community that receives such information uncritically and sees fit to pass it along.  Some of these "live tweeters" pass information along as if they are just channeling it and bear no responsibility for the content.  Nonsense.  If you disagree why are you tweeting it?  Disinformation helps NO one.   Indeed it is almost certainly more toxic to nutritional discourse than glucose could ever be to the human body.

Ultimately, glucose is so toxic, we can't live without it.