Random comments

OK folks, this is the best I can do about the conversations I felt didn't belong in my book review.  Here is a PDF of them "printed out".  Please feel free to continue the discussion here.  Thanks!


Sanjeev Sharma said…
> HDL is evidently more sophisticated a lipoprotein than originally thought, and much more needs to be learned about it before we can depend on its respective ratios for cardio-protective reassurance.

riding one of my hobby horses again, can anyone think of a single chemical that entered public awareness that this does not apply to?

I find it SO amazing that some people can be exposed to this kind of revision many times- even very WELL STUDIED entities like HDL, then they turn around and promote far less-well studied entities, studied only to the extent of reductionist micro-mechanisms or correlational studies.

they pointedly ignore that they're making the beta-carotene mistake, AGAIN.
Lighthouse Keeper said…
When you receive ad hominem attacks in return for critical thinking it exposes the inability of the other to grapple with or engage in the argument .
Hello_I_Love_You said…
Anyway, I have not seen strong evidence that Omega 3-6 imbalance is behind inflammation. I think Alan Aragon is right. Omega 3-6 imbalance is largely metabolic , i.e., fatty liver, high BMI, prediabetes, high trigs/low HDL. In a lean person, it's probably not responsible for raising CRP.

And if you low-carbed for long, one of your existing inflammation source could be the after effect of the diet. You saw this study many moons ago, which found higher CRP, higher urinary cortisol output, low leptin and low T3 in a group designated as VLCers.


That diet is 50g carbs but has high protein (150g) -- that's 850 calories from protein/carbs; no one is likely to be have been ketogenic. But they achieved those numbers without much trouble. On a really VLC/ketogenic diet of duration, that leptin is going to sink like a stone and become deficient, and dysregulate cortisol and other hormones even more and T3 will fall to the bottom quadrant. That's what's behind the hormonal dysregulation. It's not just T3. You may not be able to detect dysregulated cortisol as it may not be high or low.

tomas said…
"Anyway, I have not seen strong evidence that Omega 3-6 imbalance is behind inflammation. I think Alan Aragon is right" where can I read more on about that please?
charles grashow said…
Sanjeev Sharma said…
there may be something more recent but a quick search yields

Pedro said…
Does leptin drop on VLC even when energy intake is at maintenance?
carbsane said…
To me the O6:O3 deal is forever and horribly confounded by margarine and soybean oil based salad dressings and mayo. I'm not sure how bad the latter are other than people who eat a lot of creamy dressings/dips/mayo don't generally have great diets otherwise. Also high temp use though whenever I look into that I'm underwhelmed by the numbers involved.
Hello_I_Love_You said…
It was easy for Paleo to jump on the 1:1 O6-O3 unity bandwagon. But you look at the food sources and realize unless you're eating mega fish everyday, you can't remotely come close to it; then they started claiming you can reduce O6 by eating grass-fed beef and pasture-bred pork. The O6-O3 imbalance always gives way to metabolic disorders arising from processed foods. O6 is just a marker of processed food intake, and the imbalance itself isn't specifically responsible for obesity and inflammation. 5:1, 10:1, even 15:1 is probably ok as long as O6 is not processed.

Having said that, you've seen how Jimmy's claiming he's suffering from "Reactive Hypoglycemian" which is almost impossible to have on a VLC diet since you won't become hyperglycemic? His FBG is 90 and he claims to have RH and actually brought in a NY low-carb doc who vouched that it is indeed BG dysregulation!


This is so laughable. That's cortisol dysregulation. Those VLC side effects like heart palpitations, racing thought, anxiety, and other symptoms that resemble hypoglycemia are directly related to cortisol, which isn't necessarily high or low when dysregulated. You check these guys claming to suffer from RH and they never test below 70. And it's all coming from leptin deficiency and multifarious hormonal and immune dysfunction that results.

Chris Kresser nailed this a long time ago:

Something about berberine and glycosolve being part of the equation. His initial keto-adventures showed even worse glycaemia, fasting and otherwise. Then again, certain folk are now rationalising away glycaemia issues and insulin resistance in the context of a low carbohydrate diet.
Hello_I_Love_You said…
It's true there are many possibilities. His high FBG could be due to a combination of cortisol dysregulation, other stress hormone or glucagon or liver/glucagon dysfunction, physiological insulin resistance (in other words, glucose deficiency), FFA on insulin, etc. What's funny is these low-carbers, whenever they have BG issues, keeps citing "Reactive Hypoglycemia." Chances are, it's hormonal and the symptoms of hypoglycemia are really hormonal symptoms. The very sexy Dr. Gottfried talked about this recently to Abel James:

Yeah, and the reference to the berberine/glycosolve stuff was actually in the earlier goings of his one-year nutritional ketosis experiment. He couldn't manage his glucose so he used supplements.

Had a listen to the show, really laughed hard at the "100 to 150 grams of carbs. Oh, my gosh! That's a lot of carbs." Heh.
charles grashow said…
One of the reasons that his TC has skyrocketed is that berberine also lowers cholesterol - possibly he was too ignorant to realize that


Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins.
So berberine also lowers cholesterol by increasing LDLr activity. Shouldn't this result in lower TC if he's still taking berberine? Or is his high read actually a tamed version of something potentially higher thanks to ongoing berberine use?
Susanne said…
OK, I am getting increasingly dubious about the original sources for the ideal 1:1 Omega 6/3 ratio in Paleolithic Man. I am an archaeologist. I wanna evaluate the actual archaeological evidence. But no one seems to actually have it, which makes me very very suspicious.

I got bored a few weeks ago (stuck here during spring break) and plugged a week's worth of diet into cron-o-meter. It turns out if you cook at home and don't use a lot of processed food, it is not hard to get close to a 4:1 Omega 3/6 ratio. (As several here noted, high Omega 6 can be a proxy marker for a high ratio of processed food/fried food.) But you HAVE to eat some fatty marine fish to bring the ratio down this far.

I cannot see how prehistoric peoples living in an inland environment would be able to achieve a 1:1 ratio. This weekend, I plugged a lot of different plants and meats that have potential paleolithic equivalents into the Nutritiondata site and I cannot find any that have majority Omega 3 ratio — they are all predominantly Omega 6. This includes the "better ratio" but still majority omega-6 wild game (venison, bison, Alaska sitka deer.) Please do enlighten me if you have found exceptions that would potentially be available in the Paleolithic.

Flaxseed is the one terrestrial plant I know of that could be used to bring your ratio to 1:1: per 100g, Omega 3: 22813 mg to Omega 6: 5911mg. But flax is a domesticated plant! One of the Evil Evil Neolithic Seeds of Destruction! The earliest serious documentation for flax that I know of is in Bronze Age texts, about 2000-1500 BC depending on which culture you look at).

Artemesia Simopoulos is the big Omega 3/6 ratio person. But for her "prehistoric" evidence she cites 1) herself the (same 3-6 articles depending on the publication date);

2) Eaton/Konner 1985 (http://www.ncbi.nlm.nih.gov/pubmed/2981409) which does not say a word about omega fatty acids (it's a bit before the trend);

3) An article she co-authored with Cordain on cereal grains that I cannot get access to, but I suspect is not any more forthcoming with actual _archaeological data_.

Is this another Incestral circle-jerk?
Susanne said…
I did find this post by Stephen Guyenet (sorry, don't know how to hot-link but sometimes it just works): http://wholehealthsource.blogspot.ae/2008/09/pracical-approach-to-omega-fats.html
in which he says "I looked at a buncha people with traditional diets and they have really low ratios including down to 1:1 and beyond" but doesn't cite sources. They are heavily skewed by marine cultures and "dairy based cultures" which he says have a 1:1 ratio (do they ONLY eat butter? Also ... domesticated cows not Paleolithic, Grok).

Also: a few samples from modern peoples with "traditional diets", even hunter-gatherers, are not representative of "Paleolithic people". You do NOT want to get into that argument with a paleolithic specialist. Not even a Bronze Age specialist like me because I'm going to rip your Noble Savage pan-prehistoric fantasy apart so fast your head is going to spin.

Someone please! give me some primary data to chew on so I can get back to the actual work that I am supposed to be doing.
charles grashow said…
BTW - salt is now not allowed on the paleo diet

Hello_I_Love_You said…
I'm not sure about Stephen's sources but 1:1 is surely possible eating cold-water fish like salmon and tuna. But 1:1 eating dairy? I could be wrong but most cheeses are still 2:1 o6 to o3. Maybe artisan cheese and properly aged cheese? What's the ratio in Kerrygold butter? I'd be surprised if it is 1:1. But let's assume cold water fish and dairy will sustain you at 1:1. What other indigenous culture could maintain that ratio eating anything else?

Muscle meat grass-fed beef is still 5-6:1. Organ meats are about 2:1. So how is 1:1 realistic when not eating cold water fish or fish oil? But cold water fish could reverse that ratio quickly. I wouldn't be surprised if the Scandinavians, Eskimoes and those living near northern latitudes had over 1:2, even 1:10, o6 to o3. Those ratios can become lopsided if you eat cold water fish 3 square meals.

But where is the evidence that the imbalance is inflammatory. 1:10 O6 to O3 isn't inflammatory. Then why would 10:1 O6 to O3 be inflammatory unless O6 just represents large processed food intake? I've yet to see any study that managed to isolate the supposed inflammatory aspect of the O6:O3 imbalance. The same with grains being iinflammatory.
Hello_I_Love_You said…
It's not just inland. How could anyone in equatorial regions keep up with the 1:1 ratio? See, that's why Paleo keeps invoking their beloved Inuits. Without them Inuits, the 1:1 counter-inflammatory O6 to O3 magic ratio disappears.
carbsane said…
Hope you're still following this. I'm with you. I've looked at this a few times in the past (including the Sisson's own diet) and without cold water mammal or deep cold water fish it seems virtually impossible to get to 1:1 or even 2:1 for the O6:O3 (I think you reversed your ratio by accident there). Many warm water fish are over that ratio so you'd be hard pressed to find enough 1:10 type foods to counter the O6. Never did come across any actual studies.

There was this from Cordain (cough) http://www.nature.com/ejcn/journal/v56/n3/full/1601307a.html Is it just me or did they not analyze fat tissue?

Throw in a few nuts and you're toast on the ratios unless they are macadamias. Oh and flax? LOL ... If it were available, Grok would have taken a pass.
Susanne said…
Yes! I am still following, thanks for replying! And you're right, they did do fat analysis in that article, I had it open in a tab but confused it with one of the other Cordain articles. I read it more carefully later when I wasn't doing student office hours, ha. It's handy because they analyzed different tissues that aren't in Nutritiondata (don't know why they skip bone marrow ;-), and also some African as well as North American samples . Even if you eat an all-brainz diet it doesn't seem like the math will work though:

"Brain had the lowest n-6/n-3 (1.20-1.29), the highest concentration of 22:6 n-3 (elk, 8.90%; deer, 9.62%; antelope, 9.25%) and a P/S of 0.69."

HelloILoveYou, Simonopolous discusses O3:O6 in regards to studies on inflammation, colorectal cancer, breast cancer, and all sorts of other things, which I'm going to assume is better sourced than the "evolutionary" part but I could be wrong. There's a long 2011 article here http://www.ncbi.nlm.nih.gov/pubmed/21279554 but if you can't access the full text here's a similar shorter one from 2008:http://www.direct-ms.org/pdf/NutritionFats/Simopoulos%20Omega%20ratio%2006.pdf . She also has a popular book apparently!

I found in looking for other science based advice for the ratio, that the Harvard Health site for the public says don't worry about the ratio, just work on getting the O3:


Apparently in the last decade there were a couple of studies (the _Circulation_ one cited in the second article above and one below), that suggest the ratio in the diet is not important as long as O3 intake meets sufficiency. http://www.ncbi.nlm.nih.gov/pubmed/18196988
Susanne said…
The other tricky detail is that as far as I know, we don't have much evidence for fish and other marine creatures being a significant part of any human diet until the so-called "Broad Spectrum Revolution" in the later Paleolithic (a wider variety of plants and animals become part of the diet as part of this phenomenon too). At least according to the bone residue I think it starts about 20,000 years ago? It creeps back a bit further occasionally as new sites are analyzed, I don't really follow the literature on that stuff so I don't know if that's current. The first people reach Australia by about 50k years ago though, and they must have got there using boats, so it's hard to believe they weren't using marine resources.
Susanne said…
Artemis Simopoulos, it should be. Geez, I'm getting my Greeks mixed up.

Also, I was wrong about Nutritiondata, they have analyses for caribou bone marrow, seal meat, polar bear, HORNED OWL, and various whales. They are grouped under "Ethnic foods." :-) Doesn't say where they got it, I am imagining some unsung USDA hero doing an Alaska Native diet analysis. Brilliant!
Hello_I_Love_You said…
Dr. Frank Sacks: "Omega-6 fatty acids lower LDL cholesterol (the “bad” cholesterol) and reduce inflammation, and they are protective against heart disease. So both omega-6 and omega-3 fatty acids are healthy. While there is a theory that omega-3 fatty acids are better for our health than omega-6 fatty acids, this is not supported by the latest evidence. Thus the omega-3 to omega-6 ratio is basically the “good divided by the good,” so it is of no value in evaluating diet quality or predicting disease."

BA Griffin, Curr Opin Lipidology, 2008 Feb;19(1):57-62. doi: 10.1097/MOL.0b013e3282f2e2a8. "These two studies were independently unanimous in concluding that the ratio of n-6/n-3 polyunsaturated fatty acids is of no value in modifying cardiovascular disease risk."

Simopoulos cites a lot of studies in his article. I haven't had the chance go over the claims but do you see anywhere that O6 and O3 are competing with each other and perhaps leave certain enzymes, nutrients or biological processes in short supply, thus inducing inflammation. Most of those studies measured the ratios in obese people who consume processed foods full of o6. So the ratio itself is meaningless; the overall intake of o3 or o6, however, does matter. If you don't consume much processed foods, your o6 will be low, regardless of your o3 level. So the o6-o3 ratio will not be as lopsided. But that's a function of less processed foods, not due to magically balancing your o3 and o6 and inducing less inflammation because they're not competing with one another.
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