FRIDAY at the Physicians and Ancestral Health conference started with an excellent discussion of Mood and Memory by Dr. Georgia Ede, renowned psychiatrist and ketogenic diet blogger. You may have casually heard that although the body can do without, the brain needs sugar to run on, so eat some carbs. It turns out to be so much more complicated than that. Crucial to our working memory is the excellent function of our hippocampus, deep in the brain. While many brain structures can use glucose without insulin, the hippocampus relies on insulin and is very sensitive to insulin resistance, causing its receptors to down-regulate and essentially be less functional, in the setting of high blood sugar and high blood levels of insulin. She reviewed those at risk for memory disorders (risk factors you can’t change: your age, your family history and your ApoE status) but noted that since the big risk factor of insulin resistance is very modifiable, you can always do something about the process of memory loss. 80% of those with Alzheimers have insulin resistance or type 2 diabetes mellitus, and the risk can clearly be lowered by using diet and lifestyle measures to reverse blood sugar and diabetic problems. A good detour around pre-existing insulin resistance is coconut oil or MCT oil as a supplement.
Sugar and insulin also affect mood, high levels of both leading to an over-stimulated sympathetic nervous system and higher levels of inflammation. Although it may be difficult to arrange compliance, something like a ketogenic diet can work wonders with both depression and bipolar disorder, in one study performing better than medication.
Read more on her website here, and for a quick math calculation of your own insulin resistance, pull out your last set of lab tests. Look for your triglyceride and fasting blood sugar values, both in mg/dl, multiply them, then divide by 2, then calculate the natural log function of that number. I was a math star eons ago, but have never heard of this! So my #’s were a triglycerides of 50, a fasting blood sugar of 100 (suggests insulin resistance), 50X100=5000/2=2500. Now how to get the ln: go to your smartphone calculator, turn your phone sideways and many unusual functions are available to you, including ln. ln(2500) = 7.84. Numbers below 8.82 (for men) and 8.73 (for women) are normal.
Next up, Dr. Jasmine Moghissi reviewed case histories, with specialty cardiac lab testing, in which significant cardiac risk factors were markedly reduced with a low-carb, high fat, lifestyle intervention. Always nice to see theory at work in real life!
Dr. Robert Hansen explored the topic raised on Thursday by Dr. Gerber, starting from a different viewpoint. What starts atherosclerosis? We know that certain lipid particles penetrate the lining of the blood vessels, lead to inflammation, plaque creation, and cardiac disease. But what causes those lipid particles to penetrate, it’s NOT their sheer number. (Remember that patients admitted to the hospital with a heart attack: only half of them have high cholesterol, AND lots of people with high cholesterol never have a heart attack.) Some surprising pearls from his talk: insulin resistance (pre-diabetes and type 2 diabetes) is one of the factors initiating atherosclerosis; meditation lowers risk after a heart attack more thatn either statins or cardiac rehab.
It’s all about how oxidized, how inflamed, are all the particles circulating in our blood stream. Stress can lead to dysfunction of nervous and immune systems, raising the level of inflammation. How to tell how stressed someone is? Heart rate variability is an interesting marker to follow, can be tested at the bedside. High stress (low heart rate variability) can be balanced with exercise, meditation, yoga, biofeedback, adopting a pet, and far infrared sauna. Be smart and avoid adding to inflammation by balancing your foods wisely (enough omega 3 fatty acids) and not scorching your food!
As an internet treat, Dr. Tommy Wood joined us from Norway via some clever software program, enabling him to give us a live lecture in spite of the fact that he couldn’t get away for the retreat. You can visit his website here and also link to his podcast. He also looked at the question of root cause, in this case, the cause of insulin resistance. He credits Spreadbury (a medical student still!) for his very interesting paper noting that acellular carbs (processed foods, grains) are much more hazardous to our metabolism than cellular carbs (vegetables and fruits) which better feed our microbiome.
He again comes back to high insulin, associated with high degrees of inflammation and oxidative stress, as the root cause of metabolic disease.
He also suggested you get a dog (and take it for a walk), thereby activating AMP-k ( an excellent, non-insulin related energy generating system), especially if you can do it all outside.
He addressed the oft-heard question in the Paleo world, “Low carb sounds great and I love it…but I haven’t lost the weight I wanted to.” First, be sure you’re really “doing it” meaning the Paleo diet and the lifestyle: regular sleep, regular activity outside, and yes, a dog! He then presented two cases: one had iron overload (everything better when he started donating blood) and the other some intestinal dysbiosis. So when you’re stymied, step back and look at the big picture, which might include processed foods and other endocrine disruptors, ambient temperature, movement, sunlight exposure and sleep quality, stress management and different kinds of pollution: air particulates and electromagnetic fields.
Dr. Rick Henriksen shared with us the incredible teaching opportunity in just a short interaction, in his example, with a medical student or medical resident. Ask for an example of something done well (engage the student!) and then think of what ONE thing you would like to teach: incorporate that lesson into an agreement with the praiseworthy aspect of what they have done!
One of our two keynote speakers, Dr. Randolph Nesse, professor of Evolutionary Medicine at University of Arizona, explored the complex paradox of maladaptation: how have we changed from our ancestral lifestyle and what are the effects we notice all around us? For instance, are wisdom teeth really part of a “botched design” on the part of evolution, or have we done something that makes them a problem? (Hint: going back just 100 years, before highly processed foods, wisdom teeth weren’t a problem.)
Our health problems have shifted enormously over the same time period, from infectious to chronic and autoimmune disease, both occupying and consuming huge and increasing parts of our health care budget.
Beyond food we can look at the balance of light (too little daylight exposure, too much light at night), erratic sleep patterns, excessive use of antibiotics and probably air conditioning! And more.
And that wrapped up the second day of talks… or were they really wrapped up when the wonderful restaurant at which we dined brought us each a very tasty little sample (tasted like apple pie) of some of their homemade moonshine!