Thursday, April 30, 2015

Got Milk? Part 1

Not sure if you all have been keeping up with the recent comments, but Gabriella Kadar and Gemma have been digging into some pretty heady stuff.  I asked them if they minded if, instead, we wrote a couple posts about what they have been finding.  Here's part 1 of 5 (so far).



From: www.gotmilk.com


Interspecies Nursing

Our love affair with dairy is quite unique. Interspecies wetnursing is not entirely a foreign concept although most of us in the developed world have very little awareness or consideration of the possibilities.  There are all sorts of examples where animals of entirely different species provide milk to someone else's youngsters.  Or even where human females wetnurse piglets.  Sounds bizarre?  It would not have been a major leap of 1 + 1 for someone to have figured out that what's good for the calf is good for the baby.  The myth of Romulus and Remus being suckled by a she-wolf may not be so far off the mark.  How could anyone come up with such an idea if the concept were that foreign?

You know how good ideas spread?  Sort of like that old shampoo commercial where 'she told two friends and they told two friends and....".


Romulus and Remus symbol of Rome could be medieval replica
Was the drinking of another animals milk born out of necessity?

 

The history of dairy


As hunter-gatherers were replaced by farmers some 10-15,000 years ago, others found a niche in leading around the herds of cows, horses, sheep, and goats they had begun to domesticate. These pastoral societies were nomadic and their travels often intersected with areas inhabited by farmers. Trade was established and the nomads "intermingled" with the locals, as you suspect they would.

Through a twist of evolution, these folks who eked a living leading their herds also learned another new trick...as adolescents and adults, they could digest milk. No other animal on Earth seems to have developed this trait, it's wholly human. When animals get past the need for nursing from their mothers, they lose the enzymes needed to digest lactose in milk. Humans, technically, should not be able to drink milk, and, in fact, nearly 70% of humans cannot.

Archeologists have long known that the ancient herding societies, and others in the years to follow, did not seem to drink milk in a fluid state, but preserved it in ways involving bacteria and reduced lactose content. Certainly the first humans to drink the fresh milk of another animal found it disagreeable to their digestion, but quickly learned that somewhat spoiled milk did not. They also learned that if milk was to be stored for later, it had to be converted from its fresh, fluid state to a fermented or hardened state...giving us cheese, yogurt, kefir and others dairy delicacies.

From: Earliest evidence for cheese making in the sixth millennium BC in northern Europe. (2013)

The introduction of dairying was a critical step in early agriculture, with milk products being rapidly adopted as a major component of the diets of prehistoric farmers and pottery-using late hunter-gatherers. The processing of milk, particularly the production of cheese, would have been a critical development because it not only allowed the preservation of milk products in a non-perishable and transportable form, but also it made milk a more digestible commodity for early prehistoric farmers...This new evidence emphasizes the importance of pottery vessels in processing dairy products, particularly in the manufacture of reduced-lactose milk products among lactose-intolerant prehistoric farming communities.


 Genetics involved...LP vs LNP


Somewhere along the line, a baby was born that could digest milk as he or she matured. This baby grew up and had many strong children.  These children, with a mutated lactase gene, could also drink milk well into adulthood.   It turns out that the gene for lactase persistence is a dominant gene.  A person only needs to have one copy of this gene in order to be able to digest lactose into adulthood.

You'd think that lactose intolerance is a "fault" but it really is the normal state. Being able to digest lactose is a genetic mutation. In order to digest the lactose in milk, a person must secrete a substance (enzyme) called "lactase" in their small intestine. As the baby is weaned, in nature, the lactase enzymes stops being secreted, as it would just be a waste of resources, never expecting to dine on milk again. Humans who retain the ability to digest lactose are known as "lactase persistent," hereon out "LP".  The opposite of LP is LNP (lactase non-persistant). LNP is the "normal" state for humans past the age of weaning. That is, until the nomadic pastoralists came into the picture!

Milk: A moveable feast!


What was the advantage of being able to utilize the milk of the animals that our ancestors cared for? Energy!  When digested, lactose breaks down into glucose and galactose. The glucose would rapidly enter the bloodstream and provide the energy to the brain, the eyes, and the muscles for activity.  A person with the ability to digest milk would have had quicker access to energy. Additionally, this milk provided protein and important vitamins that were readily available. Milk was probably the original "fast food!"

Those newly endowed to be LP, having a distinct advantage of a new food source, spread the mutation preferentially to those living in Northern Europe. Today, a percentage of just about every population carries these LP genes, but many are still untouched.

Photo Credit: The evolution of lactase persistence in Europe. A synthesis of archaeological and genetic evidence
Chances are, if you can digest milk, you can trace your lineage back to the areas in darker blue. From the paper linked above:

The LP trait frequency is found in around 35 per cent of adults living in the world today, but varies widely among human populations, both between and within continents. High frequencies of LP are generally observed in northern European populations. Indeed, LP frequency can vary from 15–54% in eastern and southern Europe to 62–86% in central and western Europe, and to as high as 89–96% in the British Isles and Scandinavia. In India, LP frequency is higher in the north (63%) than further south (23%) or east. There are relatively little data on East Asians but it seems that the trait is rare there. In Africa, the distribution of LP is very patchy, with high frequencies being observed mainly in traditionally pastoralist populations. For example, LP reaches 64 per cent in Beni Amir pastoralists (Sudan), whereas in Dounglawi (Sudan), a neighbouring non-pastoralist population, LP frequency is around 20 per cent.

 

 Powerful genes!


Interestingly, the LP mutation appeared independently several times in history, in the form of various alleles in various populations.

Once the LP allele appeared, it offered a major selective advantage. In a 2004 study, researchers estimated that people with the mutation would have produced up to 19% more fertile offspring than those who lacked it. The researchers called that degree of selection “among the strongest yet seen for any gene in the genome”.

Importantly: LP must be looked at in context. It is not the gene only, it is a whole haplotype.  More genes seem to be connected with this trait, and emphasizing once again, LP conquered the human genome with a full force.  The European version is even referred to as a "hard selective sweep".

From: Genetic Signatures of Strong Recent Positive Selection at the Lactase Gene (2004)

In this study, we analyze genotypes for >100 SNPs in multiple populations, and we demonstrate two striking signatures of selection at the LCT gene. First, SNPs near LCT show large differences in allele frequencies among populations, demonstrated not only with the traditional FST measure but also with a more informative metric, pexcess. In addition, we show that the long (1 Mb) haplotype carrying the persistence-associated alleles is much longer and more common than would be expected in the absence of selection. We are also able to estimate from these genetic data the time period during which selection occurred, and we show that the selective pressure at LCT was comparable to the strongest selection yet documented in the genome.

 

For genetics geeks:


LP is enabled not because of a mutation in the lactase gene itself, but by a mutated allele in its promoter region in MCM6, a gene next to lactase gene (LCT).

Image source: Identification of a variant associated with adult-type hypolactasia


Conclusion of Part 1


Interesting stuff, eh? Well, hold onto your hats--we're just getting started! Why have few questioned our fascination with drinking milk as if it was straight from the udder? Could the drinking of fresh milk be completely against our nature, with many dire consequences? Keep reading as we lay out this series. We think you will be quite amazed at what we've uncovered here!
Tim, Gabriella, and Gemma
  

52 comments:

  1. I don't think we are adapted to consuming milk as adults. It looks like an unfinished, half-way adaptation: atlhough lactose can be digested, a milk protein called casein causes much harm for humans, like increasing the chances for cancers, and is not easily digestible.

    Besides - this lactose tolerance is hailed as an example of "recent evolution". But the preserviation of young trails in adults is a hallmark of the whole human evolution. It is called neoteny, and it allowed us to do things like still be able to learn stuff while old. So preserving something from the young age looks like a very ancient trick of hominds.

    http://www.mun.ca/biology/scarr/Neoteny_in_humans.htm

    http://www.gmilburn.ca/2009/03/30/chimpanzees-and-neoteny/


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    1. "a milk protein called casein causes much harm for humans, like increasing the chances for cancers"

      more nonsense from Colin Campbell I see

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    2. Mr. Grashow - Feel free to expand on that thought. We have written 5 long posts on milk so far, that we are continually updating until we publish them, and we do not even mention casein or A1/A2. So, I'd love to see some discussion by those of you who have looked at the protein component of milk as harmful or not, here in the comments.

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    3. TomR - Believe it or not, we are not even trying to be 'anti-milk' even if it seems like it. We're focusing more on the genetics of lactose tolerance which may have a specific set of problems associated with it, but as you are pointing out, milk may have many more surprises for us.

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    4. @Tim - I don't consider milk in anti-pro termsu, but suspect that milk adaptations and milk consumption were positive for the populations, though they might not be on a healthy side, but rather performance ones. Hey, even today bodybuilders stuff themselves with protein to grow big muscles.

      From the link on gnxp site: "Razib: There are some phenotypic tidbits in the talk apparently. The Yamna were tall in terms of their genomic potential.
      This seems plausible – apparently I think Corded Ware burials worked out about 2.5 inches taller by direct measurement in some study compared to Early Neolithic Farmers in Europe."


      Basically you have milk-drinking nomads that were bigger, stronger than farmers - partially because of milk. Not only that - they rode horses - in fact first milk drinking is supposed to be horse milk. Were more mobile. This basicaly gave them huge military advantage in wars with farmers. I suppose what you wrote about "powerful genes!", and "selection ... among the strongest yet seen for any gene in the genome” should be considered including the military advantages it gave, not only health stuff. Survival of the fittest in a literal sense.

      This contrasts with Blue Zones - many of which, like Okinawa, Sardinia are inhabited by quite small, short people, with cultures with not much achievments, kind of quiet not pushing for warfare or zeal for other types of victories or expansion.

      Consider this - tall people have higher cancer risk in general

      http://www.medicalnewstoday.com/articles/231475.php

      Add to this cancer risks from milk proteins, meat proteins or sugars, and compare with all those short farmers on low-calorie plant based diets. Side effects of being able to win wars?

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    5. @TomR, sounds like "plant based diet" nonsense to me. Human breast milk is 40% casein. So nature selected a cancer causing substance to give to our young? Truth is eating anything "increases cancer risk" hence why eating less - caloric restricted diets - increase lifespan. But who the hell wants to live that way? Quality of life matters too.
      Correlating tall people with cancer?... oh brother. Hard to take you serious. What is the causal evidence/link?
      If you look at a ranking of top milk consuming countries you won't find a correlation with a ranking of cancer incidence.
      Why is it that raw eggs and raw milk supercharge glutathione production? Not to mention great stuff for muscle growth.

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    6. @Brad - It's not that casein, methionin, leucine, IFG-1 - present in milk - are cancer causing. Cancer causing are things like viruses, mold toxins (eg. aflatoxin) or radiation (including even the Earth's background radiation). Milk substances are more like growth busters - they increase growth for those tissues that try to grow. One of the reasons that tall people have more cancer risk - they have more growth substances in their body, even naturally, like their own growth hormone. This could be beneficial - like in the case of bodybuilders trying to grow muscles, or in case of babies - trying to grow in general. But when you are old, you have already reached a decent height, muscle size etc., and age means more cancer risk - then the main tissues that would react well to the growth factors would be cancer tissues.

      You have cancers appearing in your body, and they are destroyed by the immune system or autophagy, so you don't even notice this. But if their growth is boosted by growth factors your defences might not be enought to with against cancer, thus it doesn't look like a good solution to consume them.

      One feature of cows milk that might help in old age is that it decreases iron, and iron accumulation is an issue at the old age.

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    7. @tomR, I interpreted exactly what you described but thanks for clarifying. A couple comments... Muscle "growth" does not end when you get old. Muscle tissue like all other tissues is constantly in rotation - anabolism (growth) and catabolism (reduction), renewing itself. The old saying "use it or lose it" is true, especially after age 40 when, in general, increased muscle wasting/atrophy accelerates with every passing decade (called Sarcopenia). Sufficient diet and exercise stimulus helps to counteract this effect. And since increased muscle mass has various health benefits an anabolic diet is important regardless of age. Muscle mass serves as an nutrient/energy reserve (much like fat mass) in the event of severe injury or illness. If you are in a car accident or even contract cancer more muscle mass could save your life. Increase muscle mass also increases insulin sensitivity which combats increased adiposity and risks of metabolic syndrome-like issues *and* increased cancer risk associated with it.
      So if you want those "growth factors" in milk, or any other growth promoting food, to work in your favor instead of against you, then exercise is the obvious solution. In short, I think the problem is not the milk but a sedentary lifestyle and unfit, inactive body. You should be doing this (moving and lifting) anyway since the benefits of exercise is widely universally understood.

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    8. It's also hard for me to imagine that any food that is "growth promoting" is not also *repair* promoting and defense promoting since many of the same chemical processes and nutrients/chemicals used to "grow" are also used to repair and replace tissues. The implication I'm hearing here is that the nutrients in milk are somehow promoting the potential growth of cancer cells while at the same time not being protective. This is not true, but Glutathione provides a good example of how/why damn near ANY food can be both good and bad. So is there something particularly special and bad about milk in this regard versus other nutritious food?...

      http://www.ncbi.nlm.nih.gov/pubmed/15386533

      Abstract
      Glutathione is an abundant natural tripeptide found within almost all cells. Glutathione is highly reactive and is often found conjugated to other molecules via its sulfhydryl moiety. It instils several vital roles within a cell including antioxidation, maintenance of the redox state, modulation of the immune response and detoxification of xenobiotics. With respect to cancer, glutathione metabolism is able to play both protective and pathogenic roles. It is crucial in the removal and detoxification of carcinogens, and alterations in this pathway, can have a profound effect on cell survival. However, by conferring resistance to a number of chemotherapeutic drugs, elevated levels of glutathione in tumour cells are able to protect such cells in bone marrow, breast, colon, larynx and lung cancers. Here we present a number of studies investigating the role of glutathione in promoting cancer, impeding chemotherapy, and the use of glutathione modulation to enhance anti-neoplastic therapy.

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    9. So you see the complication here? Milk, particularly raw/fresh is one of the best promoters of Glutathione production. And Glut is probably the most important body antioxidant and cancer fighters, and yet it can also contribute to cancer? argh!... enough to drive you bonkers. Logic tells me the cancer problem (source) lies elsewhere - not in fresh healthy food, of which quality milk is one.

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    10. @TomR, take a look at rankings by country of - height, cancer rates, and longevity. It's difficult to find a compelling correlation. One recent study of only women and only in one country (UK) is not compelling evidence IMO. Statistics are funny things ;-)

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    11. About milk, excercise and cancer - it's prettty clear that anabolic (body building) proteins increase your chances of cancer. Milk consist some of them (casein, leucine, methionine etc.).

      http://www.medscape.com/viewarticle/777311

      But completly avoiding anabolic stuff has a severe downside for older people, the one that Brad mentioned - accelerated muscle loss. So what should be the proper balance between the anabolic food and catabolic processes ones for the elderly, that keeps both reasonable muscles as well as decently low cancer risk? I guess the key to this question is that muscles don't need to be excercised frequently. Some programs like Body By Science call for 1 excercise session per week, and for non-responsive people even one per 2 weeks - elderly might fall into this group. So perhaps the post-resistance-workout meals , and perhaps the next day - crucial to the recovery of muscles could include milk proteins, and the rest of the days shouldn't?

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    12. Notice that some milk products are worse than milk - a milk product - hard cheese - is full of glutamate, which is increasing cancer metastasis, it's ability to migrate to other tissues etc. So it's not only casein.

      http://www.pnas.org/content/98/11/5947.full

      And lots of glutamate + casein has the ability to interfere with children's brain development:

      https://www.youtube.com/watch?v=iL4SD5f2toQ



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  2. "These pastoral societies were nomadic and their travels often intersected with areas inhabited by farmers. Trade was established and the nomads "intermingled" with the locals, as you suspect they would."

    Nice to use "intermingled" in quotes. History shows the nomadic tribes tended to exterminate farmers they met.

    http://www.unz.com/gnxp/there-were-giants-in-the-earth-in-those-days/


    http://www.unz.com/gnxp/there-were-giants-in-the-earth-in-those-days/

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  3. I can't wait to read the rest! (Terri F.---I put that as I think otherwise I show up as anonymous--which is technically fine--but anyhow...)

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  4. I am heartbroken -- and I really mean this -- about having to give up dairy in recent years. I had been a milk-drinker my entire life, but in the past two years have had to get *real* and stop lying to myself about what it does to me. For me, any kind of dairy is simply "liquid cheesecake" to my metabolism. Even when I source antibiotic and hormone-free, and even raw, if I have more than a few ounces a couple of times a week, it blows me up like a puffer fish. I gain weight so quickly on dairy is not even real. It also makes my skin really oily. I've come to the conclusion that for me the growth hormones naturally occurring in milk turn me into a teenage boy on steriods. Sadly however, I am actually a 48 year old woman. I know that for a lot of people, dairy raises insulin, and does so without the usual rise in blood sugar, so it's pretty silent and deadly in it's action. I also know this is what it does to me. I have had insulin tested both on and off of milk, and the difference is remarkable.

    I believe my intolerance is to casein and not lactose. I don't have any of the usual lactose issues that others do, but will get a bit of difficulty breathing and some heavier than usual mucous when I eat too much dairy. Fermented doesn't seem to make any difference to me, nor does the difference between A1 and A2.

    So so sad.

    And when I say heartbroken, I am not kidding. Giving it up has caused me a lot of grief. I love the stuff almost better than any other food. My perfect dessert has always been "something cold and creamy". When I think of eating, I automatically think of something with cheese, or some yogurt, or something with sour cream. It's been one of the hardest transitions I've ever had to make. I feel actual envy and resentment towards people who can drink it without any repercussions!

    I've also come to the conclusion that there is a dairy intolerance to casein that makes milk not the *ideal* food, but still allows enough of it to be digested without causing serious repercussions. So many of the populations that shouldn't be drinking milk seem to consider it a staple in their diets.

    I always find it a wonder when I see, read, or watch things about the Mongolians. They rely so heavily on milk in their diets, and do drink some of it fresh, which I find interesting considering the fact that they have so much in common genetically with the Chinese, who are considered lactose intolerant as a group. They also ferment and dry much of it.

    From Mongolius.net:

    "Out of necessity Mongolians have found creative and ingenious ways to use the milk of all five of the domestic animals in the country: sheep, cattle, goats, camels and horses. Orom is the cream that forms on top of boiled milk; aaruul are dried curds and can be seen baking in the sun on top of gers in the summer; eetsgii is the dried cheese; airag is fermented milk of mares (female horses); nermel, is the home-brewed vodka that packs a punch; tarag, is the sour yogurt; shar tos, melted butter from curds and orom, and tsagaan tos, boiled orom mixed with sometimes flour, natural fruits or eesgii. The method of drying the dairy products is common in preparing them. The Mongolians prepare enough dairy products for the long winter and spring."

    They mention "sheep, cattle, goats, camels, and horses." I've always heard that some of the other milk-producing animals produce a product that is easier on the digestion than dairy cows. I wonder if the more ancient or less-hybridized cattle they are using could make a milk that is also easier on the digestion?

    I also wonder if the drying somehow mitigates the lactose? It's so dry there, I wouldn't think it would have to be sitting out long to be a dehydrated product, but would that mean it was actually fermenting as it dried?

    This is such a great blog Tim! Keep up the good work!

    Ann

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    1. Raw goats milk is very healthy and is often better tolerated - perhaps it contains more lactase or less lactose?

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    2. @anonymous, high blood insulin levels is not a problem, blood glucose is. There is a difference. Lots of non-fattening foods cause insulin spikes without BG spike. Look up "Insulin Index" and you will see.

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    3. @ Ann - That must be awful for you, I love milk too and I'd hate to go through that. I had to give up kefir because of bloat, but I can still drink milk. The way you've described your experience I'm getting the sense this was a sudden change, is that the case?

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    4. I recently changed to making kefir with goats milk instead of cows milk. I can't taste the difference. Luckily I don't have any of the bloating and farting that I had with cow's milk, so as described I can tolerate it much better. So I can continue to use kefir because of the many beneficial benefits the contain. I let it ferment for 48 hours instead of the normal 12 to 2 hours. It is curdled when it comes out of the jar, but once I have stirred the finished product it get back to being fluid.
      Hope this helps.

      Jo tB

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    5. @Brad - have to disagree with you there. High insulin causes all kinds of havoc for women. Polycystic ovaries, high levels of androgens, ugly hair growth, acne, oily skin. Not to even mention a tendency to gain weight around the middle. Consistently high levels of insulin are the cause of many, many kinds of inflammation in the body. Is it better than high blood glucose? Sure. But is it an okay state for the body to be in for extended periods of time? NO WAY.

      High triglycerides are only one result of long-term high insulin. Eventually the pancreas is forced to slow down production of insulin, and then we have diabetes. Breast cancers are more prevalent in women with high insulin levels.

      It's better than high blood glucose, but the best approach is to find out what's making your insulin high and make the necessary changes.

      Ann


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    6. @Wildcucumber - no, not a recent change. I just started to become more aware of how food made me feel about five years ago. I cut out a lot of things then, but never considered milk a problem. Then, two years ago, my stress levels skyrocketed due to some family issues, and I suddenly couldn't eat anything for a while. My immune system tanked, and I was dealing with leaky gut and a whole host of food allergies. I was just eating meat and non-starchy veg for months while my gut healed. Then, about a year and a half later, I tried re-introducing things, one at a time, and realized that dairy definitely causes me issues I'd rather live without, and when I really started looking back, I realized I'd had those issues all along. So my discovery of the issues with dairy was pretty sudden, but the issues themselves had probably been there my whole life and I just never realized how much better I could feel without it until I wasn't eating it anymore. I still eat cheese, or sour cream, or a piece of cheesecake occasionally, but just can't eat it on a regular basis.

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    7. @Ann, you are mistaking the effects of long-term high blood glucose levels with that of insulin. Meals high in protein like fish and chicken spike insulin quite a bit (again, see the Insulin Index) and yet there is zero evidence that a diet high in those foods cause any of the conditions you mentioned. Insulin is a beneficial hormone that is there for a (good) purpose. Just because it is present in large amounts when eating high GI foods does not mean it is the problem. The problem is the high GI foods that are not a natural human diet.

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    8. Also, high trigycerides are not caused by insulin, directly per say, but rather the over eating and lack of exercise (consistent caloric surplus) and seems to be worse with a largely high GI (starchy) diet.

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    9. Brad, I consider high triglycerides happen when people are gaining weight. They get low when the person is losing weight. Mostly as you say, carbs.

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    10. Yeah, I have heard this. A friend of mine who went on a low carb diet lots a lot of weight and said his trig's went way down. Do you know how this works? It seem counter intuitive to me. If you are losing body fat you would be burning this off via lipolysis and so why doesn't that cause higher lipid levels in the blood? Is it that you burn off those lipids as they are liberated from adipose tissue?

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    11. triglycerides are a measure of energy going into storage, as in fat cells. Liver to fat cells. When energy is going in the other direction, fat cells to liver, triglycerides are low. Easiest way to get storage going to fat cells is to eat high carbs. It's all about direction. Ironically LDL can rise when fat is being lost. Seems paradoxical but it makes sense. People shouldn't freak out if they are losing weight and suddenly LDL goes up. Just keep going and it eventually goes down.

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    12. People STILL give attention to the debunked cholesterol hypothesis?

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    13. Yup. I don't but it just seems to me that people heard about it in the 1960s and 1970s and it's like brainwash.

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    14. Brad, being a T2 diabetic, I've always understood that at some stage the body can't properly digest carbs so glucose levels rise in the blood. The body responds by increasins insulin production even more in the hope that will finally push the glucose into the cells which had become insulin resistant. And what do the experts give us: sulphonylureas to stimulate the pancreas even further to product MORE insuliun again. No wonder our insulin levels are out of whack. AND our dietary advice is to eat lots ot carbs. To me that sounds absolutely counter productive, but our doctors can only prescribe pills. They don't look at diet, never have.
      So us diabetics are left to our own devices really, and if we're lucky enough to discover that we can improve our situation with foods we eat. Yippy.

      Jo tB

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    15. Jo, how about high morning blood sugars? That's from glycogen breakdown in the liver overnight. To me it indicates that insulin production by the pancreas is sluggish when endogenous glucose sources are what's floating around in the bloodstream. Endogenous glucose production does not stimulate insulin release. Ingested sources of blood glucose do because there is a signalling peptide released by the GI tract telling the Beta cells: 'glucose coming'. Insulin response precedes any significant glucose increase in the blood.

      One of my friends has high morning glucose but right after she eats something that contains carbs, her blood glucose goes down. Her doctor says she will eventually become type 2 diabetic.

      Sleep apnea and hypopneas will cause sympathetic nervous system overdrive due to low O2 sats. The body freaks out when oxygen levels go low and adrenaline is released in a sort of fight/flight response. Adrenaline will also cause glucose to be dumped from the liver even though it has nothing to do since the person is sleeping and not being physically active.

      Glucose entry to brain and muscle tissue is not dependent on insulin. The body needs immediate and emergency sources of energy when there's a crisis. But what happens when the crisis is all night long?

      Am I making sense here? Anything that adversely affects breathing during sleep will result, over time, in blood glucose dysregulation. Hypothyroidism, for example, results in floppy muscles in the throat and myxedema. Reduces air flow especially during sleep when muscles are relaxed. Anything that causes swelling of the tissues in the throat (irritation from smoking, acid reflux, tonsils, adenoids) or cause reduction in size of the airway (small lower jaws, under developed maxilla) will reduce the size of the airway and over time cause cardiac problems and blood sugar problems.

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    16. Oh and being overweight when fat is preferentially deposited in the neck. Really obese young women are spared by high estrogen levels. They can be enormous but their necks are thin. Not all women have high estrogen levels, so you see fat necks. But post menopause, fat will shift to the neck.

      Men are in a no win situation because they're testosterone dominant and get fat necks when they are overweight. It doesn't actually take too much overweight for men to have really fat necks.

      This also reduces airflow during sleep. With predictable results. It's also why men get the heart attacks earlier in life than women. Women catch up after menopause.

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    17. Gabrielle, yes I've heard of the dawn phenomenon. And my sugar levels can be high in the morning, and I had realised that I need to eat something to get the insulin production going (although the inclination is NOT to eat). The pancreas does not respond to an endogenous glucose release. It only responds to exogenous glucose intake. I can get a clogged nose when I've eaten something to which I am intolerant, like cheese, but since I don't eat that any more, it must be something else. I have been recently told that I snore at night, which I have NEVER done before (I used to talk in my sleep). I have recently been diagnosed as histamine intolerant, and now have to go on a low histamine diet. Hopefully that will aleviate all the above problems.
      I don't have a fat neck (thank God) my fat sits round my middle (apple shape). Most people don't consider me overweight even my family doctor has never considered me overweight.

      Jo tB

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    18. Thyroid?

      Snoring = hypopnea. The tissues in the throat are partially blocking the airway. Blood oxygen saturations go down but unlike with sleep apnea, it's continuous. With sleep apnea, there's huge ups and downs of oxygen saturations but with hypopnea it's constant.

      Yes, when blood glucose is high in the morning, there is no appetite. There's a dysregulation with cortisol as well which is why fat likes to deposit on the midsection. The recommendation is to get more sleep because people who get good amounts of sleep lose weight. But what happens when there's hypopnea during sleep? Doesn't damn matter does it how much someone sleeps? Hypopnea also makes people have non-restorative sleep.

      I'm making noise too but not with an open mouth. On the outbreath not the inbreath. My soft palate is blocking outflow. If I use seawater nose spray in the evening, the tissues remain more hydrated during the night and it's less of a problem. Ridiculous.

      I've studied sleep medicine for years and years and stuff like this really bothers me. It started when Dr. William C. Dement had his book published 'The Promise of Sleep'..... and then it continued for many, many years taking courses and reading a lot.

      What I love is big fat patients who have had heart attacks and are diabetic but who won't show my their sleep study reports (because I am not the one who can order them and then there's confidentiality laws so I can't just ask their physician for a copy without permission) and claim they have no apnea! Har har har har har!!!!!! Maybe not over 15 apneic episodes per hour but guaranteed they have apnea and hypopnea. Some people just don't want to change anything about how they live their lives and when everything melts down, it's never their fault. Just gotta love it.

      Not you Jo, because you are highly motivated, but I find that type 2 diabetics or at least the prediabetics are extremely apathetic. It has some major effect on the brain and mood. I don't know if it's just the high sugars, the poor quality sleep, maybe some nutritional disorders (vitamin deficiencies because high carb foods displace nutritious foods).... don't know.

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    19. Riddle me this Gabi - why is it the mornings my husband wakes up so damn chipper, exclaiming 'what a great sleep!" are after the nights he's been snoring like a sonofa--- ?

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    20. You're lucky. Or he is. Doesn't mean a thing though. I was married to a guy like that. Now he's got a debrillator pacemaker installed and he's someone else's problem. I concluded he was a brain damaged happy go lucky.

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    21. Can't spell. Defibrillator! And according to the hospital computer check on the device, he'd had electric shocks to his heart (probably while he slept so he didn't realize.)

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    22. Gabriella, looking at what my diet was for decades (long before I was diagnosed with diabetes in 2001) I would definitely count in vitamin deficiencies. Am reading the book Naked Calories at the moment. Very enlightening. They recommend taking a multi vitamin in liquid form to increase absorption. So I found an internet source and ordered a bottle. So as soon as it arrived I will start taking it.
      I will try your sea water spray and see if that helps. I have a very dry nose in summer and a runny nose in winter as soon as I get outside.
      So all the niggely bits are coming together and hopefully will improve the situation greatly. Thanks for your input.

      Jo tB

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    23. According to the lab test I don't have a thyroid problem. My TSH was 0.89 (norm 0.40-4.00), freeT4 was 1.24 (norm 0.8-1.8) and my free T3 was 2.76 (norm 2.3-4.2).

      Jo tB

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    24. Gabriella, Your post on sleep apnea/hyponea could not be better timed for me. Brain fog, non-restorative sleep, waking breathless, mildly elevated am BG. Could all this be caused by low iodine? My thyroid numbers were good but thyroglobulin was 60 (over 50 is out of range)? From my reading mildly elevated tg means low iodine = sub-clinical thyroid issues = sleep hyponea = lots of not great stuff?

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    25. Sally, the best thing to do is to get the urinary excretion for iodine checked. High thyroglobulin levels can also indicate cancer and other things. If you want to troubleshoot, then check iodine excretion. Your physician may want to investigate further in regards to the thyroid itself. 'Thyroid numbers' being 'good' can mean anything. Being 'in range' doesn't always mean 'good'.

      Overweight, neck circumference in females > 15 inches, small lower jaw, nasal septal deviation, chronic sinus problems, etc. etc. can also result in sleep breathing problems.

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  5. Ha! Just got home from picking up milk share. Now down to two quarts per week. We helped start this program many moons ago, and I am reluctant to quit even though It has been quite a while since my husband stopped consuming any dairy but ghee because it caused so much mucous that he nearly choked i his sleep, and I seem to gain too much weight from dairy. So mostly I skim off the cream to put in minusule amounts on my berries and share the rest with friends, and kefir the skimmed milk to give to the chickens. Sometimes I have a little kefir, but that seems to give me a rash. When I am feeling more energetic I will make yogurt....but then I gain weight. Perhaps if i just ate smaller amounts....all of which is to say I am conflicted about keeping the cow share. i look forward to the rest of the series.I hope it will clarify things for me.

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    1. Don't worry, the very last post is not going to say, "Milk Kills! Don't Drink!" If that was our concern, we would have started out that way.

      I think when you look back at the genetic landscape that made us able to drink milk into adulthood, it was not done so by drinking pasteurized milk, or even much fluid milk, but mostly fermented milk and cheese type things.

      Me personally? I don't think anyone needs to drink milk. I have not been a milk drinker my entire life, but I love cheese and fermented dairy things. I'm not lactose intolerant in the least. Just never got into milk, even as a kid, i hated it and would trade my carton of school milk for whatever I could or give it away.

      I think that milk is just a huge commodity and being propped up by the government as a health measure. As you read the series, you'll see that maybe pushing milk on every person is not a wise health-move.

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    2. I suspect that people who gain weight from drinking milk or eating dairy in general do so for reasons other than the dairy itself... energy intake and expenditure out of balance, poor body muscle to fat mass ratio perhaps accompanied by insulin insensivity, a carb heavy diet in general, too much sugar intake, etc.

      This analysis of dairy is very hard to argue with.

      http://www.cogitoergoedo.com/2012/03/30/does-dairy-make-you-fat/

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    3. Liquid calories are easier to consume.

      Imagine, for example, having to eat the dry sugar (or whatever modified corn syrup) by the spoon instead of drinking it in soda pop. Would anyone do it? Like one of those Big Gulp things. 32 ounce drink? Just put all the sugar in a bowl and spoon it down. Probably not.

      Milk doesn't have as much sugar as Coca cola. But it's got other calories as well.

      211 kcal in 500 ml of Coca cola
      309 kcal in 500 ml of full fat milk
      258 kcal in 500 ml of 2% milk

      People justify drinking the milk because it's 'healthy'. If you don't need the calories then of course there's weight gain.

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    4. From the admittedly biased for raw milk (Weston A Price) site.
      http://www.westonaprice.org/blogs/cmasterjohn/the-biochemical-magic-of-raw-milk-and-other-raw-foods-glutathione/

      excerpts from Chris Masterjohn, PhD...

      Glutathione — The Master Antioxidant and Detoxifier

      "a wonderful little compound called “glutathione” — this tiny compound consists of just three amino acids, but it is the master antioxidant and detoxifier of the cell."
      ...
      "The researchers searched over thirty publications identifying the sequences of edible plant and animal proteins and concluded that the only two types of protein in the food supply containing these unique bonds are whey proteins and egg white proteins. They noted the following:
      It may also be noteworthy that from time immemorial, whey from raw milk and/or undenatured raw egg white have been administered to children and to the sick as prophylactic or therapeutic measures in folk medicine.
      I have heard of a number of cases of people benefiting from including raw egg whites in their diet. It should be noted, however, that raw egg whites contain substances that inhibit digestion and decrease the availability of biotin. Some people may benefit from their apparent glutathione-boosting ability, and this may be especially important for people who cannot tolerate milk, but in others the risk of biotin deficiency or digestive troubles might outweigh this benefit. Intestinal flora produce biotin and egg yolks are loaded with it. Maintaining proper intestinal flora and eating plenty of egg yolks may allow some people to reap the benefits of raw egg whites if they do not have trouble digesting them."
      ...
      "The best foods for boosting glutathione status appear to be raw milk or raw egg whites. Many people who cannot tolerate pasteurized milk report that they can tolerate raw milk. Many others report that they cannot. Raw egg whites contain their own risks from anti-nutrients, but people who digest them well and get plenty of biotin from their intestinal flora or from additional egg yolks may be able to reap their glutathione-boosting benefits in the absence of milk.
      Besides these two unique sets of proteins, meeting our daily needs for protein with moderate amounts of meat, fish, eggs, legumes, or other plant and animal protein foods, and loading up on raw fruits and veggies appear to be the best ways to give us a good glutathione boost. A diet rich in the full spectrum of nutrients will also provide many other vitamins and minerals important to boosting glutathione status in less direct ways.
      Glutathione is not the only benefit of raw foods, nor is loss of glutathione the only drawback to excessive heating and processing. So we clearly should not base our diet merely on these data. Some people, moreover, have intolerances to fruits and vegetables, just as others may not tolerate dairy or egg whites. These facts emphasize the importance of considering each individual’s unique biochemistry rather than making a one-size-fits-all diet for everyone.
      However, to the extent that glutathione is responsible for some of the miraculous recoveries people experience with raw milk, many of us may be able to enhance these recoveries even further by loading up on raw fruits and veggies, and people who cannot tolerate raw milk may benefit from consuming these foods in addition to raw, whole eggs if they do not have a problem with whites."

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    5. @gabkad, I can easily chow down 150 to 200 grams of cheese just as a snack. That is 450-600 calories just by itself. I think the issue is it's so calorie dense and physically condensed it's easy to eat fast without sufficient time for the satiety signals to hit. Prob similar to eating nuts and other calorically dense foods.

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    6. Brad, for people who say it makes them gain weight, yup. Drink milk like it's water and face the consequences. Milk is very thirst quenching.

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  6. I was looking for articles on Nutrients in Milk and I came across yours inspiring read. Great post!

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