Scleroderma: Is Food the Cause?

An acquaintance of mine has scleroderma, and she asked me whether scleroderma has anything to do with diet. The answer to that question seems to depend on whom you ask.

People who haven’t bothered to study the scientific literature on nutrition insist that food has nothing to do with scleroderma. Such idiots deserve to be swatted on the snout with a rolled-up medical journal, because they are spreading dangerous nonsense. On the other hand, the scientists who have dedicated their scientific careers to studying the relationship between food and diet say that the autoimmune diseases, including scleroderma, are strongly related to diet.

The rules for avoiding autoimmune disease are simple: don’t eat your relatives, don’t eat too much fat, and make sure you get plenty of vitamin D. If you get an autoimmune disease anyway, get tested for celiac disease and ask a registered dietitian to help you plan an exclusion diet to see if something you are eating is triggering your problem.

Like other autoimmune diseases, scleroderma is common in the same populations that eat a lot of animal-based foods, which means a lot of animal protein and a lot of fat. On the other hand, autoimmune diseases are rare in populations that eat a low-fat, plant-based diet. Autoimmune diseases are also less common in sunny climates, which suggests that vitamin D (the “sunshine vitamin”) plays a role in preventing them. A diet-related illness called celiac disease seems to increase the risk of other autoimmune diseases, probably because it causes “leaky gut.”

Why do I say “don’t eat your relatives”? Why does eating animal protein pose such a risk of autoimmune disease? It all has to do with a simple fact about DNA. The more closely related two species are, the more alike their DNA is, and the more alike their proteins are. The more alike two proteins are, the more easily they can be mistaken for each other by the immune system.

Let’s imagine that you eat some meat and some potatoes. Ordinarily, the proteins from the meat and the proteins from the potatoes would get broken apart into individual amino acids in your digestive system, and from there the individual amino acids get absorbed into your bloodstream. But let’s imagine that you have a problem with your intestine. It leaks a little, so some fragments of protein from the meat and from the potatoes make their way into your bloodstream before they are completely broken down. The immune system may mistake these proteins for a foreign invader and make antibodies against them. Unfortunately, the proteins from the meat look a lot like your body’s own proteins, so the antibodies against them end up attacking some of your own tissue. The proteins from the potato have no “family resemblance” to anything in your body, so any antibodies that you produce against them will probably not attack your own body. So don’t eat your relatives! Eat plants, instead. However, you may have to be a little picky about which plants you eat.

In people with celiac disease, a protein from wheat (or from rye or barley, both of which are closely related to wheat) triggers the immune system to attack the intestine. Celiac disease can cause a wide range of problems, ranging from malabsorption to “leaky gut.” So you’d expect people with celiac disease to be at particularly high risk for an autoimmune disease like scleroderma. As a matter of fact, they are!

Fat in the diet can also be a problem in autoimmune disease. Roy Swank was warning people about this problem this starting in the late 1940s, but he was largely ignored, even though he published his results the world’s most prestigious medical journals. The role of a high-fat diet in causing multiple sclerosis has recently been “discovered” again. Unfortunately, no one can make a fortune from this discovery, so I’m afraid that it will fall back through the “memory hole” yet again.

If you want to put out a fire, the first thing to do is to stop pouring gasoline on it. Likewise, when you get a diagnosis of a disease that is known to be related to diet, stop eating the foods that are known to provoke that disease! In general, a low-fat, plant-based diet has been associated with a low risk of autoimmune disease. However, a few people may have trouble with wheat or some other plant-based food. Consequently, they should consult a registered dietitian for advice about an exclusion diet. People with autoimmune disease should also ask their doctor, physician assistant, or nurse practitioner to monitor their vitamin D levels and test them for celiac disease.

High-Fat Diet Causes Alzheimer’s Disease

Even Late in Life, a Low-Fat Diet Helps

The more fat you eat, the more likely you are to lose your marbles in your old age. This graph came from an article that explains why it’s reasonable to conclude that the fat in the diet is the culprit. It also explains that even late in life, a change to a better diet is beneficial.

The article mentions that in Europe and North America, higher fish consumption seemed to provide some reduction in risk. That may be because the fish were simply replacing foods that were even more dangerous. It doesn’t mean that a health-optimizing diet for a human being would include fish.

Humans and Gorillas Can Get Gout, But We Can Both Get By With Very Little Salt!

Gouty arthritis results from the buildup of crystals of uric acid in the joints.

People who eat a lot of meat are at risk for gout—one of the most painful conditions known to medical science. Gout results when crystals of a uric acid salt build up in the joints. These crystals can also build up in the urinary system, producing kidney stones—another of the most painful conditions known to medical science. A recent theory suggests that our high risk for gout is a side effect of an adaptation that enabled human beings, gorillas, and the other great apes to survive a shortage of sodium.

Although eating meat and seafood causes gout in people, it doesn’t cause gout in a natural carnivore like a cat. That’s because cats, like most mammals, produce an enzyme called uricase, which breaks uric acid down into something that dissolves easily in water and passes right out through the kidneys. Human beings and the great apes are practically the only mammals that can’t make uricase. This fact suggests that people, like gorillas, should probably be eating a highly plant-based diet.

In the wild, apes are free from gout because their plant-based diet is low in purines, which the body converts to uric acid. Fruit and vegetables are also mildly alkalinizing, and the mild metabolic alkalosis enables the blood to keep more uric acid dissolved. So the great apes can live gout-free even though they can’t make uricase. Similarly, human beings can avoid gout simply by eating a plant-based diet with a heavy emphasis on fruit and vegetables.

It’s surprising that human beings and the great apes can’t make uricase. We’re practically the only mammals that don’t. The gene for uricase has survived almost unchanged through hundreds of millions of years of evolution. That’s generally a sign that the gene does something important. Yet the lack of uricase might actually be an advantage for wild apes. The extra uric acid in their blood might enable them to survive on a diet that would otherwise be dangerously low in sodium.

As we’ve seen, gorillas eat a very low-sodium diet. Meat-eaters don’t run a risk of sodium deficiency, because meat and other animal-based foods are high in sodium.

Gout Hurts!

Gout is one of the most painful conditions known to medical science. As you can see in this 1799 cartoon by James Gillray, a gout sufferer, gout tends to strike the big toe. Back then, gout was a disease of the rich, who could afford to eat lots of meat and drink lots of booze.

Another cartoon by gout sufferer James Gillray.
Another cartoon by gout sufferer James Gillray.

Gout results from the buildup of crystals of uric acid in the joints. Sometimes, this buildup can be very severe. If you want to see how bad it can get, click here.

The good news is that gout can be prevented and treated by proper diet. Scientists have known for centuries that gout results from eating too much meat. Gout is common in the United States but is virtually unknown in societies where people eat a starchy, plant-based diet. The best way to prevent and control gout is to correct the diet. One word of caution: rapid weight loss, even from a switch to a healthy diet, can trigger an attack of gout, because of the sudden release of uric acid resulting from the loss of body fat.

In an upcoming post, I’ll explain why people get gout, why gorillas could but don’t get gout, and why real carnivores like dogs and cats and real omnivores like rats can’t get it.

If the Guest Is Too Tall for the Guest Bed, Cut Off His Feet!

According to ancient Greek mythology, there was once a man named Procrustes who was the world’s worst host. He had an inn by the side of a road, and he offered hospitality to passing strangers. Unfortunately, if you were too short to fit his iron guest bed, he would stretch you to make you fit. If you were too tall, he’d chop your feet off. Obviously, a better solution would be to find a bed that fits the guest.

Whenever I hear about someone getting their stomach stapled, I think of Procrustes. Are people obese because their stomach is too large? I doubt it. Maybe the solution to obesity isn’t to surgically reduce the size of the stomach, but to reduce the calorie density of the food. If people ate as much as they want of low-fat, high-fiber, plant-based foods, they can control their weight naturally without counting calories or feeling hungry. In other words, they could go ape, go wild, and eat plants instead of submitting to expensive and dangerous surgery. Here are a bunch of people who have done just that!

Where Do Gorillas Get Their Vitamin B12?

Termites: The Other, Other White Meat

Vitamin B12 is one of the two nutrients that are essential for human beings but aren’t available from a purely plant-based diet. The other is vitamin D, which isn’t truly a vitamin but is a hormone that your body can make for itself if you get some bright sunshine on your skin. Gorillas live in Africa, where there’s no shortage of sunshine. The interesting question is where do they get their vitamin B12? Evidently, they get it from the insects and other creepy crawlies that they eat. Their favorites are termites—the other, other white meat.

As you can see, the gorillas just dismantle the tree where the termites are. That’s probably why they don’t bother using tools to fish for termites, as chimpanzees do:

Except for vitamin D and vitamin B12, plants provide all the essential nutrients that people need. Plants contain minerals, such as calcium and iron, which they have absorbed from the soil. Plants contain all of the other vitamins and essential amino acids, which they have made for their own purposes. Plants are also the original source of the essential fatty acids. However, plants don’t make vitamin B12, and neither do animals. All of the vitamin B12 in nature comes from bacteria.

Some plant-eaters get their supply of vitamin B12 from the bacteria in their own digestive system, as long as they are eating something that contains the element cobalt. (Vitamin B12 contains cobalt). Cattle and sheep are particularly good at getting vitamin B12 from their own gut bacteria. They have a lot of bacterial fermentation going on in their stomachs, so the vitamin B12 is made before the food passes through the part of the intestine where the vitamin B12 gets absorbed. Such animals are called “foregut fermenters.”

Other species, including rabbits and gorillas and human beings, are “hindgut fermenters.” Their gut bacteria make vitamin B12, but only after the food has passed through the part of the intestine where the vitamin B12 can get absorbed. Rabbits solve this problem by eating some of their own droppings. Wild mountain gorillas sometimes do the same thing, usually during periods of bad weather. Captive gorillas do it a lot more often, possibly because they are bored.

On the other hand, gorillas and human beings can eat foods that already contain ready-made vitamin B12. For gorillas, that means tasty, tasty termites, which get vitamin B12 from their own gut bacteria. Modern human beings who don’t want to eat termites, or any other animal products, can get their vitamin B12 from a nice, clean, and very cheap supplement. As long as their gastrointestinal system is healthy, people can even take their vitamin B12 by mouth. Vitamin B12 shots are useful for people who have trouble absorbing vitamin B12 from their food, because of gastrointestinal disease.

Stupid Nutrition Quiz From LiveScience!

I just saw this “nutrition quiz” from LiveScience:

Most of the questions are misleading, and some of the answers are downright dangerous!

A “good” type of fat is …

  1. Hydrogenated oil
  2. Monounsaturated and polyunsaturated fat
  3. Trans fat and saturated fat

Their answer: Monounsaturated and polyunsaturated fat

My response: This is a misleading question, and a dangerous answer. Hydrogenated oil contains trans fat and saturated fat, so the first and third answer are really the same. The only one left is “monounsaturated and polyunsaturated fat,” which means that there is no “correct” answer to this question.

A reasonable question to ask is which kinds of fatty acids are essential in the human diet. The answer is omega-6 fatty acids (such as linoleic acid) and omega-3 fatty acids (such as alpha linolenic acid). Both of them are polyunsaturated. However, you only need a tiny amount of either one in the diet. The optimal level of omega-6 fatty acid in the diet is probably about 2% to 4% of total calories. The optimal level of omega-3 fatty acid in the diet is similar.

All kinds of fat: monounsaturated, polyunsaturated, saturated, and trans, can be incorporated into the plaque inside your arteries. Rather than eating supposedly “good” fats, people need to strictly limit their fat intake and to eat lots of leafy green vegetables. Tragically, the American Heart Association is using some stupid cartoon characters to encourage people to eat monounsaturated and polyunsaturated fat instead of saturated and trans fats, when they should be telling people to limit their fat intake to less than 10% of total calories, or until their total cholesterol level drops below 150 mg/dL.

Some benefits of a vegetarian diet that includes dairy products are …

  1. An ample supply of vitamin B12
  2. A lower intake of saturated fats
  3. A reduced risk for chronic disease such as heart disease

Their answer: A reduced risk for chronic disease such as heart disease.

My response: This is another stupid, misleading question. Do they mean what would be the advantage of adding dairy products to an otherwise purely plant-based diet? Then “an ample supply of vitamin B12” might be reasonable, but they consider that answer to be “wrong.” Vitamin B12 and vitamin D are the only essential nutrients that aren’t available from a purely plant-based diet. Unfortunately, adding dairy products to an otherwise purely plant-based diet raises the risk of serious disease, including heart disease. Even if you add nonfat dairy products, that means that you are adding extra dairy protein, which raises the risk of diseases ranging from type 1 diabetes to various cancers. If you want to reduce your risk of chronic disease, such as heart disease, you remove all animal products from the diet and take a vitamin B12 supplement.

Which vitamin can only be obtained from sunlight and supplements?

  1. E
  2. K
  3. D

Their answer is D, which is correct. Score one for them!

Nuts are …

  1. Fattening no matter what
  2. High-calorie but good for you in small doses
  3. Mostly full of trans fats

Their answer is: High-calorie but good for you in small doses.

My response: How small of a dose? An ounce? Nuts are a concentrated source of many nutrients, but they are terrifically high in fat. They are one of the fattiest foods on the planet. The exception is chestnuts, which some people call “the grain that grows on trees.”

Low-carbohydrate diets can put you at risk for …

  1. Insufficient nutrients
  2. Gaining weight
  3. Osteoporosis

Their answer is: Insufficient nutrients.

My response: The correct answer is osteoporosis! The calories in our diet come in the form of carbohydrates, fats, protein, and alcohol. When people talk about “low-carbohydrate” diets, they generally mean diets that are high in protein, as well as fat. The protein and fat typically come from animal sources. Unfortunately, the heavy doses of animal protein cause a mild form of metabolic acidosis, which is a major contributor to osteoporosis. That’s why osteoporosis is so common in societies where people eat lots of dairy products but rare among people who eat a mainly plant-based diet. Fruits and vegetables are rich in minerals and thus have a net alkalinizing effect.

Peas and beans are good plant sources of …

  1. Protein
  2. Monounsaturated fat
  3. Cholesterol

Their answer is: Protein

My response: Yes, peas and beans are rich in protein, but virtually all plant-based foods, except for some fruits, provide more than enough protein. Human protein needs are actually so modest that they are easily met by virtually any plant-based diet. It’s difficult even to design a diet that would provide enough calories but not enough protein. You’d have to eat nothing but apples or other low-protein fruit, but hardly anyone even thinks of doing that.

A primary risk factor for diabetes is …

  1. A high-sugar diet
  2. A low-carbohydrate diet
  3. A high-calorie diet

Their answer: A high-calorie diet.

My response: What kind of diabetes? The devastating type 1 diabetes that results from pancreatic failure and has to be treated with insulin replacement? The evidence is now overwhelming that it results from an autoimmune response triggered by a particular protein in cow’s milk. (No, I don’t think that goat’s milk is a safe alternative.) Or do they mean the most common form of diabetes, the milder form that occurs in fat people and goes away by itself if they eat better and exercise more? That has been linked to a high-fat diet, in particular. High-fat diets promote insulin resistance, and starchy diets promote insulin sensitivity. Switching to a starchy, high-fiber diet essentially cures type 2 diabetes, even if people eat until they are satisfied and make no effort to limit their portions.

Eggs with brown eggshells are …

  1. Healthier than eggs with white eggshells
  2. Made by a different breed of hens than eggs with white eggshells
  3. Better for baking than eggs with white eggshells

Their answer is: Made by a different breed of hens than eggs with white eggshells

My response: Eggs are chock-full of fat and cholesterol and have way too much protein. You’d be better off without them in your diet. Besides, the conditions under which the chickens are kept nowadays are frightfully unsanitary and inhumane.

The USDA recommends at least how many daily ounces of whole-grain bread, rice and the like?

  1. 3
  2. 5
  3. 10

Their answer is: 3.

My response: Who cares what the USDA recommends? The purpose of the USDA is to promote agriculture, not to promote health. Therefore, the National Institutes of Health, not the USDA, should be making the dietary recommendations.

Skipping breakfast is a good way to …

  1. Gain weight
  2. Curb your appetite later in the day
  3. Lose weight

Their answer is: Gain weight

My response: People who eat frequently can lose weight faster, but only if they’re eating the right kinds of food. Why worry about when people eat when the problem is what they are eating?

This Just In: Extra Calories Make People Gain Weight!

Eating More Fructose Than Nature Intended Is Also Probably a Bad Idea

I recently read an article about a study that supposedly found that high-fructose corn syrup had a different effect on the body than did “regular sugar.” This made little sense, because high-fructose corn syrup is only slightly higher in fructose than table sugar is. In fact, the study said exactly nothing about any difference between table sugar and high-fructose corn syrup. On the other hand, it did say that drinking a lot of sugar water can make you gain weight really fast.

During digestion, table sugar is rapidly broken down to a 50:50 mixture of two simple sugars: glucose and fructose. High-fructose corn syrup is a 45:55 mixture of glucose and fructose. Not much difference. However, the study wasn’t a comparison of high-fructose corn syrup versus what an ordinary person would think of as “regular sugar,” it compared huge doses of pure fructose to huge doses of pure glucose—a major difference.

In reality, the study showed three things. First, people can gain weight really fast if they drink a huge amount of watery syrup, which provides a lot of calories while doing very little to satisfy the appetite. Second, a calorie is a calorie. People gain weight just as effectively if they get extra calories from fructose or glucose. Third, fructose has different effects on the body’s metabolism than glucose has, but we already knew that. None of these results were surprising, so none of the findings of this study were actually newsworthy to the general public. The journalists who wrote about this story made it sound newsworthy by misinterpreting it.

Thanks to the magic of the Internet and the National Library of Medicine, I was able to find the actual article for myself. The subjects in the study first spent two weeks in a clinical research center, eating “an energy-balanced, high–complex carbohydrate (55%) diet.” Of course, 55% of calories from complex carbohydrates isn’t “high” in complex carbohydrates by my standards, but so what?

After spending two weeks eating the controlled diet, the subjects were sent home for an eight-week outpatient study, in which they were allowed to eat whatever they wanted, as long as they drank enough of a sweetened beverage to give them 25% of their calorie requirements. Some of the subjects were given a beverage sweetened with pure fructose (not high-fructose corn syrup), the others were given a beverage sweetened with glucose.

As a result of guzzling all that sugar water, the people in both groups took in more calories than they needed. In fact, people in both groups took in roughly the same number of extra calories and gained roughly the same amount of extra weight as a result. That wasn’t surprising, although it was interesting that the extra fat tended to get deposited in different places, depending on which kind of sugar was consumed. Nor was it surprising that the fructose beverages caused spikes in the amount of fat (triglycerides) in the blood after meals. Scientists already knew that fructose does that. They’ve also known for decades that high levels of fat in the blood contribute to insulin resistance, which in fact occurred among the people who drank all that extra fructose.

Although the study does suggest that eating too much fructose can be bad for you, it didn’t say anything about whether high-fructose corn syrup was significantly worse than table sugar. In fact, a commentary that accompanied the article said, “It is not known whether the adverse effects of sucrose and HFCS consumption are ‘diluted’ by their lower fructose content relative to pure fructose.” The commentary does make it clear that if you are eating too much fructose, you probably aren’t getting it from eating too much fruit. “One would have to eat vast quantities of fruits every day in order to ingest metabolically adverse amounts of dietary fructose.”

The take-home message for consumers wasn’t clear from the news accounts, but it’s very simple. It’s hard to overdose on fructose from eating fruit, but drinking syrup-water isn’t good for you.