Detox, Antioxidants, and Scurvy: Protein Beats Plants

This blog post is an updated and slightly edited version of on of my 'facebook essays', which were comments  written as normal comments in facebook but ended up being really long and more like essays. I saved the links to their original posting and plan to go through them all and update and neaten up, etc, them then post them here. This one has been done first as a friend requested a copy to sent to someone else.

I'm stick and tired of people telling me the body can't detox without 'fruit and vegetables'. So I guess that's why water fasting doesn't work? :P

The body has many systems for detoxing and even makes it's own anti-oxidants which are many many fold more efficient that any from food. One thing the body does need though, for detoxing, is quality protein. The liver is the main detoxifier of the body and requires protein to do so. A good example is Campbell's rat studies, the high-protein rats got PRE-cancerous lesions, but the low-protein rats ALL DIED!

The body's biggest anti-oxidant is glutathione.

Some foods have it but dietary absorption is very poor, we have to make our own. Glutathione is made from cysteine, glutamate, and glycine, and needs the mineral selenium. Cysteine is best found in animal foods, especially organs, and is practically always deficient on a vegetarian/vegan diet. Glycine is the major amino-acid of gelatin (along with proline), and most other proteins are low in glycine. Gelatin's best sources are feet/hooves, skin, heads of animals, made into broth. Glutamate is non-essential and readily available as long as you're eating enough protein, additionally most protein sources are rich in glutamate. Selenium's best animal food source is kidneys, and best plant food source is brazil nuts. Most people don't get enough selenium, additionally the USDA RDA is 55ug, but studies show that 200ug is a much more appropriate intake. Studies on vegetarians/vegans show very low glutathione levels, as the two out of the three amino-acids required to make it are found in animal foods.

Cysteine is a double-edged sword, it's very good for us, but bacteria also use it. Glutathione locks cysteine up so bacteria can't get it it, but our cells can easily unlock it. This is why supplementing cysteine can be dangerous, unless it's as N-acetyl-cysteine which is another 'locked up' form that greatly increases glutathione levels. Other things that boost glutathione levels are raw whey (not powdered), alpha lipoic acid, and milk thistle. Vitamin D also increases brain glutathione levels.

Glutathione is needed to excrete many toxins through bile, to form leukotrienes (which are fatty based signalling molecules formed from arachidonic acid (also only found in animal foods)), it prevents oxidative damage by being a co-factor for glutathione peroxidase AND detoxing methylglyoxal, a by-product of glycolysis (burning glucose for fuel) and lipid peroxidation (from excess PUFAs). Methylglyoxal is linked to arterial atherogenesis and it oxidises LDL.

Low glutathione levels are also strongly implicated in muscle wasting, as seen in cancer, AIDS, sepsis, trauma, burns and even athletic over-training. Supplementing glutathione in AIDS increases survival rates. Disorders such as schizophrenia, depression, and bipolar also feature low glutathione levels and data suggests oxidative damage (from lack of glutathione to protect against oxidation) can be the cause of these.

The second biggest anti-oxidant is uric acid.

Yes, too much causes gout, but the slightly increased levels on a meat heavy diet are good for us. It seems that ascorbic acid (vitamin C) and uric acid have the same functions and are possibly opposed to each other. Those on an all meat diet don't get scurvy and uric acid is likely why, as it has huge anti-oxidant capacity and is increased when you eat a lot of meat. It seems you need a lack of both uric acid and ascorbic acid to get scurvy.

Natural plant food sources of vitamin C have phytochemicals called 'xanthine oxidase inhibitors' that lower uric acid production (as xanthine oxidase produces uric acid from protein), and it seems that the body prefers to use either ascorbic acid or uric acid. This may be why refined fructose is so dangerous, as fructose itself greatly increases uric acid to gout-causing levels. Natural fructose as found in fruit though, has lots of vitamin C and xanthine oxidase inhibitors which will counter-act the uric acid increasing properties of the fructose, but excessive consumption of even natural fructose, not just refined sucrose and HFCS, can lead to gout as the uric acid raising properties of fructose is slightly higher than the uric acid lowering properties from the xanthine oxidise inhibitors in the fruit. The uric acid increase from meat though is not enough on it's own to cause gout though.

[Update: In fact the genetic mutation that means we can't synthesise ascorbic acid makes fructose more fattening and dangerous to us, some scientists theorise that this is done so that we could use fruit to fatten ourselves for cold winters more efficiently; this is bollocks, it's much more likely caused by a lack of dietary fructose rather than abundance. Why on earth (or any other planet with life :P  ) would evolution favour a mutation that makes an animal's food dangerous to it? Indeed getting fat before winter can be seen as an advantage for survival but the mutation also means that fructose is more efficient at causing insulin resistance, diabetes, obesity, cancer, gout, etc, none of which would give a survival advantage. A diet high in fruit/fructose for the purpose of getting fat for the winter, when you have this mutation, gives a very high risk of gout, which can be crippling! As our diet changed from a frugivore to a near-carnivore one we lost our ability to handle fructose as well, while finding another substance with which to replace the ascorbic acid. Ascorbic acid is made from glucose, uric acid is made from protein; you can clearly see why we changed out antioxidant as we changed our diet.]

Taking isolated or synthetic ascorbic acid, which lacks the inhibitors, will result in high uric acid and high ascorbic acid levels. The uric acid will not be lowered (as it's not the ascorbic acid that does that), and so gout will still occur. Some vitamin c supplements have added 'bioflavonoids' or 'quercetin', both of which are xanthine oxidase inhibitors and with thus lower uric acid levels. I'm not aware of any problems caused by having high uric and ascorbic acid levels at the same time though, just that plain vitamin c will not help lower uric acid levels in of itself.

This really emphasises why foods sweetened with HFCS (or even sugar) are so dangerous. It seems nature supplies to antidote with the poison in regard to fruit. But then that begs the question of why eat the poison in the first place? It seems uric acid is a safer option over ascorbic acid as it doesn't come with so much 'baggage'.

Uric acid is a HUGE reason why Arctic explorers eating just meat did not get scurvy but those sneaking biscuits got it (and recovered when the biscuits where thrown away), also sailors (whose diet was mostly biscuits, rum, and salt beef)... Phytic acid is a xanthine oxidase inhibitor! Thus they got scurvy due to the lack of uric and ascorbic acid. With sailors the scurvy was remedied through fresh fruit (or sauerkraut in the case of the Germans), supplying vitamin C. But they would've got equally good results by removing the biscuits from their diet (and possibly also the rum as alcohol and fructose are metabolised the same way by the liver, but the sailors would never allow that!).

Thus scurvy is not a disease of lack of vitamin c but a combined lack of ascorbic acid and insufficient uric acid. Supply either will cure scurvy, thus gout suffers are highly unlikely to suffer from scurvy as well. Removing xanthine oxidase inhibitors from a diet rich in fresh protein will cure and prevent scurvy. Adding fresh fruit or vegetables to a sailors diet did not always cure scurvy though, it's quite likely there needs to be a combined effort between uric and ascorbic acid. The fruits and vegetables would supply some ascorbic acid but also xanthine oxidase inhibitors, in addition to those from their biscuit rations, such that the addition ascorbic acid is not sufficient to counter-act the simultaneous decrease in uric acid.

Because natural plant sources of vitamin C often have xanthine oxidase inhibitors, this means that they are poor at preventing scurvy, as they lower uric acid more than they increase ascorbic acid in terms of anti-scorbic potential. Animal sources of vitamin c, including raw liver, spleen, adrenal glands, and blubber, do not have xanthine oxidase inhibitors and so will not reduce uric acid levels; this means they are safe to include when eating a carnivore or meat-heavy diet. Additionally pure synthetic ascorbic acid, without 'bioflavonoids' or 'quercetin' is also safe to take.

It must be noted that there seems to be a difference between fresh and dry meat/protein, as diets of only fresh meat/protein will never produce scurvy, but there have been two cases of scurvy associated with calorie-restricted pemmican-only diets. Pemmican is made of ground dried lean meat mixed with equal amounts of rendered fat. Both these pemmican-only diets that resulted in scurvy though were highly restricted in calories/amount. One case had someone eating only very small amounts of pemmican as their sole diet, while also dry fasting daily (not drinking during the day); the other features chronic diarrhoea from before a carnivore diet was started that continued no matter what the person ate (that is, it wasn't dietary related), although the person was eating plenty of pemmican the diarrhoea meant very little was absorbed and thus yielded again a restricted diet. The presentation of these cases of scurvy were unusual as they did not experience many of the usual symptoms such as loose teeth, the most prominent symptom in both cases were extensive bruising of the legs from damaged/burst capillaries under the skin. Pemmican itself is not the problem though as there is evidence from one family, consisting of a man, woman, and two young boys, who have eaten nothing but pemmican for many years without problems; the two boys were weaned from breast milk straight onto pemmican and ate no other foods. This family though ate large amounts of pemmican, equivalent to 3-4 pounds of fresh meat daily. The difference is amount or calories, the drying process may damage some of the anti-scorbic properties compared to fresh meat, such that larger than expected amounts of pemmican are needed on a dry:fresh weight or calorie basis. Pemmican was traditionally used as a travel food and thus only for short periods of up to a couple of months, and those doing heavy physical work, such as building railways, thus they would have consumed large amounts which would have been sufficient to prevent scurvy. If one is going to eat a pemmican-only diet for a longer period than a couple of months, make sure you eat plenty and drink enough water; under two months doesn't pose a risk, as does eating a mixed pemmican and fresh meat diet.

Mucous not glucose deficiency

I mentioned briefly in my first post on principles of a healthy carnivore diet that mucin is important and which amino acids are needed to ensure proper production, but I didn't go into a lot of detail at the time as to why mucin is important and the full implications of a imbalanced amino acid profile.

I haven't posted on this blog in a long time for various reasons, one of which is that I have been helping my good friend Danny Albers with his facebook page Primal North. Primal North and Mostly Meat Is What I Eat have a very similar view on nutrition, and the two of us have improved each others diets and dietary views through the many conversations I've had with Danny over the last several months. One change I've made is cutting out starches and vegetables, making 'Meat Is Almost All I Eat' as it were, and Danny has started putting gelatin in his coffee.

One topic we discussed was my theory about the truth behind Paul Jaminet's 'glucose deficiency'. Jaminet says that when we was eating a zero carb diet (except he wasn't as he doesn't consider vegetables as calories sources and thus counts what everyone else would call a low-carb diet a zero-carb one), that he experienced several problems including dry eyes, constipation, and a dry cough. Jaminet even claims that people die of starvation because of the dry cough they develop: "A clue is the fact that starving people develop a hacking cough in their final weeks of life. Despite blood glucose levels in the normal range, they cease producing mucus and their airways become dry and irritated." This is contrary to the well known general cause of death in starvation, which is heart failure. Everyone knows during prolonged starvation your muscle start to waste away, but it's not just your biceps that get eaten, eventually your body starts using the heart (which is a muscle) as well, ultimately the heart becomes so weakened it can't pump blood and you die of heart failure.

Danny rightly points out that a dry cough may be a cause of death in starving people due to a lack of mucous, but that that is in starving people, nutritional ketosis and starvation are vastly different. Yes, both have increased blood ketones and a lack of dietary carbohydrates but that is where the similarities end. A low/zero-carb diet producing nutritional ketosis includes protein, plenty of fat for fuel, vitamins, and minerals. We don't know if this 'dry cough = death' thing is from lack of carbohydrates, protein in general or specific amino acid(s), calories, a vitamin, or mineral. Unless properly tested we may never know, but it's unlikely such studies will ever occur in humans due the the 'death' factor, and animal testing may not be applicable.

Jaminet's answer, which is has stuck heavily too even to the point of declaring ketogenic diets outright dangerous, is lack of carbohydrates. But he even posts this picture showing the glycogen is fully depleted after just 3 days of fasting/starvation. If a lack of carbohydrates where the cause, then one would expect the problems to occur much much sooner, not the final few days of life.

My theory, which I'm fully stating that I do not know to be true but from talking with other people and seeing the difference after they add gelatin to their diet (which is the exact same level of evidence Jaminet has for his 'glucose deficiency' theory, except he states it as outright truth not as a theory, which it is), is that is it not a glucose deficiency but a mucous (or more specifically mucin) deficiency caused by an imbalanced amino acid profile.

Mucin is a glycoprotein, this means it's part carbohydrate ('glyco' as in glucose), and part protein. Jaminet has focused in on the 'glyco' part, I have explored the 'protein' side of things. In my research I discovered that mucin production is highly sensitive the the availability of certain amino acids: cysteine, proline, serine, and threonine. Cysteine is an essential sulphur-containing amino acid, which meat and eggs are very rich in. Proline is a conditionally essential amino acid, which along with glycine makes up most of gelatin. Serine is a non-essential amino acid which is made from glycine. Glycine and proline are very low in meat, fish, organs, dairy, eggs, and vegetarian protein sources; the only decent source is gelatin. Threonine is an essential amino acid, and meat, fish, eggs, and dairy are good sources. On a diet where the protein only comes from meat, fish, eggs, or dairy, there is plenty of cysteine and threonine, but very little glycine and proline.

Gelatin can be found in many foods, not just powdered gelatine like for making jelly/jell-o, in fact about half (update: 25-35%) of the protein in an animal is made of gelatin. But if this is the case, why is meat low in gelatin? Muscle meat certainly is, the gelatin is found in the 'odd bits' as Danny calls them: skin, feet/hooves, cartilage, heads, hair, and nails/claws. Traditionally the whole animal was eaten, not just the meat and even organs, but the 'odd bits' where simmered for days covered with water with some acid such as vinegar or lemon juice added. The acid would breakdown the 'odd bits' and a delicious gelatin-rich broth/stock was created which would turn into a solid jelly/jell-o if put in a fridge. This broth would then be used as the base for soups, stews, sauces, and even drunk straight in times of illness when no other food would stay down. Gelatin is a truly wonderful food, and incredibly healing to the gut as enterocytes (intestine cells that do the absorbing) can feed off glycine directly. Gelatin is also very good for joints, as cartilage is made from gelatin, and in the same way it helps keep the skin smooth and wrinkle-free (could abandoning gelatin-rich broth be the reason for all these 'anti-ageing' creams?), and help your hair grow thick and shiny and your nails strong.

The paleo community has made many improvements over the years, from lean meat to fatty, and more decently the addition of organs such as liver, but is still lacking in the encouragement of making and using home-made gelatinous broth. This is one thing Ray Peat gets right (see here), but both Danny and I very much disagree with his promotion of eating large amounts of refined white sugar.

Please note: all store-bought 'broth', 'stock', and bouillon cubes are nothing like real home-made broth, they are made from flours, salt, MSG, and many other chemicals. There is no substitute for the real home-made stuff.

I also encouragement the inclusion of egg shells along with bones and gelatin sources in broth, as egg shells help boost the calcium content and the membrane includes chondroitin which is also very good for joints.

Lastly, I will point out that there are many factors other than a proper amino acid profile in maintaining moist mucous membranes, such as vitamin A (retinol), saturated fats, choline, cholesterol, and many others. Retinol (true vitamin A) deficiency results in mucous-secreting cells mutating into keratin-secreting cells which results in lesions being formed, in the eye this leads to xerophthalmia and eventually keratomalacia and blindness. Saturated fats are need to form surfactants in the lungs which reduce surface tension so gas exchange can happen, the most common surfactant is dipalmitoylphosphatidylcholine, made from choline and two palmitic acids (a saturated fat); cholesterol also makes up part of the surfactants.

You'll notice that all the nutrients listed for maintaining mucous membranes are only found in animal foods (there is some palmitic acid in palm oil though) so it is highly unlikely that a problem involving mucous membranes results from a lack of plant foods in your diet. Much more likely is that it results from an imbalanced intake of certain animal foods over others, that is too much meat and not enough gelatin.