Friday, 23 June 2017

Psoriasis: More than just skin rashes and plaques & joint pain and inflammation.

A complication of Psoriasis is Psoriatic arthritis. The picture below shows what can happen to the feet, toes & toenails. Mine are nowhere near that bad.

From Signs and symptoms:
"Pain, swelling, or stiffness in one or more joints is commonly present in psoriatic arthritis.[4] Psoriatic arthritis is inflammatory, and affected joints are generally red or warm to the touch.[4] Asymmetrical oligoarthritis, defined as inflammation affecting one to four joints during the first six months of disease, is present in 70% of cases."
This is the form that I have, affecting my left shoulder, right hip & right knee. I recently drastically reduced the pain and inflammation in these joints by doubling my intake of EPA & DHA by eating two cans/day of Tesco Mackerel in spicy sauce, instead of one. Occasionally, my hands & feet temporarily swell, causing "sausage-fingers".

I'd completely suppressed my skin rashes and plaques since 2007, by supplementing with 5,000iu/day of Vitamin D3, ~3g/day of EPA & DHA from Sardines/Mackerel & ~400mg/day of Mg from ~4g/day of Epsom Salts spread out over my waking hours.

However, there's this:-
"Along with the above-noted pain and inflammation, there is extreme exhaustion that does not go away with adequate rest. The exhaustion may last for days or weeks without abatement."

I'm lucky in that the exhaustion isn't extreme, but it is significant and it co-incides with a high ambient temperature.

Tackling the exhaustion is a work in progress.

Sunday, 4 June 2017

I'm Mackerel-powered, lol!

I was eating one can/day of Tesco Mackerel in Curry, Mexican, Thai Green & Sweet Chilli sauces:-

Mackerel is very high in the long-chain omega 3 polyunsaturates EPA & DHA. It also has a strong flavour, so I get it in strongly-flavoured spicy sauces. It goes nicely with a can of Tesco Everyday Value Sweetcorn 325G

One Sunday night, I got home from the Ploughdium jam and felt hungry, so I had another can of Mackerel bringing the total to two cans that day.

The next day, I was walking to Short & Sweet coffee shop for my brunch, when I noticed that I'd lost something - the pain in my right hip! The second can had raised my intake of Mackerel-sourced omega-3 fats from an average of 3.5g to 7g! Omega-3 fats are anti-inflammatory.

I started eating two cans/day of Mackerel, to maintain the higher intake. Then I noticed my mood gradually rising...and rising...and rising.

I'm now permanently somewhat hyperthymic. See Omega-3 fatty acids and major depression: A primer for the mental health professional.

Friday, 2 June 2017

Why excessively-rapid weight loss is bad, mm-kay?

Nearly 10 years ago, I wrote Everyone is Different. Back then, I warned about excessively-rapid weight loss, as catabolising muscle results in 5.8 times faster weight loss than losing bodyfat alone.

Recently, I was directed towards the following two studies with very similar titles:-
Change in Body Composition during a Weight Loss Trial in Obese Adolescents
Changes in Body Composition During Weight Reduction in Obesity: Balance Studies Comparing Effects of Fasting and a Ketogenic Diet

In the first study, the following string of text stood out:- "Although absolute LM increased in boys and decreased in girls.." Boys gained absolute lean mass and girls lost absolute lean mass. Teenage boys have much higher testosterone levels than teenage girls. Ditto for men & women.

In the second study, the full version was behind a pay-wall. There are ways to bypass pay-walls, but they're illegal, so I'm not going to include a link to the full version. I took a couple of screen-shots instead.

Here's Table 2.

Note: The Patient was a 104kg (228.8lb) man.

1. 1000kcal/day mixed diet (60%C, 20%P, 20%F) resulted in a mean daily weight loss of 0.38kg/day (0.836lb/day). Mean potassium balance was positive, so there was some net gain of muscle, even though there was weight loss. Muscle, also glycogen+water gain probably explains the low average weight loss

2. 1000kcal/day ketogenic diet (4%C, 14%P, 82%F ≡ "Nutritional Ketosis") resulted in a mean daily weight loss of 0.82kg/day (1.804lb/day), of which 6.4kg was bodyfat and 0.2kg loss was LBM. Mean potassium balance was negative, so there was some net loss of muscle.

3. 0kcal/day total fast resulted in a mean daily weight loss of 1.28kg/day (2.816lb/day), of which only 3.4kg was bodyfat and 6.2kg was LBM. Mean potassium balance was very negative, so there was large net loss of muscle.

Here's Figure 1.

Can you spot what's going on with the Nutritional Ketosis diet? The 14%P made me suspicious, as it seemed unnecessarily precise. There's a reason for that!

At the end of day 4, weight loss due to glycogen+water depletion is starting to slow down as glycogen becomes exhausted, then it speeds up again because falling blood glucose level to ~3.3mmol/L stimulates the pituitary gland to secrete ACTH, which stimulates the adrenal cortex to secrete cortisol, which catabolises muscle into amino acids for the liver & kidneys to use for gluconeogenesis. This speeds up the rate of weight loss for 3 days.

The Energy Balance Equation explains why losing LBM results in 5.8 times faster weight loss.

From Circulating Nutrients in Starvation, here's the Figure.

"Ketone bodies" level rises linearly from near zero to 5mmol/L by day 10 in fasting. It may rise faster on Nutritional Ketosis. As ketone level rises, glucose consumption by the various tissues falls. This is why muscle catabolism stops after 3 days - there's now enough dietary protein to supply the reduced amount of glucose needed to be produced by gluconeogenesis.

This is why protein % was set to precisely 14%. If it had been lower, weight loss would have been greater, but muscle loss would have become significant, which would have made Nutritional Ketosis look bad. If it had been higher, weight loss would have been less, which would have made Nutritional Ketosis look bad.

In conclusion, don't obsess over scale weight. It's just a rough guide. The irony is that the very group who can't regain lost muscle is the same group that often tries every fad extreme weight loss diet going - females.

In females, muscle mass is like a bargain at Tesco - When it's gone, it's gone. Don't do excessively-rapid weight loss diets &/or not eat for more than 24 hours.

There's only one safe rapid fat loss diet and it's The Protein-Sparing Modified Fast (PSMF)