I did some researching via yon Google machine and discovered that nearly everyone with gout (or gouty symptoms) have an overall acidic pH. You’re reading this thinking “no shit, it’s uric acid crystals developing in the joints.”

Here’s what I did about it (standard caveats, YMMV, etc): baking soda. I discovered this during a flare up. It was recommended to take 1 tsp every hour with water until the condition resolved. It’s nasty and users will want to wash it down with even more water but I swear by it. I used urine pH strips to check acidity during the flare up and for a month after. pH was high during, came down rapidly with the baking soda and the gout resolved shortly. As long as my pH stayed near neutral the gout stayed away. During this month I experimented by stopping the baking soda treatment, but drank the same quart of water at the same time of day that I normally would when taking the baking soda (in case it was just the extra water that was helping). I didn’t change anything else. pH went back toward acid and the early onset toe pain started up within a couple of days. I went back to baking soda. Once the gout seemed to resolve I kept taking one tsp per day as a precaution, until I started to forget to take it (this probably only took another month- how quickly we forget).

My diet significantly improved a couple years ago, moving very close to paleo (thanks to a local CSA and a bunch of my wife’s home cooking) and about two months ago I went about 98% paleo. I only used the baking soda about once a month during the diet improvement phase, and not at all since going paleo.

http://www.fourhourworkweek.com/blog/2009/10/05/gout/

Bottom line – it appears to be fructose. As always with both Gary and Tim Ferriss – worth a read.

http://www.genesmart.com/pages/omega-3-index/80.php

90% relative reduction in risk for the highest quartile vs the lowest quartile. Almost sounds too good to be true, but it was reported by Dr Davis and Stephan Guyenet, and anyway of those two I have a lot of respect and deference towards Stephan.

I almost wonder what happens if you combined the omega-3 index with the hba1c test to make a combined predictor. I wonder how much they correlate with each other — my guess is they do somewhat due to the liver’s role in managing blood glucose and the liver dysfunction caused by high omega-6.

http://pubs.niaaa.nih.gov/publications/arh21-1/76.pdf

I was curious about fish oil dosing. I understand the formula, and have been keeping my wife and I on .5g per 10lbs. Should there be a different dosage for someone who is eating 90% paleo as opposed to someone on the SAD? It seems to me since we’re taking in less omega 6, that we don’t need as much omega 3 to balance it out, but I wanted to see what you have to say on this. Thanks!

-Mike

Pleased to hear (from latest podcast) that you may have some discussion in future with input from an immunologist specialist on autoimmune conditions.

Going to cut dairy right back and go genuine paleo from April to test impact of systemic inflammatory reduction on the ‘acute persistent’ allergic rhinitis (hayfever) that destroys my waking and sleeping life for two months every year (June/July – grass pollen) – in last few years its taken on an asthmatic effect too, never realised how bad that is and I only get it as a mildly.

Mega doses of dr prescribed antihistamines (which the chemist always queries due to being beyond the pharmaceutical manufacturers recommendations) do very little. I’ve tried large doses of Quercitin, Vit C and nettle – all to no avail. The only relief I get is during exercise – especially intense met cons.

I’m thinking maybe only moving to a desert somewhere may be the only cure. With added bonus of more sunshine. Any supplemental tips, thoughts greatly appreciated.

Looking fwd to yr book, keep up the great work.

CHOLESTEROL 262
TRIGLYCERIDE 54
HDL 112
LDL CALCULATED 139
CHOLESTEROL/HIGH DENSITY LIPOPROTEIN 2.3
Direct Measure LDL 123
BUN 27
GLUCOSE, FASTING 92
CREATININE 1.3
GLOMERULAR FILTRATION RATE 64-NB

My BUN levels were high (in relation to what they suggest are normal levels @ 19) but I assume that this is due to a high protein diet?

Thanks

Josh in NEVADA

jared

Maybe you can use this in the podcast. Can you expand on how leptin and other hormones work when it comes to hunger? I’m finding it hard to do the unweighted unmeasured paleo gig, and I can’t seem to eat to satiety. I can eat till I’m stuffed but then I’m uncomfortably stuffed, there’s no in between.
Also I notice that if I don’t make a meal with some sort of starchy carb source (yams, squash, etc) I get RAVENOUS an hour after I finish eating, I get hungry like all hell and some times I’ll even get a head ache. This can be from meals ranging from 500 to 2000 calories in a sitting, doesn’t matter. These meals generally include a good bit of protein, fat and 4-6 cups of cooked veggies. If I add to that some fruit or a yam, then the post eating hunger isn’t as bad. If I push through the hunger pains I’m usually good for a few more hours, but that initial hit sucks hard.
I’m 5’10” 180# at about 13% BF and have been strict paleo for the last 6 months save for a few cheats a month. I do MEBB style WODs 3-5 times a week. I’m also coming off of weighing 240# a year ago and being completely metabolically deranged. Not sure if that matters. The promise of hunger free paleo eating has eluded me thus far.

Thanks, can’t wait for the book and keep fighting the good fight.

Robb, take a look at this. A cursory explanation of the Seattle syndrome and seasonal changes, carb cycling, etc. from a Chinese medicine perspective. http://www.acupuncture.com/nutrition/5elemdiet.htm

Last I checked my fasting sugar after a shitty night sleep on the ambulance was 75mg/dL after 2 months of Paleo, so it is hopefully actually lower than this because of the extra Cortisol from no sleep. 2 years ago I did the same test and my fasting was high 80's after a good night sleep. That is pretty sweet. Bodyweight has always been the same, just better hormone responses!!!

Thanks for the info.

I’ve heard you talk about pH imbalance that tends to exist in our bodies, and how we usually need to move towards a base instead of an acid state. In regards to this how do you think bee pollen or royal jelly work at doing this? I’ve read a few articles promoting these supplements as a way to “balance” the pH of your system. Your thoughts?

Thanks
Wayne (podcast listener #9)

Other questions about BO aside, Azithro is a cheap antibiotic. If your friends are paying more than $1.25/pill (without insurance) they need to shop around. A typical (5 day, 6 pill) course of Azithro can be had for $7.

Probably a paleo diet is just as cheap….

Many thanks for the podcasts and getting this info out.

I’ve asked several folks regarding using Stevia as a sugar replacement, and most folks have given me very vague response. If you would, can you please address this.

Unlike standard type II diabetes, GD develops over a fairly short period of time. From what I understand, it is the placenta really coming on board to support the pregnancy mid-second-trimester that causes the insulin dysregulation. As A1C is a marker of hyperglycemia over the life of the red blood cell (avg age 60 days/8wks). It is a good marker for hyperglycemia long term but not short term. I would think that a significant change in A1C for a pregnant woman is going to happen weeks into GD, therefore causing weeks worth of undetected hyperglycemia, excess infant growth.

I know there are a number of studies that show that women diagnosed with GD have abnormal A1Cs, but there is a fairly fine margin (>5.7 vs nl being <5.5). The natural relative hypoglycemia that happens during pregnancy also confuses the A1c results. (If a fasting blood sugar has been 80 for six weeks, then 140 for three weeks, then an A1C reflecting an average BG of 100 makes the woman look normal, when in fact she is exposing her fetus to dangerously high sugar levels.) I think the women with GD and abnl A1Cs likely have preexisting glucose intolerance. What you really need to capture are the women with normal glucose metabolism pre-pregnancy with disorder during pregnancy.

Also, the diagnosis of GD based on a GTT is not a devastating one that has to lead to tons of intervention. (Well, if you are having a very medically managed pregnancy, this might lead to prejudice on the account of your providers, causing them to hastily intervene in labor 'cause you got a gigantic diabetic baby in there.'). The typical first step in GD management is BG checks and diet counseling. A person who is diagnosed with GD because of pseudo-glucose intolerance from a low insulin diet, is going to have normal BG checks and no further intervention will be necessary.

This is a very wordy note, but the short version: (and I would love to hear your response) — A1C Bad for diagnosing true GD and No Big Deal with (false) GD diagnosis if you are eating a paleo diet to start out with.

a friend asked me about it and I want to go to him with a solid answer. Things I’ve thought of: company just wants to sell their genetics diet kit, body weight is not the only marker for health, low fat diet can lead to other complications involving the brain, joints, etc., high carb diet can lead to all sorts of problems….

I have not been having very good luck with your magnesium(natural calm) suggestion. I take it before I go to bed, mix it with hot water like it says, and for the life of me, I have the toughest time waking up the next morning. I have been hitting the snooze for hours on end and skipping my morning workouts. And it really bugs me becuase I know if you have trouble waking up in the morning, ur not recovered enough, but this only seems to happen on the nights I take magnesium? I completely frustrated, hope to your reply soon.

Jared

Prior to being Celiac, I did eat well, very zone-paleo-ish. However, my cheats always included gluten (ie: beer, pizza, bread). Since I have been 100% strictly off gluten and following the Paleolithic way of eating, I have since gained 10 lbs. Is this normal? I am currently not following a zone-paleo method because I got too neurotic with weighing and measuring…it was not a healthy mindset for me. Currently following just Paleo, I truly do not feel that I am eating in excess, my mouth is my mouth and not a vacuum, food is just fuel…I don’t have emotional connections to it. However, my questions stem from the weight gain.

Here is my background information: I am 135 pounds at 5 foot 6 inches and in my mid-30s. I follow more of a max effort box / CFFB type of training. I train about 4 days a week doing a strength session followed by a short metcon. I supplement with pharmaceutical grade fish oil, magnesium, vitamin D and C, and glucosamine. I have completely cut out my dairy and gluten. I eat grass-fed meats (love my farmers), fish, veggies, fruit, and very few nuts. My fats mostly come from olives, avocados, coconut oil, and olive oil.

Questions:
1.Do you think the weight gain may have to do with my body being undernourished for so many years due to the auto-immunity shut down by having gluten in my system? At first, I thought this immediate weight gain was a normal transition, but the weight is still staying on.
2.Although I feel better and am performing better, I am not happy with how I look. I now have a small pudgy middle. I do realize the realities of life, I have had several children, however….how do I get back to my desired weight without going neurotic and totally psycho about weighing and measuring OR is there something to cut out or supplement to help with this process?
3.Should I alter my approach to training and add in more metcon?

I appreciate your help. I am confused as to how to approach this problem, as I AM healthier now and feeling great, but I don’t like the portion of “looking good naked” at the moment. Any thoughts or suggestions would be greatly appreciated. Thank you and please realize you do so much for this community and it is greatly appreciated. Sorry for the long blog question. Listener #8????

Robb,

Would love it if you could comment on the phenomenon of mast cell degranulation, pseudoanaphylaxis, and IgG-mediated allergy as opposed to “classic” IgE-mediated allergy.

It’s all the damn immune system! And the solution is avoiding inflammatory foods….I just can’t help myself but to seek answers. I just saw something about how some people can have anaphylaxis-like reactions to eggs that are not IgE-mediated. Apparently egg whites are “potent histamine liberators” and some people are so sensitive to histamine that they have symptoms that are as a practical matter indistinguishable from anaphylactic shock. See here http://en.wikipedia.org/wiki/Egg_allergy#Egg_white_intolerance

I’m wondering what the connection may be between IgG reactions, oversensitivity to histamine, and autoimmunity originally caused by GLUTEN.

In that case, the desensitization process might have no benefit and just make someone suffer.

Interesting.

Thanks for another great podcast. I look forward to them every Tuesday.

I also attended your seminar on Saturday and loved it. I am in trouble, however, having PROMISED a friend that I would get a recommendation on the best ‘bang for the buck’ protein and/or whey supplement for a hard gainer. He does CF and is close to 100% paleo but suffers setbacks with unscheduled events like S.W.A.T. callouts. Any suggestions would be greatly appreciated.

Robb, interesting legislation in NY about banning/limiting salt in preparation of foods in restaurants.

Another great podcast – thanks heaps to you and Andy for the work you’re doing on the show and all the great information you’re providing. It is very much appreciated and anticipated every week.

I have a few questions regarding insulin and leptin.

The first question is regarding the insulin response to larger meals and how much does it negate the enhanced insulin sensitivity brought about by decreased meal frequency? I’m asking because if we know the size of the insulin spike is determined by the composition of the meal, the size of the meal and the frequency of eating (since the insulin stimulated by the last meal will take about 3 hours to dissipate) there seems to be a fine balance between eating less often (and therefore eating more at each meal) and eating more often (and eating less at each meal).

I’m not suggesting we go back to eating 6 meals a day but I’m wondering if people who are trying to lose weight might be better off to eat say 4 meals instead of 3 because they would then eat less at each meal and have a reduced insulin response. Assuming the meals are evenly spread out through the day they could still get 4 hours between feeds and maintain some insulin sensitivity that way. Could there be a caloric figure per meal above which you may be better off inserting an additional feeding rather than taking in too much at one sitting?

My second question is regarding leptin. You’ve mentioned it a few times on the podcast but I’d love to hear you talk some more about it because I’m a little unsure of the mechanism by which it regulates apetite and also how leptin resistance may in fact cause insulin resistance.

I know leptin and ghrelin are both involved in apetite regulation but if leptin is a signal sent from fat cells to the brain to let the nervous system know how much fuel is in the tank I would think it would take hours following a meal for the fat energy that becomes available to top off the fat cells by the time it is digested, absorbed and directed by the liver. I’m thinking maybe ghrelin is more related to acute apetite regulation, ie the stomach is full, and leptin is more related to chronic apetite regulation, ie the fat cells are full or empty. Is this right?

I’m also wondering how leptin resistance may cause insulin resistance. I always thought insulin resistance was a simple scenario of decreased sensitivity brought about by too much insulin caused by too much of the wrong food too often. Do we need to complicate it by adding leptin into the equation? Or does it even matter if the fix for leptin resistance is no different from the fix for insulin resistance?

I would love to hear your thoughts on the issue as my current limited understanding has been gained by people trying to sell books on the topic – I felt they may have been overstating the importance of it in order to sell their angle. Any unbiased info would be greatly appreciated.

Once again, thank-you guys for the podcast and for the site, it’s a great resource and is very much appreciated. I look forward to next week and I also look forward to the book release.

Thanks,

Ryan Walsh

My training and nutrition (been following Paleo and listening to your suggestions on the podcast) is appropriate now. I will be getting another bone scan in a few months and I hope to see and improvement, if at all possible… if not I just hope I have not slipped into the osteoporosis category. Will more D3 help?

can marijuana have an effect on performance? even if it is not smoked?

Can you post that A1C study. I asked for a A1C test to be standard for annual lab values for our Fire Department physicals but apparently they weren’t important enough. Can you elaborate on the normal values for this test and what normal would be for a paleo eater with good insulin sensitivity. Thanks

and a billion thanks to you both for the EXCELLENT podcasts. I’ve been listening trough them now several days in a row (loving my iPod for it) and learning constantly new things as well as remembering and expanding some that I already knew. Especially interesting to hear your go for the Biosig.

Haven’t yet listened this new one and I’m saving it for tomorrow… Gonna treat myself with it after a hard workday tomorrow!

Just wanted to ask whether you’ve read the book Primal Body, Primal Mind by Nora Gedgaudas? I recently read it and was quite impressed by it. It’s almost in a line with the paleolithic approach with some additional (at least for me) info regarding longevity. Such as: the more insulin you’re body makes, the “older” you get. As in the opposite way: the least insulin you’ll manage to get by the “younger” you’ll stay (meaning naturally the different signs of aging such as cellular death et cetera). This would translate for example into not drinking coffee due to it’s insulin raising effect and I KNOW that you’re (until proven otherwise) sticking with some quality espresso and full-fat cream. ;-D

So a bit confused here, glad if you’d like to share your view on the scientific reliability of the book which I totally bought. I use the paleolithic approach as the main “tool” when coaching my trainees into better eating habits and been now using the info from Nora’s book as well.

Btw, love your longevity – health – performance -trinity, helps setting goals and to explain the differences in fine tuning with different people.

Was wondering if you could comment quickly on the efficiency in your opinion of any of the alternative therepy stuff out there. Im thinking more along the lines of acupuncture, colonic irrigation, and chinese medicine as opposed the more fairy stuff like homeopathy/chakra!

Thanks
Kevin

Just thought I’d say thanks for the podcasts. Loving the material.

I was just looking over an article in The Journal of Strength and Conditioning (from NSCA I believe) from last month. It was about a low-carb diet being better for losing fat and maintaining muscle mass versus the standard low fat diet.

Looking over “low carb” diets and even “very low carb” diets, some have between 10 and 30 grams of carbs in a day or less. How are people eating any decent amount of veggies in that situation? Even a spinach salad with broccoli and a pepper might add up to that much… and that’s only one meal.

I’m trying to connect being able to eat protein and fats essentially with reckless abandon while also consuming enough veggies and fruit to counter the acidic load of those foods.

Whatya think?

Thanks again!

Along the lines of peanut allergies, do you have any insight into what has caused the apparent increase in peanut allergies among kids? From what I hear there are now peanut free rooms they put kids in so they don’t get exposed at schools! I don’t remember anyone I went to school with having a peanut allergy let alone one so severe they need a separate room.

I have done some looking online but haven’t found any compelling studies about it.

Love the podcasts. Thank you so much for doing them. I have a question I hope you can field. A staple of my diet is organic free-range chicken (Whole Foods, TJ’s). WF posted that their chicken is fed a diet of soy and corn. Given the negative impact of both of these items in a human diet, is eating chicken raised on this diet problematic? Would I be better off ditching the chicken and switching almost exclusively to grass-feed beef (Bison)? Thanks.

Tim

Just wanted to drop you a note of thanks. I was at the PSS this past weekend at One World, where I am also a trainer and the info was awesome. You have an innate ability to talk in layman’s terms and not dumb down the information at the same time.

I really love the importance you put on rest and sleep. It’s so overlooked and so important. I’ve got the eating pretty dialed in but as a teacher and a father with a six and seven year old daughters, I am sloppiest with my sleep habits. Thanks for the constantly hitting this topic on Saturday.

Great podcast as usual. Hadn’t heard about that peanut-allergy study until listening to today’s podcast but interestingly enough I recently read about a similar study that took the same approach to helping kids overcome an egg allergy. Just thought I’d pass along the link for those interested:

http://www.sciencedaily.com/releases/2010/02/100228203038.htm

Keep up the great work!