bipolar disorderTag Archives

Critiques of the science behind plant-based diets

I’ve been reading a lot of blogs about dietary studies. A blog of particular interest is Raw Food SOS by Denise Minger. One of her posts tore apart Ancel Keys’ 22 country data. That data is often cited as proof that dietary fat causes heart disease. By the time Denise Minger got done with it, the data from the 22 countries more likely proved only that richer countries that could afford better medical care were better able to determine cause of death. In other words, the Keys study and data were rendered meaningless.

And another post dissects the movie Forks over Knives and critiques the science in that movie. So far, it isn’t looking good for the movie. Forks over Knives promotes a plant-based or vegan diet. I tried a vegan diet for about three months not so long ago. I ran into problems with it. I began developing a physical form of depression. Fortunately, my mood was still generally good. I had my blood checked, and my cholesterol had dropped too low. The total was 147. My psychiatrist was concerned. He wants to see the total be at least 160. Low cholesterol is associated with depression and other mental disorders. So I stopped being vegan and eventually recovered. As you can tell, I am not a fan of veganism. For me, at least, veganism is a dangerous diet. Generally, though, depression is more common among vegans, so it isn’t just me. One of my lowest total cholesterol readings, 125, coincided with my first round of NutriSystem back in 1990 or so. It also coincided with my diagnosis of bipolar disorder. And that, folks, is why I have adjusted my diet. I’m trying to keep my cholesterol levels from falling. I’ll have blood drawn to test cholesterol on Thursday to see if my strategy is working. I’m optimistic. My mood has been good so far this round.

References:
Denise Minger. The Truth About Ancel Keys: We’ve All Got It Wrong, Raw Food SOS.
Denise Minger. “Forks Over Knives”: Is the Science Legit? (A Review and Critique), Raw Food SOS.
Chris Masterjohn. My Experience With Vegetarianism, cholesterol-and-health.com.
Shin JY, Suls J, Martin R. Are cholesterol and depression inversely related? A meta-analysis of the association between two cardiac risk factors. Ann Behav Med. 2008 Aug;36(1):33-43. Epub 2008 Sep 12.
Michael Pekker. Could Eating A Vegan Diet Cause Depression? Clinical Depression: Symptoms and Treatment.

Adjusting my diet to avoid potential health issues

It’s important to do the best we can with the plan we’ve invested in. That’s certainly my goal. My big issue with the NutriSystem plan is making sure that my cholesterol level doesn’t tank, and I’m not entirely sure how to do that or even if it can be done. One of my lowest cholesterol readings ever was 125. This was measured following a round of NutriSystem back around 1990, and this also happened to be when I was diagnosed with bipolar disorder. I was suffering with major depression at the time. Somehow, I still managed to function. It’s critical that I don’t let my cholesterol get that low again this time because low cholesterol is a risk factor, and I’ve already seen that my mood dips with my cholesterol readings. My cholesterol readings went down when I was vegan, and I was also beginning to develop depression, so there’s a hint. My intake was very high in fiber while I was vegan, and I know that can lower cholesterol. My guess for this round is that I need to lean my intake toward more fat while, of course, staying in calorie range. I will have blood tests done to make sure that my cholesterol levels stay where they need to be. My mood is good at present at least, so that’s a good sign.

Given the unexpected challenges I have had with my own health, I would advise anyone contemplating making a major dietary change to do so with the assistance of their physician, no matter what your age or how good you think your health is.  At minimum, get a lipid panel done before the change and again a month or two into it.

Trying a ketogenic day

I’m looking forward to taking a low-carb high-fat break today. I think it’s going to be good for my mental health, literally. Here’s some background on what I mean by that. I’ve been diagnosed with bipolar disorder. Treatment is working well, so my mood has been even. Bipolar disorder, including my case, is often treated with medications originally developed to treat epileptics. Epileptics are often treated with a ketogenic diet. A ketogenic diet is a low-carb high-fat diet. The ketogenic diet used to treat epileptics resembles the induction phase of the Atkins diet in that it is recommended that patients consume 20g or less of carbohydrates. The resulting diet can get as much as 90% of its calories from fat. There is some conjecture in scientific circles that since a ketogenic diet works for epileptics, it just might work for those with bipolar disorder, too, since the medication is often the same. Tests in rats have shown promise, but the theory has not yet been formally tested in humans. I have tried a ketogenic diet before and felt quite good on it. Since a ketogenic diet works well for weight loss, too, this should not hinder me that way.

References:
El-Mallakh RS, Paskitti ME. The ketogenic diet may have mood-stabilizing properties. Med Hypotheses. 2001 Dec;57(6):724-6.
Murphy P, Likhodii S, Nylen K, Burnham WM. The Antidepressant Properties of the Ketogenic Diet. Biol Psychiatry. 2004 Dec 15;56(12):981-3.

Rethinking dietary advice

What if popular dietary advice was just plain wrong? Mainstream dietary thinking tells us that the number of calories in must balance the number of calories out. They tell us that the best way to make sure that the number of calories in is less than or equal to the number of calories out is to decrease our fat intake. They tell us that we should balance our diet with a certain amount of complex carbohydrates. They tell us that exercise can also alter the equation of calories in versus calories out. So what if all that was just plain wrong? What if the real cause of overweight was metabolic disturbance caused by an imbalance of hormones?

I am currently reading Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health by Gary Taubes which proposes exactly that theory. I am further inclined to believe that metabolic disturbance theory given my own anecdotal experiences. Firstly, I have been diagnosed with bipolar disorder and have consequently been prescribed various medications to treat that. Fortunately, these medications have been effective in controlling the bipolar disorder, but they have also led to side effects, most notably with some of the medications, weight gain. The worst of these medications for me was Depakote, an anti-seizure medication. I gained crazy amounts of weight on this medication without corresponding dietary alteration, so much so that I told my doctor to change the medication or he would have a noncompliance problem on his hands.

More recently, our dog was diagnosed with epilepsy, and Phenobarbital was prescribed to her. Before her seizure episodes and consequent prescription, we were able to feed her as much food as she wanted without her gaining weight. After she started her medication, she started gaining weight on much less food. At first, we cut back on her food to the level prescribed on the back of the bag. When she continued to gain weight, we consulted her vet and decided upon an amount of food that was even less than is typical for an active dog like her at her weight. We have since been able to control her weight at this lower consumption. Given that she is still an active dog and yet must eat less than her peers, we must assume that her medication causes some sort of metabolic disturbance.

In the book, Good Calories, Bad Calories, Gary Taubes puts forward the theory that overweight is caused by excess insulin. Excess insulin, in turn, is caused by excess carbohydrate in the diet. When carbohydrate is restricted, weight loss occurs even when calories are not restricted. The author cites studies in which carbohydrate restricted diets exceeded 3,000 calories a day and yet weight loss still occurred. Actually, they had difficulty getting their subjects to eat this amount of non-carbohydrate food, not due to boredom as has been postulated, but because the subjects had no appetite for higher consumption. Modern dietary advice tells us that all calories are created equal. Gary Taubes puts forward that this is not the case. Carbohydrates are uniquely fattening because they increase the secretion of insulin. Insulin drives the blood sugar into adipose tissue, often depriving the muscle tissue of that energy. This leads to increased food cravings, which are often satisfied with additional carbohydrates. This leads to a vicious cycle in which carbohydrates are consumed to offset an energy deficit that is redirected to the fat instead.

So let’s go back to my medications, particularly the Depakote. So why did Depakote cause such weight gain even though my dietary intake had not increased, and in fact, I was trying desperately to control my weight? As it turns out, Depakote is associated with hyperinsulinemia, which is an overproduction of insulin. Phenobarbital is likewise associated with changes in glucose metabolism. Given these effects, it is not surprising that both I and the dog would gain weight when prescribed these medications.

Recently, Woman’s World published an article promoting the use of coconut or MCT oil for weight loss. I did a little research to look into this further and found out that MCT oil is most effective for weight loss when associated with a ketogenic diet. This is a diet severely restricted in carbohydrates and high in fat. I did a little bit more research and found out that a ketogenic diet is often prescribed to epileptics. I found this particularly interesting because anti-seizure medications are often prescribed to bipolar patients. I wondered if maybe the ketogenic diet had been found effective in treating bipolar disorder. Particularly, I wanted to know if there was any contra-indication advising against a bipolar patient following a ketogenic diet. I found out that the ketogenic diet had been effective in animal studies of bipolar disorder, but that human studies have not been done. Stanford University wanted to conduct a study of the ketogenic diet for bipolar patients, but was unable to find participants for its study. Given what I have read and given my experience, I am ready to be a guinea pig for such a study.