August 23, 2012

Nutritional biochemistry

Hey Peter, what does your daughter eat?

Read Time 7 minutes

If there’s one question I get asked often, it’s this one.  And I understand why.  Anyone who knows me, and knows how obsessed I am with everything I do, knows there is one thing on earth I cherish more than anything else – my daughter.

Any of you reading this post who are parents know exactly what I’m talking about.  My daughter, and I know the same is true for Gary with his boys, is one of the greatest driving forces behind us founding NuSI.  Why?

Picture the United States as a cruise ship.  Overall, it’s a wonderful place to be.  We have so many things to be thankful for (as do many folks outside of the U.S.).  But, there are icebergs out there.  If we continue the course we’re on, our fate will be similar to that of the Titanic.  Unlike the Titanic, though, we actually have several icebergs in our path.  That is, there are many different forces in the world today that – if left unchecked – could easily disrupt our way of living.  I won’t go into detail about what I think the list of potential threats to our economic and social freedoms are – pension overhead, national security, energy security, structural problems with education – but I’ll assert my opinion on the first problem we need to get a handle on.  If we don’t figure out a way to curb the twin epidemics of obesity and diabetes, our healthcare spending alone will bankrupt us.  No one can pinpoint the day this will happen, but if not in my lifetime, I’d bet anything it will be in my daughter’s lifetime.  In other words, of all the icebergs we need to skirt past, this one is the closest to our vessel.

So, back to the question.  While we wait a decade or so for NuSI to fund the type of science that will unambiguously resolve the jugular question — What should people eat to maximize their chances for greatest health? — what do we do?  If you’ve been reading this blog, you’ll certainly have a great idea for what I do, based on my interpretation of the data currently at our fingertips.  But ambiguity remains, especially when asking an even more important question than what do I eat.  Since my daughter (and presumably your children, for those of you with children) is infinitely more important to me than anything else, including myself, how do I interpret current data around what she should eat?

Principle 1: Excess sugar is not conducive to good health for anyone

I don’t think I need to spend any additional time reviewing the harm of sugar (e.g., sucrose, high fructose corn syrup, beet sugar, cane sugar, brown sugar).  If you do want a quick refresher on this, you can read this post. If you can only make one intervention in the dietary pattern of your child, make it this one.  Based on our experience and the experience I’ve had with clients, friends, and family, a trend has emerged.  It seems the longer you wait to make changes in this area, the more difficult it can be.  Not always, but often.  Sugar is very habit forming, and from a neurochemical standpoint an addiction to sugar is not unlike an addiction to gambling, alcohol, or heroin.  Yes, they all have nuanced differences, but each of these addictive patterns or behaviors results in stimulation of the dopaminergic pathways of the brain.

How do we translate this intent into practice?  The easiest thing to do is to minimize the amount of sugar brought into the house.  This means we don’t have soda, cookies, candies, cakes, cupcakes, and other similar nutritional weapons of mass destruction lying around.  This doesn’t mean we never have them lying around.  Invariably, a grandparent or neighbor will bring over a lollipop or some cookies, but this is an exception, not a rule.

Furthermore, we don’t have any juice in our house.  Our daughter (who is 4) drinks whole milk and water.  That’s it.  Amazingly, she no longer finds sweet beverages enjoyable.  Recently, at a birthday party, she was given one of those Capri Sun sugar-syrup drinks.  She took one sip and asked for a bottle of water.  It was actually too sweet for her.

As I explain below, she still gets some sugar in her diet, but it’s probably about 20% of what the average kid her age is consuming.  And she gets plenty of fructose in the form of fruit.  But when she eats fruit, it’s usually lower fructose fruits (e.g., raspberries, blueberries, strawberries) rather than higher fructose fruits (e.g., watermelon, banana).

Principle 2: The less processed the food is, the better the food probably is

As an extension of the first principle, if you always make trade-offs in favor of cooking your food, rather than pulling it out of a box or jar, you’ll win many of these day-to-day battles.  At least half the week our daughter asks for cereal for breakfast (instead of bacon and eggs).  Rather than dump her a bowl of sugar-laden cereal, my wife or I will make her steel-cut oatmeal, to which she’ll add milk and a few raisins and walnuts.  Sure, it’s more carbs in one meal than I eat in 3 days, but it doesn’t contain sugar (beyond the fructose in the raisins).

When she wants spaghetti for dinner, we make her real sauce out of real tomatoes and garlic.  No added sugar, of course.

This requires extra work, as you can imagine. It’s much easier to dump cereal out of a box or pasta sauce out of a jar.  But if I need to sleep 15 minutes less or my wife needs to cut her run short 15 minutes to make it happen, is it worth it?  For us, the answer is yes. But, it is a choice – of both time and money – every parent needs to make.

Principle 3: Insulin and insulin-like-growth-factor (IGF) are important for childhood development

This topic is highly complex.  For anyone who has studied IGF-1, GH, IGF-BP3, STATb5, or any of the hundred other molecules involved in the highly regulated pathways of growth, don’t be offended.  It would take another series the lengths of the cholesterol series to give this topic its fair shake.  However, a few key points are worth noting.  There is sufficient evidence, for me at least, that a growing child needs a modest dose of insulin to capture their genetic (vertical) growth potential.  In fact, stunted growth is one of the documented side-effects of children on ketogenic diets, though there may be several factors accounting for that beyond the role of insulin and IGF (e.g., protein deficiency, caloric deficiency).

Ketogenic diets are a medically accepted treatment for recalcitrant seizures.  About half the children whose seizures don’t respond to any medications almost immediately stop seizure activity once they are in ketosis. Some investigators, including Dr. Elizabeth Thiele, Director of the pediatric epilepsy program at Harvard’s Mass General Hospital, are investigating this approach in adults.  I had breakfast with Dr. Thiele recently and had an amazing opportunity to learn from someone with enormous experience treating children with ketogenic diets (over bacon and eggs, of course).  According to Dr. Thiele, who described some really amazing in vivo and in vitro research, the reason for the effectiveness is not entirely clear.  That is, it’s not clear if the seizure activity is ameliorated by the presence of B-OHB (beta-hydroxyburyrate) or the stark reduction in glucose or the insulin, or some combination of these, or even something altogether different.

Of course, having too much insulin-like-growth factor is even worse.  There are numerous medical reports that describe the opposite “growth” scenario – too much IGF-1, for example, being associated with increased childhood malignancy.

Everyone wants to know if my (non-epileptic) daughter is on a ketogenic diet.  The answer is no.  If I had to guess, she probably gets 40% of total calories in the form of carbohydrates, and very few of them are sugar.  That said, she’s so used to seeing her daddy give himself “boo-boos” on his finger every day to check his ketone levels that I think she’s getting curious…but that will have to wait a long while.

Principle 4: Fat is fine

As much as you’ve heard me espouse the benefits of fat intake in adults, it’s equally or even more true in children.  As the Harvard anthropologist Daniel Lieberman points out, as we evolved from chimps to homo erectus about 1.5 million years ago, and to homo sapien about 200,000 years ago, we required an increase in our storage of body fat (from about 4-5% to 7-8% to 12-14%).  Why?  Most likely to support the requirements of our rapidly growing and developing brains.  At no point in our development is this more necessary than as children.

My daughter certainly consumes less fat than I do, but she still gets about 35-40% of her total caloric intake via fats – saturated, monounsaturated, and polyunsaturated.  Perhaps her favorite breakfast of all is bacon and eggs with cream cheese.  She likes to wrap a piece of cream cheese and scrambled eggs with a strip of bacon which she calls a “cooc-a-mooc.”  Don’t ask me how she thought of that, but she loves them.  She drinks whole milk (it’s always struck me as strange that the American College of Pediatrics recommends children switch from whole milk to skim milk abruptly at the age of 2), avocado by the truckload, and a wide variety of quality meats.

Principle 5: They are, after all, still children

My wife and I agreed a long time ago that we were not going to restrict our daughter’s eating when she was at birthday parties, on Easter egg hunts, out for Halloween, or on other “special” occasions.  A few weeks ago we took her to Disneyland for her 4th birthday.  (Anyone want to guess what it’s like for an ISTJ to spend 2 days at Disneyland?  Were it not for the look on her face, I’m not sure I could have survived.)  We decided, for these 2 days, she could eat whatever she wanted.  The day started with a bag of cotton candy larger than her head.  I couldn’t resist looking at the package to see that it contained 90 gm of sugar.  I did the quick math on converting that dose of sugar from her weight (35 pounds) to mine (165 pounds) and realized it was like me eating 450 gm of pure sugar in 20 minutes – the length of time it took her to inhale it!  That’s about 12 cans of soda.  She went on to have pretzles and cookies for lunch and, of course, a cake for dessert after dinner.

The entire time I was watching her mainline sugar – more in one day than I consume in a year – I couldn’t help but chuckle.  I sent pictures to my friends all day long.  In the end, she was pretty sick of all the junk she consumed and welcomed her usual meals. But, for a couple of days she ate just like most any other 4-year-old would on her birthday.

Principle 6: No two kids are the same

As you’re reading this keep in mind, this is an anecdotal account of my life and my child.  Yours will be different.  What works for our child may not work for your child or children.  Don’t worry about it!  In the end you’ll be the best judge of what the optimal zone is.  I really believe my daughter will live a healthier life because of the way she eats growing up.  One day, of course, she’ll have to make her own choices.  Will she completely rebel against everything we’ve tried to teach her?  Perhaps, but I don’t think so.  I really believe that kids are the product of the example set by their parents.

I used to always wonder where my tendencies came from. Not surprisingly, much of who I am today is the result of the behaviors I observed in my parents.  It’s my belief that if my daughter grows up in an environment where an emphasis is placed on eating well, it will become a natural extension of her behavior, too.

 

Photo by Foodie Factor on Unsplash

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264 Comments

  1. wish i could get my sisters to feed their kids healthy. i see what happens to most kids, and just feel helpless knowing these things will happen to them. they think “normal” is healthy and that all the problems im mysteriously not getting are normal too.

  2. Hi Peter,

    Gorgeous photos. You have a beautiful family. If I may indulge my excitement on the eve of the first day of September ( actually, the day before the eve of September), I was wondering if we could have a sneak-peak, or if perhaps you could tell us what to expect when you and Gary roll out NuSci? For instance, will this academy be an online venture where you will continue with this blog? Will NuSci, along with promoting the advancement of “right” research, offer in person consulting? Please pardon my excitement, and I will understand if you need to keep things under wrap a little while longer. I do want to take this opportunity to thank you for your unselfish time, commitment and unwavering hard work keeping your readers informed, not to mention the the personal out-of-pocket expense involved in running this blog.

  3. Thank you, Peter, for sharing here. Found the “Primal Way” about a year ago; and have never looked back…

    How about morning supplementation with 7keto for the primal set? The resulting IGF-1uptick would seem to be a boon for adult neurological health.

    Any thoughts?

  4. Love your website and your dedication to truth in dietary science. Your work is important and significant.

    I limit carbs and eat almost no sugar. I hike and do resistance training. I feed my family mostly whole foods—lots of meats, full fat cheeses, eggs, butter, olive and coconut oils, loads of vegetables, nuts, berries. A recent triumph is getting my kids to eat salads with homemade olive oil/lemon dressing, or just plain—no ranch crap in my house! My kids are lean and healthy. I am tall and lean and suspect with proper modeling and a little luck, my kids will be, too (although my husband has quite a belly, 25 lbs. overweight and resistant to limiting carbs). My real concern is how sugar affects health, not just weight. My dad was lean his whole life but died in June of leukemia at only 69 (his father died last year of pneumonia at 94). Dad had a real sweet tooth. My mother has been obese for years and was diagnosed with early onset dementia at 65. She is now 69 and in a nursing home. The only way I can maybe increase my chances of NOT getting either of these horrible disease is limiting sugar and exercise (from what I’ve read) . Gary’s NYT article last year, especially the last few paragraphs, gave me chills —the part about the doctors/researchers that choose not to consume sugar not because of weight concerns but because they don’t want to get cancer. I can’t changes my genes, but I can say no to dessert …

    • Shelly, I applaud your insight into a complex problem. It’s all about knowing what you can and can’t change and focusing on the former, while resisting the urge to awful-ize about the latter.

  5. Hi Peter, I was wondering how you handle Halloween. What do you give the neighborhood kids and what do you let your daughter have as a treat, if you don’t mind? Imagine if I gave out hard boiled eggs 🙂

  6. Hey Peter great post. I like your point on how they are all just children. Because in reality we can’t control everything they’re going to eat right? Probiotics would be good since they will eat sugar. Keep up the great work and awesome website.

  7. This was a great post. I started reading it with anxiety, because I expected you would have your daughter on a lower-carb regimen and I would end up feeling guilty. But my wife and I are pretty much doing the exact same thing with our girl. So that feels good. You’re lucky not to see mood changes when your daughter goes off her regular eating pattern. My guess is that that’s unusual. We can usually count on some kind of crash/meltdown at the end of a day when our little girl has special occasion treats. She’s younger though, so maybe that’s a factor. Anyway, thanks for the post! We had a cooc-a-moocs for breakfast. My daughter’s a big fan.

  8. You already wrote what I have been thinking about for the last year. I also react towards the gropus at FB wich is about LCHF (LowCarbHighFat/The swedish part) where ppl put out wonderfull recepies of food they are eating and adds that the kids ate something else with pasta/potatoes or rice. They eat LCHF because of the healthissue but the kids…?
    Can’t really get that!
    I been blogging in swedish but decided to start in english also because I got friends outside Sweden who asks me about this “Nordic diet”. I will put your blog on my favourites because you are awsome! <3
    http://www.myfattystory.blogspot.com

  9. Peter: It appears from the pictures that your daughter has the nice, broad dental arch that Dr. Price found in the exceptionally healthy people he studied, no doubt due to the excellent diet you and your wife followed prior to conception and during pregnancy. What a gift to a very lucky, lovely young lady. My daughter is now 25, and eating well now, but she didn’t have the benefit of a good early start, nutritionally speaking, for we were ignorant, and tended to believe the governent and media. I’m a retired educator, so I bend the ears of anyone and everyone I come across about proper nutrition whether they like it or not. Thanks for the good work! The cholesterol (my favorite food group) series is fascinating.

  10. Although it probably seems a bit cruel to her, for my 7 year old, I just can’t let her go wild on sugar, even on special occasions. Perhaps she’ll get a tiny 1cm cube of whatever cake or treat is going around, just for taste, but the idea of letting her be “normal” and overloading on the typical sugars and starches everyone else seems to take for granted as benign – I just can’t do it, not even some of the time. Heck, when I get high-carb presents from people who can’t quite grok I’m not eating starch and sugar, I can’t even bring myself to regift, because I don’t want to hurt my friends!

    I wish my daughter had enough low-carb friends to put together a birthday party where nobody would expect cake, juice, or sugary ice-cream, but perhaps that will happen in the next generation 🙂

  11. Great post! Principle #5 awesome! It is certainly hard to stand back and let them live and learn…but it seems that the only way kids truly learn is through experience. Recent experience: Our friends thought we were cruel when we laughed and laughed hearing that our older son ate two hot dogs at summer camp, got sick, and puked them up. It was the first processed/nitrate meat he’d ingested in years. He learned more of a lesson than any food censorship and cognitive reasoning promulgated my Mom’n’Dad could have ever produced.

    Now that our kids are older (10/12) it’s been wonderful to note how much of an influence they’re having on what their friends eat. Unfortunately it can get expensive for us because their friends love to eat at our house. Grass-fed beef ain’t cheap! But that’s better than the opposite – when a kid comes over for dinner and has no desire to eat anything unprocessed.

    Again – great post. Way to play to the parents. 😎

  12. I love this post. My son is 19 months old and basically eats what I eat – meat, fish, eggs, veggies, fruit, berries, nuts, goat yogourt, water. Oh, and breastmilk but I don’t eat that 🙂 His grandparents, at first, thought he wasn’t getting his vitamins because he wasn’t eating fortified foods like cereal and milk….but I keep repeating that he doesn’t need fortified foods because he eats real food. And he has treats once in awhile – cake at parties, we shared an ice cream cone on the first hot day of summer. I figure as long as I have control over what he eats I’ll make sure he eats lots of good food, trusting that when I have less control he’ll gravitate to what he knows.

    He’s full of energy, sleeps well, laughs all the time, and is a healthy boy. Some of that must be from how much we enjoy eating good food together!

    Thanks again for the post – so nice to read!

  13. I love this! I teach second grade, and I’m always trying to find ways to gently nudge the parents to cut down on the sugar they’re feeding their kids. It’s hard to do this without offending the parents. I’ve found the best way is to teach the kids why I bring the foods that I bring. They, in turn, go home and request healthier choices.

    • Christa, you’re really on the front lines. Wow. I wish you all the success possible to help parents better understand the importance of giving their kids a nudge in the right direction. Hopefully this post can be an efficient way to pass along the info.

    • My wife teaches grades 1-3. The past few years she’s forbidden sugar treats in her class (supportive mangement); changes their behaviour considerably, she claims. This year she’s at a new school with new management and parents, so they’ll eat the standard fare. Should be an interesting experiment.

  14. Totally off-topic but I think totally post-worthy question that has been bugging me for a while and I can’t find any research on…

    The standard answer to “how many calories do you have to burn to burn 1 pound of fat” is “453 grams in a pound times 8 calories in a gram of fat equals about 3600 calories.”

    While this is technically chemically true (or at least the numbers I’m using are close enough to illustrate the point), I’ve also always been told that the human body is ~75% water regardless of shape or composition.

    Here’s the conjecture part that I have been unable to corroborate by looking for medical or internet research: So, to keep a constant 75% water ratio one would lose 12 oz of water (that had “supported”) every 4 oz of fat burned off. So, really one needs to burn about 900 calories to lose 1 pound of fat (as measured in fat composition tests or similar), not 3600 calories.

    To take an illustrative example, take one of those 500 pound guys on Biggest Loser. Say he loses 100 pounds of “fat”. He wouuld need to lose 25 pounds of fat, ~90k calories (note lack of quotation marks) and 75 pounds of water to stay at 75% water composition. If he lost 100 pounds of pure fat, ~360k calories (and no water), then his water composition would jump from 75% to 93.75%.

    • The estimate of 75% of TBW (total body weight) being water is too high. Closer to about 50-60% for a lean individual. The less lean someone is, the less of their weight/mass is made up by water, as fat is anhydrous. The folks on BL are probably less than 30% water. To lose a pound of fat does, in fact, require a net reduction in about 3,500 kcal. The point I think you’re making is that this is rarely a static event. It is very hard to just lose fat mass without giving up some other mass (e.g., extracellular water, glycogen, lean tissue).

  15. Even high-normal blood sugar is not good for the brain: http://www.neurology.org/content/79/10/1019

    The aim of this study was to investigate the association between plasma glucose levels and hippocampal and amygdalar atrophy in a sample of 266 cognitively healthy individuals free of T2D, aged 60–64 years, taking part in a longitudinal study of aging.

    Methods: Fasting plasma glucose was assessed at wave 1. Hippocampal and amygdalar volumes were manually traced on 1.5 T MRI scans collected at wave 1 and at wave 2 4 years later. General linear model analyses were used to assess the relationship between plasma glucose and incident medial temporal lobe atrophy after controlling for a range of sociodemographic and health variables.

    Results: Plasma glucose levels were found to be significantly associated with hippocampal and amygdalar atrophy and accounted for 6%–10% in volume change after controlling for age, sex, body mass index, hypertension, alcohol, and smoking.

    Conclusions: High plasma glucose levels within the normal range (<6.1 mmol/L) were associated with greater atrophy of structures relevant to aging and neurodegenerative processes, the hippocampus and amygdala. These findings suggest that even in the subclinical range and in the absence of diabetes, monitoring and management of plasma glucose levels could have an impact on cerebral health.

  16. My question is about breastfeeding. I switched to a HFLC diet right after the birth of our fifth child. I’m going with the assumption that what is healthier for me is healthier for my baby, but I can definitely tell the difference in the baby’s stools (different color, smell, and texture than the previous 4 children’s). Otherwise no difference — all 5 have been healthy, happy babies to various degrees.

    Not as much success switching the other 4 children and husband to a HFLC diet! Still working on them…

  17. My daughter, 23 now and living away from home, ate slightly higher carb than I did from baby to teens with very little processed food. Once a month we had “treat night” where we’d go to the supermarket and pick whatever she wanted or go to McDonalds. Kids don’t want to be different, and I get that. As a teen, she was vegetarian for a very long time, but anaemia forced her to choose between iron tablets and eating a bit of red meat. She chose the meat. I’ve taught her all the things you teach – animal fat is ok etc etc, but most of her friends are still on the low-fat/higher carb thing, so it’s often difficult for her. It’s also difficult for me to buy nicely marbled meat – everyone is still does low-fat around these parts. She’s very slim, active and eats very healthy for someone her age. I think I’ve done a reasonable job to set her up for lifetime eating.

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