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Jane Macdougall: What a cancer expert eats for breakfast

February 8, 2014
"Dr. Gerry Krystal was silhouetted by the sweeping vista commanded by the B.C. Cancer Agency building. Behind him, the city was bristling with joggers, cyclists and, even in the dead of winter, kayakers paddling in False Creek. We are a city renowned for its healthy lifestyle.

Jennifer Sygo: Get to the roots of gut health by understanding good and bad bacteria and IBS triggers

How much do our everyday choices affect the health of our digestive system? Perhaps more than we ever imagined, actually. After a recent symposium on the effects of stress on our health (full disclosure: the symposium was sponsored by Jamieson, the supplements company), I had the opportunity to speak with Alexandra Anca, (Master’s of Health Science), who is a registered dietitian and author specializing in medical nutrition therapy for digestive diseases, celiac disease and food allergies. We spoke on the topic of gut health, and IBS specifically.
In addition to being a Distinguished Scientist at the Terry Fox Lab at the B.C. Cancer Agency, Krystal is a professor of Pathology and Laboratory Sciences at the University of British Columbia. He cycles to work. He smiles a lot. His diet is pristine. If Krystal were sushi, he’d be premium grade bluefin tuna.
The doctor and I were talking further about the role of nutrition in disease prevention. The bucket of coffee — two sugars — I’d perched on his desk had me feeling like I was blowing smoke rings in the maternity ward. Coffee — cherished elixir of life — is acidifying and that causes nasty inflammation. Sugar? Well, as we learned last week, sugar is the handmaiden to the undertaker.
We’d already discussed the findings from his studies with mice on high carb, low protein, Western-style diets. The high rates of cancer and the truncated lifespans that accompany a diet that induces spikes in blood glucose levels were clearly illustrated. To recap: cancer craves carbs and metastasis is encouraged by the pH changes that accompany high cellular glucose combustion. Food matters.
Emerging science is revealing that our bodies are far more complicated than we’d imagined. In the years ahead, you’ll be hearing a lot about the human microbiome, that community of microbes that co-evolves within your body, exerting significant influence on your immune system. Part of the co-evolution of these on-board bacteria is based on what you feed them. Just as there was the Human Genome Project, there is now the Human Microbiome Project, which is attempting to identify and characterize the micro-organisms abundant in both healthy and diseased humans. How abundant? Well, wash your hands all you want; numerically speaking, we are more microbes than we are human cells: a ratio of 10 to one. There is even talk of declaring the microbiome as a new organ of the human body and classifying people by their enterotypes, which is to say, according to which bugs live in their guts.
Microbiota can be friendly, benign or pathogenic
Microbiota can be friendly, benign or pathogenic. Some of these micro-organisms are now suspected of playing a role in chronic diseases, like multiple sclerosis, diabetes, rheumatoid arthritis, fibromyalgia, cancer, and even neuro-chemical imbalances. Many of the microbiota respond to our lifestyle choices. Food, of course, is amongst the most major of lifestyle variables. Bad food gives bad bugs ammo.
As Krystal rhapsodized about adenosine triphosphate, peptide chains and our fellow traveller, the microbiome, my eyes glazed over. I found myself wondering what he’d had for breakfast.
I mean, if you had insider information on the complex interactions between our cells, food, our microscopic bugs, and the consequences, what would you eat? If you’d seen with your own eyes the damage caused by poor choices, what choices would you make on a daily basis?
Well, apparently, it’s all about unsweetened protein. The basis of Krystal’s breakfast is plain gelatin powder and whey powder isolate. Yes: yum! He mixes these two ingredients together, using it as a base for a nut and cereal mix composed of oats — both rolled and bran — almonds; ground flax seed; pecans; plus pumpkin and sesame seeds. Over a bowl full of this, he sprinkles All Bran cereal, then instead of milk, adds whey isolate mixed with water. He recommends whey isolate because the fats and lactose — milk sugar — are removed.
He favours protein-rich almonds — slivered so as to be easier on tooth surfaces — for snacking where necessary
Sugar intake is carefully monitored.
This high protein meal usually holds him until midday. If it doesn’t, he favours protein-rich almonds — slivered so as to be easier on incisal and occlusal tooth surfaces. The doctor thinks of everything.
Lunch and dinner are likely either pink salmon or chicken, and salad with canola oil due to its preferable omega 3/6 ratio over other vegetable oils, quinoa or brown rice, and a wide variety of vegetables. He’ll also have either a pear, an apple or a grapefruit, as they sit lower on the glycemic index than other fruit.
One thing a cancer researcher will never have is soda pop or juice. In fact, Krystal says if you do nothing else, renounce juice and soda pop. Pop usually contains about 200 sugar calories. The body doesn’t properly recognize them as food calories dissolved in water and, therefore, doesn’t signal leptin secretions from fat cells to tell the brain the body has just been reloaded with 200 calories. You can surf a Coca-Cola sugar high all day and still actually be hungry, despite ingesting hundreds of calories. If you must have juice, have it with pulp, as pulp is insoluble fibre, which moves more quickly through the alimentary canal, somewhat limiting the spike in blood glucose and insulin. Best bet? Whole fruit, or plain tap water.
Come the weekend, however, Gerry eats whatever Gerry wants. Chocolate cake? Pizza? Bring it (moderately) on! But here’s a cancer cognoscenti’s trick for reducing ill effects from these indulgences. It’s based on his well-considered conjecture that, by lowering the pH of your food — making it more acidic — you can lower the glycemic index by as much as half. He does this by finding ways of adding four teaspoons of vinegar or lemon juice to his meal.
He cautions that this isn’t proven science yet, but he feels it’s a defensible deduction. He also warns not to brush your teeth for a half hour afterwards to avoid abrading softened tooth enamel. Like I said, the doctor thinks of everything!
Out the window I could still see people in breathless pursuit of the longevity and health. Exercise is essential, but if we don’t figure out how to properly feed ourselves, just watch as our socialized medical system collapses under the metabolic effects of the pitiful, standard Western diet."

Toast was toast, or how Wheat Belly and its author changed my diet

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It began, as many misadventures do, innocently enough.
I had baked a loaf of bread. A simple, honest bread made from the best of simple, honest ingredients. Nonetheless, several dinner guests declined the bread. My friends, it turned out, were boycotting gluten. Hadn’t I heard? Gluten was the new great Satan. It was as if I were offering cocktails of Red Dye No. 2 served with asbestos straws in leaded crystal tumblers.
I had misguidedly thought that homemade bread had placed me in the vanguard of healthy living. Apparently I was wrong. I’d inadvertently played into the hands of the industrial baking complex and their evil agenda.
This led me to an inquiry into the gluten gripe, that led to poking about the subject of commercial baking, that led to examining the GMO debacle that deposited me on a sofa opposite Dr. William Davis, author of the massively bestselling book, Wheat Belly, and now the Wheat Belly Cookbook.
The simple loaf of bread quickly became a can of worms. Food, it turns out, is really complicated these days.

What grains and gluten mean (or don’t mean) for weight loss

Are grains helpful or harmful to our health and our waistline? Last week we took a look at some of the nutritional pluses and minuses that come with eating whole grains, as well as some of the effects of whole versus refined grains on our health. This week, we’ll take a closer look at the role that grains, and especially gluten, play (or don’t play) in weight loss.
When it comes to weight loss, gluten-free diets are all the rage. Unfortunately, despite the claims that gluten, a protein found in wheat, barley, and rye foods promotes weight gain, there are no published clinical trials to date comparing a gluten-free versus gluten-containing diets for weight loss.
We do, however, have data on gluten-free diets for those with celiac disease, an auto-immune condition whereby the small intestine is damaged by exposure to gluten, and the news might surprise you: patients with celiac disease actually tend to have higher body mass indexes (BMIs, or a measure of height versus weight) than those without the disease.


Where to begin? It turns out that bread isn’t what it used to be because flour isn’t what it used to be because wheat isn’t what it used to be.
Historically, bread is made from four ingredients: Flour, water, salt and yeast. Bread is so natural, that by combining just two of these ingredients — flour and water — bread will sometimes make itself.
Most people buy their bread off a grocery store shelf. Mass produced store-bought bread is delightfully squishy, uniform and imperishable.
Bread needs time to rise. Time is money so industrial bakers add enzymes to hasten this process. People like certain appearances so various colourants are added to appease that aesthetic. The issue of “fresh” is challenged as bread now has to travel great distances to market, so preservatives are added. The humble loaf of bread thus morphs into something much more complex.
Denatured is the word that crops up time and time again when contemporary wheat flour is mentioned. It used to be that your bag of all-purpose flour was flecked with brown pips — the germ of the wheat. That’s milled out now as wheat germ goes rancid quickly. What do they do with the wheat germ? Millers sell it to vitamin manufacturers who sell it back to us as Vitamin E. Go figure.
There is, as they say, more grist for this mill but we need to move along.
The core issue here is with wheat. Yes, those amber waves of grain that comprise the backbone of contemporary agriculture are where things gets really complicated.
What we call wheat is a distant relative to what our grandparents called wheat
What we call wheat is a distant relative to what our grandparents called wheat. I’m going to hazard to say that there was no nefarious agenda to transform wheat into the Franken-grain many believe it’s become. Instead, it appears that a series of well-intentioned adjustments were made to address world hunger. If we could increase the yield per acre of wheat, fewer people might starve to death. A noble objective, no? The complexity at play between humans and our natural world, however, isn’t very tolerant of certain changes.
Old wheat was four feet high with seeds that clung to the stem. They were adaptable and hardy plants. Crop yield was dictated by climate and natural growing seasons. New wheat, however, is dwarf or semi-dwarf varieties of about two feet height, relying on a steady diet of nitrates, irrigation and pest control. This combination means a field can produce 10-fold the yield. Threshing is easier as the grain is exposed and engineered for more expedient harvest. I have a postcard in my office that reads: “Cheap. Fast. Good. Choose two.” Apparently, we chose cheap and fast. In many ways, it was a defensible choice.
Dr. William Davis sums it up this way: ‘Celiac disease is the canary in the coal mine’
This is the stuff you can see. On a genetic level, new wheat is different altogether. The evidence is mounting that humans are having an especially hard time with the new strains of wheat. The hybridized or genetically modified wheat protein — the infamous gluten — is something completely new. It’s these new wheat proteins that are associated with the four-fold upswing in celiac disease over the past half-century. It can be argued that all this tinkering with wheat is giving rise to the upswing in gluten intolerances as well as celiac disease. Dr. William Davis sums it up this way:
“Celiac disease is the canary in the coal mine” where wheat is concerned.
The bestseller Wheat Belly pivots upon these issues. Most are led to the book by vague complaints associated with ill effects associated with wheat consumption. Davis, a cardiologist, began his own inquiry began as he explored ways to manage his patients’ diabetic issues. Bread, it turns out, has a whopping glycemic index. A glycemic index is the comparative effect of carbohydrates on blood sugar. Table sugar has a GI of 59; a slice of whole grain bread has a GI of 72. The culprit here is the highly digestible carbohydrate, amylopectin A, which Davis says is more detrimental to the body than white sugar. New science suggests avoiding blood sugar surges is essential to good health. A high GI number will spike your blood sugar. Diabetes is providing the clues here. According to Davis, diabetes is “a proving ground for accelerated aging.” Mismanaged blood sugar issues take a hideous toll on diabetics and non-diabetics alike. What you want to avoid are advanced glycation end-products.
Glucose-protein combinations — useless debris — muck up the body in just about every way imaginable: Cataracts, dementia, wrinkles, coronary artery disease, cancer, arthritis
These are the glucose-protein combinations — useless debris — that muck up the body in just about every way imaginable. Cataracts, dementia, wrinkles, coronary artery disease, cancer, arthritis: glycemic index figures are tied to all these. Wheat is uniquely positioned because of its unique blood glucose-increasing effects to be a catalyst for this laundry list of nasty developments.
Oh my.
This, I figured, is how heavy smokers must have felt when doctor’s reversed their opinion on the health benefits of cigarettes. To my mind, there is no greater love story than that of soup and sandwich. I am helpless to resist the plain-spoken charms of the humble muffin.
If you go to the gym and wear sunscreen and find a way to hide kale in just about everything your family eats, all of the foregoing would set off alarm bells. And it did.

Battle over bread: Are wheat and other grains really anathema to healthy eating?

Are grains a nutritional enemy?
According to one increasingly popular line of thinking, grain-based foods trigger undesirable blood sugar fluctuations, tooth decay and inflammation in our body, which in turn may lead to heart disease, type 2 diabetes and even cancer. Of the grains we consume regularly, wheat and its derivatives have been targeted as being particularly harmful, largely due to the presence of gluten, a protein that is known to trigger serious health issues in those with celiac disease and in those who’ve more recently been identified as having non-celiac gluten sensitivity.
By contrast, a second line of thinking argues that it’s not grains, but rather the high intake of animal protein that is the issue with the Western diet, and that a regimen based on whole grains, fruits and vegetables, nuts, seeds, beans and pulses will pave the road to good health.


I decided to take up Davis’s challenge. I undertook a season of living wheatlessly. Toast was toast. I started in mid-September. And again in late September. Then in October, in earnest. Giving up wheat is tougher than you might imagine. One miscalculation, one mindless ingestion, one uninformed choice, and I was off the plan. Wheat is everywhere!
At this point, it was mostly just elimination. I substituted cucumber slices for crackers. I abandoned cereal for smoothies. Salads replaced sandwiches. It was, let me tell you, no fun. I became that person at the dinner party declining artisanal bread, pasta, crusted halibut steaks, dessert; the same person I had cursed while clearing the dishes. And then I got serious. I moved on to the Wheat Belly Cookbook. This entailed a shopping trip for specific provisions. My pantry filled up with subtypes of flour that had previously escaped my notice: chickpea flour, quinoa flour, coconut flour, and others. To address Davis’s warning about advanced glycation end-products, I carted home stevia and Splenda as sugar substitutes. I baked Wheat Belly muffins and thanked God I wasn’t a celiac. One dozen expensive coconut flour, stevia sweetened banana muffins languished on the counter;
nobody wanted them. We found most of the Wheat Belly Cookbook baked goods far too sweet for our taste.
I experimented with my own coconut flour crusted fried chicken and decided boiled chicken was a better option
I experimented with my own coconut flour crusted fried chicken and decided boiled chicken was a better option. Wheat Belly pizza, if you divorced yourself from all previously held concepts of pizza, was a decent vegetarian dish. The cookbook would have you believe that mashed cauliflower duplicates a biscuit crust of a chicken pot pie. It doesn’t. Which is not to say that mashed cauliflower topped with shredded cheddar isn’t tasty, it’s just not chicken pot pie. The Wheat Belly recipes that don’t hinge on wheat flour are completely acceptable recipes, but the baked goods were uniformly not to my liking; nut and seed flours make for leaden baked goods. One way to include allowable wheat-free baking was to get my hands on some non-GMO wheat. I sent away to Heritage Wheat Conservancy in Massachusetts for a bag of einkorn wheat, ground it in my Vitamix and baked a single loaf. Meh. Maybe I milled it badly? Maybe I need to adjust the recipe? I need to keep experimenting, I guess.
Ben Nelms for National Post/files
Ben Nelms for National Post/files 
Wheat Belly author William Davis says the highly digestible 
carbohydrate amylopectin A is more detrimental to
the body than white sugar.

It became a matter of having satisfying alternatives on hand. No doubt you’ll have noticed the gluten-free products flooding the market. Davis expects to see a spike in diabetes from these products as the tapioca, rice, corn and potato starches that replace wheat gluten have sky-high glycemic indexes that will ultimately take their health toll. He’d also advise you to be skeptical of the purported health benefits of whole grains. When we met in Vancouver to discuss his work, Davis spoke of a wide range of food staples that are now subjected to a broad spectrum of chemical- and radiation-based hybridization techniques that are “unleashed on an unwitting public.” His account of the “traditional breeding” methods responsible for Clearfield Wheat had me genuinely worried. But nothing about Davis suggested a strident alarmist. He seemed a soft-spoken, reasonable Midwesterner who had backed into some information he felt the public ought to be aware of, and he was proposing a way to navigate the mess we’re in.
Wheat Belly spoke of a wheat-induced mental fog that would lift as wheat cleared my system; unwanted pounds were supposed to fall off; various physical complaints were expected to subside. This was not my experience. I wasn’t looking to lose weight, and I didn’t. Mental fog wasn’t a chronic complaint of mine so I can’t say I was suddenly beset with clear-thinking punditry. My litany of physical complaints remains pretty much unchanged. Improvements, however, are dependent upon one’s personal degree of wheat intolerance and maybe I’m one of the lucky, tolerant ones. I will say that I found my appetite decreased as Davis said it likely would.
I haven’t kept up my wheat-less experiment; I miss bread too much
I haven’t kept up my wheat-less experiment; I miss bread too much. I’ve made several changes, however, but given the complex chemical issues involved with wheat, half measures offer little benefit. I learned a lot from the Wheat Belly books. The cookbook can’t be judged as a traditional cookbook — it fails miserably — but offers excellent suggestions for navigating what’s starting to look like a very serious public health issue. I’m keeping an eye on the earnest young men and women who are trying to bring pre-GMO wheat back into production and I urge you to support them, too.
And thus ends my Wheat Belly experiment. I’m going to celebrate with one of the happy adjuncts of my wheatless experience: sorghum beer! Delicious! Trust me.

Jane Macdougall: What does cancer eat? Sugar, mostly, and other lessons from my dinner with a professor of pathology


"What got my attention was his remark about celery.
You know: the dieters’ wishful thinking on whether eating celery is a sum negative activity, or not.
He was certainly entitled to speak. His name is Dr. Gerald Krystal and he’s a professor of pathology and laboratory medicine at University of British Columbia, as well as Distinguished Scientist at the Terry Fox Laboratory at the BC Cancer Agency.
We were perched like vultures over a buffet table, commenting on the many ways to die. Fats, salts, sugars, alcohol: pick your delicious poison. I like ’em all.
The dietary folklore related to celery hardly registers in Dr. Krystal’s purview. He started his career as molecular biochemist working on cell signalling, which is to say the ways cells communicate with each other. Delightfully, he describes it as a molecular square dance, with cells reacting to specific instructions that we’re still just beginning to comprehend.
What we call cancer, the medical profession refers to as malignant neoplasm. For reasons researchers are still trying to establish, cells spontaneously divide and grow uncontrollably creating malignant tumours. These tumour cells can then invade other parts of the body. Unfortunately, many of us are all too familiar with this hideous science lesson called metastasis.
But here’s what I was surprised to learn. I might have had cancer several times in my life. Same goes for you. The immune system — well-supported — is a trooper. It’s capable of dispatching proliferations and inflammations, vanquishing many invaders without you ever being aware of it. How real is the threat of cancer in a lifetime? No one knows for sure, but here’s a surprising statistic: Patients on immune-suppressant drugs following organ transplantation have a 100-fold increase of cancer incidence. When the body’s natural defences are inhibited, cancer cells can easily run amok, and they do so 100 times more often than in other people.
So, what makes the critical difference in what wins this silent battle: cancer, or your immune system? This is the question that has occupied much of Dr. Krystal’s career.
He began by observing that Positron Emission Tomography — PET scans used for tumour and inflammation detection — revealed a particular pattern of deoxyglucose use. Apparently, cancer has an appetite for glucose that is three times that than of other cells; that’s what the PET scan is looking for. This rapid ingestion of glucose leads to the secretion of lactic acid which decreases cellular pH and — here’s the aha! moment — that’s what encourages metastasis. And where does the body get all this glucose? Well, it gets it from the standard Western diet; a diet, it turns out, that’s perfectly designed to kill us all.
I was doing my best to wade through Dr. Krystal’s research, Googling every third word. In the basest of laymen’s terms I’ll tell you that his findings hinged on a suspicion that it might be possible to starve cancer by blocking a tumour from accessing glucose. Dr. Krystal set about to see if it was possible to affect tumour growth or — perhaps even better — tumour initiation by affecting blood glucose levels. At the time he started his inquiry, this theory flew in the face of the prevailing science. Almost a decade after he began, his findings reveal that diet may play an even larger role than previously suspected in who gets cancer and which cancers metastasize.
Cancer, it turns out, craves carbs. Typically, the maleficent Western diet is made up of over 50% carbohydrates and only 15% protein. Protein has a unique capacity to enhance a body’s immune system but most of us don’t get nearly enough of this essential nutrient. We love our fats, however, but the wrong sort of fats in the wrong amounts can also prove deadly.
The foodstuffs we favour create a hospitable environment for cancer in a variety of ways. Calorie-rich, but nutrient-unbalanced, our grub tends to render us immuno-incompetent. That’s a big word that means defenceless. Obesity, unhealthy in and of itself, is a widespread side effect of the typical Western diet, but also a source of systemic inflammation. Inflammation engenders DNA damage which increases the risk of cancer.
Dr. Krystal’s team continues to explore the subject of diet-related tumour growth and initiation. The clinical trials with mice, however, suggest that we should all be making massive shifts in what we eat. Almost half the mice on the western diet developed mammary cancers by middle age, whereas none of the mice on the low-carbohydrate, high-protein diet did. Only one of the test mice achieved a normal life span on the standard western diet, with the rest of dying early of cancer-associated deaths. More than 50% of the mice on a low-carbohydrate diet, however, reached or exceeded a normal life span.
The patient parking lot next to the BC Cancer Agency was full the day I visited. As I made my way up the stairs, I couldn’t help but think that we do, indeed, dig our own graves with a spoon.
The good news, however, is that it really does take more calories to digest a stick of celery than are found in celery. The other good news is that celery can’t hurt you one bit."