Very brief update

The main focus of my treatment plan right now continued to be treating SIBO.  When my guts feel like they are going to pop like a balloon, it's hard for me to concentrate of much of anything else. I do, however, feel as if this is ultimately a good thing because it has forced me return to a better diet.  In my first few years after falling ill with ME in 2011, I was a strict adherent to a diet of no-processed foods, no processed or added sugars, and very few grain-based products.  Over the years I slowly started to slip.  Now the SIBO has forced me to return to a more natural, whole-foods based diet.  

In any event, after a month on two SIBO antibiotics, I went back to my doctor (Dr. M) and reported that my symptoms of SIBO (mostly a feeling of bloating) had improved by about 80%.  Some days the symptoms were gone completely (but that was also true even before treatment).  Dr. M said most SIBO patients, especially, those with the methane-producing form of SIBO, require two one-month courses of Xifaxan and Neomycin.  So I'm back on those two specialist antibiotics for the gut. In the mean time, it is so nice to have some relief from the more intense symptoms.    

More on SIBO

When I last posted about SIBO in December, I had been told verbally by my doctor's office that the SIBO test came back positive, but I didn't yet have the results. I was, at that time, slightly concerned that the test could be a false positive.

Now I've received the written results and I am less concerned with the possibility of a false positive.  I feel fairly certain that I do have SIBO.

SIBO breath tests look for increases in either methane or hydrogen after drinking a specified amount of glucose or lactulose.  While my results showed a slight increase in methane, they showed a very great increase in hydrogen.  One common SIBO test interpretation states that "a rise in hydrogen of more than 20 ppm after 90 minutes should be considered as diagnostic of SIBO."  In me, the hydrogen rose more than 80 ppm within 90 minutes, four times more than the minimum for a SIBO diagnosis.

Dr. M prescribed rifaximin, the most commonly prescribed antibiotic to treat SIBO.  When I arrived at the pharmacy, the pharmacist advised that my insurance doesn't cover rifaximin.  Paying for it on my own is not an option.  My plan now is to re-visit my doctor later this month (mid-January) and work with her to (hopefully) obtain insurance pre-authorization for rifaximin.

In the mean time, I have switched my diet to a common SIBO diet known as the low-FODMAP diet.  So far, this diet has helped with symptom control, but has not eliminated symptoms.   The bloating and discomfort I was previously having has been mostly gone since about day 3 of the diet.  However, I only switched to the low FODMAPS diet about 2 weeks ago, so it is possible this could be just another break in the symptoms (which I would get sometimes even before I changed my diet.)

Excellent Article on Anti-Inflammatory Diet

"If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation."

Every once in a while, I find that I need to remind myself of why I've adopted an anti-inflammatory diet.  Most of the time, I don't find it difficult to stick to my diet, but sometimes I'll allow myself a little taste of a sugary dessert or bread.  When I do, sometimes it's very difficult stay on the wagon--to not go crazy and bury my face in a pile of confections.  Articles like this are perfect reminders of why I need to stay on that wagon.

The backlash against gluten-free diets: why it's wrong

We've all seen it.  And it was predictable.  There's a heavy backlash against gluten-free dieters and it's only getting stronger.  The negativity toward gluten-free dieters can get downright nasty--they're portrayed as silly trend-followers who don't really understand nutritional science.  The backlash shows up on an almost daily basis in the form of punchlines on nighttime talk shows or snide comments from your friends and co-workers.

Here's why the backlash is just plain wrong...

First, let me establish that I don't have a dog in this fight.  I don't follow a gluten free diet per se.  I do eat a low-carb, Paleo-ish diet, which happens to mean I consume little gluten as compared to, say, someone on the standard american diet (SAD).  But if I want to eat a particular food that otherwise fits my diet and by chance contains gluten, I won't hesitate.

Second, let me say a few words about why there's a backlash.  It's two simple reasons:  There is a small minority of people who simply cannot shut up about their gluten-free diets.  They utterly fail to comprehend that there are few things less interesting than hearing about someone's specialized diet. These people invited the backlash and they unfortunately raise ire against everyone else who modestly adheres to the diet because it makes a difference in their day-to-day well-being.

My advice to these gluten-free megaphones: become as low-key about your gluten-freeness as you possibly can. If you're looking for something suitable on a restaurant menu, figure out a way to ask if it's gluten free without making it sound like you'll die if a speck of gluten crosses your lips - and preferably without even using the word "gluten."  I assure you that's quite possible.

The other reason is that most people (especially we Americans) just aren't comfortable not having a strong opinion about a topic that has entered the public consciousness. We're an opinionated people for better for worse--mostly worse.  We go to the grocery store and it seems like half the product labels scream "Gluten-Free" and we want to have something to say or tweet or status-update about that, damnit.  So we feel like we're somehow obligated to choose one side of the issue of the other; either we're a gluten-free champion or a bitter cynic.  Just once I'd like to meet someone who says, "You know, I don't really have an opinion on gluten.  I haven't read enough about it to form a knowledgeable point of view."

Nintey-five percent of the time, when a gluten cynic shares their viewpoint, it goes like this:  "Gluten is only a problem for people with Celiac's disease.  If you don't have Celiac's, gluten is not an issue."

Ah, if only nutritional science was so simple.  That's like saying, "If you don't have diabetes, you can eat as much sugar as you want without any health repercussions."

Here's the real deal.  Yes, Celiac's is a serious auto-immune disease and being gluten-free is imperative for people with that disease.  But for the rest of us, there's still a large and growing body of research that suggests that gluten is pro-inflammatory.  And inflammation has been implicated as a root cause of a range of diseases, from heart disease to Alzheimer's; from autism to migraines, and many more.

Even if you don't have any of those diseases, you simply won't feel as strong and as healthy as you otherwise would if you have excess inflammation.  The inflammation might be sub-clinical (you're hardly aware of it) but it could be keeping you from feeling more energetic, clear-headed, and healthy.

This past Summer, the results of a study were published that purported to cast doubt on whether non-Celiac's gluten sensitivity was 'a real thing.'  This of course became translated into attention-grabbing headlines proclaiming the whole gluten-free craze to be some sort of hoax.  Witness the utter glee behind these "neener-neener" headlines, which totally misrepresent the study they reference:  Google results for "gluten proven false."

First, the actual "study" that was referenced in these headlines, from Monash University in Australia, followed only 37 people, which is about as significant as as a wisp of dust.  The study tracked the subjects for...one entire week!  The patience of those intrepid scientists is astonishing, isn't it?

But more importantly, even if you were to take the results of that one small study seriously, it only purports to cast doubt on a condition called "non-Celiac's gluten sensitivity."  Again, let's go back to the sugar analogy.  I don't think anybody doubts that refined sugars, in the large amounts consumed in the SAD, are bad for one's health.  It's not just about the immediate affects. Over a lifetime, consuming high amounts of sugar leads to obesity and diabetes, among other things.  This process plays out over a very long time, and does't require any kind of sugar "sensitivity" condition.

Studies suggest that the pro-inflammatory affect of gluten may operate in the same way.  Having looked at the studies showing the pro-inflammatory affects of gluten, it's really hard to discount them. (See, e.g. 1, 2, 3, 4, 5, )  Nobody has refuted any of these findings.  Certainly it doesn't take a degree in nutritional science to understand the difference between the myriad studies that observed the actual chemical process leading to inflammation from gluten, as compared to single study that followed a group of self-selecting gluten sensitive subject for a mere 7 days.

But of course we know which study made the headlines.

I'm not saying that anyone has proven with 100% certainty that gluten is categorically bad, in any amount, for 100% of the population.  Like most controversies regarding nutrition, A) there will never be enough evidence to remove all doubt, and B) the actual answer is probably highly nuanced, meaning it's possible that gluten has both benefits and detriments, and that the "right" amount depends on a number of variables, including difference in each individual's biochemistry. Again, think of sugar.

But if you're one of those bitter gluten cynics, you might want to ask yourself how sure you are that you're correct.  Even if you're not completely convinced by the gluten/inflammation connection, you'd have to admit that there's credible evidence in favor of it--a lot of it.  If you can refute the five studies I've linked above (a tiny sample), let's hear what you got.  Until then, do you really want to be rolling your eyes and making fun of people on an issue that is, at the very least, unresolved?  It's a legitimate debate and you ignore that at the risk of looking like a fool...

With the weight of the evidence pointing toward at least some real and significant problems associated with gluten consumption, it is likely you will be on the wrong side of history when all is said and done.  Might as well save yourself the backtracking now and quietly let each person explore for themselves whether reducing gluten intake is beneficial to them.  Let's all check back in 10 to 15 years and see what science says then.

I predict that, in the short term, the gluten backlash will get stronger until most gluten-free dieters are basically forced into the closet.  But the movement will quietly stick around until it gains more acceptance and, eventually, becomes more or less a permanent part of the conversation, just like....

sugar.

The case against Aspartame

One of the few good things to come out of my health problems is that I've become more aware of health and nutrition.  I have tried to spin the negative of my health problems into a positive by educating my family and close friends (subtly, and hopefully without becoming annoying).  My hope is that, because of my health problems, my family and friends can potentially avoid problems of their own.

While I've had some small successes, I've found that for the most part, people aren't very motivated to change their lifestyles or diets unless they experience health problems of their own. Case in point, my parents are both regular consumers of Aspartame (aka aspartate).  I have been trying to convince them to ditch Aspartame (along with sugar - for different reasons.)  My dad responded that he searched the internet for "dangers of Aspartame" and discovered nothing of significance.  I found that hard to believe.  So my dad challenged me to show him the links.  This post is my effort to do that.

First: For many years, controversy surrounded Aspartame and whether it was a carcinogen (a cancer causing substance).  Controversy also surrounded the FDA approval of Aspartame, which may or may not have been tainted by "irregularities" and suspicion in the process.  Over the years, research into the potential cancer-causing affects of Aspartame has found that Aspartame is probably not carcinogenic in small amounts.  Some still dispute this, but I am sufficiently convinced.  The unfortunate consequence of these findings is that, it seems, the message has mutated into "Aspartame is completely safe."

What's been lost are the other potential health hazards of Aspartame, namely that it has been repeatedly found to kill nerves, leading to or exacerbating nerve-related diseases like Alzheimer's, Parkinsons, MS, ALS, ME/CFS, and others...

There are far too many links and research papers to include in one blog post, so I will include only a few highlights.  After each link, I quote a key paragraph from the source.  But keep in mind that most of these links have a trove of information about Aspartame that goes well beyond the excerpts:

http://articles.mercola.com/sites/articles/archive/2011/11/06/aspartame-most-dangerous-substance-added-to-food.aspx

"Aspartate and glutamate act as neurotransmitters in the brain by facilitating the transmission of information from neuron to neuron. Too much aspartate or glutamate in the brain kills certain neurons by allowing the influx of too much calcium into the cells. This influx triggers excessive amounts of free radicals, which kill the cells. The neural cell damage that can be caused by excessive aspartate and glutamate is why they are referred to as "excitotoxins." They "excite" or stimulate the neural cells to death."

[The article goes on to say that nerve death due to excitotoxins is linked to, among other things, Alzheimer's disease]

http://www.ncbi.nlm.nih.gov/pubmed/23553132  

"Aspartame, a widespread sweetener used in many food products, is considered as a highly hazardous compound. Aspartame was discovered in 1965 and raises a lot of controversy up to date. Astrocytes are glial cells, the presence and functions of which are closely connected with the central nervous system (CNS). The aim of this article is to demonstrate the direct and indirect role of astrocytes participating in the harmful effects of aspartame metabolites on neurons. The artificial sweetener is broken down into phenylalanine (50%), aspartic acid (40%) and methanol (10%) during metabolism in the body. The excess of phenylalanine blocks the transport of important amino acids to the brain contributing to reduced levels of dopamine and serotonin. Astrocytes directly affect the transport of this amino acid and also indirectly by modulation of carriers in the endothelium. Aspartic acid at high concentrations is a toxin that causes hyperexcitability of neurons and is also a precursor of other excitatory amino acid - glutamates. Their excess in quantity and lack of astrocytic uptake induces excitotoxicity and leads to the degeneration of astrocytes and neurons." [Emphasis added]

http://dorway.com/doctors-speak-out/dr-blaylock/aspartame-msg-other-excitotoxins-the-hypothalamus/

In conclusion, there is compelling evidence to indicate that food additive
excitotoxins, such as aspartame, pose a serious danger to our well being,
especially so in the case of children and the elderly. It has been
demonstrated that excitotoxins in the diet can dramatically elevate free
radical generation for prolonged periods of time and that once induced, it
triggers a viscous cycle that ends in neuron death. Most authorities now
agree that elevated free radical generation is associated with virtually all
degenerative diseases as well as most injuries and toxins. It makes little
sense to expose the general public to a product that we know increases free
radical generation so dramatically and is associated with laboratory proven
injuries to the nervous system. 

http://www.fitday.com/fitness-articles/nutrition/healthy-eating/5-reasons-aspartame-is-bad-for-you.html#b

Aspartame can change the chemistry of the brain. Formaldehyde, a product of methanol, gathers in certain areas of the brain causing degenerative diseases such as Parkinson's, Alzheimer's and ALS. Aspartame consumption can also trigger seizures in both epileptics and other individuals without a history of epilepsy.  Aspartame may contain fewer calories than sugar, however, the toxic sweetener has the potential to cause serious damage to the nervous system and in the worst case scenarios can be fatal.

I could go on and include many others, but the point is made.  To be fair, there are sources that refute these findings (specifically the FDA), but it's interesting to note that none of them (at least that I have found) attempts to explain why the chemical process described above is wrong.  The response is generally, to paraphrase, "we haven't seen enough evidence to be convinced."

I've read the FDA's arguments of why Aspartame is safe, and I am not convinced.  I will not include those arguments here because I don't want to lend credence to them.  I'm not trying to be objective here, but, suffice it to say, if you want to read the other side of the argument, it is out there for you to find.  

Proof that the paleo diet is NOT dangerous

I now have personal proof that the paleo diet is not dangerous, as some claim.

I've been on a paleo diet for about a year and a half and it has completely eliminated my gut symptoms and has also cut down on Candida overgrowth in my intestines (as evidenced by Candida antibody tests.)  Incidentally, I have lost about 20 pounds since going on the paleo diet, but that was not my goal, and I would actually prefer to gain some of it back.

Since the paleo diet seems to be a trendy topic these days, I read a lot of articles on it: both pro and con.  Those who are against the paleo diet cite studies that show a correlation between red meat consumption and arterial blockage.  This always concerned me because the aforementioned correlation seems pretty solidly established in the medical literature, and has been for decades.  On the other hand, if you believe the pro-paleo crowd, red meat only contributes to arterial blockage when we eat pro-inflammatory grains, sugars, and dairy along with the meat, which creates the inflammation that allows those nasty lipids to stick.

Recently, while tracking down old medical records, I noticed that I had had a lipid panel performed in August, 2010 -- about a year before I went on the paleo diet.  So I realized that all I needed to do was have another lipid panel performed and compare the results.  Then I would have my answer as to whether paleo leads to dangerously high cholesterol levels.  I really hoped that wouldn't be the case because the diet has helped my ME/CFS symptoms so significantly.

Before we compare my before and after results, let's compare my typical daily diet before and after paleo.  Notice, I am not a strict paleo person, as I eat cheese in small quantities and a couple other minor things that some would consider cheating (olive oil, for instance).  While there are many different versions of "paleo," my main mantra is "absolutely no bread or processed sugar."  I stick to that religiously.

Before Paleo 

Breakfast:  Bagel, or cereal with lowfat milk, or a banana

Lunch:  Chicken burrito with corn chips, or a sandwich with potato salad; diet coke

Dinner:  Pasta or pizza or (occasionally) frozen TV dinner; salad; water.

Dessert:  Non-fat frozen yogurt, or cookies, or pie

After Paleo

Breakfast:  A whole large avocado, or 3 scrambled eggs, or full-fat goat milk yogurt with fresh berries.

Lunch:  Almost always a salad with chicken - olive oil for dressing; water.

Snack:  Walnuts or macadamias

Dinner:   Roast chicken or turkey, or grilled beef with steamed veggies; salad; water

Dessert:  Usually none; sometimes fresh berries

So the main thing to notice is that I eat a lot more fat and cholesterol now than I did when I had my first lipid panel 3 years ago.  And, because I came down with ME/CFS in June 2011, I am no longer able to do any cardiovascular exercise, whereas, at the time of my first lipid panel, I was doing 1 hour cardio workouts 1-3 times per week.  So traditional thinking would expect my lipid panel results to be much worse now, yet here are the results:

                                               Before Paleo         After Paleo       Reference Range

Total cholesterol                         182                        159                125-200 mg/dL

HDL (good) cholesterol               46                          46                 > or = 40 mg/dL

Triglycerides                               205                         86                  <150 mg/dL

LDL (bad) cholesterol                  95                          96                 <130 mg/dL (calc)

So the first thing to notice is that my trigylcerides were very high (out or range) before paleo, and now they are much improved.  Also, total cholesterol has come down from 182 to 159.  On the other hand, both HDL and LDL cholesterol have remained almost exactly the same, despite claims in some pro-paleo literature that those numbers would improve too.  But at least they haven't gone up, as some would have predicted.   

It appears the paleo advocates were correct that at least some of my lipid panel numbers would improve even though I'm consuming much more fat and cholesterol.  This leads me to believe that the paleo advocates probably are right when they state that grains, sugar, and casein (in dairy) make our arteries more "sticky", which causes the fats that we do eat to stick to our arterial walls.  As long as I cut out those pro-inflammatory foods, I can eat a fair amount of fat and get away with it.  

It seems to me that I could probably improve these numbers even more if I either went 100% strict on paleo (although I think I'm pretty close already) or by cutting down on red meat in favor of white meats.  Right now, I eat red meat 2 or 3 times a week.  I could easily cut that down to once per week and perhaps improve my numbers even further while continuing to adhere to the paleo diet that has helped me so much in other ways.  

Stevia may not be ideal for ME/CFS patients

Admittedly, I'm a fan of stevia and use it (or products with it) at least 3 or 4 times a week.  But for those PWMEs with low blood pressure and/or POTS/OI issues, you may want to avoid stevia or, at least, use it sparingly.  Stevia lowers blood pressure, and this can be a problem for people who already have low blood pressure.  [1] [2]

Stevia, it turns out, also helps lower blood sugar and is sometimes used as a treatment for those with hyperglycemia.  Since my blood sugar tends to run a little high even after switching to a low carb diet, I will continue to use stevia in moderation.  Incidentally, my blood pressure normalized after the first 6 months of having ME/CFS, so I'm more concerned about blood sugar than blood pressure, but I realize many of us have the opposite concern.

A flaw in my diet plan: Almonds

I've been on a low carb, Paleo-like diet for over a year.  (I say Paleo-like because I eat modest amounts of dairy from time to time.)  There's no question that the diet has helped me improve, especially my gut symptoms.  "Nausea and gut disturbances" used to be a category on my daily health chart, but I was able to eliminate that category about 3 months after switching to a low carb diet.  I don't experience gut issues any longer unless I break from the diet.  

But since changing to a low carb diet, almonds have been a major staple in my diet.  I toss those suckers back by the handful; I drink almond milk daily—all because I read somewhere that almonds are one of the few nuts that are compatible with an anti-Candida diet.  (My blood tests continue to show high Candida antibodies.)  

On the other hand, an anti-inflammatory diet is important for PWMEs.  It is thought that inflammation is one of the causes of many of our symptoms in ME/CFS,[1][2] and it seems that the low carb diet crowd keeps growing and growing in ME/CFS circles.  God knows, it has helped me.

Now, one of the keys to an anti-inflammatory diet is maintaining a low ratio of Omega 6's to Omega 3's.  Omega 6's are pro-inflammatory fatty acids, while Omega 3's are anti-inflammatory fatty acids.  Omega 6's are much more common in our foods, so it's difficult to achieve a 1-to-1 ratio of 6's to 3's, but a reasonable goal is about 3-to-1 or 2-to-1.

So as I was reading tips to lower one's Omega 6/3 ratio, I came across this tidbit from whfoods.com:

"So, how can you go about lowering your 6:3 ratio? One excellent approach is to [eliminate] foods in your diet that are relatively high in omega-6s and low in omega-3s. 

For an example, let's take almonds. With no omega-3s and about 4-5 grams of omega-6s per cup, your almonds are a member of the nut family with the highest possible 6:3 ratio. Once you've located a food like almonds with a very high 6:3 ratio, look inside of that same food group (in this case nuts) for a food with the most possible omega-3s. In this case, walnuts would make an outstanding choice within the nut group because walnuts have about 2.25 grams of omega-3s per quarter cup and a 6:3 ratio of about 4:1. Just by replacing almonds with walnuts, you could make an important shift in your 6:3 ratio."

I checked the accuracy of this ^ statement against other sources and it appears to be true.  Many other sources warn against the pro-inflammatory qualities of almonds.  It's just a little vexing to know that I may have been cancelling out some of the benefits of my diet for the last year.  On the other hand, I suppose it's encouraging that I might reap even more benefits from my diet by making one simple elimination.

Now, the challenge is to find a replacement for all those nutty almond calories.  Walnuts?  We'll see...

Review of Julian Bakery's paleo breads and cookies

It seems that Julian Bakery is all the rage on the CFS message boards and facebook groups these days.  I see them mentioned frequently.   Because I've been ordering products from them for a few months I thought I'd offer my review of some of their products.

About Julian Bakery

Based on their website, Julian Bakery was a small bakery with apparently just one brick and mortar location in La Jolla, California.  But because of their unique take on healthy baking, they seem to have exploded in popularity nationally via internet orders and contracts with retailers like Whole Foods and regional health food stores.  Apparently there's a huge unmet need for paleo, low carb, and gluten free bread products and Julian Bakery is one of the very few in the market.  

The first time I placed an order with Julian, it took two weeks to receive my shipment.  The second time: three weeks.  Toward the end of the third week I emailed the bakery to find out if my order got lost.  They nicely responded that they were running a little behind in fulfilling their orders due to large demand.  So the next time I ordered, I placed the order about 3 weeks before my last order ran out, expecting another delay.  The order showed up on my doorstep 2 days later!  If you're a glass-is-half-full, you could look at this as another exciting element of the process - like a game of roulette.  When will my goodies get here?  Who knows!

By the way, Julian sells many more types of breads besides just low carb and paleo breads.  Their focus is really on healthy breads of all kinds.  And while my local Whole Foods carries Julian's products, they only seem to carry the gluten free, full carb products.

For those of you who like to support Christian-run organizations, Julian includes a few subtle clues on their packaging and website indicating that their owners are Christians.  

Bread Products

So far, I've tried the following bread products from Julian: Paleo bread made from almond meal (1 carb); paleo bread made from coconut (1 carb); Zero carb, gluten free cinnamon bread; Zero carb, gluten free regular bread, and Smart Carb bread (3 carbs).  

These first two types of bread, made from almond and coconut respectively, really aren't "bread" at all, in the traditional sense, because they don't contain grains.  They are, however, my favorites because they seem to have more flavor.  The breads that are made from actual grains achieve their low carb-ness by relying heavily on fiber content so that the net carbs are reduced to nothing, or next to nothing.  

If you're going to enjoy these products, you may have to adjust your expectations slightly.  Julian's breads are not large, fluffy slices of traditional grocery store bread.  They're smaller, drier, and much denser, resembling small loaves of artisan breads.  While Julian's loafs vary in size, a typical slice is about 1/2 go 2/3's the surface area of traditional bread, and about half as thick.  On the other hand, each slice probably weighs more than "regular" bread because it's so dense.  

The density and the dryness took some getting used to when I first started sampling Julian breads.  I often found that I needed a glass of water to help wash down each bite due to the dryness.  But then again, traditional bread is full of unhealthy grains, sugars and carbs anyway, so it's probably best if you start thinking of those big fluffy slices as the junk food that they are.

I figured out quickly that it really helps to follow Julian's advice from their website and toast the bread -- heavily.  For some reason, this seems to give it a texture and taste that's more similar to regular bread.  

Once I adjusted my expectations, I found myself almost giddy about welcoming bread back into my life.  It revived a whole palette of convenience foods options.  Ah, the ubiquitous sandwich: I missed you.  Toast and jam: where have you been?  (That's no carb jam from Sprouts, by the way.)  My wife also discovered that using these breads to make French toast is a nice way to moisten them up.

If I had to recommend trying any of their breads first, I would suggest the coconut Paleo Bread.  It has an interesting flavor and texture that goes well with everything from jam to almond butter to french toast batter.

No Carb Cookies

Zero carb cookies.  Yes, these exist. Get them.  End of review.

OK, I was going to leave my review at that, but I guess I should say a little more.  Julian offers three flavors of zero carb cookies: Cocoa Delight, Ginger Spice, and Strawberry Banana.  I've tried all three and love them, ranked in the order listed above.  They're a little bit firmer than the gooey store-bought cookies that are full of preservatives, crisco and who-knows-what-else, but the flavor is almost as good. 

Again, the zero carb-ness is achieved by high fiber content and the use of erythritol as a sweetener instead of sugar.  

The biggest drawback here is the price, at $8.99 per box of ten (almost a dollar per cookie).  Again, I think the secret is to adjust expectations.  Whereas in my pre-sick days, I would often sit down with a box of cookies and pop 6 or 10 at a time like they were M&Ms, now I treat these cookies more like rare delicacies: one per night after dinner.  That's it.  And that's enough to make a satisfying desert.

A Different Perspective 

At least one blogger, "the Diet Doctor," claims that Julian Bakery's net carb counts are deceptive, arguing that their breads raise blood sugar more than Julian's stated carb counts would indicate.  A representative of Julian Bakery then drops by in the comments section and things get a little ugly.  

My take on it: who knows who's right?  But does anyone really doubt that Julian's breads are healthier than typical grocery store bread?  I suppose it depends on how strict your particular low carb/paleo diet is.  If you're truly aiming for no carbs, ever, then maybe the above blog post gives you some pause.  But if you're just trying to keep carbs to minimum (my goal is less than 70 per day, pursuant to Life Without Bread by Christian Allen, et al) then Julian's breads can certainly be a good way to meet your goals and still enjoy some of the flavor and convenience of bread. 

Where Do We Go From Here?

I'd be curious to hear from others who may have tried Julian Bakery's products.  What ways have you found to use these unique breads?  I'd also be interested to know if there are any other companies that make similar bread or dessert products, as I am not aware of any.

   

Interesting article busts myths against low carb diets

I don't have much time to blog today, but I did want to pass along an interesting article that busts nearly all of the myths one hears against low carb diets.  I've heard some of these myths.  While I've always had the sense that they were incorrect, I couldn't exactly explain why.  This article does a great job of it.

http://www.ketogenic-diet-resource.com/low-carb-dieting.html

Are my strange neuro symptoms tied to diet?

Every few months, I go through a period of 2-3 days where I get all sorts of strange neurological symptoms. I feel totally uncoordinated. Typing becomes very difficult. Walking becomes dicey. I feel unbalanced. Muscle twitches and numbness comes with it too.  I feel like I could fall at any time while walking.  It is a very difficult feeling to describe, but other PWMEs say they know exactly what I am talking about.  

I'm getting over one of these neuro flare-ups right now.  

Most of my crashes do NOT involve these symptoms, so it makes me wonder why a few do.  When I first got these symptoms, I thought they were possibly due to low potassium levels, as I'd recently started a B12 protocol.  Now, I'm not so sure.  I'm very good about maintaining my potassium levels while on the B12 protocol.  Are these symptoms just another bizarre aspect of this condition?  

I'm looking back on my health records for the last year trying to find any common denominator between these neuro symptoms and other factors near in time.  So far the only possibility I've come up with is that many of these episodes arose after eating eggplant.  Eggplant, of course, is a member of the nightshade family of foods, which is sometimes cited by PWME's as problematic -- specifically, leading to neuro symptoms.  But the thing is, there have been many more times throughout the past year when I've eaten eggplant and not gotten these symptoms.  Why sometimes and not others?  

I may have to cut out eggplant altogether for a while and see if the neuro symptoms stay away.  Other than that, I'm out of guesses.  I would love it if anyone else had some insight into this.  Is is just one of those inexplicable symptoms of ME/CFS that we simply have to deal with?  

More Stevia Product Reviews: Chocolate & Sodas

In previous posts, I reviewed flavored liquid stevia drops, and a homemade recipe for stevia chocolate sauce.  I've since had the opportunity to try a few more products: two stevia chocolate brands and two soda brands.  The two chocolate brands reviewed below are the only two stevia chocolate brands on the market - at least that I've been able to find.

Stevia Chocolate by Dante Confections

Dante Confections' stevia chocolate bars are available for order on Amazon for $29.95 for eight bars.  The price works out to about $3.74 per bar, which is pricey but not outrageous.  Premium chocolate bars with sugar care comparably priced.  For those of us PWMEs on no-sugar diets, stevia products are one of our few indulgences.  I forgo so many other expensive activities with ME/CFS that I'm comfortable spending a few dollars on chocolate.  

Dante Confections produces a darker variety of chocolate.  Their product only comes in one flavor: straight up chocolate.  Nothing fancy here, just coco goodness.  

My Amazon order arrived within five days, with each small brick of chocolate individually wrapped in thin tissue paper, which in turn were wrapped inside ordinary sandwich bags.  As I opened the package, I felt like I was receiving illicit contraband!  

If you're a dark chocolate lover, this is your brand.  I loved every bite of it, but then again, I can handle the relative bitterness of dark chocolate.  My wife, who prefers sweeter chocolate, sampled it and said, "I don't know how you can enjoy this stuff."  So it depends on your taste palette. 

One benefit of the darker chocolate was that I found it lasted longer.  I was much more likely to savor each square and let it melt in my mouth -- usually being satisfied with two small squares as an after-dinner treat.  With the YC brand (below), I found myself eating whole bars at a time.  I think darker chocolate forces one to savor it more, which might be a good thing when we're talking about such a pricey commodity.

The ingredients list is simple, which I found reassuring.  Three ingredients:  Chocolate liquor, stevia, and pure vanilla.  That's it.  (Incidentially, chocolate "liquor" should not be confused with chocolate "liqueur."  There is no alcohol in it.  It simply means that it's made from hardened liquid chocolate.)

Personally, I couldn't tell much of a difference between the stevia chocolate brands I review here and regular chocolate bars made with sugar.  It all tastes delicious to me.  But some of the more "sophisticated" chocolate lovers on Amazon claim they can tell the difference.  Take that for what it's worth...

Stevia Chocolate by Coco Polo

The other brand of stevia chocolate is Coco Polo.  Their chocolate is of the more milk chocolate variety, with various flavors to choose.  I ordered the variety pack of 12 bars, which I believe are no longer available.  They currently offer an 8 piece variety pack for $42.00.  This works out to about $5.25 per bar.  

I ordered Coco Polo directly from the company's website which, in my case, was a mistake.  It was 21 days from the time I placed my order until the goods arrived at my house.  When you're out of chocolate, this is an unreasonable amount of time to wait!  At about day 17, I sent an email inquiring about the status of my order.  It was never returned.  I've since discovered that Coco Polo is also available on Amazon, which might be the better choice next time.  

The Coco Polo packaging is much more professional looking, if that kind of thing matters to you. The bars arrived each sealed in gold-colored wrappers, which in turn were inside printed paper sleeves.  The sleeves contained the usual Nutrition Facts and ingredients sections on the back.  

Interestingly, the main sweeteners (by weight) in these bars is not stevia, but rather erythritol and inulin.  I'm finding that this is pretty common with "stevia" products.  I gather that it's difficult to approximate the flavor of sugar with stevia alone, but you can get pretty close with a combination of stevia and these other natural sweeteners.  Stevia is the last ingredient listed in the Coco Polo bars, which could mean that the bars only contain trace amounts of it.  But, erythritol and inulin are also both low on the glycemic index and arguably don't feed candida.  

The chocolate itself tasted much sweeter than the Dante Confections chocolate -- probably due to the darker chocolate mixture, but also because Dante doesn't use erythritol and inulin.  And of course, it was nice to have the variety of six flavors: Almond, cherry, elderberry, cocoa dark, nibs and ginger.  The only flavor that I found to be a little....odd was ginger.  Who's ever heard of ginger chocolate?    

All in all, I liked both brands for different reasons.  In the future, I'll probably alternate my orders between the two companies.  

Zevia Sodas with Stevia

Finally, I've been sampling Zevia brand sodas, which I purchased from Whole Foods and Sprouts markets (although they can also be ordered directly).  They are sold in ordinary 12oz. soda cans, packaged in six-packs, with 15 flavors available.  So far I've tried five of them: Black cherry, orange, caffeine free cola, Dr. Zevia, and ginger root beer.  

Again, it's been over eight months since I've had a regular soda with sugar or aspartame, but these sodas taste almost as good if not exactly as good as "the real thing" to me.  Prices are reasonable, although not as cheap as name brand products.  For instance, a 24 pack can be ordered from Amazon for about $19, or about $0.80 per can.  

Again, as with the chocolate reviewed above, be aware that the dominant sweetener by weight is not stevia, even though the product says "sweetened with stevia" on the can.  While this statement may be correct, Erythritol is listed four ingredients higher than stevia on the ingredients list.  But, I don't begrudge Zevia their marketing strategy, which I think is fair enough and not overly deceptive.  Anyone can look on the back of the can before buying.  

All in all, I think it's a good product and I'm grateful to see more and more options enter the marketplace for those of us who avoid sugar and artificial sweeteners.

                                                      Blue Sky Free Sodas with Stevia

7/27/12 update:  I've since discovered another brand of canned stevia sodas while shopping at Sprouts Market, called Blue Sky Free.  It is apparently manufactured by the more well-known Hansen Beverage Company.  While I've only had an opportunity to sample one flavor so far, Cherry Vanilla Creme, I find that it tastes about the same as Zevia.  And like Zevia, they also sweeten with Erythritol in addition to stevia

Their price at Sprouts Market was a little lower than Zevia - although I can't remember the exact amounts.  On Amazon, it seems to be a little cheaper as well: about $17 per 24 pack, or about $0.70 per can.

Blue Sky offers a different range of flavors than Zevia, so it's nice to have a choice between the two brands.  In addition to the usual flavors like Cola and Root Beer, Blue Sky's selection includes Lemonade and Jamaican Ginger Ale, among others.  For the full selection, see their website.

I'll try to update this post later when I've had a chance to try more Blue Sky flavors. 

Eureka: Stevia Italian sodas

There are many of us PWME's who can't (or shouldn't) drink anything with caffeine, sugar or artificial sweeteners, which basically leaves only water and herbal teas.  If you're like me, every so often you get a craving for a sweet drink.  A really bad craving.

Sure, you can try to tell yourself that primal humans drank only water.  But then again, primal humans didn't know what they were missing!  I've spent 35 years drinking whatever I want, whenever I want.  One can't simply turn off a life-long habit.

I have to credit Mrs. Calvin for this idea.  Walking through Whole Foods Market, she discovered the existence of flavored liquid stevia.  Two ounce bottles of this little magical elixir come in flavors like vanilla, lemon, orange, chocolate, raspberry and others.  From this discovery (and possibly from reading the side of the bottle) Mrs. Calvin came up with the idea of adding the flavored stevia to sparkling water to make Italian sodas.  So we tried it.

I don't want to ruin the surprise, but please sit down before you take your first sip.  And make sure your socks are on tight.

The bottles of flavored stevia that we purchased at Whole Foods cost about $13, but can probably be purchased online for less.  You only need a few drops to flavor a whole glass, so the bottle should last a very long time.

Happy gulping.

P.S.  Did you know there's a commercial brand of stevia sodas called Zevia?  If anyone's tried this, I'd like to hear from you.

P.P.S.  For more of my stevia product reviews, click here.

Stevia chocolate: a godsend

Since eliminating all bread and processed sugar from my diet in November, my taste buds have been protesting against this cruel depravation. They're screaming for stimulation. Much like me, they've been struggling to adjust and accept their new limitations.  Also like me, they try to bargain with these limitations, to cut corners, and to cheat the system. And as we have both found out, there aren't too many ways to cheat the system.  For the most part, we're stuck with our new limitations.

As part of this bargaining process, we went online a couple of weeks ago to explore what stevia-made sweets might be available for mail order. As it turns out, there are virtually none. The US stevia industry is simply too new to have gained a foothold. My heart sunk.

That's when Mrs. Calvin came to the rescue.  Being nothing short of a genius in the kitchen, she concocted a bowl of stevia chocolate syrup, which, upon first taste, almost had me weeping with joy.  OK, not really "weeping," but, it's difficult to overstate how glorious a bite of chocolate can be after a four month drought.  

We now keep a bowl of this chocolate syrup in our refrigerator at all times.  I drizzle it on plantains, berries, yogurt, almonds, walnuts, and just about anything else that fits in my diet.  I even made chocolate milk using almond milk.  The picture below is my dessert tonight.  Or, I should say, was my dessert.

Stevia chocolate on plain yogurt, topped with flax seed meal

If you'd like the recipe for Mrs. Calvin's stevia chocolate syrup, let me know in the comments and we'll figure out a way to get it to you.  I can't publish it because it's a modification of a recipe that is published elsewhere and...well...I don't want to get sued.  

At least I don't eat like THIS anymore...

Ridiculously Optimistic, Bright-Side Post #2

I've been keeping a health log since September, before ME/CFS was even a faint suggestion in my head.  At the time I started it, I was simply trying to find something, anything, in my daily routine that I could connect with my ups and downs.  It would still be a couple more months before my doctors and I suspected ME, and another month or two before I changed my diet.

A few days ago, Mrs. Calvin and I were winding down for the evening, each propped up against our sides of the headboard.  She was finishing reading The Help and I was clicking away at the laptop, updating my health log.

As I finished updating my log, I glanced back at those early months.  Looking at the "Food" column, my eyes bulged.  I began to laugh.  This caught Mrs. Calvin's attention so I read some of the entries aloud to her, and she laughed to.

How is that in the span of 5 months, I'd changed my habits so drastically that the mere mention of my old habits induced laughter?  While I doubt it will be as funny to you, readers of this blog - all three of you - I invite you to judge me anyway.  These entries are cut and pasted without edit.  (Semicolons separate breakfast; lunch; and dinner):

9/7:  Bagel; Taco Bell chalupas; orange chicken from Panda Express 

9/11:  Oatmeal, frozen breakfast burrito; peach, 2 ice cream sandwiches; steak & enchilada for dinner with Horchata.

9/12:  Breakfast burrito, Motrin; (skipped lunch); meatball sandwich and french fries.

9/13: Cottage Cheese; breakfast burrito w/ bacon; Rubio's Big Burrito Especial w/ chips for lunch; pizza with pineapple.

9/15: Breakfast sandwich w/ ham and cheese; apple, peach, nachos, peanuts; hamburger casserole & sourdough toast, apple cobbler

The list goes on and on like this.  My biggest downfall, like many Southern Californians, was Mexican food - or rather, Americanized Mexican food, where each burrito is a rice and bean filled carbohydrate bomb.  No wonder my candida antibodies were off the charts.  


(Normally, Mrs. Calvin would have stepped in to ensure that I ate healthy for at least one meal a day when we were home together, but she happened to be recovering form a C-section at this time.)  


Even now, only 5 months later, that list seems revolting to me.  So, at least I'm not slowly killing myself with that junk any longer!

Candida Diet

I started a Candida diet yesterday, and I am enjoying the thought that, with each passing day, I am killing more yeast.  Since I was already adhering to a low carb diet, the transition was smooth.  After all, the Candida diet is a low carb diet, with a handful of additional restrictions.  As it turns out, before starting the Candida diet, I was continuing to eat a few foods that were probably feeding the yeast.  The worst culprit was vinegar--which is ubiquitous in condiments and salad dressings (including the creamy kinds, like Ranch) and anything pickled.  Others included peanuts, seeds, and mushrooms, all of which can carry various types of mold that encourage the yeast.

There are dozens of Candida diets on the internet, and the basics of each are essentially the same.  Most are phased, gradually introducing new foods as you begin to win the battle against your yeast.  (Most are also vague about when you should transition from one phase to another!)  But there are also some significant differences.  A few recommend starting with...I'm not kidding here...a coffee enema.  Others insist that the first stage must begin with a liver cleanse.  For me, I'll start with the plan recommended in the book The Yeast Syndrome, by Trowbridge & Walker (which seems to be the Candida bible).  The Yeast Syndrome plan combines prescription drug treatment (check), with diet (check), and "holistic approach"....  I'll admit I need to do some further reading on the holistic aspect, but I hope it doesn't involve ordering Starbucks in an enema bag!

Personal Update: Crashing

I seem to be crashing tonight, and I don't know why.  Suddenly, I'm experiencing the return of symptoms that I haven't felt in some time, like significant brain fog, nausea, dizziness, and as always, fatigue.  The nausea is particularly frustrating because I thought, potentially, I had put that behind me  when I changed to a low carb diet in early November.  Certainly, the low carb diet has helped regardless of this setback.

This doesn't seem to be a case of post exertional malaise (PEM) because I didn't do anything out of the ordinary yesterday.  I suspect there may be a dietary cause because I consumed much more dairy than ordinary yesterday, and I have also been eating strips of prociutto as part of my dinner.  Several authors in the book "Recovery from CFS" mentioned the elimination of pork from their diets as a key factor in CFS diets.  I couldn't understand why pork would be different from any other meat until I read the following tonight, on a website concerning candida diets:

"Pork cells contain retroviruses that survive cooking and may be harmful for those with a weakened digestive system."

I'll have to experiment further and see if dairy or pork is a possible culprit.