Fasting, keto and lectin free diet

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Frunobulax
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Joined: Mon Jun 02, 2014 7:41 pm

Fasting, keto and lectin free diet

Postby Frunobulax » Fri Sep 27, 2019 9:13 am

I posted some of this as a comment in another thread, but I think it deserves its own thread (and maybe a bit more discussion). I realise that thick books have been written on that, but maybe I can give an introduction that takes only 10 minutes to read. Trust me, it's worth those 10 minutes :)

Basically, there is strong evidence that the right diet has the potential to help a lot of people with various symptoms including RLS, but it may not be the diet that you learned to be healthy during the last 50 years or so. I'm talking about a ketogenic diet, with regular fasting intervals that avoids most allergenic materials (including lectins). The general idea is that the diet has to be strictly anti inflammatory, it's designed to reduce all kind of (silent) inflammation in your body, especially in your brain. And I do consider it possible that RLS is caused by silent inflammation in the brain, like many other diseases. (This does mesh well with the BID observation, even though it would mean that BID is another symptom of the inflammation and not the cause of RLS.)

There has been a recent change in what we consider healthy (say in the last 10 years), and there is overwhelming scientific evidence that a low carb high fat diet that is low in lectins and high in prebiotics and polyphenols is much healthier for us than the typical western diet https://www.dietdoctor.com/low-carb/science. ("Change" is perhaps not entirely correct. "Landslide" is more appropriate.) Basically, avoid carbs and sugar in general, all processed foods, antibiotics (in most meat), eat plenty of salad, vegetables, nuts, fish, olive oil, coconut oil. Avoid lectins, other vegetable oils and soy products. There is some discussion as to whether animal protein is healthy, some say aye ("carnivor diet"), many say nay. I'd recommend tolLimit protein as it will be converted to Glucose in your liver, but personally think that organic meat, grass fed if possible, should be part of the diet. Saturated/animal fats are under discussion too, they seem to be a lot healthier than most people think.

There has been success treating alzheimer, other dementia, depression, autism and multiple sclerosis using primary a dietary approach, all diseases that were considered untreatable just a short while ago. Don't you think this could work for RLS too? There are several different approaches to the diet, but all of them are low carb and high in anti inflammatory food.

It is also a very good idea to fast on a regular basis, at least for some extended time to clean up the metabolic syndrom if you're insulin resistent (if you don't know, do have your HOMA checked - 75% of the US general population over 65 is insulin resistent). I find intermittent fasting the easiest to maintain and went to OMAD (one meal a day) recently. But other forms of fasting are perfectly fine too (traditional fast where you don't eat for a week, or 5/2 where you don't eat anything on 2 days during a week, whatever works for you). But if you are insulin resistent, you might need some months of low-carb diet before you can tolerate long breaks between meals.

My story is this: I went on a low-carb diet about 9 months ago (just before christmas) and cut out lectins 4 months later and basically went keto (only 25-50g carbs per day). I went to 16/8 fasting (16h break, 8h eating) 3 months ago, and to 22/2 (OMAD) a couple of weeks ago, as I finally reached the level of metabolic flexibility where I can do this. (I tried intermittent fasting before, but failed.)
  • I cut my RLS medication from 30mg oxycodone a day to 25mg after 6 months and to 20mg after 8 months, and hope that I'll be able to reduce it further. (The process does take time. Don't expect results after a couple of weeks.)
  • I lost 24 pounds, most of that during the last 3 months when I started intermittent fasting.
  • I was able to drop my PPIs (stomach acid reducers), see http://bb.rls.org/viewtopic.php?f=4&t=10519. No heartburn to speak of, unless I eat certain stuff like bell peppers, raw tomatoes or peanuts which trigger heartburn reliably.
  • I also dropped my gout medication (allopurinol) and my uric acid is better than before.
  • My psoriasis disappeared and I'm no longer taking any ointments.
  • My ME/CFS got so much better that I'm once more able to work 4h a day, I was pretty much confined to bed a year ago. (And that's rare, usually ME/CFS has only one direction and that's towards becoming a vegetable.)
  • Triglycerides and Cholesterol returned to normal range. Starting triglycerides were over 440 (with <150 considered normal, 150-200 increased risk).

There are plenty of very good videos on youtube, if you have a bit of time. Oviously I can't post all the theoretical background here, you'll want to learn about metabolic syndrom, insulin resistence, lectins and leaky gut. Some of my favorites (in no particular order):

There are plenty of books. I read only a few and can recommend Gundrys "longevity paradox". It gives a very good introduction why diet has those health effects, even though I disagree with some of his statements. But there are many other good books out there.

So why would you go against the advice of 90% of all nutritionists? To give some background, I have ME/CFS, a disease where we are completly abandoned by conventional medicine. There is no treatment at all. But some patients get a bit better through smart food selection, so I have read hundreds of articles and watched even more videos, and even though there were a lot of conflicting topics, there can't be any doubt that we need to thoroughly re-evaluate what we consider healthy. And carbs are a problem, fat isn't.

You know, black powder consists of sulfur, charcoal, and potassium nitrate. If you cut out charcoal, it won't explode. Would you derive from that that charcoal is evil and sulfur and potassium nitrate is good? Of course not, but this happens with nutrition/fat. We have a very unhealthy combination of carbs, fat, antibiotics, insecticides and lectins in our diet. Especially carbs + fat seems to be a fairly bad combination, and cutting out either will give short-term positive effects (weight loss, better insulin etc.). But it turns out that going low-fat high-carb has devastating long-term effects, as diabetes, arteriosclerosis, dementia and autoimmune diseases become rampant. There are several studies that compare different cultures, for example indians in the same region, once 500 years ago when they became corn farmers, and 4000 years ago when they were still hunter-gatherers. We assume that they had basically the same gene pool as it was the same region, and ~4000 years are nothing in evolution. Turns out that the hunter-gatherers were healthy and had a much longer life expectancy, while the corn farmers had all kinds of terrible diseases. Similar studies exist for other ancient civilisations like the Egyptians.

Why did we come to wrong conclusions, about 40 years ago when everybody "knew" that fat is bad? In nutrition, many studies have found correlations and constructed cause-effect-relations without any further proof. Other studies have been massively manipulated, or just drew weird conclusions.

  • A famous study that "proved" that saturated fat is bad (I think it was the Oslo study), and is quoted whenever that discussion comes up. Participants were separated into 2 groups. The control group would not change any eating habits. The "low-fat" group received intensive dietary counselling, and it turned out that they reduced sugar to 40g a day, less than half of the general population, among other healthy changes. Of course, all health benefits were attributed to the "low fat" and not to the other changes. (The "low sugar" and the counselling weren't even mentioned in the study. Apparently one of the authors wrote a book decades later where this nugget of information could be found.)
  • The same patterns implicitly happen in many other studies. They eliminated fat (or just saturated fat) from the diet, and relized that health gets better. Fine, but the conclusion is that fat is bad, and that's wrong on so many levels, because fat was not the only thing eliminated. Going low-fat means you cut out a lot of junk food, like chocolate bars (fat + carbs), antibiotics (from animal fat), processed food (food with high glycemic index). From this you get massive health benefits that have nothing to do with fat. But if you eat just high-fat (saturated or not) without the sugar, antibiotics and processed food (ketogenic diet) you'll get health benefits that are even better than just going low fat, and better long-term benefits. (By "long-term" I'm talking about decades.)
  • Many low-fat studies do not distinguish between fats. There is a lot of evidence that many vegetable fats/oils are very bad (canola, soy, sunflower oil and the like, which contains a lot of lectins) and play a major role in the recent diabetes epidemic. (We've seen a dramatic increase of consumed vegetable oils in the last 20 years. At the same time obesity went through the roof.) Other vegetable fats are in fact very healthy (olive oil, coconut oil, linseed oil). Trans fats are bad, no doubt there. Going low-fat means you get rid of all the bad fat, but that of course does not allow any conclusion that the other fats (the good ones) are evil.
  • As for saturated fat, I firmly believe that the antibiotics in the meat (and we have a LOT of that) kill off bacteria in the gut microbiome and are maybe the #1 reason for a lot of the weird diseases that we have (dementia, depression, autoimmune, all the diseases where doctors don't have a clue about the pathogenesis). Saturated fat = animal fat (mostly), and cutting out saturated fat means you get rid of those antibiotics. However, there are both paleopathology studies that realize that a lot of hunter-gatherers were very healthy even though they consumed a lot more meat than we do today, and modern studies that show benefits from carnivor diets. Thus, the conclusion is that saturated fats are fine if you make sure they don't contain other bad stuff. Eating meat from grass fed beasts (organic farming only without antibiotics, soy fodder and the like) is very likely fine, and coconut oil of course is considered healty in any case.
  • Cholesterol is a disease marker but not the cause. Yes, there is a clear correlation between cholesterol and heart disease, but correlation is not causation. Ambulances are usually present whenever a traffic accident happens, but it's a very bad idea to fight ambulances. Cholesterol is a repair protein, it will be produced by your body if there is some damage. So monitoring cholesterol is OK, but don't worry too much about it, it will return to normal with the right diet. Don't use statins, a healthy diet will make sure that you don't need them. OTOH trigycerides are a severe problem, you should worry about getting triglycerides back to normal range (<150 mg/dL).

Being overweight is not a cause, but a symptom that there is something wrong. Under a healthy diet (what I consider healthy), weight should return to normal range, both for overweight and underweight people, while you can eat as much as you want (no calorie restriction at all). In fact, not being able to lose weight is strongly associated with insulin resistence. But people that are not overweight may nevertheless experience a lot of symptoms from bad diets. (Maybe overweight people have a slight advantage for once, as their scales will give some indication about the success of the therapy :) )

So my advice would be this. (But I'm no doctor, so kids don't do this at home, do talk to your doctor first, and read more about this to make an informed decision.)
  1. Transition to low carb. (Up to 2 months.)
    Slowly migrate to a low-carb diet (like Atkins or a low glycemic index diet) with at most 100g carbs a day. It may take a few months until your body adapts to that. Have your insulin resistence checked (HOMA) and check for leaky gut (zonulin).
    Throw in some supplements. Have your vitamin D checked, most people are deficient. Add omega 3 fatty acids. Throw in some glutamin and inulin to aid leaky gut. Eat plenty of polyphenols and prebiotics, and take some probiotics. Add coenzyme Q10, alpha lipoic acid and carnitin, most people over 50 are deficient in these 3. (Transition phase and cleanup phase, perhaps longer.)
  2. Do a long "cleanup" phase. (This may be anything from 2 months up to a year or more, depending on how insulin resistent you are.)
    In this phase, eat mostly ketogenic (max 25g carbs a day) and do some fasting. Avoid lectins and limit dairy products. The more fasting and the less carbs, the quicker you'll be through the phase. A few cheat days are OK, and especially at the start you'll violate that protocol (most likely) on occasions, because nobody eats right 100% of the time. But the longer you go the less you'll crave for carbs and sugar, and at some point you'll be able to eat whenever you want, and it's no problem to go 24h or 48h without any food.
    There should be some gradual improvement of your symptoms (including RLS) during this phase, but again, don't expect quick results. We violated our body for many decades with bad diet, and it takes a while to repair that damage.
    The cleanup phase ends if (a) your HOMA is in a good range (no insulin resistence), (b) you have metabolic flexibility (you can fast without preparation, and use all kinds of different foods without symptoms, like high carb one day, carnivor the next, keto for the rest of the week), (c) you're happy with your weight, and (d) there has been no recent improvements of your symptoms in a while. (As long as you're getting better, don't stop the cleanup phase.)
  3. For the rest of your life stick to low carb. If you go back to a western diet, your symptoms will reappear and you'll become insulin resistent again. Some of you may have to remain on keto, everybody is different, but most of you should be OK with some carbs as long as you're far away from the 300g a day that most people eat today. Do some fasting now and then -- evolution has prepared us for streaks with much food and carbs (summer) but expects a holiday for our pancreas (winter). For example, go to 22-2 fasting for 2-3 months during the winter, perhaps starting Jan to undo some damage from Christmas and Thanksgiving :) Or fast a week (traditional fasting, no food) 3-4 times a year. Something like that. As a rule of thumb, if your diet and metabolic flexibility is fine you'll be able to fast anytime you want. If not, you strayed off the path and need another cleanup phase.

Good food:

  • Olive oil, coconut oil, linseed oil, avocados.
  • Nuts (but no peanuts or cashews, they are not nuts).
  • Leafy vegetables, most salad/vegetables unless high in starch or lectins (nightshades contain lectins)
  • Fish and pasture-raised meats and eggs
  • almond, coconut or cassava flour as replacement of wheat flour
  • Stevia, xylitol or inulin instead of other artificial sweeteners
  • Fruit in moderation, avoid fruit high in sugar and starches (mangoes, bananas, grapes, some apples etc.)

Avoid most carbs (especially corn and wheat products), whole grain products and raw nightshades (contain lectins), non-organic meat (contains antibiotics), sugar and most artificial sweeteners. Some lectins are neutralized by [pressure] cooking (nightshades, legumes) or fermenting (some lectins in grains), but not all. It's a good idea to learn what food contains lectins, and what kind of processing makes that food safe.

debbluebird
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Re: Fasting, keto and lectin free diet

Postby debbluebird » Sat Sep 28, 2019 4:57 am

I've lost 32 pounds so far and I believe in this lifestyle. Sadly it has not helped my RLS and leg spasms yet. I am hopeful.

Frunobulax
Posts: 212
Joined: Mon Jun 02, 2014 7:41 pm

Re: Fasting, keto and lectin free diet

Postby Frunobulax » Sat Sep 28, 2019 2:38 pm

debbluebird wrote:I've lost 32 pounds so far and I believe in this lifestyle. Sadly it has not helped my RLS and leg spasms yet. I am hopeful.


I hope it will work for you eventually. It's impossible to tell from a distance, perhaps there is something in your diet that prevents your microbiom from regenerating (and you're not aware of it), maybe you lack a single micronutrient (like omega-3 or a mineral/vitamin), maybe you have a gene variant that somehow causes malabsorption of something? Maybe it's something else, there is nothing that works for 100% of the patients. Did you do a microbiom test, an analysis of your gut bacteria?

Oozz
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Re: Fasting, keto and lectin free diet

Postby Oozz » Wed Oct 09, 2019 8:10 pm

Great post. I’ve been away from the forums for some times now as my RLS has been under control. To get here I went on a low fodmap diet. It was brutal, but it was well worth it. Not only did my RLS get better, but my sleep quality improved dramatically. I went from 5mg methadone to 2.5mg. My average resting heart rate and heart rate variability have improved by 10-20%. i’m slowly starting to feel like a normal person.

I’ve reintroduced most of the foods from the diet, but anytime I seem to consume too much of “inflammatory foods” my sleep suffers dramatically. There is a clear linkage for me.

In all, I think it’s important to try things out and see what works for you. Low-carb or not, is there a dietary component, what is it, and how do I adjust accordingly.

Frunobulax
Posts: 212
Joined: Mon Jun 02, 2014 7:41 pm

Re: Fasting, keto and lectin free diet

Postby Frunobulax » Fri Oct 18, 2019 12:48 pm

Frunobulax wrote:Good food:

  • Olive oil, coconut oil, linseed oil, avocados.


So if I recommend something, I'll try to keep you updated if I learn new things :)

Recently I found some pretty strong evidence that polyunsaturated fats should be avoided and saturated fats (animal fat/butter and coconut oil) are much better. I sketched the evidence against polyunsaturated fats over here: http://bb.rls.org/viewtopic.php?f=5&t=10599#p100226.

I also read recently why the mediterran diet (especially olive oil) may be a bit overrated. Apparently there were some conferences/research sponsored by the NIH (or ADA?) in the 90s, but when money ran out the olive oil companies and olive oil producing countries like Spain, Italy and Greece would happily continue the funding. As a result, there were loads of conferences with fantastic food and cultural events in those sunny, nice countries, not only scientists were invited but journalists too, and people got re-invited if they wrote nice things about the mediterran diet. Go figure. This doesn't mean that nuts and olive oil is bad (I still think they are healthy), but you can't fix your diet issues by just pouring olive oil over everything and eating a handfull of nuts every day (as has been suggested). It's pretty sad that other diets like Atkins did not receive the same PR as the mediterran diet. There were only a handful of diets comparing western diet (according to food pyramid recommendations), mediterran diet and low-carb diet, and in these studies the low-carb diets usually wins for whatever health goals are set (lowering triglycerides and losing weight for example).

The main issue with fats is that we need balance, and the balance for most of us has been tilted to Omega-6. Historically (our ancestors that were hunters and gatherers) we used to have a 1:1 ratio between Omega-3 and Omega-6 fats, but nowadays we're up to 1:20 and more. The reason for that is: All vegetable oils contain a lot of Omega-6 (especially canola, soy-, corn- and sunflower oil) and zero to little Omega-3 (except some alpha-linolenic acid that is in linseed oil, but this has to be converted to DHA and EPA so the bioavailability is not that good), and animal fats contain less Omega-3 than they used to. I read a study that the Omega-3 content in milk differs dramatically depending on what cows were fed, milk from grass-fed cows contained something like 500% more omega-3 than grain-fed cows (which is the norm). Similar observations are made for red meat. So, fish is pretty much the only source of Omega-3 left, we get less Omega-3 and more Omega-6, and all this drives inflammation. Nuts and olive oil are good but contain no Omega-3, so make sure you get your Omega-3 somewhere else.

Fun fact: Rates of arteriosclerosis , diabetes and obesity seem to be in direct correlation depending on how much grain-based oils we consume. Those "vegetable" oils (actually grain-based) crept into our life about 100 years ago, at a time where diabetes and arteriosclerosis were considered fairly rare in most countries. Use of grain-based oil really picked up in the US after 1980, and nowadays more than 80% of the consumed fat/oil comes from grains. During those 40 years, rates of obesity have tripled and rates of diagnosed diabetes have quadrupled. Association is not causation, but an association that strong is certainly a strong hint that we should find out if there is a causation. Some of these effects may come from use of trans fats, a way to make grain-based fats solid, but we really don't know.
Last edited by Frunobulax on Fri Oct 18, 2019 12:57 pm, edited 2 times in total.

Frunobulax
Posts: 212
Joined: Mon Jun 02, 2014 7:41 pm

Re: Fasting, keto and lectin free diet

Postby Frunobulax » Fri Oct 18, 2019 12:55 pm

Oozz wrote: I’ve been away from the forums for some times now as my RLS has been under control. To get here I went on a low fodmap diet.


True, I missed that, thanks for the hint. FODMAP is another thing that may cause weird symptoms for a lot of us. I'm not as well acquainted with low fodmap as I should be (perhaps), but I think low carb is automatically low fodmap too if you avoid sweeteners like Xylitol, but not the other way around as low fodmap allows fructose and gluten-free carbs?

badnights
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Re: Fasting, keto and lectin free diet

Postby badnights » Fri Nov 22, 2019 7:49 am

I think low carb is automatically low fodmap too if you avoid sweeteners like Xylitol
not quite. Food with FODMAPs (to avoid) include legumes, garlic, onions, lots of other veg, many fruits, and a lot of gluten-free grains, also some foods that are considered prebiotics (food for the good gut bugs). I wanted to try it but I gave up the idea cuz I was (still am) doing the Wahls diet, and I didn't see how I was going to get enough micronutrients if I had to cut out onions, garlic, so many vegetables, and prebiotics (I was also battling SIBO at the time, so I was trying to cultivate a good community of bugs in my gut).
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ViewsAskew
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Re: Fasting, keto and lectin free diet

Postby ViewsAskew » Thu Nov 28, 2019 12:21 am

badnights wrote:
I think low carb is automatically low fodmap too if you avoid sweeteners like Xylitol
not quite. Food with FODMAPs (to avoid) include legumes, garlic, onions, lots of other veg, many fruits, and a lot of gluten-free grains, also some foods that are considered prebiotics (food for the good gut bugs). I wanted to try it but I gave up the idea cuz I was (still am) doing the Wahls diet, and I didn't see how I was going to get enough micronutrients if I had to cut out onions, garlic, so many vegetables, and prebiotics (I was also battling SIBO at the time, so I was trying to cultivate a good community of bugs in my gut).


When you get a chance, Beth, watch that video the RLS Foundation did a couple weeks ago with the gut doctor. I thought it was interesting that he doesn't do ANY pre or probiotics when doing the SIBO treatment. He only does them after.
Ann - Take what you need, leave the rest

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