Liver Disease and Nutrition

Six and a half years ago, I was diagnosed with Liver Disease, and referred to the University of Virginia to see some liver specialists. The first thing they did was to refer me to the Transplant Program, where I underwent a battery of tests over several months to determine if the rest of my body was healthy enough to withstand the rigors of a liver transplant.

At the time, I was also having the same intermittent low thyroid symptoms I'd had for most of my life. I show all the symptoms of hypothyroidism, yet the thyroid tests always come back in the normal range. This time, the endocrinologist talked to me about foods that adversely affect the thyroid, most notably cruciferous vegetables and soy products. They are goitrogens, meaning they suppresses thyroid function and the uptake of iodine needed by the thyroid.

Cruciferous vegetables lose a lot of the goitrogens when cooked, but soy does not. I thought I had pretty much eliminated soy from my diet years ago... that is, until I discovered soy masquerades under 40 or more names as food additives. The first thing to eliminate from my diet was any food that came in a package with a long list of chemical ingredients on the label, many of which are soy-based (and from GMO soy).

The next thing to eliminate was sugars, high fructose corn syrup in particular. Fructose damages the liver and causes mitochondrial and metabolic dysfunction in the same way as any other toxin.

Sucrose (table sugar) is 50 percent glucose and 50 percent fructose. High fructose corn syrup (HFCS) is anywhere from 42 to 55 percent fructose depending on which type is used. Glucose is the form of energy our bodies are designed to run on. Every cell in our body uses glucose for energy, and it's metabolized in every organ of our body; only about 20 percent of glucose is actually metabolized in our liver. Fructose, on the other hand, can only be metabolized by the liver, because the liver is the only organ that has the transporter for it. 

Since all fructose gets shuttled to the liver, when we eat a typical Western-style diet, we consume high amounts of it, so fructose ends up taxing and damaging the liver in the same way other toxins (including alcohol) do. In fact, fructose is virtually identical to alcohol with regards to the metabolic havoc it wreaks. 

According to Dr. Lustig (an endocrinologist at the Univ. of California), fructose is a "chronic, dose-dependent liver toxin." And just like alcohol, fructose is metabolized directly into fat—not cellular energy, like glucose. So when eating fructose, it just gets stored in our fat cells, which leads to mitochondrial malfunction. 

The liver is the major site for converting excess carbohydrates and proteins into fatty acids and triglycerides, which are then exported and stored in adipose (fat) tissue.  I was advised to cut my carb intake to 50 grams a day until my system got clean, and then keep the intake to under 100 grams a day. 

The last thing to eliminate was any meat and eggs from animals that may have been fed the same soy and grain I was to avoid, as well as avoiding all fresh produce grown in a chemical cloud. That meant local free-range eggs, grass-fed beef, lamb, pastured pork, free-range chickens, and the Farmer's Market for veggies I don't grow.

Well, let me tell you, for 2-3 weeks I thought I would starve to death! Giving up the obvious addictive sugars was hard enough, but giving up bread and pasta was even worse. That's when I really started to delve into Real Foods, and things started to turn around.

Within a month, my energy levels and mental outlook began to increase, and my liver enzymes improved enough in 3-4 months that my liver docs took me off all meds.

I also began to lose a little weight. I learned to always carry a wholesome snack when I was away from home, usually a hard-boiled farm egg, or a piece of raw milk cheese (for the enzymes not found in pasteurized cheese). (Do not believe raw milk cheese might harbor pathogens. By Law, they must be aged at least 60 days before they can be sold, and if there were pathogens, the cheese would be rotten before the 60 days were up.)

Unfortunately, I have fallen partially off the "good diet" wagon over the last 12 months, mostly due to the increased cost of food and utilities versus my income (just a monthly social security check) and partly due to laziness. Eating right requires planning ahead and making time to prepare nutritious foods. In the last 3 weeks, I've had 3 sodas because I was experiencing low blood sugar while away from the house. That's 3 more than I've had in 5-6 years.

It's time to climb fully back up on that healthy food wagon no matter what else I have to give up. (Or continue a downward spiral in my health.)

There are many, many good things I can make from cheap cuts of meat and bones. Slow cooking a crockpot full of bones produces an incredibly nutritious broth/stock that's like jello when cooled.  Stock contains minerals in a form the body can absorb easily—not just calcium but also magnesium, phosphorus, silicon, sulphur and trace minerals.  Bone broth also supports joints, hair, skin and nails due to its high collagen content. In fact, some even suggest that it helps eliminate cellulite as it supports smooth connective tissue.

Cooked long and slow, bone broth also contains the broken down material from cartilage and tendons, stuff like chondroitin sulphates and glucosamine, now sold as expensive supplements for arthritis and joint pain.

The "odd bits" like heart, liver, kidneys, sweetbreads, etc. contain so much more nutrition than the muscle meats, and they are much cheaper to purchase. I just received a Christmas gift of the book Terrine, plus I found a used copy of Terrines, Påtes and Galantines on ebay for under $4 earlier this year. (If you are not familiar with terrines, think meatloaf... and a galantine is just a meaty loaf encased in a pastry shell.)

What else did I eat when I felt so great?? Bacon, eggs, sausage, homemade yogurt, salads dressed with fresh lemon juice and a drizzle of EVOO, cheese, real butter, real cream in my coffee (not UP), fresh veggies, olive oil and coconut oil, sardines, not much fruit because of the sugar content, no legumes, no grains, and grass-fed meats daily. My one daily treat was a half-inch square of an 85% cacao bar at bedtime, and it was enough.

Eating those foods also brought the ratio of my Omega-6 to Omega-3 back into a better balance (about 4:1) than the SAD (Standard American Diet) which is as much as 40:1. 

All the meat and dairy provided the essential amino acids necessary to build proteins (essential because our bodies cannot produce them internally). The failure to obtain enough of even 1 of the 10 essential amino acids has serious health implications and can result in degradation of the body's proteins. Muscle and other protein structures may be dismantled to obtain the one amino acid that is needed. "Unlike fat and starch, the human body does not store excess amino acids for later use; the amino acids must be in the food every day.

I bought some wonton wrappers yesterday and intend to make and freeze some wontons (they contain just 4 grams of carbs per wrapper). A lunch of a wonton or two added to some home canned stock is quick, easy, and nutritious. 

It's a start. Salads will be scarce over the winter because I'm leery of bagged greens, even organic ones. Thankfully I froze lots of green veggies from my summer garden.

Einkorn, an Ancient Grain

I've been reading a lot about industrialized wheat, and its impact on human health from the book, Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health, by William Davis, MD, a renowned cardiologist. What got my attention was connecting his theories and remembering two years ago when I gave up ALL grains from my diet... I lost 30 pounds and felt great.

When I was a youngster, both of my grandparent's families raised wheat in Kansas. I can remember visiting, and walking in the fields. The wheat was just over 3 feet tall, and lots was lost when the combines harvested the crops because many of the tall stalks had fallen over before harvesting.

So I did a little more reading on wheat. BigAg started to "improve" wheat around the early- 1960's, and crossbreeding resulted in much shorter (dwarf) wheat stalks with fuller heads of grain. The new wheat grew faster too. As a result, the per-acre wheat yield of modern wheat far exceeds the yield of old wheat varieties.  

"That wheat has been hybridized is not, in itself, a reason to think that wheat is bad. The bad part comes by way of a little-known situation that resulted when wheat was hybridized. Unlike with most other plants, when wheat is hybridized it is genetically altered by the addition of chromosomes. New genes that were never present in either parent were created. As a result, modern wheat varieties are profoundly different from the wheat that mankind ate for centuries prior to our industrial age. For example, the wheat mentioned in the Bible is most likely Emmer wheat, which has 28 chromosomes, while modern wheat varieties have 42 chromosomes." Source

By the way... "modern (hybridized) wheat" is NOT THE SAME AS GMO wheat!

According to Dr. Davis, modern wheat with its new genetic code, and the newly-created constituents that came with cross breeding, is largely responsible for widespread obesity (wheat bellies), but it is also doing damage to people’s bodies in other serious ways. Dr. Davis provides convincing evidence to suggest that, in addition to heart disease, modern wheat is a player in such diseases as diabetes, bowel cancer, asthma, schizophrenia, autism, hypothyroidism, and dementia, not to mention Crohn’s disease.

The earliest known ancient wheat, Einkorn, has just 14 chromosomes and is being grown organically in Tuscany (Italy) and sold in many product forms by Jovial. It's also now being grown in a small pocket in the Western US and Canada. According to Dr. Davis, Einkorn naturally crossed with wild goat grass to make Emmer wheat (with 28 chromosomes). Both of these grains are available today, although not likely in your supermarket. In fact, the 2-3 health food stores within a hundred miles of me don't carry them either, so I had to order mine online.

I bought a package of Jovial™ Einkorn pasta to try, and I have some Einkorn flour coming soon. Baking bread may be a challenge simply because using the grains is a bit different, but there's a good tutorial here.

I cooked the Einkorn pasta for spaghetti last night, and I found it really did have a slightly nutty taste. Other than that, it was just pasta. One other thing I did notice... cleaning the pot. All the pasta I have ever cooked has always left a thin starchy film on the pot, but the Einkorn did not.

Wheat is in almost everything we eat, and giving it up totally is really, really hard... no cookies, breads, cakes, hamburger buns, crackers, biscotti, muffins, pizza, sandwiches, breakfast cereals, pasta, thickened gravies and sauces... the list is almost endless.

It will likely be several months before I will really know if I can have some wheat in my diet (in the form of Einkorn or Emmer) and still have the benefits of weight loss and increased energy from my no-wheat diet of 2 years ago.

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Grits

Photo from Dan4th's photostream

There's grits, and then there's great grits, a Southern Food specialty. Sadly, even many Southerners have never had great grits, or at least not in years. Partly that's due to a fast-food lifestyle, and partly the disappearance of honest, good raw materials and proper preparation techniques.

I grew up eating grits, and over the years what I have been served in restaurants has slowly changed. Cooking grits at home didn't produce a much better dish, and I began to mostly avoid grits even though I loved them. Strangely enough, polenta has become very popular, and it is the same thing...

Polenta is simply boiled cornmeal. Grits are simply boiled cornmeal.

So, why are grits considered so yucky? Actually, if you just boil cornmeal from the grocery store, it IS yucky, whether it's called polenta or grits.

Grits is a food that is Native American in origin, and historically is a long-cooked dish of old-fashioned coarsely ground corn. As monocropping and hybrids took over, grits began to lose the taste and quality of the old varieties of corn. It's further complicated by the terms 'grits' and 'hominy grits' which I always thought were the same thing, although I knew hominy itself was different.

Hominy (also called nixtamel) is made by soaking dried maize (corn) kernels in an alkali to remove the clear coating on the kernel. In traditional Mexican recipes the process (nixtamalization) involves cooking the kernels in lime water (calcium chloride), which removes the hard outer shell along with the germ. In the US, a similar process involved soaking in lye-water made from wood-ash until the hulls are released.

Hominy Grits (sometimes called sofkee) is coarsely ground hominy, and masa (the dough used to make tortillas) is finely ground hominy.

Grits, on the other hand, are ground corn kernels dried without the alkalizing process. Yellow corn grits are made from whole kernel corn, and white corn grits are usually made from hulled corn kernels. (I'm not sure how they hull them.)

In earlier times in the US there were lots of local grist mills where people took their grains to be milled. Often they paid the miller with a portion of the grain as his fee. Even today in South Carolina, there is a law (South Carolina Code of Laws, Title 39 - Trade and Commerce, Chapter 29) on the books that corn meal and grits must be enriched (similar to flour) unless the grits is ground from corn where the miller keeps a portion as his fee.

So part of the secret to great grits is the type and quality of corn and how they are ground (stone-ground is best); the other part of the secret is cooking them. The best grits probably aren't in a box at your grocery store, and if you cannot find good grits locally, it is worth it to order them. Try Anson Mills, Logan Turnpike Mills or Delta Grind.

Cooking requires a long (and I do mean long!) slow cook so the grits completely hydrate and become creamy, somewhat like a risotto. That might be overnight in a slow cooker, or in a low-temp oven, or carefully watched on the stovetop. Grits need a lot of salt and I find it better to add it later in the cooking. Grits also love butter!

Anson Mills has a good recipe with excellent notes and instructions. They describe cooking to 'first starch' (a term unfamiliar to me) as "the early stage of grits and polenta cookery in which fine corn particles thicken the liquid enough to hold the larger particles in suspension" as part of the overall cooking process. You should read their recipe if you'd like to make great grits!

Grits are not just a breakfast side dish. They are used as a base for a plethora of dishes from breakfast to desserts, and can include many additives like cheese and shrimp. Shrimp and Grits is a popular and tasty dish on the Gulf Coast and coastal South Carolina. I'll try to make Shrimp and Grits soon, and post about it!

Soaking Flour for Baking Bread

Photo from net_efekt's photostream

I wasn't very clear about soaking whole grain flours in an acid medium to break down phytates in the flour for making bread. Sorry. Let me see if I can explain it better.

Bread recipes call for flour, water (plus possibly other ingredients, depending on the recipe) and a leavening agent such as dry yeast or a starter. If you use a packaged yeast for the leavening, it doesn't break down the phytates (i.e. destroy the phytic acid) during the fermentation process. If you are using plain ole white flour that has been stripped of its nutrients, it probably doesn't make any difference anyway since the bran containing phytates is long gone.

If you are making a nutritional, whole grain bread, there are phytates in the milled flour, and using a starter rather than packaged yeast will help destroy the phytates. First, the starter (levain, sourdough, etc) has an active microbe population that has already destroyed most of the phytates in it. When you mix the starter with the flour and water called for in the recipe and let it sit in a cool-ish spot overnight to slowly ferment, you are letting the microbes grow and break down (digest) the phytates. This actually amounts to "soaking the flour"...

The more you slow down the fermentation time, the more phytates will be disarmed. So, if you normally mix up the ingredients, let it raise to double, punch down the dough, let it raise once more, then form and bake, you are eliminating some of the phytates. To let the dough rise longer (thus what is called a slow ferment), and punch it down at least once or twice again before forming, you need cooler temps.

My kitchen is generally cool, and I can leave mine on the counter, let it rise and punch it down 2-3 times after it has first fermented overnight, and put-off baking until perhaps 36 hours from when I first began, destroying more of the phytates.

Fermenting more than 48 hours is pretty useless because by then there are few phytates remaining and your dough could begin to spoil as the microbes have nothing to eat. One of the reason to refrigerate starters between use is to keep the living microbes dormant, not dead. Bringing the microbes out of dormancy by putting the starter back in room temperatures and feeding re-activates the starter.

Any of my whole grains to be cooked as a side dish or a cooked cereal, are soaked overnight in water with some Braggs Raw Apple Cider Vinegar. The acid in vinegar will break down the phytates, and the addition of the microbes in this particular raw vinegar will increase the vitamin (nutrient) content.

Chicken, Spinach and Sprouts

Photo from VirtualErn's photostream

I used my first batch of sprouted mung beans for this dish. Easy to make although I had no recipe. I found the photo on Flickr and it looked so good!

Sauté some sliced mushrooms in extra virgin olive oil with a pat of butter for added flavor. Add cut-up chicken pieces and stir/fry until almost done. Add some fresh spinach, throw in the bean sprouts and cook just long enough to get them warmed. (I would have thrown in some sliced scallions with the chicken pieces if I'd had any.)

I served it with some hot bulgur (topped with a pat of butter) that I had soaked overnight in water with a tad of vinegar. (Rinse well if the smell of vinegar lingers and you don't like it.) It is a quick cooking grain, so it was easily cooked in the time I was also cooking the chicken.

Yum!

Soaking Grains and Legumes

Photo from The Marmot's photostream

I have soaked beans overnight for years, thinking it both softened the beans thus reducing cooking time, and eliminating some of the gas produced in the intestines during digestion. Now, with my research into phytic acid and enzyme inhibitors found in legumes and grains, I have a better understanding of the process, and how to improve it.

Usually I soak beans overnight with at least 2 changes of water. Now with the information about neutralizing the antinutrients by soaking in an acid medium, I can do better. Sally Fallon (Nourishing Traditions) recommends adding 2 tablespoons of an acid medium per cup of grains or legumes to the soaking water. (I'll cover milled grains/flours in another post later.)

My preference for the acid medium will be Bragg's Raw Apple Cider Vinegar because the friendly bacteria in it will inhibit unwanted bacteria that could contaminate my soaking water. The next day, rinse well, and cook as you normally do. For years I have read Asian rice recipes where they soak rice overnight with a few changes of water. I thought it a cultural thing, not an improvement to the bioavailability of the nutrients in the food. So, yes, you can use just plain water, as I have done with my beans for years, but it will only break down a small portion of the phytic acid.

I happen to like the taste of a good vinegar, but if you do not, there are several other acid mediums you can use although the proportions should remain the same. You can use buttermilk, yogurt, kefir, whey, milk with fresh lemon juice to acidify it, cultured milk, regular vinegar, and lemon juice. There are probably other acids that will work, too, so feel free to experiment.

I cook a lot of whole grains like brown rice, bulgur, millet, quinoa, barley (both hulled and pearled), kamut, steel-cut oats and oat groats. You can be sure that my grains will be properly soaked from now on!

Update July 2010:
I finally (and reluctantly) have had to accept the idea that our systems are not designed to process grains, seeds, or beans after seeing the incredible improvement in my health and well-being without eating them for several months. Although I miss those items, I no longer eat any grains, seeds, or beans and only the occasional soaked nut meats. It still doesn't feel right (it's hard to eradicate what I was taught for so many years), but I cannot deny the improvement!