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Mastering Nutrition

Hi, I'm Chris Masterjohn and I have a PhD in Nutritional Sciences. I am an entrepreneur in all things fitness, health, and nutrition. In this show I combine my scientific expertise with my out-of-the-box thinking to translate complex science into new, practical ideas that you can use to help yourself on your journey to vibrant health. This show will allow you to master the science of nutrition and apply it to your own life like a pro.
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Now displaying: Category: fitness & nutrition
Feb 11, 2020

Question: What to do about cataracts.

Carl Rayner says, "Cataract in one eye becoming noticeable. This eye had a posterior detachment about 11 years ago, which is basically healed. I've been on a low-carb diet for over 40 years. Eat raw cream cheese, eggs, meat and liver. In the past few years, adding fasting and more keto diet. Saw your thoughts about glutathione on the cheat sheet and interview with Wendy Myers. Am I on the right track and what else could I do? Grain intolerant. What testing beyond normal tests might be helpful?"

I believe that cataracts in the eye are largely driven by the glycation of lens proteins. The glycation of lens proteins is largely driven by methylglyoxal, which I did my doctoral dissertation on. In direct contradiction to much of the low-carbohydrate literature, glycation is not all driven by carbs. Methylglyoxal is quantitatively the most important source of advanced glycation end products in the body.

Methylglyoxal can be derived from glucose, or it can be derived from ketones, or it can be derived from protein. No one has ever done a very good study to determine whether you have more methylglyoxal on a ketogenic diet versus a high-carb diet. But there was one poorly designed study where they took a small handful of people. They said, "Here's the Atkins diet, new diet," Or what is it called? Atkins New Diet Revolution or whatever that book was called. They said, "Here, read this, go forth and do it." They went home, presumably they read the book or part of it, and they tried to do it. They came back, they lost weight, they had elevated ketones and guess what? They also had significantly higher methylglyoxal.

Also, everything in the pathway that leads from ketones to methylglyoxal was elevated. I would say the data were very strong that in those people, they had higher levels of methylglyoxal because they had higher ketone levels that were generating it. They went on the Atkins diet, and they worsened their glycation risk by making a lot more of the thing that causes most advanced glycation end products and the thing that is probably overwhelmingly driving cataracts. But they didn't show any health consequences, and they certainly didn't measure cataracts in that study because that wasn't the point of it.

They left more questions than answers. For example, what if they had a control group that lost the same amount of weight on a high-carb diet? My suspicion is that methylglyoxal would have gone up during weight loss but just not as much. I also think that if those people stabilized their new weight and then they worked carbs back into their diet, their methylglyoxal would go back down. In fact, I have a consulting client who developed cataracts that corresponded very well with when he started intermittent fasting. He did have poor glutathione status. We were able to improve his glutathione status, but the cataracts didn't go away.

Todd Becker asks, "How do you test methylglyoxal levels?" You don't. You become a guinea pig in a lab because doing a study on it. That's about it. Look, I'm not against keto and I'm not against intermittent fasting. But if you're specifically talking about dealing with cataracts, you're probably not going to get the cataract to go away, but you probably can stop them from getting worse and stop them from forming. I think intermittent fasting and keto is probably going in the wrong direction.

One thing that I do think, I don't think you're going to measure your methylglyoxal levels, but I think you should test your glutathione levels because glutathione is what detoxifies methylglyoxal. If you listen to my riboflavin podcast, we talked about cataracts being a sign of riboflavin deficiency and also being one of the things that's being investigated for whether riboflavin supplementation can help it.

Why does riboflavin supplementation help that? For the exact same reason as when I went on that big, longwinded answer about glucose-6-phosphate dehydrogenase deficiency at the beginning, the riboflavin is there to boost glutathione recycling. I think the whole story, all these pieces knit together to a very, very, very nice story, clean story saying what you want in your eye to avoid cataracts from forming and getting worse, forming in the first place and getting worse, is you want low levels of methylglyoxal in your lenses. How do you get that? You have very good glutathione status.

The keto thing is a maybe. There's no maybe that maybe keto makes that better, but there's a maybe that maybe keto makes that worse. You can't test the glutathione levels in your lens proteins, but you can test the glutathione levels in your blood. I would use the cheat sheet in a very targeted way for everything that's relevant to your glutathione status. I would follow the recommendations in there about how to boost your glutathione status. I would use your blood levels of glutathione as a metric.

Rather than getting them in the normal range, I would try to get them as high within the normal range as you can, and titrate your approaches according to what works. Test it every couple of months, make one very important change. Well, actually, follow all the steps in optimizing glutathione status right now or all the ones you're willing to do. Follow them for eight weeks, test glutathione status, get a baseline glutathione if you can, but eight weeks of all my suggestions or whatever you're willing to do with them. Retest the glutathione, see if it helped. If it helped, then tweak one thing at a time after that. Do that one thing very consistently and stably for four to eight weeks. Retest glutathione.

Whatever I said for glutathione, also consider maybe supplementing with high-dose riboflavin in there. Maybe 100 milligrams of riboflavin at each meal, I would probably revise my glutathione recommendations in the cheat sheet to include that as a possibility. Yeah, optimize against glutathione and consider riboflavin supplementation. Be very open-minded about the carbs, the keto and the fasting because those might be great for many things, but they're definitely not optimal for glutathione and methylglyoxal. Thanks, Carl.

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a

Feb 11, 2020

Question: What can be done nutritionally to specifically improve antiviral immunity?

Certainly, the fat-soluble vitamins, vitamins A and D, both important. Lauric acid as a fat. Coconut oil might be a good fat choice for the fat in your diet. Monolaurin would be a very good choice for a supplement. Lauricidin is the best monolaurin to take, 3 to 10 grams a day. Be careful of your bowel tolerance, spread it out among your meals, and cut back if it starts to loosen your stool.

Elderberry, which has mostly been studied in the context of flu, that probably has good antiviral properties.

Garlic. Garlic appears to require very high doses if you're just taking a garlic extract. If you're taking stabilized allicin, 180 micrograms a day is good. But you could raise the question what if you're missing on some of the other important compounds in the garlic. I'll debate with some of my friends about that, but what's really been tested is 180 micrograms of stabilized allicin.

Then zinc for sure in the immune response is super important.

Then you get back to nutrient density. Although I'd give special importance to vitamins A and D, arachidonic acid just mentioned, zinc and copper, both, and then those supplements. If you're missing any one particular nutrient, then you're going to wind up with a specific vulnerability that will persist until you fix that one nutrient. Thanks, anonymous.

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a

Feb 10, 2020

Question: If free T3 looks good, why is TSH still a little high? Why hasn't the T3 brought it down enough?

Your thyroid gland makes thyroid hormone. Thyroid hormone increases your metabolic rate and does a lot of related things. Your hypothalamus is governing that by controlling your pituitary, the master endocrine gland, and its secretion of TSH, which is what controls the thyroid gland and makes it make more thyroid hormone.

The way that the feedback occurs is that the circulating T4 is converted to T3 inside the cells of the pituitary. That is what suppresses the production of TSH, which is basically the pituitary monitoring the thyroid hormone levels to know whether the thyroid has done its job. If the pituitary, the master endocrine gland, decides that the thyroid has done its job, it takes down TSH, the signal to make more thyroid hormone.

You really are not looking at whether the free T3 is suppressing the TSH. Ninety percent of that suppression comes from circulating T4 that's converted to T3 inside the pituitary gland. You really are looking at whether the T4 is on the high end of normal or not. 

If your reverse T3 is on the higher end of normal, then that explains it. You basically have your brain telling your thyroid gland that it needs more thyroid hormone, but you have much of the rest of your body deciding that it's not in the position to carry out the effects on the metabolic rate that the thyroid hormone is demanding. It's converting the thyroid hormone into reverse T3, which is basically a thyroid antagonist.

If your reverse T3 is high, then I think you want to look at things like calorie intake, carb intake, and stress levels because I think those are the main things that might make your body want to resist the signal of thyroid hormone by making the reverse T3. If the reverse T3 is good, meaning it's pretty low, then I think that means that there is something either in your brain, specifically in the hypothalamus or in the pituitary or somewhere in the combination where they're just deciding that your body needs more thyroid hormone than you have.

My suspicion is that that's going to relate to how sensitive your cells are to the thyroid hormone, if your cells are somewhat resistant. Remember in the last AMA, this got brought up, and I talked about zinc deficiency and high free fatty acids being the primary things that are going to reduce sensitivity to thyroid hormone or cellular uptake. There are some indications that high free fatty acids might also decrease cellular uptake, but not much is known about what governs cellular uptake.

In fact, there are some genetic variations in cellular uptake. If the thyroid hormone levels are high in your blood because they're not getting into the cells, then that could easily explain everything. It's just that your problem seems pretty moderate because you're not saying that your thyroid hormones are sky high and your TSH is sky high. You're just saying everything is a little on the high side of normal.

It sounds like there's not a big problem, but that something somewhere your body is determining that you need a little bit more thyroid hormone. If you can address zinc, free fatty acids, and I would address zinc and free fatty acids as the top things, unless the reverse T3 is high, target carbs, calories, and stress.

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a

Jan 31, 2020

Question: What food supplements and training programs are good for developing muscle mass?

 

Overwhelmingly, what matters for muscle mass is working out, eating enough protein, and eating enough calories. 

 

You want to try and hit 10-20 sets per muscle group per week with eat set hitting within 80% of failure. So, if your doing a set of 8 reps but you could have done 20 reps with your chosen weight, that doesn’t count. You would want to pick a weight that you can lift no more than 10 times. Ideally, you’ll do some sets in the 5-rep range, 10-rep range, and 15-rep range. 

 

For protein, you probably want to be up around 1 gram per pound of body weight or per pound of target body weight. 

 

Then calories, you do need a caloric excess, but you don't want to get fat. If you know how many calories you need to be weight-stable, I recommend titrating the calories up 100 calories a day and then track your progress if you are gaining waist circumference. I know this is a little bit harder when you're a woman because you're going to have more fluctuations in water weight, but in terms of simple things to do to track your progress, waist circumference is valuable, and looking in the mirror is valuable.

 

If you can get an actual Bod Pod or DEXA scan, then that would give you more reliable information. There's a device called Skulpt. It's bioimpedance, I believe, but it's taking it at many different points where you take so much data that it actually becomes pretty accurate, but it's very time-consuming. Anyway, take your choice of what you're going to use to track your progress.

 

If you're not gaining any fat, you can very slowly add your total calories. If you are gaining fat, you need to cut back on the calories. But you need to have a caloric excess to maximize your muscle gains. That right there is probably 90% of it and anything else is probably completely pointless unless you are a very good athlete, in which case you're going to be looking for what's the next.



This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 30, 2020

Question: Should I manage my total cholesterol of 305 just for my doctor or should I be doing it for my own sake? If so, how should I do it?

 

You should want to improve your lipid profile for a lot more than to please your doctor.

 

Let's revisit this from a cholesterol skeptic point of view. Uffe Ravnskov, he wrote a book called The Cholesterol Myths. In that book, he shows a graph from the Framingham study where he maps out the people who have heart disease and the people who don't. If you look at that graph, one thing that you see is that everyone who had total cholesterol over 300 had heart disease and no one who didn't have heart disease had cholesterol that high.

 

Look, the only way to have a total cholesterol of 300 or more in most cases is to either have a thyroid disorder or to have a familial hyperlipidemia. We're talking about fasting levels here. You should want to manage your blood lipids for your own sake because people with familial hypercholesterolemia have a dramatically increased risk of having heart disease decades earlier than it becomes normal for the general population. 

 

I'm not saying it's 100% certain that if you have a cholesterol of 300 you will have heart disease, but you are way disproportionate in risk for that reason. You definitely want to address this for the sake of your health.

 

I think that if you have weight to lose, that losing weight should be one of the first things that you do to normalize your blood lipids and your inflammation. Being overweight also contributes to elevated free fatty acids, and elevated free fatty acids do raise your blood lipids. That's, in fact, the entire rationale of using high-dose niacin to lower LDL-C is by suppressing free fatty acid release.

 

It’s also important to address any inflammation in your gut. You might have microbiome issues, and working more high-fiber vegetables into your diet and diversifying across the different plant fibers is a great way to nourish your microbiome, reduce inflammation that comes from the intestines that would negatively affect your blood lipids.

 

If these things that we just talked about aren't enough to get the blood lipids into the normal range, then I think you want to experiment with eating more carbohydrate and a low-fat diet, but selecting those foods to maintain nutrient density. You could add something like psyllium husk fiber , which might be both good for your gut and the inflammation coming from your gut. It will also help reduce your cholesterol by making bile acids go into your feces and making your liver draw cholesterol from the blood.

 

If those natural things don't get your blood lipids into the normal range, then I think that you should consider being open to pharmacological methods. I've gone through all the cholesterol-skeptic literature and I'm against demonizing cholesterol. I do not believe that high cholesterol is the cause of heart disease.

 

But if your lipids are that high, it's overwhelmingly because you are not clearing them from the blood, and not clearing them from the blood is the single most important risk factor for them oxidizing, and them oxidizing does cause heart disease. 

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a




Jan 29, 2020

Question: "Do you have any recommendations on how to get enough calcium on a low-carb, no-dairy diet? I've read that vegetables provide calcium, but bioavailability is poor."

 

The bioavailability of calcium from different vegetables is highly dependent on the specific vegetables. 

 

Cruciferous vegetables have very good bioavailability. It's better than from milk. Spinach has like close to zero bioavailability. It's terrible and you shouldn't even count it. Nuts and seeds have about 20% of the calcium being absorbed. If you compare that to milk --- milk is probably going to be like 30% or 40%. Cruciferous vegetables are going to be like 50% or 55%.

 

The real problem is the volume. If you look at broccoli or kale and you look at how much volume of those foods do you need to eat in order to get 1000 to 1500 milligrams of calcium a day, which is the target, it's a ridiculously high volume. 

 

I'm a bit skeptical that you want to eat more than say 200 or 300 grams measured cooked of those foods a day because they're increasing your iodine requirement. At some point, they become a liability for your thyroid gland. I think it's best to eat two or three servings of those cruciferous vegetables a day, and that's basically maxing out the calcium that you can get from them. You're just not going to get anywhere near the 1000- to 1500-milligram target.

 

A low carbohydrate, non dairy containing diet is emulating the traditional diets of the Arctic where plant foods were very limited. How did they get their calcium? They crushed up fish bones. They freeze-dried fish bones, they pulverized them, and they ate the bone powder.

Bone meal is a traditional food. Some consider it as a supplement but it is the historic source of calcium in traditional diets that were low-carb.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 28, 2020

Question: What should people with glucose-6-phosphate dehydrogenase deficiency be doing not just about glutathione, but about folate, vitamin K, fatty acids, and neurotransmitters?

 

G6PD, glucose-6-phosphate dehydrogenase deficiency, is an inborn error of metabolism. It's the most common one in the world. About 8% globally have some impairment in this enzyme. The reason that it's important is because glucose-6-phosphate dehydrogenase is the enzyme that allows you to make NADPH, which is a specific derivative of niacin that's involved in antioxidant defense, detoxification, synthesis of neurotransmitters, and synthesis of nucleotides, which are needed for cell division because they're parts of DNA.

 

Someone with G6PD deficiency is vulnerable to hemolysis, or the destruction of red blood cells, because of glutathione deficiency. Glutathione reductase uses energy and NADPH, the thing that you can't make, to recycle glutathione. But it also uses riboflavin. So, one of the adaptations that someone with this impairment has to try to protect themselves is for the glutathione reductase enzyme to hog all the riboflavin so that it says, "I don't have enough of the raw material I need to make this happen, so I'm just going to make myself get way better at using what I do have." That's an adaptation to compensate for not being able to make NADPH is just to get way better at using NADPH to recycle glutathione.

 

Supplementing glutathione is not necessarily a bad idea. You just have to be aware that at a certain point you just can't solve every one of the dozens of problems that are happening. I think that you should measure your glutathione status. Probably the best test available, not because it's the best we could have available but because there's nothing better right now, is LabCorp's test for glutathione. If that looks low, then I would supplement with glutathione to try to bring that up to normal. 

 

For the folate recycling, you have to consider this basically as if you had a really bad MTHFR polymorphism because G6PD is needed to make the NADPH that MTHFR uses, again, with the help of riboflavin to make the methyl group on methylfolate. You can take some methylfolate, but as I've made the point in my MTHFR protocol at chrismasterjohnphd.com/methylation, you have to take 18,000 times the RDA to compensate for the 18,000 times a day that you add a methyl group to the folate molecule using that enzyme. It's not safe to take anywhere near that much folate.

 

What I would do is just very strictly follow the MTHFR protocol that I have at chrismasterjohnphd.com/methylation, and that involves doubling your choline intake because you don't need NADPH to use choline to support methylation. Just as if MTHFR didn't work because of genetics and not enzyme, what you would do is you double your choline utilization for methylation because you're not good at using folate. 

 

On recycling vitamin K, it probably just means that you need a high amount of vitamin K in your diet. I think it's probably similar as if you had a bad VKOR polymorphism. VKOR is the enzyme that recycles vitamin K using NADPH that you got from this pathway that's not working right when you have G6PD deficiency.

 

In terms of all this stuff that you are not good at synthesizing, like cholesterol, fatty acids, nucleotides, and neurotransmitters, I think the only thing that you can do for that is to try to eat a lot of these things preformed. That means eating a diet rich in relatively lean animal foods because they have a lot of preformed stuff, like cholesterol, in them and mainly in the flesh, not the fat. With plants, you want to eat mostly fibrous vegetables because they are highly cellular and rich in nutrients that you can’t make.

 

You don't want to go extremely low-fat, but if you eat a diet fairly rich in animal foods, you're going to get a lot of the specific fatty acids that you can't make. A high-fat diet is mostly giving you just a bunch of fat that you could have made yourself.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 27, 2020

Question: If my tryptophan is low, and I'm on a low-carb diet, would you recommend 5-HTP supplements or tryptophan supplements or both?

 

There are multiple reasons why tryptophan could be low. It could be that you are not eating enough protein, or it could be that you have a high utilization of the tryptophan. I would look in the test and see if the 5-hydroxyindoleacetate is elevated — because if it is, then that would suggest high serotonin production, and that might explain the low tryptophan.

 

If that is the case, you may want to look into other explanations. In this particular case, we have talked about high estrogen levels and how they might be one of those things. In which case the root cause is the high estrogen levels and you need to address it at that level.

 

Repleting the tryptophan maybe isn't necessarily the goal unless you have symptoms that are related to low tryptophan levels. If you're overproducing serotonin, if anything, you might have symptoms that are more related to high serotonin levels. 

 

You might not have any symptoms that are related to low melatonin levels, which is downstream from serotonin, in which case the main negative effect of depleting the tryptophan would probably be related to niacin because tryptophan is used to synthesize niacin — in which case the goal would probably be best served by supplementing niacin instead of tryptophan. 

 

Something to note: if you're trying to put on lean mass and it's not working, it could theoretically conceivably be possible that serotonin overproduction would be depleting the tryptophan to the point where you didn't have enough tryptophan to put on the lean mass you want.




If the tryptophan is being diverted into serotonin, that's why it's low, again, judgeable by whether 5-hydroxyindoleacetic is elevated, then it makes no sense to put 5-HTP into the system because your problem isn't that you have low serotonin. If anything, it's that you have a high serotonin. 

 

The only other explanation I would say is if you have a low protein intake, you might need to increase your protein intake. But if that were the case, you would probably see other amino acids more across the board that were depleted and not just tryptophan. 

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 24, 2020

Question: What to do if signs and symptoms of zinc deficiency persist despite taking 75 mg zinc gluconate per day.

 

You should do plasma zinc. 

 

Also you know I kind of wonder whether you're taking that right. So if you're taking 75 milligrams of zinc like at one time then it's not surprising because you're absorbing like seven of those milligrams. The rest you are not. 

 

To maximize absorption take them on an empty stomach in 10-15 mg which is typically the smallest dose available. 

 

If you're doing that and the signs, the deficiency persist they're persisting when you're taking that, then it probably isn’t zinc related.

 

If they're persisting until you take that and it goes away, then either you aren't absorbing the zinc well, or you're not taking it right. Those are the two things. 

 

If you're not absorbing it well it could be a general malabsorption disorder, something causing loss of bile, or a polymorphism or genetic impairment in a zinc transporter, or low methylation which all can affect zinc transporters.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 23, 2020

Question: Is a high value of arsenic a concern?

 

Yes, arsenic is a toxin. You probably don’t want a lot of it, if it's just a little high it might not cause terrible damage.

 

I would look at methylation if I saw high arsenic, because methylation is needed to get rid of arsenic.

 

Oh actually I should add that methylation supplements have been shown to help arsenic detoxification in areas of the world where arsenic was a serious concern.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 22, 2020

Question Are low polyunsaturated omega-6 values on the ION test a concern?

 

Not the total, but if the arachidonic acid levels are low I would look at low arachidonic acid intake, or inflammation, or oxidative stress. It would concern me because arachidonic acid is important to a lot of physiological functions, but I don't care about the total omega-6.



This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 21, 2020

Question: When high selenium does not come down in response dietary efforts and cessation of supplementation, what's going on?

 

Either there's high levels of selenium in the soil where your food is grown, or you have low methylation because methylation is needed to get rid of excess selenium.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 20, 2020

Question: Creatine, when is it recommend that if you don't have the MTHFR SNP that causes methylation problems?

 

1.)When you want to improve your physique.

 

2.)When you want to improve your athletic performance.

 

3.)When you have a rare creatine synthesis disorder.

 

4.)If you have depression, it might help.

 

5.) If you have any signs that something else is messing with your methylation even though your genetics don't explain it.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 17, 2020

Question: When should tryptophan be taken on a keto diet? Night, day, both?

 

Presumably you're doing this to try to increase tryptophan getting into the brain. 

 

The best thing to do is to take it two to three hours away from other protein. 

 

The second consideration is if you have an allotment of carbs that you concentrate at one time of day, then it would be best to take the tryptophan then. With the caveat being if you’re eating protein with the carbs. In that case it would be best to take it away from the protein + carb meal. 

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

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Jan 16, 2020

Question: Do you think there are true non-responders to creatine, or do you think that those apparent non-responders have some defects in methylation that makes typical doses of creatine sufficient only for other needs.

 

Alex Leaf would be a great person to ask about this and he's not here right now… 

 

[Alex appears] Alex, so Jen's question is are there true non-responders to creatine or do you just think that non-responders likely have some defect of methylation. It means the typical doses of creatine are only sufficient for their needs.

 

Alex: I don't think that methylation is going to be relevant here. When you look at responders and non-responders, the difference seems to be in their ability to uptake creatine into muscle cells from the serum. So, it's very unlikely be related to methylation and it has to probably do with differences in creatine transporter abilities across cell membranes.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/


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Jan 15, 2020

Question: How do I bring up low levels of arachidonic acid? Should I supplement with 250 milligrams? What brand is there from well-known company?

 

If you want 250 milligrams of arachidonic acid, eat an egg. I don't know anything about arachidonic acid supplements yet, except that they exist because you can eat eggs and you'll get plenty. Do you want to try the supplement? Well you can, but I don’t think it’s necessary. 

 

You eat two eggs a day already, so eat four. 

 

The oxidative stress and inflammation will consume the arachidonic acid, so look at that too.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 14, 2020

Question: How to interpret the pattern of high citrate, low cis-aconitate, low glutamate, and high glutamine.

 

The aconitate and citric acid are markers on the citric acid cycle where we metabolize most of our energy. If citric acid is high and isocitric acid is low, (this must be the Great Plains Test which doesn't have isocitrate/cis-aconitate) that would indicate oxidative stress.

 

In terms of the glutamate being low --- if your glutamate is low and your glutamine is on the high side, then you probably have ammonia generation from somewhere that you're mopping up with glutamate. That would be my guess, but that's another can of worms to open.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 13, 2020

Question: What are the best ways to optimize glutathione status for someone who has a G6PD deficiency?

 

Riboflavin was shown to be of benefit for normalizing oxidative stress in people who have glucose 6-phosphate dehydrogenase deficiency.

 

So for people who don't know what this is G6PD is, glucose 6-phosphate dehydrogenase is an enzyme that you use to take energy from glucose specifically, you can't take it from anything else, and you use it to recycle glutathione which is a master antioxidant of the cell. 

 

You also need this to support the recycling of vitamin K and folate and you need this for synthesis of neurotransmitters among other things.

 

But the big problem with G6PD deficiency is that you can have a lot of things go sideways when you can’t use this pathway. Red blood cells become more vulnerable to hemolysis and that is a result of oxidative stress from poor glutathione recycling in the red blood cell. 

 

One of the adaptive responses to having G6PD deficiency is the glutathione reductase enzyme -- which is the enzyme that uses riboflavin and niacin to recycle glutathione with the energy taken from G6PD. 

 

That enzyme -- glutathione reductase -- it develops a voracious appetite for riboflavin that makes all the riboflavin that won't go anywhere else, get sucked up into that enzyme. So basically you become very dependent on riboflavin support of glutathione reductase because you have lost G6PD, the enzyme that's involved in passing the energy on to riboflavin in glutathione reductase.

 

There's probably no harm to starting at 400 milligrams of riboflavin a day, but if you feel like you want to be more cautious about it, I'd start at 5 or 10 milligrams a day, test the effect on glutathione status.

 

You know in this case I think you want to look at erythrocyte glutathione status, I don't usually recommend that test, but it might be a more relevant test specifically for this condition. 

 

What I would usually recommend for glutathione status would be plasma levels of glutathione. I also think LabCorp does whole blood glutathione. 



This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 10, 2020

Question: Are there diminishing returns in the amount of fish in a weekly diet? I know you mentioned eating fish about twice a week. I've been trying to eat salmon once a day. Is there an ideal ratio of fish to non-fish protein you should aim for?

 

There's not a lot of data backing that up and the data we have is pretty poor quality. But I'm of the mind that the diminishing returns come after one or two servings of fatty fish per week. I think if you're talking about white fish it's different. But I am referring to salmon or mackerel — I think once a week or twice a week is good. 

 

As for white fish — it's not as different from meat as you might think, the real big difference in my view is there are some different, like there's selenium and iodine among other things. The big difference in salmon, mackerel, and other fatty fish, versus lean fish versus meat is the type of fat. 

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 9, 2020

Question: How to deal with the fact that blood tests for nutritional status aren’t adapted to children?

 

There aren't childhood-based ranges that are data-driven. So what if the ranges need to be a little bit different in children?

 

The approach in the Cheat Sheet is not to rely exclusively on ranges, it's also to look at the diet and lifestyle analysis and to look at signs and symptoms. 

 

So what you do is you piece together: does the diet and lifestyle analysis, the blood lab, and the signs and symptoms all say deficiency X, too much Y. Then that's very good information and what you do is you intervene on the basis of what seems probable and you monitor the outcome.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 8, 2020

Question: I just saw an email from Matt Stone referring to the overly deified nutrient vitamin A. Also, a few Weston A. Price Foundation bloggers are starting to spread the word about being sick on a high vitamin A diet. Any thoughts about this and comments about Vitamin A being toxic?

 

You shouldn't deify any nutrient, right? Any point of view that breaks down the world into good and bad molecules, is a doomed-to-failure point of view because molecules don't have virtues. 

 

Everything is about context. Too much vitamin A cannot be defined outside of context. Not just what your needs are, not just what your genetics are, not just what your turnover rate is, not just whether you are getting pregnant, but also the presence of other things in the diet. For example, vitamins D, E, and K, which will affect the vitamin A requirement because they all regulate each other's breakdown.

 

Some people have too much Vitamin A. Some people take more vitamin A than they should. There's dozens of case reports of vitamin A toxicity, but there's no evidence that people at normal intakes who are not supplementing are getting inflammation from consuming dietary levels of vitamin A.

 

The RDA is 3,000 IU. If you're correcting deficiency, 10,000 IU is highly reasonable over a short period of time. On the other hand, if you have someone who has a very long history of taking vitamin A supplements at 30,000, 40,000, 50,000 IU over 3 years, then, yeah, they might have all kinds of problems from that because they're taking too much. Toxicity is also way more likely if they're not taking vitamin D, vitamin E, or vitamin K.

 

There's nothing remotely controversial about that; no reason to question it. 

 

There are probably a lot of people in Weston A. Price who think that more of a good thing is better, and I know for a fact that many people were taking two or three tablespoons of high-vitamin cod liver oil for many years. That was nuts then and it's nuts now; they’re getting too many fat-soluble vitamins and too many polyunsaturated fatty acids from high levels of cod liver oil like that. 

 

But again, 3 to 10,000 IU, even long-term, there's no evidence of toxicity. Some people are going to be intolerant. I know anecdotes of people who take vitamin A at very low doses and it causes some hypersensitivity reaction. I don't know what causes it. So there will be stories of people who improve when they take the vitamin A out of their diets. It will happen, it makes sense.

 

And on top of that there are epidemic proportions of people with fatty liver. What happens when fatty liver gets bad? The cells that store vitamin A in the liver dump their vitamin A into the bloodstream so they can transform into cells that lay scar tissue down in the liver. So people with fatty liver, which is about three-quarters of people who are obese, right, so about 70 million Americans, maybe more now, have fatty liver disease. Some proportion of them are laying down scar tissue in their livers and they are losing the ability to properly store and metabolize vitamin A.

 

Could taking vitamin A out of the diet for them help? Probably, but it's a very tough place to be in because those people are going to have cellular vitamin A deficiency. So it's like, do you save the liver or do you save everything else? It makes sense to temporarily withdraw vitamin A, but really you need to just fix the obesity and fatty liver disease, then restore vitamin A that is needed.

 

I have no problem saying that some people take too much vitamin A and that it can be toxic, but there are people going around right now saying that vitamin A is intrinsically toxic, and those people are absolutely nuts. That's flat-Earth level thinking that it's just intrinsically toxic and not a vitamin.

 

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 7, 2020

Question: Is it ok to mix carbs and fat? There are a lot of people on the internet that claim the Randle cycle is behind America being fat, since the standard American diet is mixed in fats and carbs. Yet, I feel great on a diet of about 30% protein, 30% fat, and 40% carbs, based on meat, potatoes, fruits, and vegetables. 

 

The randle cycle addresses why you would have elevated fatty acids or hyperglycemia and hyperinsulinemia due to competition. You're more likely to have circulating energy supplies in your blood due to poor tissue uptake when you're consuming carbs and fats together, and you're more likely to be more dependent on a higher insulin response.

 

This doesn't mean that mixing them causes diabetes, it just means that there is more substrate competition and that, all else equal, if someone is on the edge of diabetes eating a mixed diet increases the probability that they're going to go over that edge because of the substrate competition contributing to hyperglycemia and the greater insulin requirement than someone who's on a low-carb or low-fat diet.

 

If you have no evidence of metabolic dysfunction on a mixed diet, then there's no issue.

 

Most Americans are fat because of caloric balance. Thinking that the glycemic or insulin response to eating plays a role in body fat gain is the same erroneous thinking that Taubes makes. There’s an element of truth in Taube’s carb-centric model, in that some people are going to eat more food in response to a high-carb diet if they have blood sugar problems. But that isn’t the norm.

 

To say that the Randle cycle is the cause of obesity is making the same mistake because it’s focusing on the glycemic and insulin responses to eating instead of overall energy balance. What makes you fat is eating too much food. 

 

The only thing that you should change about the calories in calories out (CICO) hypothesis, on a practical level, is to say that it tells you very little about the behavioral modifications that someone needs to make to sustain the caloric deficit over time.

 

So, why do people get fat? I largely endorse Stephan Guyenet's view: it's basically the proliferation of hyperpalatable food. A mixed diet leverages the principle of creating a hyperpalatable diet by mixing carbs and fat, but your diet doesn't sound hyperpalatable.

 

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Jan 6, 2020

Question: Can you explain what parent essential oils are? I was given some articles that seemed to be saying that high-dose cold-water fish oils are damaging to cell membranes and mitochondrial function.

 

"Parent essential oil" is a term invented by Brian Peskin, who looked at some  data that said it's not clear that supplementing with fish oil is good for you because doing so can cause oxidative stress and cause damage to cells.

 

That's true because the highly unsaturated oils found in fish oil, as well as in liver and egg yolks, are highly vulnerable to being damaged. This includes the physiologically essential omega-3 fatty acid, DHA, and omega-6 fatty acid, arachidonic acid. 

 

But that damage comes only when you eat too much. This is where I think Peskin is wrong, because he took that data and concluded that you don’t want to eat any of these oils. Instead, you should eat oils like flaxseed that provide the “parent” fatty acids that your body turns into DHA and arachidonic acid.

 

But the parent oils are prone to being damaged too, just to a lesser extent. On a gram to gram basis, they are safer, but you need to eat a ton of parent oils to get the physiological requirement for DHA and arachidonic acid. So, on a daily requirement basis, the parent essential oils are going to be way more damaging.

 

I recommend simply taking a small amount of arachidonic acid and DHA, since then you fulfill your requirements regardless of genetics or the environment or whatever could impede the transformation of parent oils to these physiologically essential oils. High-dose fish oil is ridiculous, and risky, but that doesn’t mean you shouldn’t consume any. 



Jan 3, 2020

Question: What are your thoughts on monitoring HRV for optimizing performance?

 

Measure your HRV every night and you stop exercising entirely to get a baseline. 

 

You completely stop working out, you don't go “oh no I'm going to lose my muscle mass,” nothing's going to happen for a week or two. And this is the whole foundation of you having good data.

 

This baseline ensures that you have good starting data that isn’t influenced by anything. 

 

Now you start working out. You do one workout that's typical, you keep taking your HRV, you may see your HRV plummet. Then you say, how long does it take me to recover on my current diet and lifestyle?

 

You repeat that, like you don't work out again until it's back up to the plateau level. Then you work out again and you see if you have a repeatable response where there's a certain amount of time on average that's fairly replicable that it takes you to recover your peak HRV after your typical workout. Then when you have that you get on that frequency.

 

You can then start playing around with factors — like does it matter what type of workout I do? Is my recovery level consistently different when I lift weights at 5 reps per set versus 15 reps per set. Is my recovery time consistently different when I do cardio, or when I do cardio and weights on the same day, or when I play soccer. Then you can start to tailor your recovery time around the specific workouts.

 

Maybe it takes you two days to recover from one workout and four days recovering from another. Lower body, upper body, if you have a lower body upper body split, does it take me five days to recover the lower body and does it take me three days to recover from upper body?

 

At that point you can start tweaking diet and lifestyle. Do I recover faster if I eat more carbs? Do I recover faster if I eat food X?  Do it recover faster if I take supplement X? Always testing one thing at a time and making sure it's replicable before you form a conclusion before you do the next test.



Jan 2, 2020

Question: Why did the FDA have a vitamin A requirement during pregnancy at 8,000 IU, which is much higher than the IOM recommendations in the past?

 

I have no idea. I do know that the concerns around vitamin A during pregnancy are that in the first weeks of pregnancy, 10,000 IU and higher has been associated with birth defects. That was one prospective study in 1995, which is higher quality than retrospective studies, but still contradicted all the retrospective studies that came to the opposite conclusion. 

 

So, there's no good consensus on the data, there's just moderately justifiable paranoia about the possibility that you could could cause birth defects. Also, there were like seven or eight letters to the editor about why that study had a bunch of problems with it, like the data just doesn't make sense.

 

So the basis for restricting A in pregnancy is a theoretical concern that doesn't have a lot of data to support it. That said, I see no reason why someone needs 10,000 IU or more going into the first eight weeks of pregnancy.

 

If you eat liver once or twice per week, you're not getting more than that. If you took a half a teaspoon of cod liver oil every day, you're not getting more than that. If you eat eggs and dairy every day, you're not getting more than that.

 

So, I would not supplement with 10,000 IU and higher vitamin A going into pregnancy, not because I'm super paranoid and there is good data justifying the restriction, but because the theoretical concern outweighs the lack of theoretical benefit in most cases for most women.

 

Now if that woman is trying to get pregnant, but her serum retinol is low and her eyes are dry and her night vision is bad and she has hyperkeratosis, then you bend the rules a little bit because you have an obvious justification to get her vitamin A levels up. 

 

It's just speculation versus speculation, so why not pave the middle ground of what you would reasonably get from food?

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



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