Science Round-Up Seconds: Does the Paleo Diet Ruin Your Lipid Profile? Plus: Liver Health & Hepatitis - Milk Thistle & Beyond. Libido Boosters & Real PDE-5 Inhibitors. "Fake" Cinnamon, Coumarin, Bloodthinning & Carcinogenic Cereals.

Is the Paleo Diet unhealthy for healthy individuals? A recent thesis would suggest just that. Learn more about and make up your mind based on the last installment of the Science Round-Up and today's Seconds (img informedhealth.com.au)
I hope you did not miss that the SuppVersity Science Round-Up will as of now always be starting early(-ier) at 12PM EST. If so, don't worry, you can still download the show and listen to Carl and me talking about the things you may be missing, the ones you get extra and those you would rather not have in your supplements and foods. Let's take silymarin, for example, as you have learned on the show, not all "liver assist", "liver clense" or "liver health" products are created equal. Most intriguingly, their ability to scavenge free radicals, as measured by the trolox assay, is not singularly dependent on the actual silymarin content, but will - as the data from the study Anthony et al. conducted (Anthony. 2013) - vary largely, depending on where the milk thistle was grown, how it was processed and thus what else, aside from the purportedly active ingredient is in it.

There is more to natural products than a single active ingredient

If you will, the "there is more to it" was a golden thread that ran through the whole show, but before we follow it up to the next topic, I want to provide you at least an excerpt from the actual data Anthony et al. produced.
Table 1: Selected products tested in the study ordered by their anti-oxidant activity in the TROLOX essay; products with highest TROLOX and anti hepatitis C viral activity highlighted in green and violet, respectively (Anthony. 2013)
As you can see my selection of the 45 products, the scientists bought and tested, reflects what you have already heard on the show: The silymarin content varies largely. In essence, the actual silymarin content may yet not even be that important. If you focus solely on their TROLOX equivalents (TROLOX is a vitamin E like antioxidant and it is used to quantify the anti-oxidant activity in a standardized way - more or less like the meter is used to quantify the length of an object or seconds are used as a standard timespans are expressed in).

More about Liv-52: Actually, the Himalaya(R) product is one of the few OTC supplements with not just one, but more than 20 studies to back its hepatoproctective and antioxidant effects. One thing to keep in min about the research is though that it was - despite being mostly published in peer-reviewed journal - in large parts conducted by scientists who work either for or with the company. As I've pointed out previously, this does not mean that the data is flawed, but it puts observations such as the improved glucose uptake (213%) , the 50% reduction in triglyceride content (anti-NAFLD effect), the 790% increase in glutathione, as well as the decreased TNF-α (-51%) and IL-8 (-550%) and concomitant -65% and -69% reductions of lipid oxidation and DNA fragmentation, respectively, Vidyashankar et al. observed in a recent in-vitro study somewhat into perspective (Vidyashankar. 2012).
If you are looking for the most potent among the readily available products in my selection the most potent "liver protectant" would actually be the PED user's first choice Liv-52, which does not even contain silymarin but is based on an undisclosed amount of  capers (Capparis spinosa), wild chicory (Cichorium intybus), arjuna (Terminalia arjuna), negro coffee (Cassia occidentalis), yarrow (Achillea millefolium) and tamarisk (Tamarixgallica). Bio Silymarin by Advanced Beta Glucon Therapy, on the other hand, is a close second with an almost identical TROLOX value (9.4 vs. 9.5 for Liv-52), is based on silymarin; plus, it exerts 77% more pronounced hepatitis C virus (HCV) antiviral activity than the Himalaya product which lists "viral hepatitis" as the #1 indication on the corresponding website.

As far as these anti-HCV effects, which were standardized against the results the scientists observed in cultures that were treated with 100 U/mL interferon-α, are concerned another Source Natural's Silymarin Plus, emerged as the most potent product. With the "plus" signaling the addition of choline, inositol, vitamin C+E, this observation confirms that antioxidant activity and anti-viral activity are two pairs of shoes - even when the active ingredient (silymarin) is the same.

Apropos active ingredient

You are yet by no means at the mercy of milk thistle and silymarin, when you want to protect your liver from harm. Spices like
  • Tumeric (curcumin)
  • Coriander
  • Garlic
  • Red chili
  • Black pepper
bust also coffee and green tea, and fruits and vegetables such as
  • carrots
  • ivy guard
  • sweet corn
  • soy (for the glycine in it)
  • grapes
  • custard apples
  • Indian gooseberries
  • pomegrenade
  • sea buckthorn
have potent anti-oxidant and antiproliferative activities (Shukla. 2013)

OTC libido boosters - more than just an alternative

Now that we are talking about alternatives, let's get straight to the next one: The "alternative" to viagra, cialis & co. Honestly, I would hope that you will never have to use one of these (I suggest you take a peak at yesterday's post "The '20 / 30 Principle' Sheds 15% Body Fat in 6 Months, Boosts Testosterone & Sexual Performance in Overweight Men. Plus: Six Signs You're Doing Too Much, Already."; read more), but in the unfortunate case you do, you may be surprised how effective the majority of them actually is.
Figure 1: Categorial breakdown of the adulterated majority of the 91 products from the Campbell study (Campbell. 2013)
A brief glance at the data in figure 2 does yet suffice to see that this is not another case of the "nature knows best principle", but simply a consequence of the fact that the majority of these products do contain either sildenafil and/or taldalfil or some sort of molecular cousin ("analogs" in figure 2). Moreover, in 18 out of these products the dosage was >110% of what would be legit on a per serving base for the prescription varieties (I suspect this is 20mg).

Also mentioned in this context: Saw palmetto is a PDE-5 inhibitor (cf. Yang. 2013). Although the evidence is from a rabbit study, it's pretty likely that there will be at least some discernible effects of saw palmetto on PDE-5 activity an iNOS activity in the human corpus cavernosum, as well.

Coumarin: Carcinogenic & blood thinning cereals

Table 2: Coumarin content in mg/100g of the samples from the Wang study
As unfortunate as it may seem, the chance that the cinnamon you consume with pre-packaged food is "real" (=verum) and from the inner bark of Cinnamomum verum are close to zero. Since this is however the only variety, where you can be almost 100% sure that you don't consume blood thinning and pro-carcinogenic coumarin, it does actually not come as a surprise that cinnamon apple sauce or a cinammon roll bought from the local supermarket contain 0.64 and 2.1mg of this agent on a per serving basis.

If you take a closer look at the rest of the data Wang et al. collected for their latest study (Table 2; cf. Wang. 2013), you may be surprised to see that regular bread, generally unsuspicious oats and purportedly healthy granola bars contain coumarin in amounts that will have you easily surpass the daily uptake limit of 0.1 mg/kg body weight, which was established by the European Food Safety Authority (EFSA) right after it became clear that coumarin is a potential carcinogen... *yamyoll*

Nedless to say that the consumption of respective supplements, which are currently heavily marketed as healthy anti-diabesity agents, could do more harm then good, when the producers play it cheap and put the next best "Cinnamomum XY" they can get their hands on into the caps.

Neither viagra nor cinnamon caps are "paleo", yet still...

E. Trexler titled his recently published thesis "Paleolithic Diet is Associated With Unfavorable Changes to Blood Lipids in Healthy Subjects", which would suggest that the paleo diet is similarly unhealthy as the consumption of "fake", coumarin-loaden cinnamon or high amounts of isolated cholorogenic acid (story is discussed in detail in the podcast; cf. Mubarak. 2013).
Figure 2: Lipid profile (left; values expressed in % of reference levels), fitness and body fat level (right) before and after the Paleo + Crossfit interention (calculated based on Traxel. 2013)
If you take a closer look at the abstract and the actual "side effects" (figure 2), the 10-weeks of paleo dieting + CrossFit-based, high-intensity circuit training exercise program had on the body composition and fitness levels, I personally cannot but ask the following question:
 "What is the significance of the elevations in LDL and minor reductions in HDL in a scenario that produces exactly what has just been shown to be at the heart of the 'Obesity Paradox' and lipid values that are still within the ever-narrowing 'normal' or 'optimal' range?"
I'll leave it up to you to answer this question and decide whether it can really be so bad to rid yourself of all modern, processed foods including any form of processed sugar, soft drinks, and coffees, while fueling your life and workout related energy by increasing your consumption of lean meat, fish, eggs, nuts, fruit, and vegetables. Have a nice weekend!

References:
  • Anthony K, Subramanya G, Uprichard S, Hammouda F, Saleh M. Antioxidant and Anti-Hepatitis C Viral Activities of Commercial Milk Thistle Food Supplements. Antioxidants. 2013; 2(1):23-36.
  • Campbell N, Clark JP, Stecher VJ, Thomas JW, Callanan AC, Donnelly BF, Goldstein I, Kaminetsky JC. Adulteration of Purported Herbal and Natural Sexual Performance Enhancement Dietary Supplements with Synthetic Phosphodiesterase Type 5 Inhibitors. J Sex Med. 2013 May 1. 
  • Mubarak A, Hodgson JM, Considine MJ, Croft KD, Matthews VB. Supplementation of a high-fat diet with chlorogenic Acid is associated with insulin resistance and hepatic lipid accumulation in mice. J Agric Food Chem. 2013 May 8;61(18):4371-8. 
  • Shukla SK, Kumar V. Bioactive Foods and Supplements for Protection against Liver Disease. In: Bioactive Food as Dietary Interventions for Liver and Gastrointestinal Disease. Elsevier. 2013. 
  • Trexler, E. Paleolithic Diet is Associated With Unfavorable Changes to Blood Lipids in Healthy Subjects Honors Research Thesis. Ohio State Univeristy. May 2013.
  • Vidyashankar S, Sharath Kumar LM, Barooah V, Sandeep Varma R, Nandakumar KS, Patki PS. Liv.52 up-regulates cellular antioxidants and increase glucose uptake to circumvent oleic acid induced hepatic steatosis in HepG2 cells. Phytomedicine. 2012 Oct 15;19(13):1156-65.
  • Yang S, Chen C, Li Y, Ren Z, Zhang Y, Wu G, Wang H, Hu Z, Yao M. Saw Palmetto Extract Enhances Erectile Responses by Inhibition of Phosphodiesterase 5 Activity and Increase in Inducible Nitric Oxide Synthase Messenger Ribonucleic Acid Expression in Rat and Rabbit Corpus Cavernosum. Urology. 2013 Apr 23. doi:pii: S0090-4295(13)00169-6.
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