Sunday, July 27, 2014

Dr Frassetto: Unique Opportunity to Drive Paleo Diet Study v. ADA Whole Wheat/Gluten 'Healthy Diet' for PCOS

Crowd-Sourced n=4

Thank you all Gentle Readers for participating earlier in one of the first gut microbiome QS study when I posted on Crowd-Sourced N=4: A Family Science Project of Resistant Starch on Gut Biome

Allan and his family reported their self monitored blood glucoses here. AmGut results soon as it takes about half a year.

UCSF Paleo Diet v ADA Whole Wheat Healthy Diet for PCOS

At UCSF Dr Lynda Frassetto et al are requesting help to prove the value and merit of the paleo diet for insulin resistant states such as PCOS. She is working collaboratively with other researchers to obtain funding for the next landmark study. What they collect via Crowdfund can be retained even if they do not reach the $40,000 goal. Dr Frassetto and I believe the paleo diet offers many hormonal and cognitive/behavioral benefits for those with insulin resistant states. I've spoken with Dr Frassetto to promote the diet at an EBT conference for emotional behavior therapy (Wired for Joy) because their participants see great mental and brain changes that complement the program.

What is needed is well designed and articulated studies like her earlier, seminal Paleo study that showed dramatic normalization of blood pressures in pre-hypertensive adults. This was not a low carb study but a basic, no grains, no legumes, no dairy paleo diet including some tubers (carrots, yams, etc). Her goal is to prove health benefits again for a group of patients that have few medical options (metformin, starvation weight loss diets, IVF, fertility treatment, etc). As you are aware in the paleosphere, many cases of spontaneous fertility and resolution of PCOS are commonplace.

A few days ago, they opened their UCSF-Crowdfund account and received $2855 already. Government funding has become scarcer of late. Many of the medical personnel for this study are in fact all volunteering their time according to Dr Frassetto. Unlike the prior study, outpatient food is not provided. Nutri Sci students (like I used to be LOL) from UC Berkeley will be volunteering to counsel diet information to trial participants. Costs for Free-testosterone, insulin, and other lab hormone measurements will be covered by funds collected.
Polycystic ovary syndrome (PCOS) is a syndrome which includes elevated androgen levels, irregular menstrual cycles and insulin resistance. Standard treatments, which include weight loss and medications to improve insulin secretion are only partly successful, and may require that young women take medications for decades.
The study investigators have been evaluating the effects of specific diets on insulin resistance in healthy volunteers and subjects with type 2 diabetes, and have found that subjects with insulin resistance seem to respond particularly well to these diet regimens.
Volunteers with PCOS are being asked to participate to see if following these diets can help regularize your menstrual cycles. The results of this study may help improve fertility treatments for women with PCOS.

An incentive from UCSF has thrown in:

Special early-bird incentive: Meet us at the Ancestral Health Symposium

Dr. Lynda Frassetto and Dr. Ashley Mason will be attending the Ancestral Health Symposium in Berkeley, CA August 7-9. We'd be happy to meet with you and talk about the study -- or if you donate at the $250 level, we'll take you to lunch and talk about anything you want!

Project Details ~~

How we'll spend the money

All $40,000 will go to costs for the study – the study personnel are all volunteering their time! Here's our approximate budget:

$20,000: Laboratory tests of insulin resistance and other biological outcomes.
$12,000: Research supplies and lab space.
$4000: Payments to participants for providing questionnaires, urine and blood samples, and uterine images.
$4000: Tracking and staying in touch with participants, data entry and administrative support.

Stephan G. at Whole Health also shares his thoughts: HERE

Thank you for your support!


Anonymous said...

Nice! I think cutting out dairy would improve my results, too.
I've actually gotten good results so far from a paleo diet. Staying away from some of my favorite junk food is hard, but the

results are making it worth it everyday.

I just followed a guide and made sure I didn't do anything too ridiculous.

Here's a link to the the guide I used:

Dr. B G said...


Thx for the link!

Glad you found it so helpful! I've had clients regain all kinds of health with the paleo diet
--no more painful boobies
--cessation of hormone related acne
--halt of painful PMS and menstrual cramping
--improved thyroid hormones (thyroid drives a lot of fertility)

Unknown said...
he is convinced that a paleo diet, compared to a Mediterranean-style diet, is better at controlling blood sugars and “reducing insulin” in diabetics (presumably type 2s). Insulin sensitivity is improved, particularly in those with insulin resistance to start with. The paleo diet group saw an average drop of fasting glucose by 23 mg/dl (1.3 mmol/l). One slide you’ll see in the video indicates the paleo diet reduced absolute hemoglobin A1c by 0.3%, compared to 0.2% with the “Mediterranean” diet. (Let me know if I got the numbers wrong.)

Color me underwhelmed so far.

Questions raised by the video include:

what is the UCSF version of the paleo diet?
how many participants were in her study?
how long did her study last?
did she study only type 2 diabetics?
what exactly was the control diet?
how severe were the cases of diabetes studied?

For answers, we await publication of the formal report.

Has her study been published yet?? All I can find is this

Which is the study protocol.

Unknown said...

Very nice and informative article! I think cutting out dairy would improve my results, too. I've actually gotten good results so far from a paleo diet. Staying away from some of my favorite junk food is hard, but the results are making it worth it everyday.

I just followed a guide and made sure I didn't do anything too ridiculous.

Here's a link to the the guide I used:

Dr. B G said...

Thanks for your deep thoughts. What were the PRE and post insulin levels? Any post prandial insulin levels? These are more accurate to track than hgba1c or BG fasting. Allan F in his RS experiments saw varying BG results. Even higher after RS paradoxically but unknown signficance because stat power too low

A1c is a weighted average with weight contribted by the last 2 wks of BG control.

I only know that the paper is submitted and pending peer review. The Mediterranean diet is a tough contender. Al dente pasta actually is low GI therefore insulin sensitizing. it's rich in fiber, plant polyphenols, omega 3 from both marine/meat and bitter greens. But my bet is that Paleo will win for rehab'ing the gut and improving intestinal permeability where all disease begins as Hippocrates noted

Dr. B G said...

Things just aren't as they seem sometimes. Recently there was a T2D study with RS and results totally sucked. So in this case numbers actually revealed and illustrated effects.

For Paleo studies I hope 16S rRNA analyses are done to truly illuminate both metabolic and microbiota effects. They're irrevocably intertwined. FMTs have been done as well in T2D with only limited success because the guts of insulin resistant and T2D are really f*kcered

Dr. B G said...

Also I'd love to see gene expression patterns with diet changes by fat biopsy punching (ouch) the test subjects as seen in the FUNGENUT (google FUNGENUT animal pharm)

JanKnitz said...

How nice to see some real research on this topic.

I was fortunate to have a great endocrinologist 14 years ago, who advised me to follow a low carb diet (never heard of Paleo back then) to treat my PCOS. I was 41 and had long given up on having a second child after going through two difficult IVF cycles to conceive my first child.

I began having regular periods almost immediately for the first time in my life. To my utter shock, surprise, and joy, I was pregnant 6 months later.

My 13 year old has PCOS, too. We don't need research to know what to do for her, but I hope it helps the estimated 10% of women who have PCOS, since most have no clue that the right diet composition can make a huge difference.

Karen said...

This I so timely - my niece from South America, who was just visiting, has PCOS. I'm wondering if she could possibly participate remotely?

Dr. B G said...

Karen, That's great. Do you mean donate or attend AHS remotely? The latter isn't possible yet

Do you have a bread blog? My kids and I are experimenting with some GF leavened breads with (sad) success -- they're are so good and we miss yeasty, fluffy goods every once in a while. Not daily. Unfortunately brown rice and other rice flour are sources of high arsenic... All the flours are refined unless fiber added or soaked whole grain.

So many reasons contribute now to PCOS before other decades. A role for awesome gut health cannot be understated. For one the fiber spectrum and low GI carb sources indeed help boost insulin sensitivity, the culprit in PCOS.

PCOS and other female specific disorders are estrogen dominant states. Estrogen and xenoestrogens stimulate pathways for excessive insulin signaling, leading to 'tired' noise and insulin resistance (IR). All insulin resistant states are vulnerable but in PCOS the female gonads come under rapid attack and hyperproliferation. Sugar, refined carbs and toxins all push higher testosterone and ever declining progesterone (our longevity hormone for females)

Paleo is great. However in this day and modern age of environmental and gut-origin toxins, it is necessary to define all root causes. Getting an awesome gut will lead to sexy health, insulin optimization and fertility. Ancestral probiotics and weeding/feeding the gut will yield untold benefits for hormones. Did you see my twitter updates today?

Consider these factors for you and daughter and the slide link:
--detox plastics, PCBs, mercury held in soft tissue and fat because they're estrogenic
--optimize thyroid (selenium, iodine, support, etc)
--optimize progesterone
--decrease estrogen dominance
--poor gut health as a result of above
--pathogens in the gut (yeast, parasites, etc that produce chemicals and mycotoxins that increase insulin resistance)

I'll be discussing shortly but Dr Lana and Dave Asprey (of bulletproof) wrote a wonderful book about Lana, a physician from Europe, and her PCOS, her fertility and how they overcame PCOS factors to conceive and give birth to amazing and bright children. Tools that she used were
--integrative/functional medicine
--paleo, no sugar/refined carb diet
--saturated fat and egg yolks rich in choline, Vitamins A/D/E/K2
--fixed her gut (diet, probiotics, etc)
--fixed subclinical thyroid
--fixed subclinical low progesterone
--exercised regularly
--thought zen and optimistic thoughts, HeartWave technology, sleep, etc

This is a topic close to me as I think it is one of the worst epidemics for women. Thanks for being interested in paleo as it is one of the important keys.

Anonymous said...

I started taking some Glucomannan as you have mentioned it several times. Every time I take just a small amount my skin starts to get itchy.
Should I stop altogether, or should I keep at it in the hope that it is a bit of a detox reaction?
Also wondering if there is something particularly beneficial about it?

Dr. B G said...

Like any new food or fiber, glucomannan may take time to shift the microbiota (gut/skin) populations. some people try lower doses and others reduce the dose until tolerable. Some have great results adding some charcoal or clay.

Please let me know how it goes

Glucomannan is digested by our gut into really amazing metabolites including mannan and glycan oligosaccharides which are immunoprotective. The amount of butyrate produced is not low as well. It raises our beneficial symbiont populations (and therefore can lead to die off of the pathogens - -which may cause itchy skin or gut flares, fatigue, etc)

GM lowers inflammation, lowers insulin resistance/diabetes, and gels up immensely with water (drinking 2 glasses of water is vital) to bulk up stools.

It probably mimics our paleo-ancestral intake of whole tubers best...

Anonymous said...

"It probably mimics our paleo-ancestral intake of whole tubers best..."

Ahh... that's interesting. Super important then.
Thanks for the additional information Dr Grace!
And thanks for so patiently answering questions, I am very grateful. I've been trawling through some of your old posts and considering some of the other probiotics like Body Biotics you have mentioned, along with the 3 you recommend.

Glucomannan is pretty weird. I mixed it with yoghurt one time and left it for a moment, came back and it was like plaster! I think I haven't been drinking nearly enough water with it. So will try again.
Thank you!

Anonymous said...

Sorry, me again with the glucommanan.
A really basic question, but do people take the charcoal / clay at the same time as the glucomannan? I know that they are super absorbers and you usually try to avoid taking anything at the same time -- though perhaps because RS is for the stomach bugs and not us per se it is different.

Also, I quickly saw on your twitter that the pill breaks the gut. Wow! I had no idea. The amount of western women on it. And the increase in auto-immune diseases mostly in women....

Anonymous said...

Dr. Grace,

Would you mind repeating here the information on the pill. I was on the pill for 25 years--my Dr. wanted me to stay on to help my osteoporosis. I finally decided that I didn't need his permission to take myself off.


Dr. B G said...


GM is like bariatric surgery! It effectively reduces the functional volume of the stomach by SWELLING 10-20X in volume!

2 cups of water minimum is needed. I never use more than 1/4-1/2 tsp EVER EVER EVER because one day I was too busy running around and had a 2 hr jog and had gut issues which I attribute to the GM.

Lori and Anon,

Sarah is a vigilant GUT GODDESS!

Since the introduction of oral contraceptives in the early 1960′s, use of The Pill, as it is generally known, has soared to approximately 7 in 10 women of childbearing age. Among young women ages 18-24, use of oral contraceptives is especially high, reaching two-thirds in 2008.
The widespread use of The Pill is a troubling issue because oral contraceptives devastate beneficial bacterial flora in the gut leaving it vulnerable to colonization and dominance from pathogenic strains such as Candida Albicans, Streptococci and Staphylococci among others.

By the time a woman who has used The Pill is ready to have children, a severe case of intractable gut dysbiosis has more than likely taken hold.
Most people think that only use of drugs such as antibiotics cause gut imbalances, but this is simply not true.

According, to Dr. Natasha Campbell-McBride MD, use of other drugs such as the Pill also cause severe gut dybiosis. What’s worse, drug induced gut imbalance is especially resistant to treatment either with probiotics or diet change.
What does this mean for your future child’s health? A lot, as it turns out!

Gut Imbalance from the Pill Reduces Absorption of Nutrients

First of all, gut imbalance brought on through use of The Pill negatively impacts the ability to digest food and absorb nutrients. As a result, even if a women eats spectacularly well during pregnancy, if she has been taking oral contraceptives for a period of time beforehand, it is highly likely that she and her baby are not reaping the full benefits of all this healthy food as the lack of beneficial flora in her gut preclude this from occurring.
In addition, beneficial flora actively synthesize nutrients including vitamin K, pantothenic acid, folic acid, thiamin (B1), cyanocobalamin (B12), amino acids and others. In an imbalanced gut, a woman is missing out on the “natural supplementation” that these good flora provide to her and her growing baby.

Not well known is the fact that use of The Pill depletes zinc in the body. Zinc is called “the intelligence mineral” as it is intimately involved in mental development. As a result, it is very important for women who have been using the Pill for any length of time even if short to wait at least 6 months before becoming pregnant to ensure that zinc levels return to normal as low zinc is associated with lowered IQ and birth defects.
It really is quite disturbing to fully realize the very real potential that use of The Pill has to trigger nutritional deficiencies! (cont)

Dr. B G said...

Pathogenic Gut Flora from The Pill Produce a Myriad of Toxins

Pathogenic, opportunistic flora that take hold in the gut when The Pill is used constantly produce toxic substances which are the by-products of their metabolism. These toxins leak into the woman’s bloodstream and guess what, they have the potential to cross the placenta! Therefore, gut dysbiosis exposes the fetus to toxins even if the woman never eats anything but organic foods and lives in an environment with no pollutants whatsoever.

Indeed, an imbalanced gut has the potential to expose a woman and her baby to just as many or even more toxins than her environment through self poisoning!

Gut Dysbiosis Triggered by The Pill and Anemia Go Hand in Hand

Most people with abnormal gut flora also suffer from various stages of anemia. This is because some of the most common pathogenic strains of bacteria that take hold in an imbalanced gut are those that consume iron: Actinomyces spp., Mycobacterium spp., pathogenic strains of E.Coli, Corynebacterium spp. and others.

Anemia during pregnancy is especially dangerous. Not only can it deprive the fetus of oxygen (iron helps build red blood cells and red blood cells carry oxygen), but it is linked to low birth weight and pre-term birth and the many long term health and associated developmental problems.
Can taking iron supplements during pregnancy combat this problem?

In a word, no! How many women do you know who consistently battle low iron levels during pregnancy despite consuming iron supplements and eating iron rich foods? I personally know many such cases.

The reason is that the more iron a patient with gut dysbiosis consumes in either food or supplement form, the stronger these pathogenic, iron loving strains become! The extra iron “feeds” them, so to speak, much the same as sugar feeds Candida Albicans. The cure for gut dysbiotic anemia is to heal and seal the gut, not take iron supplements!

A Baby “Inherits” Gut Dysbiosis from Mom

A human baby is born with a sterile gut. This means that there is no bacterial activity in a fetus’ digestive system prior to birth. The vast majority of gut flora that a child eventually develops is inherited from Mom, so if Mom has gut imbalance, so will her children and probably more severely so.
Children with imbalanced gut flora are particularly predisposed to autoimmune disorders in the form of allergies, asthma, and eczema. In more severe cases of gut dysbiosis, learning disabilities manifest such as ADHD, ADD, autism, dyslexia, dyspraxia and others. Of course, there is sometimes an environmental “trigger” which instigates these disorders, but it is crucial to keep in mind that gut dysbiosis is the primary underlying cause.

Think Twice Before Taking The Pill

When considering whether or not to take oral contraceptives, women rarely if ever consider the long term implications to themselves let alone their children. This is no surprise given that doctors rarely if ever mention this sort of thing when prescribing antibiotics let alone The Pill to their patients!

Therefore, it is vital that women take responsibility for their bodies and fully inform themselves of the potentially devastating consequences to their health and that of their children – and likely even their grandchildren – before blindly submitting themselves to the gut damaging effects of The Pill.
Sarah, The Healthy Home Economist

- See more at:

Anonymous said...

(The glucommanan poster again)

Wow I had NO idea about this info on the pill. I just thought it was antibiotics. It is HUGE!
Thanks so much for posting.

And thanks again for the glucommanan tip. Will take waaayyy less next time. I was bloated for days and it felt like there was sticky concrete stuck in there!
Will also take clay at the same time.

Thanks again,