Table of Contents

Carbohydrates and sugars

Carbohydrates are metabolized into glucose, which serves as the exclusive source of energy for most bacteria. A low-carbohydrate, insulin-resistant diet, which involves restricting consumption of carbohydrates, is recommended for Marshall Protocol (MP) patients but not required. This diet has certain benefits for MP patients: stabilization of blood sugar, weight loss, and appetite control. Additionally, holding carbohydrate intake at a reasonable level can enhance bacterial death. Conversely, eating more carbohydrates than usual can sometimes moderate intolerable immunopathologyAn unbearable or unsafe severity of bacterial die-off reaction..

What are carbohydrates and sugars?

A carbohydrate is a composition of one or more sugar molecules. The two main types of sugars are:

The body breaks down both carbohydrates and sugar into the exact same sugar molecules, so a diet high in carbohydrates will produce the same fuel for bacteria as a diet high in refined sugar. For this reason, the terms carbohydrates and sugars are used synonymously herein.

Carbohydrates and the immune response

Bacteria use carbs for energy

The Krebs Cycle is part of a metabolic pathway that converts carbohydrates, fats and proteins into a form of energy that can be used by the body. The cycle uses sugar to generate molecules of NADH, which humans use as a source of energy. But bacteria such as Borrelia, Treponema, and possibly others do not have proteins in their genomes that allow them to use NADH as an energy source. Instead, they obtain energy directly from sugar. This means that while humans must wait until sugar is broken down in order to put it to use, some bacteria can use it immediately. Consequently, extra sugar inevitably ends up benefiting the pathogen rather than the host.

Sugar has been shown to affect the immune system in ways not yet completely understood. Sugars in the body often bind to proteins, a process called glycosylation. Once attached to a protein, sugars adjust the protein’s ability to react with other molecules. T-shaped molecules named immunoglobulins have a location at the center of their structure which has a high affinity for sugar. Sugars are attracted to this region and, once attached, stay bonded for long periods of time. It is not yet known what changes sugars induce when bound to immunoglobulins, but their ability to bind these molecules does suggest that sugar can modulate the immune response.

Effect of carbs on immunopathology

Carbohydrates are metabolized into glucose, which serves as a direct source of energy for most bacteria. Keeping carbohydrate intake to a reasonable level can enhance bacterial death. Since more bacteria are likely to die in a carbohydrate-deprived environment, some MP patients may be able to use carbohydrate intake to modulate the level of their immunopathology. Those patients who experience strong immunopathology should not worry excessively about keeping carbohydrate intake to a minimum since they are experiencing bacterial die-off. Eating more carbohydrates than usual can sometimes moderate intolerable immunopathology.

Low-carb, insulin-resistant diet

A growing body of research supports the notion that the gut microbiotaThe bacterial community which causes chronic diseases - one which almost certainly includes multiple species and bacterial forms. feeds on simple carbohydrates,1) with the small intestinal microbiota driven by rapid uptake and conversion of simple carbohydrates.2) Indeed, a very low-carbohydrate diet has been shown to improve gastroesophageal reflux and its symptoms.3)

MP patients, in consultation with their health care practitioners, need to find the level of carbohydrate intake that minimizes their symptoms.

The quality of every calorie counts. Nutritiousness is important. Vegetables may be the best source of the “good carbs,” while whole grains, no matter how highly-touted, are the least beneficial of the acceptable carbs, completely inessential in the human diet, and apt to cause adverse reactions in many. The same can be said for many natural alternatives. Honey, for example, is no more nutritious than table sugar.

It's important to note that just because MP patients restrict carbohydrates, that does not mean they can eat unlimited calories from foods high in fat or protein without experiencing adverse consequences.

Managing cravings for sweets

Eating high amounts of carbohydrates can exacerbate sugar cravings. These cravings can be curtailed by reducing consumption of carbohydrates to largely low-carb vegetables and fruits.

Other tips:

Low-carb on a budget

Low-carb friendly-vegetables and meats tend to be more expensive than rice, pasta, and breads on a calorie-by-calorie basis. Smart consumers can limit the premium they pay for healthier foods. The following are some tip for eating low-carb on a budget.

Benefits of eating low-carb

Although restricting intake of carbohydrates alone will not resolve existing chronic disease, high amounts of sugar consumption have been implicated in everything from gout to cancer. Carb restrictions can have other benefits as well.

Weight management

Those who want to lower their blood sugar levels or who are very inactive or who want to lose weight or who want to control their appetite may want to keep their daily carbohydrate count very low. Others are able to progress well on the MP by simply avoiding refined sugars and eating a moderate amount of high-food-value carbohydrates.

Reduction in gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD or GORD) typically has symptoms of reflux and heartburn. These symptoms may be relieved by eating a low-carbohydrate diet or by not eating protein and carbohydrates together.

Proteins digest in the stomach, in an acid medium, while carbohydrates digest in the small intestine, in an alkaline medium. This means that eating the two together can trap undigested carbohydrates in your stomach, waiting for proteins to digest, and those carbohydrates can start to ferment in your stomach, leading to indigestion and heartburn. No fun. This is one of the reasons that many people find that reflux clears up on a low-carb diet.

Dana Carpender, HoldtheToast Press

Specific foods

Vegetables

Vegetables lowest in carbohydrates (from low to high):

Vegetables highest in carbohydrates:

When counting carbohydrates in vegetables, the grams of fiber are not included, so it can be subtracted from the total.

Fruits

Fruits lowest in sugar:

Fruits fairly high in sugar:

Fruits very high in sugar:

Cocoa and chocolate

It is likely that humans have stuck to any brew containing compounds with psychoactive properties, resulting in a better daily life, i.e., more efficient thinking, exploring, hunting, etc., however, without the serious side effects of drugs of abuse. 4)

Patient recommendations

===== Notes and comments =====

Dana Carpender's website, HoldTheToast Press Protein Power by Drs. Eades, MD is an easy-to-understand explanation of the science of carbohydrate metabolism and low carbohydrate eating You may find it helpful to use a low carbohydrate cookbook, such as any by Dana Carpender. Just remember to modify the recipes to exclude the use of foods high in vitamin D. Low-Carb Atkins Pulls Ahead in Four-Diet Face-Off Low glycemic index diet Dr Bernstein's Low Carb Diet

The ISME Journal (2011) 5, 220–230; doi:10.1038/ismej.2010.118; published online 5 August 2010

Dominant and diet-responsive groups of bacteria within the human colonic microbiota

Alan W Walker1, Jennifer Ince2, Sylvia H Duncan2, Lucy M Webster2, Grietje Holtrop3, Xiaolei Ze2, David Brown2, Mark D Stares1, Paul Scott1, Aurore Bergerat2, Petra Louis2, Freda McIntosh2, Alexandra M Johnstone2, Gerald E Lobley2, Julian Parkhill1 and Harry J Flint2

1Pathogen Genomics, Wellcome Trust Sanger Institute, Cambridge, UK 2Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, UK 3Biomathematics and Statistics Scotland, Aberdeen, UK Correspondence: HJ Flint, Microbial Ecology Group, Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen AB21 9SB, UK. E-mail: H.Flint@abdn.ac.uk

Received 25 January 2010; Revised 11 May 2010; Accepted 21 June 2010; Published online 5 August 2010.

Topof page Abstract The populations of dominant species within the human colonic microbiota can potentially be modified by dietary intake with consequences for health. Here we examined the influence of precisely controlled diets in 14 overweight men. Volunteers were provided successively with a control diet, diets high in resistant starch (RS) or non-starch polysaccharides (NSPs) and a reduced carbohydrate weight loss (WL) diet, over 10 weeks. Analysis of 16S rRNA sequences in stool samples of six volunteers detected 320 phylotypes (defined at >98% identity) of which 26, including 19 cultured species, each accounted for >1% of sequences. Although samples clustered more strongly by individual than by diet, time courses obtained by targeted qPCR revealed that ‘blooms’ in specific bacterial groups occurred rapidly after a dietary change. These were rapidly reversed by the subsequent diet. Relatives of Ruminococcus bromii (R-ruminococci) increased in most volunteers on the RS diet, accounting for a mean of 17%of total bacteria compared with 3.8% on the NSP diet, whereas the uncultured Oscillibacter group increased on the RS and WL diets. Relatives of Eubacterium rectale increased on RS (to mean 10.1%) but decreased, along with Collinsella aerofaciens, on WL. Inter-individual variation was marked, however, with >60% of RS remaining unfermented in two volunteers on the RS diet, compared to <4% in the other 12 volunteers; these two individuals also showed low numbers of R-ruminococci (<1%). Dietary non-digestible carbohydrate can produce marked changes in the gut microbiota, but these depend on the initial composition of an individual's gut microbiota.

Why shouldn't MP-patients eat as much protein and fat as they want?

It's important to note that just because MP patients restrict carbohydrates, that does not mean they can eat unlimited calories from foods high in fat or protein without experiencing adverse consequences.

See for instance: https://www.garytaubes.com/2010/12/inanity-of-overeating/ =====References=====

1)
Payne AN, Chassard C, Lacroix C. Gut microbial adaptation to dietary consumption of fructose, artificial sweeteners and sugar alcohols: implications for host-microbe interactions contributing to obesity. Obes Rev. 2012 Sep;13(9):799-809. doi: 10.1111/j.1467-789X.2012.01009.x. Epub 2012 Jun 11.
[PMID: 22686435] [DOI: 10.1111/j.1467-789X.2012.01009.x]
2)
Zoetendal EG, Raes J, van den Bogert B, Arumugam M, Booijink CCGM, Troost FJ, Bork P, Wels M, de Vos WM, Kleerebezem M. The human small intestinal microbiota is driven by rapid uptake and conversion of simple carbohydrates. ISME J. 2012 Jul;6(7):1415-26. doi: 10.1038/ismej.2011.212. Epub 2012 Jan 19.
[PMID: 22258098] [PMCID: 3379644] [DOI: 10.1038/ismej.2011.212]
3)
Austin GL, Thiny MT, Westman EC, Yancy WSJ, Shaheen NJ. A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms. Dig Dis Sci. 2006 Aug;51(8):1307-12. doi: 10.1007/s10620-005-9027-7. Epub 2006 Jul 27.
[PMID: 16871438] [DOI: 10.1007/s10620-005-9027-7]
4)
Franco R, Oñatibia-Astibia A, Martínez-Pinilla E. Health benefits of methylxanthines in cacao and chocolate. Nutrients. 2013 Oct 18;5(10):4159-73. doi: 10.3390/nu5104159.
[PMID: 24145871] [PMCID: 3820066] [DOI: 10.3390/nu5104159]