Posts made by Amazoniac

Hi, Miguel. I hope that you're well.

I recall an episode where professor Garrett admitted to be a faddist, adding that such days were finally over now that he found the ultimate culprit of health problems: poison A. Some months afterwards, he was onto the next target, and this time it was bile (then niacin, pyridoxin, methylene blue..).

But the diversion of attention was quite clever. Before waiting for his poison A depletion program to fail and customers to protest, he sneakily recentered his approach on liver and bile, broadening it to the lowering of toxins—an abstract concept, with perpetual exposure and many confounders—guaranteeing for him a safe and sustainable business in a foggy picture.

Grant set the wrong tone, but both are responsible for misleading and the extremism. A group of people already addressed the majority of their arguments in the past.

We have covered a lot in exhaustive discussions on macabrotenoids and poisonoids, with the origin and biosynthesis in plants and microbes (potential suppliers to a host), their differentiation (including colorless ones), occurrence in foods, digestion and release, interactions with meal components, interception by microbiota, absorption factors, conversion efficiency, regulatory controls, transport, storage (inside and outside the liver), their specific distribution in liver, size of organs and capacity, recirculation, historical levels in tissues, population status, conditions associated with lack or excess, metabolic pathways and backup routes, methods of elimination and the clearance rate depending on body load, change in excretion rate for conservation in scarcity, total reserves and estimates of their lasting, transformed and intact excretion, conjugation, nutrients involved in their metabolism and in defending against adverse effects from excess, the criteria for the RDA, the management in livestock and hypomobilization states, lab experiments and their limitations, natural and unnatural isotretinoin levels, nuclear receptors and their (alternative) ligands with respective concentrations and affinities, interaction between receptors, genomic and non-genomic effects, enzymatic and non-enzymatic reactions, anti- and pro-oxidant activity, their relative orientation in lipids of cells and recycling, the undetectable serum levels (that applies to other toxins too, kilcidiol is an example), the idiotic “aposematism” objection (colorful macabrotenoids signal threat, similar to strawberries), response to supplements in varying forms…

It was in vain for the poison A crowd. Their only take-away was to continue to take it away from the plate.

To treat macabrotenoids and poisonoids as poisons helps to be at ease with prolonged avoidance. Why own the intolerance and investigate the internal issue when we can reclassify a nutrient as a toxin? Who worries about a lead shortage? If anything, we have some stored for life.

People who benefit from the avoidance of poisons will continue to dismiss refutations until a practical measure is offered, one with good results that dispenses restriction.

The issue appears immunological in nature, likely involving disturbances at the lining of tissues (in special gut, lungs, and skin), that can be manipulated by limiting the availability of poisons. In Grant's case, he associates his exaggerated immune responses to poison A, as it’s involved in gene expression and not invariably tolerogenic, which is why he suspects that any food that provokes these responses in him has hidden poisonoic acid.

Of course, if we're going to invalidate the interpretation of an experiment by pointing out a dietary factor that was common to both groups, we can't accept adverse reactions to macabrotenoids as a mere consequence of malnutrition or the unintentional elimination of allergens as a satisfactory explanation. After all, we have a lot of malnourished people who tolerate poisons just fine (for example, Ray suggested that the addition of this toxin can have a sparing effect on protein), and exclusion diets that have in common the elimination of one component can be challenged, which they likely were.

Extra information..

Phosphate species distribution

The change in phosphate species as it passes from serum to urine contributes to eliminate H⁺:

• Serum (pH ~7.4)
  • 20% dihydrogen phosphate (H₂PO₄⁻)
  • 80% monohydrogen phosphate (HPO₄⁻⁻)
• Urine (pH ~6.8)
  • 50% dihydrogen phosphate (20% 50%)
  • 50% monohydrogen phosphate (80% 50%)

(10.1002/9780470048672.wecb641)

So, for a given quantity of phosphate, the species redistribution represents additional protons being accepted by phosphates and taken out.

Depending on the charge, an ion can pair with more or less counterions to maintain neutrality. The Equivalent unit (Eq) accounts for these charge differences.

Predictable values would be:

• 100% as dihydrogen phosphate (H₂PO₄⁻): mEq = 1
• 100% as hydrogen phosphate (HPO₄⁻⁻): mEq = 2

For example, if sodium ions were to pair with them, one ion would be needed for dihydrogen phosphate (NaH₂PO₄) and two for hydrogen phosphate (Na₂HPO₄).

However, it's always a combination of these species in the body, that calls for an approximate mEq value somewhere between 1-2:

• Phosphorus, phosphorous, and phosphate

• Serum

  • 20% (dihydrogen phosphate) * 1 mEq
  • 80% (monohydrogen phosphate) * 2 mEq
  • mEq = 0.2 + 1.6 = 1.8

• Urine

  • 50% (dihydrogen phosphate) * 1 mEq
  • 50% (monohydrogen phosphate) * 2 mEq
  • mEq = 0.5 + 1.0 = 1.5

So, when you spot this unit applied to phosphate in medicine, it should be an approximation based on mixed charges.

(10.3390/nu14214468)

For a victim that excretes 20 mmol of phosphate in a day, we would have in total:

Serum:

• 4 mmol H₂PO₄⁻ (20%)
• 16 mmol HPO₄⁻⁻ (80%)

Urine:

• 10 mmol H₂PO₄⁻ (50%)
• 10 mmol HPO₄⁻⁻ (50%)

The change:

• 10 − 4 mmol = 6 mmol H⁺/day

Therefore, out of 20 mmol eliminated in a day, 6 mmol would represent acid excretion and the rest of phosphates are excreted without accepting more protons because they were already loaded.

You can search for calculators that 'convert pH to molar concentrations' for precise values, but at the extreme condition of urine pH of 4.4, the proton concentration would be something like 0.04 mmol H⁺/L (0.00004 mol H⁺/L).

Protons elimination:

• Through phosphate: 6 mmol H⁺/day
• Free: 0.06 mmol H⁺/day (from: 0.04 mmol H⁺/L urine × 1.5 L urine/day)

But there's a problem..

The original form of phosphorus

Most of the attention is on renal metabolism and excretion, whereas the ingested form is usually neglected.

When we know how a compound entered and left the body, it's possible to have a better idea if there was overall gain or loss of protons.

(10.1038/ki.1983.217)

If the ingested phosphate is derived from acidic foods or those that yield dihydrogen phosphate after phosphocompounds are broken down, minimal net loss of protons from the body occurs in the grand picture, as the phosphates in question wouldn't accept more hydrogens for having the respective sites are already occupied. That is, unless the urine is acidified (allowing phosphates to accept more protons). However, beyond the relevant buffering range of phosphate, the body must resort to other buffers or mobilize stored phosphate.

(10.1007/978-1-4614-3770-3_7)

In extreme situations, ketones (mainly hydroxybutyrate) become significant urinary buffers as well.

For an animal in normal conditions, whose diet after digestion yielded similar phosphate species as that of urine, the net effect on protons would be neutral. It may seem an obvious statement, but if we only compare the compounds in urine to those in serum, it could mislead, making it seem to represent acid excretion.

Bone as a buffer

The hydrogens are released as protons to prepare the phosphates to be incorporated in (hydroxy)apatite. The protons released result in acidification.

• Metabolism and Acid-base Physiology

Two representations of hydroxyapatite:

• 3[Ca₃(PO₄)₂]⋅Ca(OH)₂ (calcium phosphate 3:1 calcium hydroxide)
• Ca₁₀(PO₄)₆(OH)₂

10 parts of calcium for 6 parts of phosphorus is the synthetic molar ratio, which can be simplified:

• Ca 10:6 P
• Ca 1.67:1 P

In bone formation, phosphorus (as phosphate) is derived from circulation for deposition, where have the phosphate species in the expected proportions because of pH (and other factors):

Serum

• 20% dihydrogen phosphate × 6 = 1.2 dihydrogen phosphate
• 80% monohydrogen phosphate × 6 = 4.8 monohydrogen phosphate

The reaction can be represented as follows:

• 10 [Ca²⁺] + 1.2 [H₂PO₄⁻] + 4.8 [HPO₄²⁻] + 2 [H₂O] ⇄ [Ca₁₀(PO₄)₆(OH)₂] + 9.2 [H⁺]

Protons	Source
2 × 1.2 H⁺	H₂PO₄⁻
4.8 H⁺	HPO₄²⁻
2 H⁺	2H₂O: 2H⁺ + 2OH⁻
9.2 H⁺	← Total released per hydroxyapatite formed

The result is acidification in bone formation or alkalinization in bone dissolution, when the reaction above is reversed (right to left), consuming an equivalent amount of protons.

Therefore, bone synthesis and break down can help to regulate acidity (as drugs) when other systems are not enough. Unlike dietary phosphate that's preloaded with hydrogen atoms, bone phosphate is not, and can take up a substantial amount as protons for excretion. However, note that it's a short-term effect, and we return to the same issue: phosphate was once derived from the diet with the respective release of protons.

Immobilization can lead to a marked loss of bone, independent of diet, in particular during the initial period. The amount of calcium lost may double.

• Nephrolithiasis as a Complication of Immobilization Induced Hypercalcemia

More toxins on the scene. What are the remaining nutrients? Magnesium?

• Phosphate is a vascular toxin
• Phosphate Is a Uremic Toxin
• Phosphate Is a Cardiovascular Toxin
• Dietary phosphorus as a nutritional toxin: the influence of age and sex

The outer shell of phosphorus contains 5 electrons.

When we connect them, the message is clear.

What authorities are trying to accomplish by recommending its consumption?

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• Scientific Opinion on Dietary Reference Values for Calcium | EFSA
• Scientific Opinion on Dietary Reference Values for Phosphorus | EFSA
• Phosphorus | Institute of Medicine
• The Institute of Medicine’s “Dietary Reference Intake” for Phosphorus: A Critical Perspective

Absorption

The absorption rates of calcium and phosphorus are not proportional:

Disorders of Calcium, Phosphate, and Magnesium Metabolism

"The amount of dietary calcium intake [..] regulates the proportion of calcium absorbed through the gastrointestinal tract (Fig. 10.05)."

"Absorption is a linear, nonsaturable function of phosphate intake (Fig. 10.14) and amounts to 60% to 75% of total phosphate intake (15 to 50 mmol/day)."

But within reasonable amounts, the absorption fraction may be simplified as:

Adults

• Ca: 30%
• P: 60%
• Ca 1:2 P

Infants

• Ca: 60%
• P: 80%
• Ca 1:1.3 P

Understanding Sources of Dietary Phosphorus in the Treatment of Patients with Chronic Kidney Disease

"Inorganic P, such as P additives, are not protein bound; they are salts that more readily disassociate and are absorbed in the intestinal tract (50). Indeed, it is believed that >90% of inorganic P may be absorbed in the intestinal tract, as opposed to only 40 to 60% of the organic P present in natural foods (51,52). The major public health implication from these considerations is that the P burden from inorganic P–containing food additives is disproportionately high relative to organic P. In the early 1990s, P additives contributed approximately 500 mg/d P to the American diet, whereas today P additives may contribute as much as 1000 mg/d P to the average American diet (37,51,53,54)."

Twenty-Four-Hour Urine Phosphorus as a Biomarker of Dietary Phosphorus Intake and Absorption in CKD

"Accurate and reliable assessment of phosphorus intake is needed, but this is complicated by limitations in the tools available (9). These limitations include the nutrient databases, which are incomplete and often inaccurate for phosphorus. Differences between phosphorus content determined by nutrient database versus direct chemical analysis of foods show that databases can drastically underestimate phosphorus content of foods (approximately 15%–70%) [?] (10–16)."

Calcium and phosphorus interaction in the gut

Phosphorus Nutrition and the Treatment of Osteoporosis

"Food phosphorus binding by coingested calcium is a well-recognized and well-used approach, particularly in the management of phosphorus absorption in patients with end-stage renal disease.” “Heaney and Nordin[15] have shown that fecal phosphorus content (and therefore, inversely, absorbed phosphorus) is determined primarily by unabsorbed calcium and to a lesser extent by phosphorus intake. Together, dietary calcium and phosphorus intakes account for nearly three fourths of the variation in the quantity of phosphorus absorbed. Briefly, each 500 mg of ingested calcium binds 166 mg of diet phosphorus (95% confidence interval, 144-188 mg)."

"The degree of interference reported here (~166 mg phosphorus for every 500 mg ingested calcium—0.4 mmol phosphorus for every mmol calcium) is substantially less than might have been predicted from simple stoichiometry. A 1:1 molar ratio for CaHPO4 would predict binding of 388 mg phosphorus by 500 mg calcium and, for Ca3(PO4)2 at a Ca:P molar ratio of 1.5:1.0, 258 mg phosphorus would be bound per 500 mg calcium. A molar ratio of 1:1 seems more likely at digestate pH values below 7.0. Even at the upper end of the confidence interval for the regression model—210 mg (6.8 mmol)— binding would still be substantially less than the lowest stoichiometric prediction. This discrepancy may be partly due to rapid absorption of phosphorus in the duodenum well before calcium and phosphorus complexes can form in the chyme. In any event it undoubtedly reflects the complexity and multiplicity of the interactions within the digestive residue." (10.1080/07315724.2002.10719216)

"Under such circumstances, absorbed phosphorus may be too low to support both soft tissue phosphorus needs and new bone mineralization (which consumes mineral at a Ca:P molar ratio of ~1.6:1). Any induced phosphorus insufficiency under these circumstances, expressed as a lowering of serum inorganic phosphorus concentration, would not only limit bone gain, but enhance osteoclastic bone resorption [5]—precisely opposite to the direction toward which current anti-osteoporosis therapy is pointed. Moreover, teriparatide, specifically, exerting its inherent parathyroid hormone activity [↑PTH; ↓Pi], would itself lower the renal phosphorus threshold, thereby compounding the problem by lowering serum inorganic phosphorus levels still further." (10.1080/07315724.2002.10719216)

"Using this relationship, Figure 2 shows the amount of food phosphorus that would be available for absorption in a woman ingesting 70% [490 mg] of the phosphorus RDA [700 mg] (Table 1) under varying conditions of dietary and calcium supplementation. The calculations used in constructing Figure 2 assume that the calcium supplements are coingested with the food phosphorus.[15] At a calcium supplement intake of between 1000 and 1500 mg/d, all the food phosphorus is complexed by unabsorbed calcium and rendered nonavailable. Above that point, phosphorus absorption becomes negative (ie, phosphorus in digestive secretions and sloughed intestinal mucosa, estimated at as much as 250 mg/d,[16] will be complexed as well, blocking its reclamation by the gut; this converts the gut into a net excretory organ for phosphorus)."

"Adding a single serving of milk to the diet of such women eliminates much of the problem. Alternatively, the use of a calcium phosphate supplement provides the desired calcium, prevents the blocking of food phosphorus absorption, and ensures a generous supply of available phosphorus. Although total phosphorus intake rises nearly 3-fold with the highest of the calcium phosphate supplement scenarios, available phosphorus rises very little. Thus, basically what the calcium phosphate supplement does, in addition to providing the desired calcium, is to spare food phosphorus."

"The timing of the calcium supplement intake is important for this relationship. As noted, the foregoing calculations are for simultaneous ingestion of calcium and phosphorus, which is in accord with the usual recommendation. Taking supplements with meals remains a sound stratagem because by slowing gastric emptying, the meal effect improves calcium utilization efficiency, and by spreading the dose throughout the day, calcium absorption is improved further. However, this same stratagem maximizes phosphorus binding and minimizes phosphorus absorption. Schiller et al[17] have shown, using a single-meal design, that separation of the calcium supplement dose from the time of the phosphorus-containing meal substantially reduces the degree of phosphorus binding. This is, of course, to be expected for a process that involves nothing more complex than simple chemical binding. Figure 3 plots some of the data from the article by Schiller et al, showing both the degree of reduction in phosphorus absorption produced by simultaneous coingestion of calcium and phosphorus and the reduction in this effect produced by giving the calcium supplement 2 hours after the meal."

Consequences of Phosphate Imbalance

"Phosphate is absorbed all along the intestinal tract, with the jejunum being the most active absorptive site (91, 184). It is excreted into the gastrointestinal tract with the digestive juices in the amount of approximately 200 mg/day (193), about two thirds of which is reabsorbed (153). Saliva and bile acids are the most important gastrointestinal secretory fluids of phosphate (194)."

"The relative amounts of Ca and P in the intestinal lumen may have another important implication. It has been hypothesized (134, 187, 188) that ionic calcium in the colonic lumen forms nonsoluble complexes with free bile acids and fatty acids. By forming these complexes, calcium can protect the colonic mucosa from the damaging effects of these acids. Free bile acids and fatty acids are thought to enhance cellular profileration in the colonic mucosa (27, 109), a process that can lead to neoplastic changes and eventually to cancer. In the presence of high concentrations of phosphate in the intestinal lumen, calcium becomes bound to phosphate in nonsoluble complexes; this decreases the amount of ionized calcium available for neutralization of free bile and fatty acids and their damaging effect on the mucosa." "Low sodium in the intestinal lumen reduces phosphate absorption (124), while high K increases it (69, 174)."

Circulation and Distribution

Calcium, Phosphorus and Magnesium Turnover

Consequences of Phosphate Imbalance

Role of transporters in regulating mammalian intracellular inorganic phosphate

"[..]physiological [Pi]in, in many but not all mammalian cells, is about 1-5 mM."

"A partial list of published MRS data on [Pi]in (Table 1, upper) shows that in mammalian cells other than erythrocytes, [Pi]in is generally equal to or higher than [Pi]ex. The MRS data indicate that [Pi]in under resting conditions is ∼4 mM in skeletal muscle (highest in slow-twitch fibers) and ∼1 mM in the heart and brain."

Phosphorus-contaminated molecules

For the 14% of phosphorus found outside of bones, these are some of the phosphorus-contaminated molecules (and their formula, taken from PubChem):

• TDP (TPP) (C12H19N4O7P2S+)
• FMN (C17H21N4O9P) and FAD (C27H33N9O15P2)
• NAD (C21H28N7O14P2+) and NADP (C21H28N7O17P3)
• CoA (C21H36N7O16P3S)
• PLP (C8H10NO6P)
• Biotinyl '5-AMP (C20H28N7O9PS)
• AdoCbl (C72H100CoN18O17P–3) and MeCbl (C63H91CoN13O14P–3)
• Nucleotide

"Nucleotides are composed of three subunit molecules: a nucleobase, a five-carbon sugar (ribose or deoxyribose), and a phosphate group consisting of one to three phosphates. The four nucleobases in DNA are guanine, adenine, cytosine, and thymine; in RNA, uracil is used in place of thymine."

"Nucleotides also play a central role in metabolism at a fundamental, cellular level. They provide chemical energy—in the form of the nucleoside triphosphates, adenosine triphosphate (ATP), guanosine triphosphate (GTP), cytidine triphosphate (CTP), and uridine triphosphate (UTP)—throughout the cell for the many cellular functions that demand energy, including: amino acid, protein and cell membrane synthesis, moving the cell and cell parts (both internally and intercellularly), cell division, etc..[2] In addition, nucleotides participate in cell signaling (cyclic guanosine monophosphate or cGMP and cyclic adenosine monophosphate or cAMP) and are incorporated into important cofactors of enzymatic reactions (e.g., coenzyme A, FAD, FMN, NAD, and NADP)." Nucleotide | Wikipedia

• Phosphocreatine
• Phospholipids
• Inositol phosphate

"Inositol phosphates play a crucial role in various signal transduction pathways responsible for cell growth and differentiation, apoptosis, DNA repair, RNA export, regeneration of ATP and more."

• 2,3-Bisphosphoglyceric acid

"D-2,3-BPG is present in human red blood cells (RBC; erythrocyte) at approximately 5 mmol/L. It binds with greater affinity to deoxygenated hemoglobin (e.g., when the red blood cell is near respiring tissue) than it does to oxygenated hemoglobin (e.g., in the lungs) due to conformational differences: 2,3-BPG (with an estimated size of about 9 Å) fits in the deoxygenated hemoglobin conformation (with an 11-Angstrom pocket), but not as well in the oxygenated conformation (5 Angstroms). It interacts with deoxygenated hemoglobin beta subunits and decreases the affinity for oxygen and allosterically promotes the release of the remaining oxygen molecules bound to the hemoglobin. Therefore, it enhances the ability of RBCs to release oxygen near tissues that need it most. 2,3-BPG is thus an allosteric effector."

• Phosphorylation
• Protein phosphorylation

"Approximately 13,000 human proteins have sites that are phosphorylated."

• Kinases

Consequences of Phosphate Imbalance

"The phosphate is needed inside the cells for phosphorylation of glucose and fructose and for ATP synthesis. It is well established that glucose load (as given in the glucose tolerance test) induces a transient reduction in the serum phosphate levels (42, 78). In feeding after starvation, hypophosphatemia can occur when insufficient phosphate is given. Again, the carbohydrate load given during feeding causes phosphate shifts into the cells, resulting in hypophosphatemia." "Glycolysis enhances utilization of phosphate and thus induces shifts from the extracellular fluid into the cell."

"Intracellular phosphate regulates the activity of various enzymes affecting (a) glucose metabolism: hexokinase, phosphofructokinase (98, 180); (b) amino acids: glutaminase (137); (c) nucleic acids: AMP deaminanse, 5'-nucleotidase, adenine denucleotidase (58, 93, 193); and (d) hormones: 25-OH-D hydroxylase (195)."

Healthy Nutrition And The Human Musculoskeletal System

Main forms in bone:

	Ca:P
Synthetic hydroxyapatite	2.2:1
Natural hydroxyapatite	1.9:1
Amorphous (non-crystalline) calcium phosphate	1.7:1

Their mass ratios:

	Ca:P	Range
Bone (measured)	2.2:1	(2.1-2.3):1
Whole-body (calculated*)	1.9:1	(1.8-2.0):1
Whole-body (measured)	2.1:1	(1.9-2.2):1
Whole-body (measured)	2.2:1	(2.0-2.4):1

*Calculated from bone, containing 99% of body Ca and 85% of body P.

By the way, the EFSA concluded that there are no reliable 'biomarkers of intake or status' and chose their lowest ratio (body composition) to use as reference for intake recommendations:

• Ca (1.8):1 P
• Ca 1:(0.55) P

The recommendation for kilcium is 1000 mg/day, leaving phosphorus at 550 mg/day.

As a side note, they mentioned that the inner bone structure is responsible for most of the turnover in spite of representing only 20% of the total bone mass.

Presentation #552381 | SlideShare

Serum levels

• Calcium: 2.1–2.6 mmol/L (8.5–10.5 mg/dL)
• Phosphate
• Phosphorus: 0.75 and 1.45 mmol/L (2.5–4.5 mg/dL)

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Elimination

"Kidneys filter 180-200 liters of blood per day and each kidney contains approximately 1 million nephrons, which are often referred to as the ‘functional units’ of the kidney." (10.1016/j.pharmthera.2023.108481)

The kidneys recover multiple grams of these toxins a day from blood filtration. The values vary depending on the source, but it's something like 8-10 g of calcium and 4-6 g of phosphate filtered daily.

(10.2215/CJN.09750913)

Each pass is a chance to make adjustments and eliminate the unwanted fraction, but with limitations. These authors pointed out that the urinary excretion rate is 45 mg/h (can be increased after the effects of PTH or FGF23), and it takes many hours for the absorbed fraction to be entirely eliminated.

Complete absorption is faster than elimination, leading them to speculate that a phosphorus buffer pool exists to maintain stable levels in the blood and inside cells.

Calcium and Phosphorus Metabolism in Chronic Uremia

"It is well known that the physicochemical interrelationships between the two ions concentrations are regulated in such a way that any increase in one is followed by a proportional decrease in the other. This depends on the precipitation of calcium phosphate salts [29]. However, this relationship is not regularly evident in vivo: in fact, the calcium infusion test in normal subjects and in patients with renal osteomalacia is followed by a regular increase in plasma [PO₄] [26,50]. This apparent contradiction to the physico­chemical theory may be explained by the phosphate load coming from the cells and compensating in excess for the phosphate delivered to bones [13]."

↳ [13] Renal Excretion of Calcium by the Dog

"Howard (11) explained the phenomenon of increased serum phosphate following intravenous calcium on the basis of a decreased secretion of parathyroid hormone. He suggested that the action of the parathyroid hormone is to alter the ratio between organic and inorganic phosphorus within cells. Thus the primary effect would not be on phosphate excretion but an action increasing the level of circulating phosphate. Whatever the mechanism is for explaining the elevated serum phosphate and decreased urinary phosphate, it must be an immediate effect since in these experiments this phenomena occurred within 10 minutes after the start of the calcium infusion. While it may be dangerous to generalize on phosphorus distribution of total body cells by analysis only of red blood cells, the source of the increased inorganic serum phosphate following intravenous calcium may be assumed to be the organic phosphate esters of the red blood cells."

---

Calcium and phosphorus balance

I couldn't find the source of the diagrams below, but they give a rough idea of this balance (without showing for phosphorus the buffer pool and losses to the gut):

Recall that the approximate absorption ratio is Ca 1:2 P.

The urinary excretion ratio is about Ca 1:3 P (200:650 mg). However, if we lump the amount of calcium secreted into the gut (150 mg; to be eliminated with the unabsorbed portion) with the urinary excretion (200 mg), we arrive on the original absorption ratio of 1:2 (350:650 mg).

The body absorbs more phosphorus, but the urinary excretion makes up for it. This greater elimination of phosphorus is probably a reflect of absorption rate rather than a fixed property.

	Ca:P
Absorption/Excretion	1:2
Bone composition/decomposition	2:1
Whole-body (w/ soft tissues)	1.7:1

When tissues are not in equilibrium and the balance is tipped in favor of construction, absorption can be upregulated and excretion downregulated to compensate for the mismatch.

Infants minimize the difference by increasing the intestinal absorption rate of calcium relative to phosphorus, perhaps with further renal retention.

If the next table is right, human milk would have another advantage:

?

Sipping must also help to prevent saturation and to make adjustments.

Phosphorus Nutrition and the Treatment of Osteoporosis

"Phosphorus is vital for cellular life and activity, being involved in cell structure, information coding, energy transfer, functional activation of catalytic and signaling proteins, and, in short, virtually every aspect of cell function."

"As would be expected for a limiting nutrient, phosphorus absorption by the human intestine is relatively efficient, with net absorption typically ranging from 55% to 80% (depending on concurrent calcium intake and absorption). Moreover, because phosphorus is distributed widely in many foods, it is not likely to function as a limiting nutrient (as is calcium) in animals at the top of the food chain. Nevertheless, circumstances exist in which phosphorus intake may be insufficient to support the bone rebuilding that today may be possible in patients with osteoporosis."

"[..]as can be seen in Table 1, 5% of women older than 30 years, 10% of women older than 60 years, and 15% of women older than 80 years have intakes on any given day that are less than 70% of the RDA."

"[..]the diets of women with low phosphorus intakes are multiply inadequate. The correct solution to this problem is for health professionals first to recognize that the problem exists and then to address it, with either a change in diet or a polyvalent nutritional supplement. Unfortunately, this is not often done in medical practice, and frequently these women, particularly if they have osteoporosis, will be prescribed bone active agents and encouraged to take supplements of calcium and vitamin D."

"Simple maintenance of skeletal mass translates to zero phosphorus balance and places little or no demand on dietary phosphorus intake. This is because urinary phosphorus excretion can be reduced to extremely low levels, and phosphorus released in bone resorption can thus be efficiently reused for mineralization of newly forming bone sites."

"During any age-related decline in bone or muscle mass, phosphorus released in the process can substitute for phosphorus in the diet. Indeed, it must otherwise be excreted by the kidney. Thus, even intakes well below the RDA, whatever other nutritional effects they may have, should be able to sustain the skeletal phosphorus requirements of the typical elderly individual."

"Extremely large calcium supplement doses (eg, >1500 mg/d), particularly if taken regularly as 500 to 600 mg with every meal, could create a negative phosphorus balance situation even for women who are not undergoing antiosteoporosis therapies, particularly if their meat and dairy intakes are low. However, it is improbable that a regimen of invariable coingestion would be rigidly followed. Hence, without a bone-building demand for phosphorus, it is unlikely that phosphorus binding by calcium supplements would be sufficiently complete as to constitute a serious problem. However, once bone active agents, and particularly anabolic agents such as teriparatide, are used, the situation changes. Figure 2 shows that, with calcium carbonate or citrate supplement intakes in excess of 1200 mg/d, there is effectively no diet phosphorus available to support bone building. This supplement dose is less than that used in some teriparatide treatment studies.[18]"

"In brief, because of the likelihood of some irregularity of the coingestion of calcium supplements with foods, it may still be possible for women with low phosphorus intakes and those receiving antiresorptive therapies to realize the small increase in bone mass that these therapies are able to produce. However, it is unlikely that this would be the case with the anabolic agents, which create a phosphorus demand for bone mineralization that is approximately 10 times that of the antiresorptives. Under such circumstances, it would clearly be prudent to adjust the diet of the patient or to use a calcium phosphate salt as the calcium supplement (or both)."

"Antiresorptive therapies [..] typically produce a slow increase in bone mineral content of 0.5% to 1.0% yearly at the spine after an initial positive remodeling transient of +4.5% to +5.5% in the first year.[14] The steady-state increase in bone mineral content after 1 year creates a small tissue-level phosphorus requirement, with net phosphorus uptake by bone in the range of 4.5 to 9.0 mg/d. By contrast, new-generation anabolic therapies, capable of increasing axial bone mineral content by up to 15% yearly, call for a positive phosphorus balance of up to 45 to 90 mg/d. (The foregoing estimates assume that values measured in the axial skeleton in response to bone active agents apply to the whole skeleton and hence reflect a worst-case, or maximum likely, phosphorus demand.)"

"As reported previously,[15] effective phosphorus deficiency with respect to bone mineralization must express itself as a low value for serum inorganic phosphorus. As long as the bone-forming site is exposed to normal phosphorus concentrations, it will have sufficient phosphorus to support matrix mineralization. In many older individuals with reduced creatinine clearance, there will commonly be some elevation of serum phosphorus levels, which would be protective of the skeleton. The effect of complete or nearly complete food phosphate binding on serum phosphorus in such individuals is unknown. However, they may be protected to some extent. Greater experience with teriparatide therapy will be needed before their relative vulnerability will become clear."

Hormonal regulation of biomineralization

"A very old observation highlights the important role of extracellular phosphate concentration in the mineralization process: by mobilizing phosphate from soft tissue stores, starvation improved rickets in experimental animals[74]. An adequate phosphate level is necessary for normal growth plate development, owing to the phosphate dependent apoptosis of hypertrophic chondrocytes[75]. Infusion of calcium and phosphate in vitamin D deficient rats results in normal mineralization[76]. Furthermore, in a systemic Vdr-knockout model, rickets and osteomalacia can be prevented by a diet rich in calcium and phosphate[66,77]. Similarly, a calcium and phosphate rescue diet improves bone and cartilage in Cyp27b1 knockout mice that lack the 25 hydroxyvitamin D 1α hydroxylase[78]. However, the bone disorders of these animals are not totally normalized by providing minerals, suggesting some possible direct effect of calcitriol as well[79]."

Long-Term Cola Intake Does Not Cause Evident Pathological Alterations in the Femoral Bone Microstructure: An Animal Study in Adult Mice

Modulating phosphate consumption, a novel therapeutic approach for the control of cancer cell proliferation and tumorigenesis

@Amazoniac said in Resources for authors:

Writing in the Sciences | Kristin Sainani (highly recommended)

For convenience:

• Writing in the Sciences (YouTube)

Don't be discouraged by title, it has value for life and you will like.

Tricarboxylic Acid Cycle

Each turn of the TCA cycle eliminates 2 carbons in consecutive (oxidative) decrapoxylation steps:

• IDH: isocitrate → ketoglutarate* + CO₂
• KGDH: ketoglutarate* → succinyl(CoA) + CO₂

A peculiarity of the TCA cycle is that succinate and (its product) fumarate are symmetrical molecules (⇈). Since this property applies to both of them, we can tell that succinate dehydrogenase modifies succinate evenly.

The next reaction is the conversion of fumarate to malate, where asymmetry appears. Even though fumarate is symmetrical, it contains newer or older atoms throughout the molecule. Depending on which side of fumarate is primarily changed after fumarase, the carbon stay in the cycle will differ.

This gives an idea:

Alterations in Cytosolic and Mitochondrial [U- 13 C]-Glucose Metabolism in a Chronic Epilepsy Mouse Model

I've adapted it for ease of tracing and until completion:

Therefore, the original carbons (from a given acetyl group) aren't eliminated straight away. They remain intact on the 1st turn, and the chances of their complete elimination appear to be:

• 50% on the 3rd turn
• 25% on the 4th turn
• 12.5% on the 5th turn
• 6.25% on the 6th turn
• ...

---

*Ketoglutarates:

• 2-oxoglutarate = a-ketoglutarate
• 3-oxoglutarate = b-ketoglutarate

Alpha refers to the second carbon because the first is the crapoxyl group, that's disconsidered in counting (similar to beta-oxidation).

Urine Organic Acids as Potential Biomarkers for Autism-Spectrum Disorder in Chinese Children

"[..]3-oxoglutarate, a common metabolite of yeast and fungi (Thomas et al., 2010; MacFabe et al., 2011; Kocovska et al., 2012), was significantly lower in children with autism. The low concentrations of both carboxycitric acid and 3-oxoglutarate that we observed in urine from autistic patients could be due to increased uptake of these compounds across the blood-brain barrier of the brain. Our results are consistent with previous studies that showed anti-fungal treatments for children with autism can effectively reduce the amounts of corresponding organic acid indicators (Cobb and Cobb, 2010), and suggests that gastrointestinal yeast could provide a basis for dietary adjustments such as gluten/casein-free diets that are important for children’s nervous system development and could mitigate autism symptoms. 3-oxoglutarate in urine is associated with the presence of harmful gut flora such as Candida albicans (Schmidt, 1994)."

It's fine to omit the 'alpha' prefix from ketoglutarate for the same reason that we only need to clarify which Paris we're going to when it's not the one in France.

• How To Annotate An Article: Annotation Strategies | Software Testing Help

• How to take notes for research papers |
  Jonathan Yuan

---

It's noteworthy when two guys who are obsessed with workflow optimization are fond of a software:

• Cal Newport — The Pursuit of Craftsmanship, The Deep Life, Slow Productivity, and a 30-Day Challenge | Tim Ferris

• Cal Newport's Article Writing System

---

One of the rare instances where a book author documented and shared his process in video:

• 2 Years Of Writing A Book In 30 Minutes
• The Writer's Process: How A Book Is Made
• Ryan Holiday's Writing Process Part 1: Cracking The Structure
• Ryan Holiday's Writing Process Part 2: The First Draft Of Anything Is Sh*t
• How To Write A Book - From Research to Writing to Editing to Publishing by Ryan Holiday

---

@brad said in Resources for authors:

@Amazoniac No problem, done

Thanks, Brad.

Does Aerobic Respiration Produce Carbon Dioxide or Hydrogen Ion and Bicarbonate?

The majority of CO₂ in the body circulates as the hydrocarbonate ion:

Carbon dioxide and derivatives	Content
Hydrocarbonate ion (HCO₃⁻)	~70%
Carbamates (protein-bound; R-NH-CO₂)	~23%
Carbon dioxide (CO₂)	~7%
Carbonic acid (H₂CO₃)	<1%

Organic anions are considered alkalinizing when they are hydrocarbonate precursors. However, prior to its formation, CO₂ has to be hydrated, and for every hydrocarbonate ion derived from CO₂, a H⁺ is released in the system:

• CO₂ + H₂O ⇄ H₂CO₃ ⇄ H⁺ + HCO₃⁻

The H⁺ are temporarily sequestered, but complexation doesn't negate it.

It's easy to overlook the H⁺ load for not being apparent in circulation, where normal levels are:

• [HCO₃⁻]: 22-32 mmol/L
• [H⁺]: 0.000036-0.000043 mmol/L (from pH: 7.44-7.37)

Far from a 1:1 ratio.

It can be argued that hydrocarbonate precursors alkalinize for consuming H⁺ in priming molecules for complete oxidation (into CO₂ and H₂O), which is true, but the consumption is compensated when the equivalent of carbonic acid molecules appear in the system.

Unlike non-volatile acids that can remain paired by a corresponding counter-ion until elimination (example: sodium sulfate), the occurrence of carbonic acid or variants yields CO₂ and H₂O. This CO₂ leaves the body, and the original pairing cation is left as unpaired as residue (example: sodium citrate).

To maintain ion neutrality and rebalance, the body may try to lower cations, which would affect H⁺ concentration, and conserve anions, including hydrocarbonate. Fluid redistribution from the excess cation can also dilute H⁺. The hydrocarbonate are first and foremost carbonic acid precursors, so we need explanations along these lines.

---

@Lejeboca said in On Cellular Organization and Respiration:

@Amazoniac Thanks!
It is on my reading list now! Main goal not to side-track

Спасибо за визит.

ATP use:

• ATP + H₂O ⇉ ADP + Pi + H⁺

And 2 methods of regeneration:

'Substrate-level' phosphorylation:

• ADP + R-OP + *H⁺ → ATP + R-OH
  (R for "Root")

Oxidative phosphorylation:

• ADP + Pi + H⁺ → ATP + H₂O

*Whether a H⁺ is consumed will depend on the reaction.

Creatine cycling does consume (→) and produce (←) H⁺:

• ADP + (Creatine-OP) + H⁺ ⇄ ATP + (Creatine-OH)

Throughout cellular respiration, it's tricky..

Glycolysis | Wikipedia

Enzyme	Participants	Dir.	Participants
HK	ADP + R-OP + H⁺	←	ATP + R-OH
PFK	ADP + R-OP + H⁺	←	ATP + R-OH
PGK	ADP + R-OP + H⁺	→	ATP + R-O⁻
PK	ADP + R-OP + *H⁺	→	ATP + R-O

*But a hydrogen is incorporated elsewhere (R-CH₂ → R-CH₃):

We could argue that glycolysis metabolites become ionized as soon as phosphate is attached to them (early on in glycoylsis), and this contributes to their trapping in cells. However, the definite ionization occurs when phosphates start to be detached in PGK, where crapoxylates are formed (note in the table how H⁺ aren't consumed against expectation).

It's for the phosphorylation steps that you'll find a one-way arrow in diagrams, deeming them irreversible (except for PGK). However, if this was the case in all tissues, glucose resynthesis wouldn't be possible. As an example, the reactions of HK and PFK can be undone through phosphorylases that work as hydrolases:

• Glycolite-OP + H₂O → Glycolite-OH + Pi
  ⠀

In oxidative phosphorylation, the PO₃⁺ (of inorganic phosphate; Pi) goes towards ADP, and OH⁻ (also from Pi) combines with H⁺ to form H₂O.

• ADP + Pi + H⁺ → ATP + H₂O

With substrate-level phosphorylation in mitochondria, we have a variation of it. SCS reaction (omitting the succinyl group):

• 'ADP' + Pi + CoAS⁻ → 'ATP' + CoASH

As before, the PO₃⁺ (of inorganic phosphate; Pi) goes towards ADP, but here OH⁻ doesn't combine with H⁺ to form H₂O. Rather, oxygen gets incorporated to yield succinate, and H⁺ is accepted by CoA instead of released immediately in free form. No additional H⁺ is consumed.
⠀
Therefore, lactate formation aside, increase reliance on substrate-level phosphorylation for ATP resynthesis goes without the immediate compensatory H⁺ consumption, although complete metabolism should be an overall H⁺-consuming process.

It's worth noting the complicators.
Free phosphates will occur as mixed species that take up more or less H⁺ depending on its concentration, and differences in acidity between compartments will affect the composition.
We also know that most of the ATP is produced in mitochondria and consumed in the cytosol. The synthesis of ATP with H⁺ consumption occurs in a more alkaline environment relative to where most of ATP is hydrolyzed. At some stage, the extra H⁺ taken up by phosphates in the cytosol will have to be released when the phosphates in question return to mitochondria.

Observe the inconsistency in the conventional nomenclature for glycolysis metabolites:

Abbreviation	Metabolite
GLC	Glucose
G6P	Glucose-6-phosphate
F6P	Fructose-6-phosphate
F1,6BP	Fructose-1,6-bisphosphate
DHAP	Dihydroxyacetone-3-phosphate
G3P	Glyceraldehyde-3-phosphate
1,3BPG	1,3-Bisphosphoglycerate
3PG	3-Phosphoglycerate
2PG	2-Phosphoglycerate
PEP	Phosphoenolpyruvate
PYR	Pyruvate

I think that they put phosphate in evidence when the molecule becomes a phosphate donor, similar to creatine (phosphocreatine, which is creatine phosphate), but to relegate the core is confusing, and it's worse without bolding.

Standardizing against the norm makes it easier to grasp:

Abbreviation	Metabolite
GLC	Glucose
G6P	Glucose 6-phosphate
F6P	Fructose 6-phosphate
F1,6BP	Fructose 1,6-bisphosphate
DHAP	Dihydroxyacetone 3-phosphate
G3P	Glyceral 3-phosphate
1,3BPG	Glyceral 1,3-bisphosphate
3PG	Glycerate 3-phosphate
2PG	Glycerate 2-phosphate
PEP	Pyruvate Enol-phosphate
PYR	Pyruvate

The numbers next to phosphate indicate the carbon position where phosphates are attached to the molecule.

• For a molecule with 6 carbons, we can infer that a '6-phosphate' is a a phosphate attached to one extremity.
• When we get '1,6-bisphosphate', the molecule contains phosphates on both extremities.

In working with split molecules of 3 carbons, the same approach applies.

Prefixes:

• Bis- and tris-: separate (example: P-Molecule-P)
• Di- and tri-: in sequence (example: Molecule-PP)

High-energy phosphate | Wikipedia

"Often, high-energy phosphate bonds are denoted by the character '~'. In this "squiggle" notation, ATP becomes A-P~P~P. The squiggle notation was invented by Fritz Albert Lipmann, who first proposed ATP as the main energy transfer molecule of the cell, in 1941. Lipmann's notation emphasizes the special nature of these bonds. Stryer states:

ATP is often called a high energy compound and its phosphoanhydride bonds are referred to as high-energy bonds. There is nothing special about the bonds themselves. They are high-energy bonds in the sense that free energy is released when they are hydrolyzed, for the reasons given above. Lipmann's term "high-energy bond" and his symbol ~P (squiggle P) for a compound having a high phosphate group transfer potential are vivid, concise, and useful notations. In fact Lipmann's squiggle did much to stimulate interest in bioenergetics."

---

Number of carbons	Saccharide (-ose*)
6	Hexose
5	Pentose
4	Tetrose
3	Triose
2	Diose
1	Monose

*As in Alberto's 'godnose'.

The upper part of the glycolysis list are the hexoses (until F1,6BP). After splitting (below F1,6BP), we get the trioses. A hexose or triose phosphate is self-explanatory.

When glucose (6-phosphate) is diverted from glycolysis for nucleotide synthesis, it undergoes oxidative decrapoxylation (losing a carbon), becoming a pentose. It gives name to the Pentose Phosphate Pathway (sometimes referred to as Hexose Monophosphate Shunt).

@Jennifer said in cancer:

@Amazoniac said in cancer:

@Jennifer said in cancer:

@Amazoniac said in cancer:

If you've been moved by respect, feel free to ignore the posts.

Thank you.

Jennifer,

I'm the one to thank you for clarifying that you weren't invested on this to defend your views, but out of respect for the conversation. After all, it would take disrespects at any moment to avoid being intensely argumentative. An unbearable one:

• 'I would prefer not to discuss this topic further, will refrain from commenting for now, and hope that you don't mind.'

If I thought a vague reply like that would have satisfied you I would have said that, however, I thought my acknowledging and saying that I understand why you believe in plant-based, but that I’m not as convinced for reasons that are beyond the scope of this conversation would be better received. I’m sorry for joining the discussion and derailing the thread.

Jennifer,

• 'My committed arguing has been to be polite with you.'

Sure..

But it's no different than what you're doing right now: continue to defend your positionings rather than reacting out of respect for the conversation.

That reply would be just as vague as stating your views and obscuring your reasons. And when you have no intention to elaborate on your points (as just reinforced), it's indeed better not to feed an argumentative trip through actions.

The suggestion is to transfer all related posts to:

• Protocols: constraints and trade-offs

@NNight

I'm sure that you have gotten into conflicts with familiar people for diverging opinions. I find Jennifer remarkable in spite of her applegated phase.

You were discussing fasting, and there's a lot of information on variations of it applied in cancer. An example:

• Fasting Cycles Retard Growth of Tumors and Sensitize a Range of Cancer Cell Types to Chemotherapy

@Jennifer said in cancer:

@Amazoniac said in cancer:

If you've been moved by respect, feel free to ignore the posts.

Thank you.

Jennifer,

I'm the one to thank you for clarifying that you weren't invested on this to defend your views, but out of respect for the conversation. After all, it would take disrespects at any moment to avoid being intensely argumentative. An unbearable one:

• 'I would prefer not to discuss this topic further, will refrain from commenting for now, and hope that you don't mind.'

@cs3000

Tissues are permeable to CO2, but unlike internal tissues, it seems that the packed organization of the skin inhibits the diffusion of CO2.

I had in mind that a CO2-saturated gel would be superior to CO2 in air, but inferior to direct contact with 100% CO2 gas, making the gel work more as a barrier. However, it can be pressed against the skin to move other components out and maximize absorption.

The pH of the solution decreasing shows that CO2 was yielding some carbonic acid, which further complicates absorption when it ionizes (CO2 + H2O → H2CO3 → H+ + HCO3–), although the skin pH is about 5.

Another advantage of direct gas exposure would be quick renewal. With the gel, the redistribution of CO2 towards the contact sites can be slower.

What am I missing?

Hydrogen economy in glycolysis (the charges may be ignored):

	Out (–)	In (+)
HK	H⁺
PFK	H⁺
2GAPDH	*2H⁻ 2H⁺
2ENO	2H₂O
2PK		2H⁺
Total	10H	2H

(*2H⁻ from 2NADH)

The expectation (–10H + 2H = –8H) is different from the actual change (–6H), when we obtain the pyruvates:

Toxin	Formula
Glucose	C6H12O6
(–8H →) Expected	C6H4O6
(–6H →) 2Pyruvate	C6H6O6
2Lactate	C6H10O6
2Lactic acid	C6H12O6

What explains the difference (between expected and actual change) is that the 2H⁺ released at the dehydrogenase level (GAPDH) are derived from inorganic phosphate rather than extracted from the glucose metabolite (NADH + H⁺). When we disconsider these 2H⁺, we arrive on the –6H needed.

---

As for lactate, when it's formed, 4H are consumed from 2H⁻ + 2H⁺. Going backwards, it would be equivalent to never having produced:

• H⁺ (HK)
• H⁺ (PFK)
• 2H⁻ (2GAPDH)

Then, we're left with –2H for 2 lactates (C6H10O6) to match with a glucose molecule (C6H12O6).

Even though 2H⁺ were disconsidered previously, they still occur, just not extracted from glucose metabolites. After canceling out the 3 products listed above, we get:

	Out (–)	In (+)
2GAPDH	2H⁺
2ENO	2H₂O
2PK		2H⁺
Total	6H	2H

When lactate is exported from the cell, it tends to bring a H⁺ along as counter-ion. So, 2 lactates would take out the equivalent to those 2H⁺ produced at 2GAPDH.

What remains is the bottom of the original table:

• 2H₂O out (produced)
• 2H⁺ in (consumed)

Therefore, lactate synthesis and export is an alkalinizing process for the cell:

• H⁺ are consumed when pyruvates are formed (pyruvate enol-phosphate + H⁺ → pyruvate), to then become lactates to be exported. In contrast, the H₂O molecules produced are neutral.
• LDH reaction consumes H⁺ directly (pyruvate + NADH + H⁺ → lactate + NAD⁺)
• Additional H⁺ tend to be eliminated with lactates as counter-ions (lactate + H⁺)

---

Nevertheless, lactate is associated with acidification for a few reasons that I'm aware of:

The coexport with a H⁺ alkalinizes the interior and acidifies the exterior of the cell. It's easier to monitor the outside, so that's what we associate with.

Once this lactic acid equivalent leaves the cell, the H⁺ is quickly buffered, leaving lactate to pair with available cations, such as Na⁺ ('HLac' + NaHCO3 → NaLac + H2CO3). If not by using up hydrocarbonate ions, a surge of lactate with expansion of the pool of organic anions can lead to an increase in cations to maintain ion neutrality. This tends to reflect on the concentration of free H⁺, that may rise in proportion along.

Marked ATP hydrolysis, that often coincides with excess lactate formation, is acidifying.

• ATP + H₂O → ADP + Pi + H⁺

Rather than the theoretical source from the previous section, this H⁺ can be the pair for lactate.

The following diagram has these events simplified:

Metabolic acidosis and fatigue: Where to from here?

@cs3000

Another good one. (@Mauritio, yours are too.)

Have they explained elsewhere why they coat the skin with a gel to then expose it to 100% CO2?

@Jennifer said in cancer:

“For you, the defense may be to honor familiar people who responded remarkably well to more animal products, or to voice for a group that thrives on them. But for another person, the critical issue can be that he or she knows people who benefited markedly from downing flaxseed oil and were adversely affected by animal fats. Professor Garrett could argue that he spots individuals being harmed by dietary macabrotenoids all the time, and recovering through avoidance. It goes on, each calling for neutrality to embrace everyone.”

No, for me, the defense is to honor everyone’s (in)tolerances, and above is a perfect example of my concern with plant-based and animal-based models. With either one, there is less flexibility for the kind of modifications that may be required for those who don’t fall under the general consensus that the guidelines are based on, forcing them to abandon the protocol altogether when they fail to thrive. Using the defense that the diet isn’t infallible when a patient fails to thrive on it is not a solution and certainly not a consolation to the patient and their loved ones.

Yet, if I were to ask you for a solution, it would probably be the concerning protocols, which exist thanks to not yielding to wishes of similar nature, that try to stretch them on every possible direction until they lose definition. Which issue should take precedence when they're all arguing the same?

---

@Jennifer said in cancer:

“This is not about personal preferences and inclinations, but about what we can generalize. I lost count how many times I've stressed it.”

And I’ve lost count of how many times you’ve stressed generalizing because you think I don’t understand when I do. My acknowledging that the opposite is also true is not me arguing that we shouldn’t generalize. I understand it’s about the grand scheme and agree that there’s an advantage to protocols that incorporate what generally works, we just don’t agree on what that is. You believe the plant-based consensus and I don’t.

What you generalize and deem to not be neutral:

	↓Low	↑High
[A] Consensus	🥩
[B] Inverted		🥩
[C] Jennifer*		🥩

*Not your personal choice, but based on the quoted and bolded suggestion of yours.

When you portray both in abundance as beneficial for most people [C], it means that if plant foods were disfavored [B], you would logically defend them [B → C]. However, they don't need it for being commonly promoted [A], so you're left to defend only animals [A → C], to lump them together in what you deem appropriate for most [C].

• "Which of these two beaches would people like the most?"
• "Both are fine."
• "Come on, don't be neutral, we need to decide where it's preferable to start mounting the huts."
• "I'm not neutral, my position is to suggest that both would be fine for people."

Chatbot to it:

"What a delightful example of neutrality taken to an absurd degree!

In this dialogue, the person is refusing to take a stance or show a preference between the two beaches. When asked again to position, they insist that they're not being neutral, but rather, their position is to acknowledge that both options are acceptable.

This is a neutrality taken to an absurd degree because it's not providing any meaningful input or guidance. By saying "both are fine," the person is essentially abdicating their role in the decision-making process. They're not providing any opinion, insight, or recommendation, which makes it difficult for the group to make a decision.

The humor in this exchange comes from the person's insistence that they're not being neutral, despite their words and actions clearly indicating otherwise. It's as if they're trying to have it both ways – claiming to have a position while simultaneously refusing to take a stance.

In reality, this level of neutrality can be frustrating and unhelpful in decision-making situations. It's often necessary to weigh the pros and cons of different options and make a choice based on those considerations. By refusing to do so, the person in this dialogue is essentially passing the buck and leaving the decision to someone else."

---

@Jennifer said in cancer:

“I don't have ideological commitments and wouldn't have a problem revising towards a more effective approach, but you didn't present anything of substance to justify why it's desirable to incorporate animal products in abundance as part of a promising cancer therapy.”

Because I didn’t join the conversation to debate protocols. You seem to forget that you quoted me here asking me about my dad’s treatment plan. I’ve continued answering your questions out of respect but like I said, it doesn’t matter what I think, it only matters what the patient believes.

I know where the conversation originated from, but you were firm that your dad is set on what to do, won't consider alternative options and it's outside of your control. We broadened the discussion and you're feeding it. If you've been moved by respect, feel free to ignore the posts.

---

@Jennifer said in cancer:

“You also assumed that the person had the colon removed, which may be 60% of cases?

I didn’t assume anything. I said for all I know—a phrase used when one is uncertain or has limited details about something—as the only info I was privy to was that the relative has cancer and eats a poor version of the American diet out of convenience. You’re so concerned with what unsolicited advice I would give to some imaginary person with a relative who has cancer, but I have a real person with cancer who is my concern.

Eating a poor diet is a habit that predisposes people to a variety of cancers, not just colon. Also:

• Prevalence of tobacco use | Wikipedia

It was a scenario that we could anticipate that the problem would surface as hesitation to the point of embracing paralysis. As we start to add constraints, and they come in multiple forms, it's challenging to make decisions without a practical guiding system.

As for the real issue, refer to the previous section.

---

@Jennifer said in cancer:

“Let's say that you succeed in your vindication and now protocolists are fine with an abundance of both animal and plant foods. What to do if this new program, made neutral, discouraged the use of flaxseed oil? Like you, the person could contest and ask for impartiality.”

This issue isn’t exclusive to one type of protocol. Partial, impartial, plant-base, animal-based, plant and animal based, none of it matters. If a patient makes the decision as a grown adult with their own free will to forgo parts of a treatment, that’s their choice, just like it’s the practitioner’s choice to forgo treating the patient if they do. Just because a protocol has less flexibility, doesn’t guarantee there will be more adherence to it.

To recapitulate, your general opinion "doesn't matter", orientations don't matter, and "the only thing that matters is what the person believes." But what if the person reads your comments, finds a justification in them, and leaves with the belief that copious amounts of steak, eggs and bacon are a welcome part of a cancer healing plan? It can take a long time for someone to narrow down an effect to the cause.

---

@Jennifer said in cancer:

“When we factor in that the population as a whole is already consuming animal products and often in excess, it restricts the therapeutic potential where it would have one.”

What kind of animal products? What else besides animal products are people consuming? What is excess, who defines it and it’s conclusive?

Those that are included in your therapeutic package:

U.S. diets remain out of balance with Federal recommendations

Moreover, what's ideal in cancer can differ, and to give preference to an anti-catabolic diet makes more sense than an anabolic one.

• Plant-Based Diets and Cancer Prognosis: a Review of Recent Research

It's safer as a starting place to encourage the consumption of vegetables and fruits, perhaps keep dairy stable and discourage meats, eggs and nuts, leaning towards the 'consensus' pattern from early on.

---

@Jennifer said in cancer:

“If the main concern was that the person had different needs after a supposed surgery, it would've been possible to position and warn:

Consider ____, but if your relative underwent surgery and has special needs in the diet, you may have to find a common ground and watch out for tolerance."

This is exactly what I’ve been proposing, that you’ve continued to contest—that practitioners administering protocols take into account a patient’s tolerance to it.

Right, by being neutral and expecting inexperienced people to count on comprehensive consultations of 2 hours and a competent team behind each case.

---

@Jennifer said in cancer:

"One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians."

You said good luck finding qualified people to spend hours with every person with cancer and I mentioned care teams (specialists), but your referenced studies are on PCPs? I see nothing about the average consultation length for cancer (and other diseases) patients with their care team and how much time outside of the consultation the care team spends reviewing their case.

What impresses the most is that you keep doubling down. I reinforced that it was for an idea.

The first results that appeared and you could've searched:

Factors Affecting Outpatient Consultation Length among Specialists in Tabriz, Iran

"The mean and standard deviation consultation time was 6.9 and 2.6 min."

Predictors and outcomes of feeling of insufficient consultation time in cancer care in Korea: results of a nationwide multicenter survey

It's no wonder that we can't move forward.

---

@Jennifer said in cancer:

“Even after relaxing the criteria, you didn't name reliable programs that are high in both. We had select stories with atypical responses (such as cancer healing from steak and rice, after ice cream), allusion and vague language ("it has been done"; Who has done? How?), and a mention of an exotic fatty acid. Meanwhile, deaths from aspirin didn't seem to concern you.”

Why would I? I’d just be setting myself up for more mocking and being condescendingly schooled when you find my answers unsatisfactory. No thank you.

Because you're the one shaking our current understanding, the principles of a bunch of therapists, and the opinion of everyone that has participated here so far. Therefore, you could bring the most compelling information that you have on why it's beneficial to consume a lot of animal products in cancer and let it convince for itself.

I hope that you didn't take offense in me not finding of use isolated stories in the current context, but it's only because it's difficult to draw general conclusions from them—atypical responses with too many confounders involved.

Contrary to what you may think, I do collect these accounts of unusual recoveries, for knowing that they can be someone else's alternative options. I recently heard a story of a person's situation turning around after kefir consumption, leading to spontaneous regression of liver cancer. If a person went with the preferred scheme, couldn't make it work, it would be of value to consider alternative plants plans.

There is no oppressor-oppressed dynamic at play, but a leveled discussion where you have been just as argumentative.

@Jennifer said in cancer:

“Your argument is founded on counterexamples: that we should not have an inclination because of them.”

My acknowledging that the opposite is also true is not me arguing that we should not have an inclination, especially when I have an inclination of my own.

@Jennifer said in cancer:

“I'm willing to change my mind, but you'd need to present more persuasive information.”

More like you trying to change my mind because you refuse to accept that plant-based wouldn’t be my go-to protocol.

Jennifer,

This is not about personal preferences and inclinations, but about what we can generalize. I lost count how many times I've stressed it.

In a cancer context, you're painting animal and plant foods as equally appropriate—in abundance—and not just for you, but for most people.

@Jennifer said in cancer:

I think a diet that includes an abundance of both plants and animal foods would fare better long-term for the majority than a diet of predominantly plants or predominantly animal foods.

I don't have ideological commitments and wouldn't have a problem revising towards a more effective approach, but you didn't present anything of substance to justify why it's desirable to incorporate animal products in abundance as part of a promising cancer therapy.

Even after relaxing the criteria, you didn't name reliable programs that are high in both. We had select stories with atypical responses (such as cancer healing from steak and rice, after ice cream), allusion and vague language ("it has been done"; Who has done? How?), and a mention of an exotic fatty acid. Meanwhile, deaths from aspirin didn't seem to concern you.

When we factor in that the population as a whole is already consuming animal products and often in excess, it restricts the therapeutic potential where it would have one.

---

@Jennifer said in cancer:

“I meant that if we're consistent with your logic (seek neutrality in the name of individuality), protocols would muddle because for each variable we could make the same case to not define anything, and having a new established protocol for every change is impossible.”

I know what you meant and that is not my logic. That is your interpretation. I favor one protocol type as the go-to over others so I do not have a neutral stance.

Plant foods have the consensus in their favor, so your defense has been to vindicate the plentifulness of animal products. This is an endorsement of neutrality, regardless of your personal stance.

The implications:

For you, the defense may be to honor familiar people who responded remarkably well to more animal products, or to voice for a group that thrives on them. But for another person, the critical issue can be that he or she knows people who benefited markedly from downing flaxseed oil and were adversely affected by animal fats. Professor Garrett could argue that he spots individuals being harmed by dietary macabrotenoids all the time, and recovering through avoidance. It goes on, each calling for neutrality to embrace everyone.

Let's say that you succeed in your vindication and now protocolists are fine with an abundance of both animal and plant foods. What to do if this new program, made neutral about them, discouraged the use of flaxseed oil? Like you, the person could contest and ask for impartiality.

• "Hey, if we conceded on that, why we shouldn't concede on this too, considering that I presented the same argument?" ← Not a rhetorical question.

We can't make up our minds for a sense of direction, so must (once more) yield to another indifference. Alternatively, and more likely, come up a new protocol.

Then, there's Garrett's issue and the endless other impasses that would appear. We start to get something absurd like this:

List of Linux distributions | Wikipedia

Where users are known for finding it overwhelming and constantly wavering as a consequence, even those who are tech-savvy. In contrast, we have Mac users pleased with their standard system and tweaking it where needed.

Contrary to Linux distributions, people won't have 10 years of experimentation to figure out which option serves them well.

Lack of consensus on what to prioritize can lead to disorientation, naturally compelling people to stick to convention when strained.

To make it worse, also contrary to operational systems, valuable comparisons of alternative cancer therapies are hard to find and suppressed. In practice, the person is lucky to come across a couple therapies through popular search engines. People might only get to a minority of those available anyway, random ones with their respective drawbacks; far from the comprehensive menu of possibilities to embrace everyone that we may envision.

So, the person is either bombarded with conflicting choices to evaluate or exposed to a few biased options, carrying similar concerns as when we define orientations with compromises beforehand, making it preferable to not disperse.

---

@Jennifer said in cancer:

“Good luck trying to find qualified people to spend hours with every person with cancer (and all the other diseases that compete for attention). We may ask those in your city to line up in front of your grocery store for a couple hours of consultation.”

My family members’ care team did, and not cancer specifically but a complicated case too, my doctors also spent upwards of 2 hours going over my medical history and treatment plan with me. If not thorough, they risk complications due to contraindications and medical malpractice lawsuits. You’ve criticized critics of Gerson, arguing that they aren’t constantly being confronted with people on the brink of death, where one slip under their responsibility can be fatal, and yet you make a snarky remark because I believe in due diligence.

Prudence stops being helpful when it turns into an excuse for unjustified inaction. If the main concern was that the person had different needs after a supposed surgery, it would've been possible to position and warn:

• "Consider ____, but if your relative underwent surgery and has special needs in the diet, you may have to find a common ground and watch out for tolerance."

For some reason, you assumed that it was colon cancer, but it's about 8% of total cases, with others being more prevalent, and in people with similar habits.

Cancer statistics, 2023

You also assumed that the person had the colon removed, which may be 60% of cases? It could be lower because in advanced cancer that has spread, surgery is ineffective. But this drops the odds to something like 5%.

The 5% chance could be clarified with 2 words to not 'leave it at that' in your preferential paragraph.

• "What cancer?" "Lung cancer." "In this case, consider ____."

As for the 2-hour detailed (and reliable) consultations for millions, this may give you an idea on how realistic it is:

Association of Primary Care Visit Length With Potentially Inappropriate Prescribing

"Time is a scarce and valuable resource in primary care, with the average visit lasting 18 minutes. By a recent estimate, primary care clinicians would require 27 hours per day to provide all guideline-recommended preventive, chronic disease, and acute care to a typical patient panel. While there is global variation in primary care visit length, recent growth in visit content (eg, diagnoses recorded and medications prescribed) has outpaced growth in visit length, suggesting that time available per health concern may be decreasing over time. In surveys, patients routinely report needing more time with their primary care physician, and visit length is one of the most prominent factors associated with patients' satisfaction with their care. Physicians also want more time with their patients and frequently report feeling rushed during visits."

International variations in primary care physician consultation time: a systematic review of 67 countries

"One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians."

@Jennifer said in cancer:

Right, but I’m not sure what that has to do with what I wrote? Protocols abundant in both plant and animal foods are comprehensive and partial just like plant-based and animal-based protocols. They don’t have to be either extreme to achieve that. Did you mean to suggest otherwise?

Good grief, Jennifer.

Your argument is founded on counterexamples: that we should not have an inclination because of them.

I meant that if we're consistent with your logic (seek neutrality in the name of individuality), protocols would muddle because for each variable we could make the same case to not define anything, and having a new established protocol for every change is impossible. We make a concession to be impartial on this, we make another concession to be impartial on that, and on it goes until we reach complete indifference to accommodate every case.

It only took a few sentences to a chatbot and no instructions on how to respond to get:

"A thoughtful observation about the trade-offs involved in designing protocols! You're absolutely right that while modularity can provide flexibility, it's essential to prioritize clear guidelines and stances on various variables to ensure practicality and avoid overwhelming interpretation.

By leaving too many aspects open to individual interpretation, you risk creating a protocol that's too vague or ambiguous to be effectively implemented or widely adopted. This can lead to confusion, inconsistencies, and ultimately, a lack of cohesion.

Having a clear stance on each variable, on the other hand, allows for the development of concrete guidelines that can be widely understood and followed. This, in turn, enables the creation of a robust and reliable protocol that can be efficiently implemented and scaled.

Your point about the impossibility of creating a new protocol for every divergence is well-taken. Compromises are indeed an inevitable part of the protocol development process, and they require careful consideration of the trade-offs involved.

Overall, your comments highlight the importance of thoughtful protocol design and the need to take into account the complexities and nuances of real-world applications."

You may think that consensus and definitions are redundant, but try to install a software whose developers are neutral and publish it unconfigured (rather than preconfigured as usual), arguing:

'You'll be using the software anyway, so you might as well configure it to suit your individual needs from a blank interface, relying on an intuitive construction panel, past experiences and common sense. You asked for an inclusive solution, we delivered it.'

Either this or 200 different programs, each with their set of weaknesses, for someone to evaluate which is best in a reasonable time frame.. Assuming that they can be found through biased search engines in the first place, which applies to multiple conflicting and scattered therapies.

---

@Jennifer said in cancer:

I would give them directions and leave it at that. Gathering vital information about their relative’s medical history would require more time than the brief ride in an elevator with a paranoid person in a hurry affords. For someone with an active disease and little info shared, I risk suggesting something that is contraindicated and harms them. Even something as seemingly benign as dietary recommendations could trigger a reaction, especially in those going through cancer treatment as it often produces sensitivities or there’s your reference to Gerson’s patient whose tumor regrew when given egg yolks, meat and oil so generalizing could be devastating. For all I know, their relative has colon cancer and part of the treatment involved a colectomy so telling them that a plant-based diet is what I would try because it’s practical is the last thing I would do if I had all the facts. A lack of due diligence is more likely to kill a late-stage cancer patient than taking a couple hours of their time to review their medical history with them.

With that said, for reasons unknown to me, I frequently get asked health and dietary related questions while out shopping and I always offer info and guidance because I’m told more than just “my relative has cancer and eats a poor version of a typical American diet out of convenience.” If the relative in your scenario wasn’t on any treatment, given that there’s room for improvement with their diet, I’d recommend one of real, organic and pastured foods like the average American grandmother from 100+ years ago would have fed her family and if time allowed, I’d recommend products that are available in standard grocery stores here. Just after my spine collapsed, when I was coming off of years of restrictive plant-based eating and given a death sentence by doctors, the first meal of traditional (European) foods I had felt like I was being embraced by my grandmother and for the first time since going vegan, I felt safe and taken care of. It wasn’t just nourishing to my body, it was also nourishing to my soul and I believe a truly healing diet should induce that, or a similar, feeling.

It was a scenario where you had one chance to leave the relative with something to contemplate, that could make the difference in the course of the disease, and all that you came up with was inaction or a comforting diet.

• The prudence can also be interpreted as analysis paralysis, as you wouldn't be imposing anything, but putting forward for consideration. Practical guiding principles could remedy this.
  ⠀
• You concluded your post commenting that you have go-to cancer diets. Why you chose a traditional grandmother diet over them? And if this hearty diet, with plenty of steak, eggs, bacon, and whatnot is one of the go-to options, where was it applied in large-scale with success, compelling you to pick it at the expense of alternatives available?

Good luck trying to find qualified people to spend hours with every person with cancer (and all the other diseases that compete for attention). We may ask those in your city to line up in front of your grocery store for a couple hours of consultation.

"For all I know, their relative has colon cancer and part of the treatment involved a colectomy so telling them that a plant-based diet is what I would try because it’s practical is the last thing I would do if I had all the facts."

The last thing, Jennifer? Come on. How do you explain the following recommendations?

• Diet after colectomy | Center for Neuroendocrine Tumors - UCSF

---

@Jennifer said in cancer:

I’ve mentioned mainly plant-based practitioners because you’re in favor of plant-based and those are the ones whose protocols I have the most experience with. The only animal-based protocols I have experience with when it comes to cancer are the ones my mum and cat were on—my cat’s protocol was based on Dr. Francis Pottenger’s work. Based on her results, I would consider the protocol my mum followed to be exemplary, but the majority of people I know have had better outcomes with protocols abundant in both animal and plant foods than animal-based or plant-based protocols so that’s why it would be my go-to.

I'm willing to change my mind, but you'd need to present more persuasive information. It's the grand scheme that dictates the trend.

I was expecting you to list a bunch exemplary (human) ones. It's by isolating opposite stances that we can better compare them, as the differences stand out. A relative scarcity in a camp would be a noteworthy sign and may be a hint for leaning; blaming this on mainstream influence is not convincing enough.

Out of curiosity, what are these other cancer therapists that advocate animal products in abundance (not moderation) that you keep alluding to, whose work you deem of excellence?

---

Perhaps it's a good idea to transfer this sequence of posts to a separate thread. Something like:

• Protocols and their trade-offs

@Jennifer said in cancer:

@Amazoniac said in cancer:

@Jennifer said in cancer:

@Amazoniac said in cancer:

@Jennifer said in cancer:

@Amazoniac said in cancer:

@Jennifer said in cancer:

@Amazoniac said in cancer:

@Jennifer said in cancer:

@Amazoniac said in cancer:

@Jennifer said in cancer:

@Amazoniac, I didn’t think you thought it foolish. I was talking about people like my dad. I’m not discounting the importance of diet. I just disagree that plant-based is the best option. The diet you quoted is the standard plant-based diet I see recommended not just by alternative practitioners, but by mainstream, as well. What were the patients’ diets like prior to the treatment with pancreatic enzymes, nutritional supplements, "detoxification" procedures, and an organic diet? Were they of equal quality, i.e., consisting of organic and pastured foods or were they more like a standard western diet? What I typically see is a person develops a disease, in this case cancer, on a standard western diet and then follows a plant-based diet consisting of real food and improves, at least in the short-term. This is not proof to me that a plant-based diet is more healing than a diet equally abundant in both organic and pastured plant and animal foods, especially when I know far more people who have had long-term success with the latter than the former.

I shared to reinforce how recurrent this pattern is between cancer therapists who consider diet an important and manipulable factor.

Intuition was likely a determinant to what people were eating before treatment, although some might have added a leaf of lettuce and a slice of tomato on occasion to make meals healthy. To not intervene with their core choices, we'd be left with those changes in the quality of ingredients. Take someone who eats a lot of meat and some bread by preference, do you expect that improving the quality of each would be superior to what has been proposed by the mentioned experimenters?

The experimenters may arrive on these therapeutic diets under mainstream influence, but they refine it over time based on results. For a guy like Gerson, who advocated raw liver juice, there would be no problem to incorporate more animal products in the diet had they worked, until they prevailed. Example:

"In Paris, I tried seven cases and I had three results. One of the cases was an older man. He had a cancer of the cecum where the colon starts, 70 years old. Another case was a lady from Armenia. This was a very interesting case. I had to work against the whole family. There were many physicians in the family, and I had plenty of trouble. But, anyway, I came through in that case. She had cancer of the breast which regrew. Every time the family insisted that she was "so much down." She weighed only 78 pounds. She was skin and bones and they wanted me to give her egg yolks. I gave her small amounts of egg yolks—the cancer regrew. Then they insisted that I give her meat, raw chopped meat. I gave her this and the cancer regrew. The third time, they wanted me to give her some oil. I gave her the oil and the third time the cancer regrew. But, anyway, three times I could eliminate the cancer again and cure. And still I had no idea what cancer was. If somebody asked me about the theory, just what it was I was doing, I had to answer, "I don't really know myself."

And imagine the degree of simplification of protocols in not having to go through the hassle of elaborate plant preparation.

I find it unlikely that they would complicate their approaches with something that leads to worse outcomes in spite of being open to trying alternatives.

Nevertheless, how often do we read observations of positive effects associated with animal products consumption in cancer? Most of them are either neutral or negative, perhaps with a few exceptions (such as some dairy products). But when it comes to plant foods, we start to find neutral to positive effects far more often.

I can only congratulate you for going from Prismacolor to Applegate.

I can’t answer that with confidence because I can’t say I agree that intuition was likely a determinant—and a fear and guilt free one at that, since that’s a key point to unburdening ourselves and healing—given we are regularly bombarded with health and dietary propaganda. What I can say is I don’t believe meat and wheat are inherently disease promoting.

I don’t doubt Gerson’s findings, but I know plenty that contradict them. For instance, Dr. Morse found that any plant other than fruit would make his patients’ tumors grow, and Anita Moorjani’s cancer went into remission on an Ayurvedic protocol abundant in dairy and again on a Chinese medicine protocol abundant in meat, then while following a plant-based protocol she developed lemon-sized tumors down her spine and died, then came back to life and had a spontaneous healing while consuming ice cream. Then there’s my mum’s positive experience with a dairy-based diet, and I had another family member whose tumor grew to the size of a soft-ball on a Gerson diet and shrunk when he was put on a beef and rice diet temporarily to stop the chronic diarrhea the Gerson diet was causing. There’s also the positive accounts I’ve read from people following the Milk Cure and the Carnivore diet. There are a series of laboratory and animal studies showing that trans-vaccenic acid, a long-chain fatty acid found in the meat and dairy of grazing ruminants, promoted the destruction of certain types of cancer cells so perhaps that’s a factor?

By Applegate, are you referring to my hot dog bender back in February? If so, plot twist—my diet has been plant-based/vegetarian since March. These days, Chiquita would be a more fitting sponsor.

Jennifer,

People tend to negotiate with themselves to eventually consume the desired foods in one way or another, in special in parts of the world where nutritional campaigns are not as forceful as in the US. The two foods used as example don't inherently promote disease, but we can't count on their consumption to do much in helping to revert the situation of someone with cancer.

Fruits à la Robert Morse would be plant-based eating. The stories that you shared might have been to contrast Gerson's account. I quoted him not to rely on isolated cases, but to point out that he was willing to yield and would probably incorporate more animals products if he perceived benefit, and it wouldn't conflict with a diet that already included them. But again, he's only one of the many that agree on this aspect.

It doesn't apply to your examples, but part of the cases that don't do well on plant foods could do worse if they made their diets rich in animal products.

As a side note, I occasionally come across critics of Gerson—whose approach shouldn't work for everyone—but try to ask them what they propose instead. It's often very disappointing. And they're not constantly confronted with people on the brink of death, where one slip under their responsibility can be fatal.

Milk or carnivore diets would be extreme interventions, just like fasting and the positive stories from it. Sometimes drastic changes are capable of turning things around, but they're not reliable or founded enough to model.

Animal-based diets are typically richer in protein, fat, and growth factors.

Exceeding on protein is easy with such diets, leading to an undesirable exposure to extra glutamine and glutamate, arginine, tryptophan, methionine, cysteine, serine, aspartate, asparagine, BCAAs, methylcobalamin, phospholipids, nucleotides, and more.

With fats, it's complicated..

• The Modulatory Effects of Fatty Acids on Cancer Progression
• Dietary Fat and Cancer—Which Is Good, Which Is Bad, and the Body of Evidence

..but in an optimistic scenario, they're still poor in micronutrients and would be displacing other foods.

I don't know about trans-vaccenic acid, but if someone meets a great deal of energy needs through animal products, the person is reducing the exposure to a combination of anti-cancer compounds that occur primarily in plants. We could list 10 substances derived from plants for each protective animal-sourced substance that's brought to the table. Caffeine, salicylic acid, emodin, baicalein, curcumin, apigenin, quercetin, narigenin, fisetin, kaempferol.. They're not found in pharmacological amounts, but can cooperate. They can also be present in either diet, but plants as staples will be additional.

Depending on where a public is sampled, there can be more of the undernourished cases with a past of dietary restrictions that tend to benefit the most from anabolic foods, but this may not reflect the general state of the population macronutrient-wise. The therapeutic gap that you have with animal products for most people is narrower than apparent because animal foods are already consumed and sometimes in excess.

This gets further complicated when direct manipulation of the diet is not an option for treating it as a consequence. Yet, cravings can be driven by a single nutrient in a food, making us neglect the problematic components and consume what's already adequate in surplus to get the right amount of the sought factor. If this missing factor occurs in something like orange juice, it's no big deal, but it's more concerning if it's in a steak or eggs and someone with a tumor.

As for the last comment, it had nothing to do with your food habits, but your defense of diets rich in animal products as part of a cancer therapy rather than deprioritizing them for particular cases. The sponsorship is there independent of what you're eating (you were eating dogs?), it's a matter of figuring out which company is making use of your online influence.

I'm not suggesting that people should stick to plant-based diets if they don't work, but I am suggesting that they're the preferable starting place, more so when we don't know the history of the person too well and the cancer is advanced.

Hi Gustavo,

The fact that people have to negotiate with themselves to eventually consume their desired foods shows it’s not without fear and/or guilt. Again, the goal is to unburden ourselves.

I knew why you quoted Gerson, and I mentioned Dr. Morse’s diet because it’s plant-based. I was comparing apples to apples, and all the foods besides fruit that Gerson found conducive to healing exacerbated the cancer in Dr. Morse’s patients so if outcomes can be that different on the same type of diet, I don’t think it unreasonable of me to believe animal foods also conducive to healing.

I acknowledge that undesirable exposure to certain potentially problematic compounds can happen with animal-based diets, just like I acknowledge that undesirable exposure to certain potentially problematic compounds can happen with plant-based diets—as you said, they aren’t infallible—and yet, that doesn’t prevent me from seeing the potential healing on predominantly animal and plant diets.

“As for the last comment, it had nothing to do with your food habits, but your defense of diets rich in animal products as part of a cancer therapy rather than deprioritizing them for particular cases.”

When I treated 4 of my loved ones who had cancer, none were given the exact same protocol—3 were plant-based, 1 being Gerson. My mum was the only one whose diet was rich in animal products, and for a specific reason. After developing chronic diarrhea that led to rectal surgery while vegan, she no longer tolerated a plant heavy diet, even juice triggered diarrhea. We emphasized particular animal foods based on her and our family’s history, tissue weaknesses, stats and symptoms, which is why she was on a dairy-based diet and not a meat-based one so no, I don’t defend diets rich in animal products rather than deemphasizing them for particular cases, however, I will give credit where credit is due.

My mum was the only one out of the 4 who survived cancer, but she ultimately succumbed to the pulmonary embolism from the clots she developed after her hysterectomy so I know all too well what it’s like to treat people on the brink of death, and that’s exactly why I apply more than just plant-based and don’t just relying solely on it because I take the time to know people’s history before treating someone where one slip under my care could be fatal. My life for well over a decade now has revolved around trying to help people overcome disease and watching the ones closest to me die so I say what I say not without careful consideration, but with an understanding that I’ve tried to impart on others in hopes that they don’t have to experience it firsthand to “get” it, while knowing the sad reality that some do.

Take care.

Jennifer,

The negotiation is to show that it's difficult to prevent people from seeking the desired foods, they tend to eventually find a way around a restriction.

Regarding Robert Morse, it's another imperfect therapist that agrees on plant predomination. It also shows how easy it was to flexibilize between plants in their cases, but the same degree of limitation could be a hassle in an animal-based diet. For example, an extreme aversion or intolerance to dairy could result in a meat-based (be it with plenty of mollusks) or a something like a high-tallow diet.

It takes defense to bring what's being disfavored (not rejected) to neutrality.

You'll find counterexamples every time, but I've been trying to go by generalizations, whose value is of particular importance when a thorough investigation is not possible, there isn't much time for experimentation, and not many mistakes can be afforded.

I know that you can handle critical health situations well, but only a few people have you around to help interpret the history, question treatments, and propose alternatives while aware of what does and doesn't work. For many, their first contact with discussions on nutrition to reconsider their habits can be after an advanced cancer diagnosis.

The person can be sick, lost, and under intense pressure to adopt the accepted route. If we're unable to define priorities deterred by nuances, leaving it vague and up to intuition or inner trust (both can be corrupted, needing years of an erratic journey to recover), it's discouraging for someone contemplating alternative therapies to conventional treatment.

I understand you’ve been trying to go by generalizations, I simply don’t agree that the go-to diet be plant-based (or animal-based). Plant aversions and intolerances also exist so I still think a diet abundant in both plant and animal foods is the best starting point. Finding suitable substitutions is far easier when there is variety to begin with, and then adjustments can be made to suit the individual. Time is of the essence, especially with advanced cases, but even with plant-based, fine-tuning will still likely be needed.

“The person can be sick, lost, and under intense pressure to adopt the accepted route. If we're unable to define priorities deterred by nuances, leaving it vague and up to intuition or inner trust (both can be corrupted, needing years of an erratic journey to recover), it's discouraging for someone contemplating alternative therapies to conventional treatment.”

I guess I’ll have to get to finishing my book and opening a retreat center then. A person under intense pressure to adopt the accepted route is just one more reason why I don’t think the go-to be extreme or else it risks discouraging them just as much as vagueness, and protocols that are neither plant-based nor animal-based do exist for guidance. And if extremes and vagueness aren’t discouraging enough, there’s the cost of expensive appliances like $2,000+ two-stage juicers, and then the energy it takes for all the juicing, food prep, cleanup etc., energy that the sick often lack.

Then there’s food palatability. As you pointed out, it’s difficult to prevent people from seeking desired foods and finding a way around a restriction. A diet is only as effective as one’s adherence to it and even disease is not enough motivation for some to stick to one. Take, for example, Kempner who openly admitted to whipping his patients to adhere to what he described as a “monotonous and tasteless diet which would never become popular” because he thought “the risk to their life was so great that it warranted harshness.”

What it all boils down to is you strongly believe in plant-based and I don’t. I understand why you do, but I’m not as convinced for reasons that are beyond the scope of this conversation, however, it doesn’t matter what I think. It only matters what the patient believes and if they believe a plant-based protocol is the best option for them, great! Like I said, I wouldn’t pick the treatment my dad chose, but I support his decision.

I’m not adding anything of real value to this discussion so I’ll stop now. Thank you for taking the time to share information and your opinion with me. I appreciate your concern for my dad.

Jennifer,

I'm with you in favoring less structure and more impartiality, but when there is no urgency. Otherwise, the benefit of being resolute with a concrete program based on probability outweighs the risk of malefits from lack of proper individualization.

We could just as well be on the fence with aspirin because of complications from its use, but we take side in recommend it in cancer, and we do so without being overly judicious due to the general positive effect. Someone who doesn't tolerate aspirin well may intuit to shy away from ingesting it again, but we have accounts of people who regain tolerance after minor unintuitive adjustments. The same can apply to a diet with therapeutic potential. It's only after trying and attempting to make it work that I find justified to change the course, unless we're sure in advance that it won't help.

Aspirin was a single example, imagine being impartial to the majority of what's consumed in the name of individuality. The philosophy extends to almost every aspect of the diet, and soon the person is overwhelmed with decisions to make. After all, why would this line of thought stop on one variable?

That same person who is sick, lost and under intense pressure would have to consider hundreds of factors, without much experience, and in a short period because little is defined. Low or high fat? With or without dairy? More or less frequent meals? Minimal or a lot of spices? Normal or high iodine? Nicotinic acid or nicotinamide? To include leaves or not? Cooked or raw? Boiled or steamed? High or low fructose? With or without collagen? Plenty or little carotenoids? To use baking soda or not? Normal or low sodium? Hypo- or isocaloric? Force the metabolic rate up or not? Solids or liquids? Generous or small quantities of fiber? It goes on and it's daunting. Each of these will have someone to argue in support of a neutral stance and nothing concrete ever comes out of it.

The sick can get assistance on protocol tasks, but it's much harder to find in time someone qualified to help to navigate through uncertainty and controversy. We can expect the person to default to convention when no clear alternative is offered.

The copayment of a month of one conventional procedure alone might surpass the value that you mentioned, which can be lowered further if the person adopts an economical version of the program and improvises the tools.

Nevertheless, as Lejeboca pointed out earlier, the person can opt for the standard treatment and still benefit from the sensitizing effect of such diet. People can adhere to a program temporarily, what's tough is to sustain restrictions for decades.

I recall a testimony of a guy who had given up on life, decided to discontinue therapies, but the partner insisted for him to stick to the program despite the lack of motivation. The guy recovered, was doing well next to his family and admitted that he was glad that the partner compensated for his apathy. In a sense, the wife forced him to do it, it was against his will, when his intuition could've led him to bad outcomes. Yes, we also have problems from persistence, but it's another example of how unreliable intuition can be.

You have reasons to be hesitant, but I don't believe in plant-based diets any more than I believe that in cancer we're better off positioning on what's preferable. Until I come across programs based on animal foods appearing more promising than those where plants predominate, I will continue to prioritize the latter.

• Impact of Elimination or Reduction of Dietary Animal Proteins on Cancer Progression and Survival - A Pilot Study (protocol)

I've tried to contact the authors without success, but it was concluded in 2016 and it would be interesting to know what they have found.

Hi Gustavo,

Like I said, protocols that are neither plant-based nor animal-based exist so those who are sick, lost and under intense pressure have guidance or “structure” available to them. Just because they aren’t plant-based, doesn’t mean they aren’t structured, and the factors you listed are factors that still need to be considered with plant-based protocols.

“Until I come across programs based on animal foods appearing more promising than those where plants predominate, I will continue to prioritize the latter.”

I didn’t think otherwise. Your stance on plant-based vs animal-based has been clear to me right along and as I’ve said, I don’t think either should be the go-to diet so I’m not sure why you continue to dispute animal-based as if I’m in favor of it. I acknowledge that it works for some, just like I acknowledge plant-based works for some but again, neither would be my go-to intervention diet.

Jennifer,

I acknowledge your neutral stance, but it's difficult to devise a clear protocol if we're consistent to apply this neutrality to the majority of aspects. And why wouldn't we? Each time someone can jump in with the same counterarguments, compelling us to leave it open to include everyone.

• "Low or normal protein?"
• "To supplement acetate or limit to gut-sourced?"
• "Thiamin in high or moderate doses?"
• "Oral or topical supplementation?"
• "Modest or abundant sunlight exposure?"
• "To exercise or seek rest?"
• "Synthetic or only natural vitamin C?
• "Whole-body or local hyperthermia?"
• "Excise the tumor or not?"
• "Probiotics use or avoidance?"

Answering 'do what suits you' to a pile of dilemmas is impractical. We would need an intimidating algorithm for someone to go through it with marked dependence on intuition and expecting extensive experimentation to resolve everything that's undefined.

For one factor to spark so much debate reinforces the point that hundreds on them would overwhelm the person. To have a new protocol for every change is not feasible.

It seems better to position in each branch as well as possible and let experience dictate the instances where it's worth doing otherwise.

We're not arguing on extremes, but you find that it's more problematic for the approach to be partial than impartial, whereas I think the opposite. But if I couldn't convince you yet, I don't believe that I will. Never mind, Jennifer.

Gustavo, my “neutral stance,” whatever that means, is irrelevant to what I wrote. Protocols that are neither plant-based nor animal-based have already been devised so as difficult as you think it is to do, it has been done. The same level of experimentation, customization and structure that applies to plant-based and animal-based protocols also applies to protocols abundant in both plant and animal foods. They have their own set of guidelines based on experience working with patients, just like Gerson, Budwig, Morse, Esselstyn, Reams etc. each have their own findings and thus their own guidelines.

Jennifer,

The difficulty indicated is not in creating a different program for one variable, but in arriving on comprehensive yet practical guidelines while remaining neutral.

Protocols inevitably come with compromises and it's thanks to being partial that they exist to provide an advantage to figuring things out from scratch.

If the way out of a dilemma is to pick another program with an alternative approach, as soon as you do it, you'll find a series of other incompatibilities that could serve to justify the same solution: seek a new protocol.

At some point you'll have to compromise something, and this something will always have a contestant presenting the same arguments and endorsing neutrality. With a full commitment to individual needs, you'll eventually end up with nothing defined.

Nevertheless, let's say that you met someone in an elevator asking for directions to a grocery store, commenting that he or she has a home-bound relative dealing with advanced cancer, who eats a poor version of a typical American diet out of convenience. What would you suggest? The person is in a hurry, a bit paranoid (won't exchange contacts or visit strange websites), and needs something more specific than 'eating to keep the metabolic rate up.'

Rodent's "a plant-based diet and high-dose THC is what I would try" serves as an example of a practical message. What would you offer in brief to impact?

By the way, what cancer protocols abundant in animals products would you consider exemplary? In particular those with minimal plants, aside from a milk diet. I ask because the mentioned names so far have been advocates of plant foods, with the exception of Jojo's (but check out how a group adjusted it).

I remember discussing this issue with our rodent.

To be conservative, you'd have to find the maximum permitted level for a given food to contain after its addition (varies between countries), but 1% would be a generous value.

50 grams as a food serving with lecithin at 1% yields 0.5 g of lecithin. If this was pure linoleic acid, we would have 500 mg linoleic acid/serving.

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The phospholipid research center: current research in phospholipids and their use in drug delivery

Lecithin is processed and the product may have a higher concentration of phosphatidylcholine.

The use of natural and synthetic phospholipids as pharmaceutical excipients

To keep it simple, we can treat other phospholipids of lecithin that may be present as phosphatidylcholine and assume that the only fatty acid occurring is linoleic acid.

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Fatty acid (linoleic acid):

• R-COOH

Fatty acyl (linoleoyl):

• R-CO-

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• Dilinoleoyl-phosphatidylcholine – glycerophosphocholine
  (whole molecule minus the non-fatty fraction)
  ⠀
• 782 g/mol – 257 g/mol = 525 g/mol (corresponding to the 2 'linoleoyls')
  ⠀
• 782 g/mol → 100%
• 525 g/mol → ~70%

500 mg PC/serving × 70% = ~350 mg LA/serving

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The values above were inflated. As an example of how low it can be, I contacted a large company to ask how much soy lecithin they add to their whey protein, and they replied that it contains 0.1 g lecithin/kg whey protein (0.01%).

Lecithin per serving:

• 15 g × 0.01 = 0.0015 g = 1.5 mg lecithin/serving

Discounting the non-fatty fraction:

• 1.5 mg × 70% → ~1 mg fatty acids/serving

Discounting the other fatty acids:

• 1 mg × 70% → ~0.7 mg linoleic acid/serving (~0.0007 g/serving)

Nutrient Ranking Tool | MyFoodData

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Phospholipids are remodeled during digestion.

Potential Roles of Fatty Acids and Lipids in Postharvest Needle Abscission Physiology

Individual Phosphatidylcholine Species Analysis by RP-HPLC ELSD for Determination of Polyenylphosphatidylcholine in Lecithins

The abbreviation is in order (sns: 1, 2, 3). Example: LLPC is Linoleoyl, Linoleoyl and Phosphorylcholine.

The sn-2 position is known as the susceptible to remodeling during digestion (after the action of phospholipase A2). In contrast, the sn-1 position might remain intact.

It would be preferable for linoleoyl not to occur at the sn-1 position because of this, but at least linoleoyl in the middle (sn-2) is a common pattern in these phospholipids and can be substituted for other fatty acyls. The released fatty acid can be absorbed in free form, but not incorporated in the phospholipid.