The Resistant Starch Challenge: Is It The Key We've Been Looking For?

[Ripley]

Actually, there are many mechanisms to keep the immune response in check, but the depletion of intracellular glutathione itself is, with bacterial toxins, one crticial way that the immune response, especially T-lymphocyte function, is suppressed. As a consequence the immune response stops punishing you, except that you already will have mobilized endotoxin that still needs to be neutralized. The research done at NIH has demonstrated that these endotoxins can remain in the lymphatic tissues for weeks. In immunocompromised individuals, the capacity to neutralize these endotoxins in the extraintestinal tissues is significantly impaired, so at first the symptoms may not seem so harsh, but as the endotoxin burden builds, and the antioxidant capacity and hydrolysis falters, symptoms can start to emerge.

I can tell you that as someone who doesn't have ME/CFS even I am currently going through this (albeit mildly). One of the reasons I brought up medicinal mushrooms in earlier comments is because I am taking chaga right now. For me, I've had a huge improvement in my mental clarity within a short time of taking it — it's very noticeably — but it gave me a stiff neck that has lasted for almost three weeks now. My doctor examined it and thought the chaga was helping me fight some kind of infection, but whatever I'm killing off is clearly also causing lymphatic congestion.

I only bring it up because even someone without ME/CFS can get these kinds of lymphatic congestions!

And I have no idea what I have either. I felt quite healthy before taking chaga, and the chaga made me feel even better (despite giving me a stiff neck).

One of the reasons I'm happy to stop PS is because I wonder if it was over-stimulating the effects of the chaga — I dont' know for sure, but I think my neck got stiffer when PS was taken along-side chaga.

 

[Sasha]

A 40g RS day would include these things:

- 1 med size green banana – 10-30g (depending on green-ness)

- 1 cup of Uncle Ben’s converted rice…cooked, cooled 24 hours, reheated or eaten cold – 20-30g

- 1 cup of cooked/cooled beans – 20-30g

- 1 cup of cooked/cooled potatoes – 10-20g

- 1/2 cup of almonds or cashews – 5-10g

- Raw carrots, med – 1-3g​

Almost all of those things look problematic. I can't get green bananas here in the UK; I'm on the Chris Kresser auto-immune 30-day paleo diet (I don't expect to ever be stable enough to be able to test and reintroduce foods) so no rice, beans, white potatoes; cashews cause my eczema and 1/2 a cup of nuts is a huge amount (a handful is usually all that's recommended). All that's left is that carrot.

I'm hoping he's going to come up with a bigger list. I wish we knew when the book was coming out!

 

[Violeta]

The end.

 

[Ripley]

I can't get green bananas here in the UK

I probably wouldn't eat green bananas every day anyway. I recently read somewhere that eating too many green bananas long term might contribute to heart valve issues.

http://yarchive.net/med/5-htp.html

Who knows if it's true or not. I really don't understand it. Something about too much serotonin in the blood, as green bananas and green plantains are apparently loaded with serotonin.

I'm on the Chris Kresser auto-immune 30-day paleo diet (I don't expect to ever be stable enough to be able to test and reintroduce foods) so no rice, beans, white potatoes; cashews cause my eczema and 1/2 a cup of nuts is a huge amount (a handful is usually all that's recommended). All that's left is that carrot.

I'm hoping he's going to come up with a bigger list. I wish we knew when the book was coming out!

I don't think you need to completely give up PS if you have trouble getting RS in your diet. There's nothing wrong with PS or RS2 so long as it isn't consumed in isolation long term. Tim and Grace just don't want people eating SAD + RS or VLC + RS and thinking they are healthy. RS needs to be eaten alongside other fermentable fibers. I think if you do that, you're probably fine. We'll likely hear more next week.

The recommendation to stop taking 4 Tbsp of PS per day is simply to point out that it's unnecessary for most people to do so since there are better ways to obtain RS for most people and RS3 seems to have a lot of benefits that they didn't initially see.

I think RS is an amazing biohack. I don't think I would have overcome my Candida as easily without it.

 

[Sasha]

II don't think you need to completely give up PS if you have trouble getting RS in your diet. There's nothing wrong with PS or RS2 so long as it isn't consumed in isolation long term. Tim and Grace just don't want people eating SAD + RS or VLC + RS and thinking they are healthy. RS needs to be eaten alongside other fermentable fibers. I think if you do that, you're probably fine.

That's a relief. I've been trying to take my PS lately at the same time as a fibre-containing meal to try to replicate natural conditions better.

 

[Lou]

This, I believe, represents a prudent strategy, although I think that you will find that symptom abatement is not so readily carried out insofar as there are many variables that control the induction of symptoms. One of the big ones, I think, is reduced glutathione. If, for example, you push yourself to where there is noticeable P.E.M., this correlates to having heavily depleted your antioxidant capacity. So, what happens when you concurrently mobilize endotoxins superimposed on high oxidative stress is that you have a greatly reduced capacity to neutralize the oxidative consequence of these, particularly in the Kupffer cells in the liver. Reactive oxygen species, like H2O2, which is produced by the inflammatory response LPS elicits will burn through your GSH reserves in the liver very quickly. This leaves little to export to the other tissues.

Fortunately, there are controls which put the brakes on the immune response, which kills the pathogenic bacteria and mobilizes the endotoxin. Actually, there are many mechanisms to keep the immune response in check, but the depletion of intracellular glutathione itself is, with bacterial toxins, one crticial way that the immune response, especially T-lymphocyte function, is suppressed. As a consequence the immune response stops punishing you, except that you already will have mobilized endotoxin that still needs to be neutralized. The research done at NIH has demonstrated that these endotoxins can remain in the lymphatic tissues for weeks. In immunocompromised individuals, the capacity to neutralize these endotoxins in the extraintestinal tissues is significantly impaired, so at first the symptoms may not seem so harsh, but as the endotoxin burden builds, and the antioxidant capacity and hydrolysis falters, symptoms can start to emerge. This ineffective extraintestinal endotoxin hydrolysis, I believe, in part accounts for the lymphatic congestion, many experience. These are in some ways, holding vessels sequestering the endotoxin from general circulation.

I guess the takeaway is to stay below the tolerable symptom threshold as you suggest, but also, at least at first, spread out any "doses" by at least 3-4 days to see what is happening. I would speculate that the cumulative effect is more consequential in those who are immunocompromised because the transit time is greatly lengthened. In fact, I have reason to believe that this process is already more efficient after my own efforts. Sorry, I hope this makes sense.

That's the thing, Vegas, everything you say (while I'm reading it) makes perfect sense, notwithstanding the fact I only understand a small fraction of what you're saying Does that make sense? Nope, of course not, I was going to say it another way, but I forgot the little jewel mid sentence.

At any rate, thanks to you and Ripley and many others here for a wealth of information that hopefully we can somehow figure out how best to apply.

 

[Ripley]

That's a relief. I've been trying to take my PS lately at the same time as a fibre-containing meal to try to replicate natural conditions better.

Sasha, sorry if I've asked you this already, but what's your reaction to (white) rice? I know Kresser allows it, particularly after the 30-day reset.

 

[Ripley]

Good reply from gabkad:

...Let’s not throw the baby out with the bathwater.

There is a valid use for reasonable quantities of potato starch and even unreasonable quantities for therapeutic purposes.

My patients who take 1 heaping tablespoon in water per day sleep well, shit well and are dedicated to this protocol. They eat sources of RS (beans) and they eat stuff like okra, asparagus, artichoke hearts, etc. but none of those or even psyllium gave them good shits.

I’d rather they take a tablespoon of PS than sleeping pills and laxatives.

I don’t think anyone needs to take 4 tablespoons indefinitely, but a combo of 1 scant teaspoon of psyllium + potato starch will regularize the colonic function and over time rebuild the muscles so that peristalsis and general colon health improves remarkably.

This also includes people who have had drippy shit for years and years, not just the constipated.

Busy people don’t always pay enough attention to diet such that they get all the various fibre types in optimum ‘doses’. PS is a sort of insurance policy and it’s not harmful. [LINK]

EDIT: And followup by Dr. Grace:

Gab ~ my comments are directed toward VLC, a diet devoid of starches by nature. People with colorectal family history or risks should consider. The best way to measure effects of carcinogens is to do a GDX organic acid (ONE, Organix, Nutri eval or ION) imho. The studies with RPS (RS2) alone show that considerably longer fecal mean transit times and increased (carcinogenic) secondary bile acids occur. There are also the studies where with certain carcinogens, RS2 avoidance (control) has less CRC tumours, initiation and progression compared to RS2 treatment arms. Very contrary to expected but likely secondary to a couple factors incl the fact that longer mean transit increases exposures of fecal carcinogens to colon and rectal epithelial (and lack of butyrate the in distal GI tract).

However this issue is ameliorated when 3-5% cellulose is in the diet (pig and rodent studies). For an average dry 400g human diet, that’s ~12-20 g cellulose. Salads don’t provide enuf.[LINK]

 

[Aileen]

While we are talking about different fibers, there is a product called PGX (PolyGlycopleX). It is a patented "super fiber complex". (Notice how big business is getting involved in pro/prebiotics now?)

I was surprised to find an article in PubMed [here] where it was tested along with FOS and cellulose in a computer-control system in the lab that mimics the human intestine. It is a FREE access article and a very interesting read, both for the results and to learn about the fake lab gut they used.

PGX [website here] has been advertised here in Canada on tv for awhile but I've always ignored it because they've been marketing it as a part of a "weight reduction strategy". I need to gain weight.

After reading the article though I'm considering trying it. It is available in local pharmacies, health food stores etc., so easy to obtain. Has anyone tried it?

 

[JPV]

Dr. Grace and Tim Steele have been digging more and more into the RS2 and RS3 research over the past few months, and they are taking a bit of a course correction. I expect them to clarify this in a post sometime next week and apparently their upcoming book downplays potato starch as well.

I think that this has a lot more to do with maintaining "street cred" with a specific faction of the Paleo community, who are somewhat religious about consuming things in their natural state as much as possible. For better or worse, RS is still basically a processed food and doesn't really fit into the diet very neatly, at least as far as the purists are concerned.

 

[Ripley]

I think that this has a lot more to do with maintaining "street cred" with a specific faction of the Paleo community, who are somewhat religious about consuming things in their natural state as much as possible. For better or worse, RS is still basically a processed food and doesn't really fit into the diet very neatly, at least as far as the purists are concerned.

Yes. There's that, certainly. Again, there's nothing wrong with taking some RS or PS — particularly when one doesn't feel they've obtained enough prebiotics on any given day. Dr. Grace just feels uncomfortable with recommending RS2 to people who don't consume any other fibers (i.e. VLC dieters).

I think the overall point is that we probably don't need to worry ourselves with getting RS2 if RS3 is regularly consumed.

And, if someone sleeps better with a spoonful of RS2 before bed, or makes them more regular, so be it. Better to have a good night sleep and a good poo than avoid RS.

RS is like having a horchata. There's nothing wrong with it. But, I guess the point is that having a horchata and eating a fiberless diet doesn't make one healthy.

I think the goal (in a perfect world) is to one day try to eat like a normal person, making food and reheating some starchy leftovers a few times a week. It's something to strive for one day. In the meantime, most people who are using RS for therapeutic purposes (diabetics, metabolic syndrome, gut repair, etc.) should keep doing what they are doing and not worry about it, while keeping in mind that it's best to consume a variety of plants and fibers along with their RS.

 

[Sasha]

Sasha, sorry if I've asked you this already, but what's your reaction to (white) rice? I know Kresser allows it, particularly after the 30-day reset.

For many years I got a little bit of eczema at the corner of my nose, now and again, and eventually figured out that rice was causing it, so I've avoided it for a long time (because if it was causing a little bit of visible eczema, I assumed it might be causing problems elsewhere in my body where I couldn't see it).

I must admit that if I start to expand the 30-day reset diet, my first test will be on chocolate but I don't have enough day-to-day stability in my symptoms to make a clear baseline for testing - if I eat something and get worse, it would be hard to tell it from my usual variation. I'm expecting to have to stay on the 30-day diet for the long term.

 

[Sasha]

And, if someone sleeps better with a spoonful of RS2 before bed,

I noticed someone (on Free the Animal, I think) saying that if they took at tbsp of PS before bed they slept better. I tried it a couple of evenings - forgot last night - but didn't notice any difference, but perhaps it helps to persist. I have insomnia as part of my ME and have been on low-dose Pregabalin (Lyrica) for several years to treat it, but it's not fully effective.

What's the mechanism of PS in helping insomnia if you take it last thing?

 

[MeSci]

Yes. There's that, certainly. Again, there's nothing wrong with taking some RS or PS — particularly when one doesn't feel they've obtained enough prebiotics on any given day. Dr. Grace just feels uncomfortable with recommending RS2 to people who don't consume any other fibers (i.e. VLC dieters).

I think the overall point is that we probably don't need to worry ourselves with getting RS2 if RS3 is regularly consumed.

And, if someone sleeps better with a spoonful of RS2 before bed, or makes them more regular, so be it. Better to have a good night sleep and a good poo than avoid RS.

RS is like having a horchata. There's nothing wrong with it. But, I guess the point is that having a horchata and eating a fiberless diet doesn't make one healthy.

I think the goal (in a perfect world) is to one day try to eat like a normal person, making food and reheating some starchy leftovers a few times a week. It's something to strive for one day. In the meantime, most people who are using RS for therapeutic purposes (diabetics, metabolic syndrome, gut repair, etc.) should keep doing what they are doing and not worry about it, while keeping in mind that it's best to consume a variety of plants and fibers along with their RS.

I am trying to avoid making it too obvious that I am feeling

(Long-term vegan, gluten-free, low-grain/low-sugar but having spuds, for 2 years plus supplements, and commonly consuming most of the now-suggested foods, so probably plenty of RS)

So I am of course cured!

Only joking. But as I am now 61 and have been ill since 1995 - albeit improved significantly from my worst - it may take quite some time - if it ever happens.

 

[Sasha]

The cold sores are clearly a sign of enhanced immunocompetency. I think I first started experiencing these about three years ago, and they would episodically re-occur for about two years. I had never had a cold sore, until this time. In the past year, this has been replaced by apthous stomatitis, which is more of a T-cell phenomenon. I welcome these, because they seemingly represent steps in the restoration of an appropriate and effective immune response.

Still looking into this and I found this about Vitamin C causing cold sores - although we're talking here about Prescript Assist possibly causing them, the mechanism is presumably the same and the author agrees with you about this being a T-cell issue:

Can Vitamin C Give Me Cold Sores?
Cold sores are caused by the herpes simplex virus. The virus lies dormant in your body until something activates it. It makes its way to the surface of your skin and causes lesions, called fever blisters or cold sores. Some people who suffer from cold sores have reported outbreaks after they have taken vitamin C or eaten vitamin C rich foods. This has them questioning whether or not the vitamin C caused the outbreak.

Vitamin C works with your immune system in many different ways. Outbreaks occur when the immune system is compromised. So why would boosting your immunity cause an outbreak?

The answer is complex. A number of things can trigger cold sores to emerge. Stress and a depressed immune system are the leading causes of cold sore outbreaks. Stressful situations and anxiety can deplete the body of its vitamin C stores within seconds, leaving you vulnerable to herpes simplex reactivation.

When you take vitamin C as a supplement or eat foods rich in vitamin C, it goes to work on your T cell production. T cells are responsible for the immunity inside of your cells. T cells come in many different forms which specialize in independent functions. Cytotoxic T cells kill cells that are infected with viruses.

As T cells are maturing, they go through many different stages. If you are in the process of building your immunity, for instance, by taking vitamin C, then T cells can attack cells containing the herpes simplex virus, but may not be able to fully combat the virus as it is released. The virus travels along nerves and makes its way to the skin’s surface, where it expresses itself as a cold sore or fever blister. But, this could actually be a good sign that your immunity is beginning to return.

As T cells mature over several months, they are more capable of destroying the virus as it is released, before it can make its way back down into dormancy where it can replicate. Furthermore, vitamin C helps your immune system to keep the surviving cells containing the virus in dormancy and inhibits replication. Every time you have an outbreak, more of the virus can be destroyed. Herpes simplex virus damages nerve cells and has been linked to Alzheimer ’s disease. Keeping your immunity up will help you to get rid of as much of the virus as possible while protecting your nerve cells from future attacks.

[...]

If you have a sore throat, swollen lymph nodes, lower back pain, or a low grade fever, it could be a sign that the virus is reactivating. Talk with your doctor about the proper dosage of vitamin C and start supplementing immediately to effectively combat the virus.

http://nutri.com/blog/2010/01/can-vitamin-c-give-me-cold-sores/
​

I'm wondering if this is a phenomenon that my GP would recognise. I'm never very clear on what to expect him (as opposed to a specialist) to know. I don't even know if specialists would recognise this - presumably they don't go in for Vitamin C, probiotics and the like and I wonder if pharmaceuticals produce this kind of effect.

 

[Ripley]

For many years I got a little bit of eczema at the corner of my nose, now and again, and eventually figured out that rice was causing it, so I've avoided it for a long time (because if it was causing a little bit of visible eczema, I assumed it might be causing problems elsewhere in my body where I couldn't see it).

I must admit that if I start to expand the 30-day reset diet, my first test will be on chocolate but I don't have enough day-to-day stability in my symptoms to make a clear baseline for testing - if I eat something and get worse, it would be hard to tell it from my usual variation. I'm expecting to have to stay on the 30-day diet for the long term.

Isn't that corner-nose-eczema just Rosacea? I used to get that a lot. But, for me, sugar was the big trigger for it. Rice and potatoes don't trigger it in me for some reason. Probably flora-related. With Rosacea, I'm not sure it's just a simple indicator of inflammation. Rosacea can be caused by many things — anything from SIBO to demodex mites living on the skin who get excited from oily secretions when you eat certain foods.

However, I would keep in mind that not all rice is the same. Of course, Kresser explains why white rice is lower in toxins than brown rice. But, most people don't know that long grain rice can be more allergenic than short grain rice for many people. And some people are the other way around, where short grain rice is more allergenic than long grain rice.

I believe Japanese "sushi rice" is the least allergenic for most people. So, I would try slowly introducing that first and then trying other species of rice before you decide that rice is not for you.

There was a time when long grain Basmati rice would put me to sleep in the middle of the day. It was like slipping into a coma. I finally figured out that all I had to do was eat short grain rice and the problem went away. Turns out that it was all related to gut flora. Certain gut bugs were eating the starches or compounds from the long grain rice and making me super sleepy. My gut flora is in better shape now, so I doubt I'd get that reaction from long grain rice anymore (though I still tend to stick to short grain rice out of habit).

Additionally, I highly recommend you learn how to properly wash your rice. Everyone in Asia washes their rice thoroughly. Takes about 5 minutes if you have a proper rice colander. Watch a few rice washing videos on YouTube for the proper instruction (here is a good one). That way, you will remove all of the talc and cornstarch powders and spray-on folic acid off the rice. You can literally see it all going down the drain, and the water should pour clear when you are done. Manufacturers add those powders in so that the rice doesn't stick together in the bag. For all you know, the various powders on the rice are causing your flareups!

 

[Ripley]

I noticed someone (on Free the Animal, I think) saying that if they took at tbsp of PS before bed they slept better. I tried it a couple of evenings - forgot last night - but didn't notice any difference, but perhaps it helps to persist. I have insomnia as part of my ME and have been on low-dose Pregabalin (Lyrica) for several years to treat it, but it's not fully effective.

What's the mechanism of PS in helping insomnia if you take it last thing?

I may be completely wrong about this, but I think certain gut bugs eat the RS (or cross-feeders eat the metabolites from RS-degraders) and this helps increase GABA production as well as the neurotransmitters for sleep regulation.

And if you don't get that kind of effect from RS, it might be an indicator that you are missing certain gut bugs that contribute to that process.

 

[Sasha]

Isn't that corner-nose-eczema just Rosacea?

I don't think so - it would ooze a bit, form a yellow crust and eventually drop off. I didn't realise what it was until a doctor noticed it during a consultation about something else.

I think I'm probably better off without rice, for the moment, at least - I have orthostatic intolerance so can't stand at a sink for five minutes or do any sort of cooking that involves a pan on a stove. I don't miss it - I'd only try to reintroduce it if it was my only source of RS.

It's interesting how different your experience was with different kinds of rice!

 

[Sasha]

I may be completely wrong about this, but I think certain gut bugs eat the RS (or cross-feeders eat the metabolites from RS-degraders) and this helps increase GABA production as well as the neurotransmitters for sleep regulation.

That's interesting - I wonder how time-critical it is? The couple of nights I tried it, I think I took it half an hour before I went to bed. I wonder if that was too late or too early.

And if you don't get that kind of effect from RS, it might be an indicator that you are missing certain gut bugs that contribute to that process.

I wish I knew what was in my gut! I wish we all did. Still waiting to hear back from uBiome - it's been a couple of months now.

 

[Aileen]

I noticed someone (on Free the Animal, I think) saying that if they took at tbsp of PS before bed they slept better. I tried it a couple of evenings - forgot last night - but didn't notice any difference, but perhaps it helps to persist. I have insomnia as part of my ME and have been on low-dose Pregabalin (Lyrica) for several years to treat it, but it's not fully effective.

What's the mechanism of PS in helping insomnia if you take it last thing?

@Sasha I haven't tried my PS yet, been working other things in first. I'm also on pregabalin which did nothing to change my sleep. Haven't heard of it being tried for sleep.

I have had major sleep problems for years. At one point last year, I nearly stopped sleeping completely.

Recently I have started trying various pre and probiotics. Started with Aline (b. infantis), then added Florastor (s. boulardii) then AG (Swanson's brand FiberAid Larch AG) and finally Mutaflor (e. coli nissle 1917). I am now getting sleepy in the evenings!!! The normal yawning, can't stay awake, must go to bed feeling that normal people get. I had forgotten what it was actually like.

I'm not sure exactly which of the above is helping. If I had to narrow it down I'd say my first guess is the AG, if not that, then the s. boulardii based on when I started on things and when I noticed the change.

I take my pre- and probiotics together, usually late morning to mid-afternoon. I take them with some food but not with any hot liquids. I can't heat food so that's not an issue for me. The AG powder I take 1/4 tsp and put it into empty capsules. I tried mixing it in water but gave me problems in my mouth. Since I could have bad bugs in there, I thought encapsulating it would be best. I'm going to do that with the PS too when I start it.

I am sleepy enough to go to bed usually between midnight and 2am. That's a big improvement for me. I have only been on it about 5 days so we'll see how things go.