Asian Odyssey

Asian Odyssey

Dr. Lonnie Lowery

I have never been to Asia. Anywhere. Science-related travel is like a pair of comfortable shoes to me, though, so I was intrigued when I heard the International Congress on Nutrition event was in Bangkok this Fall. I had some data I was sitting on and that conference flyer kept staring at me from the edge of my desk. So I did what I usually do, what has to be done if this kind of trip is to take place: I just committed to it one day in a decisive move.

Now, in my experience one never has extra time or extra money for this kind of thing. If it is to be done, it requires an element of aggressiveness (which I’m good at) and a reasonable amount of paper work (which I’m less good at). I did, however, make the necessary arrangements with some colleagues, managed to acquire a little funding and basically escaped out of my office window, despite students clamoring outside. It was like a scene from the movies. Given the destination, I couldn’t escape the parallels with a certain other, fictitious adventuring professor of which we’re all aware.

And thus my travels in Southeast Asia began. They would put the “odd” in odyssey for me and they would bring - at risk of sounding cliché - a certain philosophical illumination that I didn’t expect.

Oddities

I’m not sure where to begin. Whether it was cleaning ladies in the washroom watching me pee, or me watching people have dead skin nibbled off of their feet by ravenous fish, I was frequently presented with (what I consider) weirdness. Gold leaf offerings stuck lovingly onto elephant dung, [see picture, right], unidentifiable food items, obscene toys, cheap fruit punch offerings at micro-shrines in odd places,[see picture below] and all manner of strange customs confronted me. Coupled with a general lack of sleep (2-5 hours nightly… or was it daily?) and an ever-present “punch in the gut” feeling, presumably from some low grade food-borne illness, things definitely were a bit odd.

But whenever I was in Bangkok’s BITEC arena, the site for the 2009 International Congress of Nutrition, I was more at home. I just had to get there every day and try not to starve once I was on-site.

Commodities [see picture]

The exchange of cash and the flow of goods are everything to enterprising Thais. Travel and food are good examples. Getting to the BITEC arena was cheap by cab, when said cab had a driver who wasn’t a piece of gold-adorned elephant dung. I’ll bet many readers can identify with the odd cabby who drives all over God’s green earth (in my case, Bangkok’s damp, dark earth) to try to jack the fare, or the driver who is either A.) Clueless or B.) Hiding behind the language barrier, either way wasting time and money. Needless to say some fun exchanges took place because neither I nor my student co-adventurer were about put up with this sort of crap. Ultimately, getting across a town of 11 million people in 25 minutes can be done for three bucks.

Food was another expense and fortunately it was usually not pricey, which I was glad for, considering I had spent some money in Tokyo on the way into Bangkok. (How could I resist 15 forms of green tea, dry-packaged protein tidbits from the sea and mementos the land of the samurai in general?) Food had to be purchased despite free, sponsored conference lunches from various multinational food companies in attendance. The conference center’s boxed lunches ranged from unidentifiable and slimy to undercooked and partly inedible to simply not of my liking. So, I had to drop some coin there as well - often by converting US dollars to Thai baht, usually at a dubious exchange rate.

Policies and Methodologies

But I had traveled far to see what the shakers and movers of nutrition science were doing in their labs. After some opening fanfare (ICN takes place every four years and runs not unlike the Olympics) [see picture], scientific and world-policy sessions opened-up. Although some of the policy sessions had to be seen (imagine high-ranking scientists and politicians, even royalty, deciding on earth’s nutritional future), I gravitated toward the science. Below is brief commentary on a small sample of the talks I saw but I’m guessing the volumes of information I crammed onto my cerebral “hard drive” will appear in future articles on specific topics. [Note: Readers can also surf to the archives at www.nutritionradio.org and click the “Experiments vs. Experience” link to listen to scientific commentary, or check out Chris Shugart’s blog on T-Muscle for reports on certain talks as they happened.]

Coffee Talk

The decision whether to attend the session on coffee was a no-brainer for me. My love-hate relationship with the stuff drew me there, seeking data that might tip the balance for me. The talks, supported by various coffee industry groups, were unsurprisingly supportive of the benefits of java…

  Americans consume just a moderate amount of coffee when considering a long list of countries.

  We Americans get more than double our total antioxidant intake from coffee as compared to fruits and veg. (Sad in a way but protective of our health on some level.)

  Despite its lower phenol content, coffee is a better antioxidant (depending on how this is measured) than tea.

  Coffee intake improves both acute and chronic cognition across many studies.

  Coffee’s beneficial impact on poor glucose tolerance and diabetes was confirmed yet again, this time in “sneak peak” data on middle aged guys with poor “carb handling”, who drank five cups of instant joe for a few months. Decaf had no effect. (My recent interest in Starbucks Via was further piqued.)

Protein Speculation from (Real) Biochemists

Much of this session was less than revelatory but there was a real golden nugget near the end. A French biochemist was lecturing on the mechanisms behind why high protein diets induce leanness. These were animal data but were largely applicable to humans.

I’ll reiterate what I stated in Shugart’s Hammer: Many of the energy-related metabolic pathways that you learned about in school (glycolysis, Kreb's Cycle, lipolysis, beta-oxidation, lipogenesis, gluconeogenesis, etc.) adjust rapidly - within as little as one day - to the introduction of high-protein (20-50% of kcal) diets in rodents. Some adjustments include:

  Glycolysis gets down-regulated (glucokinase, liver pyruvate kinase)

  A reduction in fatty acid synthesis enzymes like acetyl coA carboxylase and the fatty acid synthase (FAS) complex

  No increase in fatty acid (beta) oxidation, that is “fat burning”, apparently occurs

  Gluconeogenesis gets upregulated (PEPCK, G-6-Pase subunit), making most (former) amino acids into new glucose

  A carbohydrate "draining" effect, whereby the carbons necessary for ridding the body of surplus nitrogen (in the urea cycle) are ultimately drawn from glucose

This final point is something I've only peripherally contemplated. It's cool to think that high-protein diets not only induce satiety and thus a lower carb intake, but they doubly create a "negative carbohydrate balance" due to carbon draining.

Amino Acids and Related Metabolites: Nutraceutical Goodness?

This session ranged across a random assortment of topics, from creatine to protein anabolism…

  The need for creatine synthesis arguably creates a “burden” or “demand” on whole-body amino acid metabolism (10% of our glycine, 22% of our arginine and 42% of our methionine - debatably).

  We lose 1.7% (1-2g daily) of our creatine pool, on average

  Genetic defects in creatine synthesis and transport create pronounced symptoms in brain more so than muscle.

  Two types of arginases (mitochondrial and cytosolic) break down excess arginine in the body

  Defects in arginine metabolism can lead to excess collagen and fibrosis, pulmonary hypertension (as in red cell destruction diseases) and even cardiovascular disease.

  Oral citrulline as opposed to arginine was speculated to be superior due to intestinal arginine breakdown by said arginases.

  Boosting dietary intake of citrulline via watermelon and high-protein diets was discussed in passing.

  The now famous mTOR protein synthetic pathway is maximally activated by both amino acid availability and insulin - in different molecular ways (Rheb vs. RAGG). One or the other just isn’t maximal. To me, this is molecular evidence that strategized, big eating equals massive size, not just single-minded boat-loading of protein or amino acids. (How many insulinogenic carbs that may be necessary are still up for debate and may be individual - 50g? 100g?)

  “Glucagon is dominant” over amino acids and insulin in affecting mTOR activity (suggesting that fasting is suppressive but also that the co-stimulation of glucagon with insulin after eating protein may be a failsafe against uncontrolled protein anabolism).

Lipid Talks - Novel and Otherwise

Not to be a tease but this odyssey is becoming an opus, so stay tuned for future articles. I’ve literally got volumes on this.

Vitamin D: Were We Wrong? [see picture]

Vitamin D - also a hormone that’s easily bought in the U.S., continues to be a hot topic with nutrition scientists. Here are some tidbits…

  U.S. (Institute of Medicine) recommendations (400 IU dialy) fail to correct vitamin D deficiency.

  Vitamin D deficiency is common among cancer patients (74% of breast cancer patients). And cancer is now neck-and-neck with heart disease as our number one killer.

  Literature suggests between 2000-4000 IU for a few months may be necessary to correct baseline deficiencies (ask a physician for a blood test).

  Vitamin D status does not necessarily affect calcium absorption. I find this fascinating, as this is the primary reason I was always taught for taking the stuff!

  Black and Asian persons exhibit different vitamin D status and calcium absorption efficiency, and these relate differently to their bone mineral density. Looks like racial modifications to existing guidelines may need more consideration - soon.

Itineraries

For a “down” portion of one day of the Congress, there was a chance to really live up to my imagined whip and fedora. We managed to find an excellent guide and before we knew it, were exploring the mind-blowingly ancient ruins of Ayutthaya, [see picture, top left] which was the seat of the Thai empire before Bangkok, and traveling to necessary sites and temples via river (long boat) and land (elephant) as well as van. [see pictures] Okay, so it’s not like this was being done in the remote corners of the country, but just getting an hour outside of the immense, polyglot city brought an element of authenticity and even philosophical illumination. (Our guide was a devout Theravada Buddhist who was university trained in the politics and history of the region as well. What a wealth of knowledge in this humble guy.)

This excursion also brought me into contact with dishes like star fruit “soup” with extruded green “pasta” noodles [see picture, left] and some tasty little egg-based desserts. [see picture, right] As someone who tries to log some small new life experience whenever possible, the foods I ate just added to the list.

Actually, to me, the entire trip had to include a photographed food log for multiple reasons: I’m a nutrition professor (duh), Asia’s food supply is radically different from Western countries’ staples (which helps define the region and cultures), it was my birthday on the trip, and hey, I love to eat. So here are a few photos. There was eel (I think), green tea desserts, local river fish, a gelato-like birthday cake, plenty of pickled seafood and bean milk, among other offerings. [see following pics]

Scenery

Sights were comprised of the academic / commercial type at the meeting itself, and the decidedly less academic (but equally commercial) type seen along the streets of town. [see picture] To me, the juxtaposition of high-level science and policy making with the abject poverty I saw just outside was an exercise in stretching moods and emotions. It’s just not the type of thing one sees in such rapid succession back in the ’States.

The academic / expo booths were not unlike others I’ve seen. You know the score: make the rounds, gather the freebies, listen to a few spiels and learn a little. Maybe some networking takes place if one is lucky. There was only about four or five thousand people in the expo hall at any given time, I think, so anyone who’s been to the Arnold Classic could take this in stride. (Except these are real science people and professionals, not dye-o-dermed gym bunnies in lab coats, so a different level of couth is called for.)

On the street side of things, the scenery was not unlike the exposure some readers have seen before from Chris Shugart and company. The transgressions against food safety would send the sanitation professionals I work with into an immediate cerebrovascular accident. The concept is simple. Step One: fire up a vat of hot grease that you bought last year sometime and fry the bejeezus out of the spoiling meat or insects or chicken feet on your vending cart. Step Two: Skewer and kabob everything; the tourists seem to like that. My only regret is not finding any bugs to try at least once; the shock value would have been there but honestly (barring poison barbs or whatnot) such hard dry little tidbits of fried protein are probably safer than the other stuff I saw.

Summary

It’s not really possible to summarize such an odyssey in a singular way. I’ve really come to think about this trip to Asia in two major aspects: 1.) Life experience and 2.) Educational / professional worth. I’m just a Midwest American boy, and this felt like a pretty big deal so please indulge me. Here’s a summary for each.