Wednesday, January 21, 2009

The Tokelau Island Migrant Study: Asthma

Asthma may be another "disease of civilization", uncommon in non-industrial cultures. Between 1980 and 2001, its prevalence more than doubled in American children 17 years and younger. The trend is showing no sign of slowing down (CDC NHANES surveys).



The age-standardized asthma prevalence in Tokelauan migrants to New Zealand age 15 and older, was 2 - 6 times higher than in non-migrants from 1976 to 1982, depending on gender and year. The highest prevalence was in New Zealand migrant women in 1976, at 6.8%. The lowest was in Tokelauan men in 1976 at 1.1%.

A skeptic might suggest it's because these adults grew up around certain types of pollen or other antigens, and were exposed to new ones later in life. However, even migrant children in the 0-4 age group, who were most likely born in NZ, had more asthma than on Tokelau.

What could contribute to the increased asthma prevalence upon modernization? I'm not particularly knowledgeable about the mechanisms of asthma, but it seems likely to involve a chronic over-activation of the immune system ("inflammation").

The Tokelau Island Migrant Study: Background and Overview
The Tokelau Island Migrant Study: Dental Health
The Tokelau Island Migrant Study: Cholesterol and Cardiovascular Health
The Tokelau Island Migrant Study: Weight Gain
The Tokelau Island Migrant Study: Diabetes

The Tokelau Island Migrant Study data in this post come from the book Migration and Health in a Small Society: The Case of Tokelau.

Thanks to the EPA and Wikipedia for the graph image (public domain).

30 comments:

Robert Andrew Brown said...

Excess Omega 6, lack of long chain 3 causes inflammation and oxidative stress which leads to heightened sensitivity of and reaction by the immune system.

Omega 3:6 imbalance is linked to a number of autoimmune conditions.

Several trials link increased long chain Omega 3s with lower immune sensitivity and asthma related symptoms.


Robert Brown

Author Omega Six The Devils Fat.

www.omegaxisthedevilsfat.com

Robert M. said...

Too speculative IMO. The inhalation of carbonaceous particles from internal combustion engines and coal power plants is the most likely cause of asthma. Look at modern China. People living on an isolated Pacific island are going to be breathing clear air even if they live next to the diesel generator, just because the winds will disperse the pollution.

Consistent low-level irritation of the lungs, gums, bowel, etc. can all lead to low-level bacterial infection, immune system response and the associated inflammation and other negative consequences associated with 'Western' diseases.

Stephan Guyenet said...

Robert,

If particulate matter were the problem, why do rural and urban children in the U.S. have the same asthma rate? Asthma prevalence is also increasing, despite decreasing smoking rates in the U.S.

Asthma in Rural America

Robert M. said...

Stephen:

Particulates concentration are more so associated inversely with mean wind velocity than urban/rural terrain. Just look at Beijing during the Olympics: filthy to blue skies solely due to the weather. So yeah, the Great Plains have less particulates but Appalachia not so much. Also the particulate metric, mass per cubic meter of air, probably isn't sufficient just like LDL blood serum doesn't tell the whole story. The ultra-fine particles are thought to be much more hazardous.

Furthermore, the main offenders for particulate production are not relatively light-weight gasoline cars but diesel trucks and their heavily loaded tires, as well as coal power plants. The impact of long-wear tires has been to greatly decrease the average size of particles that are thrown off by them. Low sulfur diesel formation may also be decreasing particulate size, although it's too early to tell as that change was only ushered in last year. Cooking meat (like on the BBQ) is also a large source of small particulates.

So from a hand-waving point of view, a kid living on a farm near a highway is perfectly likely to see more lung irritants than one living in a suburb. They're also more likely to be exposed to two-stroke engines.

Now, don't get me wrong, I would argue that cumulative stress on the body is what's important, so removing one stressor (e.g. wheat) could easily reduce the symptoms brought on by another stressor. I just don't believe wheat or refined carbohydrates are the proximate cause for asthma. For one, I can't imagine a mechanism.

Elite athletes tend to suffer from asthma way out of proportion to the general population and yet they don't tend to suffer from other Western diseases.

Senta said...

Hi Stephan,
I have been reading your blog for about a month now, slowly working my way through all your wonderful articles and the great comments along with your replies. There is an incredible wealth of information here, thank you so much for this resource.

I'd like to add a little bit to the discussion here on asthma, diet and particles in the air.

I live in a suburban area of California, right between two major freeways. There is so much pollution that I am constantly cleaning black soot off my window sills. I lived here for about 10 years without any breathing problems. Then I got pet house rabbits and after a few months, started having allergy problems. Itchy, watery eyes, scratchy throat and asthma.

Not wanting to get rid of my pets and not wanting to go the medical route, I investigated diet. It took me several years to find and eliminate all the culprits, but I eventually ended up on something that is a cross between WAPF and a low-carb, paleo diet. I have completely eliminated my allergies, even though the rabbits and soot are still here.

I found wheat and cow's milk to be the biggest offenders (I can still have cream and raw goat's milk). My diet is pretty low carb with an emphasis on grass-fed meats, butter and ghee, coconut oil, no vegetable oils and no grains. I take cod liver oil for the vitamins A and D and the EPA/DHA omega 3s.

I suspect my allergies were a case of antigen overload since if they were caused by just diet, I would have experienced them without adding the rabbits to the mix. In fact, I was previously and still am allergic to cats, although my reaction now to cats is much less severe than it used to be. But it is amazing to me how much changing the diet can reduce antigens and inflammation.

Senta said...

One other thing I forgot to mention in my previous post. I have discovered that the diet of the animal plays a part in my reaction to it. When I recently got a new rabbit from the shelter who had been eating commercial pellets (full of soy, grains, synthetic vitamins), I started having mild allergic reactions to him. After a couple of weeks of him eating a more natural diet of just grass hay, greens and carrots, my allergies subsided again. I am also not allergic to raw-fed (ala Pottenger study) cats. It seems that what they eat affects their dander or their saliva, as both are implicated in allergies.

Robert Andrew Brown said...

Inflammation and oxidative stress and factors in most western conditions. Oxidative stress leads to hightened immmune sensitivity.

Stephans threads have been looking at mainly western conditions in which diet plays a part, and I see them as setting out a global view rather than any suggestion of `evidence' of any particular fact.

If a dietary change increases the risk of inflammation and oxidative stress you are likely to see a rise in the risk all western conditions subject to individual susceptability.

This paper is thought provoking and starts to outline some of the underlying mechanisms that explain why the EFA are so critical in body function. Simopoulos is a world renowned figure in the field.

Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases
Artemis P. Simopoulos, MD, FACN

http://www.jacn.org/cgi/content/full/21/6/495

loves gettysburg said...

I cured my chronic bronchial asthma by eliminating milk products from my diet. Milk, not carbs.

Monica said...

Great post.

I have done needs assessments for medical education in the past and have come across a few papers indicating that maternal vitamin D deficiency in pregnancy is a potential factor in childhood asthma.

Air quality has basically increased in the US since the 60s. I don't believe it's primarily air quality -- that's an exacerbating factor. In any case, this is New Zealand we are talking about -- it's an extremely clean country with the largest city at just over a million people.

The underlying problem is physiological and the entire thing is probably multifactorial. There are many types of asthma -- it is not just one disease -- but a lot of these phenotypes have to do with different types of inflammation. Many people with asthma are not apparently allergic to anything.

A year ago I never would have considered that diet had anything to do with asthma. But it makes perfect sense now.

Robert Andrew Brown said...

Monica,

Thanks for the info there are suggestions vitamin D has a place in asthma.

This is interesting on the wider role of Vitamin D

http://www.jacionline.org/article/S0091-6749(07)03619-6/fulltext

Stephan Guyenet said...

Senta,

It sounds like you hit the nail right on the head simply through trial and error. Nice work!

Vegan farmer,

I don't think anyone was suggesting that carbs cause allergies. Milk is a common allergen so what you said makes sense. It also agrees with what Senta said.

Jacqueline said...

My son had exercise-induced asthma which is capable of progressing to full-blown asthma. We went for the Buteyko method approach (see e.g. http://www.asthmacare.ie/) and so far (one year on) it is definitely under control - he hasn't had an attack since. The Buteyko method is based on the premise that asthma is caused or at least facilitated by 'overbreathing' - in particular mouth breathing and having not enough CO2 in the respiratory system. Why do I think this is relevant on this forum? Because it seems to me, based on direct experience with my son's mouth breathing and, now, need for orthodontics, that mouth breathing is the result of 'narrow faces' and narrow nasal passages. There still is no alternative explanation for this phenomenon offered by the mainstream other than that put forward by Weston Price that it is due to insufficient pre-natal nutrition especially with fat-soluble vitamins and animal foods.
Jacqueline

Stephan Guyenet said...

Jacqueline,

Thanks for the anecdote. I'll be posting on nutrition and cranial development shortly. There's a surprising amount of data out there.

Senta said...

Stephan,

I can't take all the credit for trial and error, I did have some help. Actually, it was a web page on lectins that got me started on my journey to eliminate the allergens in my diet. You've probably already seen it: http://www.krispin.com/lectin.html

The trial and error was me not willing to give up any food unless I absolutely had to!

Matt Stone said...

Jacqueline,

Of all the comments I've read on this post, yours is by far the most intriguing based on my own investigation. As we know, mouth-breathing is a developmental issue. Recently I read about and posted some work on asthma and mouth-breathers (hypothyroid symptoms) based on Broda Barnes and Mark Starr's knowledge of hypothyroidism, which I now believe to be one of the mechanisms in which degeneration takes place (reduced thyroid = changes to mitochondrial DNA aside from chromosomal DNA, i.e. "intercepted heredity" as Price defined).

Can't wait for your posts on that Stephen. Hurry!

Particulate matter? Whaddya nuts? How does Great Britain see a doubling in childhood asthma in a period as short as a single decade due to particulate matter?

Getting away from it may provide some relief, and particulate matter may exacerbate it, but cause it? No way. It didn't cause allergies and asthma in Pottenger's cats, nor did it cause narrowing of their dental arches - a toxic, indigestible substance (cooked milk, no lactase) in their diet caused it, led to bacterial overgrowth, impaired immunity, and immune system failure, backfire, and hypersensitivity.

Asthma is a symptom of degeneration, of which a diet full of processed foods is the primary culprit - i.e. sugar, white flour, and veggie oils. Pasteurized milk ranks highly as well.

When I eat sugar I get immediate bronchoconstiction (I'm asthmatic, but have had massive improvements).

And that whole thing about raw fed cats not causing allergies. That is awesome! I would love to blame their diet instead of my debilitated self! I've got to check that out some day!

Oh, and Robert Andrew Brown...

My asthma was at it's worst after spending a summer in Alaska eating fresh, self-caught salmon every single day for 4 months and ingesting hardly any omega 6 whatsoever (no chicken, no pork, very few eggs, traces of veggie oils at the most). Eating omega 3's and cutting out 6's is not some cure-all. I was hospitalized after spending a few nights in a house with dogs and cats immediately after that summer.

Stephan Guyenet said...

Robert,

Interesting studies, thanks for posting them. They seem to support the inflammation theory.

Stan Bleszynski said...

Re: Anecdotally, many people report freedom from asthma and allergies after adopting a "paleolithic"-style or low-carbohydrate diet.

After seeing many testimonials (often personally) from people who got rid of asthma, even in an advanced stage and old age, on a high animal fat low carb diet, I would consider it to be more than anecdotal. If it works it's true!

Now _why_ does it work is an interesting question.

Stan

Senta said...

Stan,
Check out the link in my previous post. The author, Krispin Sullivan, advances an hypothesis that low-carbohydrate diets, especially a "paleolithic" diet, tend to limit the types of lectins to which many people are or have become intolerant. So as Stephan has often stressed,it seems it is not carbohydrates per se that are the problem, it is certain types of carbohydrates.

He says, "Lectin intolerance is not an 'allergy'. A person may be lectin intolerant and not have antibodies to the suspect food when given an allergy test whether blood or skin or saliva. A person may be lectin intolerant and because of the damage done by lectins end up having allergic reactions to a food (that does not contain lectin or may have other lectins), other chemicals or the environment. Lectin intolerance means the inability to deactivate the toxic lectin (prevent its binding to your cells) in the confines of your own body, be it in the gut, artery, organ, gland or brain. The lectin then proceeds to invoke immune responses that damage the cell to which it attaches and possibly surrounding cells. This antigen/antibody response may be the key to many or even most autoimmune diseases and many degenerative diseases may need to be reclassified as autoimmune."

He also says, "Some of the very best results came when switching to the so-called Paleolithic Diet. These programs included The Zone by Sears (the least effective of the bunch and the highest in lectins); D'Adamo's Blood Type Diet (the second highest in lectins and also not as effective); Eades Protein Power ; Atkins Diet Revolution ; The Specific Carbohydrate Diet from Breaking the Vicious Cycle by E Gottschall; and Neanderthin by Audette; and the Crook Candida Diet. The commonality is higher protein (and often natural unprocessed fats) and a reduction in carbohydrates, especially carbohydrates high in lectins."

Something else he mentions that I thought was very interesting is that lectins persist in both refined and unrefined vegetable oils. So besides the inflammatory nature of the Omega 6 fatty acids in vegetable oils, we also have to contend with the lectins in them.

Robert Andrew Brown said...

Matt

I am fascinated by the link between sugar and asthma.

I have searched on NCBI on glucose sucrose etc and asthma and not found much.

Is it generally recognised the case that sugar is a trigger or an observation amongst asthma sufferers that has been ignored.

And does sensitivity as suggested above depend on carb intake, glycemic load etc.

I you have any more observations or information I would be really grateful

Robert

Matt Stone said...

Robert,

I have been a very astute observer of my asthma.

Low carb reduced asthma symptoms, however, I got rid of allergies by doing a lot of raw vegan, supercarb 'cleanses' and eating an otherwise fresh-food diet. Exercise and pet dander were always my triggers.

Asthma is always worse in winter time. The dryer and colder it is, the worse. Mark Starr attributes this, and most cases of asthma to type II hypothyroidism, as diagnosed by taking the temperature in the armpit upon waking (below 97.8 is always hypothyroidism). The cold weather puts more strain on the thyroid and asthma symptoms and other seasonal disorders come out of the woodwork.

If you look at the etiology of mouth-breathers, crooked teeth, the onset of the asthma, allergy, and autoimmune epidemics, it traces back to the introduction of refined foods, most notably the refined carbohydrates, but also of course the vegetable oils.

I tend to blame sugar moreso than white rice or white flour because...

I can eat a whole loaf of white bread in a single sitting without bronchoconstriction.

I can get bronchoconstriction from eating a single piece of candy, or even smelling a glass of red wine btw. I barely notice it anymore, but it was quite severe at one point.

Overeating also causes bronchoconstriction.

Exercise...

If I'm super active (I used to be a Wilderness Ranger and hike 50 miles a week at altitude), my asthma clears, but at the end of the season it was always worse off than ever, and so was my overall health - perhaps due to elevated cortisol, adrenal exhaustion, or whatever, which should be no suprise as adrenaline is basically the medicine for asthma.

Fruit is the ultimate aggravator of acute asthma. Exercise-induced asthma varies depending on the season. I can run 15 miles in Hawaii, but get wheezy hiking up a hill in Colorado in January.

Puzzling I know. Throw in the fact that I had childhood asthma, it went away completely until age 18, and then it gradually got worse and worse until I changed my diet from cake doughnuts and chocolate milk (briefly, thought it was okay since I was exercising 50 hours a week... oops) to a zero-processed food diet based around meat and fat. It's still not totally gone by any means, but is improving just as fast as it got ugly several years ago.

I have tried mega doses of fish oil to no avail.

I have never eaten much omega 6 compared to the rest of the population. I grew up eating at home a lot, mom used real butter, and so on. Still enough to get quite an imbalance going I'm sure.

My own personal conclusions...

Eating sugar makes my asthma worse (was a hardcore sugar addict my whole life, all my molars are decayed and filled, had emergency appendectomy at age 6, tonsilectomy at 5). Only member of my family that's nearsighted, had wisdom teeth removed, and so on, which is why John Yudkin's Sweet and Dangerous reads like my biography. Love that guy.

Eating no sugar makes my asthma better.

Eating low carb made my asthma better, then there seemed to be a few slight setbacks, now I'm continuing to move forward.

Hitting puberty got rid of my health problems instantly, I went from 5'4, 135 pounds and overweight to 5'8" 128 pounds in a single year, making me particularly keyed into the role of hormones in health.

And the biggest link I've found so far is hypothyroidism. It links to all of those symptoms, from crooked teeth to asthma to... as would hypercortisolemia, because the two tend to go hand in hand. Of course, hypercortisolemia links to inflammation, as it mitigates it, and yes, I believe most illness to definitely be inflammatory in nature. However, the immune-suppression of a low metabolism seems to me to be the most logical, where there's actually a rhyme and reason for there to by inflammation - there's chronic infection!

On low carb...

Wary of going too low in carbs, as even Atkins acknowledged it to induce hypothyroidism. Plus, my girlfriend, a carb-phobe, has developed an autoimmune disease, anaphylactic reaction to shellfish which we used to pig out on together a year ago, hasn't had a period in a year, and so on. She eats almost exclusively fresh pastured meats and eggs from local farmers, coconut oil, no veggie oils, etc.

She has severely crooked teeth, many food intolerances, is very prone to infection, etc.

Her basal body temp is nearly 2 degrees below mine. I don't think these are coincidences, as all relay back to hypothyroid symptoms. Mark Starr's Hypothyroidism Type II is not a b.s. book, but one of the best to come out in years. Check it out.

Stan Bleszynski said...

Matt,

Re: Eating low carb made my asthma better, then there seemed to be a few slight setbacks, now I'm continuing to move forward.

If it relapses progressively less and less often like every few weeks, then every few months then years etc, then it is typical. In line what people report on Optimal Diet when treating similar chronic (auto-immune) diseases. It is often put in this way (not very scientifically I admit): a disease behaves like an animal being hunted - it fights you back, viciously at first but then gets weaker and disappears.

Re: your girlfriend

Something is wrong! Optimal Diet typically rectifies hypo and hyperthyroidism. Unless she has a permanent thyroid damage. I would suspect that the problem may be the total lack of carbohydrates in her food which may bring some strange symptoms (read my other recent comments). Best way I think, is to adhere to OD guidelines "religiously" (food scale & food tables etc) for a few weeks and notice any difference.

Protein: 1g/kg/day +/-15%

Carbs: 0.5-0.8g/kg/day no more and no less!

Fat: whatever is necessary to satisfy hunger.

I hope it helps,
Stan

Robert Andrew Brown said...

Matt,

Thank you very much for all your trouble in responding.

No wonder you are so passionate about diet and the effects it can have.

I am still trying to grasp how thyroid function fits in with fats metabolism.

Again many thanks, I will bear your observations in mind.

Stephan Guyenet said...

Matt,

Interesting story. I wonder if vitamin D could have to do with the fact that your symptoms are worse in the winter? The vitamin D receptor interacts with the thyroid hormone receptor in the nucleus.

I'm becoming interested in this thyroid story. Excess linoleic acid potently inhibits the effect of thyroid hormone on the liver. I would imagine it has the same effect in other tissues as well. Add vitamin D deficiency to that, as well as gluten induced autoimmune thyroiditis and goitrogens, and maybe we have an explanation for how common hypothyroidism seems to be in this country (according to Dr. Barnes).

Matt Stone said...

And to that Stephen I would say that sugar disrupts digestion, keeping gluten from being handled properly, which then leads to autoimmune thyroiditis.

Stan,
I know exactly what's wrong with my girlfried, but dealing with a girlfriend isn't always so simple. For starters, she won't admit that she's anything short of perfectly healthy after losing a lot of weight and achieving what is, by all accounts, a fantastic body. Wowza!

However, she eats, call it, 1,200 -1,500 calories per day, has a history of extremely low body temp., eats, on average, call it 20grams of carbohydrates per day, and runs marathons on this while working 40 hours a week and graduating at the top of her class in her graduate studies.

...Drinks coffee every day

...Chews Orbitz gum all day

...Is on birth control

...Other prescription meds

Yeah, she's f-ed no doubt, but you can't make other people's decisions for them. I let her deal with everything how she sees fit and don't lose too much sleep over it.

Dr. B G said...

Matt,

Your poor girlfriend... sounds like ME... 6mos to 8 yrs ago!

All correctable and reversible.

You're completely right..x you can't really tell her anything. No one listens to their loved ones. Find a 3rd party to dispense the 'info'. Good luck.

-G

Lizzie Powers said...

Hi. This blog hits very close to home to me as my two young children are both stricken with asthma. I feel like we have exhausted every route: medicinally, environmentally, diet, everything.
The oldest, Elizabeth, is 6. Her "reactive airways" began just shy of her second birthday. Full term, breastfed for 6 months. Took a DHA fortified formula till 12 months. She has required "bursts" of oral steroids about every six weeks. As a toddler and preschooler, the trigger was respiratory infection, now it is allergy and chronic sinus infection. Upon performing skin testing for allergies, the nurse called half the staff into the examining room to gawk at the enormous red wheals on Every one of the pricks. On Symbicort 160, this precious 6 year old still struggles. We have missed 20+ days of kindergarten, been to E.R. countless times and were hospitalized for three nights in October. We have even traveled two states over to see a holisitc DAN M.D. who tested her for heavy metals and wanted to "chelate" Elizabeth to cleanse her of excess Mercury and Aluminum.
While pregnant with the second I scoured for information on how to prevent this. I decided to nurse him longer, delay solids, and feed him a plant based diet. Well, this plan totally flopped when we landed in the ER at 7 months old with reactive airways. He had been exclusively breastfed and had only had avocado and other fruits and vegetables to eat. I was taking DHA supplements for the breastfeeding.
When pregnant for the third time I was bound and determined to not repeat history. All organic cleaning products came in. I took a DHA prenatal vitamin the entire pregnancy. Avoided mercurial fish like the plague. Had natural childbirth. Did not vaccinate. Did anything and everything I could think of...and guess what--"bronchiolitis" at 3 months.
We had one break two years ago when Elizabeth went about 8 months without a flare. Then I started supplementing them with DHA and a month later they both were flaring again. I also took DHA the whole pregnancy with the third, Annie, who I swear was wheezy when she was born.
Doctors try to put this on genetics. I have no asthma or allergies, but my husband had exercise induced as a preteen and has allergies. I get that there is a genetic component, but why is it starting in infancy now?
I admit, I rack my brain constantly trying to figure out what is causing this epidemic. You should see the modern pediatrician's office. Everybody's kid is wheezing, nebulizers going in every other examining room.
And here's another observation...the long haul breastfeeding mothers are the one's whose kids are always sick and have asthma.
Sometimes I wonder if it is the vaccines MY generation got (born in 1980) that we are passing down a skewed immunity to our children, deplete of ever fighting any "big" pathogens.
Not sure this is very relevant to the forum, except to say I'm not sure how much diet has to do with it when our babies are developing it before they even eat solid foods. The Vitamin D theory is intriguing. Enough blogging...off to give more breathing treatments and count respirations.

Stephan Guyenet said...

Hi Lizzie,

Sorry to hear about you kids' asthma. I won't claim to be an asthma expert but there's clearly something non-genetic causing it since the prevalence is increasing quite a bit.

Have you thought about vitamin D? It modulates the immune response and breast milk is deficient in it if the mother doesn't have much D herself. If the child doesn't get much sunlight, that could cause deficiency. As a matter of fact, rickets is on the rise in the US for exactly those reasons.

mtflight said...

Some random observations, on treating feline asthma:

I have an 8 year old gray tabby female cat, with asthma. I took her to the vet when she was under yrs old and started exhibiting this coughing/wheezing... had x-rays, and other tests adding up to hundreds of dollars.

Vet's solution? steroids. Every try to give a cat a pill? it's a nightmare.

I decided to research into this. I read about a study in Thorax, indicating that kids who had dairy fatty acids in their diet were less likely to have asthma than those without.

I deviced a diet of tuna and butter. She leaned down, became really docile, and her multiple daily asthma episodes tapered to maybe 1 a day or 5 a week or so.

Yet the asthma wasn't completely eliminated. Sometimes it would get worse, like maybe twice in one day, so I decided to supplement vitamin D3 figuring that she's an indoor cat and doesnt get UVB through the glass. I figured out the dosage comparing me to her in terms of weight and my own dosage, and started that a few weeks ago.

Asthma virtually gone. This made me assume it was the vitamin D helping and not the fish with butter. I tried a fancy no-wheat, no-gluten, no-corn, no-soy cat food. Ashtma back about 4x a day. Returned the food... ashtma gone again (she's back to tuna "in water" with a pat of butter or bacon grease, when I make bacon), and holding steady.

She looks and behaves like a 2-3 year old not an 8 year old cat.

Anna said...

Interesting about the cat & food, mtflight.

Have you considered some chicken livers for your cat? Vit A & D. I'd worry the fish and butter, while probably loads better than commercial cat food, would be nutritionally incomplete over the long haul.

Cats are very sensitive to the amount of taurine in their diet, too. When I can't get heart meat to add to the raw food I make for our cat, I add taurine capsules. I can get hearts sometimes at a few grocery stores (with gizzards) or I can buy a lamb heart at a Middle Eastern/Asian store if I drive into the bigger city (BTW, ground heart is super added to meatloaf and meatballs).

Did you read Peter's (Hyperlipid) comments about feeding fish to cats (quite some time ago)? .

Scott said...

5 weeks paleo; 5 weeks asthma free. this is the first 5 weeks i've been asthma free in over 5 years. gluten and sugar suck.