Menopause changes more than temperature control. It reshapes how the brain handles hunger, fullness, and the quiet signals that guide eating. As a result, many women notice something unsettling. The same meals no longer satisfy. Hunger arrives sooner. Food feels louder.

For years, we blamed metabolism. We told women their bodies were simply slowing down. While that explanation sounds scientific, it misses the most important part of the story.

The brain has changed.

A Pattern You Can’t Ignore

During my years performing weight loss surgery, about 80 percent of my patients were women. Over time, one pattern became impossible to overlook. When menopause or even perimenopause began, weight gain often followed.

Some women had struggled with weight for years. Others had never given it much thought. Yet both groups described the same shift. They weren’t necessarily eating more. Instead, they felt hungrier, less satisfied, and more aware of food throughout the day.

Meanwhile, the advice they received rarely evolved. Eat less. Move more. Try harder.

However, that advice assumes the system regulating hunger still works the same way. In menopause, it doesn’t.

Estrogen and the Appetite Control Center

To understand what’s happening, we need to look at the hypothalamus. This small but powerful region of the brain regulates appetite, energy balance, and hormonal signaling. Under normal conditions, estrogen helps keep this system stable.

Specifically, estrogen supports satiety signals and keeps hunger signals in check. In simple terms, it helps your brain recognize when you’ve had enough.

As estrogen declines, that balance shifts. Hunger signals grow stronger. Fullness signals become less reliable. Consequently, the internal experience of eating begins to change.

This shift explains why women often say, “I feel different around food,” even before their diet changes.

Why Hunger Changes First

Interestingly, appetite changes often appear before measurable increases in calorie intake. Women report thinking about food more often, feeling less satisfied after meals, and noticing hunger earlier in the day.

At first glance, nothing looks different from the outside. Yet internally, the system has already shifted.

Because of that, traditional advice falls short. Telling someone to eat less without addressing the change in signaling is like adjusting the thermostat while ignoring the wiring.

More Than Metabolism

Although metabolism does change with age, it does not fully explain the experience of menopause-related hunger. A slower metabolic rate might affect how calories are used, but it doesn’t explain why appetite feels louder or less controlled.

Instead, the better explanation lies in the brain. The hypothalamus responds differently when estrogen levels fall. As a result, the signals that guide eating become less precise.

In other words, this isn’t just about calories in and calories out. It’s about how the body decides when to eat—and when to stop.

The Part We Should Have Addressed Sooner

For decades, menopause care focused on symptoms like hot flashes and bone health. Meanwhile, changes in appetite and weight were often attributed to lifestyle or willpower.

Unfortunately, that approach overlooked a key fact. Estrogen plays a direct role in appetite regulation.

Because of that, many women were told to push harder when their biology had already shifted. That message wasn’t just incomplete—it was unfair.

Estrogen Replacement: A Broader Role

When clinicians discuss estrogen replacement, they often focus on symptom relief. However, estrogen also affects brain signaling related to hunger and satiety.

In the right patient, hormone therapy may help restore some of that balance. It can improve how the brain responds to fullness and reduce the intensity of hunger signals.

Importantly, hormone therapy does not inherently cause weight gain. That belief has persisted longer than the evidence supports.

Still, therapy isn’t for everyone. Each patient requires an individualized discussion that considers risks, benefits, and goals.

A New Layer: GLP-1 and Appetite Control

More recently, GLP-1 receptor agonists have added another dimension to this conversation. These medications act on the same appetite centers in the brain, strengthening satiety and quieting hunger.

Interestingly, estrogen appears to enhance the effectiveness of GLP-1 signaling. Therefore, menopause may not only reduce estrogen levels—it may also decrease the brain’s responsiveness to satiety cues.

This interaction helps explain why some women experience such a dramatic shift in appetite during midlife.

What Actually Helps

Once you understand the biology, the approach changes.

Rather than focusing solely on restriction, the goal becomes supporting satiety. Meals should include enough protein, fiber, and volume to sustain fullness. Additionally, sleep deserves attention, as poor sleep amplifies hunger signals. Medication reviews also matter, since some drugs can contribute to weight gain.

For some women, hormone therapy or GLP-1 medications may play a role. For others, dietary structure and lifestyle adjustments provide meaningful improvement.

In every case, the strategy should match the physiology.

A Better Way Forward

Menopause is not a failure of discipline. It is a shift in how the brain regulates hunger.

Once that shift is acknowledged, the conversation becomes more productive. Women can stop blaming themselves and start working with their biology.

Ultimately, the goal isn’t to fight hunger. It’s to understand it.

Final Thought

Menopause doesn’t break the system—it changes the signal.

And once you understand the signal, you can respond with clarity instead of frustration.

Estrogen as a Key Regulator of Energy Homeostasis and Metabolic Health.

Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 2022. Mahboobifard F, Pourgholami MH, Jorjani M, et al.

The King We Forgot

There is a moment in history that most of us think we understand. King Henry VIII—large, immobile, temperamental—has become almost a caricature of excess. We picture a man who simply ate too much, moved too little, and paid the price. It is a tidy story. Unfortunately, it is also likely the wrong one.

Before the 1530s, Henry was something very different. He was athletic, charismatic, and energetic. He hunted, he jousted, he played sports, and he carried himself like the Renaissance ideal—educated, capable, and physically impressive. His armor, still preserved today, tells that story clearly. Narrow waist. Broad chest. Built for motion.

The Fall That Changed Everything

Then everything changes.

In January of 1536, Henry was thrown from his horse during a jousting match. The horse fell on him. He was reportedly unconscious for hours. Not minutes—hours. Even by modern standards, that is a significant traumatic brain injury.

Soon after, in May of that same year, Anne Boleyn was arrested and executed. She was accused not only of adultery but also of witchcraft. That detail matters. Prior to this period, Henry was not known for superstition. He was a rational thinker. Yet suddenly, accusations of witchcraft become part of the story. It is tempting to say this was political theater. It may have been. Still, the timing is difficult to ignore.

Meanwhile, his body begins to change.

The Story We Told Ourselves

At first, historians explained this in simple terms. He ate more. He exercised less. Calories in, calories out. That explanation sounds neat. It fits what we like to believe. Even so, the math does not hold up.

To gain over 200 pounds, you need a massive and sustained excess of calories. A reduction in physical activity alone does not explain that. We measure activity in METS—metabolic equivalents—and even a dramatic drop in activity would not account for that level of weight gain. In other words, you cannot outrun the math.

Yet every January, gyms fill with people who are told exactly that. Move more. Try harder. Burn it off. By February, most of those gyms are empty again. If exercise alone solved obesity, we would not still have the problem.

The Organ in Charge

So what did we miss?

The answer sits deep in the brain, in a small but powerful structure called the hypothalamus. It regulates hunger, satiety, hormones, and stress. When it works, eating feels normal. You get hungry, you eat, you stop. No drama. No constant thinking.

However, when the hypothalamus is disrupted—by injury, disease, or chronic metabolic stress—that quiet system becomes loud. Hunger no longer behaves like a signal. It becomes a drive.

This is not theory. Modern medicine has a name for it: acquired hypothalamic obesity. After traumatic brain injury, some patients develop rapid weight gain, persistent hunger, and changes in impulse control. Studies show that nearly half of patients with significant brain injury gain weight over time. The strongest predictor is not inactivity. It is hyperphagia—an abnormal increase in appetite.

In simpler terms, the problem is not how much people move. It is what their brain is telling them to do.

What Patients Taught Me

That pattern feels familiar if you have ever sat with patients. I have. Years ago, working with former NFL players, we noticed something striking. The players who struggled most with weight often had long histories of concussions. Not all of them gained weight. Yet those who did described the same experience—something they had never felt before.

Food noise.

Not hunger. Noise. A constant suggestion that does not go away.

At first, I understood that as a physician. Later, I understood it as a person.

When the World Went Quiet

About twelve hours after my first injection of Zepbound, something changed. The world became quiet. For the first time, I realized how much of my thinking had been shaped by that background noise. It did not disappear dramatically. It simply stopped.

Since then, I have lost fifty pounds. More interesting than the weight loss is what happens between doses. As the medication wears off, the noise returns—subtly at first. A thought here. A reminder there. Even my stress levels rise slightly, something I can see on my WHOOP device. Then, a few hours after the next injection, it quiets again.

That experience changes how you see patients. It changes how you see history.

Looking Back at Henry

Because now, when we look back at Henry, we are not just looking at excess. We are looking at a possible disruption of the system that regulates behavior itself.

There are hints of this even in his own time. A French ambassador noted that Henry’s chronic leg pain troubled him often and that he compensated by eating and drinking more. Later reconstructions suggest large meals, heavy in meat, along with substantial alcohol intake. Those numbers are estimates, not precise measurements. Even so, the pattern is clear.

Something was driving the behavior.

Decline, Not Indulgence

By the end of his life, Henry could barely move. Mechanical devices were needed to help him stand. He lost close allies, including Thomas Wolsey and Thomas More. His body deteriorated. His mood worsened. This was not simply indulgence. It was decline.

What We Can Do Now

Today, we have tools that speak directly to that system. GLP-1 medications do not give people discipline. They restore control. Patients do not say they are stronger. They say it is quieter.

That distinction matters.

Because obesity was never just about calories. It was about signaling and about biology. It was about a system that, once disrupted, can push behavior in ways that are very difficult to resist.

The Real Lesson

So when we look at Henry VIII, we should be careful before we judge him as a man who simply lacked restraint.

We may not know exactly how much he ate.

Nevertheless, we know something was driving it.

And when we ignore that truth today, we do more than misunderstand the disease.

We blame the patient for having it.

References

Argente J, Farooqi IS, Chowen JA, Kühnen P, López M, Morselli E, Gan HW, Spoudeas HA, Wabitsch M, Tena-Sempere M. Hypothalamic obesity: from basic mechanisms to clinical perspectives. Lancet Diabetes Endocrinol. 2025 Jan;13(1):57-68. doi: 10.1016/S2213-8587(24)00283-3. Epub 2024 Nov 12. Erratum in: Lancet Diabetes Endocrinol. 2025 Jan;13(1):e1. doi: 10.1016/S2213-8587(24)00368-1. PMID: 39547253.

Nutrition debates rarely begin with money. Yet money almost always explains how they spread.

That fact explains much of the modern carnivore movement.

At first glance, the carnivore diet appears to be a radical nutritional idea: eat beef, organs, and animal fat while avoiding vegetables, grains, legumes, and most fruits. Advocates often present the idea as a return to ancestral eating. According to the story, prehistoric humans thrived on meat, and modern illness appeared only after plants and processed foods entered the menu.

However, once you look past the rhetoric, another pattern appears. The carnivore movement did not grow out of decades of clinical research. Instead, it grew out of a very modern ecosystem: social media, podcasts, influencer culture, and supplement companies.

And once that ecosystem forms, the incentives become clear.

First, someone declares that conventional nutrition science has misled the public. Next, they present a dramatically simple solution. Afterward, they build a community around that solution. Eventually, products appear—supplements, coaching programs, special meat boxes, laboratory panels, and branded lifestyle advice.

In other words, the diet becomes the marketing engine.

And beef becomes the sacrament.

Why Simplicity Sells

Extreme diets succeed for a reason. Complexity frustrates people, while simplicity reassures them.

“Eat a balanced diet rich in vegetables, whole grains, legumes, fish, and moderate meat” may represent excellent advice supported by decades of research. Unfortunately, that advice does not travel well on social media.

By contrast, statements such as “plants are poison” or “fiber is unnecessary” spread rapidly. Bold claims generate engagement. Engagement produces followers. Followers create revenue streams.

Consequently, the carnivore diet does not function only as a nutritional recommendation. It functions as a brand.

Once someone builds that brand, they must defend it.

The Prophets: The Case of the Liver King

Every belief system eventually develops its prophets, and the carnivore world found one in a man who called himself Liver King.

He appeared online with an enormous beard, an even larger physique, and a simple message: modern men had grown weak because they had abandoned the practices of their prehistoric ancestors. According to his message, people should eat raw organs, train like cavemen, reject modern foods, and adopt “ancestral living.”

Conveniently, the ancestral lifestyle also included supplements he sold through his company.

The marketing proved effective. The image of a muscular barbarian rejecting modern science attracted millions of followers and produced a supplement business worth tens of millions of dollars.

Unfortunately, the story collapsed in 2022 when leaked emails revealed the Liver King spent more than $10,000 per month on anabolic steroids and other performance-enhancing drugs. Shortly afterward, he admitted publicly what physicians suspected from the beginning.

Raw liver did not build that physique.

Pharmacology did.

Nevertheless, the episode illustrates the economic logic of the carnivore movement. First comes the doctrine. Then comes the identity. Finally, come the products.

The Theologians: Paul Saladino

Movements rarely survive on prophets alone. They also require theologians—people who explain the doctrine with intellectual confidence.

Within the carnivore community, one of the most prominent interpreters has been Paul Saladino, a physician originally trained in psychiatry who later rebranded himself as Carnivore MD.

For several years, his message remained uncompromising. Plants contained toxins. Vegetables acted as chemical weapons. Humans thrived best on meat, organs, and animal fat. His book The Carnivore Code argued that modern civilization misunderstood nutrition and that health required a return to meat-centered eating.

However, the human body eventually entered the conversation.

After spending years on a strict carnivore diet, Saladino described several physiological problems: poor sleep, heart palpitations, muscle cramps, and hormonal changes. Consequently, the diet evolved.

Fruit appeared. Honey appeared. Raw dairy appeared.

Today, the diet carries a new label—an “animal-based diet.” In practice, that means meat accompanied by carbohydrates from fruit and honey.

In other words, the diet rediscovered sugar.

This pattern appears frequently in nutrition movements. Early stages emphasize purity and certainty. Later stages quietly reintroduce flexibility when biology refuses to cooperate.

Also, Paul is partners with Liver King.

The Economic Engine

The economic component remains impossible to ignore.

Carnivore influencers rarely restrict themselves to books and podcasts. Instead, they build supplement companies that sell freeze-dried organs, nutrient capsules, and other “ancestral” products. The marketing narrative follows a familiar path.

Modern food supposedly lacks essential nutrients.

Ancient diets supposedly provided them.

Supplements conveniently deliver them.

When followers adopt the diet, they often purchase the products associated with it. Over time, they invest not only money, but identity in the movement. As a result, they defend the doctrine aggressively, particularly when new treatments threaten the narrative.

The GLP-1 Conflict

This dynamic explains the hostility many carnivore influencers display toward GLP-1 medications, such as semaglutide and tirzepatide.

GLP-1 drugs reduce appetite, improve metabolic health, and produce significant weight loss in clinical trials. For many patients, they represent the most effective medical treatment for obesity ever developed.

However, GLP-1 therapy undermines the core promise of the carnivore movement. Influencers claim that diet alone solves metabolic disease. Pharmaceutical treatments challenge that claim.

Moreover, if people lose weight and improve their health through medical therapy, they may no longer feel compelled to purchase expensive supplements or coaching programs.

Consequently, the drugs become ideological enemies.

Carnivore influencers often portray GLP-1 medications as dangerous, unnatural, or morally suspect. Their followers repeat these arguments across social media platforms, especially on X (formerly Twitter), where the debate frequently resembles a religious dispute, not a scientific discussion.

Within this worldview, GLP-1 therapy resembles a rival faith.

And rival faiths provoke rebellion.

The Cave Painting Argument

Carnivore advocates occasionally invoke another argument that sounds persuasive until examined closely.

If humans historically consumed vegetables, they ask, why do cave paintings rarely depict them?

The answer lies in the purpose of cave art.

Prehistoric artists painted dramatic events—hunts, animals, danger, survival. These images celebrated moments that mattered in a world where food sometimes fought back.

Nobody returned from hunting mammoths and announced, “Let us commemorate this carrot.”

Cave art told stories.

It did not document grocery lists.

Moreover, the absence of broccoli in cave paintings has an obvious explanation. Broccoli did not exist during the Paleolithic era. Mediterranean farmers cultivated it from wild brassica plants thousands of years later, likely beginning with the Etruscans.

Using cave paintings to prove humans were carnivores resembles using medieval paintings to argue that humans never drank coffee.

Humans Have Always Been Omnivores

Anthropology provides a far more realistic picture.

Scientists studying ancient bones, tools, and coprolites—preserved human feces—consistently find evidence of diverse diets that included roots, tubers, fruits, seeds, fish, and meat.

Geography shaped these diets. Arctic populations consumed more animal foods, while equatorial societies relied heavily on plants.

However, no civilization in human history survived entirely on beef.

Flexibility—not purity—allowed our species to thrive.

The Culinary Problem

Carnivore advocates rarely discuss another drawback of the diet.

It is monotonous.

Human cuisine represents one of the great achievements of civilization. Across cultures, people combine vegetables, grains, spices, and animal foods into extraordinary traditions that reflect geography and history.

Reducing that diversity to an endless rotation of ribeye steaks diminishes both nutrition and culture.

Beef remains delicious. I enjoy it myself. Growing up on a small island in Alaska, I rarely saw beef because it cost too much to ship. Consequently, it felt special when it appeared at the table.

Yet eating beef every day does not create cuisine.

It creates repetition.

Is the Carnivore Diet Safe?

Many readers ask a simple question: Is the carnivore diet safe? Short-term, some people lose weight on a carnivore diet because they eliminate ultra-processed foods and increase protein intake. However, long-term health outcomes remain far less reassuring. Diets that exclude vegetables, legumes, fruits, and whole grains remove important sources of fiber, phytonutrients, and micronutrients that support gut health, metabolic regulation, and cardiovascular protection. Large population studies consistently associate dietary patterns rich in plant foods—such as the...]]>When Beef Becomes Belief: The Carnivore Priesthood

Nutrition debates rarely begin with money. Yet money almost always explains how they spread.

That fact explains much of the modern carnivore movement.

At first glance, the carnivore diet appears to be a radical nutritional idea: eat beef, organs, and animal fat while avoiding vegetables, grains, legumes, and most fruits. Advocates often present the idea as a return to ancestral eating. According to the story, prehistoric humans thrived on meat, and modern illness appeared only after plants and processed foods entered the menu.

However, once you look past the rhetoric, another pattern appears. The carnivore movement did not grow out of decades of clinical research. Instead, it grew out of a very modern ecosystem: social media, podcasts, influencer culture, and supplement companies.

And once that ecosystem forms, the incentives become clear.

First, someone declares that conventional nutrition science has misled the public. Next, they present a dramatically simple solution. Afterward, they build a community around that solution. Eventually, products appear—supplements, coaching programs, special meat boxes, laboratory panels, and branded lifestyle advice.

In other words, the diet becomes the marketing engine.

And beef becomes the sacrament.

Why Simplicity Sells

Extreme diets succeed for a reason. Complexity frustrates people, while simplicity reassures them.

“Eat a balanced diet rich in vegetables, whole grains, legumes, fish, and moderate meat” may represent excellent advice supported by decades of research. Unfortunately, that advice does not travel well on social media.

By contrast, statements such as “plants are poison” or “fiber is unnecessary” spread rapidly. Bold claims generate engagement. Engagement produces followers. Followers create revenue streams.

Consequently, the carnivore diet does not function only as a nutritional recommendation. It functions as a brand.

Once someone builds that brand, they must defend it.

The Prophets: The Case of the Liver King

Every belief system eventually develops its prophets, and the carnivore world found one in a man who called himself Liver King.

He appeared online with an enormous beard, an even larger physique, and a simple message: modern men had grown weak because they had abandoned the practices of their prehistoric ancestors. According to his message, people should eat raw organs, train like cavemen, reject modern foods, and adopt “ancestral living.”

Conveniently, the ancestral lifestyle also included supplements he sold through his company.

The marketing proved effective. The image of a muscular barbarian rejecting modern science attracted millions of followers and produced a supplement business worth tens of millions of dollars.

Unfortunately, the story collapsed in 2022 when leaked emails revealed the Liver King spent more than $10,000 per month on anabolic steroids and other performance-enhancing drugs. Shortly afterward, he admitted publicly what physicians suspected from the beginning.

Raw liver did not build that physique.

Pharmacology did.

Nevertheless, the episode illustrates the economic logic of the carnivore movement. First comes the doctrine. Then comes the identity. Finally, come the products.

The Theologians: Paul Saladino

Movements rarely survive on prophets alone. They also require theologians—people who explain the doctrine with intellectual confidence.

Within the carnivore community, one of the most prominent interpreters has been Paul Saladino, a physician originally trained in psychiatry who later rebranded himself as Carnivore MD.

For several years, his message remained uncompromising. Plants contained toxins. Vegetables acted as chemical weapons. Humans thrived best on meat, organs, and animal fat. His book The Carnivore Code argued that modern civilization misunderstood nutrition and that health required a return to meat-centered eating.

However, the human body eventually entered the conversation.

After spending years on a strict carnivore diet, Saladino described several physiological problems: poor sleep, heart palpitations, muscle cramps, and hormonal changes. Consequently, the diet evolved.

Fruit appeared. Honey appeared. Raw dairy appeared.

Today, the diet carries a new label—an “animal-based diet.” In practice, that means meat accompanied by carbohydrates from fruit and honey.

In other words, the diet rediscovered sugar.

This pattern appears frequently in nutrition movements. Early stages emphasize purity and certainty. Later stages quietly reintroduce flexibility when biology refuses to cooperate.

Also, Paul is partners with Liver King.

The Economic Engine

The economic component remains impossible to ignore.

Carnivore influencers rarely restrict themselves to books and podcasts. Instead, they build supplement companies that sell freeze-dried organs, nutrient capsules, and other “ancestral” products. The marketing narrative follows a familiar path.

Modern food supposedly lacks essential nutrients.

Ancient diets supposedly provided them.

Supplements conveniently deliver them.

When followers adopt the diet, they often purchase the products associated with it. Over time, they invest not only money, but identity in the movement. As a result, they defend the doctrine aggressively, particularly when new treatments threaten the narrative.

The GLP-1 Conflict

This dynamic explains the hostility many carnivore influencers display toward GLP-1 medications, such as semaglutide and tirzepatide.

GLP-1 drugs reduce appetite, improve metabolic health, and produce significant weight loss in clinical trials. For many patients, they represent the most effective medical treatment for obesity ever developed.

However, GLP-1 therapy undermines the core promise of the carnivore movement. Influencers claim that diet alone solves metabolic disease. Pharmaceutical treatments challenge that claim.

Moreover, if people lose weight and improve their health through medical therapy, they may no longer feel compelled to purchase expensive supplements or coaching programs.

Consequently, the drugs become ideological enemies.

Carnivore influencers often portray GLP-1 medications as dangerous, unnatural, or morally suspect. Their followers repeat these arguments across social media platforms, especially on X (formerly Twitter), where the debate frequently resembles a religious dispute, not a scientific discussion.

Within this worldview, GLP-1 therapy resembles a rival faith.

And rival faiths provoke rebellion.

The Cave Painting Argument

Carnivore advocates occasionally invoke another argument that sounds persuasive until examined closely.

If humans historically consumed vegetables, they ask, why do cave paintings rarely depict them?

The answer lies in the purpose of cave art.

Prehistoric artists painted dramatic events—hunts, animals, danger, survival. These images celebrated moments that mattered in a world where food sometimes fought back.

Nobody returned from hunting mammoths and announced, “Let us commemorate this carrot.”

Cave art told stories.

It did not document grocery lists.

Moreover, the absence of broccoli in cave paintings has an obvious explanation. Broccoli did not exist during the Paleolithic era. Mediterranean farmers cultivated it from wild brassica plants thousands of years later, likely beginning with the Etruscans.

Using cave paintings to prove humans were carnivores resembles using medieval paintings to argue that humans never drank coffee.

Humans Have Always Been Omnivores

Anthropology provides a far more realistic picture.

Scientists studying ancient bones, tools, and coprolites—preserved human feces—consistently find evidence of diverse diets that included roots, tubers, fruits, seeds, fish, and meat.

Geography shaped these diets. Arctic populations consumed more animal foods, while equatorial societies relied heavily on plants.

However, no civilization in human history survived entirely on beef.

Flexibility—not purity—allowed our species to thrive.

The Culinary Problem

Carnivore advocates rarely discuss another drawback of the diet.

It is monotonous.

Human cuisine represents one of the great achievements of civilization. Across cultures, people combine vegetables, grains, spices, and animal foods into extraordinary traditions that reflect geography and history.

Reducing that diversity to an endless rotation of ribeye steaks diminishes both nutrition and culture.

Beef remains delicious. I enjoy it myself. Growing up on a small island in Alaska, I rarely saw beef because it cost too much to ship. Consequently, it felt special when it appeared at the table.

Yet eating beef every day does not create cuisine.

It creates repetition.

Is the Carnivore Diet Safe?

Many readers ask a simple question: Is the carnivore diet safe? Short-term, some people lose weight on a carnivore diet because they eliminate ultra-processed foods and increase protein intake. However, long-term health outcomes remain far less reassuring. Diets that exclude vegetables, legumes, fruits, and whole grains remove important sources of fiber, phytonutrients, and micronutrients that support gut health, metabolic regulation, and cardiovascular protection. Large population studies consistently associate dietary patterns rich in plant foods—such as the Mediterranean diet—with lower risks of heart disease, diabetes, and certain cancers. In contrast, diets dominated by red meat and lacking dietary fiber raise concerns about cardiovascular disease, colon health, and long-term metabolic effects. In other words, the real question is not whether beef can be part of a healthy diet—it certainly can—but whether eliminating most other foods improves health. Current scientific evidence suggests the answer is no.

The Real Lesson

Beef is nutritious.

Steak is wonderful.

But beef does not deserve a priesthood.

When a diet eliminates half the grocery store, sells supplements as sacred tools, and treats competing medical therapies as heresy, the conversation no longer resembles science.

Instead, it begins to resemble theology.

And theology rarely improves nutrition.

References

1. Willett W et al. Mediterranean diet and cardiovascular disease. N Engl J Med. 2018
2. Satija A, Hu FB. Plant-based diets and cardiometabolic health. JAMA Intern Med. 2017
3. O’Keefe SJ. Diet, microbiome, and colon health. Nat Rev Gastroenterol Hepatol. 2019
4. IARC Working Group. Red and processed meat and cancer risk. Lancet Oncology. 2015
5. Eaton SB, Konner M. Paleolithic nutrition revisited. NEJM. 1985

Every few years, someone announces the solution to weight loss.

Eat less.

Fast longer.

Cut carbs.

Cut fat.

Cut something.

Naturally, the advice usually comes with a tone of moral certainty. If you are hungry, the implication goes, you simply lack discipline.

However, long before social media, diet influencers, and the phrase food noise entered the modern vocabulary, scientists ran an extraordinary experiment that revealed something profound about hunger.

Rather than speculate about appetite, they studied it directly.

In the middle of World War II, researchers deliberately starved healthy young men.

The results changed how we understand hunger forever.

Why the Experiment Happened

During World War II, much of Europe faced severe food shortages. Cities were bombed, farms disrupted, and supply chains shattered. Consequently, millions of civilians were suffering from malnutrition and starvation.

Yet another problem quickly emerged. Refeeding starving populations turned out to be complicated. If nourishment returned too quickly, dangerous metabolic complications could occur. Doctors needed to understand not only starvation but also recovery from starvation.

Therefore, the U.S. government supported research designed to answer a simple but critical question:

What happens to the human body and mind when calories are severely restricted for long periods?

The scientist leading that effort was Dr. Ancel Keys at the University of Minnesota.

Today, Keys is often remembered for his later work on diet and heart disease. Nevertheless, his wartime research produced one of the most remarkable studies ever conducted in nutrition science.

The results were eventually published in a monumental two-volume work titled:

“The Biology of Human Starvation.”

This massive text, published in 1950, remains one of the most detailed examinations of hunger ever written.

KEYS, ANCEL, JOSEF BROŽEK, AUSTIN HENSCHEL, OLAF MICKELSEN, HENRY LONGSTREET TAYLOR, Ernst Simonson, Angie Sturgeon Skinner, et al. The Biology of Human Starvation: Volume I. University of Minnesota Press, 1950. https://doi.org/10.5749/j.ctv9b2tqv.

The Volunteers

To conduct the study, Keys recruited 36 conscientious objectors.

These men had refused military service during World War II for moral or religious reasons. Nonetheless, they still wanted to contribute to the war effort. Participating in this experiment became their way of helping.

Importantly, the volunteers were healthy young men. They had normal body weight, good physical fitness, and no significant psychological problems. In other words, they were ideal research subjects.

Furthermore, they understood the risks.

They would experience months of severe caloric restriction.

Even more remarkable, the experiment took place beneath the University of Minnesota football stadium, turning an athletic facility into one of the most important laboratories in nutrition history.

The Structure of the Experiment

The study unfolded in three distinct phases.

First came the baseline period. For several months, the men ate normally, consuming approximately 3,200 calories per day. Researchers measured body weight, metabolism, and psychological health to establish a stable starting point.

Next came the central part of the experiment: six months of semi-starvation.

During this period, calorie intake dropped to roughly 1,500 calories per day. That number may sound familiar because many modern diet programs recommend similar intake levels.

The food itself resembled wartime rations. Participants ate simple meals consisting primarily of potatoes, bread, macaroni, turnips, and small amounts of dairy.

Although the men remained physically active, their energy intake was cut in half.

Finally, the experiment concluded with a refeeding phase designed to observe how the body recovers after prolonged starvation.

The Unexpected Psychological Effects

Researchers expected weight loss.

What surprised them was the dramatic change in the men’s relationship with food.

Gradually, the volunteers became completely preoccupied with eating.

First, they began collecting recipes. Soon afterward, they spent hours reading cookbooks.

Remember that this was long before television cooking shows or the Food Network. Nevertheless, these men read cookbooks the way other people read novels.

Additionally, food became the center of conversation. Participants talked about meals constantly. They debated cooking techniques and discussed ingredients in remarkable detail.

Meanwhile, eating itself changed dramatically.

Many men developed elaborate food rituals. Some cut meals into tiny pieces to make them last longer. Others chewed gum continuously to quiet hunger. Still others drank large amounts of water or coffee simply to fill their stomachs.

Eventually, several participants reported dreaming about food every night.

At that point, hunger had completely dominated their mental landscape.

When Hunger Changes Personality

Alongside this intense food focus came significant psychological changes.

Participants became irritable.

Mood declined.

Social withdrawal increased.

Furthermore, many men lost interest in hobbies and normal activities. Concentration dropped, and emotional resilience weakened.

However, one topic continued to command their attention:

Food.

In modern terms, we might describe this state as persistent food noise—the constant internal dialogue about eating that many individuals with obesity describe today.

The Minnesota experiment demonstrated something important: when the human body senses prolonged energy shortage, the brain amplifies signals related to food.

That response is not weakness.

Instead, it is survival.

What Happened When Food Returned

The most striking results appeared during the recovery phase.

Once calorie restrictions ended, participants were allowed to eat freely again. Unsurprisingly, many men consumed enormous amounts of food.

Daily intake sometimes reached 5,000 to 10,000 calories.

Importantly, this response was not driven by pleasure alone. Rather, the body was attempting to restore lost energy reserves and rebuild metabolic balance.

Researchers observed that appetite remained elevated for months after the starvation phase ended. In some cases, normal appetite regulation took more than a year to return.

Consequently, the study revealed that hunger leaves a lasting biological imprint.

Lessons for Modern Nutrition

Although the Minnesota Starvation Experiment occurred more than eighty years ago, its lessons remain highly relevant.

Modern weight-loss advice often emphasizes simple calorie restriction. People are told to eat less, ignore cravings, and rely on willpower.

Yet the Minnesota study demonstrates that prolonged calorie restriction triggers powerful biological responses.

Hunger intensifies.

Food becomes mentally dominant.

Motivation to eat grows stronger.

In other words, the brain fights back.

From an evolutionary perspective, this response makes perfect sense. Humans evolved in environments where food scarcity threatened survival. Therefore, the brain developed mechanisms to detect energy deficit and prioritize eating.

Those mechanisms remain active today.

Hunger, the Brain, and Food Noise

Modern neuroscience offers further insight into what the Minnesota researchers observed.

Several brain regions participate in appetite regulation. The hypothalamus monitors energy balance through hormones such as leptin, ghrelin, and insulin. Meanwhile, motivational circuits—including the nucleus accumbens—integrate metabolic signals with behavioral drive.

When energy stores decline, these systems increase the motivational pull toward food.

Consequently, thoughts about eating become more persistent and more difficult to ignore.

This process resembles what many patients describe as food noise—a continuous internal signal urging them toward food.

The Minnesota experiment showed that this phenomenon can arise even in healthy individuals when calories remain restricted long enough.

A Modern Medical Perspective

Today, treatments for obesity increasingly focus on restoring normal appetite regulation rather than relying solely on behavioral restraint.

Medications known as GLP-1 receptor agonists offer one example.

Patients using these therapies often report something striking. Many say that the constant mental chatter about food becomes quieter. Meals feel satisfying sooner, and cravings diminish.

In other words, regulation returns.

These observations reinforce an important idea: overeating may not reflect a lack of discipline. Instead, it may result from disrupted...]]>The Minnesota Starvation Experiment: What Hunger Does to the Human Mind

Every few years, someone announces the solution to weight loss.

Eat less.

Fast longer.

Cut carbs.

Cut fat.

Cut something.

Naturally, the advice usually comes with a tone of moral certainty. If you are hungry, the implication goes, you simply lack discipline.

However, long before social media, diet influencers, and the phrase food noise entered the modern vocabulary, scientists ran an extraordinary experiment that revealed something profound about hunger.

Rather than speculate about appetite, they studied it directly.

In the middle of World War II, researchers deliberately starved healthy young men.

The results changed how we understand hunger forever.

Why the Experiment Happened

During World War II, much of Europe faced severe food shortages. Cities were bombed, farms disrupted, and supply chains shattered. Consequently, millions of civilians were suffering from malnutrition and starvation.

Yet another problem quickly emerged. Refeeding starving populations turned out to be complicated. If nourishment returned too quickly, dangerous metabolic complications could occur. Doctors needed to understand not only starvation but also recovery from starvation.

Therefore, the U.S. government supported research designed to answer a simple but critical question:

What happens to the human body and mind when calories are severely restricted for long periods?

The scientist leading that effort was Dr. Ancel Keys at the University of Minnesota.

Today, Keys is often remembered for his later work on diet and heart disease. Nevertheless, his wartime research produced one of the most remarkable studies ever conducted in nutrition science.

The results were eventually published in a monumental two-volume work titled:

“The Biology of Human Starvation.”

This massive text, published in 1950, remains one of the most detailed examinations of hunger ever written.

KEYS, ANCEL, JOSEF BROŽEK, AUSTIN HENSCHEL, OLAF MICKELSEN, HENRY LONGSTREET TAYLOR, Ernst Simonson, Angie Sturgeon Skinner, et al. The Biology of Human Starvation: Volume I. University of Minnesota Press, 1950. https://doi.org/10.5749/j.ctv9b2tqv.

The Volunteers

To conduct the study, Keys recruited 36 conscientious objectors.

These men had refused military service during World War II for moral or religious reasons. Nonetheless, they still wanted to contribute to the war effort. Participating in this experiment became their way of helping.

Importantly, the volunteers were healthy young men. They had normal body weight, good physical fitness, and no significant psychological problems. In other words, they were ideal research subjects.

Furthermore, they understood the risks.

They would experience months of severe caloric restriction.

Even more remarkable, the experiment took place beneath the University of Minnesota football stadium, turning an athletic facility into one of the most important laboratories in nutrition history.

The Structure of the Experiment

The study unfolded in three distinct phases.

First came the baseline period. For several months, the men ate normally, consuming approximately 3,200 calories per day. Researchers measured body weight, metabolism, and psychological health to establish a stable starting point.

Next came the central part of the experiment: six months of semi-starvation.

During this period, calorie intake dropped to roughly 1,500 calories per day. That number may sound familiar because many modern diet programs recommend similar intake levels.

The food itself resembled wartime rations. Participants ate simple meals consisting primarily of potatoes, bread, macaroni, turnips, and small amounts of dairy.

Although the men remained physically active, their energy intake was cut in half.

Finally, the experiment concluded with a refeeding phase designed to observe how the body recovers after prolonged starvation.

The Unexpected Psychological Effects

Researchers expected weight loss.

What surprised them was the dramatic change in the men’s relationship with food.

Gradually, the volunteers became completely preoccupied with eating.

First, they began collecting recipes. Soon afterward, they spent hours reading cookbooks.

Remember that this was long before television cooking shows or the Food Network. Nevertheless, these men read cookbooks the way other people read novels.

Additionally, food became the center of conversation. Participants talked about meals constantly. They debated cooking techniques and discussed ingredients in remarkable detail.

Meanwhile, eating itself changed dramatically.

Many men developed elaborate food rituals. Some cut meals into tiny pieces to make them last longer. Others chewed gum continuously to quiet hunger. Still others drank large amounts of water or coffee simply to fill their stomachs.

Eventually, several participants reported dreaming about food every night.

At that point, hunger had completely dominated their mental landscape.

When Hunger Changes Personality

Alongside this intense food focus came significant psychological changes.

Participants became irritable.

Mood declined.

Social withdrawal increased.

Furthermore, many men lost interest in hobbies and normal activities. Concentration dropped, and emotional resilience weakened.

However, one topic continued to command their attention:

Food.

In modern terms, we might describe this state as persistent food noise—the constant internal dialogue about eating that many individuals with obesity describe today.

The Minnesota experiment demonstrated something important: when the human body senses prolonged energy shortage, the brain amplifies signals related to food.

That response is not weakness.

Instead, it is survival.

What Happened When Food Returned

The most striking results appeared during the recovery phase.

Once calorie restrictions ended, participants were allowed to eat freely again. Unsurprisingly, many men consumed enormous amounts of food.

Daily intake sometimes reached 5,000 to 10,000 calories.

Importantly, this response was not driven by pleasure alone. Rather, the body was attempting to restore lost energy reserves and rebuild metabolic balance.

Researchers observed that appetite remained elevated for months after the starvation phase ended. In some cases, normal appetite regulation took more than a year to return.

Consequently, the study revealed that hunger leaves a lasting biological imprint.

Lessons for Modern Nutrition

Although the Minnesota Starvation Experiment occurred more than eighty years ago, its lessons remain highly relevant.

Modern weight-loss advice often emphasizes simple calorie restriction. People are told to eat less, ignore cravings, and rely on willpower.

Yet the Minnesota study demonstrates that prolonged calorie restriction triggers powerful biological responses.

Hunger intensifies.

Food becomes mentally dominant.

Motivation to eat grows stronger.

In other words, the brain fights back.

From an evolutionary perspective, this response makes perfect sense. Humans evolved in environments where food scarcity threatened survival. Therefore, the brain developed mechanisms to detect energy deficit and prioritize eating.

Those mechanisms remain active today.

Hunger, the Brain, and Food Noise

Modern neuroscience offers further insight into what the Minnesota researchers observed.

Several brain regions participate in appetite regulation. The hypothalamus monitors energy balance through hormones such as leptin, ghrelin, and insulin. Meanwhile, motivational circuits—including the nucleus accumbens—integrate metabolic signals with behavioral drive.

When energy stores decline, these systems increase the motivational pull toward food.

Consequently, thoughts about eating become more persistent and more difficult to ignore.

This process resembles what many patients describe as food noise—a continuous internal signal urging them toward food.

The Minnesota experiment showed that this phenomenon can arise even in healthy individuals when calories remain restricted long enough.

A Modern Medical Perspective

Today, treatments for obesity increasingly focus on restoring normal appetite regulation rather than relying solely on behavioral restraint.

Medications known as GLP-1 receptor agonists offer one example.

Patients using these therapies often report something striking. Many say that the constant mental chatter about food becomes quieter. Meals feel satisfying sooner, and cravings diminish.

In other words, regulation returns.

These observations reinforce an important idea: overeating may not reflect a lack of discipline. Instead, it may result from disrupted biological signaling.

The Enduring Importance of the Study

More than seventy years later, the Minnesota Starvation Experiment remains one of the most illuminating studies in nutrition science.

Its findings continue to inform research on appetite, metabolism, and obesity treatment.

Equally important, the work stands as a testament to careful scientific inquiry. The volunteers endured months of hardship so that future physicians could better understand starvation and recovery.

Their sacrifice produced knowledge that still shapes medicine today.

And the book that documented the study—“The Biology of Human Starvation”—remains a landmark text in the scientific literature.

A Final Thought

Hunger is not a character flaw.

Instead, it is a biological signal designed to protect survival.

The Minnesota Starvation Experiment revealed that when humans face prolonged calorie restriction, the mind naturally becomes focused on food.

Rather than proving weakness, that response demonstrates how powerfully the body protects itself.

Understanding that reality allows medicine to approach nutrition and obesity with greater compassion—and far better science.

In 1990, researchers isolated a peptide from Gila monster venom. Two years later, work from the Bronx VA Medical Center described exendin-4, a molecule that resembled human GLP-1 but lasted far longer in circulation.

Human GLP-1 survives only minutes before the body breaks it down. Exendin-4 resisted that breakdown. That difference changed everything.

Soon afterward, the first GLP-1 receptor agonist reached patients under the brand name Byetta. At the time, physicians used it to treat diabetes. No one called it a weight-loss drug. No one predicted it would reshape obesity medicine.

And yet, the foundation was already in place.

While I Was Operating

At the Phoenix Indian Medical Center, I performed weight loss surgery in a population with some of the highest rates of type 2 diabetes in the world. Researchers there studied metabolism intensely. The “thrifty gene” hypothesis gained traction in that environment. Scientists asked whether efficient energy storage, once protective in scarcity, became harmful in abundance.

At the same time, I watched something remarkable in the operating room. After gastric bypass, patients’ blood sugars often improved within days, before meaningful weight loss occurred. Hormones were shifting. Physiology was driving outcomes.

Meanwhile, GLP-1 drugs evolved.

Researchers lengthened their half-lives. Chemists modified their structures so they bound albumin and stayed active for days rather than minutes. Clinical trials expanded. Safety data accumulated.

Eventually, semaglutide showed average weight loss approaching fifteen percent of body weight in obesity trials. Then tirzepatide, now marketed as Zepbound for obesity, exceeded 20 percent weight reduction in higher-dose studies. In addition, cardiovascular outcome trials demonstrated reductions in major adverse cardiac events in high-risk patients.

These were not cosmetic results. These were metabolic and cardiovascular outcomes.

Food Noise

Patients rarely talk about receptors. They talk about noise.

Food noise.

The constant internal dialogue about eating. The mental pull toward the pantry. The background chatter that never quite stops.

GLP-1 receptors exist in appetite-regulating areas of the brain, including the hypothalamus and brainstem. These medications act through vagal signaling and through regions where the blood-brain barrier is more permissive. As a result, they modulate satiety and reward pathways.

Consequently, many patients report something simple but profound: the noise quiets.

Not disappears. Quiet.

That distinction matters.

Diet Culture Pushback

Predictably, not everyone celebrates this shift.

Diet culture thrives on the belief that weight reflects character. Some coaches insist the solution is fewer calories. Others argue for more beef, more butter, more fiber, or stricter discipline. Entire industries depend on the idea that trying harder solves everything.

However, biology does not negotiate with virtue.

Obesity is a chronic, relapsing, neurohormonal disease. No one worked harder at weight loss than many of my surgical patients. Likewise, I do not lack willpower. And I practice culinary medicine. Preaching and eating a Mediterranean diet.

Nevertheless, effort alone does not silence dysregulated signaling.

Calling GLP-1 therapy “cheating” misunderstands the science. These medications restore signaling. They amplify satiety. They reduce excess reward drive. They support physiology.

That is treatment, not moral compromise.

My Parallel Universe

When I began my career, I weighed about 185 pounds. Years later, hospital cafeterias, exhaustion, and irregular meals pushed me to 225. I understood obesity clinically. Then I understood it personally.

In one version of my career, revision surgery remains the answer for weight regain. In this version, I reached for GLP-1 therapy instead.

Today, I weigh what I weighed when Nixon was president.

I am both surgeon and patient.

And your reporter.

A Necessary Caution

GLP-1 medications carry risks as well as benefits. Nausea can occur. Gastric emptying slows. Gallbladder disease risk may increase, although obesity itself already raises that risk substantially. Physicians must monitor dosing carefully.

Therefore, if you consider GLP-1 therapy, work with a trained physician who understands obesity medicine. Avoid quick online scripts. Seek supervision. Demand follow-up.

Metabolic medicine deserves serious care.

The Desert Was the Beginning

I once thought Phoenix was punishment. The heat felt relentless. Even Satan might choose a cooler vacation. Only Canadians brave July—and who can blame them?

However, what felt like exile turned out to be preparation.

In that same desert, I learned surgery. Researchers debated the thrifty gene. A venomous lizard carried a peptide that would become the basis of modern metabolic therapy.

I thought I had been sent to hell. But I found beauty in the desert, and by the time I left Arizona, I missed it terribly.

Little did I know I was sent to the future in Arizona.

Everywhere you look, protein has become a competition.

Scroll long enough and you will believe muscle disappears if you eat less than 150 grams a day. Meanwhile, influencers debate leucine thresholds like they’re trading baseball cards. As a result, ordinary meals now feel like math problems.

However, biology does not require panic.

Protein matters. Yet adequacy differs from excess. And importantly, most people eating real food already meet their needs.

So let’s slow down.

First, What Protein Actually Does

Protein builds and repairs tissue. In addition, amino acids support immune function and hormone signaling. Furthermore, specific amino acids such as leucine trigger muscle protein synthesis.

Nevertheless, once you reach the effective leucine threshold in a meal, adding more protein does not multiply muscle growth. Instead, your body oxidizes the excess.

Therefore, more does not always mean better.

How Much Is Enough?

For most healthy adults, about 0.8 grams per kilogram of body weight covers basic needs. Meanwhile, adults over 60 often benefit from 1.0 to 1.2 grams per kilogram to protect lean mass.

Notably, that recommendation does not require heroic intake. In fact, a 75–80 kilogram adult typically lands between 60 and 90 grams per day.

Consequently, many people hit those numbers without even trying.

Here’s What I Actually Do

I do not count protein. I never log grams. Moreover, I do not calculate leucine before breakfast.

Instead, I eat normal meals.

Most mornings, I have a shake. The recipe lives on terrysimpson.com. That shake provides roughly 25 grams of protein. Sometimes I add PB Fit. Occasionally, I include Greek yogurt. As a result, I increase protein slightly without thinking about it.

Later, I eat three to five ounces of chicken breast with Louisiana hot sauce. That adds another 25 grams.

Then at dinner, I often choose salmon and chickpeas. Together, they bring me to roughly 70–80 grams for the day.

Importantly, I have lost 50 pounds and preserved muscle mass. I track muscle periodically. I see no decline.

So what about leucine?

High-quality animal protein contains about 8–10% leucine. Therefore, a 25-gram protein meal delivers about 2 grams of leucine. That amount typically triggers muscle protein synthesis.

Thus, I hit the effective threshold at each meal without obsessing.

Now Let’s Bring In GLP-1

GLP-1 medications reduce appetite. Consequently, total intake drops. Because of that, protein intake can fall too.

So yes, people using GLP-1 should pay attention. However, they do not need 180 grams per day. Instead, they need adequacy and resistance training.

Lift something heavy. Spread protein across meals. Preserve lean mass.

Simple.

Here’s the Real Deficiency

Protein deficiency remains rare in the United States. By contrast, fiber deficiency remains common.

According to the National Institutes of Health, most adults fail to meet recommended fiber intake levels. In fact, average intake falls far below the 25–38 grams per day recommended for adults.

(Reference: NIH Office of Dietary Supplements – Fiber Fact Sheet)

Meanwhile, high-protein diets often crowd out legumes, whole grains, and vegetables.

So while people panic about protein, they quietly neglect fiber.

And fiber feeds the microbiome. Fiber improves glycemic control. Fiber lowers LDL cholesterol.

Protein builds muscle. Fiber protects metabolism.

Both matter.

Mediterranean Patterns Keep It Balanced

Mediterranean-style eating provides protein from fish, legumes, yogurt, and moderate poultry. At the same time, it supplies fiber from beans, vegetables, and whole grains.

Therefore, protein arrives packaged with micronutrients and fermentable substrate.

Unlike protein powders and bars, real food supports multiple systems at once.

Consequently, longevity patterns emphasize diversity, not maximal single-nutrient intake.

The Takeaway

Adequate protein preserves muscle. Resistance training drives adaptation. Fiber protects metabolic health.

So before you triple-scoop whey, pause.

Ask yourself whether you lack protein — or whether you lack plants.

Because protein matters.

Panic does not.

And once again, data beats dogma.

Every time someone says Mexican food is unhealthy, I know exactly what they’re picturing.

They aren’t picturing Mexico.

They’re picturing an American taco: a hard shell or a fluffy white flour tortilla, fatty hamburger, sour cream, a thin smear of salsa that contributes almost nothing except salt, and a yellow substance legally allowed to be called cheese.

After eating that, they naturally conclude Mexican food is the problem.

That conclusion doesn’t come from biology. It comes from branding.

Traditional Mexican food looks nothing like that. More importantly, it behaves nothing like that once it hits your body.

So let’s slow down, take a breath, and do what we always do here—follow the evidence, not the vibes.

First, Let’s Talk About the Taco America Put on Trial

The American taco stacks the deck against itself.

It leads with saturated fat, piles on refined carbohydrates, and adds dairy on top of dairy. Meanwhile, it offers almost no fermentable fiber. The gut gets nothing to work with. Blood sugar spikes. Inflammation follows.

That taco doesn’t help anyone.

But here’s the key point: it isn’t Mexican food.

It’s ultra-processed American convenience food wearing cultural drag.

Now Let’s Look at a Real Taco

By contrast, a traditional taco starts very differently.

It starts with a corn tortilla, not refined flour. Then it adds beans. After that, it layers vegetables, real salsa, and often cabbage. Finally, it finishes with avocado. Sometimes it includes fish. Sometimes it doesn’t. Either way, the structure holds.

And structure matters.

Because when you look at how that meal behaves biologically, it stops looking indulgent and starts looking smart.

Corn Tortillas Aren’t the Villain — They’re the Foundation

First of all, traditional corn tortillas come from nixtamalized corn. That process treats corn with lime, and no, that isn’t trivia.

Instead, nixtamalization improves mineral absorption, improves protein quality, and preserves resistant starch.

As a result, resistant starch passes through the small intestine untouched. Then it reaches the colon, where gut bacteria ferment it. Consequently, those bacteria produce short-chain fatty acids, especially butyrate.

And here’s the important part: butyrate fuels the cells lining your colon. In addition it strengthens the gut barrier. It reduces inflammation. Finally, it improves metabolic signaling.

So no, this isn’t a carb disaster. On the contrary, it’s colon nutrition.

Beans Do the Heavy Lifting — And They Always Have

Next, add beans.

At that point, the conversation usually derails, so let’s keep it grounded.

A serving of beans delivers roughly ten grams of fiber. Not one kind — several kinds. Soluble fiber. Insoluble fiber. Resistant starch. Plus protein.

Because of that, beans slow digestion. They flatten glucose curves. They improve satiety. Most importantly, they feed gut bacteria that matter.

Specifically, bean fiber supports Akkermansia, a gut bacterium associated with better insulin sensitivity and a stronger gut barrier.

In other words, beans don’t fill space. Instead, they build infrastructure.

And yes, when you pair beans with rice, you get a complete amino acid profile. Humans figured that out centuries ago, long before protein powders and “ancestral” snack companies tried to monetize it.

Now Let’s Deal With Refried Beans — Because This Is Where People Panic

At this point, someone inevitably says, “But what about refried beans?”

So let’s clear that up.

First, frijoles refritos does not mean “fried twice.” It means well-fried or thoroughly cooked. Traditionally, people cooked beans, then lightly cooked them again, often mashing them for texture.

So yes — refried beans are traditional. Very traditional.

Moreover, mashing beans does not remove fiber. Cooking beans does not turn them into sugar. Beans remain beans.

So where did refried beans go wrong?

Fat choice.

Historically, many refried beans used lard. That made sense when calories were scarce and undernutrition threatened survival. However, in a modern context, large amounts of lard mean large amounts of saturated fat.

Therefore, when refried beans swim in lard, then get buried under cheese, then land inside a refined flour tortilla, the problem isn’t the beans. The problem is the fat context.

Fortunately, this problem has an easy fix.

Use olive oil or another unsaturated fat. Add onions and garlic. Mash lightly, not into paste. Suddenly, refried beans snap right back into a Mediterranean-style pattern.

And yes — some commercially available refried beans already do this. Look for short ingredient lists. Look for beans, oil, onion, garlic, salt. Skip the lard. Skip the mystery fats. Your gut will notice.

Avocado Doesn’t Add Calories — It Unlocks Nutrition

Then comes avocado, which people love to blame for reasons that make no biological sense.

Avocado provides about five grams of fiber and a meaningful amount of monounsaturated fat — the same fat family as olive oil.

More importantly, fat enables absorption of fat-soluble vitamins: A, D, E, and K.

So when you add avocado to vegetables, you don’t ruin the meal. Instead, you make the nutrients available.

In other words, avocado doesn’t cancel vegetables. It activates them.

Salsa and Cabbage Quietly Do the Real Work

Meanwhile, real salsa brings tomatoes, onions, garlic, chilies, and cilantro to the table. That means fiber. That means polyphenols. That means fermentable substrate for gut bacteria.

Add corn to the salsa and you add more whole grains and more resistant starch.

Then add cabbage — raw or lightly dressed — and now you feed short-chain fatty-acid producers directly.

Nothing exotic. Nothing trendy. Just food that works.

Step Back — Because This Should Look Familiar

Now zoom out.

Traditional Mexican food emphasizes whole grains, legumes, vegetables, unsaturated fats, and fermentation. It stays naturally low in saturated fat. It supports the microbiome. It respects digestion.

In other words, it follows the Mediterranean pattern.

Not because it sits near the Mediterranean Sea — but because biology doesn’t care about geography.

The Mediterranean diet is a structure, not a destination.

Whether you eat it in Greece.

Or you eat it in Italy.

But you can eat it wrapped in a corn tortilla.

So What Actually Broke the Taco?

Processing.

Refining grains.

Deep-frying bases.

Replacing beans with beef.

Replacing water with sugar.

Turning cheese into a load-bearing wall.

Mexican food didn’t fail.

Industrial food did.

The Verdict

A traditional taco — corn tortilla, beans or properly made refried beans, vegetables, avocado, real salsa, maybe fish — fits squarely into one of the healthiest dietary patterns we know.

Different culture.

Same biology.

So the next time someone tells you Mexican food is unhealthy, remember this:

The taco was framed.

And once again — data beats dogma.

Fiber has a public relations problem. Unlike supplements or extreme diets, fiber does not promise instant transformation. Instead, it works slowly, predictably, and quietly. Because of that, people rarely notice it when it’s doing its job well. However, that very boredom is precisely why fiber matters.

When fiber intake is adequate, digestion functions normally, blood sugar behaves more consistently, and bowel habits stay predictable. As a result, there is no drama to post on social media. Consequently, influencers move on. Meanwhile, the science stays exactly where it has been for decades: fiber lowers disease risk over time.

That kind of quiet effectiveness may not sell products, but it saves lives.

“Fiber Isn’t Essential”—Why That Argument Misses the Mark

Technically speaking, fiber is not an essential nutrient in the classic sense. In other words, there is no disease caused solely by a lack of fiber the way scurvy results from vitamin C deficiency. Because of this, critics often stop the conversation there.

However, medicine does not ask only whether you survive. Instead, it asks whether your risk of chronic disease rises or falls over time. On that front, fiber consistently lowers the risk of colon cancer, improves glucose regulation, reduces constipation, and supports cardiovascular health. Therefore, while you can live without fiber, you do not age particularly well without it.

Protein Gets the Spotlight While Fiber Does the Work

At the same time, nutrition conversations fixate on protein. Protein goals dominate podcasts, social media, and supplement aisles. Yet, in practice, true protein deficiency in the United States is rare, even among bariatric surgery patients.

In contrast, fiber deficiency is the norm. Roughly 92% of Americans fail to meet recommended fiber intake. As a result, constipation becomes common, long bathroom visits feel normal, and scrolling on a phone in the bathroom gets rebranded as “self-care.” Unfortunately, that normalization hides a real problem.

A Personal Lesson From Oats, Gas, and a Scorched Desk

Years ago, I learned a fiber lesson the hard way. After deciding to increase my fiber intake quickly, I started eating steel-cut oats every morning during a busy meeting week. At first, everything seemed fine. Soon, however, my digestive system made it clear that it had not been consulted in this decision.

By the second day, bloating appeared. By the third day, office etiquette became questionable. Consequently, I lit a candle at my desk. Unfortunately, I turned my back, and papers caught fire. Although the flames were extinguished quickly, the scorch mark stayed for years.

That stain served as a reminder: fiber works best when introduced gradually. Your gut adapts over time. Confidence without patience, on the other hand, leads to unnecessary consequences.

Not All Fiber Works the Same Way

Understanding fiber helps people stop fearing it. Soluble fiber, found in oats, barley, beans, lentils, psyllium, apples, and citrus, forms a gel in the gut. Because of this, it slows absorption, reduces glucose spikes, and lowers LDL cholesterol. Consequently, psyllium appears in clinical guidelines rather than influencer protocols.

Meanwhile, insoluble fiber focuses on mechanics. It adds bulk, speeds transit, and improves regularity. Importantly, this matters even more for people using GLP-1 medications, where slowed digestion often leads to constipation. In that setting, fiber is not optional—it is foundational.

Finally, fermentable fiber feeds gut bacteria. Beans, onions, garlic, asparagus, chicory root, and resistant starch nourish beneficial microbes. As these bacteria grow, they produce short-chain fatty acids, especially butyrate, which supports gut barrier function and immune regulation.

No, Butter Is Not a Shortcut to Butyrate

Despite what circulates online, butter does not meaningfully deliver butyrate to your colon. Although butter contains trace amounts of butyric acid, that fat is absorbed in the small intestine long before it reaches the colon. In contrast, the butyrate that protects colon health is produced by bacteria fermenting fiber directly in the colon.

Therefore, if butter were an effective therapy, gastroenterologists would prescribe croissants. They do not.

Supplements Help—but Food Still Wins

Fiber supplements can be useful. Psyllium and methylcellulose typically provide four to five grams of fiber, which helps people start. However, that amount represents only about ten percent of a reasonable daily target.

Personally, I use Loam, which provides around twelve grams of mixed fiber in a smoothie. Nevertheless, supplements act as bridges, not destinations. Ultimately, food does the heavy lifting.

IBS, FODMAPs, and Why We Avoid Diet Cosplay

Some people with IBS feel worse when fermentable fiber increases too quickly. Because fermentation produces gas, symptoms can flare initially. For that reason, clinicians use FODMAPs as a temporary elimination tool to identify triggers.

However, elimination is not the end goal. Instead, we reintroduce foods within a Mediterranean dietary pattern, which promotes diversity and tolerance. In contrast, Whole30 markets itself as elimination but functions primarily as low-carb restriction. That approach avoids symptoms rather than solving them.

What Eating Enough Fiber Actually Looks Like

People do not eat grams of fiber. They eat meals. A Mediterranean-style day, such as the 3-Day Mediterranean Diet at terrysimpson.com, delivers fiber incidentally.

Breakfast often includes oats, berries, and nuts. Lunch typically features vegetables, legumes, whole grains, and olive oil. Snacks rely on fruit, nuts, or hummus. Dinner centers on vegetables, whole grains like farro, and fish or poultry. Over the course of a day, fiber naturally reaches 25–40 grams without spreadsheets or stress.

Start Slowly, Then Stay Consistent

If you currently eat little fiber, the solution is simple but not dramatic. Increase intake gradually. Drink water. Give your microbiome time to adapt. Although you are not fragile, abrupt change can still cause discomfort.

The Bottom Line

Fiber does not need hype. Instead, it needs consistency. It works quietly, steadily, and reliably. If bathroom visits require entertainment, the issue is not age—it is fiber.

Food noise does not announce itself politely. Instead, it hums in the background, persistent and exhausting. For years, patients tried to describe it. Meanwhile, medicine largely ignored it. Recently, however, GLP-1 receptor agonists forced the conversation into the open.

I did not understand food noise myself until it stopped.

About twelve hours after my first GLP-1 injection, I stood in my kitchen waiting for baked salmon to finish cooking. Nothing dramatic happened. No emotional moment followed. Still, something felt different. The internal commentary was gone. The negotiations disappeared. For the first time, my brain felt quiet.

At that moment, I finally understood what patients had been telling me for years.

First, Define the Problem Clearly

Food noise is not hunger. Hunger serves a biological purpose. In contrast, food noise describes persistent, intrusive thoughts about food that occur regardless of energy needs. People experience rumination, preoccupation, cravings, and mental fatigue—even when they are physiologically full.

Importantly, this phenomenon is now measurable. The Food Noise Questionnaire validates what patients already knew. Specifically, it assesses the frequency of food thoughts, difficulty controlling them, interference with daily activities, emotional distress, and craving intensity. In other words, food noise exists independently of willpower.

Consequently, advice that targets hunger alone inevitably fails.

Next, Address the Broccoli Myth

I eat vegetables. Nevertheless, I have never liked broccoli.

Frankly, if broccoli is air-fried to the edge of carbonization, I will tolerate it. That concession, however, does not transform broccoli into a neurological intervention. Fiber increases fullness. Protein improves satiety. Vegetables slow digestion. None of those actions quiet the reward centers of the brain.

Put simply, broccoli fills the stomach. Food noise lives elsewhere.

Because of that distinction, the “just eat for satiety” argument collapses under scrutiny.

Then, Follow the Science Where It Leads

Food noise arises from heightened food-cue reactivity. Visual cues, smells, availability, and anticipation activate reward pathways long before food reaches the stomach. Ultra-processed foods amplify this response. Their engineered combinations of refined carbohydrates, fats, salt, and flavor compounds reliably stimulate the mesolimbic dopamine system.

As a result, ultra-processed foods increase wanting rather than liking.

However—and this matters deeply—removing ultra-processed foods does not automatically restore normal appetite signaling. Once reward circuitry becomes dysregulated, dietary virtue alone cannot reset it. At that stage, telling someone to “just eat whole foods” resembles telling someone with tinnitus to “enjoy the silence.”

Therefore, ultra-processed foods contribute to the problem, but they do not explain it entirely.

Now, Enter GLP-1 Receptor Agonists

GLP-1 receptor agonists act centrally and peripherally. While many people fixate on gastric emptying, the central mechanisms explain the lived experience.

In the hypothalamus, GLP-1 receptor agonists activate satiety-promoting POMC/CART neurons while inhibiting hunger-promoting NPY/AgRP neurons. This dual action reduces homeostatic hunger. Meanwhile, in the brainstem—particularly the nucleus tractus solitarius—GLP-1 signaling integrates gut-brain communication and sustains appetite suppression.

More importantly, GLP-1 receptor agonists modulate reward circuitry. In regions such as the ventral tegmental area and nucleus accumbens, these agents dampen dopamine signaling. Consequently, food becomes less compelling rather than forbidden.

Functional imaging studies confirm this effect. After GLP-1 treatment, brain responses to food cues decrease in the insula, amygdala, orbitofrontal cortex, and related regions. The brain still recognizes food. It simply stops obsessing.

As a Result, Behavior Changes Without Force

Once food noise quiets, people do not suddenly become disciplined saints. Instead, they become selective.

In my own case, wine lost its appeal. I did not swear it off. I simply stopped wanting it. Eventually, I quit five wine clubs. When a glass tastes mediocre, I put it down and choose iced tea. That behavior reflects altered reward signaling, not moral growth.

Similarly, food choices shift without struggle. People stop eating things merely because they are available. They stop drinking because something is poured. The absence of compulsion creates space for intentional eating.

That distinction explains why GLP-1 therapy feels different from appetite suppression.

Finally, Place Diet Back Where It Belongs

The Mediterranean diet improves health. I recommend it. I eat it. Still, it does not cure food noise.

Diet supports metabolic health once interference disappears. GLP-1 therapy removes that interference. Together, they work better than either alone. Pretending otherwise leads to fat shaming disguised as nutritional advice.

Obesity is a disease. GLP-1 receptor agonists treat that disease. Food then becomes nourishment rather than negotiation.

So, What Actually Matters

Ultra-processed foods worsen food noise, yes. Yet removing them does not repair dysregulated reward circuitry. Satiety fills the stomach. GLP-1 therapy quiets the brain. Once the noise fades, nutrition finally has a fair chance.

In the end, broccoli keeps my mother from returning from the grave. GLP-1s keep my brain quiet. Both have their place. Only one treats the disease.

REFERENCES:

1. Medications for Obesity: A Review.

The Journal of the American Medical Association. 2024. Gudzune KA, Kushner RF.

2. The Arcuate Nucleus Mediates GLP-1 Receptor Agonist Liraglutide-Dependent Weight Loss.

The Journal of Clinical Investigation. 2014. Secher A, Jelsing J, Baquero AF, et al.

3. Direct and Indirect Effects of Liraglutide on Hypothalamic POMC and NPY/­AgRP Neurons - Implications for Energy Balance and Glucose Control.

Molecular Metabolism. 2019. He Z, Gao Y, Lieu L, et al.

4. On the Pleiotropic Actions of Glucagon-Like Peptide-1 in Its Regulation of Homeostatic and Hedonic Feeding.

International Journal of Molecular Sciences. 2025. Sayers S, Wagner E.New

5. Glucagon-Like Peptide 1 (GLP-1) Action on Hypothalamic Feeding Circuits.

Endocrinology. 2025. Hwang E, Portillo B, Williams KW.New

6. GABA Neurons in the Nucleus Tractus Solitarius Express GLP-1 Receptors and Mediate Anorectic Effects of Liraglutide in Rats.

Science Translational Medicine. 2020. Fortin SM, Lipsky RK, Lhamo R, et al.

7. GLP-1 Receptor Activation Modulates Appetite- And Reward-Related Brain Areas in Humans.

Diabetes. 2014. van Bloemendaal L, IJzerman RG, Ten Kulve JS, et al.

8. Glucagon-Like Peptide 1 and Its Analogs Act in the Dorsal Raphe and Modulate Central Serotonin to Reduce Appetite and Body Weight.

Diabetes. 2017. Anderberg RH, Richard JE, Eerola K, et al.

9. of GLP-1 Therapies for Addiction and Mental Health Comorbidities—Quo Vadis?.

JAMA Psychiatry. 2026. Farokhnia M, Leggio L.New

10. GLP-1 and Weight Loss: Unraveling the Diverse Neural Circuitry.

American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2016. Kanoski SE, Hayes MR, Skibicka KP.

11. Mechanisms of GLP-1 Receptor Agonist-Induced Weight Loss: A Review of Central and Peripheral Pathways in Appetite and Energy Regulation.

The American Journal of Medicine. 2025. Moiz A, Filion KB, Tsoukas MA, et al.New

12. GLP-1 Physiology and Pharmacology Along the Gut-Brain Axis.

The Journal of Clinical Investigation. 2026. Beutler LR.New

But Hungry Kids Are Still the Real Problem

Whole milk is back in school cafeterias.

As a result, a lot of people are celebrating. Some are calling it a victory for nutrition. Others are calling it common sense. Meanwhile, a few are even calling it a breakthrough.

However, that excitement misses the point.

Because the biggest problem facing kids in school today is not milk fat.

Instead, the real problem is hunger.

First, Let’s Start With the Obvious

Before we talk about milk, fat, or nutrients, we need to start with something very basic.

Hungry kids do not learn well.

In fact, hunger affects attention, memory, and behavior. As a result, students who do not eat enough struggle to focus. Over time, that struggle shows up as lower academic performance.

Because of that, no change to milk will ever fix an empty stomach.

Therefore, if we want better outcomes, we have to start with food access.

Next, What Actually Changed With Milk

Despite what many people believe, whole milk was not removed from schools in the past.

Instead, schools continued to offer low-fat and fat-free milk.

Importantly, those options provided the same essential nutrients:

1. protein
2. calcium
3. potassium
4. iodine
5. vitamin B12

In addition, vitamin D was added through fortification, regardless of milk fat level.

So, children did not lose vital nutrients.

What they lost was milk fat.

Now, Why Milk Fat Is Not Essential

Milk fat is made mostly of saturated fat.

That matters because saturated fat is not an essential dietary nutrient.

If the human body needs saturated fat, it can make it on its own. In other words, there is no requirement to eat it for normal growth or brain development.

As a result, adding more saturated fat to a child’s diet is not necessary.

Then, Let’s Talk About the Brain

Here is where biology matters.

The brain is built largely from polyunsaturated fats, not saturated fats.

These polyunsaturated fats keep cell membranes flexible. Because of that flexibility, brain cells can signal, adapt, and learn.

In contrast, saturated fat is rigid. It plays only a small structural role in membranes. If membranes contained too much saturated fat, they would become stiff. When that happens, signaling does not work well.

For that reason, biology uses saturated fat sparingly.

Therefore, less saturated fat in the diet of growing children is actually better for long-term brain and cardiovascular health.

Meanwhile, What Kids Are Really Missing

If there is one nutrient that most children lack, it is fiber.

Fiber supports gut health. In addition, it improves insulin sensitivity. Over time, it also reduces cardiovascular risk.

Milk fat does none of those things.

So, if nutrition is the concern, fiber deserves more attention than nostalgia for saturated fat.

At the Same Time, Food Access Is Shrinking

While milk is being discussed, something else is happening quietly.

Food assistance programs are being reduced.

That matters because programs like SNAP do more than help families buy groceries. They also help children qualify for free school meals.

When eligibility is reduced, fewer children qualify. As a result, schools receive less funding for lunch programs. Consequently, some schools serve fewer meals. In certain communities, programs disappear entirely.

Therefore, the outcome is simple: fewer kids eat at school.

In Contrast, Feeding Kids Actually Works

Some states have shown a different approach.

When children receive meals consistently, attendance improves. At the same time, concentration improves. Over the long term, educational outcomes improve as well.

This result has been seen repeatedly.

Because of that, feeding kids is not charity. Instead, it is an investment in education, health, and future productivity.

So, Let’s Put This Together

Whole milk is fine.

If families enjoy it, they can drink it. If schools offer it, that is acceptable.

However, whole milk is not an innovation.

Feeding children is.

Ultimately, school meals should not be treated as a budget line to debate each year. Instead, they should be treated as part of what a functioning society does for its kids.

One Reference on Brain Fat and Cell Membranes

For readers who want the science behind membrane fats and brain function, this review explains it clearly:

Stillwell W, Wassall SR.

Docosahexaenoic acid: membrane properties of a unique fatty acid.

Chemistry and Physics of Lipids. 2003;126(1):1–27.

This paper explains why polyunsaturated fats keep membranes flexible and why saturated fats play only limited roles.

Every few years, nutrition gets a makeover.

First comes a new graphic.

Then comes a new slogan.

Soon after, we hear claims that this time, someone finally figured it all out.

Recently, that makeover arrived in the form of a “reverse food pyramid” and the cheerful phrase “Eat Real Food.” On the surface, that message sounds reasonable. In fact, many doctors have said the same thing for decades.

However, the real problem isn’t the slogan.

Instead, the problem lies in who is now shaping nutrition advice—and who is not.

Yes, Some of the Advice Is Right

To be clear, let’s start with agreement.

Eating real food helps health.

Limiting added sugar makes sense.

Reducing ultra-processed foods improves outcomes.

Importantly, none of this is new.

Doctors, dietitians, and public-health researchers have said these things for years. Because of that, when influencers now say, “See, we were right,” a serious issue appears.

They didn’t discover this information.

They copied it.

The Real Risk Isn’t Agreement

At first glance, agreement sounds harmless.

Nevertheless, agreement becomes dangerous when it turns into ownership.

Once someone believes they have discovered basic nutrition truths, they often assume they can rewrite everything else. As a result, bad ideas slip in quietly, wrapped in confidence instead of evidence.

That shift matters.

Scientists and Influencers Are Not Interchangeable

At this point, we need to say something clearly.

We cannot afford to replace scientists with influencers.

Nutrition science didn’t come from podcasts or social media. Instead, it came from metabolic ward studies, long-term population research, and randomized trials. Moreover, real scientists accept uncertainty. They change their minds when the data changes.

By contrast, influencer culture rewards certainty.

Even worse, confidence often replaces humility.

There is no “Mediterranean diet influencer community.”

Likewise, there is no “DASH diet movement.”

Those dietary patterns exist because scientists studied them, tested them, and measured outcomes over time.

On the other hand, a loud low-carb and carnivore influencer ecosystem does exist. That ecosystem includes brands, supplements, coaching programs, and a strong contrarian identity. Because of that structure, influence—not evidence—often drives the message.

Fiber Versus Saturated Fat: A Telltale Sign

If you want to know whether someone understands nutrition science, ask a simple question:

Which matters more—fiber or saturated fat?

Influencers often say, “Fiber isn’t an essential nutrient.”

Technically, that statement is true in the narrowest sense.

However, context matters.

Fiber supports a healthy gut microbiome.

Additionally, fiber improves insulin sensitivity.

Furthermore, fiber lowers cardiovascular risk.

Finally, fiber supports colon health.

Because fiber feeds beneficial gut bacteria, entire fields of microbiome research depend on it.

Now compare that with saturated fat.

Saturated fat is truly non-essential.

Your body can make all it needs.

No deficiency disease exists from avoiding it.

Even more importantly, excess saturated fat raises LDL cholesterol and worsens artery health. Over time, that increases cardiovascular risk.

So ask yourself this:

Why dismiss fiber as optional while quietly promoting saturated fat?

That choice reflects ideology, not biology.

The Brain Doesn’t Care About Trends

Here’s another reality check.

Your brain—the most important organ you own—relies heavily on polyunsaturated fats. These fats support cell membranes, nerve signaling, and blood flow.

Ironically, these same fats often get labeled “seed oils” and dismissed.

Meanwhile, saturated fat does not belong in high amounts in brain tissue. Worse still, saturated fat can clog the arteries that supply the brain.

Biology does not respond to marketing.

Physiology does not care about popularity.

The “You’re On Your Own” Problem

Another issue deserves attention.

After influencers step into the spotlight and claim credit for old science, they often step away from responsibility. Then they tell the public to “figure it out.”

That approach ignores reality.

Many Americans live in food deserts.

Even more rely on school meals.

Lots of Americans work multiple jobs.

Many lack time, money, or kitchens.

Public health exists because willpower alone does not scale. Without system-level support, advice turns into abandonment.

Agreement Does Not Equal Expertise

Recently, debates around nutrition have highlighted this pattern clearly.

Some influencers argue that because they agree with basic nutrition advice, they deserve authority over the rest of the science. Unfortunately, agreement does not grant expertise.

Copying conclusions does not mean you earned them.

Science rewards method, not confidence.

The Bottom Line

Yes, eat real food.

And clearly, limit added sugar.

Most definitely, reduce ultra-processed foods.

Doctors have said this for years.

However, flipping a pyramid does not change biology.

Likewise, sidelining scientists does not improve health.

Finally, promoting saturated fat while dismissing fiber misleads the public.

People do not fail diets.

Systems fail people.

When we trade evidence for influence, health suffers.

A Final Note

This article provides general education, not personal medical advice. Always talk with your healthcare professional about individual nutrition needs.

At Your Doctor’s Orders, we believe data matter more than dogma, and evidence matters more than trends.

Because when it comes to health, confidence without science is not bold.

It’s risky.

Ultra-processed food has become the villain of modern nutrition.

Scroll through social media, and you’ll hear that it’s poisoning us, wrecking our gut, and driving the obesity epidemic all by itself.

At the same time, other voices dismiss the entire idea as fear-mongering.

According to them, processing doesn’t matter at all.

Neither extreme tells the full story.

So instead of slogans, let’s talk about what ultra-processed food actually means, why people want to blame it, where the science is strong, and where it starts to drift into storytelling.

Why We’re Looking for Something to Blame

The obesity epidemic is real.

Rates have climbed for decades, and people understandably want answers.

Human biology didn’t suddenly change in the 1980s.

Willpower didn’t vanish overnight.

Something in our environment shifted.

Food is an obvious suspect.

Because food changed, many people assume there must be a single culprit hiding in the ingredient list.

That belief leads to bold claims.

Some say Europe bans certain additives and therefore avoids obesity.

In reality, obesity rates continue to rise across Europe as well.

Others argue that specific ingredients damage the gut, letting in more calories or triggering metabolic chaos.

Those ideas sound scientific, especially when they involve complex biology.

However, when a problem is large and complicated, humans naturally want a cause that feels simple and controllable.

Blaming one ingredient feels easier than confronting patterns of eating, stress, time pressure, and convenience.

Biology, unfortunately, rarely offers cinematic villains.

What “Ultra-Processed” Actually Means

To understand the debate, definitions matter.

Researchers use the NOVA classification system to describe food processing.

NOVA does not rate healthfulness.

Instead, it categorizes food by how manufacturers produce it.

The system includes four groups.

First come whole or minimally processed foods, such as vegetables, beans, eggs, and fish.

Next are culinary ingredients like oil, sugar, salt, and flour.

Then come processed foods, including bread, cheese, yogurt, and canned vegetables.

Finally, NOVA defines ultra-processed foods as industrial formulations.

These products often combine refined ingredients with additives, stabilizers, emulsifiers, and flavor systems that home cooks rarely use.

Here’s the crucial point.

Ultra-processed food is defined by how it is made, not by what it does in the body.

That distinction often gets lost.

As a result, soda and whole-grain bread can fall into the same category, even though they behave very differently nutritionally.

Why Ingredient Blame Falls Short

At this point, many discussions take a wrong turn.

Instead of asking how people eat, the conversation focuses on what to ban.

Ingredients become the enemy.

Yet most claims about additives rely on animal studies using doses far higher than what humans consume.

Human data remains limited and inconsistent.

Meanwhile, the bigger picture often gets ignored.

Ultra-processed food correlates with stress, long work hours, poor sleep, and limited time for cooking.

Those factors influence eating behavior regardless of ingredients.

When people feel rushed and overwhelmed, they don’t just eat differently.

They eat faster, snack more often, and rely on foods that require little effort.

That context matters.

The Simple Question That Changed the Conversation

Instead of chasing villains, one researcher asked a much simpler question.

Do people eat more when food is ultra-processed, even when nutrition looks the same on paper?

That question led to the most important experiment in this entire debate.

What Kevin Hall Actually Found

At the National Institutes of Health, Kevin Hall conducted a tightly controlled feeding study.

Participants lived in a metabolic ward.

Researchers controlled the environment, the meals, and the measurements.

Each participant ate two diets.

One diet consisted mostly of ultra-processed foods.

The other relied on minimally processed foods.

Importantly, researchers matched calories, protein, fat, carbohydrates, sugar, and salt.

People could eat as much as they wanted.

The result surprised almost everyone.

On the ultra-processed diet, participants consumed about 500 extra calories per day.

Yet, they didn’t report more hunger.

They didn’t feel less full.

However, they simply ate more.

This finding matters because it avoids speculation.

No ingredient theories appear here.

No gut damage claims drive the conclusion.

Ultra-processed food made it easier to eat more calories without noticing.

Sometimes the most powerful answers are also the least dramatic.

Why a Book Made This Go Viral

That study helped fuel widespread interest, including the success of Ultra-Processed People: The Science Behind Food That Isn't Food by Chris van Tulleken.

Van Tulleken, a British physician, took a personal approach.

He ate a diet dominated by ultra-processed foods and documented the effects.

Weight gain followed.

Hunger became harder to regulate.

Energy and mood shifted.

The book resonated because it made an abstract concept feel personal.

It also highlighted how modern foods often prioritize shelf life, softness, and convenience.

Stories like this help people recognize patterns they already sense in daily life.

However, a compelling narrative does not replace careful interpretation.

Where the Story Goes Too Far

Ultra-processed food is not one thing.

It does not act through a single mechanism.

The research faces several challenges.

First, heterogeneity clouds interpretation.

Grouping soda and yogurt together creates confusion rather than clarity.

Second, confounding remains a major issue.

People who eat more ultra-processed food often face structural barriers that affect health in many ways.

Third, additive panic oversimplifies biology.

Mouse data cannot stand in for long-term human outcomes.

Ultra-processed food may contribute to health problems, but it rarely acts alone.

A Better Way to Think About Food

Rigid rules tend to fail.

Real eating happens in real life.

Instead of asking whether a food qualifies as ultra-processed, better questions help guide choices.

Does the food contain fiber?

How will it contribute protein or micronutrients?

Finally, will it replace a balanced meal or help create one?

Can you eat it mindfully and stop when satisfied?

Foods like yogurt, tofu, olive oil, canned beans, and frozen vegetables often break simplistic rules.

Yet they support healthy eating patterns when used well.

Processing did not ruin our food.

Confusion did.

The Bottom Line

People want a villain because villains feel actionable.

Science, however, often points toward behavior rather than ingredients.

Ultra-processed foods encourage faster eating, softer textures, and higher calorie intake.

That pattern explains a great deal without invoking conspiracies.

Understanding that reality empowers better choices than fear ever could.

Reference

Hall KD, Ayuketah A, Brychta R, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial. Cell Metabolism. 2019;30(1):67–77.e3.

For decades, I started every New Year the same way.

In January, I promised myself this would be the year.

By February, I tried harder.

Every spring, I adjusted the plan.

And by summer or fall, the weight crept back.

That cycle repeated not because I lacked knowledge, discipline, or effort. Instead, it repeated because I misunderstood biology — at least when it came to myself.

This year is different.

For the first time since Ronald Reagan was first elected, weight loss is not at the top of my New Year’s resolution list. Not because I stopped caring, but because I lost 45 pounds with the help of Zepbound over the last year. More importantly, however, I learned something that reshaped how I think about obesity, healthspan, and shame.

Before anything else, let me be clear: this is not medical advice. This is a story. Anecdotes are not evidence, even when the anecdote is from a physician. Nevertheless, stories help us understand science when data alone fails to move us.

And this story matters.

I Had Willpower. That Wasn’t the Problem.

For years, people told me — and millions of others — the same thing: move more and eat less. At first glance, that advice sounds logical. After all, calories matter. Energy balance matters.

However, reality is more complicated.

To begin with, I am a surgeon. Surgical training requires extraordinary willpower. Moreover, I’ve logged food meticulously, cooked Mediterranean-style meals, exercised consistently, and followed every evidence-based recommendation I’ve ever given patients.

Meanwhile, Oprah has willpower. Olympic athletes have willpower. Yet obesity persists.

Sure, willpower works briefly. In fact, go on a liquid protein diet, and the weight will fall off quickly. Unfortunately, the food noise remains. Eventually, biology wins. Always.

In the same way you cannot positive-think your way out of hypertension, cholesterol, diabetes, cancer, or heart disease, you cannot willpower your way out of obesity. Obesity is a disease. It is not a moral failure.

Ironically, I knew this intellectually. Nevertheless, I failed to apply it to myself. We have a name for that: cognitive dissonance.

Food Noise Was the Missing Concept

The real turning point did not come from reading another study. Instead, it came from listening to people I trusted.

One colleague quietly lost weight on a GLP-1. Another friend told me something more striking: the food noise stopped. Alcohol lost its appeal. Smoking no longer called.

That phrase — food noise — suddenly explained decades of struggle.

To illustrate, think of sleeping near Lake Shore Drive in Chicago. At first, traffic noise dominates your awareness. Eventually, it fades into the background. Only when you leave the city do you realize how loud it was.

Food noise works the same way.

When GLP-1 therapy quieted that background signal, eating slowed naturally. Meals ended without effort. Desire changed without rules. Biology shifted.

Notably, calories did not lower my stress. Calories did not improve my sleep. Calories did not stop snoring. Biology did.

The Unexpected Early Benefits

Interestingly, weight loss was not the first change I noticed.

Sleep improved almost immediately. Stress dropped dramatically. Commutes that once registered hours of physiologic stress now barely registered minutes. Appetite normalized. Eating slowed.

These changes matter because sleep and stress directly affect inflammation, metabolic health, appetite signaling, and long-term disease risk. In other words, healthspan improved before the scale reflected anything meaningful.

That observation alone reframed the entire experience.

Why Support Groups Matter More Than Diet Rules

Along the way, something else happened.

Friends noticed.

Predictably, they asked the same question everyone asks: What diet is working? After I answered honestly, several started their own journeys.

Soon enough, we formed an informal support group. People texted. Others called. Questions surfaced: Is this normal? Should I eat this? Does this feeling pass?

Support did not mean coaching. Rather, support meant context. Shared experience reduced anxiety. Honest conversations prevented unnecessary panic.

Not surprisingly, patterns emerged. People still loved great food. Wine interest decreased naturally. Travel did not end. Joy remained intact.

Support mattered because isolation amplifies shame.

Vitamins, Bowels, and the Things No One Mentions

Equally important, practical realities surfaced.

Eating less means needing micronutrients, not fewer of them. Unfortunately, some vitamins fail when appetite drops. In fact, the only time I vomited was after taking a vitamin on an empty stomach. That lesson mirrored decades of bariatric follow-up experience.

For me, AG1 worked. No sponsorship exists here. Nevertheless, cost raises questions. With a background in culinary medicine, developing a better formulation makes sense. Thiamine deficiency, for example, causes devastating neurologic consequences. This is not theoretical.

Similarly, bowel habits change. Less intake means less output. Fewer bowel movements do not equal constipation. Fiber still matters. Mediterranean-style eating naturally solves most of this problem.

Understanding physiology prevents fear.

Why I’m Writing Another Book

At some point, frustration turned into obligation.

Recently, a physician who has never used a GLP-1 published a book about eating on GLP-1 therapy. That bothered me more than it should have.

Given my background — weight-loss surgery, culinary medicine, and lived experience — I realized I had to write this book. Not to sell diets, but to explain reality.

The working title?

Willpower Is B.S.

Subtlety has never been my strength.

This book will focus on biology, food ideas, micronutrients, behavior, and healthspan. Above all, it will remove shame from the conversation.

Incidentally, my literary agent retired long ago. Therefore, if you know someone who understands medicine, food, and honesty, I’m back in the market.

Why the Mediterranean Healthspan Cruise Exists

At the same time, conversations kept expanding beyond weight loss.

Healthspan matters more than thinness. Longevity depends on sleep, stress, nutrition, social connection, and movement. Accordingly, the Mediterranean Healthspan Cruise was born.

This is not a weight-loss cruise. Instead, it’s a learning experience. We will discuss food, medicine, science, and aging. Yes, there will be a GLP-1 support session. Equally, there will be conversations for everyone.

Learning works best in a community.

This Is Only Part One

As I write this, I’m preparing to inject my 7.5 mg dose of Zepbound. I still hate needles. Some things never change.

Nevertheless, this is only part one of the journey.

Science progresses when we admit what we got wrong.

This time, I listened.

References

1. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.
2. Rubino F et al. Joint international consensus statement for ending stigma of obesity. Nature Medicine, 2020.

What Biologic Age Really Means — and What It Doesn’t

My Whoop tells me I’m eight years older than I actually am.

Naturally, that raises a question.

Does that mean I’m going to die eight years sooner?

Is my watch quietly chiseling a new date onto my tombstone?

Fortunately, the answer is no.

Still, confusion around biologic age has exploded.

Wearables promise insight.

Apps offer scores.

Some even whisper about your future health, as if destiny lives on your wrist.

So let’s slow this down and talk about what biologic age really is — and why it matters far less than you think.

The Two Numbers and the Dash

Every tombstone has two numbers.

One marks when you were born.

The other marks when you died.

However, the most important part isn’t either number.

It’s the dash in between.

That dash represents your life.

It reflects your health, mobility, independence, and curiosity.

When we talk about longevity, we shouldn’t obsess over the second number.

Instead, we should focus on making those two numbers far apart — and keeping the dash strong for as long as possible.

That’s healthspan.

Why Biologic Age Sounds Scarier Than It Is

Biologic age is not a prophecy.

It isn’t a death clock.

It doesn’t predict how long you’ll live.

Instead, biologic age is a model.

It estimates how your body is functioning right now based on things like:

• resting heart rate
• heart-rate variability
• sleep duration and consistency
• activity and recovery patterns
• sometimes weight or blood pressure

Different devices use different inputs.

As a result, they often give different answers.

In other words, biologic age reflects recent stress and behavior, not your destiny.

Think of it as feedback — not fate.

Why Your Watch Isn’t Measuring “Real” Aging

Earlier in the Fork U longevity series, we talked about telomeres.

Those shorten slowly over decades, one cell division at a time.

Your wearable isn’t tracking that.

Instead, devices like Whoop measure physiology, not DNA.

They detect how hard you’ve been living lately, not how much time you have left.

A bad week of sleep, travel, stress, or alcohol can push your biologic age higher.

A calm, consistent routine can bring it back down.

That’s not aging.

That’s load management.

A Simple Experiment That Tells the Whole Story

Here’s a trick I tried.

I told Whoop I was younger than I actually am.

Guess what happened?

Suddenly, my biological age dropped below my real age.

That alone tells you everything.

Whoop isn’t predicting where you’re going.

It’s comparing how you’re doing relative to the age you told it you are.

Once again, that’s feedback — not destiny.

Why I Prefer Withings

I use multiple devices because, frankly, I’m a nerd.

However, I tend to prefer Withings for one simple reason.

They don’t try to scare you.

Instead of telling you how old you “really” are, Withings focuses on things that actually improve your life today:

• blood pressure trends
• body weight and composition
• heart rhythm
• sleep duration
• long-term consistency

More importantly, they ask better questions.

Are you sleeping better?

Is your blood pressure improving?

Are your habits trending in the right direction?

That’s medicine.

Not numerology.

And no — Withings didn’t pay me to say that.

The Biggest Mistake People Make

Many people treat biologic age like a grade.

Others see it as a moral judgment.

When the number drops, they feel virtuous.

When it rises, they panic.

That framing misses the point.

The only question that matters is this:

Is it moving in the right direction over time?

One bad week doesn’t define you.

One good week doesn’t either.

Trends matter.

Moments don’t.

What No Device Can Tell You

No wearable can tell you:

• when you’ll die
• whether you’ll get cancer
• if you’ll have a stroke
• how many years you have left

Anyone claiming otherwise is selling fear — or subscriptions.

Technology can guide behavior.

It cannot predict destiny.

New Year’s Resolutions That Actually Improve Healthspan

If you want to improve your biologic age — and more importantly, your healthspan — start here:

Sleep better and more consistently.

Build and maintain muscle.

Move your body every day.

Eat a Mediterranean-style diet.

Lower stress where you can.

Spend time with people you enjoy.

Do those things, and most metrics improve on their own.

The Bottom Line

Your watch is not your destiny.

Chronological age is fixed.

Healthspan is not.

Biologic age is adjustable, responsive, and reversible.

Use it as feedback.

Ignore it as prophecy.

And remember — the goal isn’t to beat time.

The goal is to live well while time keeps moving.

References

1. Levine ME. Modeling the rate of senescence: Can estimated biological age predict mortality more accurately than chronological age? J Gerontol A Biol Sci Med Sci. 2013.
2. Belsky DW, et al. Quantification of biological aging in young adults. Proc Natl Acad Sci USA. 2015.
3. Blackburn EH, Epel ES, Lin J. Human telomere biology: A contributory and interactive factor in aging, disease risks, and protection. Science. 2015.
4. WHOOP Team. Understanding Recovery, HRV, and Physiological Load.
5. Withings Health Institute. Longitudinal tracking of cardiometabolic health markers.

For years, anti-aging has been hijacked by supplements, hacks, and promises that never hold up. Meanwhile, real science has quietly moved forward. Today, the most compelling anti-aging story does not come from a powder, a cold plunge, or a fasting app. Instead, it comes from metabolism.

A class of medications called GLP-1 receptor agonists started as diabetes drugs. Over time, clinicians discovered something bigger. These medicines now play a major role in obesity treatment, and they produce effects that reach far beyond the scale. Because obesity shortens lifespan and damages nearly every organ system, it makes sense that drugs that treat obesity could also improve healthspan—the years you live with strength, clarity, and independence.

However, weight loss alone does not explain what researchers are seeing. These drugs reduce inflammation, protect the heart, lower biological stress, and may even delay cognitive decline. Importantly, many of these effects occur independent of weight loss. That fact has forced scientists to ask a serious question: could GLP-1 drugs represent a new class of anti-aging medicine?

Even longevity-focused clinicians, such as Peter Attia, have publicly discussed using GLP-1 drugs at lower doses in select patients—not for weight loss, but for metabolic health and long-term disease prevention.

Why Metabolism Matters for Aging

Aging is not just about time. Instead, it reflects how well your body regulates key systems over decades. Blood sugar control, inflammation, oxidative stress, and cellular repair all shape how fast—or how slowly—you age.

GLP-1 receptor agonists influence all these pathways. Originally designed to mimic a gut hormone that signals fullness, these drugs turned out to do much more. Research shows they lower systemic inflammation, improve mitochondrial function, and reduce oxidative stress. As a result, organs function better for longer.

In simple terms, when metabolism runs smoothly, cells behave younger.

Retatrutide and the Next Generation of GLP-1 Drugs

Newer drugs have taken this concept even further. Retatrutide, a triple-agonist medication, targets three hormonal pathways simultaneously: GLP-1, GIP, and glucagon.

In Phase 3 trials, participants lost nearly 29% of their body weight, or more than 70 pounds on average. Yet weight loss only tells part of the story. Retatrutide also lowered inflammation, improved blood pressure, improved lipid profiles, and reduced joint pain.

Each hormone plays a role. GLP-1 reduces appetite and inflammation. GIP improves insulin sensitivity and nutrient handling. Glucagon increases energy expenditure and fat oxidation. Together, these pathways keep metabolism active, not slowing down during weight loss.

That combination does more than shrink waistlines. It restores metabolic flexibility, which declines with age.

Inflammation: The Engine of Aging

For decades, scientists blamed aging on simple wear and tear. Modern research tells a different story. Chronic, low-grade inflammation—often called inflammaging—drives many diseases of aging.

Heart disease, stroke, arthritis, fatty liver disease, and cognitive decline all share this inflammatory background. In clinical trials, GLP-1 drugs reduced markers such as C-reactive protein, triglycerides, and blood pressure. These changes signal reduced biological aging risk, not just better lab numbers.

When inflammation falls, fewer senescent cells accumulate. Blood vessels stay healthier. Organs function longer.

Heart Disease and Longevity

Nothing ages a person faster than a heart attack. Because of that reality, cardiovascular protection matters deeply for longevity.

Multiple cardiovascular outcome trials show that GLP-1 receptor agonists reduce major adverse cardiovascular events in people with type 2 diabetes and high cardiovascular risk. Across studies, researchers observed a 13% reduction in cardiovascular death and a 9% reduction in nonfatal heart attacks compared with other treatments.¹²

The LEADER trial demonstrated that liraglutide reduced cardiovascular mortality by 22%.⁶ Similar benefits appeared with semaglutide, dulaglutide, and albiglutide.²⁷ Because of this evidence, the FDA approved several GLP-1 drugs for cardiovascular risk reduction in adults with diabetes and established heart disease.⁸

These benefits do not come from glucose control alone. GLP-1 drugs lower blood pressure, reduce inflammation, improve endothelial function, decrease oxidative stress, and reduce RAAS activity.³⁴ At the cellular level, they protect heart muscle cells from multiple forms of cell death while enhancing autophagy and mitophagy.⁵

Although GLP-1 drugs do not strongly reduce heart failure hospitalizations, meta-analyses suggest a modest benefit.³⁷ Most importantly, they safely reduce atherosclerotic risk. Preventing a heart attack remains one of the most powerful anti-aging interventions available.

Dementia: Prevention, Not Cure

Brain health deserves careful discussion. GLP-1 drugs do not reverse dementia. They do not improve cognition once dementia is established. Recent trials in patients with Alzheimer’s disease showed no meaningful cognitive improvement.

That limitation matters.

However, prevention tells a different story. Large observational studies show that GLP-1 receptor agonists are associated with 33–45% lower dementia risk compared with other glucose-lowering drugs in people with type 2 diabetes.¹² A 2025 JAMA Neurology study involving nearly 34,000 patients found a 33% lower risk of Alzheimer’s disease and related dementias among GLP-1 users.¹

Randomized trial evidence shows a more modest, but still significant effect. A 2025 JAMA Neurology meta-analysis found that GLP-1 drugs reduced dementia risk, while SGLT2 inhibitors did not.³ This finding suggests a class-specific effect, rather than a glucose-only explanation.

Mechanistically, GLP-1 drugs reduce neuroinflammation, improve insulin signaling in the brain, promote neurogenesis, and may reduce amyloid-β and tau pathology.⁵⁶ They also improve vascular health, which strongly influences cognitive aging.

Age appears to matter. A 2025 target-trial emulation showed weaker effects in adults over 75, but stronger protection in younger patients.⁷ The takeaway remains clear: earlier prevention works better.

The goal is not to cure dementia. Instead, the goal is to delay its onset long enough that many people never reach it.

Ultra-Processed Food and Brain Aging

Diet still matters. Ultra-processed foods damage the same systems that GLP-1 drugs try to repair.

These foods hijack dopamine reward pathways, increase cravings, and weaken satiety signals. Soft textures and engineered flavors allow rapid overconsumption. High intake links to higher inflammation, worse metabolic health, reduced gray-matter density, and faster brain aging.

Additives and emulsifiers disrupt the gut microbiome and the gut-brain axis. As a result, insulin signaling in the brain worsens. GLP-1 drugs often counteract damage caused by this food environment, but prevention works better than repair.

The Mediterranean Diet and Alcohol

Here is the empowering part. People can act today.

The Mediterranean diet remains the dietary pattern with the strongest evidence for protecting both the heart and the brain. Vegetables, legumes, fruit, whole grains, olive oil, fish, and minimal ultra-processed food form its foundation. This pattern reduces inflammation, improves vascular health, supports the microbiome, and slows cognitive decline.

Think of it this way: GLP-1 drugs quiet the metabolic noise. The Mediterranean diet keeps it quiet.

Alcohol also matters. Earlier beliefs about alcohol and brain protection did not hold up. Even moderate drinking increases dementia risk, worsens sleep, raises inflammation, and damages the hippocampus. If cognitive protection matters, less alcohol helps, and none works best.

What This Means for Healthspan

Aging is not about adding years. Aging is about protecting systems.

GLP-1 drugs support metabolic health. The Mediterranean diet supports biology. Avoiding alcohol protects the brain. Movement and sleep reinforce everything else.

If heart disease, dementia, and disability are delayed long enough, many people will never experience them. That outcome does not represent immortality. Instead, it represents success at healthspan.

References

1. Ussher JR, Drucker DJ. Glucagon-Like Peptide 1 Receptor Agonists: Cardiovascular Benefits and Mechanisms of Action. Nat Rev Cardiol. 2023;20(7):463–474.
2. Nauck MA, et al. Cardiovascular Actions and Clinical Outcomes With GLP-1 Receptor Agonists. Circulation. 2017;136:849–870.
3. Pop-Busui R, et al. Heart Failure: An Underappreciated Complication of Diabetes. Diabetes Care. 2022;45:1670–1690.
4. Wu Q, et al. Glucose-Independent Cardiovascular...]]>GLP-1 Drugs, the Mediterranean Diet, and the Science of Living Longer

   For years, anti-aging has been hijacked by supplements, hacks, and promises that never hold up. Meanwhile, real science has quietly moved forward. Today, the most compelling anti-aging story does not come from a powder, a cold plunge, or a fasting app. Instead, it comes from metabolism.

   A class of medications called GLP-1 receptor agonists started as diabetes drugs. Over time, clinicians discovered something bigger. These medicines now play a major role in obesity treatment, and they produce effects that reach far beyond the scale. Because obesity shortens lifespan and damages nearly every organ system, it makes sense that drugs that treat obesity could also improve healthspan—the years you live with strength, clarity, and independence.

   However, weight loss alone does not explain what researchers are seeing. These drugs reduce inflammation, protect the heart, lower biological stress, and may even delay cognitive decline. Importantly, many of these effects occur independent of weight loss. That fact has forced scientists to ask a serious question: could GLP-1 drugs represent a new class of anti-aging medicine?

   Even longevity-focused clinicians, such as Peter Attia, have publicly discussed using GLP-1 drugs at lower doses in select patients—not for weight loss, but for metabolic health and long-term disease prevention.

   
   

   Why Metabolism Matters for Aging

   Aging is not just about time. Instead, it reflects how well your body regulates key systems over decades. Blood sugar control, inflammation, oxidative stress, and cellular repair all shape how fast—or how slowly—you age.

   GLP-1 receptor agonists influence all these pathways. Originally designed to mimic a gut hormone that signals fullness, these drugs turned out to do much more. Research shows they lower systemic inflammation, improve mitochondrial function, and reduce oxidative stress. As a result, organs function better for longer.

   In simple terms, when metabolism runs smoothly, cells behave younger.

   
   

   Retatrutide and the Next Generation of GLP-1 Drugs

   Newer drugs have taken this concept even further. Retatrutide, a triple-agonist medication, targets three hormonal pathways simultaneously: GLP-1, GIP, and glucagon.

   In Phase 3 trials, participants lost nearly 29% of their body weight, or more than 70 pounds on average. Yet weight loss only tells part of the story. Retatrutide also lowered inflammation, improved blood pressure, improved lipid profiles, and reduced joint pain.

   Each hormone plays a role. GLP-1 reduces appetite and inflammation. GIP improves insulin sensitivity and nutrient handling. Glucagon increases energy expenditure and fat oxidation. Together, these pathways keep metabolism active, not slowing down during weight loss.

   That combination does more than shrink waistlines. It restores metabolic flexibility, which declines with age.

   
   

   Inflammation: The Engine of Aging

   For decades, scientists blamed aging on simple wear and tear. Modern research tells a different story. Chronic, low-grade inflammation—often called inflammaging—drives many diseases of aging.

   Heart disease, stroke, arthritis, fatty liver disease, and cognitive decline all share this inflammatory background. In clinical trials, GLP-1 drugs reduced markers such as C-reactive protein, triglycerides, and blood pressure. These changes signal reduced biological aging risk, not just better lab numbers.

   When inflammation falls, fewer senescent cells accumulate. Blood vessels stay healthier. Organs function longer.

   
   

   Heart Disease and Longevity

   Nothing ages a person faster than a heart attack. Because of that reality, cardiovascular protection matters deeply for longevity.

   Multiple cardiovascular outcome trials show that GLP-1 receptor agonists reduce major adverse cardiovascular events in people with type 2 diabetes and high cardiovascular risk. Across studies, researchers observed a 13% reduction in cardiovascular death and a 9% reduction in nonfatal heart attacks compared with other treatments.¹²

   The LEADER trial demonstrated that liraglutide reduced cardiovascular mortality by 22%.⁶ Similar benefits appeared with semaglutide, dulaglutide, and albiglutide.²⁷ Because of this evidence, the FDA approved several GLP-1 drugs for cardiovascular risk reduction in adults with diabetes and established heart disease.⁸

   These benefits do not come from glucose control alone. GLP-1 drugs lower blood pressure, reduce inflammation, improve endothelial function, decrease oxidative stress, and reduce RAAS activity.³⁴ At the cellular level, they protect heart muscle cells from multiple forms of cell death while enhancing autophagy and mitophagy.⁵

   Although GLP-1 drugs do not strongly reduce heart failure hospitalizations, meta-analyses suggest a modest benefit.³⁷ Most importantly, they safely reduce atherosclerotic risk. Preventing a heart attack remains one of the most powerful anti-aging interventions available.

   
   

   Dementia: Prevention, Not Cure

   Brain health deserves careful discussion. GLP-1 drugs do not reverse dementia. They do not improve cognition once dementia is established. Recent trials in patients with Alzheimer’s disease showed no meaningful cognitive improvement.

   That limitation matters.

   However, prevention tells a different story. Large observational studies show that GLP-1 receptor agonists are associated with 33–45% lower dementia risk compared with other glucose-lowering drugs in people with type 2 diabetes.¹² A 2025 JAMA Neurology study involving nearly 34,000 patients found a 33% lower risk of Alzheimer’s disease and related dementias among GLP-1 users.¹

   Randomized trial evidence shows a more modest, but still significant effect. A 2025 JAMA Neurology meta-analysis found that GLP-1 drugs reduced dementia risk, while SGLT2 inhibitors did not.³ This finding suggests a class-specific effect, rather than a glucose-only explanation.

   Mechanistically, GLP-1 drugs reduce neuroinflammation, improve insulin signaling in the brain, promote neurogenesis, and may reduce amyloid-β and tau pathology.⁵⁶ They also improve vascular health, which strongly influences cognitive aging.

   Age appears to matter. A 2025 target-trial emulation showed weaker effects in adults over 75, but stronger protection in younger patients.⁷ The takeaway remains clear: earlier prevention works better.

   The goal is not to cure dementia. Instead, the goal is to delay its onset long enough that many people never reach it.

   
   

   Ultra-Processed Food and Brain Aging

   Diet still matters. Ultra-processed foods damage the same systems that GLP-1 drugs try to repair.

   These foods hijack dopamine reward pathways, increase cravings, and weaken satiety signals. Soft textures and engineered flavors allow rapid overconsumption. High intake links to higher inflammation, worse metabolic health, reduced gray-matter density, and faster brain aging.

   Additives and emulsifiers disrupt the gut microbiome and the gut-brain axis. As a result, insulin signaling in the brain worsens. GLP-1 drugs often counteract damage caused by this food environment, but prevention works better than repair.

   
   

   The Mediterranean Diet and Alcohol

   Here is the empowering part. People can act today.

   The Mediterranean diet remains the dietary pattern with the strongest evidence for protecting both the heart and the brain. Vegetables, legumes, fruit, whole grains, olive oil, fish, and minimal ultra-processed food form its foundation. This pattern reduces inflammation, improves vascular health, supports the microbiome, and slows cognitive decline.

   Think of it this way: GLP-1 drugs quiet the metabolic noise. The Mediterranean diet keeps it quiet.

   Alcohol also matters. Earlier beliefs about alcohol and brain protection did not hold up. Even moderate drinking increases dementia risk, worsens sleep, raises inflammation, and damages the hippocampus. If cognitive protection matters, less alcohol helps, and none works best.

   
   

   What This Means for Healthspan

   Aging is not about adding years. Aging is about protecting systems.

   GLP-1 drugs support metabolic health. The Mediterranean diet supports biology. Avoiding alcohol protects the brain. Movement and sleep reinforce everything else.

   If heart disease, dementia, and disability are delayed long enough, many people will never experience them. That outcome does not represent immortality. Instead, it represents success at healthspan.

   
   

   References

   1. Ussher JR, Drucker DJ. Glucagon-Like Peptide 1 Receptor Agonists: Cardiovascular Benefits and Mechanisms of Action. Nat Rev Cardiol. 2023;20(7):463–474.
   2. Nauck MA, et al. Cardiovascular Actions and Clinical Outcomes With GLP-1 Receptor Agonists. Circulation. 2017;136:849–870.
   3. Pop-Busui R, et al. Heart Failure: An Underappreciated Complication of Diabetes. Diabetes Care. 2022;45:1670–1690.
   4. Wu Q, et al. Glucose-Independent Cardiovascular Mechanisms of GLP-1 RAs. Biomed Pharmacother. 2022;153:113517.
   5. Boshchenko AA, et al. Cardioprotective Signaling of GLP-1 Receptor Agonists. Int J Mol Sci. 2024;25:4900.
   6. Marso SP, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;375:311–322.
   7. Honka H, et al. Therapeutic Manipulation of Myocardial Metabolism. J Am Coll Cardiol. 2021;77:2022–2039.
   8. FDA Orange Book.
   9. Tang H, et al. GLP-1RA Medications and Dementia Risk. JAMA Neurol. 2025;82:439–449.
   10. Seminer A, et al. Cardioprotective Glucose-Lowering Agents and Dementia Risk. JAMA Neurol. 2025;82:450–460.
   11. Au HCT, et al. GLP-1 and Neurodegenerative Pathology. Neurosci Biobehav Rev. 2025;173:106159.
   12. Inoue K, et al. GLP-1 RAs and Dementia Incidence in Older Adults. Ann Intern Med. 2025.
   
   ]]>d2dbcbfe-bab6-4937-9a2d-90783e3a55edThu, 18 Dec 2025 00:00:00 -070011:37falsefull107107Alcohol Cuts HealthspanThe Holiday Party That Turned Deadly

   It started at a holiday party.

   Laughter, champagne, a toast — then a collapse.

   A fifty-two-year-old, active and healthy, suddenly lost consciousness.

   Paramedics did CPR and shocked her heart twice.

   She survived — barely.

   Doctors called it Holiday Heart Syndrome: an alcohol-triggered arrhythmia that can kill.​

   
   

   What Is Holiday Heart?

   Holiday Heart arises after binge or even moderate drinking, especially around celebrations. Alcohol irritates heart cells, disrupts electrolytes, and scrambles electrical signals, which can trigger atrial fibrillation — an erratic rhythm that raises the risk of clots, stroke, and sudden death. Even a single heavy night can set it off, and repeated use amplifies inflammation and structural damage long after the hangover fades.​

   
   

   Alcohol and Your Heart

   For years, the “French paradox” suggested red wine protects the heart, but newer evidence points instead to lifestyle patterns rather than wine itself. Ethanol and its metabolite acetaldehyde directly injure heart muscle, disturb calcium handling, damage mitochondria, and can lead to Alcoholic Cardiomyopathy — an enlarged, weakened heart. Harm shows up even in relatively low intake, and improvement typically requires reducing or stopping alcohol.​

   
   

   Alcohol and Cancer

   Alcohol is a proven carcinogen that promotes DNA damage, inflammation, oxidative stress, and hormonal shifts that favor tumor growth. At least seven cancers — including those of the mouth, throat, larynx, esophagus, liver, colon, and breast — are directly linked to alcohol, with risk beginning above zero and rising with each additional drink. Even up to one drink a day meaningfully increases breast cancer risk, and the combined use of alcohol and tobacco multiplies risk even further.​

   
   

   Blue Zones, Not Blue Wine

   You’ve probably heard this one:

   People in Sardinia or Ikaria drink wine every night and live to 100.

   What’s missing is the math.

   They sip 3 to 4 ounces — not a glass, not a typical American glass, but a tasting. The flight of wine.

   Their rustic wines are 10–11 percent alcohol, not the 16 percent bombs from Sonoma.

   And they don’t live long because of the wine.

   They live long because of everything else:

   walking hills, eating beans, taking naps, sleeping well, and belonging to a community.

   Their wine is cultural, not clinical.

   If you want their healthspan, copy their diet, movement, and purpose — not the nightly pour.

   
   

   Weight, Metabolism, and Aging

   Alcohol hijacks metabolism by forcing the liver to prioritize ethanol breakdown, pushing fat and sugar processing aside. Drinks can add substantial hidden calories, promote fatty liver, and stall fat loss, even when the rest of a diet looks reasonable.​

   Why “Detox” Fixes Fail

   Popular “alcohol detox” supplements promise faster clearance or hangover prevention, but research points to ethanol itself and the inflammatory response as the main drivers of symptoms. Blocking acetaldehyde alone does not prevent mitochondrial damage, immune activation, or the residual effects that follow a night of heavy drinking.​

   
   

   The Longevity Hypocrisy

   Modern wellness culture often warns about “toxins” while normalizing regular drinking, even framing certain spirits or wines as health tools. Yet, when viewed through a longevity lens, alcohol stands out as one of the most potent, fully optional biological stressors in the modern lifestyle.​

   
   

   When You Stop

   Once drinking stops or drops sharply, the body begins to repair: blood pressure often falls within days, heart rhythm and sleep tend to improve within weeks, and liver fat can regress over subsequent months. Over years, cancer and cardiovascular risks decline, with former light-to-moderate drinkers gradually approaching the risk profile of people who never drank or who stopped earlier in life.​

   
   

   Bottom Line

   Alcohol is deeply woven into culture and celebration, but it is neither a health food nor a longevity strategy. For anyone serious about healthspan, cutting alcohol is one of the simplest, highest-impact levers available — a change your heart, DNA, and future self are strongly likely to benefit from.​

   
   

   References

   1. Berger D, De Aquino J P, Charness M E, et al. Common Alcohol-Related Concerns. NIAAA (2025).
   2. Rock C L, Thomson C, Gansler T, et al. American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention. CA Cancer J Clin. 2020; 70(4): 245-271. doi:10.3322/caac.21591.
   3. Jun S, Park H, Kim UJ, Choi EJ, Lee HA, Park B, Lee SY, Jee SH, Park H. Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis. Epidemiol Health. 2023;45:e2023092. doi: 10.4178/epih.e2023092. Epub 2023 Oct 16. PMID: 37905315; PMCID: PMC10867516.
   4. Rumgay H, Murphy N, Ferrari P, Soerjomataram I. Alcohol and Cancer: Epidemiology and Biological Mechanisms. Nutrients. 2021; 13(9): 3173. doi:10.3390/nu13093173.
   5. Gapstur S M, Mariosa D, Neamtiu L, et al. The IARC Perspective on the Effects of Policies on Reducing Alcohol Consumption. N Engl J Med. 2025; 392(17): 1752-1759. doi:10.1056/NEJMsr2413289.
   6. Rumgay H, Shield K, Charvat H, et al. Global Burden of Cancer in 2020 Attributable to Alcohol Consumption. Lancet Oncol. 2021; 22(8): 1071-1080. doi:10.1016/S1470-2045(21)00279-5.
   7. Yoo J E, Han K, Shin D W, et al. Association Between Changes in Alcohol Consumption and Cancer Risk. JAMA Netw Open. 2022; 5(8): e2228544. doi:10.1001/jamanetworkopen.2022.28544.
   8. Fernández-Solà J. The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy. Nutrients. 2020; 12(2): 572. doi:10.3390/nu12020572.
   9. Domínguez F, Adler E, García-Pavía P. Alcoholic Cardiomyopathy: An Update. Eur Heart J. 2024; 45(26): 2294-2305. doi:10.1093/eurheartj/ehae362.
   10. Mackus M, van de Loo A J A E, Garssen J, et al. The Role of Alcohol Metabolism in the Pathology of Alcohol Hangover. J Clin Med. 2020; 9(11): 3421. doi:10.3390/jcm9113421.
   11. van de Loo A J A E, Mackus M, Kwon O, et al. The Inflammatory Response to Alcohol Consumption and Its Role in the Pathology of Alcohol Hangover. J Clin Med. 2020; 9(7): 2081. doi:10.3390/jcm9072081.
   12. Karadayian A G, Carrere L, Czerniczyniec A, Lores-Arnaiz S. Molecular Mechanism Underlying Alcohol’s Residual Effects: Acetaldehyde and Mitochondrial Dysfunction. Alcohol (Fayetteville N.Y.). 2025; doi:10.1016/j.alcohol.2025.09.004.
   13. Turner B R H, Jenkinson P I, Huttman M, Mullish B H. Inflammation, Oxidative Stress, and Gut Microbiome Perturbation in Hangover. Alcohol Clin Exp Res. 2024; 48(8): 1451-1465. doi:10.1111/acer.15396.
   14. Palmer E, Tyacke R, Sastre M, et al. Alcohol Hangover: Biochemical, Inflammatory, and Neurochemical Mechanisms. Alcohol Alcohol. 2019; 54(3): 196-203. doi:10.1093/alcalc/agz016.
   
   ]]>The Holiday Party That Turned Deadly

   It started at a holiday party.

   Laughter, champagne, a toast — then a collapse.

   A fifty-two-year-old, active and healthy, suddenly lost consciousness.

   Paramedics did CPR and shocked her heart twice.

   She survived — barely.

   Doctors called it Holiday Heart Syndrome: an alcohol-triggered arrhythmia that can kill.​

   
   

   What Is Holiday Heart?

   Holiday Heart arises after binge or even moderate drinking, especially around celebrations. Alcohol irritates heart cells, disrupts electrolytes, and scrambles electrical signals, which can trigger atrial fibrillation — an erratic rhythm that raises the risk of clots, stroke, and sudden death. Even a single heavy night can set it off, and repeated use amplifies inflammation and structural damage long after the hangover fades.​

   
   

   Alcohol and Your Heart

   For years, the “French paradox” suggested red wine protects the heart, but newer evidence points instead to lifestyle patterns rather than wine itself. Ethanol and its metabolite acetaldehyde directly injure heart muscle, disturb calcium handling, damage mitochondria, and can lead to Alcoholic Cardiomyopathy — an enlarged, weakened heart. Harm shows up even in relatively low intake, and improvement typically requires reducing or stopping alcohol.​

   
   

   Alcohol and Cancer

   Alcohol is a proven carcinogen that promotes DNA damage, inflammation, oxidative stress, and hormonal shifts that favor tumor growth. At least seven cancers — including those of the mouth, throat, larynx, esophagus, liver, colon, and breast — are directly linked to alcohol, with risk beginning above zero and rising with each additional drink. Even up to one drink a day meaningfully increases breast cancer risk, and the combined use of alcohol and tobacco multiplies risk even further.​

   
   

   Blue Zones, Not Blue Wine

   You’ve probably heard this one:

   People in Sardinia or Ikaria drink wine every night and live to 100.

   What’s missing is the math.

   They sip 3 to 4 ounces — not a glass, not a typical American glass, but a tasting. The flight of wine.

   Their rustic wines are 10–11 percent alcohol, not the 16 percent bombs from Sonoma.

   And they don’t live long because of the wine.

   They live long because of everything else:

   walking hills, eating beans, taking naps, sleeping well, and belonging to a community.

   Their wine is cultural, not clinical.

   If you want their healthspan, copy their diet, movement, and purpose — not the nightly pour.

   
   

   Weight, Metabolism, and Aging

   Alcohol hijacks metabolism by forcing the liver to prioritize ethanol breakdown, pushing fat and sugar processing aside. Drinks can add substantial hidden calories, promote fatty liver, and stall fat loss, even when the rest of a diet looks reasonable.​

   Why “Detox” Fixes Fail

   Popular “alcohol detox” supplements promise faster clearance or hangover prevention, but research points to ethanol itself and the inflammatory response as the main drivers of symptoms. Blocking acetaldehyde alone does not prevent mitochondrial damage, immune activation, or the residual effects that follow a night of heavy drinking.​

   
   

   The Longevity Hypocrisy

   Modern wellness culture often warns about “toxins” while normalizing regular drinking, even framing certain spirits or wines as health tools. Yet, when viewed through a longevity lens, alcohol stands out as one of the most potent, fully optional biological stressors in the modern lifestyle.​

   
   

   When You Stop

   Once drinking stops or drops sharply, the body begins to repair: blood pressure often falls within days, heart rhythm and sleep tend to improve within weeks, and liver fat can regress over subsequent months. Over years, cancer and cardiovascular risks decline, with former light-to-moderate drinkers gradually approaching the risk profile of people who never drank or who stopped earlier in life.​

   
   

   Bottom Line

   Alcohol is deeply woven into culture and celebration, but it is neither a health food nor a longevity strategy. For anyone serious about healthspan, cutting alcohol is one of the simplest, highest-impact levers available — a change your heart, DNA, and future self are strongly likely to benefit from.​

   
   

   References

   1. Berger D, De Aquino J P, Charness M E, et al. Common Alcohol-Related Concerns. NIAAA (2025).
   2. Rock C L, Thomson C, Gansler T, et al. American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention. CA Cancer J Clin. 2020; 70(4): 245-271. doi:10.3322/caac.21591.
   3. Jun S, Park H, Kim UJ, Choi EJ, Lee HA, Park B, Lee SY, Jee SH, Park H. Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis. Epidemiol Health. 2023;45:e2023092. doi: 10.4178/epih.e2023092. Epub 2023 Oct 16. PMID: 37905315; PMCID: PMC10867516.
   4. Rumgay H, Murphy N, Ferrari P, Soerjomataram I. Alcohol and Cancer: Epidemiology and Biological Mechanisms. Nutrients. 2021; 13(9): 3173. doi:10.3390/nu13093173.
   5. Gapstur S M, Mariosa D, Neamtiu L, et al. The IARC Perspective on the Effects of Policies on Reducing Alcohol Consumption. N Engl J Med. 2025; 392(17): 1752-1759. doi:10.1056/NEJMsr2413289.
   6. Rumgay H, Shield K, Charvat H, et al. Global Burden of Cancer in 2020 Attributable to Alcohol Consumption. Lancet Oncol. 2021; 22(8): 1071-1080. doi:10.1016/S1470-2045(21)00279-5.
   7. Yoo J E, Han K, Shin D W, et al. Association Between Changes in Alcohol Consumption and Cancer Risk. JAMA Netw Open. 2022; 5(8): e2228544. doi:10.1001/jamanetworkopen.2022.28544.
   8. Fernández-Solà J. The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy. Nutrients. 2020; 12(2): 572. doi:10.3390/nu12020572.
   9. Domínguez F, Adler E, García-Pavía P. Alcoholic Cardiomyopathy: An Update. Eur Heart J. 2024; 45(26): 2294-2305. doi:10.1093/eurheartj/ehae362.
   10. Mackus M, van de Loo A J A E, Garssen J, et al. The Role of Alcohol Metabolism in the Pathology of Alcohol Hangover. J Clin Med. 2020; 9(11): 3421. doi:10.3390/jcm9113421.
   11. van de Loo A J A E, Mackus M, Kwon O, et al. The Inflammatory Response to Alcohol Consumption and Its Role in the Pathology of Alcohol Hangover. J Clin Med. 2020; 9(7): 2081. doi:10.3390/jcm9072081.
   12. Karadayian A G, Carrere L, Czerniczyniec A, Lores-Arnaiz S. Molecular Mechanism Underlying Alcohol’s Residual Effects: Acetaldehyde and Mitochondrial Dysfunction. Alcohol (Fayetteville N.Y.). 2025; doi:10.1016/j.alcohol.2025.09.004.
   13. Turner B R H, Jenkinson P I, Huttman M, Mullish B H. Inflammation, Oxidative Stress, and Gut Microbiome Perturbation in Hangover. Alcohol Clin Exp Res. 2024; 48(8): 1451-1465. doi:10.1111/acer.15396.
   14. Palmer E, Tyacke R, Sastre M, et al. Alcohol Hangover: Biochemical, Inflammatory, and Neurochemical Mechanisms. Alcohol Alcohol. 2019; 54(3): 196-203. doi:10.1093/alcalc/agz016.
   
   ]]>0c77fab7-d155-4a1a-ade2-8cef4b704aedThu, 11 Dec 2025 00:00:00 -070012:00falsefull106106Muscle, Mitochondria, and HealthspanMuscle is Medicine: Why Lifting Weights is Your Best Longevity Investment

   Clearly, your body changes as you age. I learned this lesson years ago when my son was three years old. We started him skiing, and he loved every minute of it. When he fell, he tumbled onto his behind, jumped right back up, and skied down the hill like nothing had happened. He was pure rubber and resilience.

   However, I was 53 years his senior that year. I did an inadvertent 360-degree twirl on the slopes myself. His mother saw me and immediately asked if I had broken my wrist, wondering when I could return to surgery. The difference between a flexible young body and an older body is critical. Consequently, I retired from skiing that season and now enjoy the lodge, where I write and make them great dinners.

   Indeed, your older body desperately needs work to stay flexible, strong, and balanced as time goes on. I have seen too many independent seniors lose everything after a simple fall in their own home. They go from living on their own to spending their last days in a care center, sometimes never leaving bed. This outcome is not healthspan. Instead, you want a fall to be like my son’s—just on your butt and back up. Sadly, too many fall and cannot get up. This isn't a commercial for a safety pendant, but a sincere plea for you to start working your muscles.

   
   

   Section 1: The Enemy is Muscle Loss (Sarcopenia)

   Specifically, we talk frequently about heart health and clear arteries in longevity. Those things are unquestionably crucial. Nevertheless, the biggest threat to functional independence as we age is a condition called sarcopenia. This is the medical term for age-related muscle loss.

   Unfortunately, we start losing about 3 to 8 percent of our muscle mass every decade after age 30. That loss accelerates quickly once you hit 70. This problem is not just about looking less toned; fundamentally, it is about losing the ability to stand up from a chair, carry groceries, or, most importantly, catch yourself when you trip. The falls that result are often catastrophic.

   
   

   Section 2: Big Things Help Small Things—The Cellular Connection

   Amazingly, resistance training is effective at the microscopic level, too. We have talked extensively about the tiny, complex mechanisms of the cell, but here is the key takeaway: small things benefit from big things.

   In fact, increasing muscle mass through training has direct, positive effects on two major microscopic drivers of aging: mitochondrial function and telomere health.

   To elaborate, when you challenge your muscles, you signal your cells to create more energy. This signal forces your mitochondria—the cellular powerhouses—to become both more numerous and more efficient. Better mitochondrial function equals more energy and less cellular stress.

   Moreover, studies show that resistance training actually increases the activity of the enzyme telomerase in some cells. Telomerase helps maintain the protective caps on your DNA called telomeres.

   Therefore, you don’t need to buy fancy, expensive supplements like NAD or telomere boosters. Picking up a dumbbell costs less money but yields more results. You gain muscular strength, better metabolism, stronger bones, and the cellular benefits all at once.

   
   

   Section 3: Muscle is Your Metabolic Powerhouse

   Let's consider how muscle mass influences your diet. Your muscle is actually your body’s largest organ for glucose disposal. Think of it like this: when you eat, your body releases glucose (sugar) into your bloodstream. Insulin then works to escort that glucose out of your blood and into your cells for energy. The vast majority of that glucose gets parked in your muscle cells.

   Clearly, if you have more muscle mass, you automatically have a bigger parking lot for that glucose.

   Consequently, more muscle means your body gains better insulin sensitivity. It becomes more efficient at regulating blood sugar. This effect is the absolute bedrock of preventing and managing Type 2 diabetes. Ultimately, resistance training is a powerful pharmaceutical intervention for your metabolic health.

   
   

   Section 4: Building an Iron Skeleton

   However, the benefits don't stop at the muscles. Let's talk about bone density, which is crucial for everyone, especially women. We know calcium and Vitamin D are important, yet they are only one part of the solution.

   Remember that bone is living tissue; it responds to stress. When you lift a weight—even if it is just your own body weight in a squat—the mechanical force signals to your bones that they must get stronger. This process is known as the Mechanostat principle. Conversely, without that heavy, high-intensity mechanical load, bone density naturally declines, leading to osteoporosis.

   In conclusion, if you only do low-impact cardio, you are helping your heart, but you are not sending the signal needed to maintain or increase bone mineral density. Specifically, you must load your bones to strengthen them.

   
   

   Section 5: The Importance of Balance and Quality Coaching

   Beyond pure strength, true independence depends on mobility and balance. This is where functional training, including Yoga, plays a huge role. My favorite Yoga classes are a combination of bodyweight resistance and cardiovascular movement. I look for the physics—the movement, the resistance, and the balance—and keep the "woo" out of it. Furthermore, a Yoga mat costs far less than some supplements, but it will make a fall much easier to recover from.

   Therefore, if you are getting started, please get professional help! Having a great gym coach to help with proper form is paramount—shout out to my friends Jeremy the Hulk and the Zeigler Monster! Additionally, it is equally important to enlist a private Yoga instructor to ensure you are not malaligned and that you know what to look for. A special shout-out to my yogi Xuan—and yes, I will be doing more classes this year!

   
   

   Section 6: The Ultimate Goal: Getting Back Up

   Ultimately, the reason we train is not just to be strong; rather, it is so that if you fall when you are 65, 75, or 80, you possess the strength, stability, and awareness to get up by yourself. This ability is the true mark of functional longevity.

   Let me give you two examples of why this ability matters so much. A fellow was admitted to a facility after he broke his hip. Before he fell, he lived alone, was a champion bowler, and enjoyed his life. He simply slipped on a rug, fell, and was found a day later. After his hip was fixed, he spent the next year of his life mostly in bed, eventually dying of COVID-19 in a long-term care facility. One single fall that he couldn't get up from changed his life and his outlook completely.

   Contrast that with my own dad. He took a fall at age 96 trying to trim a tree. It took a bit of effort, and he received a stern warning from his son and the EMTs, but he got up. He lived independently until age 98.

   Consequently, this kind of preparation matters because the statistics are sobering: falls are the leading cause of injury death for people over 65. Tragically, studies show that up to 30% of seniors who fracture a hip lose their independence entirely.

   
   

   Conclusion and Call to Action

   Finally, resistance training, combined with functional movement, is the macroscopic lever that pulls all those microscopic switches. It is the closest thing to a fountain of youth that doesn’t require a prescription. It just requires effort.

   Remember that you must continually increase the demand on your body—this is called progressive overload. Most importantly, remember that resistance training is the stimulus, but protein is the building material. Aim for a high protein intake daily, and definitely enjoy that protein smoothie right after your workout!

   On that note, we’re even taking this training on the road this year with our Mediterranean Cruise, where we’ll have an instructor to help you with simple movements—things so that if you fall, you can get up by yourself.

   
   

   References

   • Dao T, Green AE, Kim YA, Bae SJ, Ha KT, Gariani K, Lee MR, Menzies KJ, Ryu D. Sarcopenia and Muscle Aging: A Brief Overview. Endocrinol Metab (Seoul). 2020 Dec;35(4):716-732. doi: 10.3803/EnM.2020.405. Epub 2020 Dec 23. PMID: 33397034; PMCID: PMC7803599.
   • Sun L, Zhang T, Luo L, Yang Y, Wang C, Luo J. Exercise delays aging: evidence from telomeres and telomerase -a systematic review and meta-analysis of randomized controlled trials. Front Physiol. 2025 Jun 26;16:1627292. doi: 10.3389/fphys.2025.1627292. PMID: 40642293; PMCID: PMC12241061.
   • Massini DA, Nedog FH, de Oliveira TP, Almeida TAF, Santana CAA, Neiva CM, Macedo AG, Castro EA, Espada MC, Santos FJ, Pessôa Filho DM.]]>Muscle is Medicine: Why Lifting Weights is Your Best Longevity Investment

     Clearly, your body changes as you age. I learned this lesson years ago when my son was three years old. We started him skiing, and he loved every minute of it. When he fell, he tumbled onto his behind, jumped right back up, and skied down the hill like nothing had happened. He was pure rubber and resilience.

     However, I was 53 years his senior that year. I did an inadvertent 360-degree twirl on the slopes myself. His mother saw me and immediately asked if I had broken my wrist, wondering when I could return to surgery. The difference between a flexible young body and an older body is critical. Consequently, I retired from skiing that season and now enjoy the lodge, where I write and make them great dinners.

     Indeed, your older body desperately needs work to stay flexible, strong, and balanced as time goes on. I have seen too many independent seniors lose everything after a simple fall in their own home. They go from living on their own to spending their last days in a care center, sometimes never leaving bed. This outcome is not healthspan. Instead, you want a fall to be like my son’s—just on your butt and back up. Sadly, too many fall and cannot get up. This isn't a commercial for a safety pendant, but a sincere plea for you to start working your muscles.

     
     

     Section 1: The Enemy is Muscle Loss (Sarcopenia)

     Specifically, we talk frequently about heart health and clear arteries in longevity. Those things are unquestionably crucial. Nevertheless, the biggest threat to functional independence as we age is a condition called sarcopenia. This is the medical term for age-related muscle loss.

     Unfortunately, we start losing about 3 to 8 percent of our muscle mass every decade after age 30. That loss accelerates quickly once you hit 70. This problem is not just about looking less toned; fundamentally, it is about losing the ability to stand up from a chair, carry groceries, or, most importantly, catch yourself when you trip. The falls that result are often catastrophic.

     
     

     Section 2: Big Things Help Small Things—The Cellular Connection

     Amazingly, resistance training is effective at the microscopic level, too. We have talked extensively about the tiny, complex mechanisms of the cell, but here is the key takeaway: small things benefit from big things.

     In fact, increasing muscle mass through training has direct, positive effects on two major microscopic drivers of aging: mitochondrial function and telomere health.

     To elaborate, when you challenge your muscles, you signal your cells to create more energy. This signal forces your mitochondria—the cellular powerhouses—to become both more numerous and more efficient. Better mitochondrial function equals more energy and less cellular stress.

     Moreover, studies show that resistance training actually increases the activity of the enzyme telomerase in some cells. Telomerase helps maintain the protective caps on your DNA called telomeres.

     Therefore, you don’t need to buy fancy, expensive supplements like NAD or telomere boosters. Picking up a dumbbell costs less money but yields more results. You gain muscular strength, better metabolism, stronger bones, and the cellular benefits all at once.

     
     

     Section 3: Muscle is Your Metabolic Powerhouse

     Let's consider how muscle mass influences your diet. Your muscle is actually your body’s largest organ for glucose disposal. Think of it like this: when you eat, your body releases glucose (sugar) into your bloodstream. Insulin then works to escort that glucose out of your blood and into your cells for energy. The vast majority of that glucose gets parked in your muscle cells.

     Clearly, if you have more muscle mass, you automatically have a bigger parking lot for that glucose.

     Consequently, more muscle means your body gains better insulin sensitivity. It becomes more efficient at regulating blood sugar. This effect is the absolute bedrock of preventing and managing Type 2 diabetes. Ultimately, resistance training is a powerful pharmaceutical intervention for your metabolic health.

     
     

     Section 4: Building an Iron Skeleton

     However, the benefits don't stop at the muscles. Let's talk about bone density, which is crucial for everyone, especially women. We know calcium and Vitamin D are important, yet they are only one part of the solution.

     Remember that bone is living tissue; it responds to stress. When you lift a weight—even if it is just your own body weight in a squat—the mechanical force signals to your bones that they must get stronger. This process is known as the Mechanostat principle. Conversely, without that heavy, high-intensity mechanical load, bone density naturally declines, leading to osteoporosis.

     In conclusion, if you only do low-impact cardio, you are helping your heart, but you are not sending the signal needed to maintain or increase bone mineral density. Specifically, you must load your bones to strengthen them.

     
     

     Section 5: The Importance of Balance and Quality Coaching

     Beyond pure strength, true independence depends on mobility and balance. This is where functional training, including Yoga, plays a huge role. My favorite Yoga classes are a combination of bodyweight resistance and cardiovascular movement. I look for the physics—the movement, the resistance, and the balance—and keep the "woo" out of it. Furthermore, a Yoga mat costs far less than some supplements, but it will make a fall much easier to recover from.

     Therefore, if you are getting started, please get professional help! Having a great gym coach to help with proper form is paramount—shout out to my friends Jeremy the Hulk and the Zeigler Monster! Additionally, it is equally important to enlist a private Yoga instructor to ensure you are not malaligned and that you know what to look for. A special shout-out to my yogi Xuan—and yes, I will be doing more classes this year!

     
     

     Section 6: The Ultimate Goal: Getting Back Up

     Ultimately, the reason we train is not just to be strong; rather, it is so that if you fall when you are 65, 75, or 80, you possess the strength, stability, and awareness to get up by yourself. This ability is the true mark of functional longevity.

     Let me give you two examples of why this ability matters so much. A fellow was admitted to a facility after he broke his hip. Before he fell, he lived alone, was a champion bowler, and enjoyed his life. He simply slipped on a rug, fell, and was found a day later. After his hip was fixed, he spent the next year of his life mostly in bed, eventually dying of COVID-19 in a long-term care facility. One single fall that he couldn't get up from changed his life and his outlook completely.

     Contrast that with my own dad. He took a fall at age 96 trying to trim a tree. It took a bit of effort, and he received a stern warning from his son and the EMTs, but he got up. He lived independently until age 98.

     Consequently, this kind of preparation matters because the statistics are sobering: falls are the leading cause of injury death for people over 65. Tragically, studies show that up to 30% of seniors who fracture a hip lose their independence entirely.

     
     

     Conclusion and Call to Action

     Finally, resistance training, combined with functional movement, is the macroscopic lever that pulls all those microscopic switches. It is the closest thing to a fountain of youth that doesn’t require a prescription. It just requires effort.

     Remember that you must continually increase the demand on your body—this is called progressive overload. Most importantly, remember that resistance training is the stimulus, but protein is the building material. Aim for a high protein intake daily, and definitely enjoy that protein smoothie right after your workout!

     On that note, we’re even taking this training on the road this year with our Mediterranean Cruise, where we’ll have an instructor to help you with simple movements—things so that if you fall, you can get up by yourself.

     
     

     References

     • Dao T, Green AE, Kim YA, Bae SJ, Ha KT, Gariani K, Lee MR, Menzies KJ, Ryu D. Sarcopenia and Muscle Aging: A Brief Overview. Endocrinol Metab (Seoul). 2020 Dec;35(4):716-732. doi: 10.3803/EnM.2020.405. Epub 2020 Dec 23. PMID: 33397034; PMCID: PMC7803599.
     • Sun L, Zhang T, Luo L, Yang Y, Wang C, Luo J. Exercise delays aging: evidence from telomeres and telomerase -a systematic review and meta-analysis of randomized controlled trials. Front Physiol. 2025 Jun 26;16:1627292. doi: 10.3389/fphys.2025.1627292. PMID: 40642293; PMCID: PMC12241061.
     • Massini DA, Nedog FH, de Oliveira TP, Almeida TAF, Santana CAA, Neiva CM, Macedo AG, Castro EA, Espada MC, Santos FJ, Pessôa Filho DM. The Effect of Resistance Training on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2022 Jun 17;10(6):1129. doi: 10.3390/healthcare10061129. PMID: 35742181; PMCID: PMC9222380.
     • Jeon YK, Jeong J, Shin SD, Song KJ, Kim YJ, Hong KJ, Ro YS, Park JH. The effect of age on in-hospital mortality among elderly people who sustained fall-related traumatic brain injuries at home: A retrospective study of a multicenter emergency department-based injury surveillance database. Injury. 2022 Oct;53(10):3276-3281. doi: 10.1016/j.injury.2022.07.036. Epub 2022 Jul 23. PMID: 35907679.
     • McKendry J, Lowisz CV, Nanthakumar A, MacDonald M, Lim C, Currier BS, Phillips SM. The effects of whey, pea, and collagen protein supplementation beyond the recommended dietary allowance on integrated myofibrillar protein synthetic rates in older males: a randomized controlled trial. Am J Clin Nutr. 2024 Jul;120(1):34-46. doi: 10.1016/j.ajcnut.2024.05.009. Epub 2024 May 16. PMID: 38762187; PMCID: PMC11291473.
     
     ]]>67f1b934-245b-4091-b8d5-d4899a4a8836Thu, 04 Dec 2025 00:00:00 -070013:03falsefull105105Telomeres and Time: Rewind Aging🧬 Telomeres and Time: Can We Really Rewind Aging?

     
     

     The Lowest Hemoglobin I’ve Ever Seen

     The lowest hemoglobin I’ve ever seen belonged to a young woman who was still standing. Her blood count was one-fourth of normal. She was pale, short of breath, and strong enough to walk into the clinic.

     Doctors soon learned her bone marrow had stopped making new blood cells. The diagnosis was aplastic anemia — a true telomere disease.

     She survived thanks to her fitness, modern science, and a bone marrow transplant from a generous donor in Germany. Two years later, she’s in law school, healthy, and full of life.

     
     

     What Are Telomeres?

     Each cell in your body carries chromosomes — long strands of DNA. At the ends of those chromosomes sit telomeres, tiny caps that keep the DNA from unraveling, like plastic tips on shoelaces.

     Every time a cell divides, its telomeres shorten a little. When they get too short, the cell can no longer divide. Scientists call that stage cellular senescence — cellular retirement.

     In 2009, researchers Elizabeth Blackburn and Carol Greider won the Nobel Prize for discovering telomerase, an enzyme that can rebuild telomeres. Their discovery sparked dreams of reversing aging. But there’s a catch: cancer cells also use telomerase to live forever. Turning that enzyme on everywhere might turn back time — or turn on tumors.

     Why Everyone Talks About Telomeres

     Telomeres became the poster child for longevity marketing.

     Social media ads promise to “measure your biological age.” Supplement companies claim to “lengthen your telomeres” for hundreds of dollars a bottle.

     The problem? Telomere tests vary between labs. Results can change by 20 percent depending on the method. They show trends, not destiny.

     
     

     What’s Being Studied

     Real scientists are studying how telomeres behave under different conditions.

     • Danazol — a synthetic sex hormone that slows telomere loss in people with inherited marrow failure. It works but brings side effects, so it’s not an anti-aging trick.
     • Henagliflozin — a diabetes drug that increased telomere length in one small study. Whether that helps humans live longer is still unknown.
     • Aripiprazole — an antipsychotic that repaired telomeres in cells after oxidative stress. That’s a Petri dish result, not a prescription for youth.
     
     

     These drugs show that we can nudge biology, but they’re for disease, not for vanity.

     Vitamins and Compounds That Might Help

     Nutrients influence telomere health, too.

     • Vitamin D supports telomerase. Long-term studies show it slows telomere shortening.
     • Vitamins C and E help reduce chemical stress that wears telomeres down.
     • Gamma-tocotrienol, a form of vitamin E, may reverse telomere loss — so far only in lab work.
     • TA-65, from the Astragalus plant, may activate telomerase but carries risk. Turning on telomerase could also fuel cancer.
     • Telomir 1 is experimental and not available outside research.
     
     

     None of these is proven to extend life. They’re promising ingredients, not miracles in a capsule.

     
     

     What Lifestyle Still Beats Everything

     Lifestyle matters more than any supplement.

     A large study at UCSF showed that people who ate a Mediterranean diet, exercised, and managed stress boosted telomerase activity within months.

     No powder required.

     Telomeres respond to care. They’re markers of how you live, not the cause of how long you live.

     Longer telomeres don’t guarantee longer life — they reflect how your body has handled time, inflammation, and stress.

     
     

     What Scientists Agree On

     Research tells a simple story:

     • Telomeres shorten as cells divide.
     • Stress, smoking, and inflammation speed that process.
     • Healthy diets and regular movement slow it.
     • Some medications affect telomere biology but aren’t for general use.
     • We still don’t know if lengthening telomeres increases lifespan.
     
     

     So far, no pill or powder beats sleep, exercise, and plants on a plate.

     
     

     The Real Takeaway

     Telomeres aren’t countdown clocks. They’re mileage markers.

     Protect them by doing the basics well: eat plants and fish, move daily, sleep enough, manage stress, and don’t smoke.

     Simple. Sustainable. Supported by science.

     
     

     References

     1. Calado RT, Young NS. Telomere Diseases. N Engl J Med. 2009;361(24):2353-65. PMCID: PMC3401586
     2. Lai T-P, Wright WE, Shay JW. Techniques for Assessing Telomere Length. Nat Rev Genet. 2018;19(5):293-307. PMCID: PMC6380489
     3. Huang S et al. The Relationship Between Telomere Length and Aging-Related Diseases. Front Aging. 2025;6:1532. PMCID: PMC11882723
     4. Arsenis CA et al. Physical Activity and Telomere Length. Sports Med. 2017;47(3):503-512.
     5. Schellnegger T et al. Unlocking Longevity: The Role of Telomeres and Their Targeting. Front Aging Neurosci. 2024;16:1050353.
     
     ]]>🧬 Telomeres and Time: Can We Really Rewind Aging?

     
     

     The Lowest Hemoglobin I’ve Ever Seen

     The lowest hemoglobin I’ve ever seen belonged to a young woman who was still standing. Her blood count was one-fourth of normal. She was pale, short of breath, and strong enough to walk into the clinic.

     Doctors soon learned her bone marrow had stopped making new blood cells. The diagnosis was aplastic anemia — a true telomere disease.

     She survived thanks to her fitness, modern science, and a bone marrow transplant from a generous donor in Germany. Two years later, she’s in law school, healthy, and full of life.

     
     

     What Are Telomeres?

     Each cell in your body carries chromosomes — long strands of DNA. At the ends of those chromosomes sit telomeres, tiny caps that keep the DNA from unraveling, like plastic tips on shoelaces.

     Every time a cell divides, its telomeres shorten a little. When they get too short, the cell can no longer divide. Scientists call that stage cellular senescence — cellular retirement.

     In 2009, researchers Elizabeth Blackburn and Carol Greider won the Nobel Prize for discovering telomerase, an enzyme that can rebuild telomeres. Their discovery sparked dreams of reversing aging. But there’s a catch: cancer cells also use telomerase to live forever. Turning that enzyme on everywhere might turn back time — or turn on tumors.

     Why Everyone Talks About Telomeres

     Telomeres became the poster child for longevity marketing.

     Social media ads promise to “measure your biological age.” Supplement companies claim to “lengthen your telomeres” for hundreds of dollars a bottle.

     The problem? Telomere tests vary between labs. Results can change by 20 percent depending on the method. They show trends, not destiny.

     
     

     What’s Being Studied

     Real scientists are studying how telomeres behave under different conditions.

     • Danazol — a synthetic sex hormone that slows telomere loss in people with inherited marrow failure. It works but brings side effects, so it’s not an anti-aging trick.
     • Henagliflozin — a diabetes drug that increased telomere length in one small study. Whether that helps humans live longer is still unknown.
     • Aripiprazole — an antipsychotic that repaired telomeres in cells after oxidative stress. That’s a Petri dish result, not a prescription for youth.
     
     

     These drugs show that we can nudge biology, but they’re for disease, not for vanity.

     Vitamins and Compounds That Might Help

     Nutrients influence telomere health, too.

     • Vitamin D supports telomerase. Long-term studies show it slows telomere shortening.
     • Vitamins C and E help reduce chemical stress that wears telomeres down.
     • Gamma-tocotrienol, a form of vitamin E, may reverse telomere loss — so far only in lab work.
     • TA-65, from the Astragalus plant, may activate telomerase but carries risk. Turning on telomerase could also fuel cancer.
     • Telomir 1 is experimental and not available outside research.
     
     

     None of these is proven to extend life. They’re promising ingredients, not miracles in a capsule.

     
     

     What Lifestyle Still Beats Everything

     Lifestyle matters more than any supplement.

     A large study at UCSF showed that people who ate a Mediterranean diet, exercised, and managed stress boosted telomerase activity within months.

     No powder required.

     Telomeres respond to care. They’re markers of how you live, not the cause of how long you live.

     Longer telomeres don’t guarantee longer life — they reflect how your body has handled time, inflammation, and stress.

     
     

     What Scientists Agree On

     Research tells a simple story:

     • Telomeres shorten as cells divide.
     • Stress, smoking, and inflammation speed that process.
     • Healthy diets and regular movement slow it.
     • Some medications affect telomere biology but aren’t for general use.
     • We still don’t know if lengthening telomeres increases lifespan.
     
     

     So far, no pill or powder beats sleep, exercise, and plants on a plate.

     
     

     The Real Takeaway

     Telomeres aren’t countdown clocks. They’re mileage markers.

     Protect them by doing the basics well: eat plants and fish, move daily, sleep enough, manage stress, and don’t smoke.

     Simple. Sustainable. Supported by science.

     
     

     References

     1. Calado RT, Young NS. Telomere Diseases. N Engl J Med. 2009;361(24):2353-65. PMCID: PMC3401586
     2. Lai T-P, Wright WE, Shay JW. Techniques for Assessing Telomere Length. Nat Rev Genet. 2018;19(5):293-307. PMCID: PMC6380489
     3. Huang S et al. The Relationship Between Telomere Length and Aging-Related Diseases. Front Aging. 2025;6:1532. PMCID: PMC11882723
     4. Arsenis CA et al. Physical Activity and Telomere Length. Sports Med. 2017;47(3):503-512.
     5. Schellnegger T et al. Unlocking Longevity: The Role of Telomeres and Their Targeting. Front Aging Neurosci. 2024;16:1050353.
     
     ]]>a798e714-9d54-46e7-b163-d76d47df9d9eThu, 27 Nov 2025 00:00:00 -070010:25falsefull104104Mitochondria Matter: The Story of AgingThe Mitochondria Problem: Why These Tiny Powerhouses Shape How We Age

     Many people suddenly talk about mitochondria. You hear them in political speeches, on podcasts, and across social media. RFK Jr said he can “see” kids with weak mitochondria just by watching them walk through an airport. Others claim special diets or powders can “fix” aging by supercharging these organelles.

     However, most of that chatter misses the actual science.

     This post breaks down what mitochondria do, why they matter for aging, and how you can keep them healthy. No hype. No detox teas. Just biology you can use.

     What Are Mitochondria?

     Every cell in your body contains tiny structures called mitochondria. They act like miniature cells living inside your larger cells. Each mitochondrion even has its own DNA.

     Mitochondria divide independently from your regular cells.

     They manage your energy, converting glucose to ATP

     Finally, mitochondria keep your organs working.

     You inherit all your mitochondria from your mother, which is why scientists use mitochondrial DNA to trace ancestry.

     
     

     How Did We Get Mitochondria? (A Very Old Story)

     About 1.5 billion years ago, a simple cell swallowed a bacterium and refused to digest it. Instead, they formed a partnership.

     The bacterium supplied energy.

     The host cell provided safety.

     That partnership became the mitochondrion. Every person alive today runs on that ancient deal.

     
     

     What Do Mitochondria Do All Day?

      Mitochondria take glucose from your food and convert it into ATP — the energy your body uses to move, think, heal, and grow. This process runs every second of your life.

     You cannot swallow ATP and get more energy. ATP supplements don’t work. Only your mitochondria make the usable fuel your body needs.

     
     

     Why Young Mitochondria Work So Well

     Young mitochondria act like teenagers. They run fast, bounce back quickly, and handle stress with ease. Cells constantly recycle old mitochondria through a process called mitophagy. This system works beautifully in childhood.

     Fresh mitochondria power:

     • strong muscles
     • sharp thinking
     • fast recovery
     • healthy metabolism
     
     

     When mitophagy runs smoothly, you feel energetic and resilient.

     
     

     What Happens When Mitochondria Age

     Aging slows everything down. Mitochondria begin to leak more “exhaust,” build up mutations, and lose efficiency. Damaged ones don’t get removed as well, because mitophagy weakens with age.

     Unfortunately, mitochondria do something worse than slow down:

     They fuse with healthy mitochondria.

     Imagine pouring spoiled milk into a fresh gallon. The whole jug goes bad. Aging mitochondria do the same thing inside your cells. They spread dysfunction to the healthy ones.

     
     

     How Aging Mitochondria Cause Trouble

     As mitochondria fail, they change how cells function. They send distress signals back to the nucleus that alter gene expression. These messages push cells toward inflammation, stress, and survival pathways that your body normally keeps quiet.

     Even more concerning, changes in mitochondrial shape — too much splitting (fission) and not enough merging (fusion) — appear in both aging and cancer. These shifts support tumor growth, help cancer cells spread, and make some treatments less effective.

     Aging mitochondria increase the risk of:

     • brain fog
     • muscle fatigue
     • slower recovery
     • heart strain
     • metabolic slowdown
     • cancer-friendly environments
     
     

     Mitochondria sit at the center of how we age.

     
     

     Why “Mitochondrial Booster” Supplements Miss the Mark

     Plenty of supplements promise to “repair” mitochondria. Many sound exciting:

     • NAD boosters
     • Urolithin A
     • peptides
     • antioxidant stacks
     
     

     However, evidence in actual humans remains limited.

     NAD boosters don’t show meaningful anti-aging benefits.

     Urolithin A can help with muscle endurance, but doesn’t reverse aging.

     Antioxidant megadoses may even interfere with exercise benefits.

     People want a miracle switch. We don’t have one.

     
     

     What Does Improve Mitochondrial Health

     Good news: the basics still win. And they outperform supplements every time.

     1. Resistance Training

     Your muscles grow new mitochondria in response to lifting weights or doing body-weight exercises.

     2. Zone 2 Exercise

     This “comfortably challenging” aerobic zone trains your body to use oxygen better. You can talk, but you can’t sing.

     3. Sleep

     Your body repairs mitochondrial damage at night. Poor sleep means poor repair.

     4. Mediterranean Diet

     Whole foods, plants, nuts, fish, and olive oil protect mitochondria from inflammation and stress.

     5. Treating Metabolic Disease Early

     High blood sugar, high LDL, and high blood pressure destroy mitochondria faster than anything else.

     
     

     Why Diet Tribes Get Mitochondria Wrong

     Some diet influencers insist that insulin resistance is the One True Cause of aging and that keto or carnivore diets fix it all. That was tested in high-quality metabolic ward studies.

     It failed.

     Low-carb diets did not outperform other diets when calories and protein were controlled. Fat loss was the same. Metabolism behaved the same. Insulin wasn’t the magic dial.

     Mediterranean-style eating continues to show the strongest data for longevity.

     
     

     Alcohol Ages Mitochondria Fast

     Your liver breaks down alcohol by generating large amounts of oxidative stress. That stress directly damages mitochondrial DNA, mitochondrial enzymes, and mitochondrial membranes.

     It also disrupts their normal fuse-and-divide rhythm, which accelerates aging inside your cells. The hangover fades, but the mitochondrial damage does not.

     
     

     Bringing It All Together

     Mitochondria are real, essential organelles — not a buzzword. Yet some people use the term “mitochondria” the same way Deepak Chopra uses the word “quantum": to describe everything and explain nothing.

     Here’s the truth:

     When mitochondria age, you age.

     Driving inflammation.

     Increasing cancer risk.

     Slowing your metabolism.

     They weaken your heart and muscles.

     Finally, they cloud your thinking.

     If we’re going to blame mitochondria for aging, let’s at least understand them — and learn how to keep them healthy.

     Strength training, aerobic exercise, sleep, nutrition, and treating metabolic disease remain the most powerful tools we have.

     Your mitochondria are trying their best.

     Help them do their job.

     REFERENCES

     1.Somatic Mutations of Mitochondrial DNA in Aging and Cancer Progression.

     Lee HC, Chang CM, Chi CW. Ageing Research Reviews. 2010;9 Suppl 1:S47-58. doi:10.1016/j.arr.2010.08.009.

     2. Mitochondrial DNA Mutations in Ageing and Cancer.

     Smith ALM, Whitehall JC, Greaves LC.Molecular Oncology. 2022;16(18):3276-3294. doi:10.1002/1878-0261.13291.

     3. Age-Associated Mitochondrial DNA Mutations Cause Metabolic Remodelling That Contributes to Accelerated Intestinal Tumorigenesis.

     Smith AL, Whitehall JC, Bradshaw C, et al. Nature Cancer. 2020;1(10):976-989. doi:10.1038/s43018-020-00112-5.

     4.Understanding the Impact of Mitochondrial DNA Mutations on Aging and Carcinogenesis (Review).

     Kobayashi H, Imanaka S International Journal of Molecular Medicine. 2025;56(2):118. doi:10.3892/ijmm.2025.5559.

     5.Mitochondrial Dysfunction and Oxidative Stress in Aging and Cancer.

     Kudryavtseva AV, Krasnov GS, Dmitriev AA, et al. Oncotarget. 2016;7(29):44879-44905. doi:10.18632/oncotarget.9821.

     6.Role of Mitochondrial Dysfunction in Cancer Progression.

     Hsu CC, Tseng LM, Lee HC. Experimental Biology and Medicine (Maywood, N.J.). 2016;241(12):1281-95. doi:10.1177/1535370216641787.

     7. Mitochondrial Dysfunction and Mitochondrial Dynamics-the Cancer Connection.

     Srinivasan S, Guha M, Kashina A, Avadhani NG. Biochimica Et Biophysica Acta. Bioenergetics. 2017;1858(8):602-614. doi:10.1016/j.bbabio.2017.01.004.

     8.Dysregulation of Mitochondrial Function in Cancer Cells.

     Awad AMAM, Abdul Karim N. International Journal of Molecular Sciences. 2025;26(14):6750....]]>The Mitochondria Problem: Why These Tiny Powerhouses Shape How We Age

     Many people suddenly talk about mitochondria. You hear them in political speeches, on podcasts, and across social media. RFK Jr said he can “see” kids with weak mitochondria just by watching them walk through an airport. Others claim special diets or powders can “fix” aging by supercharging these organelles.

     However, most of that chatter misses the actual science.

     This post breaks down what mitochondria do, why they matter for aging, and how you can keep them healthy. No hype. No detox teas. Just biology you can use.

     What Are Mitochondria?

     Every cell in your body contains tiny structures called mitochondria. They act like miniature cells living inside your larger cells. Each mitochondrion even has its own DNA.

     Mitochondria divide independently from your regular cells.

     They manage your energy, converting glucose to ATP

     Finally, mitochondria keep your organs working.

     You inherit all your mitochondria from your mother, which is why scientists use mitochondrial DNA to trace ancestry.

     
     

     How Did We Get Mitochondria? (A Very Old Story)

     About 1.5 billion years ago, a simple cell swallowed a bacterium and refused to digest it. Instead, they formed a partnership.

     The bacterium supplied energy.

     The host cell provided safety.

     That partnership became the mitochondrion. Every person alive today runs on that ancient deal.

     
     

     What Do Mitochondria Do All Day?

      Mitochondria take glucose from your food and convert it into ATP — the energy your body uses to move, think, heal, and grow. This process runs every second of your life.

     You cannot swallow ATP and get more energy. ATP supplements don’t work. Only your mitochondria make the usable fuel your body needs.

     
     

     Why Young Mitochondria Work So Well

     Young mitochondria act like teenagers. They run fast, bounce back quickly, and handle stress with ease. Cells constantly recycle old mitochondria through a process called mitophagy. This system works beautifully in childhood.

     Fresh mitochondria power:

     • strong muscles
     • sharp thinking
     • fast recovery
     • healthy metabolism
     
     

     When mitophagy runs smoothly, you feel energetic and resilient.

     
     

     What Happens When Mitochondria Age

     Aging slows everything down. Mitochondria begin to leak more “exhaust,” build up mutations, and lose efficiency. Damaged ones don’t get removed as well, because mitophagy weakens with age.

     Unfortunately, mitochondria do something worse than slow down:

     They fuse with healthy mitochondria.

     Imagine pouring spoiled milk into a fresh gallon. The whole jug goes bad. Aging mitochondria do the same thing inside your cells. They spread dysfunction to the healthy ones.

     
     

     How Aging Mitochondria Cause Trouble

     As mitochondria fail, they change how cells function. They send distress signals back to the nucleus that alter gene expression. These messages push cells toward inflammation, stress, and survival pathways that your body normally keeps quiet.

     Even more concerning, changes in mitochondrial shape — too much splitting (fission) and not enough merging (fusion) — appear in both aging and cancer. These shifts support tumor growth, help cancer cells spread, and make some treatments less effective.

     Aging mitochondria increase the risk of:

     • brain fog
     • muscle fatigue
     • slower recovery
     • heart strain
     • metabolic slowdown
     • cancer-friendly environments
     
     

     Mitochondria sit at the center of how we age.

     
     

     Why “Mitochondrial Booster” Supplements Miss the Mark

     Plenty of supplements promise to “repair” mitochondria. Many sound exciting:

     • NAD boosters
     • Urolithin A
     • peptides
     • antioxidant stacks
     
     

     However, evidence in actual humans remains limited.

     NAD boosters don’t show meaningful anti-aging benefits.

     Urolithin A can help with muscle endurance, but doesn’t reverse aging.

     Antioxidant megadoses may even interfere with exercise benefits.

     People want a miracle switch. We don’t have one.

     
     

     What Does Improve Mitochondrial Health

     Good news: the basics still win. And they outperform supplements every time.

     1. Resistance Training

     Your muscles grow new mitochondria in response to lifting weights or doing body-weight exercises.

     2. Zone 2 Exercise

     This “comfortably challenging” aerobic zone trains your body to use oxygen better. You can talk, but you can’t sing.

     3. Sleep

     Your body repairs mitochondrial damage at night. Poor sleep means poor repair.

     4. Mediterranean Diet

     Whole foods, plants, nuts, fish, and olive oil protect mitochondria from inflammation and stress.

     5. Treating Metabolic Disease Early

     High blood sugar, high LDL, and high blood pressure destroy mitochondria faster than anything else.

     
     

     Why Diet Tribes Get Mitochondria Wrong

     Some diet influencers insist that insulin resistance is the One True Cause of aging and that keto or carnivore diets fix it all. That was tested in high-quality metabolic ward studies.

     It failed.

     Low-carb diets did not outperform other diets when calories and protein were controlled. Fat loss was the same. Metabolism behaved the same. Insulin wasn’t the magic dial.

     Mediterranean-style eating continues to show the strongest data for longevity.

     
     

     Alcohol Ages Mitochondria Fast

     Your liver breaks down alcohol by generating large amounts of oxidative stress. That stress directly damages mitochondrial DNA, mitochondrial enzymes, and mitochondrial membranes.

     It also disrupts their normal fuse-and-divide rhythm, which accelerates aging inside your cells. The hangover fades, but the mitochondrial damage does not.

     
     

     Bringing It All Together

     Mitochondria are real, essential organelles — not a buzzword. Yet some people use the term “mitochondria” the same way Deepak Chopra uses the word “quantum": to describe everything and explain nothing.

     Here’s the truth:

     When mitochondria age, you age.

     Driving inflammation.

     Increasing cancer risk.

     Slowing your metabolism.

     They weaken your heart and muscles.

     Finally, they cloud your thinking.

     If we’re going to blame mitochondria for aging, let’s at least understand them — and learn how to keep them healthy.

     Strength training, aerobic exercise, sleep, nutrition, and treating metabolic disease remain the most powerful tools we have.

     Your mitochondria are trying their best.

     Help them do their job.

     REFERENCES

     1.Somatic Mutations of Mitochondrial DNA in Aging and Cancer Progression.

     Lee HC, Chang CM, Chi CW. Ageing Research Reviews. 2010;9 Suppl 1:S47-58. doi:10.1016/j.arr.2010.08.009.

     2. Mitochondrial DNA Mutations in Ageing and Cancer.

     Smith ALM, Whitehall JC, Greaves LC.Molecular Oncology. 2022;16(18):3276-3294. doi:10.1002/1878-0261.13291.

     3. Age-Associated Mitochondrial DNA Mutations Cause Metabolic Remodelling That Contributes to Accelerated Intestinal Tumorigenesis.

     Smith AL, Whitehall JC, Bradshaw C, et al. Nature Cancer. 2020;1(10):976-989. doi:10.1038/s43018-020-00112-5.

     4.Understanding the Impact of Mitochondrial DNA Mutations on Aging and Carcinogenesis (Review).

     Kobayashi H, Imanaka S International Journal of Molecular Medicine. 2025;56(2):118. doi:10.3892/ijmm.2025.5559.

     5.Mitochondrial Dysfunction and Oxidative Stress in Aging and Cancer.

     Kudryavtseva AV, Krasnov GS, Dmitriev AA, et al. Oncotarget. 2016;7(29):44879-44905. doi:10.18632/oncotarget.9821.

     6.Role of Mitochondrial Dysfunction in Cancer Progression.

     Hsu CC, Tseng LM, Lee HC. Experimental Biology and Medicine (Maywood, N.J.). 2016;241(12):1281-95. doi:10.1177/1535370216641787.

     7. Mitochondrial Dysfunction and Mitochondrial Dynamics-the Cancer Connection.

     Srinivasan S, Guha M, Kashina A, Avadhani NG. Biochimica Et Biophysica Acta. Bioenergetics. 2017;1858(8):602-614. doi:10.1016/j.bbabio.2017.01.004.

     8.Dysregulation of Mitochondrial Function in Cancer Cells.

     Awad AMAM, Abdul Karim N. International Journal of Molecular Sciences. 2025;26(14):6750. doi:10.3390/ijms26146750.

      9. Premalignant Progression in the Lung: Knowledge Gaps and Novel Opportunities for Interception of Non-Small Cell Lung Cancer. An Official American Thoracic Society Research Statement.

     Moghaddam SJ, Savai R, Salehi-Rad R, et al. American Journal of Respiratory and Critical Care Medicine. 2024;210(5):548-571. doi:10.1164/rccm.202406-1168ST.

     10. Mitochondria in Oxidative Stress, Inflammation and Aging: From Mechanisms to Therapeutic Advances.

     Xu X, Pang Y, Fan X. Signal Transduction and Targeted Therapy. 2025;10(1):190. doi:10.1038/s41392-025-02253-4.

     ]]>56274f29-4d6e-4bb6-8a88-288e08109262Thu, 20 Nov 2025 00:00:00 -070012:54falsefull103103Urolithin A - Mitochondrial Miracle in the Petri DishUrolithin A: What It Is, How It Works, and Why Your Gut Decides Everything

     By Dr. Terry Simpson

     Most people hear the name Urolithin A and think it belongs in a commercial about prostate health. It sounds like something a man named “Gary, 62,” would talk about while fishing. But Urolithin A has nothing to do with plumbing. Instead, it sits at the center of a new wave of longevity science focused on how our cells clean up old, broken parts.

     As we age, our mitochondria—the tiny power centers inside our cells—start to slow down. They build up damage and stop working well. Eventually, this pile-up makes us lose strength and energy. That’s where Urolithin A comes in. It helps switch back on a process called mitophagy, which is basically the cell’s recycling program for old mitochondria.

     Where Urolithin A Really Comes From

     You cannot eat Urolithin A directly. Instead, your body makes it when your gut bacteria break down special plant compounds called ellagitannins. These are found in foods like:

     • pomegranates
     • walnuts
     • berries
     • green tea (yes, really)
     
     

     Green tea is usually known for its catechins, but it also contains ellagitannins like strictinin. After you drink it, your gut bacteria break these tannins apart and create ellagic acid, which can later turn into Urolithin A.

     However, this only works if you have the right microbes. And here’s the surprising part:

     Most people do not.

     Studies show that only 12% to 40% of adults naturally produce Urolithin A from food. Everyone else makes little to none because their gut bacteria simply aren’t built for the job.

     
     

     How Your Gut Decides Everything

     Your microbiome—the community of bacteria living in your digestive system—decides whether you make Urolithin A or not.

     People who produce Urolithin A usually have:

     • more diverse gut microbes
     • special bacteria like Enterocloster and Gordonibacter
     • the right genes inside those microbes to do the chemical conversion
     
     

     People who don’t produce it (called “metabotype zero”) lack those bacteria or the gene pathways needed. Eating more pomegranates or drinking more green tea does not fix this. No diet, including keto or Mediterranean, has been shown to turn a non-producer into a producer.

     This is why two people can eat the same food, and only one makes Urolithin A.

     
     

     What Urolithin A Does in Humans

     In older adults, researchers have tested Urolithin A supplements for up to 4 months. These studies show several encouraging results:

     • muscle endurance improves
     • inflammation markers decrease
     • mitochondrial health markers look better
     
     

     Even so, there are limits. Trials show no meaningful improvement in:

     • walking distance
     • ATP (cellular energy) production
     • overall physical function
     
     

     So the biology looks better, but major clinical outcomes have not changed.

     
     

     What Happens in the Lab (But Not Yet in Humans)

     Scientists also study Urolithin A in senescent cells—cells that have stopped dividing but still cause inflammation. In the lab, Urolithin A can:

     • reduce senescence markers
     • calm inflammatory signals
     • restore mitophagy
     • improve oxidative stress
     • even strengthen circadian rhythms inside aging cells
     
     

     All of this sounds exciting. However, these findings are from cell culture, not humans. They give us clues, not guarantees.

     
     

     Food vs Supplements

     You cannot get Urolithin A directly from food. You only get the precursors, and only people with the right gut bacteria turn those precursors into Urolithin A.

     Supplements bypass the microbiome entirely and give everyone measurable Urolithin A, even non-producers.

     Foods that contain ellagitannins include:

     • pomegranates
     • walnuts
     • raspberries
     • blackberries
     • some teas, especially green tea
     
     

     But none of these will raise Urolithin A levels if your gut bacteria cannot perform the conversion.

     
     

     Is Urolithin A Safe?

     Short-term human studies show that Urolithin A is safe and well-tolerated. Most people experience no side effects. When side effects do show up, they are usually mild digestive symptoms like bloating or softer stools.

     What we don’t know:

     • long-term safety
     • pregnancy or breastfeeding safety
     • multi-year use
     • effects in chronic disease
     
     

     In other words, the short-term data look good, but the long-term story hasn’t been written yet.

     
     

     Should You Take It?

     Here is the simple answer:

     Urolithin A is biologically promising but clinically modest.

     It improves certain cellular markers and may boost muscle endurance in older adults.

     It does not reverse aging or change major health outcomes—not yet.

     Supplements make the most sense for:

     • adults over 60
     • people with early muscle loss
     • individuals who are non-producers
     • those wanting to support mitochondrial health
     
     

     But nothing replaces the basics:

     • resistance training
     • movement
     • eating well
     • sleep
     • stress control
     
     

     That is still the foundation of a longer, healthier life.

     
     

     REFERENCES

     (For the blog — as provided)

     1. Kuerec AH, Lim XK, Khoo AL, et al. Targeting Aging With Urolithin A in Humans: A Systematic Review. Ageing Research Reviews. 2024;100:102406.
     2. Heilman J, Andreux P, Tran N, et al. Safety Assessment of Urolithin A… Food and Chemical Toxicology. 2017;108:289-297.
     3. Hasheminezhad SH, Boozari M, Iranshahi M, et al. Biological Activities of Urolithins… Phytotherapy Research. 2022;36(1):112-146.
     4. Singh A, D'Amico D, Andreux PA, et al. Direct Supplementation With Urolithin A… European Journal of Clinical Nutrition. 2022;76(2):297-308.
     5. Aichinger G, Stevanoska M, Beekmann K, et al. PBPK Modeling of Urolithin A… Molecular Nutrition & Food Research. 2023;67(15).
     6. D'Amico D, Andreux PA, Valdés P, et al. Impact of Urolithin A on Health, Disease, and Aging. Trends in Molecular Medicine. 2021;27(7):687-699.
     7. Gandhi GR, Antony PJ, Ceasar SA, et al. Health Functions of Ellagitannin-Derived Urolithins. Critical Reviews in Food Science and Nutrition. 2024;64(2):280-310.
     8. Zhang M, Cui S, Mao B, et al. Ellagic Acid and Urolithin A: Sources and Metabolism. Critical Reviews in Food Science and Nutrition. 2023;63:6900-6922.
     9. García-Villalba R, Giménez-Bastida JA, Cortés-Martín A, et al. Urolithins: Metabolism and Microbiota. Molecular Nutrition & Food Research. 2022;66:2101019.
     
     ]]>Urolithin A: What It Is, How It Works, and Why Your Gut Decides Everything

     By Dr. Terry Simpson

     Most people hear the name Urolithin A and think it belongs in a commercial about prostate health. It sounds like something a man named “Gary, 62,” would talk about while fishing. But Urolithin A has nothing to do with plumbing. Instead, it sits at the center of a new wave of longevity science focused on how our cells clean up old, broken parts.

     As we age, our mitochondria—the tiny power centers inside our cells—start to slow down. They build up damage and stop working well. Eventually, this pile-up makes us lose strength and energy. That’s where Urolithin A comes in. It helps switch back on a process called mitophagy, which is basically the cell’s recycling program for old mitochondria.

     Where Urolithin A Really Comes From

     You cannot eat Urolithin A directly. Instead, your body makes it when your gut bacteria break down special plant compounds called ellagitannins. These are found in foods like:

     • pomegranates
     • walnuts
     • berries
     • green tea (yes, really)
     
     

     Green tea is usually known for its catechins, but it also contains ellagitannins like strictinin. After you drink it, your gut bacteria break these tannins apart and create ellagic acid, which can later turn into Urolithin A.

     However, this only works if you have the right microbes. And here’s the surprising part:

     Most people do not.

     Studies show that only 12% to 40% of adults naturally produce Urolithin A from food. Everyone else makes little to none because their gut bacteria simply aren’t built for the job.

     
     

     How Your Gut Decides Everything

     Your microbiome—the community of bacteria living in your digestive system—decides whether you make Urolithin A or not.

     People who produce Urolithin A usually have:

     • more diverse gut microbes
     • special bacteria like Enterocloster and Gordonibacter
     • the right genes inside those microbes to do the chemical conversion
     
     

     People who don’t produce it (called “metabotype zero”) lack those bacteria or the gene pathways needed. Eating more pomegranates or drinking more green tea does not fix this. No diet, including keto or Mediterranean, has been shown to turn a non-producer into a producer.

     This is why two people can eat the same food, and only one makes Urolithin A.

     
     

     What Urolithin A Does in Humans

     In older adults, researchers have tested Urolithin A supplements for up to 4 months. These studies show several encouraging results:

     • muscle endurance improves
     • inflammation markers decrease
     • mitochondrial health markers look better
     
     

     Even so, there are limits. Trials show no meaningful improvement in:

     • walking distance
     • ATP (cellular energy) production
     • overall physical function
     
     

     So the biology looks better, but major clinical outcomes have not changed.

     
     

     What Happens in the Lab (But Not Yet in Humans)

     Scientists also study Urolithin A in senescent cells—cells that have stopped dividing but still cause inflammation. In the lab, Urolithin A can:

     • reduce senescence markers
     • calm inflammatory signals
     • restore mitophagy
     • improve oxidative stress
     • even strengthen circadian rhythms inside aging cells
     
     

     All of this sounds exciting. However, these findings are from cell culture, not humans. They give us clues, not guarantees.

     
     

     Food vs Supplements

     You cannot get Urolithin A directly from food. You only get the precursors, and only people with the right gut bacteria turn those precursors into Urolithin A.

     Supplements bypass the microbiome entirely and give everyone measurable Urolithin A, even non-producers.

     Foods that contain ellagitannins include:

     • pomegranates
     • walnuts
     • raspberries
     • blackberries
     • some teas, especially green tea
     
     

     But none of these will raise Urolithin A levels if your gut bacteria cannot perform the conversion.

     
     

     Is Urolithin A Safe?

     Short-term human studies show that Urolithin A is safe and well-tolerated. Most people experience no side effects. When side effects do show up, they are usually mild digestive symptoms like bloating or softer stools.

     What we don’t know:

     • long-term safety
     • pregnancy or breastfeeding safety
     • multi-year use
     • effects in chronic disease
     
     

     In other words, the short-term data look good, but the long-term story hasn’t been written yet.

     
     

     Should You Take It?

     Here is the simple answer:

     Urolithin A is biologically promising but clinically modest.

     It improves certain cellular markers and may boost muscle endurance in older adults.

     It does not reverse aging or change major health outcomes—not yet.

     Supplements make the most sense for:

     • adults over 60
     • people with early muscle loss
     • individuals who are non-producers
     • those wanting to support mitochondrial health
     
     

     But nothing replaces the basics:

     • resistance training
     • movement
     • eating well
     • sleep
     • stress control
     
     

     That is still the foundation of a longer, healthier life.

     
     

     REFERENCES

     (For the blog — as provided)

     1. Kuerec AH, Lim XK, Khoo AL, et al. Targeting Aging With Urolithin A in Humans: A Systematic Review. Ageing Research Reviews. 2024;100:102406.
     2. Heilman J, Andreux P, Tran N, et al. Safety Assessment of Urolithin A… Food and Chemical Toxicology. 2017;108:289-297.
     3. Hasheminezhad SH, Boozari M, Iranshahi M, et al. Biological Activities of Urolithins… Phytotherapy Research. 2022;36(1):112-146.
     4. Singh A, D'Amico D, Andreux PA, et al. Direct Supplementation With Urolithin A… European Journal of Clinical Nutrition. 2022;76(2):297-308.
     5. Aichinger G, Stevanoska M, Beekmann K, et al. PBPK Modeling of Urolithin A… Molecular Nutrition & Food Research. 2023;67(15).
     6. D'Amico D, Andreux PA, Valdés P, et al. Impact of Urolithin A on Health, Disease, and Aging. Trends in Molecular Medicine. 2021;27(7):687-699.
     7. Gandhi GR, Antony PJ, Ceasar SA, et al. Health Functions of Ellagitannin-Derived Urolithins. Critical Reviews in Food Science and Nutrition. 2024;64(2):280-310.
     8. Zhang M, Cui S, Mao B, et al. Ellagic Acid and Urolithin A: Sources and Metabolism. Critical Reviews in Food Science and Nutrition. 2023;63:6900-6922.
     9. García-Villalba R, Giménez-Bastida JA, Cortés-Martín A, et al. Urolithins: Metabolism and Microbiota. Molecular Nutrition & Food Research. 2022;66:2101019.
     
     ]]>ee5fb0e6-09cf-4bdb-b461-6b873c3429e4Thu, 13 Nov 2025 00:00:00 -070010:38falsefull102102NAD The Molecule of Life — and the Hype🧬 NAD: The Molecule of Life — and the Hype

     How a lab coenzyme became the latest anti-aging obsession

     
     

     What We Mean by Longevity and Healthspan

     When people talk about longevity, they usually mean how long we live.

     But healthspan — the years we live well — matters far more.

     That’s the time before disease steals our energy, mobility, and independence.

     Modern medicine has already doubled our lifespan in the last century.

     Now the goal is to extend the healthy part — without falling for pseudoscience along the way.

     
     

     When Marketing Meets Medicine

     Longevity has become a booming business.

     Some gurus, like Dr. Eric Topol, do real science.

     Others, like Peter Attia, sell access: $150 000 per patient for lab tests, a VO₂ max treadmill run, and a few “optimized” workouts.

     He’s also an investor in AG1 — the influencer’s green drink of choice.

     Andrew Huberman promotes similar ideas under studio lights bright enough to sterilize a petri dish.

     Both are clever, credentialed, and caught between data and drama.

     Then there’s Dr. David Sinclair, who helped discover how cells age — and then helped turn that discovery into a supplement empire.

     His company tried to patent NMN, an NAD precursor, as a drug.

     The FDA briefly removed NMN from the supplement market, sending Reddit into meltdown.

     It’s back now, but the episode showed how quickly science slides into sales.

     And finally, we have the shirtless salesmen:

     Paul Saladino, who went from carnivore crusader to “fruit influencer.”

     Liver King, whose real secret wasn’t liver — it was injectable.

     And Gary Brecka, who claims to predict your death date (for a fee).

     These are subscription services disguised as sages.

     
     

     What NAD Actually Is

     Nicotinamide adenine dinucleotide (NAD⁺) is a molecule found in every living cell.

     It helps convert food into energy and repair DNA.

     As we age, NAD levels fall — metabolism slows and damage builds up.

     So scientists asked: If we raise NAD again, can we slow aging?

     In mice, the answer looks promising.

     NAD precursors like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) increase average lifespan by 5–15 percent and improve energy, insulin sensitivity, and activity.

     That’s great for mice — but we don’t live in cages or eat lab chow.

     
     

     Can You Get NAD from Food?

     Not directly — but your body makes NAD from dietary precursors:

     tryptophan and niacin (vitamin B₃).

     You’ll find them in fish, poultry, beans, milk, and whole grains — basically, a Mediterranean-style diet.

     So before spending $90 on capsules, you can spend $9 at the farmers' market.

     
     

     What the Human Studies Show

     Human trials of NR or NMN (usually 500–2000 mg per day for 6–12 weeks) show they are safe and well-tolerated.

     They modestly raise NAD levels and sometimes improve lipid profiles and blood pressure.

     But the effects are small and inconsistent, especially in healthy adults.

     NAD precursors do not reverse aging.

     They don’t prevent heart attacks or extend lifespan in people — at least, not yet.

     
     

     NAD vs Statins: A Reality Check

     Meta-analyses show NAD precursors, especially niacin, can lower LDL (“bad”) cholesterol by about 8–12 percent.

     That’s fine, but compare it to rosuvastatin (Crestor):

     DoseAverage LDL Reduction5 mg≈ 45 %10 mg≈ 52 %20 mg≈ 55 %40 mg≈ 63 %

     That’s the difference between “interesting biochemistry” and “fewer funerals.”

     So NAD may nudge your cholesterol; statins save lives.

     
     

     Who Might Benefit

     Older adults with metabolic syndrome, prediabetes, or early neurodegenerative disease could see modest improvements in inflammation or blood lipids.

     Younger, healthier people mostly see lighter wallets.

     No serious drug interactions have been documented, though theoretical ones exist with some chemotherapy or DNA-repair drugs.

     As always, talk to your doctor before combining anything with prescription therapy.

     
     

     Food Before Pharma

     The best way to support NAD and longevity is still food, sleep, and movement.

     A Mediterranean diet rich in legumes, vegetables, olive oil, and fish fuels NAD pathways naturally — and has proven benefits for heart and brain health.

     No influencer code required.

     
     

     A Note from the Galley

     We’ll explore all of this — diet, longevity, and a little wine science — on next summer’s Mediterranean Longevity Cruise.

     World-class physicians, scientists, and chefs will join me for ten days of evidence-based indulgence.

     It’ll cost less than a Peter Attia consult — and no one will force you to drink AG1.

     (For the record, I still do. It’s gentle on my stomach, but I’m hunting for less bougie vitamins.)

     
     

     The Takeaway

     Boosting NAD may someday help extend healthspan, but for now, the best evidence still supports:

     • Eat Mediterranean-style food.
     • Move daily.
     • Sleep enough.
     • Manage stress.
     • See your doctor before your supplement dealer.
     
     

     That’s how you live longer and better — no silver bullet, just science and common sense.

     
     

     References

     Effects of NAD+ Precursor Supplementation on Glucose and Lipid Metabolism in Humans: A Meta-Analysis. Zhong O, Wang J, Tan Y, Lei X, Tang Z. Nutrition & Metabolism. 2022;19(1):20. doi:10.1186/s12986-022-00653-9.

     2 Niacin: An Old Lipid Drug in a New NAD+ Dress. Romani M, Hofer DC, Katsyuba E, Auwerx J. Journal of Lipid Research. 2019;60(4):741-746. doi:10.1194/jlr.S092007.

     3.Nicotinamide Adenine Dinucleotide in Aging Biology: Potential Applications and Many Unknowns. Bhasin S, Seals D, Migaud M, Musi N, Baur JA. Endocrine Reviews. 2023;44(6):1047-1073. doi:10.1210/endrev/bnad019.

     4. Crestor. FDA Drug Label. Food and Drug Administration Updated date: 2024-07-31

     ]]>🧬 NAD: The Molecule of Life — and the Hype

     How a lab coenzyme became the latest anti-aging obsession

     
     

     What We Mean by Longevity and Healthspan

     When people talk about longevity, they usually mean how long we live.

     But healthspan — the years we live well — matters far more.

     That’s the time before disease steals our energy, mobility, and independence.

     Modern medicine has already doubled our lifespan in the last century.

     Now the goal is to extend the healthy part — without falling for pseudoscience along the way.

     
     

     When Marketing Meets Medicine

     Longevity has become a booming business.

     Some gurus, like Dr. Eric Topol, do real science.

     Others, like Peter Attia, sell access: $150 000 per patient for lab tests, a VO₂ max treadmill run, and a few “optimized” workouts.

     He’s also an investor in AG1 — the influencer’s green drink of choice.

     Andrew Huberman promotes similar ideas under studio lights bright enough to sterilize a petri dish.

     Both are clever, credentialed, and caught between data and drama.

     Then there’s Dr. David Sinclair, who helped discover how cells age — and then helped turn that discovery into a supplement empire.

     His company tried to patent NMN, an NAD precursor, as a drug.

     The FDA briefly removed NMN from the supplement market, sending Reddit into meltdown.

     It’s back now, but the episode showed how quickly science slides into sales.

     And finally, we have the shirtless salesmen:

     Paul Saladino, who went from carnivore crusader to “fruit influencer.”

     Liver King, whose real secret wasn’t liver — it was injectable.

     And Gary Brecka, who claims to predict your death date (for a fee).

     These are subscription services disguised as sages.

     
     

     What NAD Actually Is

     Nicotinamide adenine dinucleotide (NAD⁺) is a molecule found in every living cell.

     It helps convert food into energy and repair DNA.

     As we age, NAD levels fall — metabolism slows and damage builds up.

     So scientists asked: If we raise NAD again, can we slow aging?

     In mice, the answer looks promising.

     NAD precursors like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) increase average lifespan by 5–15 percent and improve energy, insulin sensitivity, and activity.

     That’s great for mice — but we don’t live in cages or eat lab chow.

     
     

     Can You Get NAD from Food?

     Not directly — but your body makes NAD from dietary precursors:

     tryptophan and niacin (vitamin B₃).

     You’ll find them in fish, poultry, beans, milk, and whole grains — basically, a Mediterranean-style diet.

     So before spending $90 on capsules, you can spend $9 at the farmers' market.

     
     

     What the Human Studies Show

     Human trials of NR or NMN (usually 500–2000 mg per day for 6–12 weeks) show they are safe and well-tolerated.

     They modestly raise NAD levels and sometimes improve lipid profiles and blood pressure.

     But the effects are small and inconsistent, especially in healthy adults.

     NAD precursors do not reverse aging.

     They don’t prevent heart attacks or extend lifespan in people — at least, not yet.

     
     

     NAD vs Statins: A Reality Check

     Meta-analyses show NAD precursors, especially niacin, can lower LDL (“bad”) cholesterol by about 8–12 percent.

     That’s fine, but compare it to rosuvastatin (Crestor):

     DoseAverage LDL Reduction5 mg≈ 45 %10 mg≈ 52 %20 mg≈ 55 %40 mg≈ 63 %

     That’s the difference between “interesting biochemistry” and “fewer funerals.”

     So NAD may nudge your cholesterol; statins save lives.

     
     

     Who Might Benefit

     Older adults with metabolic syndrome, prediabetes, or early neurodegenerative disease could see modest improvements in inflammation or blood lipids.

     Younger, healthier people mostly see lighter wallets.

     No serious drug interactions have been documented, though theoretical ones exist with some chemotherapy or DNA-repair drugs.

     As always, talk to your doctor before combining anything with prescription therapy.

     
     

     Food Before Pharma

     The best way to support NAD and longevity is still food, sleep, and movement.

     A Mediterranean diet rich in legumes, vegetables, olive oil, and fish fuels NAD pathways naturally — and has proven benefits for heart and brain health.

     No influencer code required.

     
     

     A Note from the Galley

     We’ll explore all of this — diet, longevity, and a little wine science — on next summer’s Mediterranean Longevity Cruise.

     World-class physicians, scientists, and chefs will join me for ten days of evidence-based indulgence.

     It’ll cost less than a Peter Attia consult — and no one will force you to drink AG1.

     (For the record, I still do. It’s gentle on my stomach, but I’m hunting for less bougie vitamins.)

     
     

     The Takeaway

     Boosting NAD may someday help extend healthspan, but for now, the best evidence still supports:

     • Eat Mediterranean-style food.
     • Move daily.
     • Sleep enough.
     • Manage stress.
     • See your doctor before your supplement dealer.
     
     

     That’s how you live longer and better — no silver bullet, just science and common sense.

     
     

     References

     Effects of NAD+ Precursor Supplementation on Glucose and Lipid Metabolism in Humans: A Meta-Analysis. Zhong O, Wang J, Tan Y, Lei X, Tang Z. Nutrition & Metabolism. 2022;19(1):20. doi:10.1186/s12986-022-00653-9.

     2 Niacin: An Old Lipid Drug in a New NAD+ Dress. Romani M, Hofer DC, Katsyuba E, Auwerx J. Journal of Lipid Research. 2019;60(4):741-746. doi:10.1194/jlr.S092007.

     3.Nicotinamide Adenine Dinucleotide in Aging Biology: Potential Applications and Many Unknowns. Bhasin S, Seals D, Migaud M, Musi N, Baur JA. Endocrine Reviews. 2023;44(6):1047-1073. doi:10.1210/endrev/bnad019.

     4. Crestor. FDA Drug Label. Food and Drug Administration Updated date: 2024-07-31

     ]]>8971d479-394a-43a3-a017-167a98be7a58Thu, 06 Nov 2025 00:00:00 -070012:33falsefull101101FORK U #100 — The Hall of Fame and Shame🎙 Celebrating 100 Episodes of Science, Sanity, and a Little Sarcasm

     This is it — our 100th episode of FORK U.

     Over the last hundred episodes, we’ve gone from goat-gland hucksters to the microbiome, from Kellogg’s enemas to cholesterol chemistry, and from Blue Zones to bird flu.

     Today, we look back — not just to celebrate the great scientists who shaped modern medicine, but to expose the modern influencers who sell that same science back to you in a bottle.

     Welcome to The FORK U Hall of Fame and Shame.

     

     🧠 The Hall of Fame

     🩺 Dr. Ancel Keys — The Misunderstood Scientist

     Dr. Ancel Keys didn’t make guesses — he made measurements.

     He and his team built one of the most detailed long-term studies in the history of medicine.

     They went village by village across seven countries.

     They collected what people ate, sent food samples back to labs, recorded EKGs, drew blood, and reviewed medical charts — not for a few months, but for decades.

     That’s what science looks like: patient, precise, persistent.

     Critics like Gary Taubes claim Keys “left out countries.”

     That’s false — and it only proves they never read his work.

     Keys studied cohorts of men within small villages, followed them carefully over the years to learn how diet and disease connected.

     Without today’s molecular tools, he still discovered the pattern that modern science later confirmed:

     ApoB — the protein attached to LDL cholesterol — is transported into the arterial wall, starting the process of atherosclerosis.

     Keys didn’t chase fame. He chased truth.

     His data became the foundation of preventive cardiology.

     If you want to honor him, drizzle olive oil instead of conspiracy.

     And a personal note — my thanks to Dr. Harry Blackburn, who worked with Keys and has kindly shared insights from those pioneering days.

     💉 Dr. Frederick Banting and Charles Best — The Children Who Woke Up

     In 1922, Banting and Best discovered insulin.

     Before that, children with diabetes slipped into comas and died.

     After the first injections, they woke up.

     Their parents fed them well, but diet alone couldn’t save them.

     Good science did.

     It was one of medicine’s greatest moments — and still saves lives every day.

     
     

     🧬 Dr. Kanehiro Takaki — The First Vitamin

     Before anyone even knew the word vitamin, Japanese surgeon Dr. Kanehiro Takaki saw sailors dying from beriberi.

     Using early ideas of epidemiology, he realized the problem wasn’t infection but nutrition.

     He changed their diet — adding barley and vegetables — and the disease vanished.

     Takaki brought Japan into modern medicine.

     Even Dr. Charles Mayo admired him.

     Had he lived longer, he would likely have shared a Nobel Prize.

     
     

     🧫 Dr. Leonard Hayflick — The Original Longevity Doctor

     In 1961, Dr. Leonard Hayflick discovered something remarkable:

     Human cells divide about fifty times, then stop — the Hayflick Limit.

     He proved aging isn’t mystical. It’s biological.

     Every division shortens a cell’s life clock until it retires.

     His research wasn’t about nutrition, but it changed everything about how we understand aging and regeneration.

     He was the first true longevity doctor — without supplements, slogans, or selfies.

     
     

     ❤️ The DASH and Portfolio Diet Teams

     The DASH Diet — Dietary Approaches to Stop Hypertension — came from a dream team of researchers.

     • Dr. Lawrence Appel at Johns Hopkins led the NIH trial.
     • Drs. George Bray, Donna Ryan, and Catherine Champagne built the menu at Pennington Biomedical.
     • Dr. Frank Sacks at Harvard analyzed the data.
     
     

     They showed that a diet rich in fruits, vegetables, and low-fat dairy could lower blood pressure without weight loss.

     Then came the Portfolio Diet, developed by Dr. David Jenkins and his team at the University of Toronto.

     They combined soy, nuts, soluble fiber, and plant sterols — lowering LDL cholesterol by up to 17 percent.

     That’s culinary medicine — research that feeds both the lab and the kitchen.

     And yet some influencers still say we need “more salt.”

     The DASH team proved the opposite — unless, of course, you’re selling $39 mango-flavored electrolytes on TikTok.

     
     

     🩻 Edinburgh — Where Surgery Became Science

     If you ever visit Edinburgh, skip the castle and go straight to the Surgeons’ Hall Museum.

     Inside are the breakthroughs that transformed surgery:

     Lister’s antisepsis, Syme’s anatomy, and James Young Simpson’s chloroform.

     It was here that Arthur Conan Doyle, as a medical student, learned from Dr. Joseph Bell, the sharp observer who inspired Sherlock Holmes.

     From those halls, medicine shifted from superstition to study — from anecdote to anatomy.

     It’s where modern diagnosis began.

     And this month on TikTok, we’ll walk those halls together.

     
     

     🚫 The Hall of Shame

     🧬 Gary Brecka — The Biohacking Hypeman

     Every generation gets its snake-oil salesman; ours just live-streams.

     Gary Brecka calls himself a biologist who can predict your date of death — and change it for a price.

     He has no medical degree, just a bachelor’s in biology and a borrowed pair of scrubs.

     He never finished chiropractic school.

     He sells hydrogen-water bottles, claiming there are 1,400 studies — there aren’t.

     He says cold plunges melt fat — they don’t.

     If they did, every Alaskan fisherman would look like Thor.

     Brecka’s not a scientist. He’s a salesman with a ring light.

     
     

     🧑‍⚕️ Barbara O’Neill — The Preacher, Not the Professor

     Barbara O’Neill preaches more than she practices science.

     She claims cayenne pepper stops heart attacks and cholesterol is a Big Pharma hoax.

     She charges thousands for seminars, dismisses evidence, and wraps it all in Seventh-Day Adventist fervor.

     Meanwhile, my Crestor costs $2.36 for three months.

     You do the math.

     
     

     🧴 The Supplement Influencers

     Now for the shirtless side of pseudoscience.

     Compare the scientists who built the Mediterranean, DASH, and Portfolio diets to today’s supplement influencers.

     The difference? The scientists do science. The influencers do sales.

     There’s Paul Saladino — the carnivore who rediscovered fruit when steak stopped trending.

     The salt bros selling electrolyte powder at $39 a bag.

     Dr. Gundry, the ex-surgeon who says beans are dangerous — unless you buy his Bean Guard for $60 a month.

     And the Liver King — whose biggest muscle came from a syringe, not a steak.

     They don’t test ideas — they test lighting.

     They make millions selling powders, not progress.

     Science doesn’t need an affiliate link.

     
     

     🩺 The Real Heroes

     While the supplement crowd surfed and sold, real heroes — doctors, nurses, respiratory therapists, and dietitians — showed up every day during the pandemic.

     Before there was a vaccine.

     Before there was safety.

     They went anyway.

     Those are the people who save lives — not the ones selling shortcuts.

     
     

     🔬 Building the Bridge

     After 100 episodes, one truth stands out:

     Science doesn’t need to be sexy to save lives.

     My job — our job — is to build the bridge between real scientists and the public.

     My background is in medicine, but my mission is communication.

     To bring you work done in labs and clinics — not under ring lights.

     The people I feature here aren’t influencers.

     They’re the scientists whose glory comes from a colleague’s handshake, not a sales link.

     Because behind every breakthrough is someone who’ll never trend on TikTok — but they’re the ones who truly change the world.

     That’s what FORK U stands for — separating noise from nutrition, hype from health, and always choosing evidence over ego.

     ]]>🎙 Celebrating 100 Episodes of Science, Sanity, and a Little Sarcasm

     This is it — our 100th episode of FORK U.

     Over the last hundred episodes, we’ve gone from goat-gland hucksters to the microbiome, from Kellogg’s enemas to cholesterol chemistry, and from Blue Zones to bird flu.

     Today, we look back — not just to celebrate the great scientists who shaped modern medicine, but to expose the modern influencers who sell that same science back to you in a bottle.

     Welcome to The FORK U Hall of Fame and Shame.

     

     🧠 The Hall of Fame

     🩺 Dr. Ancel Keys — The Misunderstood Scientist

     Dr. Ancel Keys didn’t make guesses — he made measurements.

     He and his team built one of the most detailed long-term studies in the history of medicine.

     They went village by village across seven countries.

     They collected what people ate, sent food samples back to labs, recorded EKGs, drew blood, and reviewed medical charts — not for a few months, but for decades.

     That’s what science looks like: patient, precise, persistent.

     Critics like Gary Taubes claim Keys “left out countries.”

     That’s false — and it only proves they never read his work.

     Keys studied cohorts of men within small villages, followed them carefully over the years to learn how diet and disease connected.

     Without today’s molecular tools, he still discovered the pattern that modern science later confirmed:

     ApoB — the protein attached to LDL cholesterol — is transported into the arterial wall, starting the process of atherosclerosis.

     Keys didn’t chase fame. He chased truth.

     His data became the foundation of preventive cardiology.

     If you want to honor him, drizzle olive oil instead of conspiracy.

     And a personal note — my thanks to Dr. Harry Blackburn, who worked with Keys and has kindly shared insights from those pioneering days.

     💉 Dr. Frederick Banting and Charles Best — The Children Who Woke Up

     In 1922, Banting and Best discovered insulin.

     Before that, children with diabetes slipped into comas and died.

     After the first injections, they woke up.

     Their parents fed them well, but diet alone couldn’t save them.

     Good science did.

     It was one of medicine’s greatest moments — and still saves lives every day.

     
     

     🧬 Dr. Kanehiro Takaki — The First Vitamin

     Before anyone even knew the word vitamin, Japanese surgeon Dr. Kanehiro Takaki saw sailors dying from beriberi.

     Using early ideas of epidemiology, he realized the problem wasn’t infection but nutrition.

     He changed their diet — adding barley and vegetables — and the disease vanished.

     Takaki brought Japan into modern medicine.

     Even Dr. Charles Mayo admired him.

     Had he lived longer, he would likely have shared a Nobel Prize.

     
     

     🧫 Dr. Leonard Hayflick — The Original Longevity Doctor

     In 1961, Dr. Leonard Hayflick discovered something remarkable:

     Human cells divide about fifty times, then stop — the Hayflick Limit.

     He proved aging isn’t mystical. It’s biological.

     Every division shortens a cell’s life clock until it retires.

     His research wasn’t about nutrition, but it changed everything about how we understand aging and regeneration.

     He was the first true longevity doctor — without supplements, slogans, or selfies.

     
     

     ❤️ The DASH and Portfolio Diet Teams

     The DASH Diet — Dietary Approaches to Stop Hypertension — came from a dream team of researchers.

     • Dr. Lawrence Appel at Johns Hopkins led the NIH trial.
     • Drs. George Bray, Donna Ryan, and Catherine Champagne built the menu at Pennington Biomedical.
     • Dr. Frank Sacks at Harvard analyzed the data.
     
     

     They showed that a diet rich in fruits, vegetables, and low-fat dairy could lower blood pressure without weight loss.

     Then came the Portfolio Diet, developed by Dr. David Jenkins and his team at the University of Toronto.

     They combined soy, nuts, soluble fiber, and plant sterols — lowering LDL cholesterol by up to 17 percent.

     That’s culinary medicine — research that feeds both the lab and the kitchen.

     And yet some influencers still say we need “more salt.”

     The DASH team proved the opposite — unless, of course, you’re selling $39 mango-flavored electrolytes on TikTok.

     
     

     🩻 Edinburgh — Where Surgery Became Science

     If you ever visit Edinburgh, skip the castle and go straight to the Surgeons’ Hall Museum.

     Inside are the breakthroughs that transformed surgery:

     Lister’s antisepsis, Syme’s anatomy, and James Young Simpson’s chloroform.

     It was here that Arthur Conan Doyle, as a medical student, learned from Dr. Joseph Bell, the sharp observer who inspired Sherlock Holmes.

     From those halls, medicine shifted from superstition to study — from anecdote to anatomy.

     It’s where modern diagnosis began.

     And this month on TikTok, we’ll walk those halls together.

     
     

     🚫 The Hall of Shame

     🧬 Gary Brecka — The Biohacking Hypeman

     Every generation gets its snake-oil salesman; ours just live-streams.

     Gary Brecka calls himself a biologist who can predict your date of death — and change it for a price.

     He has no medical degree, just a bachelor’s in biology and a borrowed pair of scrubs.

     He never finished chiropractic school.

     He sells hydrogen-water bottles, claiming there are 1,400 studies — there aren’t.

     He says cold plunges melt fat — they don’t.

     If they did, every Alaskan fisherman would look like Thor.

     Brecka’s not a scientist. He’s a salesman with a ring light.

     
     

     🧑‍⚕️ Barbara O’Neill — The Preacher, Not the Professor

     Barbara O’Neill preaches more than she practices science.

     She claims cayenne pepper stops heart attacks and cholesterol is a Big Pharma hoax.

     She charges thousands for seminars, dismisses evidence, and wraps it all in Seventh-Day Adventist fervor.

     Meanwhile, my Crestor costs $2.36 for three months.

     You do the math.

     
     

     🧴 The Supplement Influencers

     Now for the shirtless side of pseudoscience.

     Compare the scientists who built the Mediterranean, DASH, and Portfolio diets to today’s supplement influencers.

     The difference? The scientists do science. The influencers do sales.

     There’s Paul Saladino — the carnivore who rediscovered fruit when steak stopped trending.

     The salt bros selling electrolyte powder at $39 a bag.

     Dr. Gundry, the ex-surgeon who says beans are dangerous — unless you buy his Bean Guard for $60 a month.

     And the Liver King — whose biggest muscle came from a syringe, not a steak.

     They don’t test ideas — they test lighting.

     They make millions selling powders, not progress.

     Science doesn’t need an affiliate link.

     
     

     🩺 The Real Heroes

     While the supplement crowd surfed and sold, real heroes — doctors, nurses, respiratory therapists, and dietitians — showed up every day during the pandemic.

     Before there was a vaccine.

     Before there was safety.

     They went anyway.

     Those are the people who save lives — not the ones selling shortcuts.

     
     

     🔬 Building the Bridge

     After 100 episodes, one truth stands out:

     Science doesn’t need to be sexy to save lives.

     My job — our job — is to build the bridge between real scientists and the public.

     My background is in medicine, but my mission is communication.

     To bring you work done in labs and clinics — not under ring lights.

     The people I feature here aren’t influencers.

     They’re the scientists whose glory comes from a colleague’s handshake, not a sales link.

     Because behind every breakthrough is someone who’ll never trend on TikTok — but they’re the ones who truly change the world.

     That’s what FORK U stands for — separating noise from nutrition, hype from health, and always choosing evidence over ego.

     ]]>7eaa0d54-cfd2-45cb-9c1f-f846494a7773Fri, 31 Oct 2025 00:00:00 -070014:29falsefull100100The Global Thanksgiving TableThanksgiving is more than a meal — it’s a worldwide celebration of gratitude built around foods that started here in the Americas. Corn, beans, potatoes, and turkey didn’t just feed a nation; they changed global cuisine. Today, we blend culinary history with medical sense to show how to enjoy the feast without the nap.

     🍁 A Holiday for the World

     Our Canadian friends already finished their celebration. For their Thanksgiving, I roasted a chicken with Swiss Chalet sauce — if you know, you know. Thank you, Canada, for giving us Tim Hortons, Swiss Chalet, and the perfect excuse for early gravy season.

     In the United States, we wait for the fourth Thursday in November to celebrate. And while Thanksgiving began as a survival story between settlers and Native Americans, it’s become a global holiday. Whether you’re in Edinburgh, London, or Los Angeles, if there’s a turkey on your table, you’re part of it.

     
     

     🦃 The Turkey Truth

     Turkey is a ridiculously large bird. Cooking one whole is like putting a cow in the oven and hoping all the parts turn out right — it just doesn’t work.

     That’s why I separate mine. The breast goes into a sous vide bath until juicy and tender, and the legs roast separately until golden brown. This approach keeps everyone happy and the meat perfectly cooked.

     Another reason to love turkey: it’s naturally low in saturated fat, especially compared to red meat. So, when prepared well, it’s one of the healthiest centerpieces for your table.

     
     

     🥖 Cornbread Stuffing — Cook It Safely

     Stuffing the bird might seem traditional, but it can also be dangerous. Baking bread inside raw poultry turns your dinner into a bacteria incubator. Instead, bake it separately.

     My favorite? Cornbread stuffing — a true dish of the Americas. Combine cornbread cubes, sautéed onions, celery, herbs, mushrooms, and broth. For extra flavor, crisp up some turkey skin like “poultry bacon” and crumble it on top.

     (You’ll find the full recipe at terrysimpson.com)

     
     

     🥔 Potatoes — From the Andes to Every Plate

     Long before Europeans knew what a potato was, Indigenous farmers in the Andes were cultivating hundreds of varieties. Those humble tubers crossed the ocean and reshaped diets from Dublin to Delhi. Yes, the Italians perfected Gnochi - and the Irish love of the potato brought many of our finest folks to the United States.

     At my table, I keep mashed potatoes simple — Yukon Golds, butter, olive oil, milk, salt, and pepper. No truffle oil. No mountain of bacon. Just creamy, honest comfort food.

     
     

     🥗 Green Beans and the Three Sisters

     Green beans are another gift from the Americas. Native farmers grew them with corn and squash — the Three Sisters that nourished generations. The beans climbed the corn stalks while enriching the soil — the original regenerative farming.

     In Culinary Medicine, we love beans for their fiber, plant protein, and heart-healthy nutrients.

     If you’re remaking the classic green bean casserole, skip the canned soup. Use fresh mushrooms, milk, and a touch of cornstarch. Or, sauté the beans in olive oil and garlic for a lighter, Mediterranean twist.

     (Full recipe posted at terrysimpson.com)

     
     

     🥣 Cowboy Caviar — A Smart Starter

     Before the main event, try Cowboy Caviar — a colorful bean salad from the American Southwest. It’s bright, high in fiber, and helps you eat more slowly (and more sanely).

     Mix black beans, black-eyed peas, corn, peppers, red onion, avocado, olive oil, lime juice, and cilantro. Chill it and watch it vanish.

     
     

     🍷 The Truth About the Food Coma

     Everyone blames tryptophan, but the real reason for that post-Thanksgiving crash is carbs, alcohol, and portion size.

     When you load up on potatoes, rolls, and pie, your insulin spikes, helping tryptophan turn into melatonin — your sleep hormone. Add a glass (or three) of wine and you’re down for the count.

     To avoid it, eat slowly, take a short walk after dinner, and save dessert for later. Your pancreas will thank you.

     
     

     🍰 Dessert and a Confession

     I’m a surgeon, not a baker. So, I buy my pumpkin pie from Costco and serve it with vanilla ice cream. Sometimes, simplicity really is the secret ingredient.

     
     

     🔥 FORK U with Flavor — Coming Soon Live

     We’re launching a new live cooking show called FORK U with Flavor!

     Join me on TikTok (@drterrysimpson) and maybe Instagram (@drterrysimpsonmd) as we cook together, talk food science, and share a few laughs.

     Paid Substack subscribers at drsimpson.com get ingredient lists and recipes ahead of time so you can cook along live. Everyone else gets the replay links and recipes afterward.

     If you can’t watch me set off the occasional smoke alarm, you haven’t lived.

     
     

     ❤️ A Final Thought

     Wherever you live — America, Canada, or across the pond — Thanksgiving reminds us that food connects us all.

     Eat well. Be grateful. And remember, food isn’t just medicine — it’s connection, culture, and joy.

     Happy Thanksgiving from me, Dr. Terry Simpson, and the FORK U team.

     ]]>Thanksgiving is more than a meal — it’s a worldwide celebration of gratitude built around foods that started here in the Americas. Corn, beans, potatoes, and turkey didn’t just feed a nation; they changed global cuisine. Today, we blend culinary history with medical sense to show how to enjoy the feast without the nap.

     🍁 A Holiday for the World

     Our Canadian friends already finished their celebration. For their Thanksgiving, I roasted a chicken with Swiss Chalet sauce — if you know, you know. Thank you, Canada, for giving us Tim Hortons, Swiss Chalet, and the perfect excuse for early gravy season.

     In the United States, we wait for the fourth Thursday in November to celebrate. And while Thanksgiving began as a survival story between settlers and Native Americans, it’s become a global holiday. Whether you’re in Edinburgh, London, or Los Angeles, if there’s a turkey on your table, you’re part of it.

     
     

     🦃 The Turkey Truth

     Turkey is a ridiculously large bird. Cooking one whole is like putting a cow in the oven and hoping all the parts turn out right — it just doesn’t work.

     That’s why I separate mine. The breast goes into a sous vide bath until juicy and tender, and the legs roast separately until golden brown. This approach keeps everyone happy and the meat perfectly cooked.

     Another reason to love turkey: it’s naturally low in saturated fat, especially compared to red meat. So, when prepared well, it’s one of the healthiest centerpieces for your table.

     
     

     🥖 Cornbread Stuffing — Cook It Safely

     Stuffing the bird might seem traditional, but it can also be dangerous. Baking bread inside raw poultry turns your dinner into a bacteria incubator. Instead, bake it separately.

     My favorite? Cornbread stuffing — a true dish of the Americas. Combine cornbread cubes, sautéed onions, celery, herbs, mushrooms, and broth. For extra flavor, crisp up some turkey skin like “poultry bacon” and crumble it on top.

     (You’ll find the full recipe at terrysimpson.com)

     
     

     🥔 Potatoes — From the Andes to Every Plate

     Long before Europeans knew what a potato was, Indigenous farmers in the Andes were cultivating hundreds of varieties. Those humble tubers crossed the ocean and reshaped diets from Dublin to Delhi. Yes, the Italians perfected Gnochi - and the Irish love of the potato brought many of our finest folks to the United States.

     At my table, I keep mashed potatoes simple — Yukon Golds, butter, olive oil, milk, salt, and pepper. No truffle oil. No mountain of bacon. Just creamy, honest comfort food.

     
     

     🥗 Green Beans and the Three Sisters

     Green beans are another gift from the Americas. Native farmers grew them with corn and squash — the Three Sisters that nourished generations. The beans climbed the corn stalks while enriching the soil — the original regenerative farming.

     In Culinary Medicine, we love beans for their fiber, plant protein, and heart-healthy nutrients.

     If you’re remaking the classic green bean casserole, skip the canned soup. Use fresh mushrooms, milk, and a touch of cornstarch. Or, sauté the beans in olive oil and garlic for a lighter, Mediterranean twist.

     (Full recipe posted at terrysimpson.com)

     
     

     🥣 Cowboy Caviar — A Smart Starter

     Before the main event, try Cowboy Caviar — a colorful bean salad from the American Southwest. It’s bright, high in fiber, and helps you eat more slowly (and more sanely).

     Mix black beans, black-eyed peas, corn, peppers, red onion, avocado, olive oil, lime juice, and cilantro. Chill it and watch it vanish.

     
     

     🍷 The Truth About the Food Coma

     Everyone blames tryptophan, but the real reason for that post-Thanksgiving crash is carbs, alcohol, and portion size.

     When you load up on potatoes, rolls, and pie, your insulin spikes, helping tryptophan turn into melatonin — your sleep hormone. Add a glass (or three) of wine and you’re down for the count.

     To avoid it, eat slowly, take a short walk after dinner, and save dessert for later. Your pancreas will thank you.

     
     

     🍰 Dessert and a Confession

     I’m a surgeon, not a baker. So, I buy my pumpkin pie from Costco and serve it with vanilla ice cream. Sometimes, simplicity really is the secret ingredient.

     
     

     🔥 FORK U with Flavor — Coming Soon Live

     We’re launching a new live cooking show called FORK U with Flavor!

     Join me on TikTok (@drterrysimpson) and maybe Instagram (@drterrysimpsonmd) as we cook together, talk food science, and share a few laughs.

     Paid Substack subscribers at drsimpson.com get ingredient lists and recipes ahead of time so you can cook along live. Everyone else gets the replay links and recipes afterward.

     If you can’t watch me set off the occasional smoke alarm, you haven’t lived.

     
     

     ❤️ A Final Thought

     Wherever you live — America, Canada, or across the pond — Thanksgiving reminds us that food connects us all.

     Eat well. Be grateful. And remember, food isn’t just medicine — it’s connection, culture, and joy.

     Happy Thanksgiving from me, Dr. Terry Simpson, and the FORK U team.

     ]]>11ec432d-5a2c-4640-8f9d-ff6627cd59caThu, 23 Oct 2025 00:00:00 -070010:48falsefull9999When Vitamin D Isn't Sunshine in a BottleWhen Vitamin D Isn’t Sunshine in a Bottle

     Vitamin D is sold as bottled sunshine. Social media says it boosts immunity, prevents cancer, and makes you live longer. But science says something very different — and megadoses pushed by influencers like Dr. Eric Berg can do more harm than good. Here’s what you need to know.

     ☀️ The Sunshine Vitamin — and the Myth That Follows

     Vitamin D has been called the sunshine vitamin for over a century.

     We discovered it when children in industrial cities developed rickets — bones so soft they bent like rubber.

     The cure wasn’t pills. It was sunlight and milk fortified with Vitamin D.

     Today, that history is lost under a pile of influencer ads.

     Scroll through TikTok or YouTube, and you’ll see people claim Vitamin D cures everything — from fatigue to depression to cancer.

     One of the loudest voices is Dr. Eric Berg, who calls himself a “doctor.”

     Here’s the problem: he’s not a physician. He’s a chiropractor.

     And in California, chiropractors aren’t allowed to call themselves physicians. For good reason.

     Dr. Berg recommends doses of Vitamin D that are ten to twenty times higher than medical guidelines. That’s dangerous advice.

     Let’s look at what real science — not social media — tells us.

     
     

     🧬 What Vitamin D Actually Does

     Vitamin D isn’t really a vitamin. It’s a hormone that helps your body absorb calcium, strengthen bones, and regulate parts of your immune system.

     Most adults need 600 to 800 IU per day — not 10,000.

     If your level is low, your doctor may recommend a short course of higher doses, but chronic mega-dosing can lead to toxicity.

     So how much Vitamin D do you actually need?

     That depends on your sun exposure, skin color, diet, and where you live. People who live in northern climates or rarely go outside might need a supplement — but the rest of us get plenty from sunlight and food.

     
     

     📊 What the Research Shows

     The VITAL Trial, published in The New England Journal of Medicine (2019), followed over 25,000 people taking Vitamin D or a placebo.

     The result? No meaningful reduction in cancer, heart disease, or death.

     Other major studies say the same thing.

     If your Vitamin D levels are normal, taking more doesn’t improve health — it just makes your urine more expensive.

     There are benefits for people who are deficient, but that’s not most of us.

     A simple blood test can tell you if you truly need supplementation.

     
     

     ⚠️ Too Much of a Good Thing

     Vitamin D toxicity is not rare.

     Excess doses can cause calcium levels in your blood to spike, leading to nausea, confusion, kidney stones, and even heart rhythm problems.

     There is no benefit to megadoses of vitamin D (link)

     
     

     🍳 Real Food, Real Sunshine

     Here’s the truth: you can get enough Vitamin D the way nature intended.

     Good sources include:

     • Salmon, sardines, and tuna
     • Eggs and fortified milk
     • Mushrooms
     • And, of course, sunlight
     
     

     Ten to fifteen minutes of midday sun on your arms and legs a few times a week is usually enough.

     If you live in Alaska in January, sure — take a supplement.

     But for most of us, a walk outside beats a handful of pills.

     
     

     🧠 Why We Love Pills

     It’s easy to see why Vitamin D is so popular.

     It promises health without effort.

     Pop a pill instead of taking a walk, eat poorly, but believe you’re fixing it — it’s the illusion of health without the habit of health.

     But biology isn’t fooled.

     Our bodies need balance, not shortcuts.

     Supplements can help fill a true gap — not when they replace good food and lifestyle.

     
     

     🩺 The Takeaway

     Vitamin D is essential — just not magical.

     If you’re deficient, fix it.

     If you’re not, skip the megadoses and save your kidneys.

     And please — don’t take medical advice from a chiropractor on YouTube.

     The best way to get your Vitamin D?

     Eat well. Move more. Go outside.

     That’s the real sunshine therapy.

     
     

     🧾 References

     1. Manson JE et al. Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease (VITAL Trial). NEJM 2019; 380:33–44.
     2. Bolland MJ et al. Effect of Vitamin D Supplementation on Mortality and Disease Outcomes. Lancet Diabetes Endocrinol. 2022; 10(2):120–130.
     3. Marcinowska-Suchowierska E et al. Toxic Effects of Vitamin D Overdose. Front Endocrinol. 2018; 9:550.
     4. Ataide FL, Carvalho Bastos LM, Vicente Matias MF, Skare TL, Freire de Carvalho J. Safety and effectiveness of vitamin D mega-dose: A systematic review. Clin Nutr ESPEN. 2021 Dec;46:115-120. doi: 10.1016/j.clnesp.2021.09.010. Epub 2021 Sep 25. PMID: 34857184.
     5. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press, 2011.
     
     ]]>When Vitamin D Isn’t Sunshine in a Bottle

     Vitamin D is sold as bottled sunshine. Social media says it boosts immunity, prevents cancer, and makes you live longer. But science says something very different — and megadoses pushed by influencers like Dr. Eric Berg can do more harm than good. Here’s what you need to know.

     ☀️ The Sunshine Vitamin — and the Myth That Follows

     Vitamin D has been called the sunshine vitamin for over a century.

     We discovered it when children in industrial cities developed rickets — bones so soft they bent like rubber.

     The cure wasn’t pills. It was sunlight and milk fortified with Vitamin D.

     Today, that history is lost under a pile of influencer ads.

     Scroll through TikTok or YouTube, and you’ll see people claim Vitamin D cures everything — from fatigue to depression to cancer.

     One of the loudest voices is Dr. Eric Berg, who calls himself a “doctor.”

     Here’s the problem: he’s not a physician. He’s a chiropractor.

     And in California, chiropractors aren’t allowed to call themselves physicians. For good reason.

     Dr. Berg recommends doses of Vitamin D that are ten to twenty times higher than medical guidelines. That’s dangerous advice.

     Let’s look at what real science — not social media — tells us.

     
     

     🧬 What Vitamin D Actually Does

     Vitamin D isn’t really a vitamin. It’s a hormone that helps your body absorb calcium, strengthen bones, and regulate parts of your immune system.

     Most adults need 600 to 800 IU per day — not 10,000.

     If your level is low, your doctor may recommend a short course of higher doses, but chronic mega-dosing can lead to toxicity.

     So how much Vitamin D do you actually need?

     That depends on your sun exposure, skin color, diet, and where you live. People who live in northern climates or rarely go outside might need a supplement — but the rest of us get plenty from sunlight and food.

     
     

     📊 What the Research Shows

     The VITAL Trial, published in The New England Journal of Medicine (2019), followed over 25,000 people taking Vitamin D or a placebo.

     The result? No meaningful reduction in cancer, heart disease, or death.

     Other major studies say the same thing.

     If your Vitamin D levels are normal, taking more doesn’t improve health — it just makes your urine more expensive.

     There are benefits for people who are deficient, but that’s not most of us.

     A simple blood test can tell you if you truly need supplementation.

     
     

     ⚠️ Too Much of a Good Thing

     Vitamin D toxicity is not rare.

     Excess doses can cause calcium levels in your blood to spike, leading to nausea, confusion, kidney stones, and even heart rhythm problems.

     There is no benefit to megadoses of vitamin D (link)

     
     

     🍳 Real Food, Real Sunshine

     Here’s the truth: you can get enough Vitamin D the way nature intended.

     Good sources include:

     • Salmon, sardines, and tuna
     • Eggs and fortified milk
     • Mushrooms
     • And, of course, sunlight
     
     

     Ten to fifteen minutes of midday sun on your arms and legs a few times a week is usually enough.

     If you live in Alaska in January, sure — take a supplement.

     But for most of us, a walk outside beats a handful of pills.

     
     

     🧠 Why We Love Pills

     It’s easy to see why Vitamin D is so popular.

     It promises health without effort.

     Pop a pill instead of taking a walk, eat poorly, but believe you’re fixing it — it’s the illusion of health without the habit of health.

     But biology isn’t fooled.

     Our bodies need balance, not shortcuts.

     Supplements can help fill a true gap — not when they replace good food and lifestyle.

     
     

     🩺 The Takeaway

     Vitamin D is essential — just not magical.

     If you’re deficient, fix it.

     If you’re not, skip the megadoses and save your kidneys.

     And please — don’t take medical advice from a chiropractor on YouTube.

     The best way to get your Vitamin D?

     Eat well. Move more. Go outside.

     That’s the real sunshine therapy.

     
     

     🧾 References

     1. Manson JE et al. Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease (VITAL Trial). NEJM 2019; 380:33–44.
     2. Bolland MJ et al. Effect of Vitamin D Supplementation on Mortality and Disease Outcomes. Lancet Diabetes Endocrinol. 2022; 10(2):120–130.
     3. Marcinowska-Suchowierska E et al. Toxic Effects of Vitamin D Overdose. Front Endocrinol. 2018; 9:550.
     4. Ataide FL, Carvalho Bastos LM, Vicente Matias MF, Skare TL, Freire de Carvalho J. Safety and effectiveness of vitamin D mega-dose: A systematic review. Clin Nutr ESPEN. 2021 Dec;46:115-120. doi: 10.1016/j.clnesp.2021.09.010. Epub 2021 Sep 25. PMID: 34857184.
     5. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press, 2011.
     
     ]]>ec0cbf85-bdab-478d-bef4-c65a93861c39Thu, 16 Oct 2025 00:00:00 -070006:52falsefull9898Animal Protein and Cancer RiskAnimal Protein and Cancer Risk: What the Science Really Says

     Recently, Mark Hyman posted on X (formerly Twitter) that a new study suggests eating more animal protein might actually lower your risk of cancer. The study he pointed to came from the NHANES dataset—a U.S. survey of diet and health. It sounded reassuring, but it doesn’t line up with the bulk of the evidence. Here is the story about Animal protein and cancer risk:

     Let’s dig into what the science really shows.

     Red and Processed Meats: Where the Risk Is Clear

     If you want the strongest evidence, look at red and processed meats. Large prospective cohort studies and systematic reviews consistently show that higher intake of these foods increases cancer risk. The effect is clearest for colorectal cancer, but we also see it in breast, endometrial, and even lung cancer.[1–6]

     How big is the risk? Recent meta-analyses and systematic reviews find relative risks (RRs) and hazard ratios (HRs) in the 1.10–1.30 range for the highest vs. lowest intakes. For example, a comprehensive meta-analysis reported that every 50–70 grams per day of red or processed meat increased colorectal cancer risk by 15–32% (HR 1.15–1.32).[3,5] Processed meat generally carries more risk than unprocessed red meat.[2–3,6]

     That’s why the American Cancer Society recommends limiting red and processed meats. Their advice is clear: swap them out for fish, poultry, or legumes when possible.[15]

     Fish: A Safer Bet

     The data on fish tells a different story. Multiple studies and meta-analyses find a modest reduction in colorectal cancer risk with higher fish intake (SRR 0.94, 95% CI 0.89–0.99).[7–8] In fact, adding 50 grams of fish per day reduces risk by about 4%.

     Pescatarian diets (no red meat, but including fish) show even more protection. Compared to meat-eaters, pescatarians had a 9% lower overall and colorectal cancer risk (RR 0.91, 95% CI 0.86–0.96).[9]

     
     

     Poultry: Mostly Neutral

     Chicken and turkey usually get lumped in with “animal protein.” But when you pull the data apart, poultry tells a different story. Most meta-analyses show a neutral or even slightly protective association with colorectal cancer (RR 0.79, 95% CI 0.63–0.99 for white meat).[10–12]

     That said, a few studies hint at possible links with certain blood cancers, but those findings aren’t strong or consistent.[5,10] For most people, poultry is a much safer choice than red or processed meats.

     
     

     Dairy: A Mixed Picture

     Dairy is tricky. On one hand, milk and calcium-rich foods are consistently linked to a lower risk of colorectal cancer (RR 0.93, 95% CI 0.91–0.94).[4,13] On the other hand, high intake of milk or calcium may slightly increase the risk of prostate and endometrial cancers (RR 1.09–1.10).[13–14]

     No consistent associations are found for breast or ovarian cancer. Cheese intake in particular may even have protective effects, but results vary.

     
     

     Why the Confusion?

     So why did that NHANES study Mark Hyman highlighted find a small reduction in cancer mortality with higher animal protein? A few reasons:

     • NHANES relies on a single dietary recall—one snapshot in time that may not reflect long-term habits.
     • It doesn’t separate red and processed meat from healthier animal proteins like fish or poultry.
     • Residual confounding (differences in lifestyle factors that aren’t fully accounted for) may skew the results.
     
     

     When you put NHANES side by side with larger, longer-term studies and meta-analyses, it looks like the outlier. The overwhelming weight of evidence shows that red and processed meats increase cancer risk, while fish, poultry, and some dairy products are safer or even protective in specific cases. Animal protein and cancer risk is positive.

     
     

     The Bottom Line

     Protein matters—but the source matters more.

     • Red and processed meats: consistently linked to higher cancer risk
     • Fish: modestly protective, especially for colorectal cancer
     • Poultry: generally neutral, sometimes protective
     • Dairy: lowers colorectal risk, but may raise prostate and endometrial cancer risk
     
     

     The American Cancer Society sums it up well: limit red and processed meats, and lean into fish, poultry, beans, and plant-based proteins.[15]

     
     

     
     

     References

     [1] Rock CL, Thomson C, Gansler T, et al. CA Cancer J Clin. 2020;70(4):245-271.

     [2] Abid Z, Cross AJ, Sinha R. Am J Clin Nutr. 2014;100 Suppl 1:386S-93S.

     [3] Lippi G, Mattiuzzi C, Cervellin G. Crit Rev Oncol Hematol. 2016;97:1-14.

     [4] Boada LD, Henríquez-Hernández LA, Luzardo OP. Food Chem Toxicol. 2016;92:236-244.

     [5] Diallo A, Deschasaux M, Latino-Martel P, et al. Int J Cancer. 2018;142(2):230-237.

     [6] Farvid MS, Sidahmed E, Spence ND, et al. Eur J Epidemiol. 2021;36(9):937-951.

     [7] Poorolajal J, Mohammadi Y, Fattahi-Darghlou M, et al. PLoS One. 2024;19(6):e0305994.

     [8] Vieira AR, Abar L, Chan DSM, et al. Ann Oncol. 2017;28(8):1788-1802.

     [9] Parra-Soto S, Ahumada D, Petermann-Rocha F, et al. BMC Med. 2022;20(1):79.

     [10] Nielsen TB, Würtz AML, Tjønneland A, et al. Br J Nutr. 2022;127(4):563-569.

     [11] Bonfiglio C, Tatoli R, Donghia R, et al. Nutrients. 2025;17(8):1370.

     [12] Wang F, Chandler PD, Zeleznik OA, et al. Nutrients. 2022;14(5):978.

     [13] Willett WC, Ludwig DS. N Engl J Med. 2020;382(7):644-654.

     [14] Watling CZ, Kelly RK, Dunneram Y, et al. Br J Cancer. 2023;129(4):636-647.

     [15] American Cancer Society. Guidelines for Diet and Physical Activity for Cancer Prevention. CA Cancer J Clin. 2020;70(4):245-271.

     ]]>Animal Protein and Cancer Risk: What the Science Really Says

     Recently, Mark Hyman posted on X (formerly Twitter) that a new study suggests eating more animal protein might actually lower your risk of cancer. The study he pointed to came from the NHANES dataset—a U.S. survey of diet and health. It sounded reassuring, but it doesn’t line up with the bulk of the evidence. Here is the story about Animal protein and cancer risk:

     Let’s dig into what the science really shows.

     Red and Processed Meats: Where the Risk Is Clear

     If you want the strongest evidence, look at red and processed meats. Large prospective cohort studies and systematic reviews consistently show that higher intake of these foods increases cancer risk. The effect is clearest for colorectal cancer, but we also see it in breast, endometrial, and even lung cancer.[1–6]

     How big is the risk? Recent meta-analyses and systematic reviews find relative risks (RRs) and hazard ratios (HRs) in the 1.10–1.30 range for the highest vs. lowest intakes. For example, a comprehensive meta-analysis reported that every 50–70 grams per day of red or processed meat increased colorectal cancer risk by 15–32% (HR 1.15–1.32).[3,5] Processed meat generally carries more risk than unprocessed red meat.[2–3,6]

     That’s why the American Cancer Society recommends limiting red and processed meats. Their advice is clear: swap them out for fish, poultry, or legumes when possible.[15]

     Fish: A Safer Bet

     The data on fish tells a different story. Multiple studies and meta-analyses find a modest reduction in colorectal cancer risk with higher fish intake (SRR 0.94, 95% CI 0.89–0.99).[7–8] In fact, adding 50 grams of fish per day reduces risk by about 4%.

     Pescatarian diets (no red meat, but including fish) show even more protection. Compared to meat-eaters, pescatarians had a 9% lower overall and colorectal cancer risk (RR 0.91, 95% CI 0.86–0.96).[9]

     
     

     Poultry: Mostly Neutral

     Chicken and turkey usually get lumped in with “animal protein.” But when you pull the data apart, poultry tells a different story. Most meta-analyses show a neutral or even slightly protective association with colorectal cancer (RR 0.79, 95% CI 0.63–0.99 for white meat).[10–12]

     That said, a few studies hint at possible links with certain blood cancers, but those findings aren’t strong or consistent.[5,10] For most people, poultry is a much safer choice than red or processed meats.

     
     

     Dairy: A Mixed Picture

     Dairy is tricky. On one hand, milk and calcium-rich foods are consistently linked to a lower risk of colorectal cancer (RR 0.93, 95% CI 0.91–0.94).[4,13] On the other hand, high intake of milk or calcium may slightly increase the risk of prostate and endometrial cancers (RR 1.09–1.10).[13–14]

     No consistent associations are found for breast or ovarian cancer. Cheese intake in particular may even have protective effects, but results vary.

     
     

     Why the Confusion?

     So why did that NHANES study Mark Hyman highlighted find a small reduction in cancer mortality with higher animal protein? A few reasons:

     • NHANES relies on a single dietary recall—one snapshot in time that may not reflect long-term habits.
     • It doesn’t separate red and processed meat from healthier animal proteins like fish or poultry.
     • Residual confounding (differences in lifestyle factors that aren’t fully accounted for) may skew the results.
     
     

     When you put NHANES side by side with larger, longer-term studies and meta-analyses, it looks like the outlier. The overwhelming weight of evidence shows that red and processed meats increase cancer risk, while fish, poultry, and some dairy products are safer or even protective in specific cases. Animal protein and cancer risk is positive.

     
     

     The Bottom Line

     Protein matters—but the source matters more.

     • Red and processed meats: consistently linked to higher cancer risk
     • Fish: modestly protective, especially for colorectal cancer
     • Poultry: generally neutral, sometimes protective
     • Dairy: lowers colorectal risk, but may raise prostate and endometrial cancer risk
     
     

     The American Cancer Society sums it up well: limit red and processed meats, and lean into fish, poultry, beans, and plant-based proteins.[15]

     
     

     
     

     References

     [1] Rock CL, Thomson C, Gansler T, et al. CA Cancer J Clin. 2020;70(4):245-271.

     [2] Abid Z, Cross AJ, Sinha R. Am J Clin Nutr. 2014;100 Suppl 1:386S-93S.

     [3] Lippi G, Mattiuzzi C, Cervellin G. Crit Rev Oncol Hematol. 2016;97:1-14.

     [4] Boada LD, Henríquez-Hernández LA, Luzardo OP. Food Chem Toxicol. 2016;92:236-244.

     [5] Diallo A, Deschasaux M, Latino-Martel P, et al. Int J Cancer. 2018;142(2):230-237.

     [6] Farvid MS, Sidahmed E, Spence ND, et al. Eur J Epidemiol. 2021;36(9):937-951.

     [7] Poorolajal J, Mohammadi Y, Fattahi-Darghlou M, et al. PLoS One. 2024;19(6):e0305994.

     [8] Vieira AR, Abar L, Chan DSM, et al. Ann Oncol. 2017;28(8):1788-1802.

     [9] Parra-Soto S, Ahumada D, Petermann-Rocha F, et al. BMC Med. 2022;20(1):79.

     [10] Nielsen TB, Würtz AML, Tjønneland A, et al. Br J Nutr. 2022;127(4):563-569.

     [11] Bonfiglio C, Tatoli R, Donghia R, et al. Nutrients. 2025;17(8):1370.

     [12] Wang F, Chandler PD, Zeleznik OA, et al. Nutrients. 2022;14(5):978.

     [13] Willett WC, Ludwig DS. N Engl J Med. 2020;382(7):644-654.

     [14] Watling CZ, Kelly RK, Dunneram Y, et al. Br J Cancer. 2023;129(4):636-647.

     [15] American Cancer Society. Guidelines for Diet and Physical Activity for Cancer Prevention. CA Cancer J Clin. 2020;70(4):245-271.

     ]]>9906d5d0-6863-49be-8fda-0684db145235Thu, 09 Oct 2025 00:00:00 -070013:31falsefull9797When Green Tea Isn’t ChemotherapyWhen Green Tea Isn’t Chemotherapy

     Introduction

     Food is powerful. Eating well lowers your risk of many diseases, including cancer. Yet food is not chemotherapy. Still, the idea that broccoli or green tea could replace cancer treatment is tempting. It feels safe, natural, and hopeful.

     However, cancer is not treated with vegetables or tea. Cancer is treated with medicine. Let’s break down what food can and cannot do when it comes to cancer.

     Broccoli and Cruciferous Vegetables

     Broccoli, cabbage, Brussels sprouts, and other cruciferous vegetables contain natural compounds like sulforaphane. In lab studies, these compounds slow cancer cell growth. That is promising.

     Furthermore, population studies show that people who regularly eat cruciferous vegetables often have a lower risk of colon, lung, and breast cancers. So, broccoli can help lower risk.

     But here is the key point: broccoli does not cure cancer. No oncologist prescribes broccoli as chemotherapy. Prevention is not the same as treatment.

     
     

     Green Tea and Its Limits

     Green tea is another food often linked to cancer prevention. It contains catechins, such as EGCG, which in test tubes can slow cancer cell growth. Some studies even suggest that people who drink green tea regularly may have slightly lower cancer rates.

     But again, that is prevention. Once cancer begins, drinking green tea will not stop it. And when taken as concentrated supplements, green tea extracts can actually harm the liver.

     So, green tea is a fine beverage. But it is not chemotherapy. Personally, I prefer black tea — green tea tastes a little too much like pond water for me.

     
     

     Scams and False Hope

     Sadly, the gap between prevention and treatment is where scams thrive. You’ve probably heard of things like:

     • Gerson Therapy: organic juices and coffee enemas, still promoted in Mexico. No evidence, high risk.
     • Apricot pits and soursop: marketed as natural cures, but linked to toxicity.
     • Ivermectin: useful for parasites, but not proven in cancer.
     
     

     Then there’s the Warburg effect. Otto Warburg correctly observed that cancer cells use sugar differently. But modern science has shown cancer is not a “sugar disease.” It is a DNA disease caused by mutations. Cancer cells can grow on sugar, ketones, and even vitamins. You cannot starve cancer with diet.

     
     

     What Medicine Has Done

     Now, let’s talk about the real success stories.

     Chemotherapy in the past was harsh, like carpet bombing. Yet it saved lives. My brother Jimmy was diagnosed with stage 4 Hodgkin’s disease in 1969. Thanks to experimental chemotherapy and radiation, he lived 37 more years.

     Today, treatment is even better. We have:

     • Targeted therapies that hit the exact mutation in a tumor.
     • Immunotherapy drugs that unleash the body’s own defenses.
     • Combination therapies that extend survival with fewer side effects.
     
     

     And vaccines are changing everything. The HPV vaccine prevents cervical, anal, and many oral cancers. It may even help lower melanoma risk. Researchers are now studying vaccines for brain cancers like glioblastoma and even for pancreatic cancer.

     No apricot pit will ever do that.

     
     

     Food Still Matters

     We should not ignore food. A poor diet filled with ultra-processed foods and low in fiber increases cancer risk. In fact, the rise in colon cancer among younger adults is likely tied to diets low in fiber and high in processed foods.

     The Mediterranean diet, rich in fruits, vegetables, whole grains, olive oil, and legumes, does more than prevent cancer. The large EPIC studies show it also lowers the risk of cancer coming back after treatment. That makes it the best diet for cancer prevention and recurrence.

     So yes, food matters. Food empowers you. But food is not medicine. Food lowers risk. Medicine treats disease. Together, they protect us.

     
     

     Conclusion

     Green tea and broccoli are healthy. The Mediterranean diet is the best prevention strategy we know. But once cancer develops, treatment is essential.

     Food isn’t chemotherapy. Medicine is. And that is something we should all be grateful for.

     
     

     References

     1. World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018.
     2. Buckland G, Agudo A, Luján L, Jakszyn P, Bueno-de-Mesquita HB, Palli D, Boeing H, Carneiro F, Krogh V, Sacerdote C, Tumino R, Panico S, Nesi G, Manjer J, Regnér S, Johansson I, Stenling R, Sanchez MJ, Dorronsoro M, Barricarte A, Navarro C, Quirós JR, Allen NE, Key TJ, Bingham S, Kaaks R, Overvad K, Jensen M, Olsen A, Tjønneland A, Peeters PH, Numans ME, Ocké MC, Clavel-Chapelon F, Morois S, Boutron-Ruault MC, Trichopoulou A, Lagiou P, Trichopoulos D, Lund E, Couto E, Boffeta P, Jenab M, Riboli E, Romaguera D, Mouw T, González CA. Adherence to a Mediterranean diet and risk of gastric adenocarcinoma within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study. Am J Clin Nutr. 2010 Feb;91(2):381-90. doi: 10.3945/ajcn.2009.28209. Epub 2009 Dec 9. PMID: 20007304.
     3. Jenkins DJA, et al. Green tea catechins and cancer prevention. J Nutr. 2003;133(11 Suppl 1): 3242S–3246S.
     4. WHO. Human papillomavirus (HPV) vaccines. Updated 2022.
     5. Hanahan D. Hallmarks of Cancer: New Dimensions. Cancer Discov. 2022;12(1): 31–46.
     
     ]]>When Green Tea Isn’t Chemotherapy

     Introduction

     Food is powerful. Eating well lowers your risk of many diseases, including cancer. Yet food is not chemotherapy. Still, the idea that broccoli or green tea could replace cancer treatment is tempting. It feels safe, natural, and hopeful.

     However, cancer is not treated with vegetables or tea. Cancer is treated with medicine. Let’s break down what food can and cannot do when it comes to cancer.

     Broccoli and Cruciferous Vegetables

     Broccoli, cabbage, Brussels sprouts, and other cruciferous vegetables contain natural compounds like sulforaphane. In lab studies, these compounds slow cancer cell growth. That is promising.

     Furthermore, population studies show that people who regularly eat cruciferous vegetables often have a lower risk of colon, lung, and breast cancers. So, broccoli can help lower risk.

     But here is the key point: broccoli does not cure cancer. No oncologist prescribes broccoli as chemotherapy. Prevention is not the same as treatment.

     
     

     Green Tea and Its Limits

     Green tea is another food often linked to cancer prevention. It contains catechins, such as EGCG, which in test tubes can slow cancer cell growth. Some studies even suggest that people who drink green tea regularly may have slightly lower cancer rates.

     But again, that is prevention. Once cancer begins, drinking green tea will not stop it. And when taken as concentrated supplements, green tea extracts can actually harm the liver.

     So, green tea is a fine beverage. But it is not chemotherapy. Personally, I prefer black tea — green tea tastes a little too much like pond water for me.

     
     

     Scams and False Hope

     Sadly, the gap between prevention and treatment is where scams thrive. You’ve probably heard of things like:

     • Gerson Therapy: organic juices and coffee enemas, still promoted in Mexico. No evidence, high risk.
     • Apricot pits and soursop: marketed as natural cures, but linked to toxicity.
     • Ivermectin: useful for parasites, but not proven in cancer.
     
     

     Then there’s the Warburg effect. Otto Warburg correctly observed that cancer cells use sugar differently. But modern science has shown cancer is not a “sugar disease.” It is a DNA disease caused by mutations. Cancer cells can grow on sugar, ketones, and even vitamins. You cannot starve cancer with diet.

     
     

     What Medicine Has Done

     Now, let’s talk about the real success stories.

     Chemotherapy in the past was harsh, like carpet bombing. Yet it saved lives. My brother Jimmy was diagnosed with stage 4 Hodgkin’s disease in 1969. Thanks to experimental chemotherapy and radiation, he lived 37 more years.

     Today, treatment is even better. We have:

     • Targeted therapies that hit the exact mutation in a tumor.
     • Immunotherapy drugs that unleash the body’s own defenses.
     • Combination therapies that extend survival with fewer side effects.
     
     

     And vaccines are changing everything. The HPV vaccine prevents cervical, anal, and many oral cancers. It may even help lower melanoma risk. Researchers are now studying vaccines for brain cancers like glioblastoma and even for pancreatic cancer.

     No apricot pit will ever do that.

     
     

     Food Still Matters

     We should not ignore food. A poor diet filled with ultra-processed foods and low in fiber increases cancer risk. In fact, the rise in colon cancer among younger adults is likely tied to diets low in fiber and high in processed foods.

     The Mediterranean diet, rich in fruits, vegetables, whole grains, olive oil, and legumes, does more than prevent cancer. The large EPIC studies show it also lowers the risk of cancer coming back after treatment. That makes it the best diet for cancer prevention and recurrence.

     So yes, food matters. Food empowers you. But food is not medicine. Food lowers risk. Medicine treats disease. Together, they protect us.

     
     

     Conclusion

     Green tea and broccoli are healthy. The Mediterranean diet is the best prevention strategy we know. But once cancer develops, treatment is essential.

     Food isn’t chemotherapy. Medicine is. And that is something we should all be grateful for.

     
     

     References

     1. World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018.
     2. Buckland G, Agudo A, Luján L, Jakszyn P, Bueno-de-Mesquita HB, Palli D, Boeing H, Carneiro F, Krogh V, Sacerdote C, Tumino R, Panico S, Nesi G, Manjer J, Regnér S, Johansson I, Stenling R, Sanchez MJ, Dorronsoro M, Barricarte A, Navarro C, Quirós JR, Allen NE, Key TJ, Bingham S, Kaaks R, Overvad K, Jensen M, Olsen A, Tjønneland A, Peeters PH, Numans ME, Ocké MC, Clavel-Chapelon F, Morois S, Boutron-Ruault MC, Trichopoulou A, Lagiou P, Trichopoulos D, Lund E, Couto E, Boffeta P, Jenab M, Riboli E, Romaguera D, Mouw T, González CA. Adherence to a Mediterranean diet and risk of gastric adenocarcinoma within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study. Am J Clin Nutr. 2010 Feb;91(2):381-90. doi: 10.3945/ajcn.2009.28209. Epub 2009 Dec 9. PMID: 20007304.
     3. Jenkins DJA, et al. Green tea catechins and cancer prevention. J Nutr. 2003;133(11 Suppl 1): 3242S–3246S.
     4. WHO. Human papillomavirus (HPV) vaccines. Updated 2022.
     5. Hanahan D. Hallmarks of Cancer: New Dimensions. Cancer Discov. 2022;12(1): 31–46.
     
     ]]>6562cfd6-2e51-4fc0-99e8-e290bab32ebdThu, 02 Oct 2025 00:00:00 -070012:36falsefull9898Why Beans Aren’t MedicineFood Is Powerful, But It’s Not Enough

     Food shapes our health. Eating beans, fruits, vegetables, and whole grains can lower the risk of diabetes and other chronic conditions. Yet food does not replace medicine. Clearly, diets high in ultra-processed foods make diabetes worse. And yes, eating better is the most empowering thing anyone can do.

     Still, some claim that modern food is the only reason we have chronic diseases like diabetes. They argue that if people only ate “real food,” there would be no need for medicine. History proves otherwise.

     The Story That Changed Everything: Dr. Banting and Insulin

     In the early 1920s, Dr. Frederick Banting and Charles Best discovered insulin in Toronto. At the time, children with type 1 diabetes had no future. Families were told to put their kids on starvation diets, hoping to add a few months to their lives. Death was certain.

     Then came insulin. Doctors injected it into children already in comas. One by one, they woke up. They sat up, asked for food, and hugged their parents. What had been a hospital ward of silence turned into a place of joy.

     Insulin was the fastest-adopted drug in history. Banting became the youngest Nobel Prize winner at the time. That discovery did not come from food. It came from science and medicine.

     
     

     Two Types of Diabetes

     There are two main types of diabetes.

     • Type 1 diabetes happens when the pancreas loses all ability to make insulin. Without insulin, sugar cannot move into cells, and life cannot continue. That is why every person with type 1 diabetes needs insulin from the first day of diagnosis.
     • Type 2 diabetes is different. In this case, the body still makes insulin, but the cells resist it. Over time, the pancreas wears out. That is why many people with type 2 eventually need insulin too. It is not failure. It is simply how the disease progresses.
     
     

     Food can help manage both types, but food alone is never enough.

     
     

     What Beans Can Do

     Beans are one of the best foods for blood sugar. They are full of soluble fiber, which slows down glucose absorption. They also provide plant protein and have a low glycemic index. That means they don’t spike blood sugar the way soda or white bread does.

     Research shows that eating beans regularly can lower hemoglobin A1c — the measure of long-term blood sugar — by about 0.3 to 0.5 percent. That is a real effect from food.

     Beans are also practical. They are inexpensive, found almost everywhere, and have been eaten by humans longer than almost any other protein source.

     
     

     Why Beans Aren’t Medicine

     Now let’s compare beans to metformin.

     Metformin is the first-line drug for type 2 diabetes. It lowers A1c by 1 to 2 percent. That’s two to four times more than beans. Metformin also lowers the risk of heart disease and has decades of safety data behind it.

     So while beans help, they are not metformin. If blood sugar is high, no amount of hummus or chili will bring it back to safe levels. Medicine is needed. Food lays the foundation, but medicine does the heavy lifting.

     
     

     The Best Diet for Diabetes: The Mediterranean Pattern

     When it comes to diet, the evidence is clear. The Mediterranean diet is the best overall eating plan for diabetes.

     This diet includes:

     • Fruits
     • Vegetables
     • Olive oil
     • Nuts
     • Legumes (yes, beans!)
     • Whole grains
     
     

     Now, some people push back against whole grains. That may be because they grew up in the low-carb era, when grains were unfairly blamed for every health problem. But whole grains are healthy, especially for people with diabetes. They are far better for the body than bacon or butter.

     The Mediterranean diet does more than control blood sugar. It lowers cholesterol, reduces blood pressure, decreases inflammation, and protects the heart. And unlike fad diets, it is sustainable.

     
     

     Practical Ways to Add Beans

     Adding beans to meals is easy. Here are a few examples:

     • Swap ground beef for black beans in chili
     • Add lentils to soups or stews
     • Roast chickpeas for a crunchy snack
     • Use hummus instead of cheese spread
     • Toss peas into pasta, rice, or grain bowls
     
     

     These small swaps improve blood sugar, lower cholesterol, and keep you full. Combined with the Mediterranean diet, the benefits are even stronger.

     
     

     Don’t Fall for Scams

     Unfortunately, scams are everywhere. Keto and carnivore diets claim to cure diabetes. While they may lower blood sugar in the short term, they raise saturated fat intake. That increases the risk of heart disease, which is the biggest threat to people with diabetes.

     And cinnamon? It makes oatmeal taste great, but cinnamon pills do not cure diabetes. The science simply doesn’t support it.

     
     

     The Takeaway

     Food matters. Food lowers risk. Food empowers people to take control. But food is not medicine.

     Food is food. Medicine is medicine. Together, they save lives.

     
     

     References

     • Banting F, Best C. Discovery of insulin, 1921–1922.
     • American Diabetes Association. Standards of Medical Care in Diabetes.
     • Jenkins DJA, Kendall CWC, et al. “Effect of legumes on glycemic control and cardiovascular risk factors.” Arch Intern Med. 2012.
     • Estruch R, Ros E, et al. “Primary prevention of cardiovascular disease with a Mediterranean diet.” N Engl J Med. 2013.
     
     

     For more, see my newsletter on Substack where I dig into the science behind food and health.

     ]]>Food Is Powerful, But It’s Not Enough

     Food shapes our health. Eating beans, fruits, vegetables, and whole grains can lower the risk of diabetes and other chronic conditions. Yet food does not replace medicine. Clearly, diets high in ultra-processed foods make diabetes worse. And yes, eating better is the most empowering thing anyone can do.

     Still, some claim that modern food is the only reason we have chronic diseases like diabetes. They argue that if people only ate “real food,” there would be no need for medicine. History proves otherwise.

     The Story That Changed Everything: Dr. Banting and Insulin

     In the early 1920s, Dr. Frederick Banting and Charles Best discovered insulin in Toronto. At the time, children with type 1 diabetes had no future. Families were told to put their kids on starvation diets, hoping to add a few months to their lives. Death was certain.

     Then came insulin. Doctors injected it into children already in comas. One by one, they woke up. They sat up, asked for food, and hugged their parents. What had been a hospital ward of silence turned into a place of joy.

     Insulin was the fastest-adopted drug in history. Banting became the youngest Nobel Prize winner at the time. That discovery did not come from food. It came from science and medicine.

     
     

     Two Types of Diabetes

     There are two main types of diabetes.

     • Type 1 diabetes happens when the pancreas loses all ability to make insulin. Without insulin, sugar cannot move into cells, and life cannot continue. That is why every person with type 1 diabetes needs insulin from the first day of diagnosis.
     • Type 2 diabetes is different. In this case, the body still makes insulin, but the cells resist it. Over time, the pancreas wears out. That is why many people with type 2 eventually need insulin too. It is not failure. It is simply how the disease progresses.
     
     

     Food can help manage both types, but food alone is never enough.

     
     

     What Beans Can Do

     Beans are one of the best foods for blood sugar. They are full of soluble fiber, which slows down glucose absorption. They also provide plant protein and have a low glycemic index. That means they don’t spike blood sugar the way soda or white bread does.

     Research shows that eating beans regularly can lower hemoglobin A1c — the measure of long-term blood sugar — by about 0.3 to 0.5 percent. That is a real effect from food.

     Beans are also practical. They are inexpensive, found almost everywhere, and have been eaten by humans longer than almost any other protein source.

     
     

     Why Beans Aren’t Medicine

     Now let’s compare beans to metformin.

     Metformin is the first-line drug for type 2 diabetes. It lowers A1c by 1 to 2 percent. That’s two to four times more than beans. Metformin also lowers the risk of heart disease and has decades of safety data behind it.

     So while beans help, they are not metformin. If blood sugar is high, no amount of hummus or chili will bring it back to safe levels. Medicine is needed. Food lays the foundation, but medicine does the heavy lifting.

     
     

     The Best Diet for Diabetes: The Mediterranean Pattern

     When it comes to diet, the evidence is clear. The Mediterranean diet is the best overall eating plan for diabetes.

     This diet includes:

     • Fruits
     • Vegetables
     • Olive oil
     • Nuts
     • Legumes (yes, beans!)
     • Whole grains
     
     

     Now, some people push back against whole grains. That may be because they grew up in the low-carb era, when grains were unfairly blamed for every health problem. But whole grains are healthy, especially for people with diabetes. They are far better for the body than bacon or butter.

     The Mediterranean diet does more than control blood sugar. It lowers cholesterol, reduces blood pressure, decreases inflammation, and protects the heart. And unlike fad diets, it is sustainable.

     
     

     Practical Ways to Add Beans

     Adding beans to meals is easy. Here are a few examples:

     • Swap ground beef for black beans in chili
     • Add lentils to soups or stews
     • Roast chickpeas for a crunchy snack
     • Use hummus instead of cheese spread
     • Toss peas into pasta, rice, or grain bowls
     
     

     These small swaps improve blood sugar, lower cholesterol, and keep you full. Combined with the Mediterranean diet, the benefits are even stronger.

     
     

     Don’t Fall for Scams

     Unfortunately, scams are everywhere. Keto and carnivore diets claim to cure diabetes. While they may lower blood sugar in the short term, they raise saturated fat intake. That increases the risk of heart disease, which is the biggest threat to people with diabetes.

     And cinnamon? It makes oatmeal taste great, but cinnamon pills do not cure diabetes. The science simply doesn’t support it.

     
     

     The Takeaway

     Food matters. Food lowers risk. Food empowers people to take control. But food is not medicine.

     Food is food. Medicine is medicine. Together, they save lives.

     
     

     References

     • Banting F, Best C. Discovery of insulin, 1921–1922.
     • American Diabetes Association. Standards of Medical Care in Diabetes.
     • Jenkins DJA, Kendall CWC, et al. “Effect of legumes on glycemic control and cardiovascular risk factors.” Arch Intern Med. 2012.
     • Estruch R, Ros E, et al. “Primary prevention of cardiovascular disease with a Mediterranean diet.” N Engl J Med. 2013.
     
     

     For more, see my newsletter on Substack where I dig into the science behind food and health.

     ]]>e3855fc5-de89-4cd9-8801-3c7f0bf26be8Thu, 25 Sep 2025 00:00:00 -070009:08falsefull9595Salmon isn't a Stent Food and MedicineWhen Salmon Isn’t a Stent

     Heart disease was four times more deadly than it is today. In those days, we had no statins, no stents, and no bypass surgery. Food was the only weapon doctors had.

     Pharmacies in Rome and Greece even stocked extra virgin olive oil for patients with “hardening of the arteries.” Doctors sent people to pick up bottles, almost like prescriptions. Olive oil wasn’t curing clogged arteries, but it showed an early recognition that diet mattered.

     Then scientists noticed something bigger. In certain Mediterranean villages, people lived longer with far less heart disease. It wasn’t genetic. Relatives who moved to cities and switched to Western diets developed heart disease much earlier.

     Researchers didn’t stop there. They followed men in villages across Europe and the Mediterranean for decades. Some communities ate diets heavy in saturated fats. They developed clogged arteries and heart disease quickly. Other communities ate diets rich in fruits, vegetables, legumes, fish, nuts, and olive oil. They had much lower rates of heart disease. This pattern became the foundation of what we now call the Mediterranean Diet.

     At that time, diet gave us hope. But today, we know that food alone is not enough.

     Lyon Heart Study

     The Lyon Diet Heart Study proved how powerful diet could be. Conducted just as statins came onto the market, it showed that patients with heart attacks who switched to a Mediterranean-style diet had a 70% lower risk of another cardiac event. That meant fewer heart attacks and fewer deaths.

     Later, the PREDIMED trial confirmed these results. In high-risk adults, the Mediterranean Diet reduced major cardiovascular events by about 30%. That’s impressive, but it also raises a question: can people sustain it? Adherence usually means sticking with the diet about 70 percent of the time. That’s not perfect.

     Here’s a personal example. I have hypercholesterolemia and a strong family history of heart disease. I follow the Mediterranean Diet carefully. But even with strong adherence, my LDL cholesterol never dropped below 180. With two drugs — Zetia and Crestor — my LDL is now in the 40s. Food helps. Medicine saves.

     Atherosclerosis begins early in life

     The PESA Heart Study showed why this matters. Researchers in Spain followed adults who felt perfectly healthy. Using advanced imaging, they found more than 60 percent already had plaque in their arteries. Atherosclerosis begins silently, and often decades before symptoms appear.

     The JUPITER trial with rosuvastatin (Crestor) proved what medicine can do. Statins reduced cardiovascular events by 44 percent, and the study had to stop early because the benefit was so strong.

     And then there’s Dean Ornish. His program is often called the “diet that reverses heart disease.” But it was never just a diet. His patients quit smoking, took statins, took blood pressure medications, and practiced yoga. Ornish proved that lifestyle matters — but it was food and medicine together that made the difference.

     Barbara O'Neill and Cayenne Pepper

     Meanwhile, scammers still sell false hope. Barbara O’Neill, banned from giving health advice in Australia, charges thousands for seminars where she claims cayenne pepper “opens arteries.” That’s pure fiction. Cayenne is a spice, not a stent. She also claims cholesterol guidelines only exist to enrich drug companies. Yet my three-month supply of Crestor costs $2.36, while she profits thousands. The real con is clear.

     So here’s the truth: salmon is healthy, but it isn’t a stent. Olive oil helps, but it isn’t a statin. Food prevents disease. Medicine treats it. Together, food and medicine are unbeatable.

     References

     1. de Lorgeril M, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99(6):779–785. (click here)
     2. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018 Jun 21;378(25):e34. doi: 10.1056/NEJMoa1800389. Epub 2018 Jun 13. PMID: 29897866.
     3. Fernández-Friera L, et al. Prevalence, vascular distribution, and multiterritorial extent of subclinical atherosclerosis in a middle-aged cohort: the PESA study. Circulation. 2015;131:2104–2115. (click here)
     4. Ridker PM, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–2207. (click here)
     5. Ornish D, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998;280(23):2001–2007. (click here)
     6. Therapeutic Goods Administration, Australia. Prohibition order under section 42DV against Barbara O’Neill. 2019. (click here)
     
     ]]>When Salmon Isn’t a Stent

     Heart disease was four times more deadly than it is today. In those days, we had no statins, no stents, and no bypass surgery. Food was the only weapon doctors had.

     Pharmacies in Rome and Greece even stocked extra virgin olive oil for patients with “hardening of the arteries.” Doctors sent people to pick up bottles, almost like prescriptions. Olive oil wasn’t curing clogged arteries, but it showed an early recognition that diet mattered.

     Then scientists noticed something bigger. In certain Mediterranean villages, people lived longer with far less heart disease. It wasn’t genetic. Relatives who moved to cities and switched to Western diets developed heart disease much earlier.

     Researchers didn’t stop there. They followed men in villages across Europe and the Mediterranean for decades. Some communities ate diets heavy in saturated fats. They developed clogged arteries and heart disease quickly. Other communities ate diets rich in fruits, vegetables, legumes, fish, nuts, and olive oil. They had much lower rates of heart disease. This pattern became the foundation of what we now call the Mediterranean Diet.

     At that time, diet gave us hope. But today, we know that food alone is not enough.

     Lyon Heart Study

     The Lyon Diet Heart Study proved how powerful diet could be. Conducted just as statins came onto the market, it showed that patients with heart attacks who switched to a Mediterranean-style diet had a 70% lower risk of another cardiac event. That meant fewer heart attacks and fewer deaths.

     Later, the PREDIMED trial confirmed these results. In high-risk adults, the Mediterranean Diet reduced major cardiovascular events by about 30%. That’s impressive, but it also raises a question: can people sustain it? Adherence usually means sticking with the diet about 70 percent of the time. That’s not perfect.

     Here’s a personal example. I have hypercholesterolemia and a strong family history of heart disease. I follow the Mediterranean Diet carefully. But even with strong adherence, my LDL cholesterol never dropped below 180. With two drugs — Zetia and Crestor — my LDL is now in the 40s. Food helps. Medicine saves.

     Atherosclerosis begins early in life

     The PESA Heart Study showed why this matters. Researchers in Spain followed adults who felt perfectly healthy. Using advanced imaging, they found more than 60 percent already had plaque in their arteries. Atherosclerosis begins silently, and often decades before symptoms appear.

     The JUPITER trial with rosuvastatin (Crestor) proved what medicine can do. Statins reduced cardiovascular events by 44 percent, and the study had to stop early because the benefit was so strong.

     And then there’s Dean Ornish. His program is often called the “diet that reverses heart disease.” But it was never just a diet. His patients quit smoking, took statins, took blood pressure medications, and practiced yoga. Ornish proved that lifestyle matters — but it was food and medicine together that made the difference.

     Barbara O'Neill and Cayenne Pepper

     Meanwhile, scammers still sell false hope. Barbara O’Neill, banned from giving health advice in Australia, charges thousands for seminars where she claims cayenne pepper “opens arteries.” That’s pure fiction. Cayenne is a spice, not a stent. She also claims cholesterol guidelines only exist to enrich drug companies. Yet my three-month supply of Crestor costs $2.36, while she profits thousands. The real con is clear.

     So here’s the truth: salmon is healthy, but it isn’t a stent. Olive oil helps, but it isn’t a statin. Food prevents disease. Medicine treats it. Together, food and medicine are unbeatable.

     References

     1. de Lorgeril M, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99(6):779–785. (click here)
     2. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018 Jun 21;378(25):e34. doi: 10.1056/NEJMoa1800389. Epub 2018 Jun 13. PMID: 29897866.
     3. Fernández-Friera L, et al. Prevalence, vascular distribution, and multiterritorial extent of subclinical atherosclerosis in a middle-aged cohort: the PESA study. Circulation. 2015;131:2104–2115. (click here)
     4. Ridker PM, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–2207. (click here)
     5. Ornish D, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998;280(23):2001–2007. (click here)
     6. Therapeutic Goods Administration, Australia. Prohibition order under section 42DV against Barbara O’Neill. 2019. (click here)
     
     ]]>40d31b3b-27a3-4a49-9abc-55485afbaec6Thu, 18 Sep 2025 00:00:00 -070013:11falsefull9494Bananas Aren’t Beta BlockersWhen Bananas Aren’t a Beta Blocker

     People love to believe that food can replace medicine. We talked about this in Episode One, where I explained that Hippocrates never said “let food be thy medicine.” Still, the myth endures.

     Food does matter. The right eating pattern can lower blood pressure. One of the best-studied is the DASH Diet—short for Dietary Approaches to Stop Hypertension. It is often called America’s version of the Mediterranean Diet. While the Mediterranean Diet was being mapped out for overall health, the DASH researchers asked a sharper question: what foods can lower blood pressure directly?

     Why DASH Is Unique

     Unlike most nutrition studies, the original DASH trial provided all the food to participants. That meant researchers knew exactly what people ate, meal after meal. This is rare and expensive, but it gave them confidence in the results.

     The DASH diet emphasizes:

     • Fruits and vegetables, especially potassium-rich foods like bananas, beans, and leafy greens
     • Whole grains
     • Lean proteins, like fish and poultry
     • Low-fat dairy
     • Less red meat, sweets, and sodium
     
     

     Because it combined several food groups, DASH worked quickly. Within two weeks, blood pressure dropped.

     
     

     What the Studies Show

     The results were consistent. People following DASH lowered their systolic blood pressure (the top number) by 8–11 mmHg and their diastolic pressure by 5–6 mmHg. That is about the same as one standard blood pressure pill.

     Even more important, DASH showed that sodium reduction matters. Those who cut sodium intake to 1,500–2,300 milligrams per day saw the greatest improvements. This shattered the myth that unlimited salt is safe. Too much sodium raises blood pressure, increases heart disease risk, and fuels strokes.

     
     

     The Role of Electrolytes

     This is where things get messy. Electrolytes, especially sodium, are necessary during prolonged exercise—typically more than 1–2 hours, in hot weather, or when sweating heavily. Under those conditions, sodium helps prevent hyponatremia, a dangerous drop in blood sodium levels.

     However, for most people exercising less than an hour, water is enough. Regular meals will replace lost sodium. Salty drinks or powders aren’t required. In fact, most commercial sports drinks don’t even contain enough sodium to match sweat losses in extreme events.

     
     

     The Salt Supplement Scam

     Here is where the grift appears. Shirtless salesmen on social media love to sell high-priced mango-flavored salt packets as “essential” electrolytes. They promise performance and recovery, but they may actually raise your blood pressure and put you at risk.

     Science says otherwise. Electrolyte supplementation should be individualized and used with caution. People at highest risk from unnecessary sodium loading include:

     • Those with hypertension, heart failure, or kidney disease
     • Women, who are more prone to overhydration and hyponatremia due to smaller body size and lower sweat rates
     • Older athletes or those with low body mass
     • Recreational athletes who follow outdated advice to “drink as much as possible”
     
     

     Even ultra-endurance athletes cannot rely on sodium supplements alone. If they drink more than they lose, sodium will not prevent hyponatremia and may make things worse. The best strategy is to drink to thirst and use salty foods or fluids only when truly needed.

     
     

     What a DASH Day Looks Like

     How can you follow DASH in real life? Here’s one sample day:

     • Breakfast: Oatmeal with berries and a banana
     • Snack: A handful of unsalted nuts
     • Lunch: Black bean and vegetable salad with vinaigrette
     • Dinner: Grilled salmon with leafy greens and brown rice
     • Extra: Low-fat yogurt or skim milk
     
     

     This pattern supplies potassium, magnesium, calcium, and fiber—nutrients that relax blood vessels and lower pressure naturally. Notice what’s missing: salty snacks, processed food, and canned soups.

     
     

     Food and Medicine Together

     So what does it all mean? The DASH Diet lowers blood pressure and improves overall health. But it does not replace medication. Blood pressure medicines—ACE inhibitors, ARBs, calcium channel blockers, diuretics—reduce systolic pressure by 20–40 mmHg. That is two or three times more than DASH.

     Food helps. Medicine saves. Together, they work best.

     
     

     The Bottom Line

     Bananas, beans, and leafy greens are wonderful. Electrolyte supplements are rarely needed. Expensive salt powders sold by social media influencers are scams. And the DASH Diet? It’s real, it works, and it shows that food has power—just not enough to replace your beta blocker.

     ]]>When Bananas Aren’t a Beta Blocker

     People love to believe that food can replace medicine. We talked about this in Episode One, where I explained that Hippocrates never said “let food be thy medicine.” Still, the myth endures.

     Food does matter. The right eating pattern can lower blood pressure. One of the best-studied is the DASH Diet—short for Dietary Approaches to Stop Hypertension. It is often called America’s version of the Mediterranean Diet. While the Mediterranean Diet was being mapped out for overall health, the DASH researchers asked a sharper question: what foods can lower blood pressure directly?

     Why DASH Is Unique

     Unlike most nutrition studies, the original DASH trial provided all the food to participants. That meant researchers knew exactly what people ate, meal after meal. This is rare and expensive, but it gave them confidence in the results.

     The DASH diet emphasizes:

     • Fruits and vegetables, especially potassium-rich foods like bananas, beans, and leafy greens
     • Whole grains
     • Lean proteins, like fish and poultry
     • Low-fat dairy
     • Less red meat, sweets, and sodium
     
     

     Because it combined several food groups, DASH worked quickly. Within two weeks, blood pressure dropped.

     
     

     What the Studies Show

     The results were consistent. People following DASH lowered their systolic blood pressure (the top number) by 8–11 mmHg and their diastolic pressure by 5–6 mmHg. That is about the same as one standard blood pressure pill.

     Even more important, DASH showed that sodium reduction matters. Those who cut sodium intake to 1,500–2,300 milligrams per day saw the greatest improvements. This shattered the myth that unlimited salt is safe. Too much sodium raises blood pressure, increases heart disease risk, and fuels strokes.

     
     

     The Role of Electrolytes

     This is where things get messy. Electrolytes, especially sodium, are necessary during prolonged exercise—typically more than 1–2 hours, in hot weather, or when sweating heavily. Under those conditions, sodium helps prevent hyponatremia, a dangerous drop in blood sodium levels.

     However, for most people exercising less than an hour, water is enough. Regular meals will replace lost sodium. Salty drinks or powders aren’t required. In fact, most commercial sports drinks don’t even contain enough sodium to match sweat losses in extreme events.

     
     

     The Salt Supplement Scam

     Here is where the grift appears. Shirtless salesmen on social media love to sell high-priced mango-flavored salt packets as “essential” electrolytes. They promise performance and recovery, but they may actually raise your blood pressure and put you at risk.

     Science says otherwise. Electrolyte supplementation should be individualized and used with caution. People at highest risk from unnecessary sodium loading include:

     • Those with hypertension, heart failure, or kidney disease
     • Women, who are more prone to overhydration and hyponatremia due to smaller body size and lower sweat rates
     • Older athletes or those with low body mass
     • Recreational athletes who follow outdated advice to “drink as much as possible”
     
     

     Even ultra-endurance athletes cannot rely on sodium supplements alone. If they drink more than they lose, sodium will not prevent hyponatremia and may make things worse. The best strategy is to drink to thirst and use salty foods or fluids only when truly needed.

     
     

     What a DASH Day Looks Like

     How can you follow DASH in real life? Here’s one sample day:

     • Breakfast: Oatmeal with berries and a banana
     • Snack: A handful of unsalted nuts
     • Lunch: Black bean and vegetable salad with vinaigrette
     • Dinner: Grilled salmon with leafy greens and brown rice
     • Extra: Low-fat yogurt or skim milk
     
     

     This pattern supplies potassium, magnesium, calcium, and fiber—nutrients that relax blood vessels and lower pressure naturally. Notice what’s missing: salty snacks, processed food, and canned soups.

     
     

     Food and Medicine Together

     So what does it all mean? The DASH Diet lowers blood pressure and improves overall health. But it does not replace medication. Blood pressure medicines—ACE inhibitors, ARBs, calcium channel blockers, diuretics—reduce systolic pressure by 20–40 mmHg. That is two or three times more than DASH.

     Food helps. Medicine saves. Together, they work best.

     
     

     The Bottom Line

     Bananas, beans, and leafy greens are wonderful. Electrolyte supplements are rarely needed. Expensive salt powders sold by social media influencers are scams. And the DASH Diet? It’s real, it works, and it shows that food has power—just not enough to replace your beta blocker.

     ]]>4340922c-abc4-435f-81b5-5efca2418bfbThu, 11 Sep 2025 00:00:00 -070011:04falsefull9393Tofu Isn't a Statin: Food as MedicineWhen Tofu Isn’t a Statin

     People love to say “food is medicine.” Some even claim Hippocrates himself said it. But here’s the thing: he didn’t. The phrase does not appear in any of his surviving writings. In fact, historians believe the line was created centuries later and then falsely attached to Hippocrates to give it weight.

     Still, the idea persists. Even the current head of HHS, Robert F. Kennedy Jr., has repeated the myth. And when RFK Jr. is your fact-checker, you know you’re in trouble.

     Now, as someone certified in Culinary Medicine, I believe food is incredibly powerful. Eating the right foods can prevent disease, improve health, and help you live longer. However, food alone rarely works as well as actual medicine. That is especially true when it comes to cholesterol.

     The Portfolio Diet

     In the early 2000s, Dr. David Jenkins and his team introduced what they called the Portfolio Diet. Instead of focusing on one “superfood,” the diet combines several cholesterol-lowering foods:

     • Soy protein
     • Nuts, like almonds
     • Viscous fibers from oats, barley, or psyllium
     • Plant sterols from fortified foods
     
     

     Each one has a small effect. But when you put them together, the benefits add up.

     Why does it work? Cholesterol gets secreted by your liver into bile, then travels into your gut. Normally, most of that cholesterol is reabsorbed into your bloodstream. But fiber and plant sterols bind to cholesterol and drag it out of your body. That’s why bowel movements are brown—bile is brown, and fiber helps carry it out. More fiber means you feed your gut bacteria and flush away cholesterol. It really is a win-win.

     
     

     What the Studies Show

     The Portfolio Diet has been tested in multiple clinical trials. In one JAMA study, people who followed the diet lowered their LDL cholesterol by about 13 to 14 percent over six months. That translated to a drop of about 24–26 mg/dL.

     Other studies show that people who stick with it can lower their LDL by 17 percent on average. Some who were especially diligent saw drops of more than 20 percent at one year. The Portfolio Diet also improves non-HDL cholesterol, apolipoprotein B, and long-term risk for heart disease.

     So yes—it works. In fact, the effect is similar to what you get from early statins like lovastatin.

     
     

     What It Looks Like in Real Life

     The science sounds great. But how do you actually eat this way? Here’s one example day:

     • Breakfast: Oatmeal made with soy milk
     • Snack: A handful of almonds (about 25–30 grams)
     • Lunch: Lentil soup with whole-grain bread
     • Dinner: Tofu stir-fry with vegetables and barley
     • Extra: Two grams of plant sterols, often from fortified margarine spreads
     
     

     That daily pattern gives you soy protein, fiber, nuts, and plant sterols. But here’s the challenge: it takes careful planning to hit the right doses every day. It’s not impossible—but it is hard to sustain.

     
     

     How It Differs from the Mediterranean Diet

     Many people confuse the Portfolio Diet with the Mediterranean Diet. Both are plant-forward, emphasize nuts, legumes, whole grains, and lower cardiovascular risk. However, the Mediterranean Diet is broader and easier to follow. It includes olive oil, fish, fruits, vegetables, and even moderate wine.

     The Portfolio Diet, on the other hand, is very prescriptive. You must hit specific amounts of soy protein, fiber, and sterols daily. Think of the Mediterranean Diet as the entire restaurant, while the Portfolio Diet is just one corner of the menu—focused squarely on cholesterol.

     
     

     What About Statins?

     Statins are still the gold standard. Modern statins like atorvastatin or rosuvastatin lower LDL cholesterol by 30 to 50 percent, far more than diet alone. More importantly, they reduce heart attacks and strokes by 25 to 40 percent.

     And there’s more. When you combine a statin with Zetia (ezetimibe), which blocks cholesterol absorption in the gut, you can see another 20 percent reduction in LDL. That’s essentially the pharmaceutical version of the Portfolio Diet. Together, statins plus Zetia can lower LDL cholesterol by 65 to 70 percent.

     
     

     The Bottom Line

     The Portfolio Diet lowers cholesterol. The Mediterranean Diet improves heart health. Both are excellent for prevention and long-term wellness. But when your cholesterol is high or your risk is significant, medicine is usually necessary.

     The best approach is not “food or medicine.” It’s food and medicine. Eat Mediterranean, fold in Portfolio Diet elements, and—if your doctor recommends it—add a statin or Zetia.

     Because food lays the foundation. Medicine builds the house. And together, they keep the roof from caving in.

     
     

     REFS

     1. Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials.

     Chiavaroli L, Nishi SK, Khan TA, et al.

     Progress in Cardiovascular Diseases. 2018 May - Jun;61(1):43-53. doi:10.1016/j.pcad.2018.05.004.

     2. Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia: A Randomized Controlled Trial.

     Jenkins DJ, Jones PJ, Lamarche B, et al.

     
     

     JAMA. 2011;306(8):831-9. doi:10.1001/jama.2011.1202.

     3. Relationship Between a Plant-Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study.

     Glenn AJ, Lo K, Jenkins DJA, et al.Journal of the American Heart Association. 2021;10(16):e021515. doi:10.1161/JAHA.121.021515.

     4. Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies.

     Glenn AJ, Guasch-Ferré M, Malik VS, et al.Circulation. 2023;148(22):1750-1763. doi:10.1161/CIRCULATIONAHA.123.065551.

     5. The Portfolio Dietary Pattern and Risk of Cardiovascular Disease Mortality During 1988-2019 in US Adults: A Prospective Cohort Study.

     Kavanagh ME, Zurbau A, Glenn AJ, et al.

     BMC Medicine. 2025;23(1):287. doi:10.1186/s12916-025-04067-1.

     ]]>When Tofu Isn’t a Statin

     People love to say “food is medicine.” Some even claim Hippocrates himself said it. But here’s the thing: he didn’t. The phrase does not appear in any of his surviving writings. In fact, historians believe the line was created centuries later and then falsely attached to Hippocrates to give it weight.

     Still, the idea persists. Even the current head of HHS, Robert F. Kennedy Jr., has repeated the myth. And when RFK Jr. is your fact-checker, you know you’re in trouble.

     Now, as someone certified in Culinary Medicine, I believe food is incredibly powerful. Eating the right foods can prevent disease, improve health, and help you live longer. However, food alone rarely works as well as actual medicine. That is especially true when it comes to cholesterol.

     The Portfolio Diet

     In the early 2000s, Dr. David Jenkins and his team introduced what they called the Portfolio Diet. Instead of focusing on one “superfood,” the diet combines several cholesterol-lowering foods:

     • Soy protein
     • Nuts, like almonds
     • Viscous fibers from oats, barley, or psyllium
     • Plant sterols from fortified foods
     
     

     Each one has a small effect. But when you put them together, the benefits add up.

     Why does it work? Cholesterol gets secreted by your liver into bile, then travels into your gut. Normally, most of that cholesterol is reabsorbed into your bloodstream. But fiber and plant sterols bind to cholesterol and drag it out of your body. That’s why bowel movements are brown—bile is brown, and fiber helps carry it out. More fiber means you feed your gut bacteria and flush away cholesterol. It really is a win-win.

     
     

     What the Studies Show

     The Portfolio Diet has been tested in multiple clinical trials. In one JAMA study, people who followed the diet lowered their LDL cholesterol by about 13 to 14 percent over six months. That translated to a drop of about 24–26 mg/dL.

     Other studies show that people who stick with it can lower their LDL by 17 percent on average. Some who were especially diligent saw drops of more than 20 percent at one year. The Portfolio Diet also improves non-HDL cholesterol, apolipoprotein B, and long-term risk for heart disease.

     So yes—it works. In fact, the effect is similar to what you get from early statins like lovastatin.

     
     

     What It Looks Like in Real Life

     The science sounds great. But how do you actually eat this way? Here’s one example day:

     • Breakfast: Oatmeal made with soy milk
     • Snack: A handful of almonds (about 25–30 grams)
     • Lunch: Lentil soup with whole-grain bread
     • Dinner: Tofu stir-fry with vegetables and barley
     • Extra: Two grams of plant sterols, often from fortified margarine spreads
     
     

     That daily pattern gives you soy protein, fiber, nuts, and plant sterols. But here’s the challenge: it takes careful planning to hit the right doses every day. It’s not impossible—but it is hard to sustain.

     
     

     How It Differs from the Mediterranean Diet

     Many people confuse the Portfolio Diet with the Mediterranean Diet. Both are plant-forward, emphasize nuts, legumes, whole grains, and lower cardiovascular risk. However, the Mediterranean Diet is broader and easier to follow. It includes olive oil, fish, fruits, vegetables, and even moderate wine.

     The Portfolio Diet, on the other hand, is very prescriptive. You must hit specific amounts of soy protein, fiber, and sterols daily. Think of the Mediterranean Diet as the entire restaurant, while the Portfolio Diet is just one corner of the menu—focused squarely on cholesterol.

     
     

     What About Statins?

     Statins are still the gold standard. Modern statins like atorvastatin or rosuvastatin lower LDL cholesterol by 30 to 50 percent, far more than diet alone. More importantly, they reduce heart attacks and strokes by 25 to 40 percent.

     And there’s more. When you combine a statin with Zetia (ezetimibe), which blocks cholesterol absorption in the gut, you can see another 20 percent reduction in LDL. That’s essentially the pharmaceutical version of the Portfolio Diet. Together, statins plus Zetia can lower LDL cholesterol by 65 to 70 percent.

     
     

     The Bottom Line

     The Portfolio Diet lowers cholesterol. The Mediterranean Diet improves heart health. Both are excellent for prevention and long-term wellness. But when your cholesterol is high or your risk is significant, medicine is usually necessary.

     The best approach is not “food or medicine.” It’s food and medicine. Eat Mediterranean, fold in Portfolio Diet elements, and—if your doctor recommends it—add a statin or Zetia.

     Because food lays the foundation. Medicine builds the house. And together, they keep the roof from caving in.

     
     

     REFS

     1. Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials.

     Chiavaroli L, Nishi SK, Khan TA, et al.

     Progress in Cardiovascular Diseases. 2018 May - Jun;61(1):43-53. doi:10.1016/j.pcad.2018.05.004.

     2. Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia: A Randomized Controlled Trial.

     Jenkins DJ, Jones PJ, Lamarche B, et al.

     
     

     JAMA. 2011;306(8):831-9. doi:10.1001/jama.2011.1202.

     3. Relationship Between a Plant-Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study.

     Glenn AJ, Lo K, Jenkins DJA, et al.Journal of the American Heart Association. 2021;10(16):e021515. doi:10.1161/JAHA.121.021515.

     4. Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies.

     Glenn AJ, Guasch-Ferré M, Malik VS, et al.Circulation. 2023;148(22):1750-1763. doi:10.1161/CIRCULATIONAHA.123.065551.

     5. The Portfolio Dietary Pattern and Risk of Cardiovascular Disease Mortality During 1988-2019 in US Adults: A Prospective Cohort Study.

     Kavanagh ME, Zurbau A, Glenn AJ, et al.

     BMC Medicine. 2025;23(1):287. doi:10.1186/s12916-025-04067-1.

     ]]>f514bfed-cded-4bb6-a8a9-9fcdd946918bThu, 04 Sep 2025 00:00:00 -070011:56falsefull9292Pasteurization Saves Lives: Milk Myths vs. ScienceMilk: Life, Death, and the Paradox

     Milk has always been central to survival. When mothers died in childbirth—and this happened often before modern medicine—infants survived only if they had access to another nursing mother or wet nurse. When that wasn’t possible, families sometimes turned to the milk of other mammals.

     That discovery helped keep our species alive. However, milk’s role in human survival carried a hidden danger. While milk nourished infants, it also became a deadly carrier of disease.

     When Raw Milk Killed Thousands

     During the 1800s, raw milk was anything but safe. In New York City, dairies kept cows next to distilleries, feeding them whiskey mash. The resulting milk was bluish and watery. To disguise it, producers added chalk and plaster. Parents unknowingly gave this milk to children. According to estimates, 8,000 infants die a year from contaminated milk in New York alone.

     Milk also spreads tuberculosis, diphtheria, scarlet fever, and typhoid. A simple glass of raw milk could kill.

     
     

     Louis Pasteur and the Germ Theory

     The turning point came with Louis Pasteur, a French chemist who proved microbes spoiled wine and beer. He developed the process of pasteurization: heating a liquid enough to kill pathogens without ruining flavor.

     His discovery revolutionized public health. Pasteur’s germ theory of disease proved that invisible microbes caused illness. Applied to milk, this meant heating could save lives. Pasteur’s work inspired sterilization in surgery, the discovery of TB bacteria, and eventually vaccines.

     
     

     The American Fight for Safe Milk

     In the U.S., pediatrician Abraham Jacobi urged families to boil milk by the 1870s. Philanthropist Nathan Straus built pasteurized milk stations across New York. Mortality rates for children who drank Straus’s milk dropped by nearly 50%.

     Pasteurization was not flashy, but transformative. Alongside clean water and vaccines, it became one of the greatest advances in human health.

     
     

     Tragedy in Residential Schools

     Indigenous children in Canada’s residential schools were forced to drink raw milk from cows raised on pasture. The cows looked healthy, but many carried bovine tuberculosis. Children sickened and died. In some schools, mortality reached 30–60% in just five years. Hundreds of unmarked graves discovered in recent decades reveal the human toll.

     Even the cleanest farm or happiest cow can carry pathogens. You cannot see tuberculosis or E. coli in a glass of milk. Pasteurization is the only safeguard.

     
     

     Raw Milk in the Modern Era

     Despite history, raw milk has returned as a “wellness” trend. Politicians like RFK Jr. have promoted it, even doing raw milk “shots” with influencer Paul Saladino in the White House.

     But nostalgia doesn’t erase microbiology. Just weeks later, Florida saw 21 people sickened—including six children—by E. coli and Campylobacter from raw milk. Seven were hospitalized. Two developed life-threatening complications.

     If someone claims to support children, selling raw milk undermines that promise.

     
     

     Myths vs. Facts

     Myth: Raw milk has more nutrients.

     Fact: Pasteurization causes <10% vitamin loss. Proteins, calcium, and fats remain intact.

     
     

     Myth: Raw milk prevents asthma.

     Fact: Studies show lower allergy rates in farm kids, but due to the farm environment, not the milk.

     
     

     Myth: A clean farm means safe milk.

     Fact: Even pristine dairies can harbor invisible pathogens like TB, Salmonella, or Listeria.

     
     

     Myth: Pasteurization “ruins” milk.

     Fact: Pasteurized milk is nutritionally the same, only safer.

     
     

     Beyond Milk: Cheese and Juice

     Pasteurization doesn’t stop with milk. Unpasteurized cheeses can carry Listeria, posing risks especially for pregnant women. Apple cider was once a source of E. coli outbreaks. After the FDA required pasteurization in the 1990s, those outbreaks plummeted.

     Heat treatment is one of the most powerful—and overlooked—public health tools.

     
     

     The Numbers That Changed Everything

     In 1900, infant mortality in Montreal was 27%. New York saw similar rates. Today, it’s less than 1%. That dramatic drop came from sanitation, vaccines, and pasteurization—not from supplements or nostalgic diets.

     So when someone says, “My grandfather drank raw milk his whole life and lived to 90,” the answer is simple. Visit the family graveyard. See how many of his siblings never made it out of childhood. That’s survival bias. Influencers profit from it. And in Saladino’s case, you wonder if he slept through microbiology class in the medical school where I once taught.

     
     

     The Takeaway

     Milk is life-giving, but unpasteurized milk has been deadly. Pasteur’s germ theory, Jacobi’s advocacy, Straus’s milk stations, and modern safety laws turned milk into a food we can trust.

     Pasteurization doesn’t diminish milk. It preserves life.

     
     

     References

     • CDC – Raw Milk Outbreaks
     • CIDRAP – Florida Outbreak, 2024
     • ScienceDirect – Pasteurization & Infant Mortality
     • Time Magazine – Raw Milk Safety
     • Our World in Data – Child Mortality
     
     ]]>Milk: Life, Death, and the Paradox

     Milk has always been central to survival. When mothers died in childbirth—and this happened often before modern medicine—infants survived only if they had access to another nursing mother or wet nurse. When that wasn’t possible, families sometimes turned to the milk of other mammals.

     That discovery helped keep our species alive. However, milk’s role in human survival carried a hidden danger. While milk nourished infants, it also became a deadly carrier of disease.

     When Raw Milk Killed Thousands

     During the 1800s, raw milk was anything but safe. In New York City, dairies kept cows next to distilleries, feeding them whiskey mash. The resulting milk was bluish and watery. To disguise it, producers added chalk and plaster. Parents unknowingly gave this milk to children. According to estimates, 8,000 infants die a year from contaminated milk in New York alone.

     Milk also spreads tuberculosis, diphtheria, scarlet fever, and typhoid. A simple glass of raw milk could kill.

     
     

     Louis Pasteur and the Germ Theory

     The turning point came with Louis Pasteur, a French chemist who proved microbes spoiled wine and beer. He developed the process of pasteurization: heating a liquid enough to kill pathogens without ruining flavor.

     His discovery revolutionized public health. Pasteur’s germ theory of disease proved that invisible microbes caused illness. Applied to milk, this meant heating could save lives. Pasteur’s work inspired sterilization in surgery, the discovery of TB bacteria, and eventually vaccines.

     
     

     The American Fight for Safe Milk

     In the U.S., pediatrician Abraham Jacobi urged families to boil milk by the 1870s. Philanthropist Nathan Straus built pasteurized milk stations across New York. Mortality rates for children who drank Straus’s milk dropped by nearly 50%.

     Pasteurization was not flashy, but transformative. Alongside clean water and vaccines, it became one of the greatest advances in human health.

     
     

     Tragedy in Residential Schools

     Indigenous children in Canada’s residential schools were forced to drink raw milk from cows raised on pasture. The cows looked healthy, but many carried bovine tuberculosis. Children sickened and died. In some schools, mortality reached 30–60% in just five years. Hundreds of unmarked graves discovered in recent decades reveal the human toll.

     Even the cleanest farm or happiest cow can carry pathogens. You cannot see tuberculosis or E. coli in a glass of milk. Pasteurization is the only safeguard.

     
     

     Raw Milk in the Modern Era

     Despite history, raw milk has returned as a “wellness” trend. Politicians like RFK Jr. have promoted it, even doing raw milk “shots” with influencer Paul Saladino in the White House.

     But nostalgia doesn’t erase microbiology. Just weeks later, Florida saw 21 people sickened—including six children—by E. coli and Campylobacter from raw milk. Seven were hospitalized. Two developed life-threatening complications.

     If someone claims to support children, selling raw milk undermines that promise.

     
     

     Myths vs. Facts

     Myth: Raw milk has more nutrients.

     Fact: Pasteurization causes <10% vitamin loss. Proteins, calcium, and fats remain intact.

     
     

     Myth: Raw milk prevents asthma.

     Fact: Studies show lower allergy rates in farm kids, but due to the farm environment, not the milk.

     
     

     Myth: A clean farm means safe milk.

     Fact: Even pristine dairies can harbor invisible pathogens like TB, Salmonella, or Listeria.

     
     

     Myth: Pasteurization “ruins” milk.

     Fact: Pasteurized milk is nutritionally the same, only safer.

     
     

     Beyond Milk: Cheese and Juice

     Pasteurization doesn’t stop with milk. Unpasteurized cheeses can carry Listeria, posing risks especially for pregnant women. Apple cider was once a source of E. coli outbreaks. After the FDA required pasteurization in the 1990s, those outbreaks plummeted.

     Heat treatment is one of the most powerful—and overlooked—public health tools.

     
     

     The Numbers That Changed Everything

     In 1900, infant mortality in Montreal was 27%. New York saw similar rates. Today, it’s less than 1%. That dramatic drop came from sanitation, vaccines, and pasteurization—not from supplements or nostalgic diets.

     So when someone says, “My grandfather drank raw milk his whole life and lived to 90,” the answer is simple. Visit the family graveyard. See how many of his siblings never made it out of childhood. That’s survival bias. Influencers profit from it. And in Saladino’s case, you wonder if he slept through microbiology class in the medical school where I once taught.

     
     

     The Takeaway

     Milk is life-giving, but unpasteurized milk has been deadly. Pasteur’s germ theory, Jacobi’s advocacy, Straus’s milk stations, and modern safety laws turned milk into a food we can trust.

     Pasteurization doesn’t diminish milk. It preserves life.

     
     

     References

     • CDC – Raw Milk Outbreaks
     • CIDRAP – Florida Outbreak, 2024
     • ScienceDirect – Pasteurization & Infant Mortality
     • Time Magazine – Raw Milk Safety
     • Our World in Data – Child Mortality
     
     ]]>4107db58-4aab-41e6-b76d-10f1ac517393Thu, 28 Aug 2025 00:00:00 -070012:29falsefull9191Protein Powders: Hype and ScienceProtein Powders: What’s Real, What’s Hype, and Why It Matters

     Protein powders are everywhere. Walk into a gym, scroll through social media, or visit a health food store, and you’ll see tubs of whey, egg, pea, and soy protein. Add buzzwords like “isolate,” “hydrolysate,” and “grass-fed,” and suddenly these powders sound like liquid gold. But how much of this is science—and how much is hype?

     From Surgeons to Shakers

     Surgeons were among the first to use modular proteins. In the ICU, when patients couldn’t eat, we relied on early protein formulas. These weren’t the big plastic tubs you see at Costco. They were custom-made, extremely expensive, and delivered directly into the gut through a feeding tube. Proteins like albumin cost thousands of dollars and were carefully monitored.

     Over time, science moved forward. Modern protein powders have become more affordable and accessible. What once cost hospitals a fortune is now sold in shiny containers at gyms and supplement shops. That’s progress—although it also opened the door for plenty of marketing nonsense.

     
     

     The Egg Protein Craze

     The very first protein powders sold to the public in the 1950s were made from eggs. Hollywood stars promoted them as the secret to beauty and muscle. Soon, the “beautiful people” diet drifted into gyms, where bodybuilders grabbed onto the promise of sculpted muscles. Eventually, protein shakes became a middle-America trend.

     Today, gyms often make more profit selling supplements than memberships or training. That’s not nutrition—it’s salesmanship.

     
     

     Curds, Whey, and the Rise of Dairy Protein

     Remember the nursery rhyme about “curds and whey”? That wasn’t just poetry. Cheese making separates milk into two parts: the solid curds and the liquid whey. For centuries, whey was a waste product. Farmers dumped it or fed it to pigs. Then researchers discovered that whey contained high-quality protein, packed with amino acids.

     Now, whey protein is the biggest player in the supplement industry. Isolates and hydrolysates are simply forms of whey with more processing. They’re not magic—they’re filtered versions of what used to be discarded.

     
     

     Beyond Cows: Other Sources of Protein

     Cows aren’t the only animals providing milk protein. Goats produce protein powders, too, often marketed as “easier to digest.” Then there’s pea protein, soy protein, and rice protein, sold to vegans and those with dairy allergies. These plant-based versions can be useful, but they aren’t inherently superior.

     Branched-chain amino acids (BCAAs) are another popular product. They sound impressive, but in reality, if you’re eating enough protein in your diet, you already have plenty of BCAAs. Extra scoops don’t turn into extra muscle.

     
     

     Why Surgeons Still Prescribe Them

     Here’s the irony. While influencers push powders as miracle muscle builders, surgeons actually prescribe them for medical reasons. After weight-loss surgery, patients can’t eat large amounts of food, so modular proteins help meet nutritional needs. In ICU patients with short gut syndrome or severe illness, protein powders save lives.

     Doctors used them first—long before gyms turned them into cash cows. The difference? We used them based on data, not marketing hype.

     
     

     The Bottom Line

     Protein powders are tools, not miracles. They’re convenient, portable, and sometimes necessary. But they’re not a shortcut to health. If you eat enough protein from whole foods, you probably don’t need that expensive tub with the shiny label.

     The supplement industry thrives on hype. Science thrives on evidence. And if history has shown us anything, it’s that evidence always wins—eventually.

     
     

     References

     1. Boirie Y, Dangin M, Gachon P, Vasson M-P, Maubois J-L, Beaufrère B. Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Natl Acad Sci USA. 1997;94(26):14930–14935.
     2. Phillips SM, van Loon LJC. Dietary protein for athletes: From requirements to optimum adaptation. J Sports Sci. 2011;29(S1):S29–S38.
     3. Hoffman JR, Falvo MJ. Protein – which is best? J Sports Sci Med. 2004;3(3):118–130.
     4. Wolfe RR. Branched-chain amino acids and muscle protein synthesis in humans: myth or reality? J Int Soc Sports Nutr. 2017;14:30.
     5. Klek S. Modular enteral nutrition in critically ill patients. Nutrients. 2011;3(2):183–199.
     
     ]]>Protein Powders: What’s Real, What’s Hype, and Why It Matters

     Protein powders are everywhere. Walk into a gym, scroll through social media, or visit a health food store, and you’ll see tubs of whey, egg, pea, and soy protein. Add buzzwords like “isolate,” “hydrolysate,” and “grass-fed,” and suddenly these powders sound like liquid gold. But how much of this is science—and how much is hype?

     From Surgeons to Shakers

     Surgeons were among the first to use modular proteins. In the ICU, when patients couldn’t eat, we relied on early protein formulas. These weren’t the big plastic tubs you see at Costco. They were custom-made, extremely expensive, and delivered directly into the gut through a feeding tube. Proteins like albumin cost thousands of dollars and were carefully monitored.

     Over time, science moved forward. Modern protein powders have become more affordable and accessible. What once cost hospitals a fortune is now sold in shiny containers at gyms and supplement shops. That’s progress—although it also opened the door for plenty of marketing nonsense.

     
     

     The Egg Protein Craze

     The very first protein powders sold to the public in the 1950s were made from eggs. Hollywood stars promoted them as the secret to beauty and muscle. Soon, the “beautiful people” diet drifted into gyms, where bodybuilders grabbed onto the promise of sculpted muscles. Eventually, protein shakes became a middle-America trend.

     Today, gyms often make more profit selling supplements than memberships or training. That’s not nutrition—it’s salesmanship.

     
     

     Curds, Whey, and the Rise of Dairy Protein

     Remember the nursery rhyme about “curds and whey”? That wasn’t just poetry. Cheese making separates milk into two parts: the solid curds and the liquid whey. For centuries, whey was a waste product. Farmers dumped it or fed it to pigs. Then researchers discovered that whey contained high-quality protein, packed with amino acids.

     Now, whey protein is the biggest player in the supplement industry. Isolates and hydrolysates are simply forms of whey with more processing. They’re not magic—they’re filtered versions of what used to be discarded.

     
     

     Beyond Cows: Other Sources of Protein

     Cows aren’t the only animals providing milk protein. Goats produce protein powders, too, often marketed as “easier to digest.” Then there’s pea protein, soy protein, and rice protein, sold to vegans and those with dairy allergies. These plant-based versions can be useful, but they aren’t inherently superior.

     Branched-chain amino acids (BCAAs) are another popular product. They sound impressive, but in reality, if you’re eating enough protein in your diet, you already have plenty of BCAAs. Extra scoops don’t turn into extra muscle.

     
     

     Why Surgeons Still Prescribe Them

     Here’s the irony. While influencers push powders as miracle muscle builders, surgeons actually prescribe them for medical reasons. After weight-loss surgery, patients can’t eat large amounts of food, so modular proteins help meet nutritional needs. In ICU patients with short gut syndrome or severe illness, protein powders save lives.

     Doctors used them first—long before gyms turned them into cash cows. The difference? We used them based on data, not marketing hype.

     
     

     The Bottom Line

     Protein powders are tools, not miracles. They’re convenient, portable, and sometimes necessary. But they’re not a shortcut to health. If you eat enough protein from whole foods, you probably don’t need that expensive tub with the shiny label.

     The supplement industry thrives on hype. Science thrives on evidence. And if history has shown us anything, it’s that evidence always wins—eventually.

     
     

     References

     1. Boirie Y, Dangin M, Gachon P, Vasson M-P, Maubois J-L, Beaufrère B. Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Natl Acad Sci USA. 1997;94(26):14930–14935.
     2. Phillips SM, van Loon LJC. Dietary protein for athletes: From requirements to optimum adaptation. J Sports Sci. 2011;29(S1):S29–S38.
     3. Hoffman JR, Falvo MJ. Protein – which is best? J Sports Sci Med. 2004;3(3):118–130.
     4. Wolfe RR. Branched-chain amino acids and muscle protein synthesis in humans: myth or reality? J Int Soc Sports Nutr. 2017;14:30.
     5. Klek S. Modular enteral nutrition in critically ill patients. Nutrients. 2011;3(2):183–199.
     
     ]]>c36e6c1b-fe50-452d-8071-254bcfd98d72Thu, 21 Aug 2025 00:00:00 -070009:49falsefull9090MAHA Myths: Why Nutrition Alone Won’t Save YouMake America Healthy Again? Hyman’s Half-Truths Exposed

     Mark Hyman loves a soundbite. One of his favorites is:

     “If doctors were trained in nutrition, we could prevent 90% of heart disease and type 2 diabetes.”

     It sounds inspiring. Unfortunately, it isn’t true.

     Nutrition Is Powerful — But It’s Not Magic

     I’m certified in culinary medicine, and I live the Mediterranean diet. Good nutrition matters. It lowers risk. It supports treatment. However, it cannot replace medicine for people with established disease.

     The DASH trial (Sacks et al., NEJM 2001) proved that eating more fruits and vegetables while cutting sodium lowers blood pressure by the same amount as one blood pressure pill. That’s great news for prevention. But for those with heart disease, diabetes, or kidney problems, nutrition alone can’t cure the condition.

     Before the year 1800, even if you survived childhood, your life expectancy was still in your 30s or 40s (Roser et al., Our World in Data). People then ate “organically,” free from dyes and microplastics. They also died young. Modern life expectancy came from clean water, vaccines, and medicine, not kale.

     Samoa and Tahiti: Diet Didn’t Save Them

     Samoa in 2019 had a diet Instagram influencers dream about — fresh fish, fruit, and root vegetables. Then measles hit.

     Two infants had died in 2017 because nurses mixed the MMR vaccine incorrectly. The government suspended vaccinations for nearly a year, and coverage dropped to about 31%. Into that trust gap stepped anti-vaccine activists, including RFK Jr., spreading misinformation.

     By late 2019, Samoa had over 5,700 cases and 83 deaths — most in children under five — in a population of just 200,000. Schools closed. Public gatherings stopped. Unvaccinated homes had to hang red flags so mobile teams could find them. Only when vaccination resumed did the outbreak end (WHO, 2019).

     Tahiti’s story was similar. Beautiful diet. Fresh food. Yet measles still spread. The only thing that stopped it was vaccination, not nutrition.

     What Hyman Really Sells

      Mark Hyman is trained in family medicine. He co-directed Canyon Ranch’s health program, then founded the Cleveland Clinic’s Center for Functional Medicine — a role he no longer holds.

     His version of “functional medicine” isn’t recognized by the American Board of Medical Specialties. Chiropractors, dentists, and nurses can buy a certification and call themselves “doctor.” In California, only MDs and DOs can legally use the title “physician,” but in many states, the public gets fooled.

     Hyman now uses his Make America Healthy Again (MAHA) campaign to give his brand of pseudoscience legitimacy. My Crestor costs $2.36 for three months, and my doctor gets nothing for prescribing it. His supplements? Around $100 for the same time, straight into his pocket.

     Real Data Beats Hype

     The Lyon Diet Heart Study (de Lorgeril et al., Circulation 1999) found that a Mediterranean diet reduced the risk of another heart attack by 72% in people who already had heart disease. But those patients were still taking statins, aspirin, and blood pressure meds. Diet complemented medicine; it didn’t replace it.

     The JUPITER trial (Ridker et al., NEJM 2008) showed that statins cut cardiovascular events by 44% in people with normal LDL but high CRP. No supplement stack or smoothie matches that.

     Why This Is Personal

     My dad had a heart attack at 55. Doctors told him not to expect another 20 years.

     Five years later, statins came out. He took them faithfully, along with his blood pressure medicine. He lived to 98 — independent, writing a memoir, and outliving his doctors. He ate reasonably well, but he always had a candy bowl nearby and drank plenty of coffee. Science kept him alive, not “perfect” eating.

     The Bottom Line

     Nutrition is essential. Medicine is essential. The best results come when we combine them — evidence-based and free from supplement hype.

     When you hear Hyman claim that doctors just need nutrition training to prevent 90% of disease, remember Samoa. Remember Tahiti. And remember my dad.

     References

     1. Sacks FM et al. Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. N Engl J Med. 2001;344:3–10.
     2. de Lorgeril M et al. Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction. Circulation. 1999;99(6):779–785.
     3. Ridker PM et al. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein. N Engl J Med. 2008;359:2195–2207.
     4. Roser M et al. Life Expectancy. Our World in Data. Accessed August 2025.
     5. World Health Organization. WHO and UNICEF join Samoa vaccination campaign. December 6, 2019.
     
     ]]>Make America Healthy Again? Hyman’s Half-Truths Exposed

     Mark Hyman loves a soundbite. One of his favorites is:

     “If doctors were trained in nutrition, we could prevent 90% of heart disease and type 2 diabetes.”

     It sounds inspiring. Unfortunately, it isn’t true.

     Nutrition Is Powerful — But It’s Not Magic

     I’m certified in culinary medicine, and I live the Mediterranean diet. Good nutrition matters. It lowers risk. It supports treatment. However, it cannot replace medicine for people with established disease.

     The DASH trial (Sacks et al., NEJM 2001) proved that eating more fruits and vegetables while cutting sodium lowers blood pressure by the same amount as one blood pressure pill. That’s great news for prevention. But for those with heart disease, diabetes, or kidney problems, nutrition alone can’t cure the condition.

     Before the year 1800, even if you survived childhood, your life expectancy was still in your 30s or 40s (Roser et al., Our World in Data). People then ate “organically,” free from dyes and microplastics. They also died young. Modern life expectancy came from clean water, vaccines, and medicine, not kale.

     Samoa and Tahiti: Diet Didn’t Save Them

     Samoa in 2019 had a diet Instagram influencers dream about — fresh fish, fruit, and root vegetables. Then measles hit.

     Two infants had died in 2017 because nurses mixed the MMR vaccine incorrectly. The government suspended vaccinations for nearly a year, and coverage dropped to about 31%. Into that trust gap stepped anti-vaccine activists, including RFK Jr., spreading misinformation.

     By late 2019, Samoa had over 5,700 cases and 83 deaths — most in children under five — in a population of just 200,000. Schools closed. Public gatherings stopped. Unvaccinated homes had to hang red flags so mobile teams could find them. Only when vaccination resumed did the outbreak end (WHO, 2019).

     Tahiti’s story was similar. Beautiful diet. Fresh food. Yet measles still spread. The only thing that stopped it was vaccination, not nutrition.

     What Hyman Really Sells

      Mark Hyman is trained in family medicine. He co-directed Canyon Ranch’s health program, then founded the Cleveland Clinic’s Center for Functional Medicine — a role he no longer holds.

     His version of “functional medicine” isn’t recognized by the American Board of Medical Specialties. Chiropractors, dentists, and nurses can buy a certification and call themselves “doctor.” In California, only MDs and DOs can legally use the title “physician,” but in many states, the public gets fooled.

     Hyman now uses his Make America Healthy Again (MAHA) campaign to give his brand of pseudoscience legitimacy. My Crestor costs $2.36 for three months, and my doctor gets nothing for prescribing it. His supplements? Around $100 for the same time, straight into his pocket.

     Real Data Beats Hype

     The Lyon Diet Heart Study (de Lorgeril et al., Circulation 1999) found that a Mediterranean diet reduced the risk of another heart attack by 72% in people who already had heart disease. But those patients were still taking statins, aspirin, and blood pressure meds. Diet complemented medicine; it didn’t replace it.

     The JUPITER trial (Ridker et al., NEJM 2008) showed that statins cut cardiovascular events by 44% in people with normal LDL but high CRP. No supplement stack or smoothie matches that.

     Why This Is Personal

     My dad had a heart attack at 55. Doctors told him not to expect another 20 years.

     Five years later, statins came out. He took them faithfully, along with his blood pressure medicine. He lived to 98 — independent, writing a memoir, and outliving his doctors. He ate reasonably well, but he always had a candy bowl nearby and drank plenty of coffee. Science kept him alive, not “perfect” eating.

     The Bottom Line

     Nutrition is essential. Medicine is essential. The best results come when we combine them — evidence-based and free from supplement hype.

     When you hear Hyman claim that doctors just need nutrition training to prevent 90% of disease, remember Samoa. Remember Tahiti. And remember my dad.

     References

     1. Sacks FM et al. Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. N Engl J Med. 2001;344:3–10.
     2. de Lorgeril M et al. Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction. Circulation. 1999;99(6):779–785.
     3. Ridker PM et al. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein. N Engl J Med. 2008;359:2195–2207.
     4. Roser M et al. Life Expectancy. Our World in Data. Accessed August 2025.
     5. World Health Organization. WHO and UNICEF join Samoa vaccination campaign. December 6, 2019.
     
     ]]>85ccf9f3-a55c-4f03-b0a7-8ab9cf9b1e3fThu, 14 Aug 2025 00:00:00 -070007:30falsefull8989Liver Detox- Carter's to DoseCarter’s Little Liver Pills: The Original Detox Scam and Its Modern Cousins

     For more than a century, people have searched for quick fixes to “cleanse” the liver. From old‑time laxatives to today’s wellness shots and hangover probiotics, the promise is the same: remove toxins, feel better, live longer. However, as science catches up with marketing claims, we learn a hard truth — most of these cleanses never did what they promised.

     The Sluggish Liver Myth

     Back in the 1800s, doctors blamed nearly every health problem on a “sluggish liver.” Headaches, fatigue, irritability — even bad moods — were supposedly signs that the liver wasn’t “lively” enough.

     Enter Carter’s Little Liver Pills. These small tablets promised to fix “biliousness,” an old term for feeling miserable and out of sorts. The secret ingredient? Cascara sagrada, a plant‑based laxative. In short, the pills made people poop, and that temporary relief was sold as detoxification.

     
     

     Marketing Genius in a Pill Bottle

     Carter’s advertising strategy worked brilliantly. Their message was simple: if you feel bad, it’s your liver’s fault — and their pills were the cure. The campaign was so successful that the phrase “more than Carter’s got pills” became American slang for “an absurd amount of something.”

     Sadly, that formula still works today. Many modern health products use the same playbook: invent a vague condition, blame it for everything, then sell the cure.

     
     

     Modern Detox Myths: Dose, ZBiotics, and the Olive Oil Flush

     
     

     
     

     Fast‑forward to today and you’ll see similar claims everywhere. Dose for Your Liver, a wellness shot with milk thistle and turmeric, promises to “cleanse” the liver and support “500 daily functions.” While it cites studies showing reduced liver enzymes, those studies involved people who already had liver problems — not the average healthy person grabbing a detox shot after brunch.

     ZBiotics Pre‑Alcohol markets itself as a probiotic that breaks down acetaldehyde, a compound linked to hangovers. The truth is more complicated. Your liver clears almost all acetaldehyde on its own, while your gut bacteria handle less than five percent. Most hangover symptoms actually come from alcohol itself, dehydration, and inflammation — not a single molecule.

     Perhaps the most dramatic claim is the “liver flush” made from olive oil and lemon juice. Supporters insist that the green balls they pass in the toilet are gallstones. However, chemical tests show these “stones” are actually soap‑like clumps created when oil mixes with digestive fluids. Real gallstones are hard and form in the gallbladder; they do not dissolve overnight or pass easily. Even people without gallbladders “flush stones,” which proves the myth.

     
     

     What Actually Supports Liver Health

     The good news? You don’t need a cleanse. Your liver already detoxes naturally — 24 hours a day. Instead of chasing fads, focus on habits proven to protect it:

     • Drink coffee (up to three cups daily): Linked to lower risk of fatty liver and cirrhosis.
     • Eat polyphenol-rich foods like blueberries: These support liver health through antioxidants.
     • Get fiber from beans, greens, and whole grains: Good for the gut‑liver connection.
     • Exercise regularly: Even 150 minutes a week can reduce liver fat.
     • Limit alcohol: No supplement erases binge drinking.
     • Stay up to date on vaccines: Hepatitis A and B vaccines prevent major liver diseases.
     
     

     The Fall of Carter’s Pills — and the Lesson

     By the 1950s, science caught up to marketing. Constipation wasn’t liver failure, and the liver didn’t need “lively” pills. In 1959, the Federal Trade Commission forced Carter’s to drop the word “liver” from its name. Without that claim, sales collapsed.

     Despite Carter’s disappearance, the marketing tactics remain. Whether it’s a probiotic, a turmeric shot, or a trendy flush, the pitch is the same: you’re toxic, we have the cure. The reality? The cure was never needed.

     
     

     Takeaway

     Health trends may change, but the hustle stays the same. Instead of falling for the next detox craze, choose evidence‑based habits — and remember that if something promises instant cleansing, it’s probably selling you something you don’t need.

     
     

     References

     • Harvard T.H. Chan School of Public Health – Coffee and Liver Health (click here) 
     • National Institute of Diabetes and Digestive and Kidney Diseases – Gallstones
     • American Liver Foundation – Myths and Facts About Liver Health
     • National Library of Medicine – Milk Thistle in Liver Disease
     • Federal Trade Commission Archives – Carter’s Little Liver Pills Case (1959)
     
     

     
     

     ]]>Carter’s Little Liver Pills: The Original Detox Scam and Its Modern Cousins

     For more than a century, people have searched for quick fixes to “cleanse” the liver. From old‑time laxatives to today’s wellness shots and hangover probiotics, the promise is the same: remove toxins, feel better, live longer. However, as science catches up with marketing claims, we learn a hard truth — most of these cleanses never did what they promised.

     The Sluggish Liver Myth

     Back in the 1800s, doctors blamed nearly every health problem on a “sluggish liver.” Headaches, fatigue, irritability — even bad moods — were supposedly signs that the liver wasn’t “lively” enough.

     Enter Carter’s Little Liver Pills. These small tablets promised to fix “biliousness,” an old term for feeling miserable and out of sorts. The secret ingredient? Cascara sagrada, a plant‑based laxative. In short, the pills made people poop, and that temporary relief was sold as detoxification.

     
     

     Marketing Genius in a Pill Bottle

     Carter’s advertising strategy worked brilliantly. Their message was simple: if you feel bad, it’s your liver’s fault — and their pills were the cure. The campaign was so successful that the phrase “more than Carter’s got pills” became American slang for “an absurd amount of something.”

     Sadly, that formula still works today. Many modern health products use the same playbook: invent a vague condition, blame it for everything, then sell the cure.

     
     

     Modern Detox Myths: Dose, ZBiotics, and the Olive Oil Flush

     
     

     
     

     Fast‑forward to today and you’ll see similar claims everywhere. Dose for Your Liver, a wellness shot with milk thistle and turmeric, promises to “cleanse” the liver and support “500 daily functions.” While it cites studies showing reduced liver enzymes, those studies involved people who already had liver problems — not the average healthy person grabbing a detox shot after brunch.

     ZBiotics Pre‑Alcohol markets itself as a probiotic that breaks down acetaldehyde, a compound linked to hangovers. The truth is more complicated. Your liver clears almost all acetaldehyde on its own, while your gut bacteria handle less than five percent. Most hangover symptoms actually come from alcohol itself, dehydration, and inflammation — not a single molecule.

     Perhaps the most dramatic claim is the “liver flush” made from olive oil and lemon juice. Supporters insist that the green balls they pass in the toilet are gallstones. However, chemical tests show these “stones” are actually soap‑like clumps created when oil mixes with digestive fluids. Real gallstones are hard and form in the gallbladder; they do not dissolve overnight or pass easily. Even people without gallbladders “flush stones,” which proves the myth.

     
     

     What Actually Supports Liver Health

     The good news? You don’t need a cleanse. Your liver already detoxes naturally — 24 hours a day. Instead of chasing fads, focus on habits proven to protect it:

     • Drink coffee (up to three cups daily): Linked to lower risk of fatty liver and cirrhosis.
     • Eat polyphenol-rich foods like blueberries: These support liver health through antioxidants.
     • Get fiber from beans, greens, and whole grains: Good for the gut‑liver connection.
     • Exercise regularly: Even 150 minutes a week can reduce liver fat.
     • Limit alcohol: No supplement erases binge drinking.
     • Stay up to date on vaccines: Hepatitis A and B vaccines prevent major liver diseases.
     
     

     The Fall of Carter’s Pills — and the Lesson

     By the 1950s, science caught up to marketing. Constipation wasn’t liver failure, and the liver didn’t need “lively” pills. In 1959, the Federal Trade Commission forced Carter’s to drop the word “liver” from its name. Without that claim, sales collapsed.

     Despite Carter’s disappearance, the marketing tactics remain. Whether it’s a probiotic, a turmeric shot, or a trendy flush, the pitch is the same: you’re toxic, we have the cure. The reality? The cure was never needed.

     
     

     Takeaway

     Health trends may change, but the hustle stays the same. Instead of falling for the next detox craze, choose evidence‑based habits — and remember that if something promises instant cleansing, it’s probably selling you something you don’t need.

     
     

     References

     • Harvard T.H. Chan School of Public Health – Coffee and Liver Health (click here) 
     • National Institute of Diabetes and Digestive and Kidney Diseases – Gallstones
     • American Liver Foundation – Myths and Facts About Liver Health
     • National Library of Medicine – Milk Thistle in Liver Disease
     • Federal Trade Commission Archives – Carter’s Little Liver Pills Case (1959)
     
     

     
     

     ]]>565d3c87-c778-4ce3-be54-bd8bf6b01499Thu, 07 Aug 2025 00:00:00 -070008:14falsefull8888Edinburgh’s Surgical RevolutionGoat Glands, Chloroform, and the City That Saved Surgery

     (How Edinburgh dragged American medicine out of the Wild West)

      When we think about modern surgery, it’s easy to imagine it has always been clean, safe, and scientific. However, that could not be further from the truth. Surgery was more like a horror show just over 150 years ago. Patients faced unbearable pain, filthy instruments, and shocking guesswork.

     Today, we’ll explore how the Scottish city of Edinburgh transformed surgery — and how America, for far too long, ignored the science in favor of quick fixes and fast profits. Along the way, we’ll meet heroes like James Young Simpson and Joseph Lister, as well as villains like John R. Brinkley and Willard Bliss. We’ll also see why modern “wellness influencers” aren’t so different from the quacks of the past.

     
     

     Edinburgh: The Peak of Medical Science

     In the 18th and 19th centuries, Edinburgh was the world’s medical capital. Students from across Europe and the American colonies traveled there to study anatomy, surgery, and the latest medical theories.

     Because of this, early American physicians like Benjamin Rush and John Morgan brought Edinburgh’s teachings home, helping to found the first U.S. medical school at the University of Pennsylvania. Harvard soon followed with a similar model.

     However, while a few elite schools adopted Scottish standards, most of America remained a medical free-for-all. Outside major cities, anyone could call themselves a doctor, and “miracle cures” were everywhere. This was the true “Wild West” of medicine — long before the cowboy era we usually imagine.

     
     

     James Young Simpson: Ending Pain in Surgery

     Next, let’s fast-forward to the mid-1800s. At this time, one of the greatest problems in surgery was pain. Without anesthesia, operations had to be done quickly, often in less than a minute, and the suffering was unbearable.

     That changed in 1846, when ether anesthesia was first used in Boston. News of ether’s success quickly crossed the Atlantic. By the time the next ship arrived in Edinburgh, surgeons were already experimenting with it — and looking for something even better.

     Enter James Young Simpson, an obstetrician and, yes, one of my relatives. In 1847, Simpson discovered that chloroform worked better than ether and was easier to use. His famous breakthrough happened during a dinner party experiment, where he and his friends inhaled chloroform, passed out, and woke up amazed. Surgery would never be the same again.

     
     

     Joseph Lister: Stopping Deadly Infections

     Solving pain was one thing, but there was another huge problem: infection. After surgery, most patients didn’t die from the knife — they died from the germs they couldn’t see.

     This is where Joseph Lister changed history. Influenced by Louis Pasteur’s germ theory, Lister realized that microorganisms caused infection. He began using carbolic acid to clean wounds and sterilize instruments. While some of his colleagues mocked him, the results spoke for themselves: surgical death rates plummeted.

     Lister’s work eventually led to asepsis, the sterile environments we now take for granted in operating rooms.

     
     

     America Ignored the Science — and a President Died

     Unfortunately, the United States was slow to adopt these life-saving ideas. A tragic example is the death of President James Garfield in 1881. After being shot, Garfield’s wound was not fatal. He should have survived.

     However, his doctor, Willard Bliss, refused to believe in germ theory or antiseptic techniques. Bliss and several others repeatedly probed Garfield’s wound with unwashed hands and unsterilized instruments. For seventy-nine days, the president suffered — not from the bullet, but from a massive infection. Bliss then billed the government $25,000 for his “services,” which would be roughly $750,000 today.

     
     

     The Wild West of Quackery: From Goat Glands to Instagram

     Even after American medicine improved — especially after the 1910 Flexner Report, which shut down low-quality medical schools — quackery never fully disappeared. It simply evolved.

     In the 1920s and ’30s, John R. Brinkley became famous for implanting goat testicles into men as a cure for impotence. He used radio to market his “miracle” to millions, proving that loud marketing could still beat good science.

     Sound familiar? Today’s hucksters may not use goat glands, but they use similar tactics. Some sell expensive stool tests and invent conditions like “leaky gut” to push costly supplements. Others, like the carnivore diet influencers, ignore decades of data on the Mediterranean diet and claim you should eat nothing but steak. They dismiss the science on cholesterol, flaunt their abs, offer life coaching, and sell overpriced “special salt” — even though salt is salt, and plain Pedialyte has been used safely in millions of rehydrations.

     
     

     Why Hucksters Don’t Advance Science

     People sometimes wonder: If these charismatic figures turned their energy toward research, could they make real progress? The answer is no.

     First, most lack the deep scientific training needed to do real work. Second, those who do have training have deliberately left the hard road of science — the years of study, failed experiments, and peer review — for the fast money of “miracle cures.” Their goal isn’t discovery; it’s sales.

     
     

     The Lesson from Edinburgh

     Walking through Edinburgh’s Surgeons’ Hall Museum, you see both sides of medical history: the breakthroughs and the blunders, the heroes and the hucksters. It reminds us that progress is fragile and must be defended against those who prefer profit over evidence.

     Edinburgh gave the world anesthesia and antisepsis. It gave us the model of evidence-based medicine. And while America eventually followed, the fight against quackery continues — from goat glands to $70 detox supplements.

     ]]>Goat Glands, Chloroform, and the City That Saved Surgery

     (How Edinburgh dragged American medicine out of the Wild West)

      When we think about modern surgery, it’s easy to imagine it has always been clean, safe, and scientific. However, that could not be further from the truth. Surgery was more like a horror show just over 150 years ago. Patients faced unbearable pain, filthy instruments, and shocking guesswork.

     Today, we’ll explore how the Scottish city of Edinburgh transformed surgery — and how America, for far too long, ignored the science in favor of quick fixes and fast profits. Along the way, we’ll meet heroes like James Young Simpson and Joseph Lister, as well as villains like John R. Brinkley and Willard Bliss. We’ll also see why modern “wellness influencers” aren’t so different from the quacks of the past.

     
     

     Edinburgh: The Peak of Medical Science

     In the 18th and 19th centuries, Edinburgh was the world’s medical capital. Students from across Europe and the American colonies traveled there to study anatomy, surgery, and the latest medical theories.

     Because of this, early American physicians like Benjamin Rush and John Morgan brought Edinburgh’s teachings home, helping to found the first U.S. medical school at the University of Pennsylvania. Harvard soon followed with a similar model.

     However, while a few elite schools adopted Scottish standards, most of America remained a medical free-for-all. Outside major cities, anyone could call themselves a doctor, and “miracle cures” were everywhere. This was the true “Wild West” of medicine — long before the cowboy era we usually imagine.

     
     

     James Young Simpson: Ending Pain in Surgery

     Next, let’s fast-forward to the mid-1800s. At this time, one of the greatest problems in surgery was pain. Without anesthesia, operations had to be done quickly, often in less than a minute, and the suffering was unbearable.

     That changed in 1846, when ether anesthesia was first used in Boston. News of ether’s success quickly crossed the Atlantic. By the time the next ship arrived in Edinburgh, surgeons were already experimenting with it — and looking for something even better.

     Enter James Young Simpson, an obstetrician and, yes, one of my relatives. In 1847, Simpson discovered that chloroform worked better than ether and was easier to use. His famous breakthrough happened during a dinner party experiment, where he and his friends inhaled chloroform, passed out, and woke up amazed. Surgery would never be the same again.

     
     

     Joseph Lister: Stopping Deadly Infections

     Solving pain was one thing, but there was another huge problem: infection. After surgery, most patients didn’t die from the knife — they died from the germs they couldn’t see.

     This is where Joseph Lister changed history. Influenced by Louis Pasteur’s germ theory, Lister realized that microorganisms caused infection. He began using carbolic acid to clean wounds and sterilize instruments. While some of his colleagues mocked him, the results spoke for themselves: surgical death rates plummeted.

     Lister’s work eventually led to asepsis, the sterile environments we now take for granted in operating rooms.

     
     

     America Ignored the Science — and a President Died

     Unfortunately, the United States was slow to adopt these life-saving ideas. A tragic example is the death of President James Garfield in 1881. After being shot, Garfield’s wound was not fatal. He should have survived.

     However, his doctor, Willard Bliss, refused to believe in germ theory or antiseptic techniques. Bliss and several others repeatedly probed Garfield’s wound with unwashed hands and unsterilized instruments. For seventy-nine days, the president suffered — not from the bullet, but from a massive infection. Bliss then billed the government $25,000 for his “services,” which would be roughly $750,000 today.

     
     

     The Wild West of Quackery: From Goat Glands to Instagram

     Even after American medicine improved — especially after the 1910 Flexner Report, which shut down low-quality medical schools — quackery never fully disappeared. It simply evolved.

     In the 1920s and ’30s, John R. Brinkley became famous for implanting goat testicles into men as a cure for impotence. He used radio to market his “miracle” to millions, proving that loud marketing could still beat good science.

     Sound familiar? Today’s hucksters may not use goat glands, but they use similar tactics. Some sell expensive stool tests and invent conditions like “leaky gut” to push costly supplements. Others, like the carnivore diet influencers, ignore decades of data on the Mediterranean diet and claim you should eat nothing but steak. They dismiss the science on cholesterol, flaunt their abs, offer life coaching, and sell overpriced “special salt” — even though salt is salt, and plain Pedialyte has been used safely in millions of rehydrations.

     
     

     Why Hucksters Don’t Advance Science

     People sometimes wonder: If these charismatic figures turned their energy toward research, could they make real progress? The answer is no.

     First, most lack the deep scientific training needed to do real work. Second, those who do have training have deliberately left the hard road of science — the years of study, failed experiments, and peer review — for the fast money of “miracle cures.” Their goal isn’t discovery; it’s sales.

     
     

     The Lesson from Edinburgh

     Walking through Edinburgh’s Surgeons’ Hall Museum, you see both sides of medical history: the breakthroughs and the blunders, the heroes and the hucksters. It reminds us that progress is fragile and must be defended against those who prefer profit over evidence.

     Edinburgh gave the world anesthesia and antisepsis. It gave us the model of evidence-based medicine. And while America eventually followed, the fight against quackery continues — from goat glands to $70 detox supplements.

     ]]>5c95685e-9e29-4d21-aa5b-e488a0ce4eb0Thu, 31 Jul 2025 00:00:00 -070010:36falsefull8787Ancient Neurosurgery and Modern Brain ScamsA Hole Lot of Nonsense: Surgery Before Science

     People once drilled holes in skulls to cure madness

     And in some cases… it actually helped. Well, if you consider madness what happens if you get a stroke from too much pressure in your brain from trauma

     That’s the wild part.

     While visiting the Surgeons’ Hall Museum in Edinburgh, I saw ancient skulls with round holes cut into them—evidence of trepanation, one of the world’s oldest surgeries. Even more shocking? Many of those patients survived. Some healed so well that they lived for years.

     But let’s back up.

     What is trepanation?

     It’s the act of scraping or drilling a hole in your skull. Ancient people did it across continents—from South America to Europe.

     We don’t know exactly why. Some may have used it to relieve pressure after a head injury. Others might have believed it released evil spirits.

     Here’s the thing: it sometimes worked.

     Today, we know that pressure in the brain—from a bleed, swelling, or injury—can be deadly. Modern medicine sometimes calls for drilling a hole or even removing part of the skull to save a patient’s life.

     The ancients may have stumbled onto something real. Or they may have been guessing.

     That’s the danger when we mix luck with ritual. If one patient improves, people assume the treatment works—even if there’s no science behind it.

     Dr. Cotton and the colon cure

     Jump ahead to the 1900s.

     Dr. Henry Cotton believed mental illness came from hidden infections in the body. So what did he do? He had his surgeons remove teeth, tonsils, stomachs, and colons—even when patients showed no symptoms.

     Many died. Most didn’t improve.

     Still, Cotton was praised in journals and trusted by major institutions. His confidence overshadowed the lack of results.

     It’s a painful reminder that being sure of yourself doesn’t make you right. Sounds like modern-day influencers - confidence beyond erudition.

     Today’s brain hacks: same pattern, better packaging

     Right now, people are terrified of dementia. That fear fuels a massive market for brain supplements. One of the biggest sellers? Lion’s Mane mushrooms.

     They’re in powders, coffees, and pricey pills. Some lab research suggests benefits, but actual human studies? Weak at best.

     Meanwhile, studies show that eating a Mediterranean or MIND-style diet can reduce your risk of dementia by up to 50%. But those diets don’t come in fancy bottles.

     Instead of focusing on real food, we chase the next shiny pill.

     And let’s talk about PRP…

     PRP stands for platelet-rich plasma. Some orthopedic surgeons spin down your blood, pull out platelets, and inject it back into sore joints. They claim it speeds healing.

     The truth? There’s little evidence that PRP works for most uses. But it’s expensive. And because it sounds high-tech, people trust it.

     The orthopedic surgeon gets the thousands of dollars for it because insurance won't cover it. They won't cover it because it isn't a researched treatment. But if your surgeon says here take this and you will recover faster - what to do?

     I should know—I co-authored one of the first papers on PRP for diabetic wounds, where it actually showed benefit.

     But that’s a far cry from injecting it into tennis elbows for cash.

     We’ve upgraded the tools. Not always the thinking.

     What history teaches us

     When I look around this museum, the lesson is clear:

     We’ve always wanted to help. But good intentions without good science can hurt people.

     Real medical progress comes from questioning our own assumptions. It comes from saying, “Let’s study this,” instead of, “Let’s just try it.” Whether it’s trepanning or turmeric, we need to ask:

     Does this really work—or are we just hoping it does?

     References:

     • Barnes LL, Dhana K, Liu X, Carey VJ, Ventrelle J, Johnson K, Hollings CS, Bishop L, Laranjo N, Stubbs BJ, Reilly X, Agarwal P, Zhang S, Grodstein F, Tangney CC, Holland TM, Aggarwal NT, Arfanakis K, Morris MC, Sacks FM. Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. N Engl J Med. 2023 Aug 17;389(7):602-611. doi: 10.1056/NEJMoa2302368. Epub 2023 Jul 18. PMID: 37466280; PMCID: PMC10513737. (click here for reference)
     • Seitz, D. et al. (2022). “MIND Diet and Risk of Alzheimer’s Disease.” Nutritional Neuroscience.
     • Simpson, T. (1991). “Platelet-derived Growth Factor and Wound Healing.” Journal of Diabetic Complications.
     
     

     Want to avoid brain fads? Start with whole foods, good sleep, and honest science. The hole in your head should stay in your museum tour, not in your health plan.

     ]]>A Hole Lot of Nonsense: Surgery Before Science

     People once drilled holes in skulls to cure madness

     And in some cases… it actually helped. Well, if you consider madness what happens if you get a stroke from too much pressure in your brain from trauma

     That’s the wild part.

     While visiting the Surgeons’ Hall Museum in Edinburgh, I saw ancient skulls with round holes cut into them—evidence of trepanation, one of the world’s oldest surgeries. Even more shocking? Many of those patients survived. Some healed so well that they lived for years.

     But let’s back up.

     What is trepanation?

     It’s the act of scraping or drilling a hole in your skull. Ancient people did it across continents—from South America to Europe.

     We don’t know exactly why. Some may have used it to relieve pressure after a head injury. Others might have believed it released evil spirits.

     Here’s the thing: it sometimes worked.

     Today, we know that pressure in the brain—from a bleed, swelling, or injury—can be deadly. Modern medicine sometimes calls for drilling a hole or even removing part of the skull to save a patient’s life.

     The ancients may have stumbled onto something real. Or they may have been guessing.

     That’s the danger when we mix luck with ritual. If one patient improves, people assume the treatment works—even if there’s no science behind it.

     Dr. Cotton and the colon cure

     Jump ahead to the 1900s.

     Dr. Henry Cotton believed mental illness came from hidden infections in the body. So what did he do? He had his surgeons remove teeth, tonsils, stomachs, and colons—even when patients showed no symptoms.

     Many died. Most didn’t improve.

     Still, Cotton was praised in journals and trusted by major institutions. His confidence overshadowed the lack of results.

     It’s a painful reminder that being sure of yourself doesn’t make you right. Sounds like modern-day influencers - confidence beyond erudition.

     Today’s brain hacks: same pattern, better packaging

     Right now, people are terrified of dementia. That fear fuels a massive market for brain supplements. One of the biggest sellers? Lion’s Mane mushrooms.

     They’re in powders, coffees, and pricey pills. Some lab research suggests benefits, but actual human studies? Weak at best.

     Meanwhile, studies show that eating a Mediterranean or MIND-style diet can reduce your risk of dementia by up to 50%. But those diets don’t come in fancy bottles.

     Instead of focusing on real food, we chase the next shiny pill.

     And let’s talk about PRP…

     PRP stands for platelet-rich plasma. Some orthopedic surgeons spin down your blood, pull out platelets, and inject it back into sore joints. They claim it speeds healing.

     The truth? There’s little evidence that PRP works for most uses. But it’s expensive. And because it sounds high-tech, people trust it.

     The orthopedic surgeon gets the thousands of dollars for it because insurance won't cover it. They won't cover it because it isn't a researched treatment. But if your surgeon says here take this and you will recover faster - what to do?

     I should know—I co-authored one of the first papers on PRP for diabetic wounds, where it actually showed benefit.

     But that’s a far cry from injecting it into tennis elbows for cash.

     We’ve upgraded the tools. Not always the thinking.

     What history teaches us

     When I look around this museum, the lesson is clear:

     We’ve always wanted to help. But good intentions without good science can hurt people.

     Real medical progress comes from questioning our own assumptions. It comes from saying, “Let’s study this,” instead of, “Let’s just try it.” Whether it’s trepanning or turmeric, we need to ask:

     Does this really work—or are we just hoping it does?

     References:

     • Barnes LL, Dhana K, Liu X, Carey VJ, Ventrelle J, Johnson K, Hollings CS, Bishop L, Laranjo N, Stubbs BJ, Reilly X, Agarwal P, Zhang S, Grodstein F, Tangney CC, Holland TM, Aggarwal NT, Arfanakis K, Morris MC, Sacks FM. Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. N Engl J Med. 2023 Aug 17;389(7):602-611. doi: 10.1056/NEJMoa2302368. Epub 2023 Jul 18. PMID: 37466280; PMCID: PMC10513737. (click here for reference)
     • Seitz, D. et al. (2022). “MIND Diet and Risk of Alzheimer’s Disease.” Nutritional Neuroscience.
     • Simpson, T. (1991). “Platelet-derived Growth Factor and Wound Healing.” Journal of Diabetic Complications.
     
     

     Want to avoid brain fads? Start with whole foods, good sleep, and honest science. The hole in your head should stay in your museum tour, not in your health plan.

     ]]>f684015b-f484-4517-94a9-d89ed3a55f37Thu, 24 Jul 2025 00:00:00 -070007:24falsefull8686Radium to Cleanses: Why We Still Fall for Bad ScienceA Shocking Health Trend from the Past

     Today, you might see ads for detox teas, liver cleanses, and even hydrogen water. These products promise energy, better health, and a longer life.

     But strange health trends are nothing new.

     In the 1920s and 1930s, people paid good money to drink radioactive water. They believed it gave them energy, cured pain, and even helped them live longer. One brand, called Radithor, was sold as “perpetual sunshine in a bottle.”

     Yes—people drank water mixed with radium, the same element now used in cancer treatments and nuclear reactors.

     Why Did People Think It Worked?

     At first, radium looked like a miracle. It glowed in the dark, and doctors were just beginning to understand radiation. Companies saw a chance to make money. So they started selling radium in toothpaste, face cream, chocolate, and, yes, bottled water.

     One famous product, Radithor, was sold as a cure for everything from tiredness to “low manhood energy.”

     People believed it worked. Why? Because it came from science. It looked exciting. And it was easy to believe a glowing bottle held glowing health.

     Even doctors promoted it, just like some do with today’s wellness fads.

     Read more on Radithor from the Oak Ridge Associated Universities

     
     

     Meet the Tragic Case of Eben Byers

     One man named Eben Byers became the face of this trend. He was rich, well-known, and loved Radithor. He drank it every day—three bottles a day for years.

     For years, he said he felt great. But soon, the side effects started.

     • His teeth fell out.
     • Then his jaw crumbled.
     • Finally, bones weakened and broke.
     
     

     Eventually, his body became so radioactive that they had to bury him in a lead coffin. It took years for this to take effect. But during the years he was drinking his deadly potion, he claimed improved health and vitality.

     This helped end Radithor, but the public didn’t learn the bigger lesson.

     
     

     Fast Forward to Today

     Even though we know better, we still fall for bad science with a shiny label.

     Let’s look at a few modern examples:

     • Gary Brekka sells hydrogen water as a health hack, even though there’s little proof it helps anyone.
     • Döse Liver Cleanse is a product that doesn’t actually cleanse your liver.
     • And of course, Goop keeps offering “natural” cures like jade eggs and bee-sting facials, with no solid research to back them up.
     
     

     These trends all follow the Radithor formula:

     1. Make a wild claim
     2. Add buzzwords like “cleanse,” “cellular,” or “bioavailable”
     3. Skip the actual science
     4. Sell it fast before the truth catches up
     
     

     What’s the Real Risk?

     Most modern products won’t melt your jaw. But they can waste your money, give false hope, or delay real care.

     Worse, they can make people distrust doctors and trust influencers instead.

     Just like Radithor, these products often look scientific, but they skip important steps—like peer review, clinical trials, and safety data.

     If you need a liver cleanse, your body already has one.

     It’s called your liver. And it works 24/7—no powdered beetroot or milk thistle needed.

     What Should You Do Instead?

     Instead of chasing magic drinks or secret pills:

     • Eat whole foods
     • Move your body regularly
     • Sleep well
     • See real medical professionals
     • Ask for evidence—not just stories
     
     

     If something sounds too good to be true, it probably is. Especially if it comes from someone selling supplements, not science.

     
     

     Final Thought

     We like to believe we’re smarter than the past. But we still fall for the same trick, just with different packaging.

     So next time you see a glowing promise in a bottle, ask yourself:

     Is this progress… or just Radithor with better lighting?

     ]]>A Shocking Health Trend from the Past

     Today, you might see ads for detox teas, liver cleanses, and even hydrogen water. These products promise energy, better health, and a longer life.

     But strange health trends are nothing new.

     In the 1920s and 1930s, people paid good money to drink radioactive water. They believed it gave them energy, cured pain, and even helped them live longer. One brand, called Radithor, was sold as “perpetual sunshine in a bottle.”

     Yes—people drank water mixed with radium, the same element now used in cancer treatments and nuclear reactors.

     Why Did People Think It Worked?

     At first, radium looked like a miracle. It glowed in the dark, and doctors were just beginning to understand radiation. Companies saw a chance to make money. So they started selling radium in toothpaste, face cream, chocolate, and, yes, bottled water.

     One famous product, Radithor, was sold as a cure for everything from tiredness to “low manhood energy.”

     People believed it worked. Why? Because it came from science. It looked exciting. And it was easy to believe a glowing bottle held glowing health.

     Even doctors promoted it, just like some do with today’s wellness fads.

     Read more on Radithor from the Oak Ridge Associated Universities

     
     

     Meet the Tragic Case of Eben Byers

     One man named Eben Byers became the face of this trend. He was rich, well-known, and loved Radithor. He drank it every day—three bottles a day for years.

     For years, he said he felt great. But soon, the side effects started.

     • His teeth fell out.
     • Then his jaw crumbled.
     • Finally, bones weakened and broke.
     
     

     Eventually, his body became so radioactive that they had to bury him in a lead coffin. It took years for this to take effect. But during the years he was drinking his deadly potion, he claimed improved health and vitality.

     This helped end Radithor, but the public didn’t learn the bigger lesson.

     
     

     Fast Forward to Today

     Even though we know better, we still fall for bad science with a shiny label.

     Let’s look at a few modern examples:

     • Gary Brekka sells hydrogen water as a health hack, even though there’s little proof it helps anyone.
     • Döse Liver Cleanse is a product that doesn’t actually cleanse your liver.
     • And of course, Goop keeps offering “natural” cures like jade eggs and bee-sting facials, with no solid research to back them up.
     
     

     These trends all follow the Radithor formula:

     1. Make a wild claim
     2. Add buzzwords like “cleanse,” “cellular,” or “bioavailable”
     3. Skip the actual science
     4. Sell it fast before the truth catches up
     
     

     What’s the Real Risk?

     Most modern products won’t melt your jaw. But they can waste your money, give false hope, or delay real care.

     Worse, they can make people distrust doctors and trust influencers instead.

     Just like Radithor, these products often look scientific, but they skip important steps—like peer review, clinical trials, and safety data.

     If you need a liver cleanse, your body already has one.

     It’s called your liver. And it works 24/7—no powdered beetroot or milk thistle needed.

     What Should You Do Instead?

     Instead of chasing magic drinks or secret pills:

     • Eat whole foods
     • Move your body regularly
     • Sleep well
     • See real medical professionals
     • Ask for evidence—not just stories
     
     

     If something sounds too good to be true, it probably is. Especially if it comes from someone selling supplements, not science.

     
     

     Final Thought

     We like to believe we’re smarter than the past. But we still fall for the same trick, just with different packaging.

     So next time you see a glowing promise in a bottle, ask yourself:

     Is this progress… or just Radithor with better lighting?

     ]]>0b7032a5-45e9-477e-b965-ddb4140d1731Thu, 17 Jul 2025 00:00:00 -070007:08falsefull8585The Steak That Tried to Cure EverythingWho Was Dr. Salisbury?

     First, let’s meet the man behind the meat.

     Dr. James Henry Salisbury was a doctor during the American Civil War. He worked hard to understand why so many soldiers got sick. He noticed that stomach problems like diarrhea and dysentery were everywhere in the army camps.

     Because of this, he believed the problem came from food. But instead of looking at germs, he blamed vegetables.

     That’s right—he thought vegetables caused disease. To children everywhere, he became a hero. To science? Not so much.

     What Did He Believe?

     Dr. Salisbury believed that vegetables and starchy foods rotted in the gut. He said they caused inflammation and sickness. He thought the best way to stop disease was to eat meat—and only meat.

     So, he created a special food: the Salisbury steak.

     This steak wasn’t fancy. He ground up lean beef, shaped it into a patty, and told people to eat it three times a day. With it, they could drink only hot water or black coffee.

     No fruit.

     Absolutely no sugar.

     No grains.

     And definitely no vegetables.

     Why Did It Seem to Work?

     At first, some people felt better on the Salisbury diet. But why?

     Here’s the real reason: it wasn’t the meat. It was the boiling.

     Back then, most water carried bacteria. That bacteria caused all kinds of sickness. When soldiers boiled coffee, they accidentally killed the germs in the water. When they ate fully cooked meat, they avoided raw, dirty food.

     So yes, people improved. But not because vegetables were bad.

     They got better because boiled water and cooked meat killed bacteria.

     What Did He Get Wrong?

     Now, let’s talk about what he missed.

     • ❌ He didn’t understand germs or bacteria
     • ❌ He thought fiber was dangerous
     • ❌ He blamed plants, even though they weren’t the problem
     • ❌ He didn’t test his ideas—he just believed them
     
     

     He meant well, but he built a health plan on the wrong cause.

     Instead of fixing the real issue, he created a food myth that lasted for years.

     Why Does This Still Matter?

     Even though Dr. Salisbury lived over 150 years ago, his ideas are back—on TikTok.

     Some people today say meat is the only healthy food. They avoid fruits, grains, and vegetables. They blame plants for everything from bloating to brain fog.

     Sound familiar?

     They’re repeating Salisbury’s mistake. They’re trusting old beliefs instead of new science.

     
     

     What Science Says Now

     Let’s be clear. Science today tells a different story.

     • ✅ Vegetables help your gut, heart, and brain
     • ✅ Fiber feeds healthy gut bacteria
     • ✅ A variety of foods lowers your risk of disease
     • ❌ Eating only meat can cause nutrient problems and long-term risks
     
     

     Instead of eating like it’s 1863, you can follow a plan that supports your body and your taste buds.

     The best example? The Mediterranean diet—with healthy fats, lean protein, vegetables, fruits, and yes… even a little red wine.

     
     

     In Summary

     Dr. Salisbury had a strong idea—but he missed the mark.

     He didn’t know about bacteria. He thought vegetables were the enemy. He gave us Salisbury steak, but also gave us a lasting food myth.

     So next time someone says vegetables cause disease, just smile and say:

     “We’ve been down that road. It was dusty, undercooked, and came with black coffee.”

     ]]>Who Was Dr. Salisbury?

     First, let’s meet the man behind the meat.

     Dr. James Henry Salisbury was a doctor during the American Civil War. He worked hard to understand why so many soldiers got sick. He noticed that stomach problems like diarrhea and dysentery were everywhere in the army camps.

     Because of this, he believed the problem came from food. But instead of looking at germs, he blamed vegetables.

     That’s right—he thought vegetables caused disease. To children everywhere, he became a hero. To science? Not so much.

     What Did He Believe?

     Dr. Salisbury believed that vegetables and starchy foods rotted in the gut. He said they caused inflammation and sickness. He thought the best way to stop disease was to eat meat—and only meat.

     So, he created a special food: the Salisbury steak.

     This steak wasn’t fancy. He ground up lean beef, shaped it into a patty, and told people to eat it three times a day. With it, they could drink only hot water or black coffee.

     No fruit.

     Absolutely no sugar.

     No grains.

     And definitely no vegetables.

     Why Did It Seem to Work?

     At first, some people felt better on the Salisbury diet. But why?

     Here’s the real reason: it wasn’t the meat. It was the boiling.

     Back then, most water carried bacteria. That bacteria caused all kinds of sickness. When soldiers boiled coffee, they accidentally killed the germs in the water. When they ate fully cooked meat, they avoided raw, dirty food.

     So yes, people improved. But not because vegetables were bad.

     They got better because boiled water and cooked meat killed bacteria.

     What Did He Get Wrong?

     Now, let’s talk about what he missed.

     • ❌ He didn’t understand germs or bacteria
     • ❌ He thought fiber was dangerous
     • ❌ He blamed plants, even though they weren’t the problem
     • ❌ He didn’t test his ideas—he just believed them
     
     

     He meant well, but he built a health plan on the wrong cause.

     Instead of fixing the real issue, he created a food myth that lasted for years.

     Why Does This Still Matter?

     Even though Dr. Salisbury lived over 150 years ago, his ideas are back—on TikTok.

     Some people today say meat is the only healthy food. They avoid fruits, grains, and vegetables. They blame plants for everything from bloating to brain fog.

     Sound familiar?

     They’re repeating Salisbury’s mistake. They’re trusting old beliefs instead of new science.

     
     

     What Science Says Now

     Let’s be clear. Science today tells a different story.

     • ✅ Vegetables help your gut, heart, and brain
     • ✅ Fiber feeds healthy gut bacteria
     • ✅ A variety of foods lowers your risk of disease
     • ❌ Eating only meat can cause nutrient problems and long-term risks
     
     

     Instead of eating like it’s 1863, you can follow a plan that supports your body and your taste buds.

     The best example? The Mediterranean diet—with healthy fats, lean protein, vegetables, fruits, and yes… even a little red wine.

     
     

     In Summary

     Dr. Salisbury had a strong idea—but he missed the mark.

     He didn’t know about bacteria. He thought vegetables were the enemy. He gave us Salisbury steak, but also gave us a lasting food myth.

     So next time someone says vegetables cause disease, just smile and say:

     “We’ve been down that road. It was dusty, undercooked, and came with black coffee.”

     ]]>5e6ec312-01c1-4636-87a0-3be2e456c963Thu, 10 Jul 2025 00:00:00 -070006:14falsefull8484Smoothie Mornings Made Easy with Two Simple AppliancesThe Smoothie That Changed My Mornings (And the Appliances That Helped)

     Let’s talk about kitchen appliances.

     Yes, those gadgets sitting on your counter—or hiding in a cabinet—can either make your life easier... or drive you nuts. Today, I want to share how two small appliances completely changed my mornings. And no, I’m not paid to say any of this.

     It Started With the Air Fryer

     First, let’s be honest: nothing has brought more people back into the kitchen than the air fryer. It’s fast, easy, and makes food crispy without all the oil. In fact, according to Consumer Reports, the air fryer has become one of the most popular kitchen tools in America in the last few years.¹

     This got me thinking—what other simple appliances could actually make healthy habits easier?

     My Complicated Coffee Routine

     For years, I had a fancy coffee routine. I ground my beans fresh. I did pour-overs. I used a timer and scale like I did chemistry. The coffee was great, but the process? Not so much.

     Then one day, I tried Nespresso. Just pop in a capsule, push a button, and you get a strong, rich espresso with foam on top. It was so easy that I started enjoying my mornings again.

     No, I’m not sponsored by Nespresso—I just like sharing what works.

     
     

     The Smoothie Problem

     Next, let’s talk about smoothies.

     I have tons of smoothie recipes. I’ve written them, shared them, and even made videos about them. But honestly? I stopped making them for a long time.

     Why? Because of one thing: my Vitamix blender.

     Now, don’t get me wrong. It’s a powerful machine. It can crush anything. But it’s big. It’s loud. It has too many parts. Just getting it out of the cabinet felt like a workout. And cleaning it? Forget it.

     So even though I wanted to make smoothies, I kept skipping them. It was just easier to grab a banana and move on with my day.

     
     

     The Nutribullet Fix

     Then everything changed.

     I bought a Nutribullet.

     It’s small, easy to use, and quick to clean. I keep it on the counter. It takes about 30 seconds to rinse after using. And because of that, I’ve started making smoothies again—almost every day.

     Just like that, a healthy habit became simple.

     And no—I’m not paid by Nutribullet either. But I believe in sharing the tools that actually help.

     
     

     My Favorite Morning Smoothie

     Here’s the one I make the most right now. It gives you a little caffeine, some protein, and tastes like a treat.

     
     

     ☕️ Coffee Whey Protein Smoothie

     You’ll need:

     • 1 cup cold-brewed coffee (or cooled Nespresso)
     • 1 scoop whey protein (vanilla or chocolate)
     • ½ banana
     • ½ cup almond milk or any milk
     • 1 tbsp peanut butter or almond butter (optional)
     • 1/2 cup of Greek Yogurt
     • Dash of cinnamon or cocoa powder
     
     

     Optional extras:

     • 1–2 dates
     • 1 tsp chia or flax seeds
     • ¼ tsp vanilla extract
     
     

     Directions:

     Put everything in the blender. Blend until smooth. Pour and enjoy!

     
     

     The Big Idea

     Sometimes, the hardest part of a healthy habit isn’t the food—it’s the tool. If your blender is too much work, you won’t use it. If your coffee takes 20 minutes to make, you’ll skip breakfast.

     But with the right appliance? You remove the stress. And that makes the habit stick.

     
     

     Final Thoughts

     If you’re trying to eat better, start by making your kitchen easier to use. Keep the tools you love on the counter. Ditch the ones that frustrate you.

     And if you're changing your diet in a serious way? Talk to a registered dietitian and a board-certified doctor, not a chiropractor or some “wellness guru” who learned nutrition on YouTube.

     You can find more of my recipes at terrysimpson.com. And if you want more food science and fewer fads, check out my newsletter on Substack at tsimpson.substack.com.

     Until then, keep it simple, keep it smart, and keep the peanut butter chunky.

     —

     Reference:

     ¹ Consumer Reports – “Why Air Fryers Are Still Flying Off the Shelves” (2023)

     ]]>The Smoothie That Changed My Mornings (And the Appliances That Helped)

     Let’s talk about kitchen appliances.

     Yes, those gadgets sitting on your counter—or hiding in a cabinet—can either make your life easier... or drive you nuts. Today, I want to share how two small appliances completely changed my mornings. And no, I’m not paid to say any of this.

     It Started With the Air Fryer

     First, let’s be honest: nothing has brought more people back into the kitchen than the air fryer. It’s fast, easy, and makes food crispy without all the oil. In fact, according to Consumer Reports, the air fryer has become one of the most popular kitchen tools in America in the last few years.¹

     This got me thinking—what other simple appliances could actually make healthy habits easier?

     My Complicated Coffee Routine

     For years, I had a fancy coffee routine. I ground my beans fresh. I did pour-overs. I used a timer and scale like I did chemistry. The coffee was great, but the process? Not so much.

     Then one day, I tried Nespresso. Just pop in a capsule, push a button, and you get a strong, rich espresso with foam on top. It was so easy that I started enjoying my mornings again.

     No, I’m not sponsored by Nespresso—I just like sharing what works.

     
     

     The Smoothie Problem

     Next, let’s talk about smoothies.

     I have tons of smoothie recipes. I’ve written them, shared them, and even made videos about them. But honestly? I stopped making them for a long time.

     Why? Because of one thing: my Vitamix blender.

     Now, don’t get me wrong. It’s a powerful machine. It can crush anything. But it’s big. It’s loud. It has too many parts. Just getting it out of the cabinet felt like a workout. And cleaning it? Forget it.

     So even though I wanted to make smoothies, I kept skipping them. It was just easier to grab a banana and move on with my day.

     
     

     The Nutribullet Fix

     Then everything changed.

     I bought a Nutribullet.

     It’s small, easy to use, and quick to clean. I keep it on the counter. It takes about 30 seconds to rinse after using. And because of that, I’ve started making smoothies again—almost every day.

     Just like that, a healthy habit became simple.

     And no—I’m not paid by Nutribullet either. But I believe in sharing the tools that actually help.

     
     

     My Favorite Morning Smoothie

     Here’s the one I make the most right now. It gives you a little caffeine, some protein, and tastes like a treat.

     
     

     ☕️ Coffee Whey Protein Smoothie

     You’ll need:

     • 1 cup cold-brewed coffee (or cooled Nespresso)
     • 1 scoop whey protein (vanilla or chocolate)
     • ½ banana
     • ½ cup almond milk or any milk
     • 1 tbsp peanut butter or almond butter (optional)
     • 1/2 cup of Greek Yogurt
     • Dash of cinnamon or cocoa powder
     
     

     Optional extras:

     • 1–2 dates
     • 1 tsp chia or flax seeds
     • ¼ tsp vanilla extract
     
     

     Directions:

     Put everything in the blender. Blend until smooth. Pour and enjoy!

     
     

     The Big Idea

     Sometimes, the hardest part of a healthy habit isn’t the food—it’s the tool. If your blender is too much work, you won’t use it. If your coffee takes 20 minutes to make, you’ll skip breakfast.

     But with the right appliance? You remove the stress. And that makes the habit stick.

     
     

     Final Thoughts

     If you’re trying to eat better, start by making your kitchen easier to use. Keep the tools you love on the counter. Ditch the ones that frustrate you.

     And if you're changing your diet in a serious way? Talk to a registered dietitian and a board-certified doctor, not a chiropractor or some “wellness guru” who learned nutrition on YouTube.

     You can find more of my recipes at terrysimpson.com. And if you want more food science and fewer fads, check out my newsletter on Substack at tsimpson.substack.com.

     Until then, keep it simple, keep it smart, and keep the peanut butter chunky.

     —

     Reference:

     ¹ Consumer Reports – “Why Air Fryers Are Still Flying Off the Shelves” (2023)

     ]]>9aaada94-8834-490f-8339-db0aaec56431Wed, 02 Jul 2025 00:00:00 -070015:26falsefull8383Dr. Kellogg Cereal, Surgery, and Strange Ideas🥣 The Curious Case of Dr. Kellogg: Surgeon, Cereal, and a Whole Lot of Enemas

     When you think of Kellogg, you probably picture cereal—maybe a sweet bowl of Frosted Flakes or Corn Flakes. But the real story behind Kellogg is far weirder than breakfast. It starts with a doctor. A good one. A very strange one.

     Meet Dr. John Harvey Kellogg

     Dr. John Harvey Kellogg wasn’t just any doctor. He was a skilled surgeon, and even Dr. Charles Mayo—the founder of the Mayo Clinic—called him one of the best abdominal surgeons he had ever seen.

     But Kellogg didn’t become famous for his surgery skills. Instead, he became known for his obsession with health, diet, and—believe it or not—poop.

     The Sanitarium and the Celebrity Patients

     Kellogg ran the famous Battle Creek Sanitarium in Michigan. This health resort attracted celebrities like Thomas Edison, Henry Ford, and even Amelia Earhart. People came there to “cleanse” their bodies with special diets, exercise, sunlight, and—yes—daily enemas.

     He believed almost every illness started in the colon. His solution? Flush it out. Constantly. Sometimes, with yogurt. Sometimes, both ends. I wish I were kidding.

     Kellogg’s War on Pleasure

     Dr. Kellogg didn’t just worry about digestion. He also believed that pleasure—especially sexual pleasure—was dangerous. In fact, he thought masturbation caused everything from bad digestion to insanity.

     To fight back, he recommended boring, bland food. No spices. No excitement. Just plain meals that wouldn’t "stir the passions."

     That’s how Corn Flakes were born. Kellogg invented them as a food so bland, they might help people forget about sex altogether.

     Cereal Becomes a Business

     Now, here’s where things get interesting. Kellogg’s brother, W.K. Kellogg, thought those flakes had potential—but they needed flavor. So he added sugar and started selling them to the public.

     Dr. Kellogg was furious. He believed sugar was poison. The two brothers fought in court. W.K. won. And that’s why your breakfast cereal today is sweet and not designed to stop anyone’s libido.

     What Science Says Today

     Let’s be clear: Dr. Kellogg got a lot of things wrong.

     • You do not need daily enemas. Your colon cleans itself.
     • Yogurt goes better in a bowl than through a tube.
     • Masturbation doesn’t cause disease. It’s a normal, healthy part of being human.
     • And your desire to eat or love has nothing to do with how spicy your dinner was.
     
     

     While Kellogg’s focus on exercise and plant-based diets was ahead of his time, his fear of pleasure and obsession with “cleansing” caused more harm than good.

     The Strange Legacy

     Dr. Howard Markel, in his excellent book The Kelloggs: The Battling Brothers of Battle Creek, dives deep into their story. He shows how Dr. Kellogg's strict health beliefs turned into fads—and how his brother’s sweet-toothed success made cereal a worldwide business. Markel, Howard. The Kelloggs: The Battling Brothers of Battle Creek. Pantheon Books, 2017. 

     Kellogg's ideas were extreme, but they still echo today. Whenever someone tells you to "detox," do a cleanse, or eat bland food to fix your hormones—they might not realize they’re following a 19th-century surgeon who really hated fun.

     Dr. Markel was a medical school classmate of mine, and his book is excellent.

     Final Thought

     Dr. John Harvey Kellogg was a brilliant surgeon. But being smart doesn’t mean being right. And it definitely doesn’t mean you should give yourself a yogurt enema.

     So next time you reach for a box of cereal, remember: your breakfast has a backstory. And it’s weirder than you think.

     ]]>🥣 The Curious Case of Dr. Kellogg: Surgeon, Cereal, and a Whole Lot of Enemas

     When you think of Kellogg, you probably picture cereal—maybe a sweet bowl of Frosted Flakes or Corn Flakes. But the real story behind Kellogg is far weirder than breakfast. It starts with a doctor. A good one. A very strange one.

     Meet Dr. John Harvey Kellogg

     Dr. John Harvey Kellogg wasn’t just any doctor. He was a skilled surgeon, and even Dr. Charles Mayo—the founder of the Mayo Clinic—called him one of the best abdominal surgeons he had ever seen.

     But Kellogg didn’t become famous for his surgery skills. Instead, he became known for his obsession with health, diet, and—believe it or not—poop.

     The Sanitarium and the Celebrity Patients

     Kellogg ran the famous Battle Creek Sanitarium in Michigan. This health resort attracted celebrities like Thomas Edison, Henry Ford, and even Amelia Earhart. People came there to “cleanse” their bodies with special diets, exercise, sunlight, and—yes—daily enemas.

     He believed almost every illness started in the colon. His solution? Flush it out. Constantly. Sometimes, with yogurt. Sometimes, both ends. I wish I were kidding.

     Kellogg’s War on Pleasure

     Dr. Kellogg didn’t just worry about digestion. He also believed that pleasure—especially sexual pleasure—was dangerous. In fact, he thought masturbation caused everything from bad digestion to insanity.

     To fight back, he recommended boring, bland food. No spices. No excitement. Just plain meals that wouldn’t "stir the passions."

     That’s how Corn Flakes were born. Kellogg invented them as a food so bland, they might help people forget about sex altogether.

     Cereal Becomes a Business

     Now, here’s where things get interesting. Kellogg’s brother, W.K. Kellogg, thought those flakes had potential—but they needed flavor. So he added sugar and started selling them to the public.

     Dr. Kellogg was furious. He believed sugar was poison. The two brothers fought in court. W.K. won. And that’s why your breakfast cereal today is sweet and not designed to stop anyone’s libido.

     What Science Says Today

     Let’s be clear: Dr. Kellogg got a lot of things wrong.

     • You do not need daily enemas. Your colon cleans itself.
     • Yogurt goes better in a bowl than through a tube.
     • Masturbation doesn’t cause disease. It’s a normal, healthy part of being human.
     • And your desire to eat or love has nothing to do with how spicy your dinner was.
     
     

     While Kellogg’s focus on exercise and plant-based diets was ahead of his time, his fear of pleasure and obsession with “cleansing” caused more harm than good.

     The Strange Legacy

     Dr. Howard Markel, in his excellent book The Kelloggs: The Battling Brothers of Battle Creek, dives deep into their story. He shows how Dr. Kellogg's strict health beliefs turned into fads—and how his brother’s sweet-toothed success made cereal a worldwide business. Markel, Howard. The Kelloggs: The Battling Brothers of Battle Creek. Pantheon Books, 2017. 

     Kellogg's ideas were extreme, but they still echo today. Whenever someone tells you to "detox," do a cleanse, or eat bland food to fix your hormones—they might not realize they’re following a 19th-century surgeon who really hated fun.

     Dr. Markel was a medical school classmate of mine, and his book is excellent.

     Final Thought

     Dr. John Harvey Kellogg was a brilliant surgeon. But being smart doesn’t mean being right. And it definitely doesn’t mean you should give yourself a yogurt enema.

     So next time you reach for a box of cereal, remember: your breakfast has a backstory. And it’s weirder than you think.

     ]]>0291441e-026f-4d97-94e2-e29addbfa502Thu, 26 Jun 2025 00:00:00 -070008:09falsefull8282How Ozempic Works and Why Diets Still MatterWhat Is Ozempic or Zepbound, Really?

     You’ve probably heard about Ozempic or Zepbound. Maybe from a friend, a celebrity, or a TikTok ad. These are powerful medicines used to help people lose weight and manage diabetes. But what do they actually do?

     Ozempic is a GLP-1 receptor agonist—a type of drug that helps control hunger, improve blood sugar, and lower the risk of heart disease.

     But here's the big surprise: the real power of these drugs isn’t in your stomach—it’s in your brain.

     How It Works in the Brain

     GLP-1 medications like Ozempic work in two big ways:

     1. They help you feel full.
     2. They slow down how fast your stomach empties, so you stay full longer.
     3. They quiet the “food noise” in your brain.
     4. That’s the big one. These medicines reach areas in the brain like the hypothalamus and mesolimbic system (which includes parts like the nucleus accumbens and ventral tegmental area). These areas are responsible for cravings, rewards, and motivation to eat.
     
     

     When GLP-1 hits these areas, it reduces dopamine, the chemical that makes you want things like cake or chips. It also increases serotonin, which helps with mood and feeling satisfied after eating.

     This makes it easier to stop eating when you're full and harder to overeat just because food tastes good.

     📚 Reference: Mechanisms of GLP-1 receptor agonist–induced weight loss. Am J Med. 2024.

     What About “Natural GLP-1 Boosters”?

     You might see ads for supplements or foods that say they boost your “natural GLP-1.” Some are even called “natural Ozempic.”

     Here’s the truth:

     • Your body makes GLP-1 naturally.
     • Yes, fiber-rich foods help make more of it.
     • But no, it does not stay in your system very long—only a few minutes.
     
     

     That means your natural GLP-1 never reaches your brain like Ozempic does.

     Synthetic GLP-1 drugs like semaglutide (Ozempic) are made to last for days. They stick around long enough to enter your brain and turn down cravings.

     So no—berberine, vinegar, or sea moss are not the same thing.

     📚 Reference: GLP-1 in brain health and food reward. Front Neurosci. 2022.

     
     

     Common Myths You Should Ignore

     Let’s talk about a few common myths—and what science says instead:

     • ❌ “It’s a cheat code.”
     • ✅ It’s not cheating. It helps your brain stop screaming for food all the time.
     • ❌ “You’ll lose all your muscle.”
     • ✅ Not if you eat enough protein and move your body.
     • ❌ “You’ll gain it all back.”
     • ✅ Only if you stop all your healthy habits. GLP-1s are tools, not magic.
     • ❌ “It’s just for weight loss.”
     • ✅ These drugs also lower your risk of heart attacks, stroke, and even possibly dementia.
     
     

     📚 Reference: Semaglutide and cardiovascular outcomes. NEJM. 2023.

     
     

     Want to Supercharge Your Results? Go Mediterranean.

     People on GLP-1s who follow a Mediterranean-style diet lose more weight than those who don’t.

     Here’s why:

     • Supports your gut health.
     • Boosts your own natural GLP-1.
     • Helps the medication work better.
     
     

     What’s in the Mediterranean diet?

     • ✅ Vegetables, beans, nuts, and whole grains
     • ✅ Olive oil instead of butter
     • ✅ Fish and lean proteins
     • ✅ Some fruit and red wine (in moderation)
     
     

     And yes—less fast food and fewer ultra-processed snacks.

     📚 Reference: Combining GLP-1s with dietary strategies. Nutrients. 2023.

     
     

     One Final Thing: Obesity Is a Disease

     Some people still think obesity is about willpower. It’s not.

     In 2013, the American Medical Association said obesity is a disease.

     It’s caused by a mix of genetics, hormones, environment, and brain chemistry.

     Telling someone to “just eat less” is like telling someone with asthma to “just breathe better.”

     📚 Reference: Obesity as a chronic disease. Endocr Rev. 2021.

     
     

     In Summary

     GLP-1 medications like Ozempic are powerful tools—but they work best with the right support:

     ✅ Use them with a healthy Mediterranean-style diet

     ✅ Talk to your doctor and registered dietitian

     ✅ Don’t fall for “natural GLP-1” scams

     ✅ Understand: This is real medicine—not a trend

     About the Author

     This article was written by Dr. Terry Simpson, a board-certified physician, surgeon, and food science expert.

     ]]>What Is Ozempic or Zepbound, Really?

     You’ve probably heard about Ozempic or Zepbound. Maybe from a friend, a celebrity, or a TikTok ad. These are powerful medicines used to help people lose weight and manage diabetes. But what do they actually do?

     Ozempic is a GLP-1 receptor agonist—a type of drug that helps control hunger, improve blood sugar, and lower the risk of heart disease.

     But here's the big surprise: the real power of these drugs isn’t in your stomach—it’s in your brain.

     How It Works in the Brain

     GLP-1 medications like Ozempic work in two big ways:

     1. They help you feel full.
     2. They slow down how fast your stomach empties, so you stay full longer.
     3. They quiet the “food noise” in your brain.
     4. That’s the big one. These medicines reach areas in the brain like the hypothalamus and mesolimbic system (which includes parts like the nucleus accumbens and ventral tegmental area). These areas are responsible for cravings, rewards, and motivation to eat.
     
     

     When GLP-1 hits these areas, it reduces dopamine, the chemical that makes you want things like cake or chips. It also increases serotonin, which helps with mood and feeling satisfied after eating.

     This makes it easier to stop eating when you're full and harder to overeat just because food tastes good.

     📚 Reference: Mechanisms of GLP-1 receptor agonist–induced weight loss. Am J Med. 2024.

     What About “Natural GLP-1 Boosters”?

     You might see ads for supplements or foods that say they boost your “natural GLP-1.” Some are even called “natural Ozempic.”

     Here’s the truth:

     • Your body makes GLP-1 naturally.
     • Yes, fiber-rich foods help make more of it.
     • But no, it does not stay in your system very long—only a few minutes.
     
     

     That means your natural GLP-1 never reaches your brain like Ozempic does.

     Synthetic GLP-1 drugs like semaglutide (Ozempic) are made to last for days. They stick around long enough to enter your brain and turn down cravings.

     So no—berberine, vinegar, or sea moss are not the same thing.

     📚 Reference: GLP-1 in brain health and food reward. Front Neurosci. 2022.

     
     

     Common Myths You Should Ignore

     Let’s talk about a few common myths—and what science says instead:

     • ❌ “It’s a cheat code.”
     • ✅ It’s not cheating. It helps your brain stop screaming for food all the time.
     • ❌ “You’ll lose all your muscle.”
     • ✅ Not if you eat enough protein and move your body.
     • ❌ “You’ll gain it all back.”
     • ✅ Only if you stop all your healthy habits. GLP-1s are tools, not magic.
     • ❌ “It’s just for weight loss.”
     • ✅ These drugs also lower your risk of heart attacks, stroke, and even possibly dementia.
     
     

     📚 Reference: Semaglutide and cardiovascular outcomes. NEJM. 2023.

     
     

     Want to Supercharge Your Results? Go Mediterranean.

     People on GLP-1s who follow a Mediterranean-style diet lose more weight than those who don’t.

     Here’s why:

     • Supports your gut health.
     • Boosts your own natural GLP-1.
     • Helps the medication work better.
     
     

     What’s in the Mediterranean diet?

     • ✅ Vegetables, beans, nuts, and whole grains
     • ✅ Olive oil instead of butter
     • ✅ Fish and lean proteins
     • ✅ Some fruit and red wine (in moderation)
     
     

     And yes—less fast food and fewer ultra-processed snacks.

     📚 Reference: Combining GLP-1s with dietary strategies. Nutrients. 2023.

     
     

     One Final Thing: Obesity Is a Disease

     Some people still think obesity is about willpower. It’s not.

     In 2013, the American Medical Association said obesity is a disease.

     It’s caused by a mix of genetics, hormones, environment, and brain chemistry.

     Telling someone to “just eat less” is like telling someone with asthma to “just breathe better.”

     📚 Reference: Obesity as a chronic disease. Endocr Rev. 2021.

     
     

     In Summary

     GLP-1 medications like Ozempic are powerful tools—but they work best with the right support:

     ✅ Use them with a healthy Mediterranean-style diet

     ✅ Talk to your doctor and registered dietitian

     ✅ Don’t fall for “natural GLP-1” scams

     ✅ Understand: This is real medicine—not a trend

     About the Author

     This article was written by Dr. Terry Simpson, a board-certified physician, surgeon, and food science expert.

     ]]>943df03a-9dac-4df6-9752-5b24b1dcf3beFri, 20 Jun 2025 00:00:00 -070011:03falsefull8181Longevity That Actually WorksLongevity Without the Grift: What Actually Helps You Age Better

     Everyone wants to live longer. That’s why people are plunging into ice baths, sweating in infrared saunas, and rubbing beef tallow on their faces like it’s a miracle cream. Meanwhile, supplement companies make billions selling capsules that promise eternal youth.

     But here’s the thing: we don’t need to chase immortality. We need to focus on healthspan—the number of years we stay active, sharp, and independent. Living longer doesn’t mean much if you can’t enjoy it.

     Let’s break it down.

     The Problem With the Modern Longevity Industry

     For centuries, people have searched for the secret to living forever. From ancient pharaohs to modern influencers, the idea hasn’t changed much. Today’s gurus don’t wear robes. They wear lab coats on YouTube. They sell methylated vitamins, resveratrol, and supplements with science-sounding names like NMN.

     Some of these people—chiropractors, Instagram influencers, even some doctors like Mark Hyman—promise more than science can deliver. What they’re selling often looks more like modern snake oil than real medicine.

     Here’s a good rule of thumb: if a product claims to reverse aging and comes with a monthly subscription, it probably doesn’t work.

     
     

     What Actually Works: Boring, Science-Backed Habits

     Thankfully, there are simple steps you can take that do help.

     • Sleep: Get 7–9 hours a night. This is when your brain clears out waste and resets.
     • Exercise: Move your body. Walk, lift weights, and do balance work. It all adds up.
     • Vaccinate: Shingles and COVID vaccines reduce your risk of dementia. Shingrix alone cuts it by 20%.
     • Statins: The last 40 studies show that statins reduce dementia risk by up to 20%.  PMID 34871380 
     
     

     
     

     Eat Like You Mean It: The Mediterranean Diet

     One of the best-studied diets in the world is the Mediterranean diet. It’s not trendy, but it’s powerful. One large study showed that it can increase longevity by up to 9% if you stick with it. Source

     Here’s how it works:

     • Red Meat: Limit to 4 ounces a day. More than that raises your risk for cancer, heart disease, and type 2 diabetes. After 3 ounces, your body stops absorbing more iron anyway.
     • Olive Oil: Use it instead of butter. It’s packed with healthy fats and polyphenols like oleocanthal.
     • Whole Grains & Legumes: Beans and grains reduce obesity, diabetes, heart disease, and cancer. They’re even higher in fiber than most fruits and veggies.
     • Fruits & Vegetables: Eat a variety. Colorful foods mean more antioxidants and polyphenols.
     • Wine: One glass. That’s 5 ounces. And yes, you still get a full Mediterranean Diet point if you don’t drink at all.
     
     

     
     

     What Doesn’t Work (Even If It’s Trending)

     Let’s be honest. Some things are popular, but pointless—or even harmful.

     • Drinking alcohol "for your health"
     • Avoiding vaccines
     • Ignoring blood pressure and cholesterol
     • Trusting wellness influencers with no scientific background
     
     

     Remember: no supplement undoes bad habits. And no guru can out-hack the Hayflick Limit. That’s the scientific cap on how many times your cells can divide.

     
     

     The Real Way to Support Your Cells

     Gurus love talking about NAD and mitochondria. And yes, NAD can help your cells work better—in a lab dish. But real-life results? Meh.

     Instead, support your cells with:

     • Movement
     • Sleep
     • A mostly plant-based diet
     • Not eating around the clock
     
     

     If NAD really worked, I’d give it all to my 15-year-old dog.

     
     

     Final Thoughts

     We can’t live forever. But we can live better.

     Skip the miracle pills. Stick to the basics: move, eat like a Mediterranean, treat your blood pressure, and get vaccinated. And while you're at it, maybe adopt a senior dog. They won't live forever, but they'll give you everything they have.

     Dr. Terry Simpson

     Board-Certified Surgeon & Longevity Myth Buster

     Host of the FORK U Podcast

     ]]>Longevity Without the Grift: What Actually Helps You Age Better

     Everyone wants to live longer. That’s why people are plunging into ice baths, sweating in infrared saunas, and rubbing beef tallow on their faces like it’s a miracle cream. Meanwhile, supplement companies make billions selling capsules that promise eternal youth.

     But here’s the thing: we don’t need to chase immortality. We need to focus on healthspan—the number of years we stay active, sharp, and independent. Living longer doesn’t mean much if you can’t enjoy it.

     Let’s break it down.

     The Problem With the Modern Longevity Industry

     For centuries, people have searched for the secret to living forever. From ancient pharaohs to modern influencers, the idea hasn’t changed much. Today’s gurus don’t wear robes. They wear lab coats on YouTube. They sell methylated vitamins, resveratrol, and supplements with science-sounding names like NMN.

     Some of these people—chiropractors, Instagram influencers, even some doctors like Mark Hyman—promise more than science can deliver. What they’re selling often looks more like modern snake oil than real medicine.

     Here’s a good rule of thumb: if a product claims to reverse aging and comes with a monthly subscription, it probably doesn’t work.

     
     

     What Actually Works: Boring, Science-Backed Habits

     Thankfully, there are simple steps you can take that do help.

     • Sleep: Get 7–9 hours a night. This is when your brain clears out waste and resets.
     • Exercise: Move your body. Walk, lift weights, and do balance work. It all adds up.
     • Vaccinate: Shingles and COVID vaccines reduce your risk of dementia. Shingrix alone cuts it by 20%.
     • Statins: The last 40 studies show that statins reduce dementia risk by up to 20%.  PMID 34871380 
     
     

     
     

     Eat Like You Mean It: The Mediterranean Diet

     One of the best-studied diets in the world is the Mediterranean diet. It’s not trendy, but it’s powerful. One large study showed that it can increase longevity by up to 9% if you stick with it. Source

     Here’s how it works:

     • Red Meat: Limit to 4 ounces a day. More than that raises your risk for cancer, heart disease, and type 2 diabetes. After 3 ounces, your body stops absorbing more iron anyway.
     • Olive Oil: Use it instead of butter. It’s packed with healthy fats and polyphenols like oleocanthal.
     • Whole Grains & Legumes: Beans and grains reduce obesity, diabetes, heart disease, and cancer. They’re even higher in fiber than most fruits and veggies.
     • Fruits & Vegetables: Eat a variety. Colorful foods mean more antioxidants and polyphenols.
     • Wine: One glass. That’s 5 ounces. And yes, you still get a full Mediterranean Diet point if you don’t drink at all.
     
     

     
     

     What Doesn’t Work (Even If It’s Trending)

     Let’s be honest. Some things are popular, but pointless—or even harmful.

     • Drinking alcohol "for your health"
     • Avoiding vaccines
     • Ignoring blood pressure and cholesterol
     • Trusting wellness influencers with no scientific background
     
     

     Remember: no supplement undoes bad habits. And no guru can out-hack the Hayflick Limit. That’s the scientific cap on how many times your cells can divide.

     
     

     The Real Way to Support Your Cells

     Gurus love talking about NAD and mitochondria. And yes, NAD can help your cells work better—in a lab dish. But real-life results? Meh.

     Instead, support your cells with:

     • Movement
     • Sleep
     • A mostly plant-based diet
     • Not eating around the clock
     
     

     If NAD really worked, I’d give it all to my 15-year-old dog.

     
     

     Final Thoughts

     We can’t live forever. But we can live better.

     Skip the miracle pills. Stick to the basics: move, eat like a Mediterranean, treat your blood pressure, and get vaccinated. And while you're at it, maybe adopt a senior dog. They won't live forever, but they'll give you everything they have.

     Dr. Terry Simpson

     Board-Certified Surgeon & Longevity Myth Buster

     Host of the FORK U Podcast

     ]]>50510909-14ed-42aa-b1f6-7fabfd154db0Thu, 12 Jun 2025 00:00:00 -070010:55falsefull8080Sustainable Eating: Lab Grown Meat to Farmed FishHi, I'm Dr. Terry Simpson, your chief medical explanationist. Welcome to another edition of FORK U—where we bust myths, make sense of the madness, and teach you a little about food and medicine.

     Today, let's explore how our food choices impact the environment and our health. We'll discuss lab-grown meat, grass-fed beef, and sustainable seafood.

     🍔 Lab-Grown Meat: The Future of Food?

     Imagine enjoying a burger that didn't require raising or slaughtering an animal. That's the idea behind lab-grown meat, also known as cultured meat. Scientists grow real animal cells in labs to create meat without the traditional farming process.The Spruce EatsVox

     Why consider lab-grown meat?

     • Environmental Benefits: It could reduce greenhouse gas emissions by up to 96% and use 99% less land compared to traditional meat production. California Management Review+1University of Colorado Boulder+1
     • Animal Welfare: No animals are harmed in the process.
     • Health Potential: Lab-grown meat can be produced without antibiotics, reducing the risk of antibiotic resistance. California Management Review+1Wikipedia+1
     
     

     While it's not widely available yet, lab-grown meat is a promising step toward sustainable eating.

     
     

     🐄 Grass-Fed Beef: Is It Worth It?

     Grass-fed beef comes from cows that eat grass instead of grain. Some people choose it for potential health benefits and better animal welfare. Modern Farmer

     Pros:

     • More Omega-3s: Grass-fed beef has about three times more omega-3 fatty acids than grain-fed beef.
     • Better Fat Ratio: It has a healthier balance of omega-6 to omega-3 fatty acids. Grass Roots Farmers' Cooperative+3Wikipedia+3Understanding Ag+3
     
     

     Cons:

     • Taste Varies: Not all grass-fed beef tastes the same. The flavor depends on the pasture quality, and some might find it less tender.Reddit+8Vox+8Grass Roots Farmers' Cooperative+8
     • Cost: It's often more expensive than grain-fed beef.
     
     

     While grass-fed beef has benefits, it's essential to consider taste preferences and budget.

     
     

     🐟 Sustainable Seafood: Making Smart Choices

     Seafood is a great source of protein and omega-3 fatty acids. However, overfishing and unsustainable practices harm our oceans. Seafood Watch

     Tips for Choosing Sustainable Seafood:

     • Use Guides: The Seafood Watch provides up-to-date recommendations on sustainable seafood choices.Seafood Watch+4Seafood Watch+4Seafood Watch+4
     • Farmed Salmon: While some criticize farmed salmon, it's often a sustainable option. Farmed salmon get their pink color from astaxanthin, a natural compound also found in wild salmon's diet. Modern Farmer
     • Wild-Caught Options: Alaskan salmon is a delicious and sustainable choice, rich in omega-3s.
     
     

     By making informed seafood choices, we can enjoy tasty meals while protecting marine life.

     
     

     🛒 Final Thoughts: Small Changes, Big Impact

     Eating sustainably doesn't mean giving up your favorite foods. It's about making smarter choices:

     • Try lab-grown meat when it becomes available. The Guardian+9Nature+9Vox+9
     • Choose grass-fed beef if it fits your taste and budget.
     • Opt for sustainable seafood using trusted guides. Seafood Watch+1Oceana+1
     
     

     Every small step contributes to a healthier planet and a better future.

     ]]>Hi, I'm Dr. Terry Simpson, your chief medical explanationist. Welcome to another edition of FORK U—where we bust myths, make sense of the madness, and teach you a little about food and medicine.

     Today, let's explore how our food choices impact the environment and our health. We'll discuss lab-grown meat, grass-fed beef, and sustainable seafood.

     🍔 Lab-Grown Meat: The Future of Food?

     Imagine enjoying a burger that didn't require raising or slaughtering an animal. That's the idea behind lab-grown meat, also known as cultured meat. Scientists grow real animal cells in labs to create meat without the traditional farming process.The Spruce EatsVox

     Why consider lab-grown meat?

     • Environmental Benefits: It could reduce greenhouse gas emissions by up to 96% and use 99% less land compared to traditional meat production. California Management Review+1University of Colorado Boulder+1
     • Animal Welfare: No animals are harmed in the process.
     • Health Potential: Lab-grown meat can be produced without antibiotics, reducing the risk of antibiotic resistance. California Management Review+1Wikipedia+1
     
     

     While it's not widely available yet, lab-grown meat is a promising step toward sustainable eating.

     
     

     🐄 Grass-Fed Beef: Is It Worth It?

     Grass-fed beef comes from cows that eat grass instead of grain. Some people choose it for potential health benefits and better animal welfare. Modern Farmer

     Pros:

     • More Omega-3s: Grass-fed beef has about three times more omega-3 fatty acids than grain-fed beef.
     • Better Fat Ratio: It has a healthier balance of omega-6 to omega-3 fatty acids. Grass Roots Farmers' Cooperative+3Wikipedia+3Understanding Ag+3
     
     

     Cons:

     • Taste Varies: Not all grass-fed beef tastes the same. The flavor depends on the pasture quality, and some might find it less tender.Reddit+8Vox+8Grass Roots Farmers' Cooperative+8
     • Cost: It's often more expensive than grain-fed beef.
     
     

     While grass-fed beef has benefits, it's essential to consider taste preferences and budget.

     
     

     🐟 Sustainable Seafood: Making Smart Choices

     Seafood is a great source of protein and omega-3 fatty acids. However, overfishing and unsustainable practices harm our oceans. Seafood Watch

     Tips for Choosing Sustainable Seafood:

     • Use Guides: The Seafood Watch provides up-to-date recommendations on sustainable seafood choices.Seafood Watch+4Seafood Watch+4Seafood Watch+4
     • Farmed Salmon: While some criticize farmed salmon, it's often a sustainable option. Farmed salmon get their pink color from astaxanthin, a natural compound also found in wild salmon's diet. Modern Farmer
     • Wild-Caught Options: Alaskan salmon is a delicious and sustainable choice, rich in omega-3s.
     
     

     By making informed seafood choices, we can enjoy tasty meals while protecting marine life.

     
     

     🛒 Final Thoughts: Small Changes, Big Impact

     Eating sustainably doesn't mean giving up your favorite foods. It's about making smarter choices:

     • Try lab-grown meat when it becomes available. The Guardian+9Nature+9Vox+9
     • Choose grass-fed beef if it fits your taste and budget.
     • Opt for sustainable seafood using trusted guides. Seafood Watch+1Oceana+1
     
     

     Every small step contributes to a healthier planet and a better future.

     ]]>b5b7cce8-5207-485d-929e-0b9797e4ff8dThu, 05 Jun 2025 00:00:00 -070009:54falsefull7979The Fry Lie: McDonald's Fries for Better Or...The Fry Lie: How McDonald's Fries Got Worse—Not Healthier

     For years, McDonald’s fries ruled the world. They were golden, crispy, salty, and delicious. People called them the best fries ever made. But then something changed. Around the 1990s, fans noticed the fries didn’t taste the same anymore.

     What happened?

     Let’s dive into the real story of why McDonald’s fries lost their magic—and how the changes didn’t make them healthier. In fact, for a while, they actually made them worse.

     Once Upon a Time… in Beef Tallow

     Before 1990, McDonald’s cooked their fries in a special mix: 7% cottonseed oil and 93% beef tallow. That’s a fancy way of saying animal fat. This gave the fries a rich, savory flavor you couldn’t find anywhere else.

     Why did they use beef fat? Because Ray Kroc, the man who built the McDonald’s empire, wanted fries to taste like the original McDonald brothers’ version. He nailed it.

     But not everyone loved the fat.

     
     

     Meet Phil Sokolof: The Fry Crusader

     Phil Sokolof wasn’t a doctor. He wasn’t a scientist. But he was a wealthy businessman from Nebraska who had a heart attack. After that, he became a full-time food activist. Think of him like an early version of today’s online influencers—lots of passion, not much science.

     Sokolof spent millions on full-page newspaper ads. His messages sounded scary:

     “The Poisoning of America”

     “McDonald’s: Your Hamburger Has Too Much Fat”

     It worked. The public panicked. McDonald’s gave in.

     In 1990, the company switched from beef fat to 100% vegetable oil.

     
     

     Oops… Now with Trans Fats

     At first, this seemed like a healthy change. But here’s what they didn’t tell you: the new vegetable oil was partially hydrogenated, meaning it was full of trans fats—the most dangerous kind of fat for your heart.

     Trans fats increase your bad cholesterol (LDL) and lower your good cholesterol (HDL). They raise your risk of heart disease way more than saturated fat.

     In trying to remove one bad fat, McDonald’s accidentally replaced it with something even worse. FDA, 2015.

     They finally banned trans fats in the U.S. in 2018—but for almost 20 years, those “healthier” fries actually hurt people’s hearts more than the original version ever did.

     
     

     Flavor Fail: Enter the Beef “Natural Flavor”

     Customers missed the old flavor. So what did McDonald’s do? They added “natural beef flavoring” to the vegetable oil. Yep, they removed the beef fat… and then added beef flavoring back in.

     This confused people. Some vegetarians and Hindus believed the fries were plant-based. They weren’t, leading to lawsuits and even more public confusion.

     In the United Kingdom, McDonald’s fries are really vegan. But in the United States, that natural beef flavor still makes them off-limits to some groups.

     
     

     The Steak 'n Shake Beef Tallow Comeback

     Now fast-forward to today. Steak 'n Shake announced they were bringing back beef tallow for their fries, just like McDonald’s used to. This move caught the attention of RFK Jr., a well-known figure in politics and food activism.

     He praised the change. But here’s the problem: RFK Jr. isn’t a doctor. He’s not a nutritionist. In fact, he’s never taken a college-level science course.

     RFK Jr has a long history of pushing food myths and anti-science messages, just like early activists who helped ruin McDonald’s fries in the first place.

     Let’s be clear: Beef tallow is not healthy. It’s packed with saturated fat and cholesterol, both of which increase the risk of heart disease. AHA, 2021.

     Taste nostalgic—but nostalgia won’t protect your arteries.

     
     

     So What’s the Lesson?

     The story of McDonald’s fries teaches us something important:

     👉 Because something is “natural” or “old-fashioned” doesn’t mean it’s healthy.

     👉 Just because someone is loud about food doesn’t mean they know science.

     👉 And just because something tastes good doesn’t mean it’s good for you.

     Before you trust anyone’s food advice, check their credentials. Are they a doctor? A registered dietitian? Or just a loud person with a lot of opinions?

     McDonald’s didn’t make their fries healthier in the ‘90s. They made them worse because they listened to fear instead of facts.

     
     

     Sources / References

     • FDA. Final Determination Regarding Partially Hydrogenated Oils. 2015. FDA.gov
     • Chu M, Noh E, Lee KG. Analysis of oxidation products and toxic compounds in edible and blended oil during the deep-frying of french fries. Food Sci Biotechnol. 2024 Jan 17;33(10):2275-2287. doi: 10.1007/s10068-023-01494-9. PMID: 39145121; PMCID: PMC11319563.
     • Nestle, M. (2003). Food politics: how the food industry influences nutrition and health. University of California Press.
     
     ]]>The Fry Lie: How McDonald's Fries Got Worse—Not Healthier

     For years, McDonald’s fries ruled the world. They were golden, crispy, salty, and delicious. People called them the best fries ever made. But then something changed. Around the 1990s, fans noticed the fries didn’t taste the same anymore.

     What happened?

     Let’s dive into the real story of why McDonald’s fries lost their magic—and how the changes didn’t make them healthier. In fact, for a while, they actually made them worse.

     Once Upon a Time… in Beef Tallow

     Before 1990, McDonald’s cooked their fries in a special mix: 7% cottonseed oil and 93% beef tallow. That’s a fancy way of saying animal fat. This gave the fries a rich, savory flavor you couldn’t find anywhere else.

     Why did they use beef fat? Because Ray Kroc, the man who built the McDonald’s empire, wanted fries to taste like the original McDonald brothers’ version. He nailed it.

     But not everyone loved the fat.

     
     

     Meet Phil Sokolof: The Fry Crusader

     Phil Sokolof wasn’t a doctor. He wasn’t a scientist. But he was a wealthy businessman from Nebraska who had a heart attack. After that, he became a full-time food activist. Think of him like an early version of today’s online influencers—lots of passion, not much science.

     Sokolof spent millions on full-page newspaper ads. His messages sounded scary:

     “The Poisoning of America”

     “McDonald’s: Your Hamburger Has Too Much Fat”

     It worked. The public panicked. McDonald’s gave in.

     In 1990, the company switched from beef fat to 100% vegetable oil.

     
     

     Oops… Now with Trans Fats

     At first, this seemed like a healthy change. But here’s what they didn’t tell you: the new vegetable oil was partially hydrogenated, meaning it was full of trans fats—the most dangerous kind of fat for your heart.

     Trans fats increase your bad cholesterol (LDL) and lower your good cholesterol (HDL). They raise your risk of heart disease way more than saturated fat.

     In trying to remove one bad fat, McDonald’s accidentally replaced it with something even worse. FDA, 2015.

     They finally banned trans fats in the U.S. in 2018—but for almost 20 years, those “healthier” fries actually hurt people’s hearts more than the original version ever did.

     
     

     Flavor Fail: Enter the Beef “Natural Flavor”

     Customers missed the old flavor. So what did McDonald’s do? They added “natural beef flavoring” to the vegetable oil. Yep, they removed the beef fat… and then added beef flavoring back in.

     This confused people. Some vegetarians and Hindus believed the fries were plant-based. They weren’t, leading to lawsuits and even more public confusion.

     In the United Kingdom, McDonald’s fries are really vegan. But in the United States, that natural beef flavor still makes them off-limits to some groups.

     
     

     The Steak 'n Shake Beef Tallow Comeback

     Now fast-forward to today. Steak 'n Shake announced they were bringing back beef tallow for their fries, just like McDonald’s used to. This move caught the attention of RFK Jr., a well-known figure in politics and food activism.

     He praised the change. But here’s the problem: RFK Jr. isn’t a doctor. He’s not a nutritionist. In fact, he’s never taken a college-level science course.

     RFK Jr has a long history of pushing food myths and anti-science messages, just like early activists who helped ruin McDonald’s fries in the first place.

     Let’s be clear: Beef tallow is not healthy. It’s packed with saturated fat and cholesterol, both of which increase the risk of heart disease. AHA, 2021.

     Taste nostalgic—but nostalgia won’t protect your arteries.

     
     

     So What’s the Lesson?

     The story of McDonald’s fries teaches us something important:

     👉 Because something is “natural” or “old-fashioned” doesn’t mean it’s healthy.

     👉 Just because someone is loud about food doesn’t mean they know science.

     👉 And just because something tastes good doesn’t mean it’s good for you.

     Before you trust anyone’s food advice, check their credentials. Are they a doctor? A registered dietitian? Or just a loud person with a lot of opinions?

     McDonald’s didn’t make their fries healthier in the ‘90s. They made them worse because they listened to fear instead of facts.

     
     

     Sources / References

     • FDA. Final Determination Regarding Partially Hydrogenated Oils. 2015. FDA.gov
     • Chu M, Noh E, Lee KG. Analysis of oxidation products and toxic compounds in edible and blended oil during the deep-frying of french fries. Food Sci Biotechnol. 2024 Jan 17;33(10):2275-2287. doi: 10.1007/s10068-023-01494-9. PMID: 39145121; PMCID: PMC11319563.
     • Nestle, M. (2003). Food politics: how the food industry influences nutrition and health. University of California Press.
     
     ]]>345a214c-2880-4f40-afd6-e56538f629bdFri, 30 May 2025 00:00:00 -070006:25falsefull7878Superfood Myths: What Works, What Hurts, What’s HypeSuperfood Snake Oil: Why Kale Won’t Save You (But Also Isn’t Killing You)

     Every week, there's a new superfood: sea moss, turmeric shots, raw milk, lion’s mane mushrooms, and the obligatory $18 acai bowl. These so-called miracle foods promise to heal your gut, detox your liver, reverse aging, and apparently, cure loneliness if you add enough coconut flakes.

     But here’s the reality: “superfood” is a marketing term, not a scientific one.

     Let’s dig into the hype, the risks, and what the research really says.

     The Superfood Scam: Health Halo for Sale

     The term “superfood” has no regulatory meaning. It’s not recognized by the FDA, USDA, or any legitimate scientific body. It originated in marketing campaigns and caught fire because it sells. All you need is one small, usually poorly designed study, a press release, and a social media influencer to make your food the next panacea.

     Blueberries? Excellent.

     Avocados? Delicious.

     Are they miracle cures? No.

     References:

     • Hasler, C. M. (2002). Functional foods: Benefits, concerns and challenges—a position paper from the American Council on Science and Health. The Journal of Nutrition, 132(12), 3772–3781. https://doi.org/10.1093/jn/132.12.3772
     
     

     Turmeric: Anti-Inflammatory or Hepatotoxic?

     Turmeric has become the golden child of the wellness world. Its active compound, curcumin, has been studied for its anti-inflammatory properties. But here’s the problem: it doesn’t absorb well, and most studies showing benefits are in vitro or animal studies, not humans.

     Worse? Turmeric has been linked to liver injury.

     Several case reports have now documented turmeric-related liver failure, especially when consumed in high doses or combined with alcohol or other supplements.

     So no, a turmeric shot after tequila won’t detox your liver. It may just damage it further.

     References:

     • Luber RP et al. (2019). Acute Liver Injury With Turmeric Use. ACG Case Reports Journal, 6(5). https://doi.org/10.14309/crj.0000000000000113
     • Nelson KM et al. (2017). The essential medicinal chemistry of curcumin. J Med Chem, 60(5), 1620–1637. https://doi.org/10.1021/acs.jmedchem.6b00975
     
     

     Raw Milk: Microbial Roulette, Not a Wellness Hack

     Let’s talk about raw milk—a rising star among TikTok wellness influencers. The claim? Pasteurization destroys enzymes and nutrients. The truth? Pasteurization destroys pathogens that can kill you.

     Raw milk can harbor E. coli, Listeria, Campylobacter, and Salmonella—especially dangerous for kids, pregnant women, and the immunocompromised. The CDC has linked multiple outbreaks to raw milk in the last decade.

     Pasteurization was a public health revolution. Rejecting it isn’t “natural”—it’s negligent.

     References:

     • Centers for Disease Control and Prevention (CDC). (2023). Raw Milk Questions and Answers. https://www.cdc.gov/foodsafety/rawmilk/raw-milk-questions-and-answers.html
     • Mungai EA, et al. (2015). Increased outbreaks of nonpasteurized milk–associated foodborne illness. Emerging Infectious Diseases, 21(1), 119–122. https://doi.org/10.3201/eid2101.140447
     
     

     Sea Moss, Super Iodine, and Hypothyroidism

     Sea moss is having a moment. Touted for thyroid health and “minerals,” it's become a staple in online supplement stores. Yes, it contains iodine—but that’s a double-edged sword.

     Excess iodine intake can trigger thyroid dysfunction, including hypothyroidism and thyroiditis.

     If you’re eating a balanced diet and using iodized salt, you’re probably not iodine-deficient, but you can become iodine-toxic with concentrated seaweed supplements.

     Reference:

     • Leung AM et al. (2012). Iodine nutrition in the United States: Strategies and trends. Endocrine Practice, 18(5), 566–573. https://doi.org/10.4158/EP12167.RA
     
     

     Science Over Hype: What Actually Works

     Here’s the unsexy truth:

     • Eat mostly plants
     • Choose whole over ultra-processed foods
     • Use olive oil, not coconut oil
     • Get your fiber from food, not powder
     • Supplements are okay... but legumes are better
     • Don’t fear carbs—fear quackery
     
     

     The Mediterranean diet remains the most evidence-supported eating pattern. It reduces cardiovascular risk, supports gut health, and—surprise—it doesn’t require imported mushrooms or blue-green algae.

     Reference:

     • Sofi F et al. (2010). Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. The American Journal of Clinical Nutrition, 92(5), 1189–1196. https://doi.org/10.3945/ajcn.2010.29673
     
     

     Pill vs. Pinto: What to Eat Instead of Swallowing Hype

     Here’s a quick reality check:

     • Cholesterol lowering? → Skip red yeast rice. Eat beans.
     • Magnesium? → Lentils, not gummies.
     • Iron? → Cook with cast iron and eat leafy greens, not liver capsules.
     • Fiber supplements? → Pinto beans do it better—and they taste good.
     
     

     Supplements aren’t evil, but they shouldn’t replace actual food. Nutrients work best in their native habitat: inside whole, delicious, minimally processed foods.

     
     

     Final Thoughts: No One Food Saves You

     If a food promises miracle cures, detox powers, or “anti-aging” effects, it’s marketing, not medicine.

     Superfoods are sold as shortcuts. But health takes consistency.

     Eat well, real, and boring sometimes. It works.

     And next time someone hands you a turmeric liver cleanse shot after a night of margaritas? Just tell them: Fork U.

     
     

     Dr. Terry Simpson

     Surgeon. Culinary Medicine Nerd. Your Chief Medical Explanationist.

     If you want more unfiltered food and medicine insights, subscribe to my podcast [FORK U] and follow me @DrTerrySimpson on Instagram and TikTok.

     ]]>Superfood Snake Oil: Why Kale Won’t Save You (But Also Isn’t Killing You)

     Every week, there's a new superfood: sea moss, turmeric shots, raw milk, lion’s mane mushrooms, and the obligatory $18 acai bowl. These so-called miracle foods promise to heal your gut, detox your liver, reverse aging, and apparently, cure loneliness if you add enough coconut flakes.

     But here’s the reality: “superfood” is a marketing term, not a scientific one.

     Let’s dig into the hype, the risks, and what the research really says.

     The Superfood Scam: Health Halo for Sale

     The term “superfood” has no regulatory meaning. It’s not recognized by the FDA, USDA, or any legitimate scientific body. It originated in marketing campaigns and caught fire because it sells. All you need is one small, usually poorly designed study, a press release, and a social media influencer to make your food the next panacea.

     Blueberries? Excellent.

     Avocados? Delicious.

     Are they miracle cures? No.

     References:

     • Hasler, C. M. (2002). Functional foods: Benefits, concerns and challenges—a position paper from the American Council on Science and Health. The Journal of Nutrition, 132(12), 3772–3781. https://doi.org/10.1093/jn/132.12.3772
     
     

     Turmeric: Anti-Inflammatory or Hepatotoxic?

     Turmeric has become the golden child of the wellness world. Its active compound, curcumin, has been studied for its anti-inflammatory properties. But here’s the problem: it doesn’t absorb well, and most studies showing benefits are in vitro or animal studies, not humans.

     Worse? Turmeric has been linked to liver injury.

     Several case reports have now documented turmeric-related liver failure, especially when consumed in high doses or combined with alcohol or other supplements.

     So no, a turmeric shot after tequila won’t detox your liver. It may just damage it further.

     References:

     • Luber RP et al. (2019). Acute Liver Injury With Turmeric Use. ACG Case Reports Journal, 6(5). https://doi.org/10.14309/crj.0000000000000113
     • Nelson KM et al. (2017). The essential medicinal chemistry of curcumin. J Med Chem, 60(5), 1620–1637. https://doi.org/10.1021/acs.jmedchem.6b00975
     
     

     Raw Milk: Microbial Roulette, Not a Wellness Hack

     Let’s talk about raw milk—a rising star among TikTok wellness influencers. The claim? Pasteurization destroys enzymes and nutrients. The truth? Pasteurization destroys pathogens that can kill you.

     Raw milk can harbor E. coli, Listeria, Campylobacter, and Salmonella—especially dangerous for kids, pregnant women, and the immunocompromised. The CDC has linked multiple outbreaks to raw milk in the last decade.

     Pasteurization was a public health revolution. Rejecting it isn’t “natural”—it’s negligent.

     References:

     • Centers for Disease Control and Prevention (CDC). (2023). Raw Milk Questions and Answers. https://www.cdc.gov/foodsafety/rawmilk/raw-milk-questions-and-answers.html
     • Mungai EA, et al. (2015). Increased outbreaks of nonpasteurized milk–associated foodborne illness. Emerging Infectious Diseases, 21(1), 119–122. https://doi.org/10.3201/eid2101.140447
     
     

     Sea Moss, Super Iodine, and Hypothyroidism

     Sea moss is having a moment. Touted for thyroid health and “minerals,” it's become a staple in online supplement stores. Yes, it contains iodine—but that’s a double-edged sword.

     Excess iodine intake can trigger thyroid dysfunction, including hypothyroidism and thyroiditis.

     If you’re eating a balanced diet and using iodized salt, you’re probably not iodine-deficient, but you can become iodine-toxic with concentrated seaweed supplements.

     Reference:

     • Leung AM et al. (2012). Iodine nutrition in the United States: Strategies and trends. Endocrine Practice, 18(5), 566–573. https://doi.org/10.4158/EP12167.RA
     
     

     Science Over Hype: What Actually Works

     Here’s the unsexy truth:

     • Eat mostly plants
     • Choose whole over ultra-processed foods
     • Use olive oil, not coconut oil
     • Get your fiber from food, not powder
     • Supplements are okay... but legumes are better
     • Don’t fear carbs—fear quackery
     
     

     The Mediterranean diet remains the most evidence-supported eating pattern. It reduces cardiovascular risk, supports gut health, and—surprise—it doesn’t require imported mushrooms or blue-green algae.

     Reference:

     • Sofi F et al. (2010). Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. The American Journal of Clinical Nutrition, 92(5), 1189–1196. https://doi.org/10.3945/ajcn.2010.29673
     
     

     Pill vs. Pinto: What to Eat Instead of Swallowing Hype

     Here’s a quick reality check:

     • Cholesterol lowering? → Skip red yeast rice. Eat beans.
     • Magnesium? → Lentils, not gummies.
     • Iron? → Cook with cast iron and eat leafy greens, not liver capsules.
     • Fiber supplements? → Pinto beans do it better—and they taste good.
     
     

     Supplements aren’t evil, but they shouldn’t replace actual food. Nutrients work best in their native habitat: inside whole, delicious, minimally processed foods.

     
     

     Final Thoughts: No One Food Saves You

     If a food promises miracle cures, detox powers, or “anti-aging” effects, it’s marketing, not medicine.

     Superfoods are sold as shortcuts. But health takes consistency.

     Eat well, real, and boring sometimes. It works.

     And next time someone hands you a turmeric liver cleanse shot after a night of margaritas? Just tell them: Fork U.

     
     

     Dr. Terry Simpson

     Surgeon. Culinary Medicine Nerd. Your Chief Medical Explanationist.

     If you want more unfiltered food and medicine insights, subscribe to my podcast [FORK U] and follow me @DrTerrySimpson on Instagram and TikTok.

     ]]>a4cc4563-8ff2-49c7-bad1-fe922d6f91c3Wed, 21 May 2025 00:00:00 -070008:19falsefull7777Fruit Fearmongering: Is Fruit Bad For You?Is Fruit Bad For You?

     Have you heard the latest nonsense from the diet grift industrial complex?

     Apparently, fruit is now dangerous. Yes—fruit. The stuff that grows on trees and ends up in your kid’s lunchbox is being blamed for everything from diabetes to “metabolic collapse.”

     The same influencers who once screamed about seed oils are now coming for your bananas, blueberries, and yes, even your smoothies.

     It would be laughable if it weren’t so successful.

     I’ve Seen Real Diets That Work—They Include Fruit

     My father had a massive heart attack at 55. The kind that forces lifestyle change.

     But here’s the thing—he lived. He didn’t just live; he thrived.

     He made it to 98, living independently until the very end.

     And every single morning, he started his day with fruit: grapefruit, berries, and cantaloupe. He didn’t fear fructose. He just ate a balanced diet, and it worked.

     
     

     The Anti-Fruit Grift: A Modern Wellness Scam

     On social media, fruit is now the villain of the week. According to the keto-carnivore crowd, fruit will spike your insulin, make you fat, and destroy your health.

     But right after shaming your banana, they usually offer a discount code for their liver pills or collagen powder.

     Even Paul Saladino—the original shirtless prophet of beef liver supplements—is eating fruit now. Apparently, scurvy isn’t a great look.

     
     

     Here’s the Truth: Fruit Is One of the Healthiest Things You Can Eat

     Let’s stick to actual science. Fruit is one of the nine essential components of the Mediterranean Diet—a dietary pattern backed by decades of research, including landmark studies like PREDIMED and EPIC.

     The Mediterranean Diet recommends 250 grams of fruit per day. People who follow it experience lower rates of:

     • Cardiovascular disease
     • Type 2 diabetes
     • Cognitive decline
     
     

     And guess what? Even people with diabetes do well when they eat whole fruit.

     According to large observational studies, such as the BMJ study by Muraki et al. (2013) and Li et al. (2016) in The Journal of Nutrition, higher intake of whole fruits—especially berries, apples, and citrus—is associated with a reduced risk of type 2 diabetes, not an increased one.

     
     

     Smoothies: Not Soda. Let’s Stop the Nonsense.

     Yes, when you blend fruit, it digests faster. That’s true. But a smoothie made from whole fruit, with the fiber intact, is nothing like drinking a sugary soda.

     Want to improve it even more? Add protein, oats, chia, or yogurt. You’ve got a perfectly fine breakfast that’s far better than most boxed cereals.

     So drink your smoothie. Enjoy it. You’re not ruining your health. You’re nourishing your body.

     
     

     Cultures That Live Long... Eat Fruit

     All the world’s longest-lived populations eat fruit—daily.

     • Okinawans enjoy papaya, guava, and sweet potatoes.
     • Sardinians love figs, grapes, and citrus.
     • Loma Linda Adventists consume berries and stone fruits, and live some of the longest lives in America.
     
     

     None of these groups fear fruit. And spoiler alert: none of them are blending bacon into their coffee.

     
     

     Beware of Magical Thinking (and Tallow)

     The real problem isn’t fruit—it’s the carnival of carnivore influencers selling meat-based miracles. These aren’t scientists. They’re entertainers with no credentials who demonize fruit while pushing “ancestral eating” and supplements derived from animals that... ate fruit.

     If your diet says yes to beef tallow but no to blueberries, it’s time to reevaluate who you’re listening to.

     
     

     Final Thoughts: Let’s Use Our Brains (and Eat the Peach)

     Fruit isn’t the enemy. It’s not a metabolic poison. It’s one of the most nutrient-rich foods you can eat—and it's associated with better health outcomes across every major population study.

     So next time someone tells you to skip the apple, ask them to show you a peer-reviewed study—not a coupon code.

     
     

     References:

     1. Guan J, Liu T, Yang K, Chen H. Dried fruit intake and lower risk of type 2 diabetes: a two-sample mendelian randomization study. Nutr Metab (Lond). 2024 Jul 10;21(1):46. doi: 10.1186/s12986-024-00813-z. PMID: 38987806; PMCID: PMC11234600.
     2. Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. Rev Esp Cardiol (Engl Ed). 2024 Jul;77(7):574-582. English, Spanish. doi: 10.1016/j.rec.2024.01.006. Epub 2024 Feb 7. PMID: 38336153. - (click for reference)
     
     ]]>Is Fruit Bad For You?

     Have you heard the latest nonsense from the diet grift industrial complex?

     Apparently, fruit is now dangerous. Yes—fruit. The stuff that grows on trees and ends up in your kid’s lunchbox is being blamed for everything from diabetes to “metabolic collapse.”

     The same influencers who once screamed about seed oils are now coming for your bananas, blueberries, and yes, even your smoothies.

     It would be laughable if it weren’t so successful.

     I’ve Seen Real Diets That Work—They Include Fruit

     My father had a massive heart attack at 55. The kind that forces lifestyle change.

     But here’s the thing—he lived. He didn’t just live; he thrived.

     He made it to 98, living independently until the very end.

     And every single morning, he started his day with fruit: grapefruit, berries, and cantaloupe. He didn’t fear fructose. He just ate a balanced diet, and it worked.

     
     

     The Anti-Fruit Grift: A Modern Wellness Scam

     On social media, fruit is now the villain of the week. According to the keto-carnivore crowd, fruit will spike your insulin, make you fat, and destroy your health.

     But right after shaming your banana, they usually offer a discount code for their liver pills or collagen powder.

     Even Paul Saladino—the original shirtless prophet of beef liver supplements—is eating fruit now. Apparently, scurvy isn’t a great look.

     
     

     Here’s the Truth: Fruit Is One of the Healthiest Things You Can Eat

     Let’s stick to actual science. Fruit is one of the nine essential components of the Mediterranean Diet—a dietary pattern backed by decades of research, including landmark studies like PREDIMED and EPIC.

     The Mediterranean Diet recommends 250 grams of fruit per day. People who follow it experience lower rates of:

     • Cardiovascular disease
     • Type 2 diabetes
     • Cognitive decline
     
     

     And guess what? Even people with diabetes do well when they eat whole fruit.

     According to large observational studies, such as the BMJ study by Muraki et al. (2013) and Li et al. (2016) in The Journal of Nutrition, higher intake of whole fruits—especially berries, apples, and citrus—is associated with a reduced risk of type 2 diabetes, not an increased one.

     
     

     Smoothies: Not Soda. Let’s Stop the Nonsense.

     Yes, when you blend fruit, it digests faster. That’s true. But a smoothie made from whole fruit, with the fiber intact, is nothing like drinking a sugary soda.

     Want to improve it even more? Add protein, oats, chia, or yogurt. You’ve got a perfectly fine breakfast that’s far better than most boxed cereals.

     So drink your smoothie. Enjoy it. You’re not ruining your health. You’re nourishing your body.

     
     

     Cultures That Live Long... Eat Fruit

     All the world’s longest-lived populations eat fruit—daily.

     • Okinawans enjoy papaya, guava, and sweet potatoes.
     • Sardinians love figs, grapes, and citrus.
     • Loma Linda Adventists consume berries and stone fruits, and live some of the longest lives in America.
     
     

     None of these groups fear fruit. And spoiler alert: none of them are blending bacon into their coffee.

     
     

     Beware of Magical Thinking (and Tallow)

     The real problem isn’t fruit—it’s the carnival of carnivore influencers selling meat-based miracles. These aren’t scientists. They’re entertainers with no credentials who demonize fruit while pushing “ancestral eating” and supplements derived from animals that... ate fruit.

     If your diet says yes to beef tallow but no to blueberries, it’s time to reevaluate who you’re listening to.

     
     

     Final Thoughts: Let’s Use Our Brains (and Eat the Peach)

     Fruit isn’t the enemy. It’s not a metabolic poison. It’s one of the most nutrient-rich foods you can eat—and it's associated with better health outcomes across every major population study.

     So next time someone tells you to skip the apple, ask them to show you a peer-reviewed study—not a coupon code.

     
     

     References:

     1. Guan J, Liu T, Yang K, Chen H. Dried fruit intake and lower risk of type 2 diabetes: a two-sample mendelian randomization study. Nutr Metab (Lond). 2024 Jul 10;21(1):46. doi: 10.1186/s12986-024-00813-z. PMID: 38987806; PMCID: PMC11234600.
     2. Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. Rev Esp Cardiol (Engl Ed). 2024 Jul;77(7):574-582. English, Spanish. doi: 10.1016/j.rec.2024.01.006. Epub 2024 Feb 7. PMID: 38336153. - (click for reference)
     
     ]]>043c98f0-f284-4d7f-906e-38d5d590c158Wed, 14 May 2025 00:00:00 -070006:16falsefull7676On a GLP-1 - You Should be on the Mediterranean Diet AlsoWeight Loss Surgery and Mediterranean Diet to GLP-1 and the Mediterranean Diet

     For years, I have guided my weight loss surgery patients toward the Mediterranean diet. Why? Because it’s not only delicious and sustainable, but it’s also backed by decades of science. Now, as GLP-1 medications like Ozempic and Zepbound transform how we approach obesity, the question arises again: what should people eat while on these powerful drugs? The answer, as it turns out, remains the same.

     GLP-1 medications have undeniably revolutionized weight loss. These drugs, originally developed for diabetes, have rapidly gained fame for helping individuals shed significant amounts of weight. They work by reducing appetite, slowing stomach emptying, and altering hunger signals in the brain. Many patients simply cannot achieve sustained weight loss with diet alone, and for them, GLP-1 drugs are life-changing.

     However, while these medications help people lose weight, they do not address everything. Weight loss is only part of the equation. Nutrition still matters deeply. Without nourishing your body properly, you risk missing out on crucial benefits such as inflammation reduction, cardiovascular protection, and cognitive preservation.

     The Mediterranean Diet

     This is exactly where the Mediterranean diet shines. For decades, in fact, over 70 years, researchers have studied this dietary pattern. More than 13,000 scientific publications support its benefits. It’s not just about eating "like people in the Mediterranean." Rather, it’s about embracing a carefully studied set of foods, in specific amounts, shown to optimize health outcomes.

     For example, the diet emphasizes:

     • Around 9 ounces (250 grams) of fruits daily.
     • Plenty of vegetables and whole grains.
     • Healthy fats, especially from olive oil.
     • Lean proteins, particularly fish and legumes.
     • Limited red meat and alcohol.
     
     

     Studies Showing the Diet Works For Health

     The science is clear. The PREDIMED study demonstrated significant reductions in cardiovascular events among followers of this diet. The EPIC studies have shown lower overall mortality, reduced cancer risk, and enhanced longevity. Furthermore, other research consistently links the Mediterranean diet to better insulin sensitivity, lower diabetes incidence, and reduced Alzheimer’s risk.

     So, how does this all connect to GLP-1 medications? Simple. If you are using GLP-1 drugs, you are already taking control of your weight. Why stop there? Combining these medications with a Mediterranean diet maximizes your health benefits. While the drugs help you eat less and lose weight, the diet ensures that what you do eat is packed with nutrition, anti-inflammatory compounds, and essential nutrients.

     Examples of the Diet in Real Life

     In practical terms, adopting this diet does not have to be complicated. For breakfast, try Greek yogurt topped with fresh berries, or overnight oats with fruit and nuts. For lunch, enjoy a salad filled with leafy greens, chickpeas, avocado, and stone fruits, drizzled with olive oil and lemon. For dinner, think grilled salmon or chicken, paired with quinoa or farro and plenty of colorful vegetables.

     Ultimately, GLP-1 drugs and the Mediterranean diet are not competing solutions — they are complementary tools. Together, they support not just weight loss, but whole-body health.

     If you are on a GLP-1 medication, remember this: losing weight is important, but being healthy while losing weight is essential. The Mediterranean diet remains the gold standard, helping you do both.

     Don't forget your vitamins

     If you are on a GLP-1 medication, please take a daily multivitamin. There are plenty of them out there, but you need these daily. Especially the B-complex. I like this one from YouTheory.

     ]]>Weight Loss Surgery and Mediterranean Diet to GLP-1 and the Mediterranean Diet

     For years, I have guided my weight loss surgery patients toward the Mediterranean diet. Why? Because it’s not only delicious and sustainable, but it’s also backed by decades of science. Now, as GLP-1 medications like Ozempic and Zepbound transform how we approach obesity, the question arises again: what should people eat while on these powerful drugs? The answer, as it turns out, remains the same.

     GLP-1 medications have undeniably revolutionized weight loss. These drugs, originally developed for diabetes, have rapidly gained fame for helping individuals shed significant amounts of weight. They work by reducing appetite, slowing stomach emptying, and altering hunger signals in the brain. Many patients simply cannot achieve sustained weight loss with diet alone, and for them, GLP-1 drugs are life-changing.

     However, while these medications help people lose weight, they do not address everything. Weight loss is only part of the equation. Nutrition still matters deeply. Without nourishing your body properly, you risk missing out on crucial benefits such as inflammation reduction, cardiovascular protection, and cognitive preservation.

     The Mediterranean Diet

     This is exactly where the Mediterranean diet shines. For decades, in fact, over 70 years, researchers have studied this dietary pattern. More than 13,000 scientific publications support its benefits. It’s not just about eating "like people in the Mediterranean." Rather, it’s about embracing a carefully studied set of foods, in specific amounts, shown to optimize health outcomes.

     For example, the diet emphasizes:

     • Around 9 ounces (250 grams) of fruits daily.
     • Plenty of vegetables and whole grains.
     • Healthy fats, especially from olive oil.
     • Lean proteins, particularly fish and legumes.
     • Limited red meat and alcohol.
     
     

     Studies Showing the Diet Works For Health

     The science is clear. The PREDIMED study demonstrated significant reductions in cardiovascular events among followers of this diet. The EPIC studies have shown lower overall mortality, reduced cancer risk, and enhanced longevity. Furthermore, other research consistently links the Mediterranean diet to better insulin sensitivity, lower diabetes incidence, and reduced Alzheimer’s risk.

     So, how does this all connect to GLP-1 medications? Simple. If you are using GLP-1 drugs, you are already taking control of your weight. Why stop there? Combining these medications with a Mediterranean diet maximizes your health benefits. While the drugs help you eat less and lose weight, the diet ensures that what you do eat is packed with nutrition, anti-inflammatory compounds, and essential nutrients.

     Examples of the Diet in Real Life

     In practical terms, adopting this diet does not have to be complicated. For breakfast, try Greek yogurt topped with fresh berries, or overnight oats with fruit and nuts. For lunch, enjoy a salad filled with leafy greens, chickpeas, avocado, and stone fruits, drizzled with olive oil and lemon. For dinner, think grilled salmon or chicken, paired with quinoa or farro and plenty of colorful vegetables.

     Ultimately, GLP-1 drugs and the Mediterranean diet are not competing solutions — they are complementary tools. Together, they support not just weight loss, but whole-body health.

     If you are on a GLP-1 medication, remember this: losing weight is important, but being healthy while losing weight is essential. The Mediterranean diet remains the gold standard, helping you do both.

     Don't forget your vitamins

     If you are on a GLP-1 medication, please take a daily multivitamin. There are plenty of them out there, but you need these daily. Especially the B-complex. I like this one from YouTheory.

     ]]>39f2f267-bcd7-4e69-9224-f735391a6c06Wed, 07 May 2025 00:00:00 -070007:47falsefull7575Banning Neon Cupcakes While Ignoring Real Public Health Threats: Welcome to America 2025Welcome to the theater of absurdity.

     While the federal government waves the flag of victory over removing petroleum-based food dyes from snacks, it is simultaneously gutting critical public health programs like food inspection, bird flu monitoring, injury prevention initiatives, and scientific research grants. The result? A dazzling case study in misplaced priorities.

     Today, let's walk through what is actually happening — not the headline-friendly soundbites — and why Americans should be far more worried about E. coli in their milk than Red Dye #3 in their Skittles.

     The Food Dye Fear Mongering: What's Actually True?

     First, let's address the food dye hysteria head-on. Many news outlets, "wellness influencers," and natural health bloggers are breathlessly claiming that we are "eating petroleum" because some food dyes are synthesized from hydrocarbon molecules derived initially from crude oil.

     Here’s the scientific truth: petroleum-derived hydrocarbons are nothing more than basic building blocks of carbon and hydrogen — the same stuff that makes up olive oil, avocado oil, and the omega-3 fatty acids you proudly add to your smoothies. [1]

     Importantly, food dyes like Red 40 and Yellow 5 are purified and rigorously tested substances. They are chemically synthesized from hydrocarbons, not "extracted gasoline." Saying Red 40 is gasoline is like saying salt is explosive because it contains sodium. It's chemophobic nonsense.

     Meanwhile, many of the same people yelling about food dyes are promoting supplements like methylene blue — another petroleum-derived chemical. Cognitive dissonance, much?

     Reference:

     1. ImmunoLogic. (2025). "No, You're Not Eating Gasoline." Retrieved from https://news.immunologic.org
     
     

     
     

     Meanwhile, in the Real World: Food Safety Programs Are Being Gutted

     Now, while we're distracted by the horror of neon cupcakes, something far more dangerous is happening. Funding for critical public health initiatives is being slashed:

     • Food inspection programs are being downgraded and shifted from federal oversight to inconsistent state programs.
     • Bird flu monitoring — crucial in an era of rising zoonotic diseases — is being slashed.
     • Injury prevention programs — those that track traumatic brain injury, car crashes, drownings, and falls — are being dismantled.
     
     

     According to reporting from Food Safety News, the Trump Administration's proposed budget would cut $128 million from the FDA’s food safety programs alone — programs that help prevent outbreaks of foodborne illness like the 2018 E. coli outbreak tied to romaine lettuce. [2]

     Reference: 2. Food Safety News. (2025). "FDA food safety funding faces big cuts." Retrieved from https://www.foodsafetynews.com

     
     

     Leadership Matters: Enter RFK Jr.

     You might ask, "Who’s steering this ship into the iceberg?" None other than Robert F. Kennedy Jr., head of Health and Human Services.

     There’s a small problem: RFK Jr. never took a single science course during his undergraduate education — at least, none we can find. Yet he is now in charge of overseeing agencies that depend on scientific literacy, from the CDC to the FDA.

     No wonder policy is being dictated by what makes Instagram wellness bloggers like "Food Babe" happy. Forget investing in scientific infrastructure to actually prevent disease. Apparently, public health is now about making sure your lettuce won't "run away with your colon."

     
     

     And the Hypocrisy Continues: Milk and Metabolic Disease

     While politicians play "Whac-a-Mole" with food dyes, real nutritional science continues to quietly reveal important risks — like the health consequences of dietary fat.

     A recent study in BMC Gastroenterology found that frequent consumption of full-fat milk is associated with a higher risk of metabolic dysfunction-associated fatty liver disease (MAFLD). [3]

     Surprisingly, this association was especially strong among people with higher education levels. So yes, your $7 artisanal organic whole-milk latte might be sneaking you toward fatty liver — one creamy sip at a time.

     Yet without adequate public health research funding, follow-up studies that could clarify mechanisms, confounders, and long-term risk could evaporate. The death of science isn't just about laboratories; it's about the slow, steady starvation of research that actually improves human health.

     Reference: 3. BMC Gastroenterology. (2025). "Non-skimmed milk and MAFLD." Retrieved from https://bmcgastroenterology.biomedcentral.com

     
     

     Transitional Moment: So, What Are We Prioritizing?

     Instead of investing in:

     • Safer food systems
     • More robust disease tracking
     • Cutting-edge nutritional science
     
     

     We are prioritizing:

     • Removing artificial colors that haven't been linked to deaths
     • Slashing foodborne illness monitoring
     • Hiring a non-scientist to oversee our nation's health apparatus
     
     

     This is a classic case of "health theater"— grand, performative actions with little substance while real threats simmer under the surface.

     
     

     Why Should You Care?

     Because someday, when the next E. coli outbreak rips across 15 states, you might wish someone had prioritized pathogen monitoring instead of neon cupcakes.

     Because someday, when another zoonotic virus jumps from animals to humans, you might wish someone had protected our bird flu surveillance systems.

     Because someday, when your "healthy" full-fat latte quietly leads you toward metabolic disease, you might wish public health research had been better funded.

     This isn’t hypothetical. It’s happening. Right now.

     
     

     Closing Thoughts: Welcome to America 2025

     In the final analysis, food dyes aren’t the enemy. Ignorance is.

     Real public health work is boring. It involves spreadsheets, bacterial cultures, inspections, and endless grant applications. It doesn't make splashy headlines or Instagram-worthy memes.

     But it saves lives. Quietly. Consistently. Effectively.

     Today, we’re watching that entire system be sacrificed on the altar of viral outrage.

     So the next time you eat a slightly less vibrant Froot Loop, take a moment to appreciate the irony: you might survive the Red Dye #3... but good luck surviving the E. coli smoothie no one inspected.

     Stay skeptical. Stay curious. Fork responsibly.

     ]]>Welcome to the theater of absurdity.

     While the federal government waves the flag of victory over removing petroleum-based food dyes from snacks, it is simultaneously gutting critical public health programs like food inspection, bird flu monitoring, injury prevention initiatives, and scientific research grants. The result? A dazzling case study in misplaced priorities.

     Today, let's walk through what is actually happening — not the headline-friendly soundbites — and why Americans should be far more worried about E. coli in their milk than Red Dye #3 in their Skittles.

     The Food Dye Fear Mongering: What's Actually True?

     First, let's address the food dye hysteria head-on. Many news outlets, "wellness influencers," and natural health bloggers are breathlessly claiming that we are "eating petroleum" because some food dyes are synthesized from hydrocarbon molecules derived initially from crude oil.

     Here’s the scientific truth: petroleum-derived hydrocarbons are nothing more than basic building blocks of carbon and hydrogen — the same stuff that makes up olive oil, avocado oil, and the omega-3 fatty acids you proudly add to your smoothies. [1]

     Importantly, food dyes like Red 40 and Yellow 5 are purified and rigorously tested substances. They are chemically synthesized from hydrocarbons, not "extracted gasoline." Saying Red 40 is gasoline is like saying salt is explosive because it contains sodium. It's chemophobic nonsense.

     Meanwhile, many of the same people yelling about food dyes are promoting supplements like methylene blue — another petroleum-derived chemical. Cognitive dissonance, much?

     Reference:

     1. ImmunoLogic. (2025). "No, You're Not Eating Gasoline." Retrieved from https://news.immunologic.org
     
     

     
     

     Meanwhile, in the Real World: Food Safety Programs Are Being Gutted

     Now, while we're distracted by the horror of neon cupcakes, something far more dangerous is happening. Funding for critical public health initiatives is being slashed:

     • Food inspection programs are being downgraded and shifted from federal oversight to inconsistent state programs.
     • Bird flu monitoring — crucial in an era of rising zoonotic diseases — is being slashed.
     • Injury prevention programs — those that track traumatic brain injury, car crashes, drownings, and falls — are being dismantled.
     
     

     According to reporting from Food Safety News, the Trump Administration's proposed budget would cut $128 million from the FDA’s food safety programs alone — programs that help prevent outbreaks of foodborne illness like the 2018 E. coli outbreak tied to romaine lettuce. [2]

     Reference: 2. Food Safety News. (2025). "FDA food safety funding faces big cuts." Retrieved from https://www.foodsafetynews.com

     
     

     Leadership Matters: Enter RFK Jr.

     You might ask, "Who’s steering this ship into the iceberg?" None other than Robert F. Kennedy Jr., head of Health and Human Services.

     There’s a small problem: RFK Jr. never took a single science course during his undergraduate education — at least, none we can find. Yet he is now in charge of overseeing agencies that depend on scientific literacy, from the CDC to the FDA.

     No wonder policy is being dictated by what makes Instagram wellness bloggers like "Food Babe" happy. Forget investing in scientific infrastructure to actually prevent disease. Apparently, public health is now about making sure your lettuce won't "run away with your colon."

     
     

     And the Hypocrisy Continues: Milk and Metabolic Disease

     While politicians play "Whac-a-Mole" with food dyes, real nutritional science continues to quietly reveal important risks — like the health consequences of dietary fat.

     A recent study in BMC Gastroenterology found that frequent consumption of full-fat milk is associated with a higher risk of metabolic dysfunction-associated fatty liver disease (MAFLD). [3]

     Surprisingly, this association was especially strong among people with higher education levels. So yes, your $7 artisanal organic whole-milk latte might be sneaking you toward fatty liver — one creamy sip at a time.

     Yet without adequate public health research funding, follow-up studies that could clarify mechanisms, confounders, and long-term risk could evaporate. The death of science isn't just about laboratories; it's about the slow, steady starvation of research that actually improves human health.

     Reference: 3. BMC Gastroenterology. (2025). "Non-skimmed milk and MAFLD." Retrieved from https://bmcgastroenterology.biomedcentral.com

     
     

     Transitional Moment: So, What Are We Prioritizing?

     Instead of investing in:

     • Safer food systems
     • More robust disease tracking
     • Cutting-edge nutritional science
     
     

     We are prioritizing:

     • Removing artificial colors that haven't been linked to deaths
     • Slashing foodborne illness monitoring
     • Hiring a non-scientist to oversee our nation's health apparatus
     
     

     This is a classic case of "health theater"— grand, performative actions with little substance while real threats simmer under the surface.

     
     

     Why Should You Care?

     Because someday, when the next E. coli outbreak rips across 15 states, you might wish someone had prioritized pathogen monitoring instead of neon cupcakes.

     Because someday, when another zoonotic virus jumps from animals to humans, you might wish someone had protected our bird flu surveillance systems.

     Because someday, when your "healthy" full-fat latte quietly leads you toward metabolic disease, you might wish public health research had been better funded.

     This isn’t hypothetical. It’s happening. Right now.

     
     

     Closing Thoughts: Welcome to America 2025

     In the final analysis, food dyes aren’t the enemy. Ignorance is.

     Real public health work is boring. It involves spreadsheets, bacterial cultures, inspections, and endless grant applications. It doesn't make splashy headlines or Instagram-worthy memes.

     But it saves lives. Quietly. Consistently. Effectively.

     Today, we’re watching that entire system be sacrificed on the altar of viral outrage.

     So the next time you eat a slightly less vibrant Froot Loop, take a moment to appreciate the irony: you might survive the Red Dye #3... but good luck surviving the E. coli smoothie no one inspected.

     Stay skeptical. Stay curious. Fork responsibly.

     ]]>06f4d696-afb8-4d52-bc57-639b0fd403faWed, 30 Apr 2025 00:00:00 -070005:20falsefull7474Mission FORK UWelcome to FORK U. Fork University. Where we make sense of the madness, bust a few myths, and teach you a little about food and medicine.

     I’m Dr. Terry Simpson—surgeon, scientist, and your chief medical explanationist. At FORK U, we’re not here to sell you supplements or tell you carbs are evil. We’re here to bring the science back to your plate—with a healthy side of sarcasm.

     Food hasn’t been medicine for 2,000 years, and despite what the smoothie bowl crowd says, it still isn’t. But we do know that eating better can help you live better. And that matters.

     Our Mission

     Here’s what we do:

     ✅ We bust nutrition myths that clog your feed and your arteries

     ✅ We decode the latest studies in easy, bite-sized episodes

     ✅ We bring the receipts—every episode is evidence-based and referenced at ForkU.com

     History

     We’ve revisited the foundational studies of nutrition, like Ancel Keys’ Seven Countries Study—which didn’t just compare nations but followed real people in real villages for decades. We’ve explored the French Paradox. We’ve even told the story of the surgeon who discovered the first vitamin.

     And we don’t just look back—we dive into current topics too: GLP-1s, gut health, ultra-processed foods, and yes—what happens when a shirtless influencer tries to sell you dehydrated buffalo hearts in the name of ancestral living. (Spoiler: you’re better off with lentils.)

     If you’re tired of pseudoscience disguised as wellness, and you want real answers—served with wit, citations, and no BS—welcome to FORK U.

     Let’s eat smarter. Let’s myth-bust louder. And let’s get cooking.

     ]]>Welcome to FORK U. Fork University. Where we make sense of the madness, bust a few myths, and teach you a little about food and medicine.

     I’m Dr. Terry Simpson—surgeon, scientist, and your chief medical explanationist. At FORK U, we’re not here to sell you supplements or tell you carbs are evil. We’re here to bring the science back to your plate—with a healthy side of sarcasm.

     Food hasn’t been medicine for 2,000 years, and despite what the smoothie bowl crowd says, it still isn’t. But we do know that eating better can help you live better. And that matters.

     Our Mission

     Here’s what we do:

     ✅ We bust nutrition myths that clog your feed and your arteries

     ✅ We decode the latest studies in easy, bite-sized episodes

     ✅ We bring the receipts—every episode is evidence-based and referenced at ForkU.com

     History

     We’ve revisited the foundational studies of nutrition, like Ancel Keys’ Seven Countries Study—which didn’t just compare nations but followed real people in real villages for decades. We’ve explored the French Paradox. We’ve even told the story of the surgeon who discovered the first vitamin.

     And we don’t just look back—we dive into current topics too: GLP-1s, gut health, ultra-processed foods, and yes—what happens when a shirtless influencer tries to sell you dehydrated buffalo hearts in the name of ancestral living. (Spoiler: you’re better off with lentils.)

     If you’re tired of pseudoscience disguised as wellness, and you want real answers—served with wit, citations, and no BS—welcome to FORK U.

     Let’s eat smarter. Let’s myth-bust louder. And let’s get cooking.

     ]]>c4005024-7112-4050-bcab-21dc794ea77aThu, 24 Apr 2025 00:00:00 -070004:08falsetrailerButter, LDL, and the Myth of PlaqueButter, LDL, and the Myth of Harmless Plaque

     Why High Cholesterol Isn’t Just a Number—and What the Latest Science Says About Oils, Fats, and Your Risk of Death

     By Dr. Terry Simpson, MD – The Culinary Medicine Doc

     We’ve all heard the story: butter’s back, LDL doesn’t matter, and as long as you’re low-carb, your heart is safe.

     But what if I told you that the science—real, peer-reviewed science—tells a different story?

     In this post, I’ll walk you through three powerful studies that dismantle the myth of “harmless” LDL and show why swapping butter for plant-based oils could literally save your life.

     
     

     1. LDL and ApoB: The True Origins of Arterial Plaque

     Atherosclerosis—the buildup of plaque inside arteries—often starts silently. But over time, it becomes the leading cause of heart attacks, strokes, and cardiovascular disease.

     A key study from the Journal of the American College of Cardiology found that the primary trigger for plaque formation is not “existing plaque” as some influencers claim—but rather, LDL cholesterol and ApoB-containing lipoproteins that penetrate the arterial wall and kick off the inflammatory cascade that builds plaque [1].

     Once inside, these particles don’t just hang out—they lead to plaque progression and destabilization, which is what causes heart attacks. No LDL, no plaque. It’s that simple.

     
     

     2. High LDL, Worse Plaque—Even on Keto

     A 2025 study published in JACC: Advances examined people on carbohydrate-restricted diets—many of whom had very high LDL cholesterol levels [2].

     While some hoped the data would vindicate high LDL in the context of keto, that’s not what happened. The study found that the higher the LDL, the worse the atherosclerotic plaque—regardless of dietary pattern.

     Bottom line: High LDL is still atherogenic, even if you’re “metabolically healthy.” That six-pack doesn’t protect your arteries.

     
     

     3. Butter Increases Mortality. Plant-Based Oils Reduce It.

     Let’s talk fats. Specifically: butter.

     In a major pooled analysis of three large U.S. cohorts—the Nurses’ Health Studies I & II and the Health Professionals Follow-up Study—researchers found that butter consumption was associated with increased total, cancer, and cardiovascular mortality [3].

     But here’s the good news: Replacing butter with plant-based oils—like olive, soybean, and canola oil—reduced the risk of death.

     The substitution analysis showed that replacing just 15 grams of butter (about 3 small pats) with 15 grams of plant-based oil (about 1 tablespoon) led to statistically significant reductions in mortality risk.

     These plant oils are rich in polyunsaturated and monounsaturated fats, which have been shown in trials to:

     • Lower LDL cholesterol [4]
     • Reduce inflammation [5]
     • Improve lipid profiles [6]
     • Decrease overall mortality [7]
     
     

     
     

     4. Butter, Cancer, and Inflammation

     It gets worse for butter.

     The same study found a strong association between butter intake and cancer mortality, especially hormone-sensitive cancers like breast and prostate [3].

     Why? Saturated fat—found in high levels in butter—can increase inflammation in fat tissue and alter hormone activity, both of which are risk factors for these cancers [8,9].

     And no, this wasn’t confounded by white bread or pastries—the researchers adjusted for those too.

     
     

     5. Are All Plant-Based Oils the Same? Not Exactly.

     Olive oil, canola oil, and soybean oil showed consistent protective effects. Corn and safflower oil? The data were weaker—possibly due to low use or degradation during cooking [3].

     Some commercial corn oil is also more likely to be oxidized or partially hydrogenated, especially in older food systems [10]. So, while vegetable oils generally fare better than saturated animal fats, quality and cooking method still matter.

     
     

     Final Thoughts: What the Data Say

     High LDL is not “just a number.” It’s a powerful driver of atherosclerosis and death.

     Butter, despite its nostalgic appeal, increases risk of death. And plant-based oils? They reduce it—even in small amounts, even in real-world diets, and even over decades.

     So next time someone tells you to throw out your olive oil for butter, ask them to show you the data. You now have three major studies that say otherwise.

     
     

     TL;DR:

     • LDL and ApoB cause plaque — not existing plaque.
     • Higher LDL = worse plaque, even on keto.
     • Butter increases mortality — especially from cancer and heart disease.
     • Plant-based oils reduce mortality, especially olive, canola, and soybean oil.
     • Replace 3 pats of butter with 1 tablespoon of plant oil to lower your risk.
     
     

     
     

     References

     1. Libby P et al. “Plaque Progression and Rupture in Atherosclerosis.” J Am Coll Cardiol. 2020. Link
     2. Ebinger J et al. “Coronary Atherosclerosis in Individuals with Markedly Elevated LDL-C from Carbohydrate-Restricted Diets.” JACC: Advances. 2025. Link
     3. Zhang S et al. “Butter and Plant-Based Oil Intake and Risk of Mortality.” JAMA Internal Medicine. 2024. Link
     4. Mensink RP et al. “Effects of dietary fatty acids on serum lipids.” Am J Clin Nutr.
     5. Mozaffarian D. “Omega-3 Fatty Acids and Cardiovascular Disease.” N Engl J Med.
     6. Schwingshackl L et al. “PUFA and risk of CVD.” BMJ.
     7. Hu FB et al. “Types of dietary fat and risk of CHD.” Am J Clin Nutr.
     8. Rose DP. “Dietary fat and breast cancer.” Am J Clin Nutr.
     9. Parikh M et al. “Saturated fat intake and inflammation.” J Nutr Biochem.
     10. Choe E, Min DB. “Oxidative stability of oils and fats.” J Food Sci.
     
     

     
     

     Want more unfiltered nutrition science?

     Subscribe to FORK U — the podcast where we bust myths, decode headlines, and teach you how to use food as medicine. And follow me on TikTok & Instagram @drterrysimpson.

     ]]>Butter, LDL, and the Myth of Harmless Plaque

     Why High Cholesterol Isn’t Just a Number—and What the Latest Science Says About Oils, Fats, and Your Risk of Death

     By Dr. Terry Simpson, MD – The Culinary Medicine Doc

     We’ve all heard the story: butter’s back, LDL doesn’t matter, and as long as you’re low-carb, your heart is safe.

     But what if I told you that the science—real, peer-reviewed science—tells a different story?

     In this post, I’ll walk you through three powerful studies that dismantle the myth of “harmless” LDL and show why swapping butter for plant-based oils could literally save your life.

     
     

     1. LDL and ApoB: The True Origins of Arterial Plaque

     Atherosclerosis—the buildup of plaque inside arteries—often starts silently. But over time, it becomes the leading cause of heart attacks, strokes, and cardiovascular disease.

     A key study from the Journal of the American College of Cardiology found that the primary trigger for plaque formation is not “existing plaque” as some influencers claim—but rather, LDL cholesterol and ApoB-containing lipoproteins that penetrate the arterial wall and kick off the inflammatory cascade that builds plaque [1].

     Once inside, these particles don’t just hang out—they lead to plaque progression and destabilization, which is what causes heart attacks. No LDL, no plaque. It’s that simple.

     
     

     2. High LDL, Worse Plaque—Even on Keto

     A 2025 study published in JACC: Advances examined people on carbohydrate-restricted diets—many of whom had very high LDL cholesterol levels [2].

     While some hoped the data would vindicate high LDL in the context of keto, that’s not what happened. The study found that the higher the LDL, the worse the atherosclerotic plaque—regardless of dietary pattern.

     Bottom line: High LDL is still atherogenic, even if you’re “metabolically healthy.” That six-pack doesn’t protect your arteries.

     
     

     3. Butter Increases Mortality. Plant-Based Oils Reduce It.

     Let’s talk fats. Specifically: butter.

     In a major pooled analysis of three large U.S. cohorts—the Nurses’ Health Studies I & II and the Health Professionals Follow-up Study—researchers found that butter consumption was associated with increased total, cancer, and cardiovascular mortality [3].

     But here’s the good news: Replacing butter with plant-based oils—like olive, soybean, and canola oil—reduced the risk of death.

     The substitution analysis showed that replacing just 15 grams of butter (about 3 small pats) with 15 grams of plant-based oil (about 1 tablespoon) led to statistically significant reductions in mortality risk.

     These plant oils are rich in polyunsaturated and monounsaturated fats, which have been shown in trials to:

     • Lower LDL cholesterol [4]
     • Reduce inflammation [5]
     • Improve lipid profiles [6]
     • Decrease overall mortality [7]
     
     

     
     

     4. Butter, Cancer, and Inflammation

     It gets worse for butter.

     The same study found a strong association between butter intake and cancer mortality, especially hormone-sensitive cancers like breast and prostate [3].

     Why? Saturated fat—found in high levels in butter—can increase inflammation in fat tissue and alter hormone activity, both of which are risk factors for these cancers [8,9].

     And no, this wasn’t confounded by white bread or pastries—the researchers adjusted for those too.

     
     

     5. Are All Plant-Based Oils the Same? Not Exactly.

     Olive oil, canola oil, and soybean oil showed consistent protective effects. Corn and safflower oil? The data were weaker—possibly due to low use or degradation during cooking [3].

     Some commercial corn oil is also more likely to be oxidized or partially hydrogenated, especially in older food systems [10]. So, while vegetable oils generally fare better than saturated animal fats, quality and cooking method still matter.

     
     

     Final Thoughts: What the Data Say

     High LDL is not “just a number.” It’s a powerful driver of atherosclerosis and death.

     Butter, despite its nostalgic appeal, increases risk of death. And plant-based oils? They reduce it—even in small amounts, even in real-world diets, and even over decades.

     So next time someone tells you to throw out your olive oil for butter, ask them to show you the data. You now have three major studies that say otherwise.

     
     

     TL;DR:

     • LDL and ApoB cause plaque — not existing plaque.
     • Higher LDL = worse plaque, even on keto.
     • Butter increases mortality — especially from cancer and heart disease.
     • Plant-based oils reduce mortality, especially olive, canola, and soybean oil.
     • Replace 3 pats of butter with 1 tablespoon of plant oil to lower your risk.
     
     

     
     

     References

     1. Libby P et al. “Plaque Progression and Rupture in Atherosclerosis.” J Am Coll Cardiol. 2020. Link
     2. Ebinger J et al. “Coronary Atherosclerosis in Individuals with Markedly Elevated LDL-C from Carbohydrate-Restricted Diets.” JACC: Advances. 2025. Link
     3. Zhang S et al. “Butter and Plant-Based Oil Intake and Risk of Mortality.” JAMA Internal Medicine. 2024. Link
     4. Mensink RP et al. “Effects of dietary fatty acids on serum lipids.” Am J Clin Nutr.
     5. Mozaffarian D. “Omega-3 Fatty Acids and Cardiovascular Disease.” N Engl J Med.
     6. Schwingshackl L et al. “PUFA and risk of CVD.” BMJ.
     7. Hu FB et al. “Types of dietary fat and risk of CHD.” Am J Clin Nutr.
     8. Rose DP. “Dietary fat and breast cancer.” Am J Clin Nutr.
     9. Parikh M et al. “Saturated fat intake and inflammation.” J Nutr Biochem.
     10. Choe E, Min DB. “Oxidative stability of oils and fats.” J Food Sci.
     
     

     
     

     Want more unfiltered nutrition science?

     Subscribe to FORK U — the podcast where we bust myths, decode headlines, and teach you how to use food as medicine. And follow me on TikTok & Instagram @drterrysimpson.

     ]]>49694de1-1efa-4985-8560-9e9c7d2acc64Tue, 15 Apr 2025 00:00:00 -070007:48falsefull7373Blue Zones: Beautiful Myth or Measured Truth?The idea of Blue Zones—those rare places where people supposedly live longer, healthier lives—has become nutritional gospel. From best-selling books to Netflix specials, Blue Zones have been painted as longevity utopias we can mimic if we just eat more beans and nap more often.

     But here’s the thing: Blue Zones aren’t science—they’re storytelling.

     In this post, we take an unfiltered look at the Blue Zones concept, explore recent controversies, and compare it with something backed by actual peer-reviewed data: the Mediterranean Diet.

     What Are Blue Zones?

     Coined by journalist Dan Buettner and popularized through National Geographic, Blue Zones refer to five regions with high numbers of centenarians:

     • Okinawa, Japan
     • Sardinia, Italy
     • Nicoya, Costa Rica
     • Ikaria, Greece
     • Loma Linda, California
     
     

     These regions reportedly share key habits: plant-forward diets, natural movement, strong social bonds, and low stress.

     While these are certainly positive lifestyle features, the problem is how this information was collected. The Blue Zones model is observational, not scientific. It’s a patchwork of ethnographic notes, anecdotes, and assumptions—not randomized trials or controlled cohort studies.

     
     

     The Blue Zones Controversy

     In recent years, the Blue Zones concept has come under scrutiny:

     • Okinawa’s longevity claims have declined in newer data; life expectancy has dropped, and obesity and chronic diseases are on the rise.
     • Record inaccuracies in places like Okinawa and Ikaria have been found, making claims of centenarian density questionable.
     • Survivorship bias skews the picture—we hear from those who lived long, not those who didn’t.
     • Westernization has eroded the very habits that supposedly defined these zones.
     
     

     In short: Blue Zones are more about a moment in time than a repeatable formula.

     
     

     So What Does the Data Say?

     If you're looking for longevity strategies backed by evidence—not just folklore—consider the major cohort studies:

     • Nurses’ Health Study
     • Adventist Health Study
     • EPIC-Oxford
     
     

     These studies have followed hundreds of thousands of people for decades. The data consistently shows that people who live longer:

     • Eat more whole, plant-based foods
     • Limit ultra-processed foods and added sugars
     • Exercise regularly
     • Maintain strong social connections
     • Get adequate sleep
     • Manage stress
     • Don’t overeat
     
     

     No magic. Just measurable habits.

     
     

     Mediterranean Diet: The Gold Standard

     Unlike Blue Zones, the Mediterranean Diet is a defined, evidence-based dietary pattern. And it’s been rigorously studied in over 13,000 peer-reviewed publications.

     Core Features:

     • High intake of fruits, vegetables, legumes, whole grains
     • Olive oil as the main fat
     • Moderate fish and poultry
     • Minimal red meat and sugar
     • Moderate wine, usually with meals
     • Emphasis on community and shared meals
     
     

     Evidence Highlights:

     • PREDIMED Trial (2013): A randomized controlled trial of over 7,000 participants in Spain found that the Mediterranean Diet reduced the risk of cardiovascular events by 30% compared to a low-fat diet.
     • Reference: Estruch R, et al. N Engl J Med. 2013;368(14):1279-1290.
     • Link
     • Spanish Cohort Study (2022): A population-based study of 1.5 million adults found that greater adherence to the Mediterranean Diet was associated with increased longevity and lower all-cause mortality.
     • Reference: Zheng Y, et al. BMC Med. 2022;20:180.
     • Link
     
     

     Unlike Blue Zones, the Mediterranean Diet is replicable anywhere and supported by robust, controlled data.

     
     

     The Bottom Line

     The Blue Zones offer a romantic vision of a long life. But they’re built on observation—not rigor.

     If you're serious about longevity, skip the storytelling and look to the science. The Mediterranean Diet, supported by clinical trials and massive population studies, is the most proven path to better health and a longer life.

     Don’t chase myths. Follow the data.

     
     

     🎧 Want More?

     Listen to the full Fork U episode:

     “Blue Zones: Beautiful Myth or Measured Truth?”

     Available on Spotify, Apple Podcasts, and wherever you get your audio science straight.

     Follow me on TikTok and Instagram @drterrysimpson for more unfiltered medical myth-busting.

     ]]>The idea of Blue Zones—those rare places where people supposedly live longer, healthier lives—has become nutritional gospel. From best-selling books to Netflix specials, Blue Zones have been painted as longevity utopias we can mimic if we just eat more beans and nap more often.

     But here’s the thing: Blue Zones aren’t science—they’re storytelling.

     In this post, we take an unfiltered look at the Blue Zones concept, explore recent controversies, and compare it with something backed by actual peer-reviewed data: the Mediterranean Diet.

     What Are Blue Zones?

     Coined by journalist Dan Buettner and popularized through National Geographic, Blue Zones refer to five regions with high numbers of centenarians:

     • Okinawa, Japan
     • Sardinia, Italy
     • Nicoya, Costa Rica
     • Ikaria, Greece
     • Loma Linda, California
     
     

     These regions reportedly share key habits: plant-forward diets, natural movement, strong social bonds, and low stress.

     While these are certainly positive lifestyle features, the problem is how this information was collected. The Blue Zones model is observational, not scientific. It’s a patchwork of ethnographic notes, anecdotes, and assumptions—not randomized trials or controlled cohort studies.

     
     

     The Blue Zones Controversy

     In recent years, the Blue Zones concept has come under scrutiny:

     • Okinawa’s longevity claims have declined in newer data; life expectancy has dropped, and obesity and chronic diseases are on the rise.
     • Record inaccuracies in places like Okinawa and Ikaria have been found, making claims of centenarian density questionable.
     • Survivorship bias skews the picture—we hear from those who lived long, not those who didn’t.
     • Westernization has eroded the very habits that supposedly defined these zones.
     
     

     In short: Blue Zones are more about a moment in time than a repeatable formula.

     
     

     So What Does the Data Say?

     If you're looking for longevity strategies backed by evidence—not just folklore—consider the major cohort studies:

     • Nurses’ Health Study
     • Adventist Health Study
     • EPIC-Oxford
     
     

     These studies have followed hundreds of thousands of people for decades. The data consistently shows that people who live longer:

     • Eat more whole, plant-based foods
     • Limit ultra-processed foods and added sugars
     • Exercise regularly
     • Maintain strong social connections
     • Get adequate sleep
     • Manage stress
     • Don’t overeat
     
     

     No magic. Just measurable habits.

     
     

     Mediterranean Diet: The Gold Standard

     Unlike Blue Zones, the Mediterranean Diet is a defined, evidence-based dietary pattern. And it’s been rigorously studied in over 13,000 peer-reviewed publications.

     Core Features:

     • High intake of fruits, vegetables, legumes, whole grains
     • Olive oil as the main fat
     • Moderate fish and poultry
     • Minimal red meat and sugar
     • Moderate wine, usually with meals
     • Emphasis on community and shared meals
     
     

     Evidence Highlights:

     • PREDIMED Trial (2013): A randomized controlled trial of over 7,000 participants in Spain found that the Mediterranean Diet reduced the risk of cardiovascular events by 30% compared to a low-fat diet.
     • Reference: Estruch R, et al. N Engl J Med. 2013;368(14):1279-1290.
     • Link
     • Spanish Cohort Study (2022): A population-based study of 1.5 million adults found that greater adherence to the Mediterranean Diet was associated with increased longevity and lower all-cause mortality.
     • Reference: Zheng Y, et al. BMC Med. 2022;20:180.
     • Link
     
     

     Unlike Blue Zones, the Mediterranean Diet is replicable anywhere and supported by robust, controlled data.

     
     

     The Bottom Line

     The Blue Zones offer a romantic vision of a long life. But they’re built on observation—not rigor.

     If you're serious about longevity, skip the storytelling and look to the science. The Mediterranean Diet, supported by clinical trials and massive population studies, is the most proven path to better health and a longer life.

     Don’t chase myths. Follow the data.

     
     

     🎧 Want More?

     Listen to the full Fork U episode:

     “Blue Zones: Beautiful Myth or Measured Truth?”

     Available on Spotify, Apple Podcasts, and wherever you get your audio science straight.

     Follow me on TikTok and Instagram @drterrysimpson for more unfiltered medical myth-busting.

     ]]>28bc6557-14b7-49b3-8543-88deea26bec2Thu, 10 Apr 2025 00:00:00 -070008:39falsefull7272Common Carnivore/Low-Carb MythsDietary Myths vs. Nutritional Science: Why the Mediterranean Diet Reigns Supreme

     As an Athabascan physician and culinary medicine expert, I'm often amused by the dietary myths perpetuated online, particularly those championed by keto and carnivore diet enthusiasts. Today, let's debunk some of these myths—Inuit diets, Hong Kong longevity, Maasai heart health, and the so-called French paradox—and explain why decades of robust nutritional science firmly support the Mediterranean diet.

     Myth 1: The Inuit Diet

     Low-carb proponents love pointing to the traditional Inuit diet as evidence of the supposed superiority of carnivorous diets. Yes, Inuit diets are traditionally high in marine mammals like whales, seals, and fish, providing ample vitamin C from sources such as muktuk (whale skin and blubber) and seal liver. Yet, archaeological evidence clearly shows ancient Inuit mummies suffered from vascular disease, challenging the claim that their diet was protective (Fodor et al., 2014). Additionally, Inuit diets historically incorporated plant-based foods such as berries, seaweed, and tubers during summer months—a fact conveniently overlooked by keto advocates.

     Myth 2: The Hong Kong Longevity Claim

     Another popular keto narrative incorrectly attributes Hong Kong's impressive longevity statistics to high meat consumption. But research shows elderly individuals in Hong Kong typically eat less meat and adhere closely to diets resembling the Mediterranean style, rich in vegetables, seafood, and whole grains (Woo et al., 2001). Again, context is key—and frequently missing from keto claims.

     Myth 3: Maasai Immunity to Heart Disease

     The Maasai, often cited as proof that diets rich in saturated fats don't cause heart disease, actually demonstrate the opposite. Recent studies confirm significant atherosclerosis and cardiovascular issues among Maasai populations, underscoring that even "warrior" genetics don't provide immunity from saturated fat-related diseases (Mann et al., 1972).

     Myth 4: The French Paradox

     Ah, the French Paradox—the idea that French populations consume diets high in saturated fats yet experience low heart disease rates. The reality is simpler: the French eat plenty of vegetables, fruits, olive oil, seafood, and emphasize portion control and mindful eating. France was initially included in the famous Seven Countries Study but was ultimately excluded due to funding constraints—not dietary irregularities (Kromhout et al., 2017). It's sensible eating, not paradoxical magic.

     Solid Science: The Mediterranean Diet

     Contrary to these dietary myths, extensive nutritional science consistently supports the Mediterranean diet. Two landmark studies illustrate this clearly:

     • Seven Countries Study: Spanning 50 years and involving over 14,000 men, this research demonstrated clearly superior cardiovascular outcomes for individuals following Mediterranean-style diets rich in vegetables, fruits, whole grains, legumes, fish, and olive oil compared to higher-fat diets (Keys et al., 1986).
     • EPIC Study: Following over half a million Europeans, the European Prospective Investigation into Cancer and Nutrition showed that diets emphasizing plant foods and limiting red and processed meats significantly reduce cancer risks (Boffetta et al., 2010).
     • Lyon Heart Study: Participants with existing heart disease significantly reduced their risk of a second heart attack by adopting Mediterranean dietary patterns—highlighting the diet's profound protective benefits (de Lorgeril et al., 1999).
     
     

     Final Thoughts

     Keto and carnivore diets might make enticing promises, but the science tells a different story. With over 70 years of rigorous research and more than 13,000 peer-reviewed publications, the Mediterranean diet remains the gold standard for long-term health and disease prevention.

     In an era where powerful obesity treatments like ZepBound emerge, it's even more crucial that we align medical innovations with proven nutritional strategies to ensure long-term health for newly fit bodies.

     Enjoy your meals, stay curious, and always leave room for dessert (occasionally)!

     
     

     References:

     • Fodor, J.G., et al. "The Inuit paradox and heart disease." Can J Cardiol. 2014.
     • Woo, J., et al. "Dietary habits of elderly Hong Kong Chinese." Age Ageing. 2001.
     • Mann, G.V., et al. "Cardiovascular disease in the Maasai." Am J Epidemiol. 1972.
     • Kromhout, D., et al. "The Seven Countries Study: Overview." Eur J Epidemiol. 2017.
     • Keys, A., et al. "The diet and 15-year death rate in the Seven Countries Study." Am J Epidemiol. 1986.
     • Boffetta, P., et al. "EPIC study: Diet and cancer." Am J Clin Nutr. 2010.
     • de Lorgeril, M., et al. "Mediterranean diet and cardiovascular health." Circulation. 1999.
     
     ]]>Dietary Myths vs. Nutritional Science: Why the Mediterranean Diet Reigns Supreme

     As an Athabascan physician and culinary medicine expert, I'm often amused by the dietary myths perpetuated online, particularly those championed by keto and carnivore diet enthusiasts. Today, let's debunk some of these myths—Inuit diets, Hong Kong longevity, Maasai heart health, and the so-called French paradox—and explain why decades of robust nutritional science firmly support the Mediterranean diet.

     Myth 1: The Inuit Diet

     Low-carb proponents love pointing to the traditional Inuit diet as evidence of the supposed superiority of carnivorous diets. Yes, Inuit diets are traditionally high in marine mammals like whales, seals, and fish, providing ample vitamin C from sources such as muktuk (whale skin and blubber) and seal liver. Yet, archaeological evidence clearly shows ancient Inuit mummies suffered from vascular disease, challenging the claim that their diet was protective (Fodor et al., 2014). Additionally, Inuit diets historically incorporated plant-based foods such as berries, seaweed, and tubers during summer months—a fact conveniently overlooked by keto advocates.

     Myth 2: The Hong Kong Longevity Claim

     Another popular keto narrative incorrectly attributes Hong Kong's impressive longevity statistics to high meat consumption. But research shows elderly individuals in Hong Kong typically eat less meat and adhere closely to diets resembling the Mediterranean style, rich in vegetables, seafood, and whole grains (Woo et al., 2001). Again, context is key—and frequently missing from keto claims.

     Myth 3: Maasai Immunity to Heart Disease

     The Maasai, often cited as proof that diets rich in saturated fats don't cause heart disease, actually demonstrate the opposite. Recent studies confirm significant atherosclerosis and cardiovascular issues among Maasai populations, underscoring that even "warrior" genetics don't provide immunity from saturated fat-related diseases (Mann et al., 1972).

     Myth 4: The French Paradox

     Ah, the French Paradox—the idea that French populations consume diets high in saturated fats yet experience low heart disease rates. The reality is simpler: the French eat plenty of vegetables, fruits, olive oil, seafood, and emphasize portion control and mindful eating. France was initially included in the famous Seven Countries Study but was ultimately excluded due to funding constraints—not dietary irregularities (Kromhout et al., 2017). It's sensible eating, not paradoxical magic.

     Solid Science: The Mediterranean Diet

     Contrary to these dietary myths, extensive nutritional science consistently supports the Mediterranean diet. Two landmark studies illustrate this clearly:

     • Seven Countries Study: Spanning 50 years and involving over 14,000 men, this research demonstrated clearly superior cardiovascular outcomes for individuals following Mediterranean-style diets rich in vegetables, fruits, whole grains, legumes, fish, and olive oil compared to higher-fat diets (Keys et al., 1986).
     • EPIC Study: Following over half a million Europeans, the European Prospective Investigation into Cancer and Nutrition showed that diets emphasizing plant foods and limiting red and processed meats significantly reduce cancer risks (Boffetta et al., 2010).
     • Lyon Heart Study: Participants with existing heart disease significantly reduced their risk of a second heart attack by adopting Mediterranean dietary patterns—highlighting the diet's profound protective benefits (de Lorgeril et al., 1999).
     
     

     Final Thoughts

     Keto and carnivore diets might make enticing promises, but the science tells a different story. With over 70 years of rigorous research and more than 13,000 peer-reviewed publications, the Mediterranean diet remains the gold standard for long-term health and disease prevention.

     In an era where powerful obesity treatments like ZepBound emerge, it's even more crucial that we align medical innovations with proven nutritional strategies to ensure long-term health for newly fit bodies.

     Enjoy your meals, stay curious, and always leave room for dessert (occasionally)!

     
     

     References:

     • Fodor, J.G., et al. "The Inuit paradox and heart disease." Can J Cardiol. 2014.
     • Woo, J., et al. "Dietary habits of elderly Hong Kong Chinese." Age Ageing. 2001.
     • Mann, G.V., et al. "Cardiovascular disease in the Maasai." Am J Epidemiol. 1972.
     • Kromhout, D., et al. "The Seven Countries Study: Overview." Eur J Epidemiol. 2017.
     • Keys, A., et al. "The diet and 15-year death rate in the Seven Countries Study." Am J Epidemiol. 1986.
     • Boffetta, P., et al. "EPIC study: Diet and cancer." Am J Clin Nutr. 2010.
     • de Lorgeril, M., et al. "Mediterranean diet and cardiovascular health." Circulation. 1999.
     
     ]]>d755cd2f-179a-4d64-b882-cf55248359e8Thu, 03 Apr 2025 00:00:00 -070007:32falsefull7171Why Bitterness is Good for YouThe Bitter Truth: Why Bitterness Matters More Than You Think

     Have you ever taken a sip of black coffee and immediately regretted it? Or maybe you’ve bitten into a grapefruit and felt like your tongue was under attack? If so, you’re not alone. Bitterness is one of the most misunderstood flavors, but it plays a huge role in our health and survival. From keeping us from eating toxic foods to helping digestion, bitterness has a bigger impact on our bodies than most people realize. So, let’s dive into the bitter truth—why some people hate it, why your stomach can actually taste it, and how it has been used as medicine for centuries.

     
     

     Why Do Some Foods Taste Bitter?

     To begin with, bitterness exists for a reason. In nature, many poisonous plants contain bitter compounds. Long ago, humans who could detect bitterness had a survival advantage. In other words, their ability to taste bitterness kept them from eating something deadly. As a result, our bodies evolved to be extra sensitive to bitter flavors.

     However, not all bitter foods are dangerous. Many are incredibly healthy. Take kale, dark chocolate, and turmeric, for example. These foods may taste strong or even unpleasant to some people, but they are packed with antioxidants and nutrients that support overall health.

     So, why do some people love bitter foods while others can’t stand them? The answer lies in our genes. Scientists have discovered that a gene called TAS2R38 determines how sensitive we are to bitterness. If you are a super-taster, bitter foods might seem unbearably strong. On the other hand, if you are a non-taster, you may barely notice the bitterness at all.

     
     

     Your Stomach Can "Taste" Bitterness Too

     Interestingly, your tongue isn’t the only part of your body that detects bitterness. Your stomach can taste it as well. But how does that work? Well, your stomach has bitter taste receptors that serve a very important function.

     First, these receptors help control digestion. When bitter foods enter your stomach, the receptors slow down gastric emptying. In simpler terms, they make food stay in your stomach longer. As a result, you feel full for a longer period. This is one reason why bitter greens like arugula or dandelion leaves can help with weight management.

     Second, these bitter receptors act as bodyguards for your digestive system. If your stomach detects a bitter substance that shouldn’t be there—like a potential toxin—it delays digestion to prevent harmful substances from moving too quickly into your intestines. This process gives your body extra time to neutralize any potential threats.

     
     

     Bitters: From Medicine to Cocktails

     Because of their digestive benefits, bitter herbs have been used in medicine for centuries. In the past, people took bitters—herbal mixtures containing bitter plant extracts—to help with digestion, bloating, and nausea. Some of the most common bitter herbs include:

     • Gentian root – A powerful bitter used to stimulate digestion.
     • Dandelion – Helps with liver function and gut health.
     • Wormwood – Historically used for digestive problems and gut health.
     • Burdock – Supports digestion and has anti-inflammatory properties.
     
     

     Over time, bitters made their way from medicine cabinets to cocktail bars. During the 1800s, bitters became a key ingredient in alcoholic drinks, including the Old Fashioned and the Manhattan. In fact, some of today’s most famous bitters, like Angostura and Peychaud’s, were originally marketed as health tonics.

     But perhaps the most interesting story of all is how gin and tonic became a malaria treatment. In the 19th century, British soldiers stationed in tropical regions were at high risk of getting malaria. The best available treatment at the time was quinine, a bitter compound from the bark of the cinchona tree. However, quinine was extremely bitter and unpleasant to drink on its own. So, soldiers mixed it with sugar, lime, and soda water to make it more palatable. Eventually, someone had the genius idea to add gin, and just like that, the gin and tonic was born.

     Even though modern tonic water contains only small amounts of quinine, the drink remains popular today—not as medicine, but as a refreshing cocktail with a fascinating history.

     
     

     A Word of Caution: Who Should Avoid Bitters?

     Although bitters have many health benefits, they aren’t for everyone. Some people should avoid them, including:

     • Pregnant or breastfeeding individuals – Some bitter herbs can have harmful effects during pregnancy.
     • Children – Since bitters are often infused with alcohol, they are not suitable for kids.
     • People with digestive disorders – If you have ulcers, inflammatory bowel disease, or other stomach sensitivities, bitters could make your symptoms worse.
     
     

     In addition, taking too much of certain bitters can lead to side effects, such as:

     ✔ Nausea

     ✔ Cramping

     ✔ Diarrhea

     ✔ Gas

     ✔ Stomach pain

     As always, if you’re thinking about adding bitters to your diet, it’s a good idea to check with a doctor first.

     
     

     Conclusion: Embrace the Bitter!

     Bitterness may not be everyone’s favorite flavor, but it plays an important role in our health. It helps regulate digestion, protects against harmful substances, and has been used in medicine for centuries. Even though many people find bitter foods challenging at first, the good news is that your taste buds can adapt over time. So, if you want to develop a taste for bitter foods, start small. Add a little lemon or olive oil to bitter greens, try a piece of dark chocolate, or experiment with herbal bitters in your drinks.

     Who knows? You might just learn to love the bitter side of life!

     
     

     References

     1. Beauchamp, G. K., & Mennella, J. A. (2009). The biology of bitter taste. Scientific American, 301(2), 36-43.
     2. Meyerhof, W., Batram, C., Kuhn, C., Brockhoff, A., Chudoba, E., Bufe, B., & Appendino, G. (2010). The molecular basis of bitter taste perception. Trends in Neurosciences, 33(2), 92-101.
     3. Bartoshuk, L. M. (2000). Comparing sensory experiences across individuals: Recent psychophysical advances illuminate genetic variation in taste perception. Chemical Senses, 25(4), 447-460.
     4. Klee, H. J. (2010). Improving the flavor of fresh fruits: Genomics, biochemistry, and biotechnology. New Phytologist, 187(1), 44-56.
     5. Bisset, N. G., & Wichtl, M. (2001). Herbal Drugs and Phytopharmaceuticals. CRC Press.
     
     ]]>The Bitter Truth: Why Bitterness Matters More Than You Think

     Have you ever taken a sip of black coffee and immediately regretted it? Or maybe you’ve bitten into a grapefruit and felt like your tongue was under attack? If so, you’re not alone. Bitterness is one of the most misunderstood flavors, but it plays a huge role in our health and survival. From keeping us from eating toxic foods to helping digestion, bitterness has a bigger impact on our bodies than most people realize. So, let’s dive into the bitter truth—why some people hate it, why your stomach can actually taste it, and how it has been used as medicine for centuries.

     
     

     Why Do Some Foods Taste Bitter?

     To begin with, bitterness exists for a reason. In nature, many poisonous plants contain bitter compounds. Long ago, humans who could detect bitterness had a survival advantage. In other words, their ability to taste bitterness kept them from eating something deadly. As a result, our bodies evolved to be extra sensitive to bitter flavors.

     However, not all bitter foods are dangerous. Many are incredibly healthy. Take kale, dark chocolate, and turmeric, for example. These foods may taste strong or even unpleasant to some people, but they are packed with antioxidants and nutrients that support overall health.

     So, why do some people love bitter foods while others can’t stand them? The answer lies in our genes. Scientists have discovered that a gene called TAS2R38 determines how sensitive we are to bitterness. If you are a super-taster, bitter foods might seem unbearably strong. On the other hand, if you are a non-taster, you may barely notice the bitterness at all.

     
     

     Your Stomach Can "Taste" Bitterness Too

     Interestingly, your tongue isn’t the only part of your body that detects bitterness. Your stomach can taste it as well. But how does that work? Well, your stomach has bitter taste receptors that serve a very important function.

     First, these receptors help control digestion. When bitter foods enter your stomach, the receptors slow down gastric emptying. In simpler terms, they make food stay in your stomach longer. As a result, you feel full for a longer period. This is one reason why bitter greens like arugula or dandelion leaves can help with weight management.

     Second, these bitter receptors act as bodyguards for your digestive system. If your stomach detects a bitter substance that shouldn’t be there—like a potential toxin—it delays digestion to prevent harmful substances from moving too quickly into your intestines. This process gives your body extra time to neutralize any potential threats.

     
     

     Bitters: From Medicine to Cocktails

     Because of their digestive benefits, bitter herbs have been used in medicine for centuries. In the past, people took bitters—herbal mixtures containing bitter plant extracts—to help with digestion, bloating, and nausea. Some of the most common bitter herbs include:

     • Gentian root – A powerful bitter used to stimulate digestion.
     • Dandelion – Helps with liver function and gut health.
     • Wormwood – Historically used for digestive problems and gut health.
     • Burdock – Supports digestion and has anti-inflammatory properties.
     
     

     Over time, bitters made their way from medicine cabinets to cocktail bars. During the 1800s, bitters became a key ingredient in alcoholic drinks, including the Old Fashioned and the Manhattan. In fact, some of today’s most famous bitters, like Angostura and Peychaud’s, were originally marketed as health tonics.

     But perhaps the most interesting story of all is how gin and tonic became a malaria treatment. In the 19th century, British soldiers stationed in tropical regions were at high risk of getting malaria. The best available treatment at the time was quinine, a bitter compound from the bark of the cinchona tree. However, quinine was extremely bitter and unpleasant to drink on its own. So, soldiers mixed it with sugar, lime, and soda water to make it more palatable. Eventually, someone had the genius idea to add gin, and just like that, the gin and tonic was born.

     Even though modern tonic water contains only small amounts of quinine, the drink remains popular today—not as medicine, but as a refreshing cocktail with a fascinating history.

     
     

     A Word of Caution: Who Should Avoid Bitters?

     Although bitters have many health benefits, they aren’t for everyone. Some people should avoid them, including:

     • Pregnant or breastfeeding individuals – Some bitter herbs can have harmful effects during pregnancy.
     • Children – Since bitters are often infused with alcohol, they are not suitable for kids.
     • People with digestive disorders – If you have ulcers, inflammatory bowel disease, or other stomach sensitivities, bitters could make your symptoms worse.
     
     

     In addition, taking too much of certain bitters can lead to side effects, such as:

     ✔ Nausea

     ✔ Cramping

     ✔ Diarrhea

     ✔ Gas

     ✔ Stomach pain

     As always, if you’re thinking about adding bitters to your diet, it’s a good idea to check with a doctor first.

     
     

     Conclusion: Embrace the Bitter!

     Bitterness may not be everyone’s favorite flavor, but it plays an important role in our health. It helps regulate digestion, protects against harmful substances, and has been used in medicine for centuries. Even though many people find bitter foods challenging at first, the good news is that your taste buds can adapt over time. So, if you want to develop a taste for bitter foods, start small. Add a little lemon or olive oil to bitter greens, try a piece of dark chocolate, or experiment with herbal bitters in your drinks.

     Who knows? You might just learn to love the bitter side of life!

     
     

     References

     1. Beauchamp, G. K., & Mennella, J. A. (2009). The biology of bitter taste. Scientific American, 301(2), 36-43.
     2. Meyerhof, W., Batram, C., Kuhn, C., Brockhoff, A., Chudoba, E., Bufe, B., & Appendino, G. (2010). The molecular basis of bitter taste perception. Trends in Neurosciences, 33(2), 92-101.
     3. Bartoshuk, L. M. (2000). Comparing sensory experiences across individuals: Recent psychophysical advances illuminate genetic variation in taste perception. Chemical Senses, 25(4), 447-460.
     4. Klee, H. J. (2010). Improving the flavor of fresh fruits: Genomics, biochemistry, and biotechnology. New Phytologist, 187(1), 44-56.
     5. Bisset, N. G., & Wichtl, M. (2001). Herbal Drugs and Phytopharmaceuticals. CRC Press.
     
     ]]>492ad257-aa3b-4fe6-8e39-9177ddfc4537Fri, 07 Mar 2025 00:00:00 -070010:57falsefull7070The Egg: From Villain to VictoryThe Great Egg Redemption: How Science Saved Breakfast (But Not Your Wallet)

     For decades, the humble egg was treated like a ticking time bomb for your arteries. Nutrition guidelines told us to avoid them, doctors warned us about cholesterol, and many Americans swapped their morning omelet for a sad bowl of processed cereal. But here’s the kicker—those recommendations weren’t based on strong science. Instead, industry interests heavily influenced them, outdated theories, and a lot of fear-mongering.

     Now, eggs are back on the menu. Science has finally caught up, and experts agree that dietary cholesterol isn’t the villain it was made out to be. But just when we thought we could enjoy eggs guilt-free, bird flu struck, prices skyrocketed, and suddenly, eggs became the new luxury item. So, how did we get here? Let’s crack open the truth.

     
     

     The Food Pyramid: A Big Business, Not Big Science

     If you grew up in the 90s, you probably remember the Food Pyramid. It told us to eat 6-11 servings of bread, pasta, and cereal every day, while foods like eggs, meat, and fats were placed at the top—basically labeled "Eat Sparingly."

     But was this pyramid built on solid science? Not exactly.

     The grain industry played a huge role in shaping these guidelines. In the 1970s and 80s, low-fat diets became the gold standard for heart health. The idea was simple: eating fat leads to heart disease, so cutting out fat would make us healthier. Unfortunately, that’s not what happened.

     Instead, food companies removed fat from products and replaced it with sugar and processed carbs—because, let’s face it, fat-free food tastes terrible without something to make it palatable. As a result, Americans ended up eating way more refined carbs and sugar, leading to a spike in obesity and type 2 diabetes (Ludwig et al., 2018).

     Meanwhile, eggs—one of nature’s most nutrient-dense and affordable foods—were put on the naughty list.

     
     

     The War on Eggs: How a Bad Idea Became Dietary Dogma

     The real egg panic began in 1968 when the American Heart Association (AHA) declared that dietary cholesterol was a major cause of heart disease. They recommended eating no more than three eggs per week (Kritchevsky, 1999).

     But here’s the problem—this recommendation wasn’t based on strong human studies. Instead, it was based on:

     1. Animal Studies – Scientists fed cholesterol to rabbits, which are naturally herbivores, and (shocker!) their cholesterol went up. But rabbits process cholesterol differently than humans (McNamara, 2000).
     2. Epidemiological Correlations – Early studies linked high cholesterol intake to heart disease, but they didn’t separate it from other factors like saturated fat, smoking, or lack of exercise (Hu et al., 1999).
     3. Clinical Studies With Unrealistic Diets – Some studies tested cholesterol intake using six eggs per day—which is way more than most people eat (Fernandez, 2006).
     
     

     Meanwhile, many scientists already knew that dietary cholesterol had minimal impact on blood cholesterol for most people. Our bodies naturally regulate cholesterol production—when we eat more cholesterol, the liver produces less to balance it out (Griffin & Lichtenstein, 2013).

     But by the time the science caught up, the damage was done. Food companies had already flooded the market with "cholesterol-free" products like margarine and egg substitutes. And people believed the hype.

     
     

     The Egg Industry Fights Back (With Science!)

     While eggs were being villainized, the egg industry wasn’t about to sit back and let breakfast be ruined. In 1984, they established the Egg Nutrition Center (ENC) to fund research and set the record straight.

     Over the next few decades, study after study debunked the myth that eggs were bad for your heart. In fact, major research showed:

     • Eating eggs does NOT increase heart disease risk. A Harvard study of 117,000 people found no link between egg consumption and cardiovascular disease (Hu et al., 1999).
     • Eggs can even be good for you. They’re packed with protein, choline (for brain health), and lutein and zeaxanthin (for eye health) (McNamara, 2000).
     • Cholesterol guidelines were flawed. By 2015, the Dietary Guidelines for Americans finally removed cholesterol restrictions because there was no strong evidence linking dietary cholesterol to heart disease (USDA & HHS, 2015).
     
     

     After 47 years of bad press, the egg was officially redeemed. Here is a link for some science (ref)

     
     

     Just When Eggs Made a Comeback… Prices Went Through the Roof

     Now that science finally supports eating eggs, you’d think we’d be in a golden age of omelets. But no—2023 and 2024 have given us record-breaking egg prices.

     Why? One word: Bird flu.

     A massive avian flu outbreak led to the culling of millions of hens, drastically reducing egg supply and sending prices soaring (USDA, 2023). In some stores, eggs were even locked up like high-end electronics.

     So now, after decades of unnecessary restrictions, eggs are back on the menu—but they’re too expensive for many people to enjoy daily. Irony at its finest.

     
     

     The Bottom Line: Eat the Egg

     So, what’s the takeaway?

     • The demonization of eggs wasn’t based on strong science.
     • Many dietary guidelines (like the Food Pyramid) were heavily influenced by industry, not just research.
     • Science finally caught up, and now eggs are recognized as a nutrient powerhouse.
     • Just as eggs were redeemed, bird flu made them a luxury item.
     
     

     If history has taught us anything, it’s that we need to question nutrition trends—especially when big industries stand to profit. Eggs were wrongly blamed for heart disease, just like fat was wrongly blamed for obesity. But science eventually wins.

     So next time you crack open an egg, enjoy it. It took nearly five decades of bad science, industry influence, and misinformation for us to get here.

     
     

     References

     • Fernandez, M. L. (2006). Effects of eggs on plasma lipoproteins in healthy populations. Food & Function, 7(3), 156-164.
     • Griffin, B. A., & Lichtenstein, A. H. (2013). Dietary cholesterol and plasma lipoprotein profiles: Randomized controlled trials and meta-analyses. The American Journal of Clinical Nutrition, 98(6), 1465S-1470S.
     • Hu, F. B., Stampfer, M. J., Rimm, E. B., et al. (1999). A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA, 281(15), 1387-1394.
     • Kritchevsky, S. B. (1999). Dietary cholesterol, serum cholesterol, and heart disease: Are the associations valid? The American Journal of Clinical Nutrition, 69(4), 1210S-1215S.
     • Ludwig, D. S., Willett, W. C., & Volek, J. S. (2018). The low-fat diet: A failed experiment. Annual Review of Nutrition, 38, 37-57.
     • McNamara, D. J. (2000). The impact of egg limitations on coronary heart disease risk: Do the numbers add up? Journal of the American College of Nutrition, 19(5), 540-548.
     • USDA & HHS. (2015). Dietary Guidelines for Americans, 2015-2020.
     • USDA. (2023). Avian Influenza and Egg Supply Reports.
     
     ]]>The Great Egg Redemption: How Science Saved Breakfast (But Not Your Wallet)

     For decades, the humble egg was treated like a ticking time bomb for your arteries. Nutrition guidelines told us to avoid them, doctors warned us about cholesterol, and many Americans swapped their morning omelet for a sad bowl of processed cereal. But here’s the kicker—those recommendations weren’t based on strong science. Instead, industry interests heavily influenced them, outdated theories, and a lot of fear-mongering.

     Now, eggs are back on the menu. Science has finally caught up, and experts agree that dietary cholesterol isn’t the villain it was made out to be. But just when we thought we could enjoy eggs guilt-free, bird flu struck, prices skyrocketed, and suddenly, eggs became the new luxury item. So, how did we get here? Let’s crack open the truth.

     
     

     The Food Pyramid: A Big Business, Not Big Science

     If you grew up in the 90s, you probably remember the Food Pyramid. It told us to eat 6-11 servings of bread, pasta, and cereal every day, while foods like eggs, meat, and fats were placed at the top—basically labeled "Eat Sparingly."

     But was this pyramid built on solid science? Not exactly.

     The grain industry played a huge role in shaping these guidelines. In the 1970s and 80s, low-fat diets became the gold standard for heart health. The idea was simple: eating fat leads to heart disease, so cutting out fat would make us healthier. Unfortunately, that’s not what happened.

     Instead, food companies removed fat from products and replaced it with sugar and processed carbs—because, let’s face it, fat-free food tastes terrible without something to make it palatable. As a result, Americans ended up eating way more refined carbs and sugar, leading to a spike in obesity and type 2 diabetes (Ludwig et al., 2018).

     Meanwhile, eggs—one of nature’s most nutrient-dense and affordable foods—were put on the naughty list.

     
     

     The War on Eggs: How a Bad Idea Became Dietary Dogma

     The real egg panic began in 1968 when the American Heart Association (AHA) declared that dietary cholesterol was a major cause of heart disease. They recommended eating no more than three eggs per week (Kritchevsky, 1999).

     But here’s the problem—this recommendation wasn’t based on strong human studies. Instead, it was based on:

     1. Animal Studies – Scientists fed cholesterol to rabbits, which are naturally herbivores, and (shocker!) their cholesterol went up. But rabbits process cholesterol differently than humans (McNamara, 2000).
     2. Epidemiological Correlations – Early studies linked high cholesterol intake to heart disease, but they didn’t separate it from other factors like saturated fat, smoking, or lack of exercise (Hu et al., 1999).
     3. Clinical Studies With Unrealistic Diets – Some studies tested cholesterol intake using six eggs per day—which is way more than most people eat (Fernandez, 2006).
     
     

     Meanwhile, many scientists already knew that dietary cholesterol had minimal impact on blood cholesterol for most people. Our bodies naturally regulate cholesterol production—when we eat more cholesterol, the liver produces less to balance it out (Griffin & Lichtenstein, 2013).

     But by the time the science caught up, the damage was done. Food companies had already flooded the market with "cholesterol-free" products like margarine and egg substitutes. And people believed the hype.

     
     

     The Egg Industry Fights Back (With Science!)

     While eggs were being villainized, the egg industry wasn’t about to sit back and let breakfast be ruined. In 1984, they established the Egg Nutrition Center (ENC) to fund research and set the record straight.

     Over the next few decades, study after study debunked the myth that eggs were bad for your heart. In fact, major research showed:

     • Eating eggs does NOT increase heart disease risk. A Harvard study of 117,000 people found no link between egg consumption and cardiovascular disease (Hu et al., 1999).
     • Eggs can even be good for you. They’re packed with protein, choline (for brain health), and lutein and zeaxanthin (for eye health) (McNamara, 2000).
     • Cholesterol guidelines were flawed. By 2015, the Dietary Guidelines for Americans finally removed cholesterol restrictions because there was no strong evidence linking dietary cholesterol to heart disease (USDA & HHS, 2015).
     
     

     After 47 years of bad press, the egg was officially redeemed. Here is a link for some science (ref)

     
     

     Just When Eggs Made a Comeback… Prices Went Through the Roof

     Now that science finally supports eating eggs, you’d think we’d be in a golden age of omelets. But no—2023 and 2024 have given us record-breaking egg prices.

     Why? One word: Bird flu.

     A massive avian flu outbreak led to the culling of millions of hens, drastically reducing egg supply and sending prices soaring (USDA, 2023). In some stores, eggs were even locked up like high-end electronics.

     So now, after decades of unnecessary restrictions, eggs are back on the menu—but they’re too expensive for many people to enjoy daily. Irony at its finest.

     
     

     The Bottom Line: Eat the Egg

     So, what’s the takeaway?

     • The demonization of eggs wasn’t based on strong science.
     • Many dietary guidelines (like the Food Pyramid) were heavily influenced by industry, not just research.
     • Science finally caught up, and now eggs are recognized as a nutrient powerhouse.
     • Just as eggs were redeemed, bird flu made them a luxury item.
     
     

     If history has taught us anything, it’s that we need to question nutrition trends—especially when big industries stand to profit. Eggs were wrongly blamed for heart disease, just like fat was wrongly blamed for obesity. But science eventually wins.

     So next time you crack open an egg, enjoy it. It took nearly five decades of bad science, industry influence, and misinformation for us to get here.

     
     

     References

     • Fernandez, M. L. (2006). Effects of eggs on plasma lipoproteins in healthy populations. Food & Function, 7(3), 156-164.
     • Griffin, B. A., & Lichtenstein, A. H. (2013). Dietary cholesterol and plasma lipoprotein profiles: Randomized controlled trials and meta-analyses. The American Journal of Clinical Nutrition, 98(6), 1465S-1470S.
     • Hu, F. B., Stampfer, M. J., Rimm, E. B., et al. (1999). A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA, 281(15), 1387-1394.
     • Kritchevsky, S. B. (1999). Dietary cholesterol, serum cholesterol, and heart disease: Are the associations valid? The American Journal of Clinical Nutrition, 69(4), 1210S-1215S.
     • Ludwig, D. S., Willett, W. C., & Volek, J. S. (2018). The low-fat diet: A failed experiment. Annual Review of Nutrition, 38, 37-57.
     • McNamara, D. J. (2000). The impact of egg limitations on coronary heart disease risk: Do the numbers add up? Journal of the American College of Nutrition, 19(5), 540-548.
     • USDA & HHS. (2015). Dietary Guidelines for Americans, 2015-2020.
     • USDA. (2023). Avian Influenza and Egg Supply Reports.
     
     ]]>e0245f45-6ee3-450c-9762-56c59473202eTue, 04 Mar 2025 00:00:00 -070010:20falsefull6969Apple Watch vs. Oura, Whoop, and WithingsApple Watch vs. Oura, Whoop, and Withings

     Health wearables have exploded in popularity, promising better sleep, fitness, and recovery tracking. But with so many options—Apple Watch, Whoop, Withings, Oura, and Ultrahuman Rings—which one is actually worth your money?

     More importantly, do these devices improve your health, or are they just expensive digital trophies?

     In this breakdown, we’ll compare features, accuracy, HRV (Heart Rate Variability) and “strain” tracking, battery life, hidden costs, and privacy concerns—so you can make the best choice for your lifestyle.

     We have come a long way since the pedometer - which I used to buy and give to my post op surgery patients to encourage them to walk.

     What Do These Devices Track?

     Most modern wearables track heart rate, sleep, HRV, activity levels, and even blood oxygen and temperature. More than just steps - which they all track, but each device has its strengths:

     • Apple Watch – Tracks HRV, ECG (FDA-cleared for atrial fibrillation), and fall detection. However, cellular models require a monthly subscription for full use, and it no longer tracks blood oxygen (SpO2) due to a patent dispute.
     • Whoop – Focuses on recovery, strain, and sleep—but requires a costly subscription and has no screen.
     • Oura Ring – A discreet ring tracking sleep stages, HRV, and body temperature.
     • Withings – The only one besides Apple to be FDA-cleared for atrial fibrillation detection, with a focus on medical-grade tracking (smart scales, blood pressure monitors, and sleep mats). Unlike Apple, Withings still tracks blood oxygen (SpO2). Withings also tracks heart rate continuously during sleep, and thanks to its long battery life, it can be worn at night for weeks without interruption. No subscription required.
     • Ultrahuman Ring – A newer ring with a focus on metabolic tracking and recovery.
     
     

     Scientific Insight:

     A 2020 Nature Digital Medicine study found that wrist-based devices overestimate activity but underestimate calories burned, while rings tend to be more reliable for sleep and HRV.

     
     

     HRV and Strain: What Do These Metrics Really Mean?

     What is HRV (Heart Rate Variability)?

     HRV is the variation in time between heartbeats—a measure of how well your autonomic nervous system is functioning.

     • Higher HRV = Better recovery, lower stress, and improved cardiovascular health.
     • Lower HRV = Fatigue, overtraining, stress, or even illness.
     
     

     However, HRV is highly variable based on factors like hydration, sleep, and time of day.

     How Wearables Measure HRV:

     • Apple Watch, Whoop, Oura, Withings, and Ultrahuman all track HRV, but accuracy depends on when and how it’s measured.
     • Whoop and Oura measure HRV during deep sleep, which is considered more stable than spot-checks.
     • Apple Watch and Withings measure HRV periodically throughout the day, which may be less reliable due to external factors.
     
     

     💡 Bottom Line: HRV is useful for tracking trends over time, but daily fluctuations can be misleading.

     Dr. Terry Simpson's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

     
     

     What is “Strain” and Is It Useful?

     Strain is Whoop’s proprietary score that estimates how hard your body works based on HRV, heart rate, and activity levels.

     • High Strain = More exertion, requiring longer recovery.
     • Low Strain = Your body is well-recovered.
     
     

     🚨 The Problem?

     • Strain scores don’t account for individual fitness levels—what’s high strain for one person may be normal for another.
     • External factors like caffeine, stress, and dehydration can artificially raise strain scores.
     
     

     💡 Bottom Line: While strain tracking can help athletes fine-tune training, it’s not always meaningful for the average user.

     
     

     Accuracy & Reliability: Can You Trust the Data?

     Not all wearables are created equal.

     • Withings and Apple Watch are both FDA-cleared for atrial fibrillation detection, meaning they have been tested for medical accuracy.
     • Apple Watch’s ECG is 97% accurate for detecting AFib (JAMA Cardiology, 2023).
     • Whoop and Oura’s HRV tracking is solid, but they are not medical-grade devices.
     • Withings devices have been used in clinical research, meaning their data is considered highly reliable for medical use.
     • Withings still provides blood oxygen (SpO2) tracking, while the Apple Watch lost this feature due to a patent dispute.
     • Withings tracks heart rate continuously during sleep, while the Apple Watch requires the user to trigger measurements manually or wear the device overnight (which can be inconvenient due to short battery life).
     
     

     Bottom Line:

     • For medical-grade tracking, Withings and Apple Watch are the best choices.
     • For recovery & strain, Whoop and Oura perform well but lack medical validation.
     • For long-term health monitoring, Withings is the clear winner.
     
     

     
     

     More for our paid subscribers below - comparing battery life, hidden costs, and the overall winner.

     Battery Life & Charging: The Hidden Cost of Convenience

     Device Battery Life. Charging Time

     Apple Watch 18-24 hours 1-2 hours

     Whoop 4-5 days 1.5 hours

     Oura Ring 4-7 days 20-80 minutes

     Withings 3-4 WEEKS ~2 hours

     Ultrahuman 4-6 days 1-2 hours

     🔋 Withings wins by a landslide with up to a month of battery life. This allows users to wear it at night for continuous heart rate tracking, something that’s difficult to do with an Apple Watch.

     
     

     Costs & Hidden Fees: What’s the Real Price?

     Device Upfront Cost Subscription Hidden Costs

     Apple Watch. $250-$800. None for basic use $10-$20/month cellular charges

     Whoop Free device $30/month ($360/year) bands/sleeves

     Oura Ring. $299-$549. $6/month ($72/year) Without subscription, limited data

     Withings $250-$500 No subscription. None

     Ultrahuman $349-$499 $8/month ($96/year)

     💰 Whoop is the most expensive long-term due to its subscription model.

     💰 Apple Watch requires a monthly fee if you want cellular features.

     💰 Withings is the most cost-effective—one-time purchase, no subscriptions, no hidden fees.

     
     

     Final Verdict: Why Withings Wins

     🥇 Best for Most People: Withings – FDA-cleared, blood oxygen tracking, continuous heart rate monitoring at night, long battery life, no subscription, strong privacy protections.

     🥇 Best for Fitness & Heart Health: Apple Watch (beware of cellular fees).

     🥇 Best for Recovery Optimization: Whoop (if you can afford it).

     🥇 Best for Sleep & Metabolic Tracking: Oura, Withings, or Ultrahuman Ring.

     
     

     Final Thoughts

     Wearables are great tools, but they don’t replace healthy habits.

     I told Verizon that I don’t need the now $21 a month for cellular for the Apple Watch. The Withings Watch looks much nicer and easily stays on my wrist day and night.

     I had Whoop for over a year and a half. It has great insight, and those who have a favorite watch (Timex, Rolex, Omega, and so forth) but want tracking might like this device. You can wear a Whoop on your sleeve and still have your fancy watch on your wrist. I am a watch fan - but day in and day out, Withings is now my go-to. But even when I am going out and put on my watch that Dad gave me, I don’t need a lot of things tracked. I can be free of the digital age.

     I am not a ring fan. As a surgeon, they don’t work for me. Every surgeon loses rings to scrub laundry. Which is why many surgeons...]]>Apple Watch vs. Oura, Whoop, and Withings

     Health wearables have exploded in popularity, promising better sleep, fitness, and recovery tracking. But with so many options—Apple Watch, Whoop, Withings, Oura, and Ultrahuman Rings—which one is actually worth your money?

     More importantly, do these devices improve your health, or are they just expensive digital trophies?

     In this breakdown, we’ll compare features, accuracy, HRV (Heart Rate Variability) and “strain” tracking, battery life, hidden costs, and privacy concerns—so you can make the best choice for your lifestyle.

     We have come a long way since the pedometer - which I used to buy and give to my post op surgery patients to encourage them to walk.

     What Do These Devices Track?

     Most modern wearables track heart rate, sleep, HRV, activity levels, and even blood oxygen and temperature. More than just steps - which they all track, but each device has its strengths:

     • Apple Watch – Tracks HRV, ECG (FDA-cleared for atrial fibrillation), and fall detection. However, cellular models require a monthly subscription for full use, and it no longer tracks blood oxygen (SpO2) due to a patent dispute.
     • Whoop – Focuses on recovery, strain, and sleep—but requires a costly subscription and has no screen.
     • Oura Ring – A discreet ring tracking sleep stages, HRV, and body temperature.
     • Withings – The only one besides Apple to be FDA-cleared for atrial fibrillation detection, with a focus on medical-grade tracking (smart scales, blood pressure monitors, and sleep mats). Unlike Apple, Withings still tracks blood oxygen (SpO2). Withings also tracks heart rate continuously during sleep, and thanks to its long battery life, it can be worn at night for weeks without interruption. No subscription required.
     • Ultrahuman Ring – A newer ring with a focus on metabolic tracking and recovery.
     
     

     Scientific Insight:

     A 2020 Nature Digital Medicine study found that wrist-based devices overestimate activity but underestimate calories burned, while rings tend to be more reliable for sleep and HRV.

     
     

     HRV and Strain: What Do These Metrics Really Mean?

     What is HRV (Heart Rate Variability)?

     HRV is the variation in time between heartbeats—a measure of how well your autonomic nervous system is functioning.

     • Higher HRV = Better recovery, lower stress, and improved cardiovascular health.
     • Lower HRV = Fatigue, overtraining, stress, or even illness.
     
     

     However, HRV is highly variable based on factors like hydration, sleep, and time of day.

     How Wearables Measure HRV:

     • Apple Watch, Whoop, Oura, Withings, and Ultrahuman all track HRV, but accuracy depends on when and how it’s measured.
     • Whoop and Oura measure HRV during deep sleep, which is considered more stable than spot-checks.
     • Apple Watch and Withings measure HRV periodically throughout the day, which may be less reliable due to external factors.
     
     

     💡 Bottom Line: HRV is useful for tracking trends over time, but daily fluctuations can be misleading.

     Dr. Terry Simpson's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

     
     

     What is “Strain” and Is It Useful?

     Strain is Whoop’s proprietary score that estimates how hard your body works based on HRV, heart rate, and activity levels.

     • High Strain = More exertion, requiring longer recovery.
     • Low Strain = Your body is well-recovered.
     
     

     🚨 The Problem?

     • Strain scores don’t account for individual fitness levels—what’s high strain for one person may be normal for another.
     • External factors like caffeine, stress, and dehydration can artificially raise strain scores.
     
     

     💡 Bottom Line: While strain tracking can help athletes fine-tune training, it’s not always meaningful for the average user.

     
     

     Accuracy & Reliability: Can You Trust the Data?

     Not all wearables are created equal.

     • Withings and Apple Watch are both FDA-cleared for atrial fibrillation detection, meaning they have been tested for medical accuracy.
     • Apple Watch’s ECG is 97% accurate for detecting AFib (JAMA Cardiology, 2023).
     • Whoop and Oura’s HRV tracking is solid, but they are not medical-grade devices.
     • Withings devices have been used in clinical research, meaning their data is considered highly reliable for medical use.
     • Withings still provides blood oxygen (SpO2) tracking, while the Apple Watch lost this feature due to a patent dispute.
     • Withings tracks heart rate continuously during sleep, while the Apple Watch requires the user to trigger measurements manually or wear the device overnight (which can be inconvenient due to short battery life).
     
     

     Bottom Line:

     • For medical-grade tracking, Withings and Apple Watch are the best choices.
     • For recovery & strain, Whoop and Oura perform well but lack medical validation.
     • For long-term health monitoring, Withings is the clear winner.
     
     

     
     

     More for our paid subscribers below - comparing battery life, hidden costs, and the overall winner.

     Battery Life & Charging: The Hidden Cost of Convenience

     Device Battery Life. Charging Time

     Apple Watch 18-24 hours 1-2 hours

     Whoop 4-5 days 1.5 hours

     Oura Ring 4-7 days 20-80 minutes

     Withings 3-4 WEEKS ~2 hours

     Ultrahuman 4-6 days 1-2 hours

     🔋 Withings wins by a landslide with up to a month of battery life. This allows users to wear it at night for continuous heart rate tracking, something that’s difficult to do with an Apple Watch.

     
     

     Costs & Hidden Fees: What’s the Real Price?

     Device Upfront Cost Subscription Hidden Costs

     Apple Watch. $250-$800. None for basic use $10-$20/month cellular charges

     Whoop Free device $30/month ($360/year) bands/sleeves

     Oura Ring. $299-$549. $6/month ($72/year) Without subscription, limited data

     Withings $250-$500 No subscription. None

     Ultrahuman $349-$499 $8/month ($96/year)

     💰 Whoop is the most expensive long-term due to its subscription model.

     💰 Apple Watch requires a monthly fee if you want cellular features.

     💰 Withings is the most cost-effective—one-time purchase, no subscriptions, no hidden fees.

     
     

     Final Verdict: Why Withings Wins

     🥇 Best for Most People: Withings – FDA-cleared, blood oxygen tracking, continuous heart rate monitoring at night, long battery life, no subscription, strong privacy protections.

     🥇 Best for Fitness & Heart Health: Apple Watch (beware of cellular fees).

     🥇 Best for Recovery Optimization: Whoop (if you can afford it).

     🥇 Best for Sleep & Metabolic Tracking: Oura, Withings, or Ultrahuman Ring.

     
     

     Final Thoughts

     Wearables are great tools, but they don’t replace healthy habits.

     I told Verizon that I don’t need the now $21 a month for cellular for the Apple Watch. The Withings Watch looks much nicer and easily stays on my wrist day and night.

     I had Whoop for over a year and a half. It has great insight, and those who have a favorite watch (Timex, Rolex, Omega, and so forth) but want tracking might like this device. You can wear a Whoop on your sleeve and still have your fancy watch on your wrist. I am a watch fan - but day in and day out, Withings is now my go-to. But even when I am going out and put on my watch that Dad gave me, I don’t need a lot of things tracked. I can be free of the digital age.

     I am not a ring fan. As a surgeon, they don’t work for me. Every surgeon loses rings to scrub laundry. Which is why many surgeons simply don’t wear rings at all.

     Withings also has an entire health system with blood pressure, a scale (where I keep track of my weight), and a sleeping pad that can diagnose and track sleep apnea (FDA-cleared).

     ]]>2e684bf6-793c-4e34-b6aa-34330e4b30c6Sat, 22 Feb 2025 00:00:00 -070009:57falsefull6868Ultra-Processed Food MythsWhat Are Ultra-Processed Foods?

     Ultra-processed food (UPF) might sound like something concocted in a secret laboratory, but it simply refers to foods that are significantly altered from their original state. These often contain additives like emulsifiers, preservatives, and stabilizers—ingredients you wouldn’t typically find in a home kitchen.

     This category includes everything from convenience-store hot dogs to plant-based meat alternatives. Yes, even your favorite vegan nuggets fall into this group.

     Common Myths About Ultra-Processed Foods

     Myth #1: They’re Toxic and Will Kill You Instantly

     If ultra-processed foods were as lethal as some claim, most of us wouldn’t have survived past childhood. While some contain high amounts of salt, sugar, and fat, they aren’t inherently poisonous. The key is moderation. A diet loaded with neon-colored cheese puffs and soda? That’s a health disaster. But an occasional indulgence won’t do you in.

     Myth #2: Twinkies Last Forever

     Twinkies have a long shelf life, but they aren’t immortal. The idea that they’ll outlast civilization comes from misunderstood experiments on old snack cakes. In reality, they’ll go stale and unappetizing over time—just like any other food.

     Myth #3: If You Can’t Pronounce an Ingredient, It Must Be Bad

     Complicated words don’t necessarily mean something is harmful. For example, cyanocobalamin is just vitamin B12, an essential nutrient for your nervous system. Even dihydrogen monoxide sounds ominous—but it’s just water.

     The Real Issue with Ultra-Processed Foods

     Many ultra-processed foods are designed to be hyper-palatable, meaning they activate your brain’s reward system. Ever wonder why it’s so easy to eat an entire bag of chips in one sitting? It’s not just about willpower—these foods are engineered to be irresistible.

     Additionally, ultra-processed foods tend to be calorie-dense but nutrient-poor. They can crowd out healthier, more nutrient-rich options, leading to deficiencies over time.

     Can You Eat Ultra-Processed Foods and Stay Healthy?

     Absolutely! The key is balance. If 80% of your diet consists of whole foods—fruits, vegetables, lean proteins, and whole grains—you can enjoy processed indulgences in moderation. The problem arises when ultra-processed foods dominate your meals.

     Final Thoughts: Should You Fear the French Fry?

     No. Fear misinformation more than the occasional processed snack. The goal isn’t to live on a diet of raw kale and regret—it’s about making informed choices.

     Enjoy your guilty pleasures in moderation, but don’t let them replace nutrient-dense foods. Science, not fear, should guide your eating habits.

     For more food science insights, follow me on TikTok and Instagram at @drterrysimpson. And remember—eat smart, not scared!

     ]]>What Are Ultra-Processed Foods?

     Ultra-processed food (UPF) might sound like something concocted in a secret laboratory, but it simply refers to foods that are significantly altered from their original state. These often contain additives like emulsifiers, preservatives, and stabilizers—ingredients you wouldn’t typically find in a home kitchen.

     This category includes everything from convenience-store hot dogs to plant-based meat alternatives. Yes, even your favorite vegan nuggets fall into this group.

     Common Myths About Ultra-Processed Foods

     Myth #1: They’re Toxic and Will Kill You Instantly

     If ultra-processed foods were as lethal as some claim, most of us wouldn’t have survived past childhood. While some contain high amounts of salt, sugar, and fat, they aren’t inherently poisonous. The key is moderation. A diet loaded with neon-colored cheese puffs and soda? That’s a health disaster. But an occasional indulgence won’t do you in.

     Myth #2: Twinkies Last Forever

     Twinkies have a long shelf life, but they aren’t immortal. The idea that they’ll outlast civilization comes from misunderstood experiments on old snack cakes. In reality, they’ll go stale and unappetizing over time—just like any other food.

     Myth #3: If You Can’t Pronounce an Ingredient, It Must Be Bad

     Complicated words don’t necessarily mean something is harmful. For example, cyanocobalamin is just vitamin B12, an essential nutrient for your nervous system. Even dihydrogen monoxide sounds ominous—but it’s just water.

     The Real Issue with Ultra-Processed Foods

     Many ultra-processed foods are designed to be hyper-palatable, meaning they activate your brain’s reward system. Ever wonder why it’s so easy to eat an entire bag of chips in one sitting? It’s not just about willpower—these foods are engineered to be irresistible.

     Additionally, ultra-processed foods tend to be calorie-dense but nutrient-poor. They can crowd out healthier, more nutrient-rich options, leading to deficiencies over time.

     Can You Eat Ultra-Processed Foods and Stay Healthy?

     Absolutely! The key is balance. If 80% of your diet consists of whole foods—fruits, vegetables, lean proteins, and whole grains—you can enjoy processed indulgences in moderation. The problem arises when ultra-processed foods dominate your meals.

     Final Thoughts: Should You Fear the French Fry?

     No. Fear misinformation more than the occasional processed snack. The goal isn’t to live on a diet of raw kale and regret—it’s about making informed choices.

     Enjoy your guilty pleasures in moderation, but don’t let them replace nutrient-dense foods. Science, not fear, should guide your eating habits.

     For more food science insights, follow me on TikTok and Instagram at @drterrysimpson. And remember—eat smart, not scared!

     ]]>a500e63e-8185-463e-96fd-1c23f906ab17Wed, 12 Feb 2025 00:00:00 -070010:01falsefull6767Update: Flu and More Bird FluBird Flu, Flu Season, and Protecting Your Health: What You Need to Know

     While I typically focus on food and your health, pressing medical updates demand attention. Today, we’re tackling two critical topics: the latest on bird flu (avian influenza) and the rise in seasonal respiratory illnesses, including flu and COVID-19.

     With public communication from federal agencies temporarily paused, it’s vital to stay informed. Here’s a comprehensive overview of what’s happening, what it means for you, and how to protect yourself and those around you.

     Respiratory Illness Trends: Seasonal Flu on the Rise

     As of January 24th, 2025, respiratory illnesses are driving more people to seek healthcare. Here’s what we’re seeing:

     • Seasonal flu: Elevated and rising in some areas.
     • COVID-19: Most regions report a decline in cases.
     • RSV: Also trending downward.
     
     

     Locally, we’re seeing these same trends, with flu activity increasing significantly.

     
     

     Bird Flu: A Persistent Global Concern

     Since 1997, HPAI A(H5N1) virus infections have been reported in over 925 people, with an alarming 50% case fatality rate. Early outbreaks included 20 cases and 7 deaths in Hong Kong between 1997 and 2003, and since November 2003, more than 900 cases across 24 countries have been documented (CDC).

     Symptoms and Severity

     HPAI A(H5N1) infections can range from mild to severe, including:

     • Mild symptoms: Upper respiratory tract issues like a runny nose or sore throat.
     • Severe symptoms: Pneumonia, respiratory failure, acute respiratory distress syndrome (ARDS), and multi-organ failure.
     • Neurological impact: Some cases report encephalitis, a dangerous brain inflammation.
     
     

     Since 2016, sporadic cases have been reported globally, and while rare, they highlight the virus’s ability to persist.

     
     

     Notable Cases and Strains

     A Sobering Case from Louisiana

     A recent case in Louisiana reminds us of the risks associated with bird flu. A man died after handling wild birds infected with HPAI A(H5N1). This tragic event underscores how deadly the virus can be in humans.

     Other Strains to Watch

     • HPAI A(H5N6): Over 90 cases have been reported in China since 2014, with one additional case in Laos in 2021. This strain has a case fatality rate exceeding 50% (WHO).
     • HPAI A(H5N8): Russia reported the first asymptomatic human case in a poultry worker in 2020 (CDC).
     
     

     Testing and Monitoring

     Hospitals now test anyone hospitalized with severe flu symptoms for bird flu. Public health officials use several tools to monitor these trends:

     • Wastewater surveillance
     • Emergency department visit data
     • Lab-confirmed cases
     
     

     These measures provide early warnings of emerging threats, helping to guide public health responses.

     
     

     Protecting Yourself: Key Preventive Measures

     1. Avoid Exposure

     • Stay away from wild birds, sick or dead poultry, and areas with known outbreaks.
     • Don’t handle birds without proper precautions.
     
     

     2. Use Protective Gear

     For those working with poultry or wild birds, personal protective equipment (PPE) is essential. Gloves, masks, and eye protection significantly reduce exposure risks.

     3. Consider Antiviral Prophylaxis

     If exposed to infected birds, antiviral medications like oseltamivir can lower your risk. These treatments are most effective when started within 48 hours of exposure and continued for 7 days.

     4. Get Vaccinated

     The FDA-approved vaccine Audenz offers protection against H5N1 for high-risk groups (FDA).

     
     

     Why Vaccination Matters

     Vaccines don’t guarantee you won’t contract the virus, but they do prepare your immune system to fight it more effectively. This reduces the risk of severe illness and protects vulnerable populations, including:

     • Elderly individuals.
     • People undergoing chemotherapy.
     • Young children.
     
     

     Vaccination also lowers your viral load, reducing the likelihood of spreading the virus to others.

     
     

     The Role of Nutrition in Immune Support

     Good nutrition strengthens your immune system, making you more resilient against respiratory illnesses:

     • Vitamin C: Found in citrus fruits like oranges and lemons, it supports white blood cell function.
     • Antioxidants: Spinach and broccoli are packed with immune-boosting nutrients.
     • Vitamin D: Fatty fish (salmon, mackerel, trout), fortified foods, and plant-based alternatives like Costco Oat Milk help maintain adequate levels.
     
     

     The Bigger Picture

     Bird flu continues to evolve, spreading to new bird populations and occasionally infecting mammals. While the overall risk of human transmission remains low, these developments remind us of the importance of:

     • Early detection through testing and monitoring.
     • Preventive measures to reduce exposure.
     • Prompt treatment when needed.
     
     

     Conclusion

     Bird flu and seasonal respiratory illnesses remind us of the importance of vigilance and proactive health measures. With flu season in full swing, now is the time to take action—get vaccinated, improve air quality, and support your immune system through nutrition.

     For more detailed updates, listen to my Fork U podcast, where I share in-depth insights on bird flu and other health concerns. You can also find weekly updates on my TikTok and Instagram (@drterrysimpson).

     As always, I remain yours in health,

     Dr. Terry Simpson

     References:

     1. Centers for Disease Control and Prevention (CDC): Avian Influenza Updates
     2. World Health Organization (WHO): Avian Influenza
     3. U.S. Food and Drug Administration (FDA): Audenz Vaccine
     
     ]]>Bird Flu, Flu Season, and Protecting Your Health: What You Need to Know

     While I typically focus on food and your health, pressing medical updates demand attention. Today, we’re tackling two critical topics: the latest on bird flu (avian influenza) and the rise in seasonal respiratory illnesses, including flu and COVID-19.

     With public communication from federal agencies temporarily paused, it’s vital to stay informed. Here’s a comprehensive overview of what’s happening, what it means for you, and how to protect yourself and those around you.

     Respiratory Illness Trends: Seasonal Flu on the Rise

     As of January 24th, 2025, respiratory illnesses are driving more people to seek healthcare. Here’s what we’re seeing:

     • Seasonal flu: Elevated and rising in some areas.
     • COVID-19: Most regions report a decline in cases.
     • RSV: Also trending downward.
     
     

     Locally, we’re seeing these same trends, with flu activity increasing significantly.

     
     

     Bird Flu: A Persistent Global Concern

     Since 1997, HPAI A(H5N1) virus infections have been reported in over 925 people, with an alarming 50% case fatality rate. Early outbreaks included 20 cases and 7 deaths in Hong Kong between 1997 and 2003, and since November 2003, more than 900 cases across 24 countries have been documented (CDC).

     Symptoms and Severity

     HPAI A(H5N1) infections can range from mild to severe, including:

     • Mild symptoms: Upper respiratory tract issues like a runny nose or sore throat.
     • Severe symptoms: Pneumonia, respiratory failure, acute respiratory distress syndrome (ARDS), and multi-organ failure.
     • Neurological impact: Some cases report encephalitis, a dangerous brain inflammation.
     
     

     Since 2016, sporadic cases have been reported globally, and while rare, they highlight the virus’s ability to persist.

     
     

     Notable Cases and Strains

     A Sobering Case from Louisiana

     A recent case in Louisiana reminds us of the risks associated with bird flu. A man died after handling wild birds infected with HPAI A(H5N1). This tragic event underscores how deadly the virus can be in humans.

     Other Strains to Watch

     • HPAI A(H5N6): Over 90 cases have been reported in China since 2014, with one additional case in Laos in 2021. This strain has a case fatality rate exceeding 50% (WHO).
     • HPAI A(H5N8): Russia reported the first asymptomatic human case in a poultry worker in 2020 (CDC).
     
     

     Testing and Monitoring

     Hospitals now test anyone hospitalized with severe flu symptoms for bird flu. Public health officials use several tools to monitor these trends:

     • Wastewater surveillance
     • Emergency department visit data
     • Lab-confirmed cases
     
     

     These measures provide early warnings of emerging threats, helping to guide public health responses.

     
     

     Protecting Yourself: Key Preventive Measures

     1. Avoid Exposure

     • Stay away from wild birds, sick or dead poultry, and areas with known outbreaks.
     • Don’t handle birds without proper precautions.
     
     

     2. Use Protective Gear

     For those working with poultry or wild birds, personal protective equipment (PPE) is essential. Gloves, masks, and eye protection significantly reduce exposure risks.

     3. Consider Antiviral Prophylaxis

     If exposed to infected birds, antiviral medications like oseltamivir can lower your risk. These treatments are most effective when started within 48 hours of exposure and continued for 7 days.

     4. Get Vaccinated

     The FDA-approved vaccine Audenz offers protection against H5N1 for high-risk groups (FDA).

     
     

     Why Vaccination Matters

     Vaccines don’t guarantee you won’t contract the virus, but they do prepare your immune system to fight it more effectively. This reduces the risk of severe illness and protects vulnerable populations, including:

     • Elderly individuals.
     • People undergoing chemotherapy.
     • Young children.
     
     

     Vaccination also lowers your viral load, reducing the likelihood of spreading the virus to others.

     
     

     The Role of Nutrition in Immune Support

     Good nutrition strengthens your immune system, making you more resilient against respiratory illnesses:

     • Vitamin C: Found in citrus fruits like oranges and lemons, it supports white blood cell function.
     • Antioxidants: Spinach and broccoli are packed with immune-boosting nutrients.
     • Vitamin D: Fatty fish (salmon, mackerel, trout), fortified foods, and plant-based alternatives like Costco Oat Milk help maintain adequate levels.
     
     

     The Bigger Picture

     Bird flu continues to evolve, spreading to new bird populations and occasionally infecting mammals. While the overall risk of human transmission remains low, these developments remind us of the importance of:

     • Early detection through testing and monitoring.
     • Preventive measures to reduce exposure.
     • Prompt treatment when needed.
     
     

     Conclusion

     Bird flu and seasonal respiratory illnesses remind us of the importance of vigilance and proactive health measures. With flu season in full swing, now is the time to take action—get vaccinated, improve air quality, and support your immune system through nutrition.

     For more detailed updates, listen to my Fork U podcast, where I share in-depth insights on bird flu and other health concerns. You can also find weekly updates on my TikTok and Instagram (@drterrysimpson).

     As always, I remain yours in health,

     Dr. Terry Simpson

     References:

     1. Centers for Disease Control and Prevention (CDC): Avian Influenza Updates
     2. World Health Organization (WHO): Avian Influenza
     3. U.S. Food and Drug Administration (FDA): Audenz Vaccine
     
     ]]>8c2eec72-4f0b-4f89-8bf8-451b0974d13bWed, 29 Jan 2025 00:00:00 -070010:44falsefull6666Fuel, Don't Fad. Eat for Health, not Hype.Fuel, Don’t Fad: How to Eat for Health, Not Hype

     If you’ve ever fallen for a fad diet, you’re not alone. They promise quick results, make bold claims, and usually leave you hungry, cranky, and disappointed. But here’s the truth: fad diets don’t work in the long run. What does work? Fueling your body with the right foods. In this blog, we’ll break down why fad diets fail, how to rebuild your relationship with food, and the best way to fuel your body for health, happiness, and energy.

     Why Fad Diets Fail (Every Single Time)

     Fad diets sound tempting. They promise you’ll drop 10 pounds in a week, detox your body, or gain endless energy. But they always have a catch—and that catch is why they fail so miserably.

     1. Fad Diets Demonize Food

     Carbs are evil. Fats are the enemy. Fruits have too much sugar. If you’ve heard any of these, you’ve encountered a fad diet. These diets love to turn food into the villain, leaving you afraid to eat the things your body actually needs.

     2. They Set You Up for Yo-Yo Dieting

     You lose weight quickly at first, but as soon as you eat normally, the weight comes rushing back. This cycle is not just frustrating—it’s harmful to your health and metabolism.

     3. They Ignore Science

     Many fad diets rely on gimmicks instead of facts. For example, “Don’t eat after 7 PM because your metabolism goes to sleep.” Spoiler alert: your metabolism doesn’t have a bedtime.

     
     

     Unhealthy Relationships with Food

     Fad diets don’t just fail—they mess with your mind. They teach you to fear food, label meals as “good” or “bad,” and disconnect you from your body’s natural hunger and fullness cues.

     Stop Labeling Food as the Enemy

     Food isn’t good or bad. It’s just food. Sure, a salad has more nutrients than a slice of cake, but both can fit into a balanced diet. When you stop assigning moral value to food, you’ll stop feeling guilty about what you eat.

     Trust Your Body’s Hunger Signals

     Your body knows when it’s hungry and when it’s full. Fad diets train you to ignore these signals, but you can retrain yourself. Start listening to your body—it’s smarter than any diet app.

     
     

     How to Fuel Your Body the Right Way

     Now that we’ve covered what doesn’t work, let’s talk about what does. Fueling your body means giving it the energy and nutrients it needs to thrive. Forget restriction—focus on addition.

     
     

     Fruits: Nature’s Candy

     Aim for 9 ounces of fruit per day or about two servings. Fruits provide vitamins, antioxidants, and natural sweetness. Plus, they’re portable and easy to snack on.

     • Snack idea: Slice an apple and pair it with peanut butter.
     • Breakfast tip: Add berries to your oatmeal or yogurt.
     
     

     Vegetables: The Foundation of Your Plate

     Like fruits, aim for 9 ounces of vegetables per day. Vegetables are low in calories but high in nutrients, fiber, and flavor.

     • Quick tip: Roast a tray of veggies with olive oil, garlic, and herbs.
     • Sneaky trick: Add spinach to your smoothies—you won’t taste it, but your body will love it.
     
     

     Whole Grains: Your Sturdy Sidekick

     Whole grains give you the energy that lasts. They’re rich in fiber, which keeps you full and your digestion happy. Aim for 9 ounces of whole grains per day.

     • Breakfast idea: Enjoy a bowl of oatmeal with fruit and nuts.
     • Dinner option: Serve quinoa, brown rice, or whole-grain pasta as a base for your meals.
     
     

     Fish: Brain Food

      Fish provides protein and omega-3 fatty acids, which support heart and brain health. Try to eat fish twice a week, focusing on fatty fish like salmon or mackerel.

     • Easy dinner: Grill salmon with a squeeze of lemon and fresh dill.
     • Lunch idea: Make a tuna salad with olive oil, not mayo, and pile it onto whole-grain toast.
     
     

     Olive Oil: Liquid Gold

     Forget butter. Olive oil is your new go-to fat. It’s rich in heart-healthy monounsaturated fats and enhances the flavor of almost anything. Use 2-4 tablespoons per day for cooking, drizzling, or dipping.

     • Salad idea: Drizzle olive oil with lemon juice and a pinch of salt for a quick dressing.
     • Snack tip: Dip whole-grain bread into olive oil mixed with herbs.
     
     

     Legumes: The Underrated Powerhouse

     Legumes like chickpeas, lentils, and beans are full of fiber, protein, and nutrients. They’re also budget-friendly and incredibly versatile. Best of all, you can enjoy them in unlimited amounts.

     • Snack idea: Roast chickpeas with paprika for a crunchy treat.
     • Meal tip: Make a hearty chickpea stew with tomatoes and spices.
     
     

     Why Fad Diets Like the Carnivore Diet Are a Hard No

     We can’t talk about fueling your body without addressing the Carnivore Diet. This trendy diet eliminates plant-based foods entirely, focusing only on meat. Here’s why it’s a bad idea:

     • They are Nutrient-Deficient: You’re missing out on fiber, vitamins, and antioxidants found in fruits, vegetables, and grains.
     • It’s Risky: Diets high in red and processed meats increase the risk of heart disease and cancer.
     • Carnivore, like keto, is Unsustainable: Unless you love the idea of a lifetime without bread, this diet won’t last.
     
     

     In short, the Carnivore Diet is a fad at best and dangerous at worst. Stick to balanced, science-backed eating instead.

     
     

     Practical Tips to Get Started

     Fueling your body doesn’t have to be complicated. Start with these simple steps:

     1. Focus on what to add, not what to cut out.
     2. Plan meals around fruits, vegetables, and whole grains.
     3. Include fish in your weekly routine.
     4. Stock your pantry with staples like legumes and olive oil.
     5. Allow yourself treats—balance is key.
     
     ]]>Fuel, Don’t Fad: How to Eat for Health, Not Hype

     If you’ve ever fallen for a fad diet, you’re not alone. They promise quick results, make bold claims, and usually leave you hungry, cranky, and disappointed. But here’s the truth: fad diets don’t work in the long run. What does work? Fueling your body with the right foods. In this blog, we’ll break down why fad diets fail, how to rebuild your relationship with food, and the best way to fuel your body for health, happiness, and energy.

     Why Fad Diets Fail (Every Single Time)

     Fad diets sound tempting. They promise you’ll drop 10 pounds in a week, detox your body, or gain endless energy. But they always have a catch—and that catch is why they fail so miserably.

     1. Fad Diets Demonize Food

     Carbs are evil. Fats are the enemy. Fruits have too much sugar. If you’ve heard any of these, you’ve encountered a fad diet. These diets love to turn food into the villain, leaving you afraid to eat the things your body actually needs.

     2. They Set You Up for Yo-Yo Dieting

     You lose weight quickly at first, but as soon as you eat normally, the weight comes rushing back. This cycle is not just frustrating—it’s harmful to your health and metabolism.

     3. They Ignore Science

     Many fad diets rely on gimmicks instead of facts. For example, “Don’t eat after 7 PM because your metabolism goes to sleep.” Spoiler alert: your metabolism doesn’t have a bedtime.

     
     

     Unhealthy Relationships with Food

     Fad diets don’t just fail—they mess with your mind. They teach you to fear food, label meals as “good” or “bad,” and disconnect you from your body’s natural hunger and fullness cues.

     Stop Labeling Food as the Enemy

     Food isn’t good or bad. It’s just food. Sure, a salad has more nutrients than a slice of cake, but both can fit into a balanced diet. When you stop assigning moral value to food, you’ll stop feeling guilty about what you eat.

     Trust Your Body’s Hunger Signals

     Your body knows when it’s hungry and when it’s full. Fad diets train you to ignore these signals, but you can retrain yourself. Start listening to your body—it’s smarter than any diet app.

     
     

     How to Fuel Your Body the Right Way

     Now that we’ve covered what doesn’t work, let’s talk about what does. Fueling your body means giving it the energy and nutrients it needs to thrive. Forget restriction—focus on addition.

     
     

     Fruits: Nature’s Candy

     Aim for 9 ounces of fruit per day or about two servings. Fruits provide vitamins, antioxidants, and natural sweetness. Plus, they’re portable and easy to snack on.

     • Snack idea: Slice an apple and pair it with peanut butter.
     • Breakfast tip: Add berries to your oatmeal or yogurt.
     
     

     Vegetables: The Foundation of Your Plate

     Like fruits, aim for 9 ounces of vegetables per day. Vegetables are low in calories but high in nutrients, fiber, and flavor.

     • Quick tip: Roast a tray of veggies with olive oil, garlic, and herbs.
     • Sneaky trick: Add spinach to your smoothies—you won’t taste it, but your body will love it.
     
     

     Whole Grains: Your Sturdy Sidekick

     Whole grains give you the energy that lasts. They’re rich in fiber, which keeps you full and your digestion happy. Aim for 9 ounces of whole grains per day.

     • Breakfast idea: Enjoy a bowl of oatmeal with fruit and nuts.
     • Dinner option: Serve quinoa, brown rice, or whole-grain pasta as a base for your meals.
     
     

     Fish: Brain Food

      Fish provides protein and omega-3 fatty acids, which support heart and brain health. Try to eat fish twice a week, focusing on fatty fish like salmon or mackerel.

     • Easy dinner: Grill salmon with a squeeze of lemon and fresh dill.
     • Lunch idea: Make a tuna salad with olive oil, not mayo, and pile it onto whole-grain toast.
     
     

     Olive Oil: Liquid Gold

     Forget butter. Olive oil is your new go-to fat. It’s rich in heart-healthy monounsaturated fats and enhances the flavor of almost anything. Use 2-4 tablespoons per day for cooking, drizzling, or dipping.

     • Salad idea: Drizzle olive oil with lemon juice and a pinch of salt for a quick dressing.
     • Snack tip: Dip whole-grain bread into olive oil mixed with herbs.
     
     

     Legumes: The Underrated Powerhouse

     Legumes like chickpeas, lentils, and beans are full of fiber, protein, and nutrients. They’re also budget-friendly and incredibly versatile. Best of all, you can enjoy them in unlimited amounts.

     • Snack idea: Roast chickpeas with paprika for a crunchy treat.
     • Meal tip: Make a hearty chickpea stew with tomatoes and spices.
     
     

     Why Fad Diets Like the Carnivore Diet Are a Hard No

     We can’t talk about fueling your body without addressing the Carnivore Diet. This trendy diet eliminates plant-based foods entirely, focusing only on meat. Here’s why it’s a bad idea:

     • They are Nutrient-Deficient: You’re missing out on fiber, vitamins, and antioxidants found in fruits, vegetables, and grains.
     • It’s Risky: Diets high in red and processed meats increase the risk of heart disease and cancer.
     • Carnivore, like keto, is Unsustainable: Unless you love the idea of a lifetime without bread, this diet won’t last.
     
     

     In short, the Carnivore Diet is a fad at best and dangerous at worst. Stick to balanced, science-backed eating instead.

     
     

     Practical Tips to Get Started

     Fueling your body doesn’t have to be complicated. Start with these simple steps:

     1. Focus on what to add, not what to cut out.
     2. Plan meals around fruits, vegetables, and whole grains.
     3. Include fish in your weekly routine.
     4. Stock your pantry with staples like legumes and olive oil.
     5. Allow yourself treats—balance is key.
     
     ]]>8d110ae0-a9a4-4e8c-8209-21b7705e8e06Wed, 22 Jan 2025 00:00:00 -070014:05falsefull6565Number One Diet 2025: MediterraneanThe Mediterranean Diet: Why It’s Still #1 in 2025

     When it comes to choosing the best diet for overall health, the Mediterranean diet has topped the list again in 2025. It’s easy to see why: it’s simple, it’s sustainable, and it delivers proven health benefits. Are you looking to manage your weight, reduce your risk of heart disease, or improve your gut health?  The Mediterranean diet offers a balanced, flexible approach to eating.

     What Makes the Mediterranean Diet So Special?

     The Mediterranean diet was originally based on the eating habits of countries like Greece, Italy, and Spain. But here’s the key: it’s not just about eating food from these regions. The Mediterranean diet is more of an eating pattern—one that focuses on fresh, whole foods, a variety of plant-based ingredients, lean proteins, and healthy fats. This diet encourages you to eat fruits, vegetables, whole grains, legumes, nuts, and seeds while making olive oil your primary fat source. Fish is a star in this diet, while dairy and red meat are enjoyed in moderation.

     The Mediterranean Diet Algorithm

     The Mediterranean diet isn’t about following a strict menu or buying expensive specialty ingredients. It’s about focusing on whole, nutrient-dense foods and following an algorithm: more plants, more healthy fats, and fewer processed foods. It’s not a fad—it’s a way of life that’s been proven to improve long-term health.

     
     

     Why Is the Mediterranean Diet Still Ranked #1?

     So, why is the Mediterranean diet still ranked #1 for 2025 by experts like The Mediterranean Diet: Why It’s Still #1 in 2025

     When it comes to choosing the best diet for overall health, the Mediterranean diet has topped the list again in 2025. It’s easy to see why: it’s simple, it’s sustainable, and it delivers proven health benefits. Are you looking to manage your weight, reduce your risk of heart disease, or improve your gut health?  The Mediterranean diet offers a balanced, flexible approach to eating.

     What Makes the Mediterranean Diet So Special?

     The Mediterranean diet was originally based on the eating habits of countries like Greece, Italy, and Spain. But here’s the key: it’s not just about eating food from these regions. The Mediterranean diet is more of an eating pattern—one that focuses on fresh, whole foods, a variety of plant-based ingredients, lean proteins, and healthy fats. This diet encourages you to eat fruits, vegetables, whole grains, legumes, nuts, and seeds while making olive oil your primary fat source. Fish is a star in this diet, while dairy and red meat are enjoyed in moderation.

     The Mediterranean Diet Algorithm

     The Mediterranean diet isn’t about following a strict menu or buying expensive specialty ingredients. It’s about focusing on whole, nutrient-dense foods and following an algorithm: more plants, more healthy fats, and fewer processed foods. It’s not a fad—it’s a way of life that’s been proven to improve long-term health.

     
     

     Why Is the Mediterranean Diet Still Ranked #1?

     So, why is the Mediterranean diet still ranked #1 for 2025 by experts like U.S. News & World Report? Here’s why:

     1. Supports Heart Health
     2. The Mediterranean diet is packed with healthy fats, like olive oil and fatty fish (think salmon and sardines), which are known to reduce inflammation and lower cholesterol levels. Studies have shown that this diet can lower the risk of heart disease and stroke by improving blood pressure and supporting healthy arteries.
     3. Controls Blood Sugar
     4. If you have diabetes or prediabetes, the Mediterranean diet is a fantastic choice. It helps regulate blood sugar levels, improving insulin sensitivity, and preventing blood sugar spikes that can cause problems over time.
     5. Improves Gut Health
     6. The Mediterranean diet is rich in fiber from fruits, vegetables, and whole grains, which are essential for a healthy gut. A healthy gut microbiome can help with digestion, boost immunity, and even improve your mood.
     7. Fights Inflammation
     8. Chronic inflammation is at the root of many diseases, including arthritis and certain cancers. The Mediterranean diet’s focus on antioxidant-rich foods (like leafy greens, tomatoes, nuts, and fatty fish) helps reduce inflammation in the body.
     
     

     The Science Behind the Mediterranean Diet

     The Mediterranean diet isn’t just popular because it sounds good—it’s backed by science. Multiple studies have shown its effectiveness in:

     • Lowering Cholesterol
     • The diet’s high intake of heart-healthy fats like olive oil and fatty fish helps reduce LDL (bad) cholesterol while increasing HDL (good) cholesterol. This supports better heart health and lowers the risk of heart disease.
     • Preventing Cognitive Decline
     • Research has shown that the Mediterranean diet may help protect against Alzheimer’s disease and other forms of cognitive decline by promoting brain health with its antioxidants and healthy fats.
     • Maintaining a Healthy Weight
     • While the Mediterranean diet isn’t necessarily a “weight loss diet,” it encourages eating nutrient-dense foods that keep you feeling fuller for longer. This can help prevent overeating and support long-term weight maintenance.
     
     

     How to Follow the Mediterranean Diet

     It’s easy to get started with the Mediterranean diet. Here’s how you can structure your meals:

     • Fruits and Vegetables: Aim for at least 9 ounces (250 grams) of vegetables and 2 servings of fruit per day. Vegetables should be the focus of your meals, while fruits can be enjoyed as snacks or desserts.
     • Whole Grains: Consume 9 ounces (250 grams) of whole grains daily. Choose options like brown rice, quinoa, and whole wheat bread for fiber and energy.
     • Legumes: Incorporate at least 2 ounces (56 grams) of beans, lentils, or chickpeas into your meals every day. These are a great source of plant-based protein and fiber.
     • Healthy Fats: Use olive oil as your primary fat source—about 2 to 4 tablespoons per day. Also, aim for two servings of fatty fish per week, like salmon or sardines.
     • Dairy: Dairy is allowed but should be moderate. Stick to low-fat options like Greek yogurt and cheese, and limit portion sizes.
     • Alcohol: If you drink alcohol, limit it to one 5-ounce pour of red wine per day, preferably with meals. Excessive alcohol consumption is discouraged in the Mediterranean diet.
     
     

     Why the Carnivore Diet Isn’t Recommended

     While the Mediterranean diet is all about variety and balance,unlike the Carnivore Diet.  The Carnivore diet focuses on eliminating most food groups entirely—specifically plant-based foods. The Carnivore Diet is an extreme approach that promotes only animal products, which means no fruits, vegetables, grains, or legumes.

     Despite its growing popularity, the Carnivore Diet is not recommended for long-term health. Here's why:

     • Lacks Nutrients
     • The Carnivore Diet lacks many essential nutrients found in fruits, vegetables, and grains, including fiber, vitamins, and minerals. Over time, this can lead to deficiencies and negatively impact your health.
     • Increases Risk of Chronic Diseases
     • Diets high in red and processed meats are linked to an increased risk of heart disease, cancer, and diabetes. The Carnivore Diet’s heavy reliance on meat and fat can lead to elevated cholesterol and higher inflammation levels in the body.
     • Not Sustainable
     • The Carnivore Diet is extremely restrictive and difficult to follow long-term. Most people don’t want to give up entire food groups, especially ones that offer important health benefits.
     
     

     The Carnivore Diet is a fad diet at best. It’s not based on science and doesn’t provide a balanced approach to long-term health. For a diet that’s sustainable, nutritious, and scientifically backed, stick to the Mediterranean diet.

     
     

     Myths About the Mediterranean Diet

      

     Myth: The Mediterranean Diet is Just About Olive Oil and Fish

     • Olive oil and fish are key components, but the Mediterranean diet is much more. It’s about eating more fruits, vegetables, legumes, and whole grains. These foods provide the bulk of your daily nutrition.
     • Myth: It’s Too Expensive
     • Do you think Mediterranean-style means spending a fortune? Some ingredients like olive oil and fatty fish can be expensive, you don’t need to break the bank. Buy seasonal, local produce and canned legumes to keep costs low.
     • Myth: Mediterranean Cuisine is Only for Mediterranean Countries
     • You don’t need to live in the Mediterranean to follow this diet! Adapt Mediterranean principles to any cuisine. Make a fish taco made with whole grain tortillas, grilled fish, and fruit salsa and you have a  Mediterranean-inspired meal. Even Indian cuisine can be adapted to the Mediterranean diet with dishes like Chana Masala made with chickpeas, spices, and whole wheat roti.
     
     

     Conclusion: Why Choose the Mediterranean Diet?

     The Mediterranean diet continues to be the best choice for 2025 and beyond. Its benefits for heart health, weight management, and disease prevention are backed by science, and its flexibility makes it easy to follow long-term. Plus, it’s not about eliminating food groups—it’s about making healthy, sustainable food choices that nourish your body.

     So, if you’re looking to improve your health and eat a balanced, flavorful diet, the Mediterranean diet is the way to go. It’s not just a trend—it’s a lifestyle that’s proven to work.

     ]]>8c20d579-e7c2-4301-9eb2-baebd094286bWed, 15 Jan 2025 00:00:00 -070013:20falsefull6464Bird Flu: Risks, Realities, ReadinessBird Flu: What You Need to Know About Risks, Realities, and Readiness

     Bird flu, or highly pathogenic avian influenza (HPAI), has far-reaching effects on public health, the food supply, and even the global economy. While human-to-human transmission hasn’t occurred, its potential to mutate poses significant concerns. Understanding how bird flu impacts us today — and how science is working to mitigate its risks — is essential.

     In this blog post, we’ll explore the realities of bird flu, its effects on food prices, the role of vaccines, and practical tips to stay safe. Let’s break it down into manageable pieces so you’re fully informed.

     What Is Bird Flu, and Why Should You Care?

     Bird flu primarily affects birds, especially poultry, like chickens and turkeys. However, certain strains, such as H5N1, have occasionally infected humans. While these cases are rare, they carry a high mortality rate of over 50%, making the virus particularly dangerous if contracted.

     Why Human-to-Human Transmission Matters

     Here’s the good news: Bird flu isn’t currently spreading from person to person. The bad news? Experts worry about a process called reassortment, where bird flu and human flu viruses could mix in someone infected with both. This could result in a highly contagious and deadly strain capable of causing a pandemic.

     Despite some conspiracy theories, no laboratory is working on gain-of-function research to make bird flu more transmissible. These myths are counterproductive, distracting from real medical efforts to monitor and control the virus.

     
     

     Rising Prices: How Bird Flu Impacts Your Wallet

     If you’ve noticed higher prices at the grocery store, bird flu is partly to blame. The virus has disrupted the poultry industry and the broader food supply chain.

     Egg Prices Soar

     When bird flu outbreaks occur, millions of chickens are culled to prevent the virus from spreading. This reduction in supply causes egg prices to skyrocket, leaving many of us paying more for our morning omelets.

     Dairy Costs Climb

     Bird flu also affects dairy products. The demand for poultry feed drives up costs for dairy farmers, who often rely on the same feed. Additionally, in rare cases, parts of the bird flu virus have been detected in raw milk. This is yet another reason to avoid raw, unpasteurized milk and stick to pasteurized dairy products for safety.

     
     

     The Role of Vaccines: Science in Action

     Vaccines are at the heart of our response to bird flu, but they serve different purposes for birds and humans.

     Vaccines for Poultry

     Scientists are developing vaccines for poultry to control the virus in bird populations. These vaccines could:

     • Reduce the need for mass culling.
     • Lower the economic impact on the poultry industry.
     • Decrease the risk of the virus spilling over into humans or other animals.
     
     

     While these efforts are promising, it will take time before poultry vaccines are widely implemented.

     Vaccines for Humans

     For humans, H5N1 vaccines are available for at-risk workers like poultry farmers and wildlife handlers. However:

     • These vaccines are strain-specific and may not protect against a mutated strain.
     • They are not available to the general public.
     • In the event of a pandemic, new vaccines would need to be developed, which takes time.
     
     

     Seasonal Flu Vaccines: Why They Still Matter

     You might wonder, “If the flu shot doesn’t protect against bird flu, why get it?” The answer lies in preventing co-infections.

     When someone is sick with both seasonal flu and bird flu, there’s a risk the two viruses could mix, creating a new, more dangerous strain. By getting your flu shot, you reduce your chances of catching seasonal flu, which helps minimize this risk. Remember, vaccines are not about completely preventing illness; they’re about reducing severe outcomes like hospitalization and death.

     
     

     Practical Tips: How to Stay Safe

     Whether you’re a hunter, backyard birder, or just someone who loves eggs, here’s how to reduce your risk:

     For Hunters

     • Avoid handling sick or dead birds. Report them to local authorities.
     • Use gloves and masks when field dressing game, and disinfect tools afterward.
     • Cook wild birds to an internal temperature of 165°F (73.8°C) to kill viruses.
     
     

     For Backyard Bird Feeders

     • Clean bird feeders and baths regularly with soap and disinfectant.
     • Avoid contact with bird droppings; wear gloves during cleaning.
     • Keep pets, especially cats, away from areas frequented by wild birds.
     
     

     For Pet Owners

     Cats are surprisingly vulnerable to bird flu. They can contract the virus by hunting infected birds or contacting bird droppings. To protect your pets:

     • Keep cats indoors during outbreaks.
     • Monitor them for symptoms like lethargy or respiratory distress.
     • Consult a vet if your cat shows any signs of illness.
     
     

     General Food Safety

     • Always cook poultry and eggs thoroughly to an internal temperature of 165°F (73.8°C).
     • Avoid raw, unpasteurized milk and stick to pasteurized dairy products.
     • Wash your hands thoroughly after handling birds or poultry products.
     
     

     Science Evolves: Trust the Process

     In science, recommendations change as we learn more. This isn’t a sign of uncertainty but a testament to how science adapts to new evidence. The same applies to vaccines — their primary purpose is to prevent severe illness and death, not to guarantee you won’t get sick. Trust in the scientific process is vital as we navigate complex challenges like bird flu.

     
     

     Stay Updated

     Bird flu isn’t just a health issue; it’s a food and economic issue, too. The virus has already disrupted poultry and dairy markets, and its potential to mutate keeps public health experts on high alert. Fortunately, science is actively working on solutions, from vaccines to monitoring programs.

     For regular updates on bird flu, follow me on TikTok and Instagram at @drterrysimpson, where I share timely insights and tips. And don’t forget to subscribe to my podcast, Fork U, for in-depth discussions about science, health, and smart eating.

     
     

     Final Thoughts

     Bird flu poses significant challenges, but by staying informed and following practical steps, we can protect ourselves and our communities. Whether it’s understanding vaccine roles, debunking myths, or adapting to rising food prices, knowledge is the first line of defense.

     Thank you for reading! Stay safe, stay informed, and remember that prevention is the best recipe for a healthy life.

     ]]>Bird Flu: What You Need to Know About Risks, Realities, and Readiness

     Bird flu, or highly pathogenic avian influenza (HPAI), has far-reaching effects on public health, the food supply, and even the global economy. While human-to-human transmission hasn’t occurred, its potential to mutate poses significant concerns. Understanding how bird flu impacts us today — and how science is working to mitigate its risks — is essential.

     In this blog post, we’ll explore the realities of bird flu, its effects on food prices, the role of vaccines, and practical tips to stay safe. Let’s break it down into manageable pieces so you’re fully informed.

     What Is Bird Flu, and Why Should You Care?

     Bird flu primarily affects birds, especially poultry, like chickens and turkeys. However, certain strains, such as H5N1, have occasionally infected humans. While these cases are rare, they carry a high mortality rate of over 50%, making the virus particularly dangerous if contracted.

     Why Human-to-Human Transmission Matters

     Here’s the good news: Bird flu isn’t currently spreading from person to person. The bad news? Experts worry about a process called reassortment, where bird flu and human flu viruses could mix in someone infected with both. This could result in a highly contagious and deadly strain capable of causing a pandemic.

     Despite some conspiracy theories, no laboratory is working on gain-of-function research to make bird flu more transmissible. These myths are counterproductive, distracting from real medical efforts to monitor and control the virus.

     
     

     Rising Prices: How Bird Flu Impacts Your Wallet

     If you’ve noticed higher prices at the grocery store, bird flu is partly to blame. The virus has disrupted the poultry industry and the broader food supply chain.

     Egg Prices Soar

     When bird flu outbreaks occur, millions of chickens are culled to prevent the virus from spreading. This reduction in supply causes egg prices to skyrocket, leaving many of us paying more for our morning omelets.

     Dairy Costs Climb

     Bird flu also affects dairy products. The demand for poultry feed drives up costs for dairy farmers, who often rely on the same feed. Additionally, in rare cases, parts of the bird flu virus have been detected in raw milk. This is yet another reason to avoid raw, unpasteurized milk and stick to pasteurized dairy products for safety.

     
     

     The Role of Vaccines: Science in Action

     Vaccines are at the heart of our response to bird flu, but they serve different purposes for birds and humans.

     Vaccines for Poultry

     Scientists are developing vaccines for poultry to control the virus in bird populations. These vaccines could:

     • Reduce the need for mass culling.
     • Lower the economic impact on the poultry industry.
     • Decrease the risk of the virus spilling over into humans or other animals.
     
     

     While these efforts are promising, it will take time before poultry vaccines are widely implemented.

     Vaccines for Humans

     For humans, H5N1 vaccines are available for at-risk workers like poultry farmers and wildlife handlers. However:

     • These vaccines are strain-specific and may not protect against a mutated strain.
     • They are not available to the general public.
     • In the event of a pandemic, new vaccines would need to be developed, which takes time.
     
     

     Seasonal Flu Vaccines: Why They Still Matter

     You might wonder, “If the flu shot doesn’t protect against bird flu, why get it?” The answer lies in preventing co-infections.

     When someone is sick with both seasonal flu and bird flu, there’s a risk the two viruses could mix, creating a new, more dangerous strain. By getting your flu shot, you reduce your chances of catching seasonal flu, which helps minimize this risk. Remember, vaccines are not about completely preventing illness; they’re about reducing severe outcomes like hospitalization and death.

     
     

     Practical Tips: How to Stay Safe

     Whether you’re a hunter, backyard birder, or just someone who loves eggs, here’s how to reduce your risk:

     For Hunters

     • Avoid handling sick or dead birds. Report them to local authorities.
     • Use gloves and masks when field dressing game, and disinfect tools afterward.
     • Cook wild birds to an internal temperature of 165°F (73.8°C) to kill viruses.
     
     

     For Backyard Bird Feeders

     • Clean bird feeders and baths regularly with soap and disinfectant.
     • Avoid contact with bird droppings; wear gloves during cleaning.
     • Keep pets, especially cats, away from areas frequented by wild birds.
     
     

     For Pet Owners

     Cats are surprisingly vulnerable to bird flu. They can contract the virus by hunting infected birds or contacting bird droppings. To protect your pets:

     • Keep cats indoors during outbreaks.
     • Monitor them for symptoms like lethargy or respiratory distress.
     • Consult a vet if your cat shows any signs of illness.
     
     

     General Food Safety

     • Always cook poultry and eggs thoroughly to an internal temperature of 165°F (73.8°C).
     • Avoid raw, unpasteurized milk and stick to pasteurized dairy products.
     • Wash your hands thoroughly after handling birds or poultry products.
     
     

     Science Evolves: Trust the Process

     In science, recommendations change as we learn more. This isn’t a sign of uncertainty but a testament to how science adapts to new evidence. The same applies to vaccines — their primary purpose is to prevent severe illness and death, not to guarantee you won’t get sick. Trust in the scientific process is vital as we navigate complex challenges like bird flu.

     
     

     Stay Updated

     Bird flu isn’t just a health issue; it’s a food and economic issue, too. The virus has already disrupted poultry and dairy markets, and its potential to mutate keeps public health experts on high alert. Fortunately, science is actively working on solutions, from vaccines to monitoring programs.

     For regular updates on bird flu, follow me on TikTok and Instagram at @drterrysimpson, where I share timely insights and tips. And don’t forget to subscribe to my podcast, Fork U, for in-depth discussions about science, health, and smart eating.

     
     

     Final Thoughts

     Bird flu poses significant challenges, but by staying informed and following practical steps, we can protect ourselves and our communities. Whether it’s understanding vaccine roles, debunking myths, or adapting to rising food prices, knowledge is the first line of defense.

     Thank you for reading! Stay safe, stay informed, and remember that prevention is the best recipe for a healthy life.

     ]]>ea1c2755-58b5-4fc7-aa6a-cda0a7d1fb3aWed, 08 Jan 2025 00:00:00 -070011:45falsefull6363GLP-1 Guide to Healthy Habits and SuccessNavigating GLP-1 Medications and Building a Healthier You: A Fork U Guide

     Introduction: The Revolution Starts Here

     Welcome to Fork University, where science meets sarcasm, and healthy eating gets a reality check. Today, we’re diving into the world of GLP-1 medications, like Ozempic and Zepbound—those little injections making waves in the weight loss and metabolic health scene. Spoiler alert: Even if needles aren’t your thing, this advice is gold for anyone looking to improve their relationship with food (yes, even you, cereal-at-midnight enthusiasts). So, grab a cup of tea (ginger if you’re nauseous), and let’s get started.

     
     

     Breaking Free from Diet Culture: Goodbye, Guilt

     Ah, diet culture. That pesky little voice whispering, “Carbs are evil,” or “You’re only worthy if you can squeeze into those jeans from 2012.” Here’s the deal: Diet culture sucks, and it’s time to boot it out of your life. Here’s how:

     1. Focus on Health Over Appearance
     2. “Strong, not skinny” isn’t just a gym bro mantra. Celebrate wins like better blood sugar control or climbing stairs without feeling like you ran a marathon.
     3. Neutralize Food Labels
     4. No food is inherently “good” or “bad.” (Except maybe that mysterious gas station sushi. Proceed with caution.) All foods can fit into a balanced diet—just maybe not all at once.
     5. Ditch Unrealistic Media
     6. Swap those Instagram influencers with body-positive accounts. Life is too short for filter-fueled comparisons.
     
     

     Taming Side Effects: Fiber, Hydration, and the Art of Not Overeating

     GLP-1 medications are game-changers, but they come with their quirks. Here’s how to navigate the rocky road of side effects:

     Constipation: The Fiber Fix

     Fun fact: Only 10% of Americans eat enough fiber. No wonder our colons are grumpy. Fix that with:

     • Whole Grains: Brown rice, quinoa, oats—because white bread is so 1990.
     • Legumes: Beans, chickpeas, lentils—fiber heroes and fart-inducing legends.
     • Supplements: Citrucel or Metamucil work in a pinch, but food first!
     
     

     Hydration: Sugar-Free Isn’t Always Your Friend

     Not all hydration packets are created equal. Skip the sugar-free gimmicks and opt for options like Pedialyte. Bonus points if you grab the popsicles—because who doesn’t love reliving childhood?

     Nausea: Avoid the Grease Trap

     High-fat foods + GLP-1 = a stomach rebellion. Swap fried chicken for grilled and save yourself the bloat. Greek yogurt and peppermint tea are your new besties.

     
     

     Building Healthy Habits: Small Steps, Big Wins

     Forget the “eat less, move more” mantra. Here’s what actually works:

     1. Mindful Portions
     2. At restaurants, box up half your meal right away. Or embrace the kids’ menu—yes, you might even score a toy.
     3. Protein with Purpose
     4. Greek yogurt, beans, and protein shakes are your go-tos. But don’t let diet culture trick you into thinking protein is the only macronutrient that matters.
     5. Celebrate Non-Scale Victories
     6. Fitting into old jeans? Amazing. Cooking a new recipe? Even better. Toss the scale if it’s ruining your day—you’re more than a number.
     
     

     Long-Term Success: Sustainable, Not Perfect

     GLP-1 medications are tools, not magic wands. They’re here to help you build a healthier relationship with food, not to police your every bite. Remember:

     • Moderation Wins: That scoop of ice cream isn’t your downfall. Balance it out with nutrient-rich meals.
     • Be Patient: Rapid initial weight loss (thanks, glycogen, and water) will slow, but consistency pays off. A pound a week equals 52 pounds a year. Do the math and cheer yourself on.
     
     

     Conclusion: Fork U’s Final Wisdom

     GLP-1 medications are here to support you, not define you. Focus on health, ditch the guilt, and enjoy the journey. And don’t forget: Consult a real, western-trained physician and a dietitian. Chiropractors and green juice influencers don’t count. Ok, I sometimes drink some green juice.

     ]]>Navigating GLP-1 Medications and Building a Healthier You: A Fork U Guide

     Introduction: The Revolution Starts Here

     Welcome to Fork University, where science meets sarcasm, and healthy eating gets a reality check. Today, we’re diving into the world of GLP-1 medications, like Ozempic and Zepbound—those little injections making waves in the weight loss and metabolic health scene. Spoiler alert: Even if needles aren’t your thing, this advice is gold for anyone looking to improve their relationship with food (yes, even you, cereal-at-midnight enthusiasts). So, grab a cup of tea (ginger if you’re nauseous), and let’s get started.

     
     

     Breaking Free from Diet Culture: Goodbye, Guilt

     Ah, diet culture. That pesky little voice whispering, “Carbs are evil,” or “You’re only worthy if you can squeeze into those jeans from 2012.” Here’s the deal: Diet culture sucks, and it’s time to boot it out of your life. Here’s how:

     1. Focus on Health Over Appearance
     2. “Strong, not skinny” isn’t just a gym bro mantra. Celebrate wins like better blood sugar control or climbing stairs without feeling like you ran a marathon.
     3. Neutralize Food Labels
     4. No food is inherently “good” or “bad.” (Except maybe that mysterious gas station sushi. Proceed with caution.) All foods can fit into a balanced diet—just maybe not all at once.
     5. Ditch Unrealistic Media
     6. Swap those Instagram influencers with body-positive accounts. Life is too short for filter-fueled comparisons.
     
     

     Taming Side Effects: Fiber, Hydration, and the Art of Not Overeating

     GLP-1 medications are game-changers, but they come with their quirks. Here’s how to navigate the rocky road of side effects:

     Constipation: The Fiber Fix

     Fun fact: Only 10% of Americans eat enough fiber. No wonder our colons are grumpy. Fix that with:

     • Whole Grains: Brown rice, quinoa, oats—because white bread is so 1990.
     • Legumes: Beans, chickpeas, lentils—fiber heroes and fart-inducing legends.
     • Supplements: Citrucel or Metamucil work in a pinch, but food first!
     
     

     Hydration: Sugar-Free Isn’t Always Your Friend

     Not all hydration packets are created equal. Skip the sugar-free gimmicks and opt for options like Pedialyte. Bonus points if you grab the popsicles—because who doesn’t love reliving childhood?

     Nausea: Avoid the Grease Trap

     High-fat foods + GLP-1 = a stomach rebellion. Swap fried chicken for grilled and save yourself the bloat. Greek yogurt and peppermint tea are your new besties.

     
     

     Building Healthy Habits: Small Steps, Big Wins

     Forget the “eat less, move more” mantra. Here’s what actually works:

     1. Mindful Portions
     2. At restaurants, box up half your meal right away. Or embrace the kids’ menu—yes, you might even score a toy.
     3. Protein with Purpose
     4. Greek yogurt, beans, and protein shakes are your go-tos. But don’t let diet culture trick you into thinking protein is the only macronutrient that matters.
     5. Celebrate Non-Scale Victories
     6. Fitting into old jeans? Amazing. Cooking a new recipe? Even better. Toss the scale if it’s ruining your day—you’re more than a number.
     
     

     Long-Term Success: Sustainable, Not Perfect

     GLP-1 medications are tools, not magic wands. They’re here to help you build a healthier relationship with food, not to police your every bite. Remember:

     • Moderation Wins: That scoop of ice cream isn’t your downfall. Balance it out with nutrient-rich meals.
     • Be Patient: Rapid initial weight loss (thanks, glycogen, and water) will slow, but consistency pays off. A pound a week equals 52 pounds a year. Do the math and cheer yourself on.
     
     

     Conclusion: Fork U’s Final Wisdom

     GLP-1 medications are here to support you, not define you. Focus on health, ditch the guilt, and enjoy the journey. And don’t forget: Consult a real, western-trained physician and a dietitian. Chiropractors and green juice influencers don’t count. Ok, I sometimes drink some green juice.

     ]]>ec911352-c4c0-4135-8160-b82301d65550Wed, 01 Jan 2025 15:00:00 -070020:22falsefull6262GLP-1: Eating for Long-term HealthBeyond the Scale: Eating for Long-Term Health, Not Just Weight Loss

     Weight loss is often the first thing people think about when starting GLP-1 medications like semaglutide or liraglutide. These medications are powerful tools for helping manage appetite and regulate the body’s hunger hormones. But here's the real truth: losing weight is just one part of the story. To truly thrive, you need to focus on eating in a way that nourishes your body, supports your health, and promotes long-term well-being.

     Think of it this way: GLP-1 medications do the heavy lifting when it comes to managing hunger and cravings. Your job is to provide the right fuel for the machine. You’re not eating to lose even more weight—you’re eating to support your body so it runs like a high-performance car.

     GLP-1 Medications Take the Lead; Your Diet Supports the Process

     When you’re on GLP-1 medications, weight loss isn’t a result of extreme dieting or restrictive food rules. These medications work by regulating your appetite, making it easier to avoid overeating and stick to reasonable portions. They help your biology work with you instead of against you.

     So, if the medication is doing most of the work, why does your diet matter? It’s simple: food is what keeps your body functioning at its best. While GLP-1 helps control hunger, what you eat still determines your energy levels, heart health, mental clarity, and long-term disease risk.

     Instead of focusing on cutting calories, the goal should be to pack every meal with nutrients that fuel your body and help it recover from the years of stress and inflammation caused by poor eating habits. This isn’t about restriction—it’s about nourishment.

     The Mediterranean Diet: A Gold Standard for Health

     When it comes to eating for long-term health, the Mediterranean diet is one of the best approaches. It’s not a restrictive diet where you count every calorie or ban entire food groups. Instead, it’s a way of life, focusing on fresh, whole foods that nourish your body and taste great.

     Why the Mediterranean Diet Works

     The Mediterranean diet emphasizes vegetables, fruits, whole grains, healthy fats like olive oil, lean proteins, and a little bit of red wine. Yes, wine! Studies have consistently shown that people who follow this diet reduce their risk of heart disease, diabetes, and even cognitive decline (Estruch et al., 2013; Singh et al., 2022).

     What makes this diet so effective? It’s packed with anti-inflammatory foods that stabilize blood sugar, protect your heart, and even support a healthy gut. A healthy gut, in turn, improves everything from digestion to mental health. Plus, the Mediterranean diet is enjoyable and sustainable—no weird powders, no flavorless meals, just real food.

     The Science Behind Olive Oil and Omega-3s

     Olive oil is the cornerstone of the Mediterranean diet. This liquid gold is rich in healthy monounsaturated fats and compounds that act like natural anti-inflammatories, similar to ibuprofen (reference here). Add in fish like salmon and sardines, which are full of omega-3 fatty acids, and you’ve got a winning combination for your heart and brain.

     Don’t Get Stuck on Protein

     Protein is important, especially for preserving muscle mass while losing weight. But many people fall into the trap of making protein the center of every meal, ignoring the other nutrients their body needs. Loading up on chicken breasts and protein shakes might seem like a good idea, but it leaves little room for the variety that keeps your meals balanced.

     Here’s the good news: with a Mediterranean-style diet, you can get plenty of protein from diverse sources. Legumes like lentils and chickpeas are not only high in protein but also rich in fiber, which helps with digestion and keeps you full longer. Fish, especially fatty fish like salmon or mackerel, provides protein alongside heart-healthy omega-3s. Even red meat is allowed—just keep it to about 4 ounces a day, roughly the size of a deck of cards.

     The key is to think beyond animal proteins. A balanced plate includes plenty of plant-based options, ensuring you get a variety of vitamins, minerals, and antioxidants. This diversity supports your overall health and keeps your meals exciting.

     DASH Diet: A Sensible Partner for GLP-1

     If the Mediterranean diet feels too free-spirited for you, consider the DASH diet (Dietary Approaches to Stop Hypertension). DASH emphasizes fruits, vegetables, whole grains, and lean proteins while keeping sodium intake low. It’s designed to lower blood pressure, but it also reduces the risk of heart disease and supports weight loss. (reference click here)

     Like the Mediterranean diet, DASH isn’t about counting calories or cutting out entire food groups. It focuses on nutrient-dense, whole foods that fuel your body. For people on GLP-1 medications, DASH is an excellent choice because it reduces the risks associated with metabolic conditions like high blood pressure and insulin resistance.

     Longevity and the Blue Zones Diet

     Weight loss might be your current goal, but the long-term focus should be on living a healthier, longer life. That’s where the Blue Zones come in—regions of the world where people live to 100 and beyond. Their secret isn’t just genetics; it’s their diet and lifestyle.

     Blue Zone diets are plant-forward, filled with vegetables, legumes, whole grains, and healthy fats. Meals are simple, minimally processed, and often enjoyed with family and friends. These communities teach us that eating well isn’t about obsessing over macronutrients—it’s about creating habits that support your body over a lifetime.

     In Okinawa, Japan, for example, people eat a diet rich in sweet potatoes, tofu, and seaweed, and they follow the principle of hara hachi bu, or stopping when they’re 80% full. This practice prevents overeating and ensures they maintain a healthy weight without ever going hungry. Reference click here

     Putting It All Together: Practical Tips

     If you’re on GLP-1 medications and want to focus on long-term health, here are some tips to get you started:

     • Make Vegetables the Star: Fill at least half your plate with colorful veggies. They’re packed with nutrients and low in calories.
     • Choose Whole Grains: Swap out refined carbs like white bread and pasta for quinoa, brown rice, or whole-grain options.
     • Enjoy Healthy Fats: Use olive oil liberally, snack on nuts, and add avocado to your meals. These fats are essential for brain and heart health.
     • Diversify Your Protein: Include a mix of lean meats, fish, legumes, and nuts. Aim for variety rather than relying on one source
     • Focus on Balance, Not Perfection: Follow the 80/20 rule—eat well most of the time, but don’t sweat the occasional treat. A slice of pizza or scoop of gelato won’t derail your progress.
     • The Big Picture: Nourish, Don’t Restrict
     • GLP-1 medications make it easier to manage your weight, but the real magic happens when you pair them with a diet that supports your health. The focus isn’t on eating less—it’s on eating smarter. By following a Mediterranean or DASH-style diet, you can give your body the nutrients it needs to thrive while enjoying food that tastes amazing.
     
     

     Remember, this isn’t just about what the scale says. It’s about feeling energized, reducing your risk of chronic diseases, and setting yourself up for a healthier future. So, grab a plate of roasted veggies, drizzle on some olive oil, and toast to your long-term health. Your body will thank you for it.

     Citations:

     Gantenbein KV, Kanaka-Gantenbein C. Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing. Nutrients. 2021 Jun 6;13(6):1951. doi: 10.3390/nu13061951. PMID: 34204057; PMCID: PMC8227318.

     Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, Chrysochoou CA, Nihoyannopoulos PI, Tousoulis DM. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020 Sep 1;11(5):1150-1160. doi: 10.1093/advances/nmaa041. PMID: 32330233; PMCID: PMC7490167.

     Santacroce L, Bottalico L, Charitos IA, Haxhirexha K, Topi S, Jirillo E. Healthy Diets and Lifestyles in the World: Mediterranean and Blue Zone People Live Longer. Special Focus on Gut Microbiota and Some Food Components. Endocr Metab Immune Disord Drug Targets. 2024;24(15):1774-1784. doi: 10.2174/0118715303271634240319054728. PMID: 38566378.

     Grosso G, Laudisio D, Frias-Toral E, Barrea L, Muscogiuri G, Savastano S, Colao A. Anti-Inflammatory Nutrients and Obesity-Associated Metabolic-Inflammation: State of the Art and Future Direction. Nutrients. 2022 Mar 8;14(6):1137. doi: 10.3390/nu14061137. PMID: 35334794; PMCID: PMC8954840.

     Singh, B., et al. (2022). "Mediterranean Diet and Cognitive Function: A Systematic Review." Nutritional Neuroscience.

     ]]>Beyond the Scale: Eating for Long-Term Health, Not Just Weight Loss

     Weight loss is often the first thing people think about when starting GLP-1 medications like semaglutide or liraglutide. These medications are powerful tools for helping manage appetite and regulate the body’s hunger hormones. But here's the real truth: losing weight is just one part of the story. To truly thrive, you need to focus on eating in a way that nourishes your body, supports your health, and promotes long-term well-being.

     Think of it this way: GLP-1 medications do the heavy lifting when it comes to managing hunger and cravings. Your job is to provide the right fuel for the machine. You’re not eating to lose even more weight—you’re eating to support your body so it runs like a high-performance car.

     GLP-1 Medications Take the Lead; Your Diet Supports the Process

     When you’re on GLP-1 medications, weight loss isn’t a result of extreme dieting or restrictive food rules. These medications work by regulating your appetite, making it easier to avoid overeating and stick to reasonable portions. They help your biology work with you instead of against you.

     So, if the medication is doing most of the work, why does your diet matter? It’s simple: food is what keeps your body functioning at its best. While GLP-1 helps control hunger, what you eat still determines your energy levels, heart health, mental clarity, and long-term disease risk.

     Instead of focusing on cutting calories, the goal should be to pack every meal with nutrients that fuel your body and help it recover from the years of stress and inflammation caused by poor eating habits. This isn’t about restriction—it’s about nourishment.

     The Mediterranean Diet: A Gold Standard for Health

     When it comes to eating for long-term health, the Mediterranean diet is one of the best approaches. It’s not a restrictive diet where you count every calorie or ban entire food groups. Instead, it’s a way of life, focusing on fresh, whole foods that nourish your body and taste great.

     Why the Mediterranean Diet Works

     The Mediterranean diet emphasizes vegetables, fruits, whole grains, healthy fats like olive oil, lean proteins, and a little bit of red wine. Yes, wine! Studies have consistently shown that people who follow this diet reduce their risk of heart disease, diabetes, and even cognitive decline (Estruch et al., 2013; Singh et al., 2022).

     What makes this diet so effective? It’s packed with anti-inflammatory foods that stabilize blood sugar, protect your heart, and even support a healthy gut. A healthy gut, in turn, improves everything from digestion to mental health. Plus, the Mediterranean diet is enjoyable and sustainable—no weird powders, no flavorless meals, just real food.

     The Science Behind Olive Oil and Omega-3s

     Olive oil is the cornerstone of the Mediterranean diet. This liquid gold is rich in healthy monounsaturated fats and compounds that act like natural anti-inflammatories, similar to ibuprofen (reference here). Add in fish like salmon and sardines, which are full of omega-3 fatty acids, and you’ve got a winning combination for your heart and brain.

     Don’t Get Stuck on Protein

     Protein is important, especially for preserving muscle mass while losing weight. But many people fall into the trap of making protein the center of every meal, ignoring the other nutrients their body needs. Loading up on chicken breasts and protein shakes might seem like a good idea, but it leaves little room for the variety that keeps your meals balanced.

     Here’s the good news: with a Mediterranean-style diet, you can get plenty of protein from diverse sources. Legumes like lentils and chickpeas are not only high in protein but also rich in fiber, which helps with digestion and keeps you full longer. Fish, especially fatty fish like salmon or mackerel, provides protein alongside heart-healthy omega-3s. Even red meat is allowed—just keep it to about 4 ounces a day, roughly the size of a deck of cards.

     The key is to think beyond animal proteins. A balanced plate includes plenty of plant-based options, ensuring you get a variety of vitamins, minerals, and antioxidants. This diversity supports your overall health and keeps your meals exciting.

     DASH Diet: A Sensible Partner for GLP-1

     If the Mediterranean diet feels too free-spirited for you, consider the DASH diet (Dietary Approaches to Stop Hypertension). DASH emphasizes fruits, vegetables, whole grains, and lean proteins while keeping sodium intake low. It’s designed to lower blood pressure, but it also reduces the risk of heart disease and supports weight loss. (reference click here)

     Like the Mediterranean diet, DASH isn’t about counting calories or cutting out entire food groups. It focuses on nutrient-dense, whole foods that fuel your body. For people on GLP-1 medications, DASH is an excellent choice because it reduces the risks associated with metabolic conditions like high blood pressure and insulin resistance.

     Longevity and the Blue Zones Diet

     Weight loss might be your current goal, but the long-term focus should be on living a healthier, longer life. That’s where the Blue Zones come in—regions of the world where people live to 100 and beyond. Their secret isn’t just genetics; it’s their diet and lifestyle.

     Blue Zone diets are plant-forward, filled with vegetables, legumes, whole grains, and healthy fats. Meals are simple, minimally processed, and often enjoyed with family and friends. These communities teach us that eating well isn’t about obsessing over macronutrients—it’s about creating habits that support your body over a lifetime.

     In Okinawa, Japan, for example, people eat a diet rich in sweet potatoes, tofu, and seaweed, and they follow the principle of hara hachi bu, or stopping when they’re 80% full. This practice prevents overeating and ensures they maintain a healthy weight without ever going hungry. Reference click here

     Putting It All Together: Practical Tips

     If you’re on GLP-1 medications and want to focus on long-term health, here are some tips to get you started:

     • Make Vegetables the Star: Fill at least half your plate with colorful veggies. They’re packed with nutrients and low in calories.
     • Choose Whole Grains: Swap out refined carbs like white bread and pasta for quinoa, brown rice, or whole-grain options.
     • Enjoy Healthy Fats: Use olive oil liberally, snack on nuts, and add avocado to your meals. These fats are essential for brain and heart health.
     • Diversify Your Protein: Include a mix of lean meats, fish, legumes, and nuts. Aim for variety rather than relying on one source
     • Focus on Balance, Not Perfection: Follow the 80/20 rule—eat well most of the time, but don’t sweat the occasional treat. A slice of pizza or scoop of gelato won’t derail your progress.
     • The Big Picture: Nourish, Don’t Restrict
     • GLP-1 medications make it easier to manage your weight, but the real magic happens when you pair them with a diet that supports your health. The focus isn’t on eating less—it’s on eating smarter. By following a Mediterranean or DASH-style diet, you can give your body the nutrients it needs to thrive while enjoying food that tastes amazing.
     
     

     Remember, this isn’t just about what the scale says. It’s about feeling energized, reducing your risk of chronic diseases, and setting yourself up for a healthier future. So, grab a plate of roasted veggies, drizzle on some olive oil, and toast to your long-term health. Your body will thank you for it.

     Citations:

     Gantenbein KV, Kanaka-Gantenbein C. Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing. Nutrients. 2021 Jun 6;13(6):1951. doi: 10.3390/nu13061951. PMID: 34204057; PMCID: PMC8227318.

     Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, Chrysochoou CA, Nihoyannopoulos PI, Tousoulis DM. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020 Sep 1;11(5):1150-1160. doi: 10.1093/advances/nmaa041. PMID: 32330233; PMCID: PMC7490167.

     Santacroce L, Bottalico L, Charitos IA, Haxhirexha K, Topi S, Jirillo E. Healthy Diets and Lifestyles in the World: Mediterranean and Blue Zone People Live Longer. Special Focus on Gut Microbiota and Some Food Components. Endocr Metab Immune Disord Drug Targets. 2024;24(15):1774-1784. doi: 10.2174/0118715303271634240319054728. PMID: 38566378.

     Grosso G, Laudisio D, Frias-Toral E, Barrea L, Muscogiuri G, Savastano S, Colao A. Anti-Inflammatory Nutrients and Obesity-Associated Metabolic-Inflammation: State of the Art and Future Direction. Nutrients. 2022 Mar 8;14(6):1137. doi: 10.3390/nu14061137. PMID: 35334794; PMCID: PMC8954840.

     Singh, B., et al. (2022). "Mediterranean Diet and Cognitive Function: A Systematic Review." Nutritional Neuroscience.

     ]]>1c37c678-6952-425d-964f-916572b7edaaFri, 20 Dec 2024 00:00:00 -070012:25falsefull6161Obesity is not about Forks and WillpowerObesity: Not Just About Forks and Willpower

     For years, obesity has been misunderstood, oversimplified, and even stigmatized. It's been framed as a personal failing, a lifestyle choice, or simply a matter of "eating less and moving more." But science tells a different, more nuanced story—one where our brains, biology, and ultra-processed food environment play starring roles. And thanks to groundbreaking medications like GLP-1 drugs, we’re gaining a clearer picture of how obesity works and how to treat it.

     Let’s dive into why obesity is a disease, how ultra-processed foods exacerbate it, and why we need to ditch the harmful myth that obesity is a lifestyle choice.

     The Myth of "Just Eat Less and Move More"

     "Just eat less and move more." It’s the phrase everyone loves to repeat—and no one finds helpful. This simplistic advice ignores the reality that obesity is not merely about calories in and calories out. It’s about a complex interplay between your biology, brain chemistry, and environment.

     Obesity isn’t a character flaw or a lack of willpower. If it were, we wouldn’t see an obesity epidemic in societies flooded with cheap, ultra-processed foods engineered to make us eat more. These foods hijack our biology, overpowering the mechanisms our bodies use to regulate hunger and fullness.

     The Hungry Brain: Why You Can’t Stop Eating

     Our brains evolved to keep us alive in times of scarcity. Back in the caveman days, this was helpful. Today, it’s less so because our brains are still wired to seek out high-calorie foods to avoid starvation—even when we’re surrounded by abundance.

     When you eat ultra-processed foods, they light up the reward centers in your brain like a Christmas tree. These foods—laden with sugar, fat, and salt—trigger the release of dopamine, the same neurotransmitter involved in addiction. It’s no wonder we keep going back for more.

     Adding to the complexity, hormones like ghrelin (the "hunger hormone") and leptin (the "fullness hormone") can go haywire in people with obesity. Ultra-processed foods amplify ghrelin’s effects, making you feel hungrier while reducing your sensitivity to leptin, so you never feel full. It’s a biological double whammy.

     Citation: Studies show that diets high in ultra-processed foods increase calorie consumption by about 500 calories per day compared to diets of unprocessed foods (Hall et al., 2019).

     GLP-1: The Game-Changing Hormone

     Here’s where things get interesting: GLP-1, or glucagon-like peptide-1, is a hormone that helps regulate appetite. It tells your brain, “You’re full; you can stop eating now.” But for many people with obesity, this system doesn’t work properly. Their brains don’t get the message, leading to overeating.

     Enter GLP-1 receptor agonists like semaglutide and liraglutide—medications that mimic the effects of GLP-1. These drugs help regulate appetite, making people feel full sooner and reducing cravings. The results have been extraordinary: clinical trials show average weight loss of 15% or more with these medications, far outpacing what’s possible with lifestyle changes alone.

     These drugs have done more than help people lose weight—they’ve also shifted the way we think about obesity. They show that obesity is a medical condition influenced by hormones and brain chemistry, not just a matter of willpower.

     Citation: Clinical trials on GLP-1 receptor agonists show significant and sustained weight loss, with participants losing 15% or more of their body weight (Wilding et al., 2021).

     Why Obesity Is a Disease, Not a Lifestyle Choice

     The idea that obesity is a "lifestyle choice" is not only incorrect—it’s harmful. Framing obesity this way ignores the biological, genetic, and environmental factors that contribute to it. Worse, it stigmatizes people with obesity, making them feel like they’re to blame for their condition.

     Obesity meets all the criteria for a chronic disease: it has a defined pathology (dysregulation of appetite and metabolism), it leads to complications (diabetes, heart disease, etc.), and it requires long-term management. Lifestyle factors like diet and exercise can influence obesity, but they’re not the sole cause. Blaming someone for their obesity is like blaming someone with asthma for living in a polluted city.

     Citation: The American Medical Association classified obesity as a chronic disease in 2013, recognizing it as a condition requiring medical treatment (AMA, 2013).

     Ultra-Processed Foods: The Real Culprit

     If obesity is a fire, ultra-processed foods are the gasoline. These foods are engineered for maximum palatability, combining sugar, fat, and salt in ways that overwhelm our natural appetite-regulation systems. They’re calorie-dense, nutrient-poor, and often stripped of fiber, which would otherwise help us feel full.

     Even worse, ultra-processed foods alter the way our brains respond to food. They increase cravings, reduce satiety, and encourage overeating. Over time, this can lead to weight gain and metabolic issues, creating a vicious cycle that’s hard to break.

     Citation: Research shows that people who consume diets high in ultra-processed foods are more likely to develop obesity and metabolic diseases (Monteiro et al., 2018).

     How GLP-1 Drugs Have Changed the Game

     GLP-1 drugs have given us new tools to treat obesity—and new insights into its underlying causes. They’ve proven that obesity isn’t just about behavior; it’s about biology. When you treat obesity like a disease rather than a moral failing, people get better.

     But these medications are just one piece of the puzzle. To tackle obesity on a larger scale, we need to address the broader food environment. That means making healthy, unprocessed foods more accessible, reducing the marketing of ultra-processed foods, and investing in public health initiatives that promote nutrition education.

     Why Fat Shaming Is Harmful (and Wrong)

     Let’s address the elephant in the room: fat shaming. The idea that you can "shame" someone into losing weight is not only cruel—it’s ineffective. Research shows that weight stigma leads to stress, low self-esteem, and even more weight gain. It’s a lose-lose situation.

     Instead of shaming people for their weight, we need to focus on creating supportive environments that help everyone make healthier choices. That includes treating obesity as the complex, multifactorial disease that it is—not a personal failure.

     Citation: Weight stigma is associated with increased psychological distress, unhealthy eating behaviors, and reduced motivation for physical activity (Puhl & Heuer, 2010).

     Moving Forward: What We Can Do

     Here’s how we can start to shift the conversation around obesity:

     Acknowledge Obesity as a Disease: Let’s treat obesity like any other chronic condition with empathy and evidence-based care.

     Focus on the Food Environment: We need to address the root causes of obesity, including the overabundance of ultra-processed foods.

     Reduce Stigma: Stop blaming individuals for their weight. Instead, offer support and solutions.

     Expand Access to GLP-1 Drugs: These medications are game-changers, but they’re expensive and not always covered by insurance. Making them accessible is crucial.

     Conclusion: It’s Time to Change the Narrative

     Obesity is not a lifestyle choice. It’s a complex, chronic disease driven by biology, brain chemistry, and the environment we live in. Thanks to advances in science, like GLP-1 drugs, we’re starting to understand and treat obesity in ways that are effective and compassionate.

     The next time someone tells you to “just eat less and move more,” remind them that obesity is about much more than that. It’s time to move past the myths, embrace the science, and support people on their journey to better health.

     And maybe, just maybe, it’s time to rethink that bag of chips.

     References

     Hall, K. D., et al. (2019). "Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain." Cell Metabolism.

     Wilding, J. P. H., et al. (2021). "Once-Weekly Semaglutide in Adults with Overweight or Obesity." The New England Journal of Medicine.

     Monteiro, C. A., et al. (2018). "Ultra-Processed Foods, Diet Quality, and Health Using the NOVA Classification System." Public Health Nutrition.

     Puhl, R., & Heuer, C. (2010). "Obesity Stigma: Important Considerations for Public Health." American Journal of Public Health.

     AMA (2013). "American Medical Association House of Delegates Resolution 420 (A-13)."

     ]]>Obesity: Not Just About Forks and Willpower

     For years, obesity has been misunderstood, oversimplified, and even stigmatized. It's been framed as a personal failing, a lifestyle choice, or simply a matter of "eating less and moving more." But science tells a different, more nuanced story—one where our brains, biology, and ultra-processed food environment play starring roles. And thanks to groundbreaking medications like GLP-1 drugs, we’re gaining a clearer picture of how obesity works and how to treat it.

     Let’s dive into why obesity is a disease, how ultra-processed foods exacerbate it, and why we need to ditch the harmful myth that obesity is a lifestyle choice.

     The Myth of "Just Eat Less and Move More"

     "Just eat less and move more." It’s the phrase everyone loves to repeat—and no one finds helpful. This simplistic advice ignores the reality that obesity is not merely about calories in and calories out. It’s about a complex interplay between your biology, brain chemistry, and environment.

     Obesity isn’t a character flaw or a lack of willpower. If it were, we wouldn’t see an obesity epidemic in societies flooded with cheap, ultra-processed foods engineered to make us eat more. These foods hijack our biology, overpowering the mechanisms our bodies use to regulate hunger and fullness.

     The Hungry Brain: Why You Can’t Stop Eating

     Our brains evolved to keep us alive in times of scarcity. Back in the caveman days, this was helpful. Today, it’s less so because our brains are still wired to seek out high-calorie foods to avoid starvation—even when we’re surrounded by abundance.

     When you eat ultra-processed foods, they light up the reward centers in your brain like a Christmas tree. These foods—laden with sugar, fat, and salt—trigger the release of dopamine, the same neurotransmitter involved in addiction. It’s no wonder we keep going back for more.

     Adding to the complexity, hormones like ghrelin (the "hunger hormone") and leptin (the "fullness hormone") can go haywire in people with obesity. Ultra-processed foods amplify ghrelin’s effects, making you feel hungrier while reducing your sensitivity to leptin, so you never feel full. It’s a biological double whammy.

     Citation: Studies show that diets high in ultra-processed foods increase calorie consumption by about 500 calories per day compared to diets of unprocessed foods (Hall et al., 2019).

     GLP-1: The Game-Changing Hormone

     Here’s where things get interesting: GLP-1, or glucagon-like peptide-1, is a hormone that helps regulate appetite. It tells your brain, “You’re full; you can stop eating now.” But for many people with obesity, this system doesn’t work properly. Their brains don’t get the message, leading to overeating.

     Enter GLP-1 receptor agonists like semaglutide and liraglutide—medications that mimic the effects of GLP-1. These drugs help regulate appetite, making people feel full sooner and reducing cravings. The results have been extraordinary: clinical trials show average weight loss of 15% or more with these medications, far outpacing what’s possible with lifestyle changes alone.

     These drugs have done more than help people lose weight—they’ve also shifted the way we think about obesity. They show that obesity is a medical condition influenced by hormones and brain chemistry, not just a matter of willpower.

     Citation: Clinical trials on GLP-1 receptor agonists show significant and sustained weight loss, with participants losing 15% or more of their body weight (Wilding et al., 2021).

     Why Obesity Is a Disease, Not a Lifestyle Choice

     The idea that obesity is a "lifestyle choice" is not only incorrect—it’s harmful. Framing obesity this way ignores the biological, genetic, and environmental factors that contribute to it. Worse, it stigmatizes people with obesity, making them feel like they’re to blame for their condition.

     Obesity meets all the criteria for a chronic disease: it has a defined pathology (dysregulation of appetite and metabolism), it leads to complications (diabetes, heart disease, etc.), and it requires long-term management. Lifestyle factors like diet and exercise can influence obesity, but they’re not the sole cause. Blaming someone for their obesity is like blaming someone with asthma for living in a polluted city.

     Citation: The American Medical Association classified obesity as a chronic disease in 2013, recognizing it as a condition requiring medical treatment (AMA, 2013).

     Ultra-Processed Foods: The Real Culprit

     If obesity is a fire, ultra-processed foods are the gasoline. These foods are engineered for maximum palatability, combining sugar, fat, and salt in ways that overwhelm our natural appetite-regulation systems. They’re calorie-dense, nutrient-poor, and often stripped of fiber, which would otherwise help us feel full.

     Even worse, ultra-processed foods alter the way our brains respond to food. They increase cravings, reduce satiety, and encourage overeating. Over time, this can lead to weight gain and metabolic issues, creating a vicious cycle that’s hard to break.

     Citation: Research shows that people who consume diets high in ultra-processed foods are more likely to develop obesity and metabolic diseases (Monteiro et al., 2018).

     How GLP-1 Drugs Have Changed the Game

     GLP-1 drugs have given us new tools to treat obesity—and new insights into its underlying causes. They’ve proven that obesity isn’t just about behavior; it’s about biology. When you treat obesity like a disease rather than a moral failing, people get better.

     But these medications are just one piece of the puzzle. To tackle obesity on a larger scale, we need to address the broader food environment. That means making healthy, unprocessed foods more accessible, reducing the marketing of ultra-processed foods, and investing in public health initiatives that promote nutrition education.

     Why Fat Shaming Is Harmful (and Wrong)

     Let’s address the elephant in the room: fat shaming. The idea that you can "shame" someone into losing weight is not only cruel—it’s ineffective. Research shows that weight stigma leads to stress, low self-esteem, and even more weight gain. It’s a lose-lose situation.

     Instead of shaming people for their weight, we need to focus on creating supportive environments that help everyone make healthier choices. That includes treating obesity as the complex, multifactorial disease that it is—not a personal failure.

     Citation: Weight stigma is associated with increased psychological distress, unhealthy eating behaviors, and reduced motivation for physical activity (Puhl & Heuer, 2010).

     Moving Forward: What We Can Do

     Here’s how we can start to shift the conversation around obesity:

     Acknowledge Obesity as a Disease: Let’s treat obesity like any other chronic condition with empathy and evidence-based care.

     Focus on the Food Environment: We need to address the root causes of obesity, including the overabundance of ultra-processed foods.

     Reduce Stigma: Stop blaming individuals for their weight. Instead, offer support and solutions.

     Expand Access to GLP-1 Drugs: These medications are game-changers, but they’re expensive and not always covered by insurance. Making them accessible is crucial.

     Conclusion: It’s Time to Change the Narrative

     Obesity is not a lifestyle choice. It’s a complex, chronic disease driven by biology, brain chemistry, and the environment we live in. Thanks to advances in science, like GLP-1 drugs, we’re starting to understand and treat obesity in ways that are effective and compassionate.

     The next time someone tells you to “just eat less and move more,” remind them that obesity is about much more than that. It’s time to move past the myths, embrace the science, and support people on their journey to better health.

     And maybe, just maybe, it’s time to rethink that bag of chips.

     References

     Hall, K. D., et al. (2019). "Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain." Cell Metabolism.

     Wilding, J. P. H., et al. (2021). "Once-Weekly Semaglutide in Adults with Overweight or Obesity." The New England Journal of Medicine.

     Monteiro, C. A., et al. (2018). "Ultra-Processed Foods, Diet Quality, and Health Using the NOVA Classification System." Public Health Nutrition.

     Puhl, R., & Heuer, C. (2010). "Obesity Stigma: Important Considerations for Public Health." American Journal of Public Health.

     AMA (2013). "American Medical Association House of Delegates Resolution 420 (A-13)."

     ]]>9a057dd7-4a54-4168-8d9c-99a143f4a257Fri, 13 Dec 2024 00:00:00 -070009:10falsefull6060Diets are Dead. Long Live Diets.The Future of Diets: From Weight Loss to Nutrition, Thanks to GLP-1 Drugs

     For as long as we can remember, dieting has been humanity’s awkward tango with food—three steps forward, two cheat days back. From eating grapefruit by the dozen to proclaiming kale chips as a snack revolution, our obsession with shrinking waistlines has been both fascinating and exhausting. But what if we could take weight loss off the table (pun intended) entirely? Thanks to the rise of GLP-1 drugs like semaglutide and liraglutide, we’re on the cusp of doing just that.

     These drugs are shifting the focus from counting calories to counting nutrients. In other words, dieting is getting a much-needed rebrand. So grab your kale smoothie and settle in as we dive into why the diets of the future will be all about health, not weight. And don’t worry—we’ll keep this fun. After all, food is supposed to be enjoyable.

     The GLP-1 Revolution: Shedding Pounds Without Shedding Tears

     GLP-1 drugs mimic glucagon-like peptide-1, a hormone that tells your brain, "Hey, you're full; stop eating." It’s like having a friend at dinner who gently slaps your hand every time you reach for another breadstick. Clinical trials have shown that these medications can lead to an average weight loss of 15% or more, a feat most fad diets can only dream of achieving.

     Why This Changes Everything

     1. Goodbye, Diet Culture: With GLP-1 drugs doing the heavy lifting for weight management, the days of suffering through celery juice cleanses might finally be behind us.
     2. Hello, Health Goals: People can start focusing on nutrition instead of staring longingly at someone else’s fries.
     3. Medical Validation: It’s not you; it’s your biology. GLP-1 drugs reduce hunger and help people feel fuller faster—no willpower shaming required.
     
     

     If this feels like the dieting equivalent of inventing the wheel, it is. But this wheel rolls straight into a new frontier: nutrition.

     Citation: Clinical trials on GLP-1 drugs have shown sustained weight loss for a majority of participants (Wilding et al., 2021).

     From Weight Loss to Wellness: The New Role of Diets

     Imagine a world where diets aren’t about punishing your body but fueling it. This shift doesn’t mean we’ll all suddenly start eating quinoa salads with reckless abandon—it means recognizing that food is more than just a number on a scale.

     1. Nutrition Over Numbers

     The new wave of diets prioritizes nutrient density. Instead of obsessing over how many carbs are in a bagel, we’ll care about how those carbs fuel our energy, brain function, and immune system.

     • Gut Health Heroes: Say hello to fermented foods like kimchi and yogurt.
     • Brain Boosters: Omega-3-rich salmon and walnuts are here to make you smarter (or at least more functional before your coffee).
     • Immune Support Squad: Citrus fruits, garlic, and spinach are basically your body’s bodyguards.
     
     

     Fun Fact: Your brain is about 60% fat, so eating healthy fats can actually make you a better thinker. Finally, an excuse for avocado toast!

     2. Functional Foods

     Instead of dieting to fit into jeans from a decade ago, people will start eating with specific goals in mind:

     • Performance Diets: Foods that fuel workouts and keep you going on marathon Netflix sessions.
     • Longevity Diets: Think Mediterranean diet vibes—olive oil, nuts, and a glass of red wine (for antioxidants, of course).
     • Condition-Targeted Eating: Anti-inflammatory diets for arthritis or low-glycemic diets for diabetes management.
     
     

     It’s food as medicine but without the terrifying side effects that come at the end of pharmaceutical commercials.

     Tech + Food = The Diet of Tomorrow

     Let’s face it: we’re already living in the age of smart everything—phones, watches, even refrigerators. The next logical step? Using technology to make eating smarter, too.

     • Biometric Tracking: Imagine a smartwatch that tells you when you’re low on magnesium and suggests snacking on almonds.
     • AI Nutrition Coaches: Apps that analyze your meal choices and politely suggest adding a vegetable or two.
     • Meal Kits for the Modern Era: Personalized, pre-portioned meals based on your DNA or gut microbiome.
     
     

     If the idea of AI judging your pizza consumption feels invasive, remember that it’s only trying to help. Plus, it’ll never side-eye your second slice.

     
     

     What Happens to Diet Culture?

     For years, diet culture has been as relentless as a telemarketer, selling us impossible ideals and plenty of guilt. But with GLP-1 drugs making weight loss a medical issue instead of a personal failing, we might finally be able to exorcise the ghosts of diets past.

     1. No More Food Shame: GLP-1 drugs take the blame off you and put it squarely on biology. Didn’t lose weight on your juice cleanse? That’s because juice cleanses are terrible, not because you’re weak.
     2. Shifting Goals: The focus moves to health outcomes like better energy, clearer skin, and reduced risk of chronic disease.
     3. Diverse Definitions of Health: Turns out your value isn’t tied to your ability to fit into skinny jeans. Who knew?
     
     

     But let’s not get too smug—diet culture is like a cockroach. Just because you think you’ve squashed it doesn’t mean it won’t find a new way to thrive. Be wary of buzzwords like "clean eating" or "biohacking;" they’re often just rebranded food guilt.

     
     

     Challenges to Consider

     Before we declare victory over bad diets, there are a few hurdles to clear:

     • Access to GLP-1 Drugs: These medications are expensive and often not covered by insurance. If they’re going to revolutionize health, they need to be affordable for everyone.
     • Nutritional Education: We’ll need to teach people how to nourish their bodies without falling into new fads.
     • Avoiding Over-Medicalization: Weight loss drugs are a tool, not a replacement for a balanced lifestyle. Don’t toss your running shoes just yet.
     
     

     Citation: "Cost and insurance coverage are significant barriers to GLP-1 access for many patients" (Drucker, 2022).

     How to Embrace the New Era of Diets Today

     Ready to ditch the old diet mentality and embrace the future? Here’s how you can get started:

     • Add More Colors to Your Plate: No, not M&Ms—fruits and veggies. The more variety, the better.
     • Think About Food as Fuel: Skip the crash diets and focus on eating foods that energize you.
     • Experiment with Recipes: The future of eating should be fun, not a chore. Try new cuisines, flavors, and textures.
     • Celebrate Small Wins: Did you swap your afternoon candy bar for an apple today? That’s a win worth celebrating.
     
     

     Conclusion: Diets Are Dead (Long Live Diets!)

     Thanks to GLP-1 drugs, we’re witnessing the dawn of a new era. The diets of tomorrow aren’t about deprivation—they’re about abundance. They’ll prioritize what food can do for us, from boosting our mood to supporting long-term health.

     This isn’t just a trend; it’s a revolution. And with the right tools, education, and maybe a little humor, we can finally stop fighting food and start embracing it. So let’s raise a glass (of antioxidant-rich red wine) to the end of diets as we know them. Cheers to a healthier, happier future!

     ]]>The Future of Diets: From Weight Loss to Nutrition, Thanks to GLP-1 Drugs

     For as long as we can remember, dieting has been humanity’s awkward tango with food—three steps forward, two cheat days back. From eating grapefruit by the dozen to proclaiming kale chips as a snack revolution, our obsession with shrinking waistlines has been both fascinating and exhausting. But what if we could take weight loss off the table (pun intended) entirely? Thanks to the rise of GLP-1 drugs like semaglutide and liraglutide, we’re on the cusp of doing just that.

     These drugs are shifting the focus from counting calories to counting nutrients. In other words, dieting is getting a much-needed rebrand. So grab your kale smoothie and settle in as we dive into why the diets of the future will be all about health, not weight. And don’t worry—we’ll keep this fun. After all, food is supposed to be enjoyable.

     The GLP-1 Revolution: Shedding Pounds Without Shedding Tears

     GLP-1 drugs mimic glucagon-like peptide-1, a hormone that tells your brain, "Hey, you're full; stop eating." It’s like having a friend at dinner who gently slaps your hand every time you reach for another breadstick. Clinical trials have shown that these medications can lead to an average weight loss of 15% or more, a feat most fad diets can only dream of achieving.

     Why This Changes Everything

     1. Goodbye, Diet Culture: With GLP-1 drugs doing the heavy lifting for weight management, the days of suffering through celery juice cleanses might finally be behind us.
     2. Hello, Health Goals: People can start focusing on nutrition instead of staring longingly at someone else’s fries.
     3. Medical Validation: It’s not you; it’s your biology. GLP-1 drugs reduce hunger and help people feel fuller faster—no willpower shaming required.
     
     

     If this feels like the dieting equivalent of inventing the wheel, it is. But this wheel rolls straight into a new frontier: nutrition.

     Citation: Clinical trials on GLP-1 drugs have shown sustained weight loss for a majority of participants (Wilding et al., 2021).

     From Weight Loss to Wellness: The New Role of Diets

     Imagine a world where diets aren’t about punishing your body but fueling it. This shift doesn’t mean we’ll all suddenly start eating quinoa salads with reckless abandon—it means recognizing that food is more than just a number on a scale.

     1. Nutrition Over Numbers

     The new wave of diets prioritizes nutrient density. Instead of obsessing over how many carbs are in a bagel, we’ll care about how those carbs fuel our energy, brain function, and immune system.

     • Gut Health Heroes: Say hello to fermented foods like kimchi and yogurt.
     • Brain Boosters: Omega-3-rich salmon and walnuts are here to make you smarter (or at least more functional before your coffee).
     • Immune Support Squad: Citrus fruits, garlic, and spinach are basically your body’s bodyguards.
     
     

     Fun Fact: Your brain is about 60% fat, so eating healthy fats can actually make you a better thinker. Finally, an excuse for avocado toast!

     2. Functional Foods

     Instead of dieting to fit into jeans from a decade ago, people will start eating with specific goals in mind:

     • Performance Diets: Foods that fuel workouts and keep you going on marathon Netflix sessions.
     • Longevity Diets: Think Mediterranean diet vibes—olive oil, nuts, and a glass of red wine (for antioxidants, of course).
     • Condition-Targeted Eating: Anti-inflammatory diets for arthritis or low-glycemic diets for diabetes management.
     
     

     It’s food as medicine but without the terrifying side effects that come at the end of pharmaceutical commercials.

     Tech + Food = The Diet of Tomorrow

     Let’s face it: we’re already living in the age of smart everything—phones, watches, even refrigerators. The next logical step? Using technology to make eating smarter, too.

     • Biometric Tracking: Imagine a smartwatch that tells you when you’re low on magnesium and suggests snacking on almonds.
     • AI Nutrition Coaches: Apps that analyze your meal choices and politely suggest adding a vegetable or two.
     • Meal Kits for the Modern Era: Personalized, pre-portioned meals based on your DNA or gut microbiome.
     
     

     If the idea of AI judging your pizza consumption feels invasive, remember that it’s only trying to help. Plus, it’ll never side-eye your second slice.

     
     

     What Happens to Diet Culture?

     For years, diet culture has been as relentless as a telemarketer, selling us impossible ideals and plenty of guilt. But with GLP-1 drugs making weight loss a medical issue instead of a personal failing, we might finally be able to exorcise the ghosts of diets past.

     1. No More Food Shame: GLP-1 drugs take the blame off you and put it squarely on biology. Didn’t lose weight on your juice cleanse? That’s because juice cleanses are terrible, not because you’re weak.
     2. Shifting Goals: The focus moves to health outcomes like better energy, clearer skin, and reduced risk of chronic disease.
     3. Diverse Definitions of Health: Turns out your value isn’t tied to your ability to fit into skinny jeans. Who knew?
     
     

     But let’s not get too smug—diet culture is like a cockroach. Just because you think you’ve squashed it doesn’t mean it won’t find a new way to thrive. Be wary of buzzwords like "clean eating" or "biohacking;" they’re often just rebranded food guilt.

     
     

     Challenges to Consider

     Before we declare victory over bad diets, there are a few hurdles to clear:

     • Access to GLP-1 Drugs: These medications are expensive and often not covered by insurance. If they’re going to revolutionize health, they need to be affordable for everyone.
     • Nutritional Education: We’ll need to teach people how to nourish their bodies without falling into new fads.
     • Avoiding Over-Medicalization: Weight loss drugs are a tool, not a replacement for a balanced lifestyle. Don’t toss your running shoes just yet.
     
     

     Citation: "Cost and insurance coverage are significant barriers to GLP-1 access for many patients" (Drucker, 2022).

     How to Embrace the New Era of Diets Today

     Ready to ditch the old diet mentality and embrace the future? Here’s how you can get started:

     • Add More Colors to Your Plate: No, not M&Ms—fruits and veggies. The more variety, the better.
     • Think About Food as Fuel: Skip the crash diets and focus on eating foods that energize you.
     • Experiment with Recipes: The future of eating should be fun, not a chore. Try new cuisines, flavors, and textures.
     • Celebrate Small Wins: Did you swap your afternoon candy bar for an apple today? That’s a win worth celebrating.
     
     

     Conclusion: Diets Are Dead (Long Live Diets!)

     Thanks to GLP-1 drugs, we’re witnessing the dawn of a new era. The diets of tomorrow aren’t about deprivation—they’re about abundance. They’ll prioritize what food can do for us, from boosting our mood to supporting long-term health.

     This isn’t just a trend; it’s a revolution. And with the right tools, education, and maybe a little humor, we can finally stop fighting food and start embracing it. So let’s raise a glass (of antioxidant-rich red wine) to the end of diets as we know them. Cheers to a healthier, happier future!

     ]]>f6c8519f-4e36-4323-83ac-60d927a0f1e5Tue, 10 Dec 2024 00:00:00 -070011:14falsefull5959From Starving to StuffedFrom Starving to Stuffed: The Evolution of Obesity in America

     The rise of ultra-processed foods in the United States closely parallels the surge in obesity rates and increased caloric intake observed from the 1980s onward. Starting in the 1970s, shifts in food production and consumer habits paved the way for these foods to become dietary staples, ultimately contributing to the obesity epidemic we see today. Let’s explore how these changes unfolded and their direct link to America’s rising weight problem.

     1970s: Setting the Stage for Ultra-Processed Foods

     In the 1970s, the food industry underwent dramatic changes that laid the groundwork for the proliferation of ultra-processed foods.

     1. Economic Shifts and Agricultural Policies
     2. In 1973, new agricultural policies began to encourage farmers to produce more crops like corn, soy, and wheat. These policies made ingredients, particularly high-fructose corn syrup (HFCS) from corn, much cheaper for food manufacturers to obtain (Nestle, 2002). As a result, companies could produce food more cost-effectively and in larger quantities, leading to affordable, calorie-dense, ultra-processed foods.
     3. Rise of Convenient Snack Foods and Fast Food
     4. At the same time, the popularity of fast-food chains and processed snacks grew. Brands like McDonald's, Coca-Cola, and Frito-Lay expanded their offerings and marketed these convenient, hyper-palatable foods to the masses. They loaded these products with refined sugars, fats, and additives to enhance flavor and shelf life, making them hard to resist and easily accessible.
     5. The “Diet” Food Craze
     6. The 1970s also saw a surge in demand for high-protein diet products due to growing concerns about carbohydrates. Low-carb became the flavor, and at any given time, 10% of the country was on low-carbohydrate diets. Ironically, these “diet” foods often contained as many or more calories as regular options.
     
     

     1980s: Ultra-Processed Foods Take Center Stage, and Obesity Rates Start to Climb

     By the 1980s, ultra-processed foods had fully embedded themselves in American diets, creating a foundation for the obesity epidemic.

     1. Processed Food Production Surges
     2. Food companies expanded their product lines in the 1980s, launching a wide range of snack foods, frozen meals, and sugary drinks. These foods were not only inexpensive but also tasty, thanks to the addition of refined sugars and fats, as well as preservatives to prolong shelf life (Monteiro et al., 2013). Marketing highlighted their convenience, appealing to busy families and individuals.
     3. Caloric Intake Climbs
     4. Alongside the rise in ultra-processed foods, average daily caloric intake also increased. Between the late 1970s and early 2000s, Americans consumed over 200 more calories per day. This rise came largely from high-calorie processed snacks and sugary drinks that were easy to consume between meals (Wright et al., 2004).
     5. Obesity Rates Begin Their Upward Trajectory
     6. During the 1980s, obesity rates started climbing. From 1980 to 2000, the obesity rate in U.S. adults jumped from 15% to 30% (Flegal et al., 2012). Children and teenagers weren’t spared either; childhood obesity rates nearly tripled, aligning with the increased availability of ultra-processed foods.
     
     

     1990s: Fast Food and Convenience Foods Dominate the American Diet

     The 1990s brought even more ultra-processed foods, solidifying their role in the American diet.

     1. Fast Food Reigns Supreme
     2. Fast-food outlets exploded across the country in the 1990s, offering cheap, calorie-dense meals that were easily accessible. These chains embraced supersizing, encouraging customers to choose larger portions for just a small price increase. As a result, Americans began consuming more calories per meal, often in ultra-processed fast food.
     3. Sugary Beverages Become a Staple
     4. Consumption of sugar-sweetened beverages (SSBs) like sodas and sweetened teas, also skyrocketed during this decade. Many of these drinks relied on HFCS, delivering a heavy dose of empty calories without satisfying hunger. Studies show that sugary drinks don’t curb appetite the same way solid foods do, leading people to consume extra calories without feeling full (Malik et al., 2010).
     5. Caloric Intake Peaks
     6. By the end of the 1990s, Americans’ average daily caloric intake had reached new heights, with ultra-processed foods making up a significant portion of the diet. Research indicates that nearly 60% of Americans’ daily calories came from ultra-processed foods by the late 1990s (Monteiro et al., 2013). The rise in these calorie-dense, low-nutrient foods is directly correlated with increasing body weight and obesity rates.
     
     

     2000s to Present: Ultra-Processed Foods and the Obesity Epidemic

     As we moved into the 2000s, ultra-processed foods remained a dominant force in the American diet, pushing obesity rates even higher.

     1. Obesity Reaches Public Health Crisis Levels
     2. By 2020, nearly 42% of American adults and 20% of children were considered obese (Hales et al., 2020). Studies have consistently linked this trend with ultra-processed foods, which are designed to be “hyper-palatable” and, thus, difficult to resist. Their addictive taste profile has fueled a snacking culture, where more people consume larger portions and eat more frequently throughout the day.
     3. Calories from Ultra-Processed Foods Remain High
     4. Research shows that 60-70% of the average American’s daily calories now come from ultra-processed foods (Juul & Hemmingsson, 2015). These foods are often low in fiber, protein, and essential nutrients, which leaves people unsatisfied and more likely to overeat. Additionally, foods high in refined carbs and sugars cause blood sugar spikes and crashes, leading to frequent hunger pangs and cravings.
     5. The Health Toll Beyond Obesity
     6. Ultra-processed foods haven’t just contributed to obesity; they’ve also been linked to type 2 diabetes, cardiovascular disease, and certain cancers. Their high-calorie density, poor nutritional profile, and use of additives have been shown to negatively impact health, making them a major public health concern.
     7. Efforts to Combat Ultra-Processed Food Consumption
     8. Despite public health campaigns promoting whole foods, ultra-processed options remain attractive for many Americans due to their affordability and convenience. In many low-income areas, they’re also more readily available than fresh, whole foods, perpetuating health disparities.
     
     

     Conclusion: Ultra-Processed Foods and America’s Obesity Epidemic

     Since the 1970s, the rise of ultra-processed foods in the United States has closely tracked with an increase in calorie consumption and obesity rates. As companies produced more of these convenient, highly palatable foods, Americans’ eating habits changed, leading to greater calorie intake through frequent snacking, sugary drinks, and supersized portions. The dominance of ultra-processed foods in the diet has not only contributed to rising obesity rates but also to an increase in related health issues like diabetes and heart disease.

     Although efforts to reduce ultra-processed food consumption continue, their deep-rooted presence in American culture and food systems makes reversing the trend challenging. For a healthier future, we need a multifaceted approach that includes improved access to nutritious foods, public health policies, and greater awareness about the risks associated with ultra-processed foods.

     References:

     • Malik, V. S., et al. (2010). Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care, 33(11), 2477-2483.
     • Monteiro, C. A., et al. (2013). Ultra-processed products are becoming dominant in the global food system. Obesity Reviews, 14(S2), 21-28.
     • Nestle, M. (2002). Food Politics: How the Food Industry Influences Nutrition and Health. University of California Press.
     • Hales, C. M., et al. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief, (360), 1-8.
     
     ]]>From Starving to Stuffed: The Evolution of Obesity in America

     The rise of ultra-processed foods in the United States closely parallels the surge in obesity rates and increased caloric intake observed from the 1980s onward. Starting in the 1970s, shifts in food production and consumer habits paved the way for these foods to become dietary staples, ultimately contributing to the obesity epidemic we see today. Let’s explore how these changes unfolded and their direct link to America’s rising weight problem.

     1970s: Setting the Stage for Ultra-Processed Foods

     In the 1970s, the food industry underwent dramatic changes that laid the groundwork for the proliferation of ultra-processed foods.

     1. Economic Shifts and Agricultural Policies
     2. In 1973, new agricultural policies began to encourage farmers to produce more crops like corn, soy, and wheat. These policies made ingredients, particularly high-fructose corn syrup (HFCS) from corn, much cheaper for food manufacturers to obtain (Nestle, 2002). As a result, companies could produce food more cost-effectively and in larger quantities, leading to affordable, calorie-dense, ultra-processed foods.
     3. Rise of Convenient Snack Foods and Fast Food
     4. At the same time, the popularity of fast-food chains and processed snacks grew. Brands like McDonald's, Coca-Cola, and Frito-Lay expanded their offerings and marketed these convenient, hyper-palatable foods to the masses. They loaded these products with refined sugars, fats, and additives to enhance flavor and shelf life, making them hard to resist and easily accessible.
     5. The “Diet” Food Craze
     6. The 1970s also saw a surge in demand for high-protein diet products due to growing concerns about carbohydrates. Low-carb became the flavor, and at any given time, 10% of the country was on low-carbohydrate diets. Ironically, these “diet” foods often contained as many or more calories as regular options.
     
     

     1980s: Ultra-Processed Foods Take Center Stage, and Obesity Rates Start to Climb

     By the 1980s, ultra-processed foods had fully embedded themselves in American diets, creating a foundation for the obesity epidemic.

     1. Processed Food Production Surges
     2. Food companies expanded their product lines in the 1980s, launching a wide range of snack foods, frozen meals, and sugary drinks. These foods were not only inexpensive but also tasty, thanks to the addition of refined sugars and fats, as well as preservatives to prolong shelf life (Monteiro et al., 2013). Marketing highlighted their convenience, appealing to busy families and individuals.
     3. Caloric Intake Climbs
     4. Alongside the rise in ultra-processed foods, average daily caloric intake also increased. Between the late 1970s and early 2000s, Americans consumed over 200 more calories per day. This rise came largely from high-calorie processed snacks and sugary drinks that were easy to consume between meals (Wright et al., 2004).
     5. Obesity Rates Begin Their Upward Trajectory
     6. During the 1980s, obesity rates started climbing. From 1980 to 2000, the obesity rate in U.S. adults jumped from 15% to 30% (Flegal et al., 2012). Children and teenagers weren’t spared either; childhood obesity rates nearly tripled, aligning with the increased availability of ultra-processed foods.
     
     

     1990s: Fast Food and Convenience Foods Dominate the American Diet

     The 1990s brought even more ultra-processed foods, solidifying their role in the American diet.

     1. Fast Food Reigns Supreme
     2. Fast-food outlets exploded across the country in the 1990s, offering cheap, calorie-dense meals that were easily accessible. These chains embraced supersizing, encouraging customers to choose larger portions for just a small price increase. As a result, Americans began consuming more calories per meal, often in ultra-processed fast food.
     3. Sugary Beverages Become a Staple
     4. Consumption of sugar-sweetened beverages (SSBs) like sodas and sweetened teas, also skyrocketed during this decade. Many of these drinks relied on HFCS, delivering a heavy dose of empty calories without satisfying hunger. Studies show that sugary drinks don’t curb appetite the same way solid foods do, leading people to consume extra calories without feeling full (Malik et al., 2010).
     5. Caloric Intake Peaks
     6. By the end of the 1990s, Americans’ average daily caloric intake had reached new heights, with ultra-processed foods making up a significant portion of the diet. Research indicates that nearly 60% of Americans’ daily calories came from ultra-processed foods by the late 1990s (Monteiro et al., 2013). The rise in these calorie-dense, low-nutrient foods is directly correlated with increasing body weight and obesity rates.
     
     

     2000s to Present: Ultra-Processed Foods and the Obesity Epidemic

     As we moved into the 2000s, ultra-processed foods remained a dominant force in the American diet, pushing obesity rates even higher.

     1. Obesity Reaches Public Health Crisis Levels
     2. By 2020, nearly 42% of American adults and 20% of children were considered obese (Hales et al., 2020). Studies have consistently linked this trend with ultra-processed foods, which are designed to be “hyper-palatable” and, thus, difficult to resist. Their addictive taste profile has fueled a snacking culture, where more people consume larger portions and eat more frequently throughout the day.
     3. Calories from Ultra-Processed Foods Remain High
     4. Research shows that 60-70% of the average American’s daily calories now come from ultra-processed foods (Juul & Hemmingsson, 2015). These foods are often low in fiber, protein, and essential nutrients, which leaves people unsatisfied and more likely to overeat. Additionally, foods high in refined carbs and sugars cause blood sugar spikes and crashes, leading to frequent hunger pangs and cravings.
     5. The Health Toll Beyond Obesity
     6. Ultra-processed foods haven’t just contributed to obesity; they’ve also been linked to type 2 diabetes, cardiovascular disease, and certain cancers. Their high-calorie density, poor nutritional profile, and use of additives have been shown to negatively impact health, making them a major public health concern.
     7. Efforts to Combat Ultra-Processed Food Consumption
     8. Despite public health campaigns promoting whole foods, ultra-processed options remain attractive for many Americans due to their affordability and convenience. In many low-income areas, they’re also more readily available than fresh, whole foods, perpetuating health disparities.
     
     

     Conclusion: Ultra-Processed Foods and America’s Obesity Epidemic

     Since the 1970s, the rise of ultra-processed foods in the United States has closely tracked with an increase in calorie consumption and obesity rates. As companies produced more of these convenient, highly palatable foods, Americans’ eating habits changed, leading to greater calorie intake through frequent snacking, sugary drinks, and supersized portions. The dominance of ultra-processed foods in the diet has not only contributed to rising obesity rates but also to an increase in related health issues like diabetes and heart disease.

     Although efforts to reduce ultra-processed food consumption continue, their deep-rooted presence in American culture and food systems makes reversing the trend challenging. For a healthier future, we need a multifaceted approach that includes improved access to nutritious foods, public health policies, and greater awareness about the risks associated with ultra-processed foods.

     References:

     • Malik, V. S., et al. (2010). Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care, 33(11), 2477-2483.
     • Monteiro, C. A., et al. (2013). Ultra-processed products are becoming dominant in the global food system. Obesity Reviews, 14(S2), 21-28.
     • Nestle, M. (2002). Food Politics: How the Food Industry Influences Nutrition and Health. University of California Press.
     • Hales, C. M., et al. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief, (360), 1-8.
     
     ]]>88c9ad56-ff35-42f2-8289-0e90544e7719Tue, 19 Nov 2024 00:00:00 -070014:58falsefull5858Food Noise, Addictions, and OzempicIn recent years, GLP-1 agonists have gained significant attention as effective treatments for obesity and type 2 diabetes. However, emerging research suggests these medications may also influence brain function and behaviors related to reward and addiction. In this article, we’ll explore how GLP-1 agonists work, where they act in the brain, and how they can help reduce “food noise” — the constant chatter about food that often distracts us from healthier choices.

     Understanding GLP-1 Agonists

     GLP-1, or glucagon-like peptide-1, is a hormone released from the intestines after eating. It plays a crucial role in regulating appetite and glucose metabolism. GLP-1 agonists mimic this hormone, enhancing insulin secretion and reducing glucagon levels, which leads to lower blood sugar and reduced appetite. Popular medications in this class include semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda).

     How GLP-1 Agonists Affect the Brain

     Recent studies have illuminated the complex ways in which GLP-1 agonists impact brain function, particularly in areas involved in reward processing. Researchers have found GLP-1 receptors in key brain regions such as:

     Hypothalamus: This area regulates appetite and energy balance.

     Nucleus Accumbens: Part of the brain's reward system, it processes pleasure and reward.

     Prefrontal Cortex: This region is crucial for decision-making and impulse control.

     By acting on these regions, GLP-1 agonists can dampen the brain's reward response to food, which may help reduce cravings for high-calorie, palatable foods (Müller et al., 2022).

     GLP-1 Agonists and Food Noise

     “Food noise” refers to the mental chatter and constant preoccupation with food choices, cravings, and dietary restrictions that many people experience. This noise can lead to unhealthy eating patterns and distract individuals from making mindful food choices.

     GLP-1 agonists appear to quiet this food noise. By enhancing satiety signals and reducing cravings, these medications help individuals feel fuller longer and decrease the frequency of thoughts about food. Studies indicate that people using GLP-1 agonists often report less preoccupation with eating and cravings, allowing them to focus on other aspects of their lives (Chaudhary et al., 2023).

     Implications for Other Addictions

     Interestingly, the effects of GLP-1 agonists extend beyond appetite regulation. Some studies suggest these medications may also influence other forms of addiction. For example, animal research indicates that GLP-1 agonists can reduce alcohol consumption, highlighting their potential for treating alcohol use disorder (Gonzalez et al., 2021).

     This intersection raises important questions about the ethical use of GLP-1 agonists. While they can serve as valuable tools in addiction treatment, we must consider the implications of modifying behaviors that involve complex neurological pathways.

     It even appears to change one's reaction to stress.

     Conclusion

     GLP-1 agonists offer more than just a path to weight loss; they may help reshape our relationship with food and reduce the noise that often accompanies dietary decisions. As we continue to explore the benefits of these medications, understanding their multifaceted role in brain function is essential.

     Further research will clarify how we can harness the potential of GLP-1 agonists in treating not only obesity but also other forms of addiction.

     References

     Chaudhary, N., et al. (2023). The effects of GLP-1 agonists on cognitive function and eating behaviors: A review. Journal of Obesity, 12(4), 234-245.

     Gonzalez, R., et al. (2021). GLP-1 receptor signaling and alcohol consumption: Implications for addiction treatment. Neuroscience Letters, 748, 135709.

     Müller, T.D., et al. (2022). GLP-1 receptor agonists: An update on their role in obesity treatment. Obesity Reviews, 23(2), e13356.

     By addressing both obesity and potentially other forms of addiction, GLP-1 agonists represent a promising avenue in our quest for better health. Stay informed and explore how these medications can fit into your overall wellness journey!

     ]]>In recent years, GLP-1 agonists have gained significant attention as effective treatments for obesity and type 2 diabetes. However, emerging research suggests these medications may also influence brain function and behaviors related to reward and addiction. In this article, we’ll explore how GLP-1 agonists work, where they act in the brain, and how they can help reduce “food noise” — the constant chatter about food that often distracts us from healthier choices.

     Understanding GLP-1 Agonists

     GLP-1, or glucagon-like peptide-1, is a hormone released from the intestines after eating. It plays a crucial role in regulating appetite and glucose metabolism. GLP-1 agonists mimic this hormone, enhancing insulin secretion and reducing glucagon levels, which leads to lower blood sugar and reduced appetite. Popular medications in this class include semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda).

     How GLP-1 Agonists Affect the Brain

     Recent studies have illuminated the complex ways in which GLP-1 agonists impact brain function, particularly in areas involved in reward processing. Researchers have found GLP-1 receptors in key brain regions such as:

     Hypothalamus: This area regulates appetite and energy balance.

     Nucleus Accumbens: Part of the brain's reward system, it processes pleasure and reward.

     Prefrontal Cortex: This region is crucial for decision-making and impulse control.

     By acting on these regions, GLP-1 agonists can dampen the brain's reward response to food, which may help reduce cravings for high-calorie, palatable foods (Müller et al., 2022).

     GLP-1 Agonists and Food Noise

     “Food noise” refers to the mental chatter and constant preoccupation with food choices, cravings, and dietary restrictions that many people experience. This noise can lead to unhealthy eating patterns and distract individuals from making mindful food choices.

     GLP-1 agonists appear to quiet this food noise. By enhancing satiety signals and reducing cravings, these medications help individuals feel fuller longer and decrease the frequency of thoughts about food. Studies indicate that people using GLP-1 agonists often report less preoccupation with eating and cravings, allowing them to focus on other aspects of their lives (Chaudhary et al., 2023).

     Implications for Other Addictions

     Interestingly, the effects of GLP-1 agonists extend beyond appetite regulation. Some studies suggest these medications may also influence other forms of addiction. For example, animal research indicates that GLP-1 agonists can reduce alcohol consumption, highlighting their potential for treating alcohol use disorder (Gonzalez et al., 2021).

     This intersection raises important questions about the ethical use of GLP-1 agonists. While they can serve as valuable tools in addiction treatment, we must consider the implications of modifying behaviors that involve complex neurological pathways.

     It even appears to change one's reaction to stress.

     Conclusion

     GLP-1 agonists offer more than just a path to weight loss; they may help reshape our relationship with food and reduce the noise that often accompanies dietary decisions. As we continue to explore the benefits of these medications, understanding their multifaceted role in brain function is essential.

     Further research will clarify how we can harness the potential of GLP-1 agonists in treating not only obesity but also other forms of addiction.

     References

     Chaudhary, N., et al. (2023). The effects of GLP-1 agonists on cognitive function and eating behaviors: A review. Journal of Obesity, 12(4), 234-245.

     Gonzalez, R., et al. (2021). GLP-1 receptor signaling and alcohol consumption: Implications for addiction treatment. Neuroscience Letters, 748, 135709.

     Müller, T.D., et al. (2022). GLP-1 receptor agonists: An update on their role in obesity treatment. Obesity Reviews, 23(2), e13356.

     By addressing both obesity and potentially other forms of addiction, GLP-1 agonists represent a promising avenue in our quest for better health. Stay informed and explore how these medications can fit into your overall wellness journey!

     ]]>21364902-ef6a-4d45-90f9-64b251671724Mon, 11 Nov 2024 00:00:00 -070009:47falsefull5757Cholesterol and Heart DiseaseApolipoprotein B (apoB) is the causative agent in atherosclerosis. If your apoB is low, you will not develop atherosclerosis. However, if your apoB is high, you could die young.

     We know this because of genetic studies of people with different levels of apoB and their health outcomes.

     What is Atherosclerosis of the heart?

     Atherosclerosis is a progressive laying down of "plaque" in the wall of the coronary arteries.  Since the coronary arteries feed the heart, this can lead to three outcomes:

     1. The plaque impinges on the artery. Thus, the plaque will decrease blood flow to the heart. This can lead to angina or a poorly working cardiac muscle.
     2. The plaque can rupture (burst) into the artery. Next the body repairs this by clotting the blood. Thus,  the blood flows to that portion of the heart is stopped. Without blood flow, the heart muscle starves, and if the flow isn't restored, that part of the heart will die. This is a heart attack or myocardial infarction.
     3. The plaque can have no result.  Meaning, it isn't stopping blood flow to lead to angina, and it doesn't occlude the artery.
     
     

     What is in the plaque?

     In the above artery, you can see the yellow cholesterol in the wall. This is a "soft" plaque, like porridge.

     The plaque is not inside the vessel. The artery is lined by a layer called the intima. So how does cholesterol get from the inside of the blood vessel to behind the layer?

     The Process of Atherosclerotic Plaque Formation

     Lipoprotein Entry into the Arterial Wall: The process begins when ApoB-containing lipoproteins pass through the endothelial layer of arteries. Normally, this layer acts as a barrier, but factors like high blood pressure or inflammation can make it more permeable, allowing these particles to accumulate beneath the endothelial cells.

     Retention and Modification: Once inside the arterial wall, ApoB lipoproteins are trapped by proteoglycans (components of the extracellular matrix). These retained lipoproteins undergo modifications, such as oxidation, which makes them more likely to trigger inflammatory responses.

     Inflammatory Response: The modified lipoproteins activate endothelial cells and attract immune cells like monocytes. These monocytes enter the arterial wall and transform into macrophages. Macrophages engulf the modified lipoproteins, turning into foam cells, which are a hallmark of early atherosclerotic plaque.

     Plaque Development: Over time, foam cells accumulate, leading to the formation of fatty streaks in the arterial wall. Smooth muscle cells migrate into the intimal layer of the artery, contributing to the formation of a fibrous cap that covers the plaque. This cap consists of connective tissue, calcium, and cholesterol deposits.

     Progression and Complications: As the plaque grows, it narrows the artery and restricts blood flow. If the fibrous cap ruptures, it can lead to the formation of a blood clot (thrombus), which may block the artery entirely, causing a heart attack or stroke.

     Preventing Plaque Formation

     Understanding how ApoB-containing lipoproteins contribute to atherosclerosis underscores the importance of managing blood cholesterol levels. Lifestyle changes such as diet, exercise, and medications like statins can reduce LDL levels, lowering the risk of plaque formation and subsequent cardiovascular events.

     Atherosclerosis is a gradual process that starts with the seemingly harmless entry of ApoB lipoproteins into arterial walls. By addressing the risk factors that promote lipoprotein retention and inflammation, the progression of atherosclerosis can be slowed or prevented.

     LDL particle size

     LDL particles can vary in size, and it was previously believed smaller, denser LDL particles were more atherogenic than larger, buoyant ones. However, research has shown that the number of LDL particles, regardless of size, is a more significant determinant of cardiovascular risk. Studies indicate that the concentration of LDL particles is more closely associated with atherosclerosis than the size of the particles themselves.

     The ApoB Factor: Why It's a Big Deal

     ApoB is a protein found on the surface of atherogenic lipoproteins, including LDL, VLDL, and IDL. Each of these particles contains one ApoB molecule, making ApoB a direct measure of the number of atherogenic particles in the blood. This measurement is crucial because it provides a clearer picture of the atherogenic burden in the bloodstream than LDL-C alone.

     Why ApoB is the Star Player

     Direct Measure of Risk: ApoB directly measures the number of atherogenic particles, providing a more accurate assessment of cardiovascular risk.

     Independent of Particle Size: Unlike LDL size, which can vary and complicate risk assessment, ApoB consistently reflects the number of risk-contributing particles.

     Predictive Power: Numerous studies have shown that ApoB is a better predictor of cardiovascular events than LDL-C or other traditional lipid measures.

     ApoB: Direct Measurement of Atherogenic Particles

     Apolipoprotein B (ApoB) is the main protein component of several lipoproteins, including low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and lipoprotein(a). Each atherogenic particle contains one molecule of ApoB, making ApoB a direct measure of the number of atherogenic particles circulating in the bloodstream.

     Key Points:

     Direct Indicator of Particle Number: Since each atherogenic lipoprotein particle has one ApoB molecule, measuring ApoB provides an accurate count of these particles. This is crucial because the more atherogenic particles present, the higher the risk of these particles penetrating the arterial walls and contributing to plaque formation.

     Independent of Cholesterol Content:

     The cholesterol content does not influence ApoB measurement within these particles. Therefore, it provides a clearer picture of cardiovascular risk, especially in cases where LDL cholesterol (LDL-C) levels might be normal, but the number of LDL particles (and thus ApoB) is high.

     HDL-TG Ratio: A Marker of Lipid Metabolism

     The HDL-TG ratio, which is the ratio of high-density lipoprotein cholesterol (HDL-C) to triglycerides (TG), is used as a marker to assess lipid metabolism and insulin resistance. A high HDL-TG ratio generally indicates a favorable lipid profile and a lower risk of cardiovascular disease. However, this ratio has limitations:

     Indirect vs direct measure:

     Indirect Measurement: The HDL-TG ratio provides an indirect measure of cardiovascular risk. It does not directly quantify the number of atherogenic particles but rather gives a sense of lipid metabolism status. While a low HDL-C and high TG level can indicate higher cardiovascular risk, it doesn't directly account for the number of atherogenic particles present.

     Variability and Confounding Factors:

     Several factors can influence the ratio, including lifestyle, diet, and metabolic disorders, which can confound its predictive value for cardiovascular risk. Additionally, HDL-C levels alone have not consistently been shown to correlate with reduced cardiovascular risk, as HDL particles can vary in functionality.

     Why ApoB is More Important

     Predictive Power: Numerous studies have shown that ApoB is a stronger predictor of cardiovascular events than the HDL-TG ratio. For instance, the INTERHEART study highlighted that ApoB levels were more predictive of myocardial infarction than other lipid markers, including the HDL-TG ratio.

     Comprehensive Risk Assessment: ApoB accounts for all atherogenic particles, providing a more comprehensive assessment of cardiovascular risk compared to measures that only consider cholesterol content or ratios of different lipid components.

      Focusing on the Right Metric

     In summary, the focus has shifted from LDL particle size to the number of atherogenic particles, as measured by ApoB. This shift is grounded in the understanding that cardiovascular disease risk is more closely linked to the number of these particles rather than their size or cholesterol content alone. Therefore, ApoB provides a more accurate and reliable measure for assessing cardiovascular risk.

     Conclusion

     While both ApoB and the HDL-TG ratio can provide valuable information about lipid metabolism and cardiovascular risk, ApoB is considered more important due to its direct measurement of atherogenic particles. This makes it a more reliable and comprehensive marker for assessing the risk of atherosclerosis and related cardiovascular events.

      

     Citations:

     Sniderman, A. D., & Tsimikas, S. (2014). Apolipoprotein B. Circulation, 129(11), 1112-1120.

     Packard, C. J., & Shepherd, J. (1999). Lipoprotein heterogeneity and apolipoprotein B metabolism. Atherosclerosis, 141(1), 27-42.

     McQueen, M. J., Hawken, S., Wang, X., Ounpuu, S., Sniderman, A., Probstfield, J., ... & Yusuf, S. (2008). Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. The Lancet, 372(9634), 224-233.

     Cromwell, W. C., & Otvos, J. D. (2004). Low-density lipoprotein particle number and risk for cardiovascular disease. Current Atherosclerosis Reports, 6(5), 381-387.

     Mora, S., Otvos, J. D., Rifai, N., Rosenson, R. S., Buring, J. E., & Ridker, P. M. (2009). Lipoprotein particle profiles by nuclear magnetic resonance compared with standard lipids and apolipoproteins in predicting incident...]]>Apolipoprotein B (apoB) is the causative agent in atherosclerosis. If your apoB is low, you will not develop atherosclerosis. However, if your apoB is high, you could die young.

     We know this because of genetic studies of people with different levels of apoB and their health outcomes.

     What is Atherosclerosis of the heart?

     Atherosclerosis is a progressive laying down of "plaque" in the wall of the coronary arteries.  Since the coronary arteries feed the heart, this can lead to three outcomes:

     1. The plaque impinges on the artery. Thus, the plaque will decrease blood flow to the heart. This can lead to angina or a poorly working cardiac muscle.
     2. The plaque can rupture (burst) into the artery. Next the body repairs this by clotting the blood. Thus,  the blood flows to that portion of the heart is stopped. Without blood flow, the heart muscle starves, and if the flow isn't restored, that part of the heart will die. This is a heart attack or myocardial infarction.
     3. The plaque can have no result.  Meaning, it isn't stopping blood flow to lead to angina, and it doesn't occlude the artery.
     
     

     What is in the plaque?

     In the above artery, you can see the yellow cholesterol in the wall. This is a "soft" plaque, like porridge.

     The plaque is not inside the vessel. The artery is lined by a layer called the intima. So how does cholesterol get from the inside of the blood vessel to behind the layer?

     The Process of Atherosclerotic Plaque Formation

     Lipoprotein Entry into the Arterial Wall: The process begins when ApoB-containing lipoproteins pass through the endothelial layer of arteries. Normally, this layer acts as a barrier, but factors like high blood pressure or inflammation can make it more permeable, allowing these particles to accumulate beneath the endothelial cells.

     Retention and Modification: Once inside the arterial wall, ApoB lipoproteins are trapped by proteoglycans (components of the extracellular matrix). These retained lipoproteins undergo modifications, such as oxidation, which makes them more likely to trigger inflammatory responses.

     Inflammatory Response: The modified lipoproteins activate endothelial cells and attract immune cells like monocytes. These monocytes enter the arterial wall and transform into macrophages. Macrophages engulf the modified lipoproteins, turning into foam cells, which are a hallmark of early atherosclerotic plaque.

     Plaque Development: Over time, foam cells accumulate, leading to the formation of fatty streaks in the arterial wall. Smooth muscle cells migrate into the intimal layer of the artery, contributing to the formation of a fibrous cap that covers the plaque. This cap consists of connective tissue, calcium, and cholesterol deposits.

     Progression and Complications: As the plaque grows, it narrows the artery and restricts blood flow. If the fibrous cap ruptures, it can lead to the formation of a blood clot (thrombus), which may block the artery entirely, causing a heart attack or stroke.

     Preventing Plaque Formation

     Understanding how ApoB-containing lipoproteins contribute to atherosclerosis underscores the importance of managing blood cholesterol levels. Lifestyle changes such as diet, exercise, and medications like statins can reduce LDL levels, lowering the risk of plaque formation and subsequent cardiovascular events.

     Atherosclerosis is a gradual process that starts with the seemingly harmless entry of ApoB lipoproteins into arterial walls. By addressing the risk factors that promote lipoprotein retention and inflammation, the progression of atherosclerosis can be slowed or prevented.

     LDL particle size

     LDL particles can vary in size, and it was previously believed smaller, denser LDL particles were more atherogenic than larger, buoyant ones. However, research has shown that the number of LDL particles, regardless of size, is a more significant determinant of cardiovascular risk. Studies indicate that the concentration of LDL particles is more closely associated with atherosclerosis than the size of the particles themselves.

     The ApoB Factor: Why It's a Big Deal

     ApoB is a protein found on the surface of atherogenic lipoproteins, including LDL, VLDL, and IDL. Each of these particles contains one ApoB molecule, making ApoB a direct measure of the number of atherogenic particles in the blood. This measurement is crucial because it provides a clearer picture of the atherogenic burden in the bloodstream than LDL-C alone.

     Why ApoB is the Star Player

     Direct Measure of Risk: ApoB directly measures the number of atherogenic particles, providing a more accurate assessment of cardiovascular risk.

     Independent of Particle Size: Unlike LDL size, which can vary and complicate risk assessment, ApoB consistently reflects the number of risk-contributing particles.

     Predictive Power: Numerous studies have shown that ApoB is a better predictor of cardiovascular events than LDL-C or other traditional lipid measures.

     ApoB: Direct Measurement of Atherogenic Particles

     Apolipoprotein B (ApoB) is the main protein component of several lipoproteins, including low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and lipoprotein(a). Each atherogenic particle contains one molecule of ApoB, making ApoB a direct measure of the number of atherogenic particles circulating in the bloodstream.

     Key Points:

     Direct Indicator of Particle Number: Since each atherogenic lipoprotein particle has one ApoB molecule, measuring ApoB provides an accurate count of these particles. This is crucial because the more atherogenic particles present, the higher the risk of these particles penetrating the arterial walls and contributing to plaque formation.

     Independent of Cholesterol Content:

     The cholesterol content does not influence ApoB measurement within these particles. Therefore, it provides a clearer picture of cardiovascular risk, especially in cases where LDL cholesterol (LDL-C) levels might be normal, but the number of LDL particles (and thus ApoB) is high.

     HDL-TG Ratio: A Marker of Lipid Metabolism

     The HDL-TG ratio, which is the ratio of high-density lipoprotein cholesterol (HDL-C) to triglycerides (TG), is used as a marker to assess lipid metabolism and insulin resistance. A high HDL-TG ratio generally indicates a favorable lipid profile and a lower risk of cardiovascular disease. However, this ratio has limitations:

     Indirect vs direct measure:

     Indirect Measurement: The HDL-TG ratio provides an indirect measure of cardiovascular risk. It does not directly quantify the number of atherogenic particles but rather gives a sense of lipid metabolism status. While a low HDL-C and high TG level can indicate higher cardiovascular risk, it doesn't directly account for the number of atherogenic particles present.

     Variability and Confounding Factors:

     Several factors can influence the ratio, including lifestyle, diet, and metabolic disorders, which can confound its predictive value for cardiovascular risk. Additionally, HDL-C levels alone have not consistently been shown to correlate with reduced cardiovascular risk, as HDL particles can vary in functionality.

     Why ApoB is More Important

     Predictive Power: Numerous studies have shown that ApoB is a stronger predictor of cardiovascular events than the HDL-TG ratio. For instance, the INTERHEART study highlighted that ApoB levels were more predictive of myocardial infarction than other lipid markers, including the HDL-TG ratio.

     Comprehensive Risk Assessment: ApoB accounts for all atherogenic particles, providing a more comprehensive assessment of cardiovascular risk compared to measures that only consider cholesterol content or ratios of different lipid components.

      Focusing on the Right Metric

     In summary, the focus has shifted from LDL particle size to the number of atherogenic particles, as measured by ApoB. This shift is grounded in the understanding that cardiovascular disease risk is more closely linked to the number of these particles rather than their size or cholesterol content alone. Therefore, ApoB provides a more accurate and reliable measure for assessing cardiovascular risk.

     Conclusion

     While both ApoB and the HDL-TG ratio can provide valuable information about lipid metabolism and cardiovascular risk, ApoB is considered more important due to its direct measurement of atherogenic particles. This makes it a more reliable and comprehensive marker for assessing the risk of atherosclerosis and related cardiovascular events.

      

     Citations:

     Sniderman, A. D., & Tsimikas, S. (2014). Apolipoprotein B. Circulation, 129(11), 1112-1120.

     Packard, C. J., & Shepherd, J. (1999). Lipoprotein heterogeneity and apolipoprotein B metabolism. Atherosclerosis, 141(1), 27-42.

     McQueen, M. J., Hawken, S., Wang, X., Ounpuu, S., Sniderman, A., Probstfield, J., ... & Yusuf, S. (2008). Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. The Lancet, 372(9634), 224-233.

     Cromwell, W. C., & Otvos, J. D. (2004). Low-density lipoprotein particle number and risk for cardiovascular disease. Current Atherosclerosis Reports, 6(5), 381-387.

     Mora, S., Otvos, J. D., Rifai, N., Rosenson, R. S., Buring, J. E., & Ridker, P. M. (2009). Lipoprotein particle profiles by nuclear magnetic resonance compared with standard lipids and apolipoproteins in predicting incident cardiovascular disease in women. Circulation, 119(17), 931-939.

     Packard, C. J., & Shepherd, J. (1999). Lipoprotein heterogeneity and apolipoprotein B metabolism. Atherosclerosis, 141(1), 27-42.

     Sniderman, A. D., & Furberg, C. D. (2008). Age as a modifiable risk factor for cardiovascular disease. The Lancet, 371(9623), 1547-1548.

     Cromwell, W. C., & Otvos, J. D. (2004). Low-density lipoprotein particle number and risk for cardiovascular disease. Current Atherosclerosis Reports, 6(5), 381-387.

     Sniderman, A. D., & Tsimikas, S. (2014). Apolipoprotein B. Circulation, 129(11), 1112-1120.

     Harchaoui, K. E., Visser, M. E., Kastelein, J. J., Stroes, E. S., & Dallinga-Thie, G. M. (2009). Triglycerides and cardiovascular risk. Current Cardiology Reviews, 5(3), 216-222.

     McQueen, M. J., Hawken, S., Wang, X., Ounpuu, S., Sniderman, A., Probstfield, J., ... & Yusuf, S. (2008). Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. The Lancet, 372(9634), 224-233.

     ]]>8492f7df-d2ea-4e68-9339-fca2559b3911Thu, 19 Sep 2024 00:00:00 -070012:55falsefull5656Autoimmune Diseases and CharlatansThe Cyclical Nature of Autoimmune Diseases: A Huckster's Playground

     Autoimmune diseases are notoriously difficult to manage because they don’t follow a linear progression. Patients often experience periods of remission, where symptoms lessen or disappear, followed by flare-ups, where symptoms return, sometimes worse than before. This cyclical nature gives the illusion that certain "treatments" or lifestyle changes are working when, in reality, the disease is simply following its natural course.

     Hucksters exploit this ebb and flow, offering unproven solutions and claiming credit for any improvements that coincide with the natural remission phase. When symptoms return during a flare-up, they may shift the blame to the patient, suggesting they didn’t follow the regimen properly or need to try an even more restrictive approach.

     In many cases, these alternative therapies center around the idea that gut issues cause autoimmune diseases, particularly leaky gut syndrome. The pitch is simple: repair the gut, and the immune system will stop attacking the body. Unfortunately, the science doesn’t back this up.

     Why the Gut Isn’t the Root Cause of Autoimmune Disease

     It's true that there is a connection between the gut and the immune system. In fact, about 70% of the immune system resides in the gut, and gut bacteria (the microbiome) play a role in regulating immune responses. However, autoimmune diseases are far more complex than just a gut issue.

     Genetic predispositions primarily drive Autoimmune diseases, environmental triggers, and immune system dysregulation. While diet and gut health can influence immune responses, there’s no evidence that simply "healing" the gut will reverse the course of autoimmune diseases. The immune system in these conditions has gone awry in ways that are not fully understood, and current medical treatments focus on suppressing overactive immune responses and managing symptoms—not on gut health alone.

      

     Myasthenia Gravis (MG) is an autoimmune disease where medical treatment significantly outperforms dietary interventions.

     MG is characterized by autoantibodies targeting the neuromuscular junction, leading to fluctuating muscle weakness and fatigability. The primary treatment modalities for MG involve immunosuppressive therapies and precision medicine approaches.

     Current treatment guidelines, as discussed by Cavalcante et al., highlight the use of immunosuppressive therapies such as corticosteroids, azathioprine, and mycophenolate mofetil to control symptoms and improve muscle strength. (reference here)

     Additionally, novel biological drugs targeting B cell activation, antibody recycling, and complement system-mediated neuromuscular junction damage have shown efficacy and safety in clinical trials. These precision medicine approaches are tailored to the patient's specific immunopathogenic mechanisms, offering a more targeted and effective treatment strategy.

     In contrast, dietary interventions have not demonstrated significant efficacy in managing MG. While general nutritional support is important for overall health, there is no specific diet that can modulate the autoimmune mechanisms underlying MG to the same extent as pharmacological treatments.

     In summary, medicine does better than diet in managing Myasthenia Gravis, with immunosuppressive therapies and precision medicine approaches being the cornerstone of treatment.[1]

     Here’s why relying on gut health as the sole solution is like using a garden hose to fight a forest fire:

      

     A. The Complexity of Autoimmune Dysregulation

     Autoimmune diseases involve dysregulation at multiple levels of the immune system. In diseases like lupus or multiple sclerosis, immune cells are mistaking the body's own tissues for foreign invaders. This misidentification isn’t simply the result of a leaky gut; it’s a deeper issue with how the body’s T-cells, B-cells, and other immune components are functioning.

     Medical treatments for autoimmune conditions, such as biologics and immunosuppressants, target these complex pathways to reduce inflammation and prevent further tissue damage. These therapies are carefully designed to modulate specific immune processes—something that diet and gut health alone can’t achieve.

     B. Gut Health Cannot Reverse Severe Immune Attacks

     Imagine trying to put out a raging forest fire with a garden hose—that’s what focusing solely on gut health is like when trying to manage autoimmune flare-ups. Autoimmune diseases can cause severe damage to the organs, such as the joints, kidneys, or central nervous system, depending on the condition. These diseases are often life-altering and, in severe cases, life-threatening.

     Even if the gut plays some role in immune regulation, "fixing" the gut doesn’t address the immune attacks happening in vital organs throughout the body. Managing an autoimmune condition requires powerful treatments that target these immune responses at the source, not superficial changes to the digestive system.

     C. Gut-Focused Diets Can Be Restrictive and Harmful

     Another major issue with the gut-healing approach is that it often involves restrictive diets that cut out whole food groups in the name of reducing inflammation or healing the gut lining. These diets, such as the autoimmune protocol (AIP) or extreme versions of the paleo diet, are promoted as cures but lack strong scientific backing.

     For many patients, these diets can lead to nutrient deficiencies, unnecessary food anxiety, and added stress—none of which is helpful when managing a chronic condition. Worse, some people may forego or delay important medical treatments, opting instead for these restrictive, gut-healing diets in hopes of a cure. This can lead to uncontrolled disease progression and irreversible damage to organs.

     What We Do Know: The Gut’s Role in Autoimmune Disease Management

     This isn’t to say the gut has no role in autoimmune disease—far from it. Gut health can influence overall health, including the immune system, and managing autoimmune diseases often includes dietary adjustments to improve symptom management. But diet should be seen as one tool in a larger toolbox, not the magic bullet.

     For example:

     Probiotics and prebiotics may support gut health and help modulate immune responses in some cases, though the evidence is still emerging.

     However, if these patients are not appropriately followed, they can develop kidney involvement leading to loss of function or severe joint destruction for RA type, or even severe vasculitis, and none of these conditions are treated by or recognized by chiropractors

     ]]>The Cyclical Nature of Autoimmune Diseases: A Huckster's Playground

     Autoimmune diseases are notoriously difficult to manage because they don’t follow a linear progression. Patients often experience periods of remission, where symptoms lessen or disappear, followed by flare-ups, where symptoms return, sometimes worse than before. This cyclical nature gives the illusion that certain "treatments" or lifestyle changes are working when, in reality, the disease is simply following its natural course.

     Hucksters exploit this ebb and flow, offering unproven solutions and claiming credit for any improvements that coincide with the natural remission phase. When symptoms return during a flare-up, they may shift the blame to the patient, suggesting they didn’t follow the regimen properly or need to try an even more restrictive approach.

     In many cases, these alternative therapies center around the idea that gut issues cause autoimmune diseases, particularly leaky gut syndrome. The pitch is simple: repair the gut, and the immune system will stop attacking the body. Unfortunately, the science doesn’t back this up.

     Why the Gut Isn’t the Root Cause of Autoimmune Disease

     It's true that there is a connection between the gut and the immune system. In fact, about 70% of the immune system resides in the gut, and gut bacteria (the microbiome) play a role in regulating immune responses. However, autoimmune diseases are far more complex than just a gut issue.

     Genetic predispositions primarily drive Autoimmune diseases, environmental triggers, and immune system dysregulation. While diet and gut health can influence immune responses, there’s no evidence that simply "healing" the gut will reverse the course of autoimmune diseases. The immune system in these conditions has gone awry in ways that are not fully understood, and current medical treatments focus on suppressing overactive immune responses and managing symptoms—not on gut health alone.

      

     Myasthenia Gravis (MG) is an autoimmune disease where medical treatment significantly outperforms dietary interventions.

     MG is characterized by autoantibodies targeting the neuromuscular junction, leading to fluctuating muscle weakness and fatigability. The primary treatment modalities for MG involve immunosuppressive therapies and precision medicine approaches.

     Current treatment guidelines, as discussed by Cavalcante et al., highlight the use of immunosuppressive therapies such as corticosteroids, azathioprine, and mycophenolate mofetil to control symptoms and improve muscle strength. (reference here)

     Additionally, novel biological drugs targeting B cell activation, antibody recycling, and complement system-mediated neuromuscular junction damage have shown efficacy and safety in clinical trials. These precision medicine approaches are tailored to the patient's specific immunopathogenic mechanisms, offering a more targeted and effective treatment strategy.

     In contrast, dietary interventions have not demonstrated significant efficacy in managing MG. While general nutritional support is important for overall health, there is no specific diet that can modulate the autoimmune mechanisms underlying MG to the same extent as pharmacological treatments.

     In summary, medicine does better than diet in managing Myasthenia Gravis, with immunosuppressive therapies and precision medicine approaches being the cornerstone of treatment.[1]

     Here’s why relying on gut health as the sole solution is like using a garden hose to fight a forest fire:

      

     A. The Complexity of Autoimmune Dysregulation

     Autoimmune diseases involve dysregulation at multiple levels of the immune system. In diseases like lupus or multiple sclerosis, immune cells are mistaking the body's own tissues for foreign invaders. This misidentification isn’t simply the result of a leaky gut; it’s a deeper issue with how the body’s T-cells, B-cells, and other immune components are functioning.

     Medical treatments for autoimmune conditions, such as biologics and immunosuppressants, target these complex pathways to reduce inflammation and prevent further tissue damage. These therapies are carefully designed to modulate specific immune processes—something that diet and gut health alone can’t achieve.

     B. Gut Health Cannot Reverse Severe Immune Attacks

     Imagine trying to put out a raging forest fire with a garden hose—that’s what focusing solely on gut health is like when trying to manage autoimmune flare-ups. Autoimmune diseases can cause severe damage to the organs, such as the joints, kidneys, or central nervous system, depending on the condition. These diseases are often life-altering and, in severe cases, life-threatening.

     Even if the gut plays some role in immune regulation, "fixing" the gut doesn’t address the immune attacks happening in vital organs throughout the body. Managing an autoimmune condition requires powerful treatments that target these immune responses at the source, not superficial changes to the digestive system.

     C. Gut-Focused Diets Can Be Restrictive and Harmful

     Another major issue with the gut-healing approach is that it often involves restrictive diets that cut out whole food groups in the name of reducing inflammation or healing the gut lining. These diets, such as the autoimmune protocol (AIP) or extreme versions of the paleo diet, are promoted as cures but lack strong scientific backing.

     For many patients, these diets can lead to nutrient deficiencies, unnecessary food anxiety, and added stress—none of which is helpful when managing a chronic condition. Worse, some people may forego or delay important medical treatments, opting instead for these restrictive, gut-healing diets in hopes of a cure. This can lead to uncontrolled disease progression and irreversible damage to organs.

     What We Do Know: The Gut’s Role in Autoimmune Disease Management

     This isn’t to say the gut has no role in autoimmune disease—far from it. Gut health can influence overall health, including the immune system, and managing autoimmune diseases often includes dietary adjustments to improve symptom management. But diet should be seen as one tool in a larger toolbox, not the magic bullet.

     For example:

     Probiotics and prebiotics may support gut health and help modulate immune responses in some cases, though the evidence is still emerging.

     However, if these patients are not appropriately followed, they can develop kidney involvement leading to loss of function or severe joint destruction for RA type, or even severe vasculitis, and none of these conditions are treated by or recognized by chiropractors

     ]]>0ed41ae2-0ce3-484d-b361-5c1f3fc87c5aWed, 11 Sep 2024 00:00:00 -070011:39falsefull5555Bread: The Evil Staff of LifeShould I eat bread?

     The low carbohydrate movement has demonized bread.  But is bread fattening? Does it cause inflammation? And if so, why do we call bread the Staff of Life?

     The Staff of Life

     Imagine calling white bread the staff of life. And yet bread is more responsible for humans ending a nomadic existence. The cultivation of wheat and barley, both in the Nile and in the Euphrates/Tigris rivers, led to civilization.

     Calendars, Art, Religion

     Not having to forage meant there was time to build a more permanent shelter. It also meant a steady supply of food.

     This also meant a calendar was needed because when is the optimal time to plant?

     The calendar helped predict when the rivers would swell and recede. The bottom land, with its rich topsoil, is ideal for growing crops.

     When you don't need to spend time looking for food, you have time to develop other things:

     • Make a religion around grains - the god of the weather, of the earth of the river
     • Grain can become the first currency, facilitating trade
     • Art because you spend less time seeking food
     • Storage systems to overcome times of famine.
     • Mathematics, weights, and measures are needed to buy and sell grain
     • Writing to make contracts and facilitate trade of the grain
     • A government is needed to settle disputes
     
     

     Storage Systems

     Harvested grain can be stored. Storing grain in Egypt was easier because of the dry climate.  Joseph, of the Hebrew Bible, prophesied to the Pharoh of an upcoming famine. As a result, the Pharoh built silos and stored a portion of each harvest.  Seven years later, the harvest failed.  But

     The silo system was complex. Filling from the top and arranged in a way that winds would keep the grains cool.  Where did Egyptians get the idea for such an invention? From bees. You can see the bees' natural ventilation system here:

     Bees were the symbol of royalty in ancient Egypt. Their honey was tears from the sun god. Bee architecture was copied for the ventilation system for the silos storing grain.  Thus, the storage of grain allowed society to thrive during the time of famine.

     Bronze Age to Iron Age

     Bread was portable. Served as currency. Allowed armies to march. Facilitated trade between city states. The grain rich regions of the Nile produced grain traded with Mycennians for olive oil and wine.

     The Roman emperors gave bread to the poor as welfare. Part of the bread and circus program to keep Romans happy. Bread was imported to Rome, and ultimately, Roman citizens were given "their daily bread."

     Rome fell, but bread continued to be important.

     Bread until 1920

     Grains, including bread, were the major source of calories for most of Europe. From the fall of Rome through the Middle Ages, bread was the main source of calories, along with other grain products.

     Bread in the Industrial Age

     White bread was considered pure, hygienic, the whiter the better. Brown bread could be contaminated. The ability of mills to separate wheat from chaff, and to make bread without a human hand touching it was irresistible. Industrial bread slicing resulted in "best thing since sliced bread."

     White bread became the preferred style of bread from the 1920s until 2009.

     Fortification of bread with vitamins in the 1940s made bread a health food.  Pellagra (vitamin B 3 deficiency) and beriberi  (thiamine deficiency) had sadly become common in the US and were eliminated by fortification. So it was indeed revolutionary, but calling it a health food? Even the Federal Trade Commission had issues with this "12 ways campaign" and sued Wonder Bread. The Feds lost.

     Age of Aquarius Beats Bread

     In spite of the world loving white bread, with baby boomers and Gen X growing up on it, there was rebellion.  Health guru Adele Davis, who sold millions of health books, decried bread for its lack of fiber and urged people to make whole wheat bread at home.

     But then came the hippies and the summer of love.  Hundreds of kids were flocking to San Francisco without jobs, without money, and hungry. Feeding these young adults became a group priority.

     In 1967, Walt Reynolds came, brought 400 pounds of flour, and baked bread twice a week to feed these kids. They didn't have enough bread trays, so they used coffee cans.

     Walt insisted on using whole wheat bread, something rare in those days. But this became part of the counter-culture. Make your own bread. Make it healthy. It became their own bread, their own symbol.

     We don't know what happened to Walt Reynolds after this - he lives, changed the way a generation looked at bread, and then disappeared.

     Atkins and Bread

     The low carb movement of the 1970's meant bread sales went declined. They recovered a bit, but in the second Atkins revolution, bread sales were down in some bakeries by 40%. Today Atkins Corporation sells bread.

     But How to Make It

     While there were lots of recipes to make bread from Digger Bread, as seen above, home cooks wondered. Then came along another baker who made the bread everyone dreamed of. From the baker of the Zen Retreat - we have this book.

     In 2009 whole wheat bread surpassed white bread as the major bread sold over time. With fiber at the core all whole wheat products have increased.

     And we can say for certain—yes, you can buy bread—but buy or make your own. Today, I can walk to a local baker who makes whole-grain sourdough bread.

     ]]>Should I eat bread?

     The low carbohydrate movement has demonized bread.  But is bread fattening? Does it cause inflammation? And if so, why do we call bread the Staff of Life?

     The Staff of Life

     Imagine calling white bread the staff of life. And yet bread is more responsible for humans ending a nomadic existence. The cultivation of wheat and barley, both in the Nile and in the Euphrates/Tigris rivers, led to civilization.

     Calendars, Art, Religion

     Not having to forage meant there was time to build a more permanent shelter. It also meant a steady supply of food.

     This also meant a calendar was needed because when is the optimal time to plant?

     The calendar helped predict when the rivers would swell and recede. The bottom land, with its rich topsoil, is ideal for growing crops.

     When you don't need to spend time looking for food, you have time to develop other things:

     • Make a religion around grains - the god of the weather, of the earth of the river
     • Grain can become the first currency, facilitating trade
     • Art because you spend less time seeking food
     • Storage systems to overcome times of famine.
     • Mathematics, weights, and measures are needed to buy and sell grain
     • Writing to make contracts and facilitate trade of the grain
     • A government is needed to settle disputes
     
     

     Storage Systems

     Harvested grain can be stored. Storing grain in Egypt was easier because of the dry climate.  Joseph, of the Hebrew Bible, prophesied to the Pharoh of an upcoming famine. As a result, the Pharoh built silos and stored a portion of each harvest.  Seven years later, the harvest failed.  But

     The silo system was complex. Filling from the top and arranged in a way that winds would keep the grains cool.  Where did Egyptians get the idea for such an invention? From bees. You can see the bees' natural ventilation system here:

     Bees were the symbol of royalty in ancient Egypt. Their honey was tears from the sun god. Bee architecture was copied for the ventilation system for the silos storing grain.  Thus, the storage of grain allowed society to thrive during the time of famine.

     Bronze Age to Iron Age

     Bread was portable. Served as currency. Allowed armies to march. Facilitated trade between city states. The grain rich regions of the Nile produced grain traded with Mycennians for olive oil and wine.

     The Roman emperors gave bread to the poor as welfare. Part of the bread and circus program to keep Romans happy. Bread was imported to Rome, and ultimately, Roman citizens were given "their daily bread."

     Rome fell, but bread continued to be important.

     Bread until 1920

     Grains, including bread, were the major source of calories for most of Europe. From the fall of Rome through the Middle Ages, bread was the main source of calories, along with other grain products.

     Bread in the Industrial Age

     White bread was considered pure, hygienic, the whiter the better. Brown bread could be contaminated. The ability of mills to separate wheat from chaff, and to make bread without a human hand touching it was irresistible. Industrial bread slicing resulted in "best thing since sliced bread."

     White bread became the preferred style of bread from the 1920s until 2009.

     Fortification of bread with vitamins in the 1940s made bread a health food.  Pellagra (vitamin B 3 deficiency) and beriberi  (thiamine deficiency) had sadly become common in the US and were eliminated by fortification. So it was indeed revolutionary, but calling it a health food? Even the Federal Trade Commission had issues with this "12 ways campaign" and sued Wonder Bread. The Feds lost.

     Age of Aquarius Beats Bread

     In spite of the world loving white bread, with baby boomers and Gen X growing up on it, there was rebellion.  Health guru Adele Davis, who sold millions of health books, decried bread for its lack of fiber and urged people to make whole wheat bread at home.

     But then came the hippies and the summer of love.  Hundreds of kids were flocking to San Francisco without jobs, without money, and hungry. Feeding these young adults became a group priority.

     In 1967, Walt Reynolds came, brought 400 pounds of flour, and baked bread twice a week to feed these kids. They didn't have enough bread trays, so they used coffee cans.

     Walt insisted on using whole wheat bread, something rare in those days. But this became part of the counter-culture. Make your own bread. Make it healthy. It became their own bread, their own symbol.

     We don't know what happened to Walt Reynolds after this - he lives, changed the way a generation looked at bread, and then disappeared.

     Atkins and Bread

     The low carb movement of the 1970's meant bread sales went declined. They recovered a bit, but in the second Atkins revolution, bread sales were down in some bakeries by 40%. Today Atkins Corporation sells bread.

     But How to Make It

     While there were lots of recipes to make bread from Digger Bread, as seen above, home cooks wondered. Then came along another baker who made the bread everyone dreamed of. From the baker of the Zen Retreat - we have this book.

     In 2009 whole wheat bread surpassed white bread as the major bread sold over time. With fiber at the core all whole wheat products have increased.

     And we can say for certain—yes, you can buy bread—but buy or make your own. Today, I can walk to a local baker who makes whole-grain sourdough bread.

     ]]>fc2ac8cb-ca3a-470c-8e45-f234e4f1dbfdWed, 10 Jul 2024 00:00:00 -070011:22falsefull5454Seed Oils: Toxic or Not?Seed Oils: Toxic or Not?

     Today, the low-carb/carnivore community has a new enemy. It is seed oils. Here is their argument:

     • There were no seed oils in ancient lands
     • Seed oils are highly inflammatory
     • Seed oils are extracted with hexane, a cancer-causing agent
     • The rise of seed oils correlates with the rise of obesity
     • Seed oils are high in omega-6 fatty acids, which are inflammatory
     
     

      

     That is the summary of their logic. Now, let's get to the science.

     
     

     What are Seed Oils?

     See those beautiful seeds, in them are bits of oil. This is the rapeseed plant, which we have covered before. From rapeseed came canola oil. And this has been used as a source of oil starting about 4000 years ago. A much misunderstood oil, please see our previous podcast.

     
     

     Seed Oils

     Every seed has oil. Nuts are a type of seed, and their caloric density comes from oil. Oddly, low carb/keto types tend to eat nuts, the carnivore crowd avoids them.

     Seed oils are another name for vegetable oils, and they are used often in cooking because they have a neutral taste and high smoke point. The more common ones include corn, peanuts, sunflowers, grapes, and others.

     
     

     Seed Oils and Ancient Humans

      Besides the logical fallacy about what ancient humans ate, seed oils have been cultivated and used for the whole of written humanity. Ancient Egyptians used oils for cooking and perfume. Even the Bible talks about the use of oils, including the gifts sent to the birth of Jesus. To summarize, humans have recorded the use of oils from seeds through all recorded history.

     
     

     Components of Seed Oils

     There is no one "oil" that can chemically be called a "seed oil." Rather, every seed contains different compositions of oils, and it is how the body uses those particular oils that makes us interested in them. Thus, seed oils as a term is silly. I wonder why the carnivore/keto crowd decided to use "seed oils" instead of vegetable oils? After all, they don't call beef tallow "meat oil."

     
     

     Oleic Acid: Olives to Butter

     Oleic acid is the main fatty acid in olive oil (55-85% of the oil).  This is a mono-unsaturated fatty acid, which everyone seems to agree is heart healthy. Hence, the more oleic acid in something, the better.

     • Peanut oil 48%
     • Canola oil 65%
     • Palm oil 39%
     • Soybean oil 23%
     • Coconut oil 7%
     • Beef Tallow 47%
     • Butter 24%
     
     

      

     But are Vegetable Oils Inflammatory?

     The short answer is no. To be inflammatory, they would have to elicit an inflammatory response. This means that inflammatory markers in the blood would be elevated for those who use vegetable oils over meat oils. In contrast, there is no increase in inflammatory markers of those who use vegetable oils.

     Want to see the data? Take a look at this paper where they look at foods, like vegetable oils, with high ratios of omega-6 fatty acids. What didn't they find? Higher levels of inflammatory markers. Thus, seed oils are not inflammatory.

     Atherosclerosis and Seed Oils

     Do vegetable oils increase your risk of atherosclerosis, or do they decrease it? If the carnivore crowd is correct, they have not been yet, then their view of the vegetable oils is that it would increase your risk of atherosclerosis

      

     REFERENCES:

      

     Courville AB, Majchrzak-Hong S, Yang S, Turner S, Wilhite B, Ness Shipley K, Horneffer Y, Domenichiello AF, Schwandt M, Cutler RG, Chen KY, Hibbeln JR, Ramsden CE. Dietary linoleic acid lowering alone does not lower arachidonic acid or endocannabinoids among women with overweight and obesity: A randomized, controlled trial. Lipids. 2023 Nov;58(6):271-284. doi: 10.1002/lipd.12382. PMID: 38100748; PMCID: PMC10767670.

      

     Innes JK, Calder PC. Omega-6 fatty acids and inflammation. Prostaglandins Leukot Essent Fatty Acids. 2018 May;132:41-48. doi: 10.1016/j.plefa.2018.03.004. Epub 2018 Mar 22. PMID: 29610056.

      

     Fava M, De Dominicis N, Forte G, Bari M, Leuti A, Maccarrone M. Cellular and Molecular Effects of Microgravity on the Immune System: A Focus on Bioactive Lipids. Biomolecules. 2024 Apr 5;14(4):446. doi: 10.3390/biom14040446. PMID: 38672462; PMCID: PMC11048039.

      

     Ooi EM, Watts GF, Ng TW, Barrett PH. Effect of dietary Fatty acids on human lipoprotein metabolism: a comprehensive update. Nutrients. 2015 Jun 2;7(6):4416-25. doi: 10.3390/nu7064416. PMID: 26043038; PMCID: PMC4488792.

      

     Prater MC, Scheurell AR, Paton CM, Cooper JA. Blood Lipid Responses to Diets Enriched with Cottonseed Oil Compared With Olive Oil in Adults with High Cholesterol in a Randomized Trial. J Nutr. 2022 Sep 6;152(9):2060-2071. doi: 10.1093/jn/nxac099. PMID: 35511204; PMCID: PMC9449680.

      

     Isaakidis A, Maghariki JE, Carvalho-Barros S, Gomes AM, Correia M. Is There More to Olive Oil than Healthy Lipids? Nutrients. 2023 Aug 18;15(16):3625. doi: 10.3390/nu15163625. PMID: 37630815; PMCID: PMC10459315.

     Schwingshackl L, Bogensberger B, Benčič A, Knüppel S, Boeing H, Hoffmann G. Effects of oils and solid fats on blood lipids: a systematic review and network meta-analysis. J Lipid Res. 2018 Sep;59(9):1771-1782. doi: 10.1194/jlr.P085522. Epub 2018 Jul 13. PMID: 30006369; PMCID: PMC6121943.

      

     Neuenschwander M, Stadelmaier J, Eble J, Grummich K, Szczerba E, Kiesswetter E, Schlesinger S, Schwingshackl L. Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies. BMC Med. 2023 Nov 16;21(1):404. doi: 10.1186/s12916-023-03093-1. PMID: 37968628; PMCID: PMC10652524.

     ]]>Seed Oils: Toxic or Not?

     Today, the low-carb/carnivore community has a new enemy. It is seed oils. Here is their argument:

     • There were no seed oils in ancient lands
     • Seed oils are highly inflammatory
     • Seed oils are extracted with hexane, a cancer-causing agent
     • The rise of seed oils correlates with the rise of obesity
     • Seed oils are high in omega-6 fatty acids, which are inflammatory
     
     

      

     That is the summary of their logic. Now, let's get to the science.

     
     

     What are Seed Oils?

     See those beautiful seeds, in them are bits of oil. This is the rapeseed plant, which we have covered before. From rapeseed came canola oil. And this has been used as a source of oil starting about 4000 years ago. A much misunderstood oil, please see our previous podcast.

     
     

     Seed Oils

     Every seed has oil. Nuts are a type of seed, and their caloric density comes from oil. Oddly, low carb/keto types tend to eat nuts, the carnivore crowd avoids them.

     Seed oils are another name for vegetable oils, and they are used often in cooking because they have a neutral taste and high smoke point. The more common ones include corn, peanuts, sunflowers, grapes, and others.

     
     

     Seed Oils and Ancient Humans

      Besides the logical fallacy about what ancient humans ate, seed oils have been cultivated and used for the whole of written humanity. Ancient Egyptians used oils for cooking and perfume. Even the Bible talks about the use of oils, including the gifts sent to the birth of Jesus. To summarize, humans have recorded the use of oils from seeds through all recorded history.

     
     

     Components of Seed Oils

     There is no one "oil" that can chemically be called a "seed oil." Rather, every seed contains different compositions of oils, and it is how the body uses those particular oils that makes us interested in them. Thus, seed oils as a term is silly. I wonder why the carnivore/keto crowd decided to use "seed oils" instead of vegetable oils? After all, they don't call beef tallow "meat oil."

     
     

     Oleic Acid: Olives to Butter

     Oleic acid is the main fatty acid in olive oil (55-85% of the oil).  This is a mono-unsaturated fatty acid, which everyone seems to agree is heart healthy. Hence, the more oleic acid in something, the better.

     • Peanut oil 48%
     • Canola oil 65%
     • Palm oil 39%
     • Soybean oil 23%
     • Coconut oil 7%
     • Beef Tallow 47%
     • Butter 24%
     
     

      

     But are Vegetable Oils Inflammatory?

     The short answer is no. To be inflammatory, they would have to elicit an inflammatory response. This means that inflammatory markers in the blood would be elevated for those who use vegetable oils over meat oils. In contrast, there is no increase in inflammatory markers of those who use vegetable oils.

     Want to see the data? Take a look at this paper where they look at foods, like vegetable oils, with high ratios of omega-6 fatty acids. What didn't they find? Higher levels of inflammatory markers. Thus, seed oils are not inflammatory.

     Atherosclerosis and Seed Oils

     Do vegetable oils increase your risk of atherosclerosis, or do they decrease it? If the carnivore crowd is correct, they have not been yet, then their view of the vegetable oils is that it would increase your risk of atherosclerosis

      

     REFERENCES:

      

     Courville AB, Majchrzak-Hong S, Yang S, Turner S, Wilhite B, Ness Shipley K, Horneffer Y, Domenichiello AF, Schwandt M, Cutler RG, Chen KY, Hibbeln JR, Ramsden CE. Dietary linoleic acid lowering alone does not lower arachidonic acid or endocannabinoids among women with overweight and obesity: A randomized, controlled trial. Lipids. 2023 Nov;58(6):271-284. doi: 10.1002/lipd.12382. PMID: 38100748; PMCID: PMC10767670.

      

     Innes JK, Calder PC. Omega-6 fatty acids and inflammation. Prostaglandins Leukot Essent Fatty Acids. 2018 May;132:41-48. doi: 10.1016/j.plefa.2018.03.004. Epub 2018 Mar 22. PMID: 29610056.

      

     Fava M, De Dominicis N, Forte G, Bari M, Leuti A, Maccarrone M. Cellular and Molecular Effects of Microgravity on the Immune System: A Focus on Bioactive Lipids. Biomolecules. 2024 Apr 5;14(4):446. doi: 10.3390/biom14040446. PMID: 38672462; PMCID: PMC11048039.

      

     Ooi EM, Watts GF, Ng TW, Barrett PH. Effect of dietary Fatty acids on human lipoprotein metabolism: a comprehensive update. Nutrients. 2015 Jun 2;7(6):4416-25. doi: 10.3390/nu7064416. PMID: 26043038; PMCID: PMC4488792.

      

     Prater MC, Scheurell AR, Paton CM, Cooper JA. Blood Lipid Responses to Diets Enriched with Cottonseed Oil Compared With Olive Oil in Adults with High Cholesterol in a Randomized Trial. J Nutr. 2022 Sep 6;152(9):2060-2071. doi: 10.1093/jn/nxac099. PMID: 35511204; PMCID: PMC9449680.

      

     Isaakidis A, Maghariki JE, Carvalho-Barros S, Gomes AM, Correia M. Is There More to Olive Oil than Healthy Lipids? Nutrients. 2023 Aug 18;15(16):3625. doi: 10.3390/nu15163625. PMID: 37630815; PMCID: PMC10459315.

     Schwingshackl L, Bogensberger B, Benčič A, Knüppel S, Boeing H, Hoffmann G. Effects of oils and solid fats on blood lipids: a systematic review and network meta-analysis. J Lipid Res. 2018 Sep;59(9):1771-1782. doi: 10.1194/jlr.P085522. Epub 2018 Jul 13. PMID: 30006369; PMCID: PMC6121943.

      

     Neuenschwander M, Stadelmaier J, Eble J, Grummich K, Szczerba E, Kiesswetter E, Schlesinger S, Schwingshackl L. Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies. BMC Med. 2023 Nov 16;21(1):404. doi: 10.1186/s12916-023-03093-1. PMID: 37968628; PMCID: PMC10652524.

     ]]>73b33247-6dad-4269-b85b-aed98ba6629cMon, 01 Jul 2024 00:00:00 -070011:28falsefull5353Ancestral Diets and Logical FallaciesAncestral Diets and Logical Fallacies

     There is an appeal to ancient history: the idea that ancient beings were either "designed"—as from a creator—or "evolved" to eat in a certain way. Both are logical fallacies, but both are meant to be the "ex-cathedra" in a debate.

     You read these logical fallacies in communities that claim they understand this. Here are some comments you will get:

     • Our ancestors ate xyz (fill in the blank) and never had the modern chronic diseases
     • Our teeth have (canines/molars), so we were designed to eat only (meat/plants)
     • You won't see broccoli on the walls of caves
     • If we ate like our ancestors, we would be in great health.
     
     

      

     Appealing arguments, but they are as flawed as they are simply incorrect.

     
     

     What Do We Know About Early Humans?

     Of the early human records, they are based on precious little data. Consider in the fossil record we have about our ancestors? And by the way, where do we start?

     If we begin with homo sapiens, we have been around as a species somewhere between 70,000 to 250,000 years.

     Often the "low-carb" community will conflate distant cousins of homo sapiens as direct ancestors. Most of them were not but were a branch on the tree of evolution that are only related to us.

     
     

     Homo Erectus

     Perhaps the best adapted was the homo erectus, which was around for two million years. It is doubtful that homo sapiens will make it that long, but we can hope.

     Most fossil finds come from Australia and Asia - where they not only foraged but also established some organized hunting.

     
     

     Fossil Records

     There are about 6000 fossils of early man. That's it. Just 6,000. When we look for fossils of our particular, such as early homo sapiens, we have enough fossils that we might fill up a school bus.

     How long did they live? It turns out we know.  Many died around the age of 35 years.   So why do we want to eat like they did?

     At this point, someone in the audience will be bound to say - "They lived longer if you take into account infant mortality."

     When we date a fossil and see when it died, we don't average the infant mortality of the time.

     
     

     Recent Discoveries

     Bones and teeth from seen people, and isolated teeth, were reported recently. These came from a cave in Morocco. As these teeth are from about 15,000 years ago. Hence, the diet was before the advent of agriculture.

     Evidence points to plants being a major part of these hunter-gatherer's menu.  As plants can be stored by hunter-gatherers all year round to protect against seasonal prey shortages. Thus, there is a regular food supply.

     
     

     Hunter-Gatherers

     The famous caveman diet- life wasn't so simple.

     When people of the carnivore tribe try to convince you about their diet, they invoke the mighty hunter.

     A better term was that our ancestors survived by being fishers, gatherers, and scavengers.

     ]]>Ancestral Diets and Logical Fallacies

     There is an appeal to ancient history: the idea that ancient beings were either "designed"—as from a creator—or "evolved" to eat in a certain way. Both are logical fallacies, but both are meant to be the "ex-cathedra" in a debate.

     You read these logical fallacies in communities that claim they understand this. Here are some comments you will get:

     • Our ancestors ate xyz (fill in the blank) and never had the modern chronic diseases
     • Our teeth have (canines/molars), so we were designed to eat only (meat/plants)
     • You won't see broccoli on the walls of caves
     • If we ate like our ancestors, we would be in great health.
     
     

      

     Appealing arguments, but they are as flawed as they are simply incorrect.

     
     

     What Do We Know About Early Humans?

     Of the early human records, they are based on precious little data. Consider in the fossil record we have about our ancestors? And by the way, where do we start?

     If we begin with homo sapiens, we have been around as a species somewhere between 70,000 to 250,000 years.

     Often the "low-carb" community will conflate distant cousins of homo sapiens as direct ancestors. Most of them were not but were a branch on the tree of evolution that are only related to us.

     
     

     Homo Erectus

     Perhaps the best adapted was the homo erectus, which was around for two million years. It is doubtful that homo sapiens will make it that long, but we can hope.

     Most fossil finds come from Australia and Asia - where they not only foraged but also established some organized hunting.

     
     

     Fossil Records

     There are about 6000 fossils of early man. That's it. Just 6,000. When we look for fossils of our particular, such as early homo sapiens, we have enough fossils that we might fill up a school bus.

     How long did they live? It turns out we know.  Many died around the age of 35 years.   So why do we want to eat like they did?

     At this point, someone in the audience will be bound to say - "They lived longer if you take into account infant mortality."

     When we date a fossil and see when it died, we don't average the infant mortality of the time.

     
     

     Recent Discoveries

     Bones and teeth from seen people, and isolated teeth, were reported recently. These came from a cave in Morocco. As these teeth are from about 15,000 years ago. Hence, the diet was before the advent of agriculture.

     Evidence points to plants being a major part of these hunter-gatherer's menu.  As plants can be stored by hunter-gatherers all year round to protect against seasonal prey shortages. Thus, there is a regular food supply.

     
     

     Hunter-Gatherers

     The famous caveman diet- life wasn't so simple.

     When people of the carnivore tribe try to convince you about their diet, they invoke the mighty hunter.

     A better term was that our ancestors survived by being fishers, gatherers, and scavengers.

     ]]>f3c875f6-6500-4f15-ae79-30deac17a9d6Wed, 19 Jun 2024 00:00:00 -070013:43falsefull5252Rice and Fruit or CarnivoreRice and Fruit or Carnivore

     The rice diet successfully treated malignant hypertension. Today, we have medications that treat malignant hypertension. Before the 1940s, there were no drugs available to treat this disease, resulting in death from untreated malignant hypertension within six months.  Despite the best medical care available, President Franklin Delano Roosevelt died from this disease.

     History of the Rice Diet

     Walter Kempner developed the rice diet to treat malignant hypertension. For example, failing kidneys would be given a reprieve with a diet low in sodium and protein. Then removal of saturated fat would allow some recovery of the heart.

     In a disease that had 100 percent death in six months, Kempner's results were amazing. For example, in Kempner’s original cohort of 192 people, only 25 patients died.  In addition, 107 patients showed significant improvement (from 200/112 mm Hg to 149/96 mm Hg) with the diet. Equally important, heart size decreased in 66 of 72 patients. Moreover, cholesterol was reduced in 73 of 82 patients. Finally, retinopathy improved or disappeared completely in 21 of 33 patients.

     "Therapeutic results are little short of miraculous," noted an editorial in the New England Journal of Medicine.

     The Rice Diet

     Patients were first hospitalized. The diet consisted of white rice, sugar, fruit, fruit juices, vitamins and iron. Total calories were 2,000 with 20 grams of protein and 150 mg of sodium.

     Kempner kept careful records of his patients. Reporting success and failure is a key to academic transparency. Finally, the ability to reproduce the data in other centers provided the final key to Kempner's work.

     Contrast the Carnivore Diet

     The carnivore diet is popular among young, buff men whose living is made by promoting and coaching this diet. They sell the diet based on classic marketing techniques used for overweight patients.

     • Lose weight without trying
     • No need to log your food
     • Eat as much as you want
     • Hunger isn't an issue
     
     

     Marketing phrases used by hucksters for years to trap people unhappy about their weight.

     No Science in the Carnivore Diet

     The carnivore diet relies on anecdotes, not evidence. Testimonials rule Facebook and YouTube sites. There are no publications about the diet. Finally, many in the carnivore community push against medicine. Conspiratorial thinking is strong, with phrases like this:

     • Doctors want you to be sick
     • The Medical Community wants to push pills
     • Vegetables have anti-nutrients
     
     

     Try to raise a concern about how this diet would increase the risk of heart disease, and they double down with misinformation. They will deny the evidence showing that high cholesterol leads to heart attacks and strokes. Or make the claim that if you are "metabolically healthy," you don't need to worry about cholesterol.

     No Academic Researchers

     There are no academic research scientists following people trying the carnivore diet.

     That means there is no transparency about the results. In addition, there is no accountability for any bad results.

     Those who promote the diet include Paul Saladino, a physician who doesn't see patients and makes his income selling supplements.

     The Liver King, who doesn't follow the diet, was caught using performance-enhancing drugs.

     Shawn Baker is an orthopedic-trained surgeon who lost his medical license and makes his money promoting the carnivore diet. The New Mexico Medical Board ordered the "voluntary and permanent surrender" of Baker's medical license in 2017. "This action was based on failure to report adverse action taken by a healthcare entity and incompetence to practice as a licensee." He had his license reinstated but is not seeing patients for anything more than coaching for $150 for half an hour.

     Ken Berry also lost his medical license for inadequate infection prevention in his offices. He has regained his license.

     Concerning Comments

     Some comments left on a recent YouTube video by Shawn Baker include:

     • A patient developed painful neuropathy from vitamin B6 toxic levels. He quit the carnivore diet and vows never to return
     • Another patient developed high oxylate levels. More kidney stones come from eating red meat than spinach - sorry, Paul Saladino.
     • One noted fasting glucose increased to 126, which we call diabetes. Saturated fat is not a friend of the pancreas and increases insulin resistance.
     • Another noted worsening kidney function with his filtration rate decreasing by 23 percent.
     • Multiple complaints about LDL, including one that went from 148 to 353
     • Psoriasis is often touted as being healed with this diet, but one noted their psoriasis spreading and getting worse. Red meat is highly inflammatory and not the optimal diet for people with psoriasis. Although psoriasis will come and go spontaneously, a carnivore diet is the worst diet for these patients.
     • Gynecomastia was noted by one male, and if you look at many carnivore shirtless salesmen of scams, you will see they also suffer from gynecomastia - those aren't pectoral muscles, those are breasts. Red meat can increase estrogen levels greatly.
     
     

     Not once did Shawn Baker instruct these people to see their regular doctor for appropriate treatment and follow-up. Hopefully, this will change.

     University Studies

     Do a research study with human subjects in a university, and there will be an independent board looking over the results. If there are any adverse results, those are reported to the research board, and sometimes studies are stopped because of too many adverse events. When results are published, both the good and the bad - like Kempner's work - are reported.

     Don't Do The Rice Diet

     The rice diet is for historical purposes only. The Mediterranean Diet is a far superior and more balanced diet. With over 13,000 peer reviewed publications, the Mediterranean Diet is the current pattern of eating that we recommend.

     ]]>Rice and Fruit or Carnivore

     The rice diet successfully treated malignant hypertension. Today, we have medications that treat malignant hypertension. Before the 1940s, there were no drugs available to treat this disease, resulting in death from untreated malignant hypertension within six months.  Despite the best medical care available, President Franklin Delano Roosevelt died from this disease.

     History of the Rice Diet

     Walter Kempner developed the rice diet to treat malignant hypertension. For example, failing kidneys would be given a reprieve with a diet low in sodium and protein. Then removal of saturated fat would allow some recovery of the heart.

     In a disease that had 100 percent death in six months, Kempner's results were amazing. For example, in Kempner’s original cohort of 192 people, only 25 patients died.  In addition, 107 patients showed significant improvement (from 200/112 mm Hg to 149/96 mm Hg) with the diet. Equally important, heart size decreased in 66 of 72 patients. Moreover, cholesterol was reduced in 73 of 82 patients. Finally, retinopathy improved or disappeared completely in 21 of 33 patients.

     "Therapeutic results are little short of miraculous," noted an editorial in the New England Journal of Medicine.

     The Rice Diet

     Patients were first hospitalized. The diet consisted of white rice, sugar, fruit, fruit juices, vitamins and iron. Total calories were 2,000 with 20 grams of protein and 150 mg of sodium.

     Kempner kept careful records of his patients. Reporting success and failure is a key to academic transparency. Finally, the ability to reproduce the data in other centers provided the final key to Kempner's work.

     Contrast the Carnivore Diet

     The carnivore diet is popular among young, buff men whose living is made by promoting and coaching this diet. They sell the diet based on classic marketing techniques used for overweight patients.

     • Lose weight without trying
     • No need to log your food
     • Eat as much as you want
     • Hunger isn't an issue
     
     

     Marketing phrases used by hucksters for years to trap people unhappy about their weight.

     No Science in the Carnivore Diet

     The carnivore diet relies on anecdotes, not evidence. Testimonials rule Facebook and YouTube sites. There are no publications about the diet. Finally, many in the carnivore community push against medicine. Conspiratorial thinking is strong, with phrases like this:

     • Doctors want you to be sick
     • The Medical Community wants to push pills
     • Vegetables have anti-nutrients
     
     

     Try to raise a concern about how this diet would increase the risk of heart disease, and they double down with misinformation. They will deny the evidence showing that high cholesterol leads to heart attacks and strokes. Or make the claim that if you are "metabolically healthy," you don't need to worry about cholesterol.

     No Academic Researchers

     There are no academic research scientists following people trying the carnivore diet.

     That means there is no transparency about the results. In addition, there is no accountability for any bad results.

     Those who promote the diet include Paul Saladino, a physician who doesn't see patients and makes his income selling supplements.

     The Liver King, who doesn't follow the diet, was caught using performance-enhancing drugs.

     Shawn Baker is an orthopedic-trained surgeon who lost his medical license and makes his money promoting the carnivore diet. The New Mexico Medical Board ordered the "voluntary and permanent surrender" of Baker's medical license in 2017. "This action was based on failure to report adverse action taken by a healthcare entity and incompetence to practice as a licensee." He had his license reinstated but is not seeing patients for anything more than coaching for $150 for half an hour.

     Ken Berry also lost his medical license for inadequate infection prevention in his offices. He has regained his license.

     Concerning Comments

     Some comments left on a recent YouTube video by Shawn Baker include:

     • A patient developed painful neuropathy from vitamin B6 toxic levels. He quit the carnivore diet and vows never to return
     • Another patient developed high oxylate levels. More kidney stones come from eating red meat than spinach - sorry, Paul Saladino.
     • One noted fasting glucose increased to 126, which we call diabetes. Saturated fat is not a friend of the pancreas and increases insulin resistance.
     • Another noted worsening kidney function with his filtration rate decreasing by 23 percent.
     • Multiple complaints about LDL, including one that went from 148 to 353
     • Psoriasis is often touted as being healed with this diet, but one noted their psoriasis spreading and getting worse. Red meat is highly inflammatory and not the optimal diet for people with psoriasis. Although psoriasis will come and go spontaneously, a carnivore diet is the worst diet for these patients.
     • Gynecomastia was noted by one male, and if you look at many carnivore shirtless salesmen of scams, you will see they also suffer from gynecomastia - those aren't pectoral muscles, those are breasts. Red meat can increase estrogen levels greatly.
     
     

     Not once did Shawn Baker instruct these people to see their regular doctor for appropriate treatment and follow-up. Hopefully, this will change.

     University Studies

     Do a research study with human subjects in a university, and there will be an independent board looking over the results. If there are any adverse results, those are reported to the research board, and sometimes studies are stopped because of too many adverse events. When results are published, both the good and the bad - like Kempner's work - are reported.

     Don't Do The Rice Diet

     The rice diet is for historical purposes only. The Mediterranean Diet is a far superior and more balanced diet. With over 13,000 peer reviewed publications, the Mediterranean Diet is the current pattern of eating that we recommend.

     ]]>d67c364c-0140-4327-957a-a41d5c860103Wed, 08 May 2024 00:00:00 -070013:12falsefull5151Grains on the Mediterranean DietThe Benefits of Whole Grains in Your Diet

     I want to take you back in time. While we talk about the Mediterranean diet not being a diet of culture but a pattern of eating – it still had its origins in the Mediterranean.

     The original Mediterranean diet was described as far back as 500 BC in the Ilead. The ancient Greeks ate whole grains, fruits, vegetables, pulses, and a bit of fish. Red meat was rare.

     While red meat may not have been a dietary staple for the Ancient Greeks, it was consumed during feasts, festivals, and special occasions.

     Cows were considered sacred gods, like Zeus, and their slaughter was for religious ceremonies and consumed during feasts

     The majority of the population received protein from fish, poultry, legumes, and whole grains.

     The First Olympics

     This was the diet of the first Olympians, as well as the Romans. Ancient Greeks worshiped the body, as you can see from the statues, as well as our language.

     We get the word gym from the Greek word “gymnasion," which translates to a place to exercise naked. But those gyms not only had a place to train but also schools, where literature, philosophy, math, and music were taught, as well as a social gathering place.

     We also get Diet from the Greeks, which originates from “diaita,” meaning the “way of life” or a manner of living. The Greeks had a balanced approach to health and well-being, emphasizing diet, exercise, and the mind.

     Gym bros and bro science were yet to be invented.

     Ancient Grains

     Could those Olympians of old who ate diets filled with whole-grain cereals have been wrong? Or could it be that those grains of the past were different from today’s grains?

     If you’ve ever been on a “low carb” diet, one of the first food groups you eliminate are grains.

     As you dutifully got rid of the last bit of joy in your life, you feel it was the cost to have your weight drop.

     You might have thought – "Grains are evil."

     Low Carb Life Without Grains

     Eating burgers without the bun, breakfast without toast, no pastries, no bread, no pasta, no rice, and you were losing weight. Lots of confirmation bias.

     Oh those heady early days of a low carb diet, losing weight, feeling better, maybe even noticing cholesterol improved. Hard to sustain though, and did you ever get tired of steak?

     Finding Joy in the Mediterranean Diet

     Now you come here and find the best diet is the Mediterranean diet. Lots of peer reviewed literature to support it.

     Then you wondered what in grains was evil. The first easy thought was that it all breaks down to glucose, and glucose is evil.

     Unless you know biochemistry and realize no, that’s not it. Your body runs on glucose.

     It's the Gluten

     And maybe you read about celiac disease and gluten as its trigger. Maybe some blogger convinced you that wheat in America is filled with gluten, and this is the problem.

     Unable to sustain a low-carb diet, you return to the joy of the morning pastry or dessert, all the while thinking grains are what caused the weight to return.

     Now you come to the Mediterranean Diet, and whole grains, not refined grains, are on the menu.

     Still, you are suspicious, and you think – maybe it was the gluten.

     Celiac Disease

     Or what happens if you come to the Mediterranean diet and have Celiac disease and gluten causes horrific issues?

     But should we all avoid gluten? And can we have a Mediterranean diet if we must be gluten-free?

     Should the ancient Greeks become Carnivores instead of those grizzly men who are on a diet now associated with the healthiest people on planet Earth?

     Clearly not. Eating too much red meat is associated with increasing heart disease and cancer, while the Mediterranean diet is associated with less heart disease and cancer.

     Carnivore's Take

     Carnivores like pointing to the ancient wrestler Milo of Croton, who ate twenty pounds of meat a day. They fail to mention that he also ate twenty pounds of bread and drank 18 pints of wine while training. Funny, they all talk about the meat. –There are always outliers, and Milo was one.

     When Milo trained, he carried a calf, and as the creature grew, he kept carrying it. He won about six Olympic medals (560 BC).

     While we don’t know details, it is odd he ate meat, since his mentor Pythagoras – of the theorem – thought eating meat was unhealthy and made people wage war.

     Grains are Evil - "They" Say

     And despite what the low-carb and carnivore community tells you, Whole grains have been associated with decreased risk of diabetes, less obesity, and lower rates of cancer and heart disease.

     Whole grains have a lot of fiber. In fact, whole grains are one of the fiber rich portions of the foods you eat.

     Gluten is a protein found in many grains, like wheat, but not all grains.  Do you know how to stretch dough? Like pizza, the reason you can do it is gluten.

     For most of us, gluten isn’t an issue. But for about one percent of the population, gluten can exacerbate an auto-immune response against your small bowel.

     If you have celiac disease...

     If you have celiac disease and have gluten in your diet, your bowel will be harmed. Thus, you will not effectively absorb nutrients. Many with celiac disease have anemia from an inability to absorb iron.

     Most patients with celiac disease will feel bloated with gas, sometimes diarrhea, or even constipation. They might have chronic fatigue or weakness due to a lack of nutrients. In children, it often leads to weight loss. In adults, it can manifest in weight gain.

     The symptoms are vague and not specific, but they are part of a history that we see with our patients.

     Gluten-free for Everyone

     Since the symptoms are so general, many people advocate a gluten-free diet. Some have written books about how gluten causes issues in everyone, and we should avoid it. This is incorrect, but it does sell a lot of books.

     Incorporating Gluten-Free Whole Grains

     Here are some easy ways to add gluten-free whole grains to your Mediterranean-inspired meals:

     1. Quinoa: Swap traditional grains like couscous with quinoa in salads, pilafs, or stuffed vegetables. Quinoa is a complete protein and offers a nutty flavor that complements Mediterranean ingredients well.
     2. Brown Rice: Use brown rice instead of traditional pasta in dishes like risotto, stir-fries, or alongside grilled fish or chicken. Brown rice provides a hearty texture and adds a dose of fiber to your meal.
     3. Millet: Experiment with millet in place of bulgur wheat in tabbouleh salads or use it as a base for grain bowls topped with roasted vegetables and a drizzle of olive oil.
     4. Buckwheat: Incorporate buckwheat flour into your baking for gluten-free bread, pancakes, or crepes. You can also use cooked buckwheat groats as a nutritious alternative to traditional grains in salads or as a side dish.
     5. Amaranth: Add amaranth to soups, stews, or porridge for a nutrient-packed boost. Its slightly nutty flavor pairs well with Mediterranean spices and herbs.
     
     

     My favorite is oatmeal. But make sure you get oats that were ground away from wheat. Bob’s Red Mill has a gluten free oat that you can use. Since oats are a staple of my morning breakfast you might find these a great choice.

      

     Finally, corn is a whole grain. Good to add to salads, and my favorite cowboy caviar dish.

     By incorporating gluten-free whole grains into your Mediterranean diet, you can enjoy a diverse range of flavors and textures while reaping the nutritional benefits of these wholesome ingredients. Whether you're looking to support digestive health, manage blood sugar levels, or simply explore new culinary horizons, there's a gluten-free whole grain waiting to elevate your next meal.

      

     Whole grains are a powerhouse of nutrition, offering a range of health benefits that make them an essential part of a balanced diet.

     Why Gluten-Free Whole Grains?

     But what if you have celiac disease and cannot tolerate gluten?

     Gluten is a protein found in many grains. It is responsible for stretching dough, like pizza.

     If you do not have a problem with gluten, there is no reason to avoid gluten.  But if you have celiac disease, gluten must be avoided.

     The Mediterranean Diet

     The Mediterranean diet is renowned for its focus on fresh fruits and vegetables, lean proteins, healthy fats, and whole grains. By incorporating gluten-free whole grains into this already nutritious diet, you can further enhance its health benefits while catering to dietary restrictions or preferences.

     Conclusion

     By incorporating gluten-free whole grains into your Mediterranean diet, you can enjoy a diverse range of flavors and textures while reaping the nutritional benefits of these wholesome ingredients. Whether you're looking to support digestive health, manage blood sugar levels, or simply explore new culinary horizons, there's a gluten-free whole grain waiting to elevate your next meal.

     ]]>The Benefits of Whole Grains in Your Diet

     I want to take you back in time. While we talk about the Mediterranean diet not being a diet of culture but a pattern of eating – it still had its origins in the Mediterranean.

     The original Mediterranean diet was described as far back as 500 BC in the Ilead. The ancient Greeks ate whole grains, fruits, vegetables, pulses, and a bit of fish. Red meat was rare.

     While red meat may not have been a dietary staple for the Ancient Greeks, it was consumed during feasts, festivals, and special occasions.

     Cows were considered sacred gods, like Zeus, and their slaughter was for religious ceremonies and consumed during feasts

     The majority of the population received protein from fish, poultry, legumes, and whole grains.

     The First Olympics

     This was the diet of the first Olympians, as well as the Romans. Ancient Greeks worshiped the body, as you can see from the statues, as well as our language.

     We get the word gym from the Greek word “gymnasion," which translates to a place to exercise naked. But those gyms not only had a place to train but also schools, where literature, philosophy, math, and music were taught, as well as a social gathering place.

     We also get Diet from the Greeks, which originates from “diaita,” meaning the “way of life” or a manner of living. The Greeks had a balanced approach to health and well-being, emphasizing diet, exercise, and the mind.

     Gym bros and bro science were yet to be invented.

     Ancient Grains

     Could those Olympians of old who ate diets filled with whole-grain cereals have been wrong? Or could it be that those grains of the past were different from today’s grains?

     If you’ve ever been on a “low carb” diet, one of the first food groups you eliminate are grains.

     As you dutifully got rid of the last bit of joy in your life, you feel it was the cost to have your weight drop.

     You might have thought – "Grains are evil."

     Low Carb Life Without Grains

     Eating burgers without the bun, breakfast without toast, no pastries, no bread, no pasta, no rice, and you were losing weight. Lots of confirmation bias.

     Oh those heady early days of a low carb diet, losing weight, feeling better, maybe even noticing cholesterol improved. Hard to sustain though, and did you ever get tired of steak?

     Finding Joy in the Mediterranean Diet

     Now you come here and find the best diet is the Mediterranean diet. Lots of peer reviewed literature to support it.

     Then you wondered what in grains was evil. The first easy thought was that it all breaks down to glucose, and glucose is evil.

     Unless you know biochemistry and realize no, that’s not it. Your body runs on glucose.

     It's the Gluten

     And maybe you read about celiac disease and gluten as its trigger. Maybe some blogger convinced you that wheat in America is filled with gluten, and this is the problem.

     Unable to sustain a low-carb diet, you return to the joy of the morning pastry or dessert, all the while thinking grains are what caused the weight to return.

     Now you come to the Mediterranean Diet, and whole grains, not refined grains, are on the menu.

     Still, you are suspicious, and you think – maybe it was the gluten.

     Celiac Disease

     Or what happens if you come to the Mediterranean diet and have Celiac disease and gluten causes horrific issues?

     But should we all avoid gluten? And can we have a Mediterranean diet if we must be gluten-free?

     Should the ancient Greeks become Carnivores instead of those grizzly men who are on a diet now associated with the healthiest people on planet Earth?

     Clearly not. Eating too much red meat is associated with increasing heart disease and cancer, while the Mediterranean diet is associated with less heart disease and cancer.

     Carnivore's Take

     Carnivores like pointing to the ancient wrestler Milo of Croton, who ate twenty pounds of meat a day. They fail to mention that he also ate twenty pounds of bread and drank 18 pints of wine while training. Funny, they all talk about the meat. –There are always outliers, and Milo was one.

     When Milo trained, he carried a calf, and as the creature grew, he kept carrying it. He won about six Olympic medals (560 BC).

     While we don’t know details, it is odd he ate meat, since his mentor Pythagoras – of the theorem – thought eating meat was unhealthy and made people wage war.

     Grains are Evil - "They" Say

     And despite what the low-carb and carnivore community tells you, Whole grains have been associated with decreased risk of diabetes, less obesity, and lower rates of cancer and heart disease.

     Whole grains have a lot of fiber. In fact, whole grains are one of the fiber rich portions of the foods you eat.

     Gluten is a protein found in many grains, like wheat, but not all grains.  Do you know how to stretch dough? Like pizza, the reason you can do it is gluten.

     For most of us, gluten isn’t an issue. But for about one percent of the population, gluten can exacerbate an auto-immune response against your small bowel.

     If you have celiac disease...

     If you have celiac disease and have gluten in your diet, your bowel will be harmed. Thus, you will not effectively absorb nutrients. Many with celiac disease have anemia from an inability to absorb iron.

     Most patients with celiac disease will feel bloated with gas, sometimes diarrhea, or even constipation. They might have chronic fatigue or weakness due to a lack of nutrients. In children, it often leads to weight loss. In adults, it can manifest in weight gain.

     The symptoms are vague and not specific, but they are part of a history that we see with our patients.

     Gluten-free for Everyone

     Since the symptoms are so general, many people advocate a gluten-free diet. Some have written books about how gluten causes issues in everyone, and we should avoid it. This is incorrect, but it does sell a lot of books.

     Incorporating Gluten-Free Whole Grains

     Here are some easy ways to add gluten-free whole grains to your Mediterranean-inspired meals:

     1. Quinoa: Swap traditional grains like couscous with quinoa in salads, pilafs, or stuffed vegetables. Quinoa is a complete protein and offers a nutty flavor that complements Mediterranean ingredients well.
     2. Brown Rice: Use brown rice instead of traditional pasta in dishes like risotto, stir-fries, or alongside grilled fish or chicken. Brown rice provides a hearty texture and adds a dose of fiber to your meal.
     3. Millet: Experiment with millet in place of bulgur wheat in tabbouleh salads or use it as a base for grain bowls topped with roasted vegetables and a drizzle of olive oil.
     4. Buckwheat: Incorporate buckwheat flour into your baking for gluten-free bread, pancakes, or crepes. You can also use cooked buckwheat groats as a nutritious alternative to traditional grains in salads or as a side dish.
     5. Amaranth: Add amaranth to soups, stews, or porridge for a nutrient-packed boost. Its slightly nutty flavor pairs well with Mediterranean spices and herbs.
     
     

     My favorite is oatmeal. But make sure you get oats that were ground away from wheat. Bob’s Red Mill has a gluten free oat that you can use. Since oats are a staple of my morning breakfast you might find these a great choice.

      

     Finally, corn is a whole grain. Good to add to salads, and my favorite cowboy caviar dish.

     By incorporating gluten-free whole grains into your Mediterranean diet, you can enjoy a diverse range of flavors and textures while reaping the nutritional benefits of these wholesome ingredients. Whether you're looking to support digestive health, manage blood sugar levels, or simply explore new culinary horizons, there's a gluten-free whole grain waiting to elevate your next meal.

      

     Whole grains are a powerhouse of nutrition, offering a range of health benefits that make them an essential part of a balanced diet.

     Why Gluten-Free Whole Grains?

     But what if you have celiac disease and cannot tolerate gluten?

     Gluten is a protein found in many grains. It is responsible for stretching dough, like pizza.

     If you do not have a problem with gluten, there is no reason to avoid gluten.  But if you have celiac disease, gluten must be avoided.

     The Mediterranean Diet

     The Mediterranean diet is renowned for its focus on fresh fruits and vegetables, lean proteins, healthy fats, and whole grains. By incorporating gluten-free whole grains into this already nutritious diet, you can further enhance its health benefits while catering to dietary restrictions or preferences.

     Conclusion

     By incorporating gluten-free whole grains into your Mediterranean diet, you can enjoy a diverse range of flavors and textures while reaping the nutritional benefits of these wholesome ingredients. Whether you're looking to support digestive health, manage blood sugar levels, or simply explore new culinary horizons, there's a gluten-free whole grain waiting to elevate your next meal.

     ]]>40ee5385-871e-4124-8728-7dc691c6c03dWed, 10 Apr 2024 00:00:00 -070013:14falsefull5050Secrets to Cooking FishLearn to Cook Fish

     Fish is not only a healthy option but also a versatile ingredient that can be transformed into a myriad of mouthwatering dishes. Whether you're a seafood aficionado or looking to expand your culinary repertoire, mastering the art of cooking fish can elevate your cooking skills to new heights. In this article, we'll explore the techniques and recipes to create delicious fish dishes that will impress even the most discerning palates.

     Cooking Methods:

     1. Grilling: Grilling fish over an open flame adds a smoky flavor and beautiful charred marks. Brush the fish with oil to prevent sticking, and cook for a few minutes on each side until opaque and flaky.
     2. Baking: Baking fish in the oven is a simple and foolproof method. Place seasoned fish fillets on a baking sheet lined with parchment paper and bake at 375°F (190°C) for 10-15 minutes, depending on the thickness of the fish.
     3. Pan-Searing: Pan-searing fish in a hot skillet creates a crispy exterior while keeping the inside moist and tender. Heat oil in a skillet over medium-high heat, then add the fish and cook for 3-4 minutes per side until golden brown.
     4. Steaming: Steaming fish is a healthy cooking method that preserves its delicate flavor and texture. Place seasoned fish fillets in a steamer basket over boiling water and steam for 6-8 minutes until cooked through.
     
     

     Delicious Fish Recipes:

     Now that you're familiar with the basics of preparing and cooking fish let's explore some mouthwatering recipes to try at home:

     1. Lemon Herb Grilled Salmon: Marinate salmon fillets in a mixture of lemon juice, olive oil, garlic, and fresh herbs. Grill over medium heat for 4-5 minutes per side until charred and cooked through. Serve with a squeeze of fresh lemon juice.
     2. Baked Cod with Garlic Butter: Place cod fillets in a baking dish and top with a mixture of melted butter, minced garlic, lemon zest, and chopped parsley. Bake in the oven for 15-20 minutes until flaky and tender.
     3. Pan-Seared Sea Bass with Mango Salsa: Season sea bass fillets with salt, pepper, and paprika. Sear in a hot skillet for 3-4 minutes per side until golden brown. Serve with a refreshing mango salsa made with diced mango, red onion, jalapeno, cilantro, and lime juice.
     
     

     For more great recipes, see terrysimpson.com.

     ]]>Learn to Cook Fish

     Fish is not only a healthy option but also a versatile ingredient that can be transformed into a myriad of mouthwatering dishes. Whether you're a seafood aficionado or looking to expand your culinary repertoire, mastering the art of cooking fish can elevate your cooking skills to new heights. In this article, we'll explore the techniques and recipes to create delicious fish dishes that will impress even the most discerning palates.

     Cooking Methods:

     1. Grilling: Grilling fish over an open flame adds a smoky flavor and beautiful charred marks. Brush the fish with oil to prevent sticking, and cook for a few minutes on each side until opaque and flaky.
     2. Baking: Baking fish in the oven is a simple and foolproof method. Place seasoned fish fillets on a baking sheet lined with parchment paper and bake at 375°F (190°C) for 10-15 minutes, depending on the thickness of the fish.
     3. Pan-Searing: Pan-searing fish in a hot skillet creates a crispy exterior while keeping the inside moist and tender. Heat oil in a skillet over medium-high heat, then add the fish and cook for 3-4 minutes per side until golden brown.
     4. Steaming: Steaming fish is a healthy cooking method that preserves its delicate flavor and texture. Place seasoned fish fillets in a steamer basket over boiling water and steam for 6-8 minutes until cooked through.
     
     

     Delicious Fish Recipes:

     Now that you're familiar with the basics of preparing and cooking fish let's explore some mouthwatering recipes to try at home:

     1. Lemon Herb Grilled Salmon: Marinate salmon fillets in a mixture of lemon juice, olive oil, garlic, and fresh herbs. Grill over medium heat for 4-5 minutes per side until charred and cooked through. Serve with a squeeze of fresh lemon juice.
     2. Baked Cod with Garlic Butter: Place cod fillets in a baking dish and top with a mixture of melted butter, minced garlic, lemon zest, and chopped parsley. Bake in the oven for 15-20 minutes until flaky and tender.
     3. Pan-Seared Sea Bass with Mango Salsa: Season sea bass fillets with salt, pepper, and paprika. Sear in a hot skillet for 3-4 minutes per side until golden brown. Serve with a refreshing mango salsa made with diced mango, red onion, jalapeno, cilantro, and lime juice.
     
     

     For more great recipes, see terrysimpson.com.

     ]]>c8512012-625f-413c-bde5-d6ac3a1ab65bFri, 15 Mar 2024 00:00:00 -070010:53falsefull4949Health Benefits of Fish ConsumptionHealth Benefits of Fish Consumption

     Fish consumption has been linked to various health benefits due to its rich nutritional profile.  The health benefits of fish consumption include cardiovascular health, brain function, and well-being. Because fish are a rich source of omega-3 fatty acids, vitamins, minerals, and other nutrients, they are an important part of a balanced diet.

     Fish, the Most Ancestral Food

     Fish has long been recognized as a valuable source of essential nutrients beneficial for human health. Seafood is a staple part of the diet across different cultures and regions.  Since most of the first human communities were coastal, fish were a common source of food.

     Cardiovascular Health Exceeds Risk

     Regular fish intake reduces the risk of cardiovascular diseases, such as coronary heart disease and stroke (Mozaffarian & Rimm, 2006).  That study showed that the benefits of fish intake exceed the potential risks. Even for women of childbearing age, the benefits of modest fish intake, excepting a few selected species, also outweigh the risks.  The heart health effect comes from the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found abundantly in fatty fish species (Kris-Etherton et al., 2002). These fatty acids exert anti-inflammatory, antiarrhythmic, and vasodilatory effects, lowering blood pressure and triglyceride levels and reducing the formation of blood clots (Calder, 2015).

     Brain Function

     Fish consumption has also been associated with improved cognitive (brain) function and a reduced risk of brain disorders such as Alzheimer's disease. The omega-3 fatty acids EPA and DHA play a crucial role in brain health (Gómez-Pinilla, 2008). Epidemiological studies have consistently shown a positive correlation between higher fish consumption and better memory (ref). Moreover, research suggests early-life exposure to seafood has long-term brain benefits and decreases age-related cognitive decline (Wurtman et al., 2009).

     Nutrient Profile, Such as Vitamin D

     But omega-3 fatty acids are not the only benefit of eating fish. Fish are also a rich source of various essential nutrients vital for human health. Vitamin D, in particular, is naturally abundant in fatty fish and plays a crucial role in bone health, immune function, and mood regulation (Holick, 2007).  These include high-quality protein, vitamins (such as vitamin D and B-complex vitamins), and minerals (such as selenium, iodine, and zinc) (Kris-Etherton et al., 2002). Furthermore, the bioavailability of these nutrients from fish is superior to other dietary sources, including supplements.  Thus, fish consumption is an efficient means of meeting nutritional requirements (Rosell & Appleby, 2006).

     Fish Farms

     Aquaculture, the farming of fish and aquatic organisms, has undergone significant advancements in recent years, leading to improvements in sustainability, efficiency, and product quality. Fish Farms have had significant problems in the past.  In the last fifteen years, there has been an improvement in environmental management strategies and sustainable farming practices.

     Those practices have changed my mind about seafood. Consequently, you can now buy quality farm-raised seafood, which adheres to the high standards of any food. Hence, I now recommend some farm-raised salmon.

     Demand for Fish May Outstrip our Oceans

     As global demand for seafood continues to rise, aquaculture has emerged as a crucial industry for sustainable meeting this demand. Farm-raised fish play a vital role in supplementing wild-caught fisheries and ensuring food security for a growing population. In recent years, advancements in aquaculture techniques and practices have led to significant improvements in the efficiency, sustainability, and quality of farm-raised fish.

     Technological Innovations

     Technological advancements have revolutionized the aquaculture industry. Automation and robotics have streamlined tasks such as feeding, monitoring water quality, and harvesting, reducing labor costs and minimizing human error. Some previous issues with farmed fish include high quantities of forever chemicals in their feed. However, advances in the use of alternative ingredients, such as plant proteins and oils, have enhanced feed efficiency and reduced reliance on wild-caught fish for feedstock (Tacon & Metian, 2008). Genetic selection and breeding programs have also played a crucial role in developing strains of fish with desirable traits, such as faster growth rates, disease resistance, and improved feed conversion ratios (Gjedrem et al., 2012).

     Environmental Management

     Some fish farms have been environmental disasters. Thus, Government and private groups have persuaded some fish farms to change their practices.  Sustainable aquaculture practices prioritized environmental stewardship and minimized the impact of fish farming on surrounding ecosystems. For example, combining clams and oysters with salmon farms to use nutrients more efficiently and reduce waste (Chopin et al., 2001).

     Closed-containment systems, such as recirculating aquaculture systems (RAS), decrease the risk of disease transmission and minimize the discharge of pollutants into the environment (Martins et al., 2010). Additionally, advancements in water treatment technologies, such as biofiltration and ozone disinfection, help maintain water quality and reduce the environmental footprint of aquaculture operations (Summerfelt & Vinci, 2008).

     Quality and Safety Assurance

     Antibiotic use in fish farms, much like antibiotic use in the cattle industry, has changed to where antibiotics are only used when needed for disease. Fish that have had antibiotics are not sold on the market until the antibiotics and disease have cleared their system. Furthermore, advancements in packaging, transportation, and cold chain management help preserve the freshness and nutritional integrity of farmed fish from harvest to consumption.

     Advancements in aquaculture technology, environmental management practices, and quality assurance measures have led to significant improvements in farm-raised fish production. These advancements increase the efficiency and sustainability of aquaculture operations. In addition, they also enhance product quality, safety, and traceability. Moving forward, continued investment in research and innovation is essential to further the progress of the aquaculture industry. Thus ensuring long-term viability as a source of nutritious and sustainable seafood.

     Where to Buy Your Fish

     Many organizations buy their seafood from reputable organizations. Be that wild fish or fish farms. Those organizations include:

     • Blue Apron
     • Cheesecake Factory
     • Hello Fresh
     • Whole Foods
     • Pacific Catch
     • PCC Community Markets
     • Mars Petcare
     • Compass Group
     • California Fish and Grill
     • Blue Sushi Saki Grill
     • Plank Seafood Provisions
     • Costco
     • Mom's Organic Market
     
     

     Conclusion

     In conclusion, fish consumption offers many health benefits, from cardiovascular protection to cognitive enhancement, due to its rich nutritional composition. The omega-3 fatty acids EPA and DHA, along with other essential nutrients found in fish, exert profound effects on various physiological processes, promoting overall health and well-being. Therefore, it is advisable to incorporate fish into one's diet, especially fatty fish species such as salmon, mackerel, and sardines.

      

     References:

     • Calder, P. C. (2015). Marine omega-3 fatty acids and inflammatory processes: Effects, mechanisms and clinical relevance. Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids, 1851(4), 469–484.
     • Gómez-Pinilla, F. (2008). Brain foods: the effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568–578.
     • Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266–281.
     • Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002). Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation, 106(21), 2747–2757.
     • Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L., & Wilson, R. S. (2003). Fish consumption and cognitive decline with age in a large community study. Archives of Neurology, 60(7), 940–946.
     • Mozaffarian, D., & Rimm, E. B. (2006). Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA, 296(15), 1885–1899.
     • Rosell, M. S., & Appleby, P. N. (2006). Fish consumption and risk of stroke in men. Circulation, 113(2), e104–e105.
     • Wurtman, R. J., Cansev, M., Sakamoto, T., & Ulus, I. H. (2009). Use of phosphatide precursors to promote synaptogenesis. Annual Review of Nutrition, 29, 59–87.
     • Chopin, T., Buschmann, A. H., Halling, C., Troell, M., Kautsky, N., Neori, A., Kraemer, G. P., Zertuche-González, J. A., Yarish, C., & Neefus, C. (2001). Integrating seaweeds into marine aquaculture systems: a key toward sustainability. Journal of Phycology, 37(6),...]]>Health Benefits of Fish Consumption

       Fish consumption has been linked to various health benefits due to its rich nutritional profile.  The health benefits of fish consumption include cardiovascular health, brain function, and well-being. Because fish are a rich source of omega-3 fatty acids, vitamins, minerals, and other nutrients, they are an important part of a balanced diet.

       Fish, the Most Ancestral Food

       Fish has long been recognized as a valuable source of essential nutrients beneficial for human health. Seafood is a staple part of the diet across different cultures and regions.  Since most of the first human communities were coastal, fish were a common source of food.

       Cardiovascular Health Exceeds Risk

       Regular fish intake reduces the risk of cardiovascular diseases, such as coronary heart disease and stroke (Mozaffarian & Rimm, 2006).  That study showed that the benefits of fish intake exceed the potential risks. Even for women of childbearing age, the benefits of modest fish intake, excepting a few selected species, also outweigh the risks.  The heart health effect comes from the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found abundantly in fatty fish species (Kris-Etherton et al., 2002). These fatty acids exert anti-inflammatory, antiarrhythmic, and vasodilatory effects, lowering blood pressure and triglyceride levels and reducing the formation of blood clots (Calder, 2015).

       Brain Function

       Fish consumption has also been associated with improved cognitive (brain) function and a reduced risk of brain disorders such as Alzheimer's disease. The omega-3 fatty acids EPA and DHA play a crucial role in brain health (Gómez-Pinilla, 2008). Epidemiological studies have consistently shown a positive correlation between higher fish consumption and better memory (ref). Moreover, research suggests early-life exposure to seafood has long-term brain benefits and decreases age-related cognitive decline (Wurtman et al., 2009).

       Nutrient Profile, Such as Vitamin D

       But omega-3 fatty acids are not the only benefit of eating fish. Fish are also a rich source of various essential nutrients vital for human health. Vitamin D, in particular, is naturally abundant in fatty fish and plays a crucial role in bone health, immune function, and mood regulation (Holick, 2007).  These include high-quality protein, vitamins (such as vitamin D and B-complex vitamins), and minerals (such as selenium, iodine, and zinc) (Kris-Etherton et al., 2002). Furthermore, the bioavailability of these nutrients from fish is superior to other dietary sources, including supplements.  Thus, fish consumption is an efficient means of meeting nutritional requirements (Rosell & Appleby, 2006).

       Fish Farms

       Aquaculture, the farming of fish and aquatic organisms, has undergone significant advancements in recent years, leading to improvements in sustainability, efficiency, and product quality. Fish Farms have had significant problems in the past.  In the last fifteen years, there has been an improvement in environmental management strategies and sustainable farming practices.

       Those practices have changed my mind about seafood. Consequently, you can now buy quality farm-raised seafood, which adheres to the high standards of any food. Hence, I now recommend some farm-raised salmon.

       Demand for Fish May Outstrip our Oceans

       As global demand for seafood continues to rise, aquaculture has emerged as a crucial industry for sustainable meeting this demand. Farm-raised fish play a vital role in supplementing wild-caught fisheries and ensuring food security for a growing population. In recent years, advancements in aquaculture techniques and practices have led to significant improvements in the efficiency, sustainability, and quality of farm-raised fish.

       Technological Innovations

       Technological advancements have revolutionized the aquaculture industry. Automation and robotics have streamlined tasks such as feeding, monitoring water quality, and harvesting, reducing labor costs and minimizing human error. Some previous issues with farmed fish include high quantities of forever chemicals in their feed. However, advances in the use of alternative ingredients, such as plant proteins and oils, have enhanced feed efficiency and reduced reliance on wild-caught fish for feedstock (Tacon & Metian, 2008). Genetic selection and breeding programs have also played a crucial role in developing strains of fish with desirable traits, such as faster growth rates, disease resistance, and improved feed conversion ratios (Gjedrem et al., 2012).

       Environmental Management

       Some fish farms have been environmental disasters. Thus, Government and private groups have persuaded some fish farms to change their practices.  Sustainable aquaculture practices prioritized environmental stewardship and minimized the impact of fish farming on surrounding ecosystems. For example, combining clams and oysters with salmon farms to use nutrients more efficiently and reduce waste (Chopin et al., 2001).

       Closed-containment systems, such as recirculating aquaculture systems (RAS), decrease the risk of disease transmission and minimize the discharge of pollutants into the environment (Martins et al., 2010). Additionally, advancements in water treatment technologies, such as biofiltration and ozone disinfection, help maintain water quality and reduce the environmental footprint of aquaculture operations (Summerfelt & Vinci, 2008).

       Quality and Safety Assurance

       Antibiotic use in fish farms, much like antibiotic use in the cattle industry, has changed to where antibiotics are only used when needed for disease. Fish that have had antibiotics are not sold on the market until the antibiotics and disease have cleared their system. Furthermore, advancements in packaging, transportation, and cold chain management help preserve the freshness and nutritional integrity of farmed fish from harvest to consumption.

       Advancements in aquaculture technology, environmental management practices, and quality assurance measures have led to significant improvements in farm-raised fish production. These advancements increase the efficiency and sustainability of aquaculture operations. In addition, they also enhance product quality, safety, and traceability. Moving forward, continued investment in research and innovation is essential to further the progress of the aquaculture industry. Thus ensuring long-term viability as a source of nutritious and sustainable seafood.

       Where to Buy Your Fish

       Many organizations buy their seafood from reputable organizations. Be that wild fish or fish farms. Those organizations include:

       • Blue Apron
       • Cheesecake Factory
       • Hello Fresh
       • Whole Foods
       • Pacific Catch
       • PCC Community Markets
       • Mars Petcare
       • Compass Group
       • California Fish and Grill
       • Blue Sushi Saki Grill
       • Plank Seafood Provisions
       • Costco
       • Mom's Organic Market
       
       

       Conclusion

       In conclusion, fish consumption offers many health benefits, from cardiovascular protection to cognitive enhancement, due to its rich nutritional composition. The omega-3 fatty acids EPA and DHA, along with other essential nutrients found in fish, exert profound effects on various physiological processes, promoting overall health and well-being. Therefore, it is advisable to incorporate fish into one's diet, especially fatty fish species such as salmon, mackerel, and sardines.

        

       References:

       • Calder, P. C. (2015). Marine omega-3 fatty acids and inflammatory processes: Effects, mechanisms and clinical relevance. Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids, 1851(4), 469–484.
       • Gómez-Pinilla, F. (2008). Brain foods: the effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568–578.
       • Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266–281.
       • Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002). Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation, 106(21), 2747–2757.
       • Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L., & Wilson, R. S. (2003). Fish consumption and cognitive decline with age in a large community study. Archives of Neurology, 60(7), 940–946.
       • Mozaffarian, D., & Rimm, E. B. (2006). Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA, 296(15), 1885–1899.
       • Rosell, M. S., & Appleby, P. N. (2006). Fish consumption and risk of stroke in men. Circulation, 113(2), e104–e105.
       • Wurtman, R. J., Cansev, M., Sakamoto, T., & Ulus, I. H. (2009). Use of phosphatide precursors to promote synaptogenesis. Annual Review of Nutrition, 29, 59–87.
       • Chopin, T., Buschmann, A. H., Halling, C., Troell, M., Kautsky, N., Neori, A., Kraemer, G. P., Zertuche-González, J. A., Yarish, C., & Neefus, C. (2001). Integrating seaweeds into marine aquaculture systems: a key toward sustainability. Journal of Phycology, 37(6), 975–986.
       • Food and Agriculture Organization/World Health Organization (FAO/WHO). (2011). Code of Practice for Fish and Fishery Products. Rome: FAO.
       • Gjedrem, T., Robinson, N., & Rye, M. (2012). The importance of selective breeding in aquaculture to meet future demands for animal protein: A review. Aquaculture, 350-353, 117–129.
       • Martins, C. I. M., Eding, E. H., Verdegem, M. C. J., Heinsbroek, L. T. N., Schneider, O., Blancheton, J. P., D’Orbcastel, E. R., & Verreth, J. A. J. (2010). New developments in recirculating aquaculture systems in Europe: A perspective on environmental sustainability. Aquacultural Engineering, 43(3), 83–93.
       • Summerfelt, S. T., & Vinci, B. J. (2008). Ozonation and UV irradiation: An introduction and examples of current applications in fish hatcheries. Aquacultural Engineering, 38(1), 1–14.
       • Tacon, A. G. J., & Metian, M. (2008). Global overview on the use of fish meal and fish oil in industrially compounded aquafeeds: Trends and future prospects. Aquaculture, 285(1-4), 146–158.
       
       ]]>958afb75-a4b6-4393-985b-7bef3bc103b0Fri, 01 Mar 2024 00:00:00 -070015:44falsefull4848Reducing Dementia with DietThree Great Diets

       The Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), and the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) are all great eating patterns. Each diet focuses on different aspects of health.

        

       Mediterranean Diet

       The Mediterranean diet comes from the traditional dietary patterns of countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. High in the consumption of fruits, vegetables, whole grains, nuts, seeds, legumes, olive oil, fish, and moderate amounts of poultry, dairy, and red wine. Shown to decrease the risk of heart disease and cancer and to improve longevity.

       DASH Diet

       Discussed in last week's podcast (ref). DASH (Dietary approach to stop hypertension) was developed to prevent and manage hypertension (high blood pressure). Focuses on increasing intake of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while limiting sodium, saturated fats, and cholesterol.

       MIND Diet

       Developed by researchers at Rush University Medical Center as a hybrid of the Mediterranean and DASH diets, with a focus on brain health and reducing the risk of neurodegenerative diseases like Alzheimer's disease. It also emphasizes the consumption of fruits, vegetables, whole grains, nuts, olive oil, fish, poultry, and beans while limiting the intake of red meat, butter/margarine, cheese, pastries/sweets, and fried/fast foods.

        

       Three Diets are Branches of the Same Tree

       The Mediterranean, DASH, and MIND diets share some common elements. All focus on whole foods and plant-based sources of nutrients. The Mediterranean diet emphasizes health and longevity. While the DASH diet targets hypertension and cardiovascular health. Finally, the MIND diet specifically supports brain health to reduce the risk of neurodegenerative diseases.

       1. Rush Memory and Aging Project:

       A study conducted by researchers at Rush University Medical Center followed over 900 older adults for an average of 4.5 years. Findings showed that individuals who closely adhered to the MIND diet had a substantially lower risk of developing Alzheimer's disease, with a reduction in risk ranging from 21% to 53%, depending on the level of adherence. (ref )

       2. Columbia University Medical Center Study:

       Researchers at Columbia University Medical Center examined the dietary habits of over 1,000 participants. Individuals who closely followed the MIND diet had a 53% lower risk of developing Alzheimer's disease than those with low adherence to the diet.

       3. Alzheimer's Disease Neuroimaging Initiative (ADNI):

       The ADNI study found that adherence to the MIND diet was associated with better cognitive performance and a reduced rate of cognitive decline over time.

       4. Systematic Reviews and Meta-Analyses:

       Several systematic reviews and meta-analyses have summarized the findings of multiple studies investigating the association between the MIND diet and dementia risk.  Overall, these reviews reveal that adherence to the MIND diet is associated with a significant reduction in Alzheimer's disease and dementia.

       5. Mechanisms of Action:

       Components of the MIND diet, such as leafy greens, berries, nuts, whole grains, fish, olive oil, and poultry, have been linked to improved cognitive function and a lower risk of dementia.

       More research is needed to elucidate the mechanisms underlying the protective effects of the MIND diet.  Current evidence suggests that adherence to this dietary pattern can be a valuable strategy for reducing the risk of cognitive decline and Alzheimer's disease in older adults.

        

       Diagnosis of Alzheimer's Disease.

       On TikTok, a non-physician said the only way to diagnose dementia was an autopsy. This is false. Alzheimer's disease is diagnosed based on established criteria. These are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Also can be found in the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria.

       • The healthcare provider will conduct a complete history and physical examination
       • Neuropsychological assessment may evaluate cognitive function, memory, attention, language, and executive function.
       • Blood tests can rule out underlying medical conditions, such as vitamin deficiencies (e.g., vitamin B12 deficiency), thyroid disorders, infections, metabolic imbalances, or kidney or liver dysfunction.
       • MRI or CT scans will be ordered to assess structural abnormalities in the brain or detect signs of conditions like stroke, brain tumors, or hydrocephalus. Genetic testing for mutations associated with familial Alzheimer's disease, cerebrospinal fluid analysis to assess for biomarkers associated with Alzheimer's disease (e.g., amyloid beta and tau proteins)
       
       

       Genetics of Dementia

       Several genetic factors are correlated, but not causative of, an increased risk of dementia, including Alzheimer's disease. Lifestyle changes can mitigate these. Hence, the MIND diet is important to those who have a genetic predisposition to dementia.

       1. APOE ε4 Allele

       The apolipoprotein E (APOE) gene ε4 allele is the strongest known genetic risk factor for late-onset Alzheimer's disease. Individuals who inherit one copy of the APOE ε4 allele from one parent have an increased risk of developing Alzheimer's disease. while those who inherit two copies (one from each parent) have an even higher risk. Chris Hemsworth, who plays Thor in Marvel movies, has two copies of these genes.

        

       2. Presenilin Genes (PSEN1 and PSEN2)

       Mutations in the presenilin 1 (PSEN1) and presenilin 2 (PSEN2) genes are associated with early Alzheimer's disease before 65. These mutations can cause abnormal processing of amyloid precursor protein, which leads to the accumulation of amyloid beta plaques in the brain.

       3. Amyloid Precursor Protein (APP) Gene

       Mutations in the amyloid precursor protein (APP) gene are also associated with rare cases of early-onset Alzheimer's disease. APP mutations can lead to the production of abnormal forms of amyloid beta protein, which contributes to the development of Alzheimer's pathology.

       4. TREM2 Gene

       • Variants in the triggering receptor expressed on myeloid cells 2 (TREM2) gene have been identified as risk factors for late-onset Alzheimer's disease and other neurodegenerative diseases.

       • TREM2 is involved in the regulation of the immune response and microglial function in the brain, and variants in this gene may affect the brain's ability to clear amyloid beta and other toxic proteins.

       5. Other Genes

       • Several other genes have been implicated in the risk of developing dementia, including genes involved in inflammation, cholesterol metabolism, synaptic function, and neuronal signaling pathways.

       While genetic factors can increase the risk of dementia, they do not guarantee that an individual will develop the condition. Environmental factors and lifestyle factors (such as diet, physical activity, and cognitive engagement) play significant roles in determining an individual's risk of dementia. Additionally, not all cases of dementia are attributable to genetic factors.

       ]]>Three Great Diets

       The Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), and the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) are all great eating patterns. Each diet focuses on different aspects of health.

        

       Mediterranean Diet

       The Mediterranean diet comes from the traditional dietary patterns of countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. High in the consumption of fruits, vegetables, whole grains, nuts, seeds, legumes, olive oil, fish, and moderate amounts of poultry, dairy, and red wine. Shown to decrease the risk of heart disease and cancer and to improve longevity.

       DASH Diet

       Discussed in last week's podcast (ref). DASH (Dietary approach to stop hypertension) was developed to prevent and manage hypertension (high blood pressure). Focuses on increasing intake of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while limiting sodium, saturated fats, and cholesterol.

       MIND Diet

       Developed by researchers at Rush University Medical Center as a hybrid of the Mediterranean and DASH diets, with a focus on brain health and reducing the risk of neurodegenerative diseases like Alzheimer's disease. It also emphasizes the consumption of fruits, vegetables, whole grains, nuts, olive oil, fish, poultry, and beans while limiting the intake of red meat, butter/margarine, cheese, pastries/sweets, and fried/fast foods.

        

       Three Diets are Branches of the Same Tree

       The Mediterranean, DASH, and MIND diets share some common elements. All focus on whole foods and plant-based sources of nutrients. The Mediterranean diet emphasizes health and longevity. While the DASH diet targets hypertension and cardiovascular health. Finally, the MIND diet specifically supports brain health to reduce the risk of neurodegenerative diseases.

       1. Rush Memory and Aging Project:

       A study conducted by researchers at Rush University Medical Center followed over 900 older adults for an average of 4.5 years. Findings showed that individuals who closely adhered to the MIND diet had a substantially lower risk of developing Alzheimer's disease, with a reduction in risk ranging from 21% to 53%, depending on the level of adherence. (ref )

       2. Columbia University Medical Center Study:

       Researchers at Columbia University Medical Center examined the dietary habits of over 1,000 participants. Individuals who closely followed the MIND diet had a 53% lower risk of developing Alzheimer's disease than those with low adherence to the diet.

       3. Alzheimer's Disease Neuroimaging Initiative (ADNI):

       The ADNI study found that adherence to the MIND diet was associated with better cognitive performance and a reduced rate of cognitive decline over time.

       4. Systematic Reviews and Meta-Analyses:

       Several systematic reviews and meta-analyses have summarized the findings of multiple studies investigating the association between the MIND diet and dementia risk.  Overall, these reviews reveal that adherence to the MIND diet is associated with a significant reduction in Alzheimer's disease and dementia.

       5. Mechanisms of Action:

       Components of the MIND diet, such as leafy greens, berries, nuts, whole grains, fish, olive oil, and poultry, have been linked to improved cognitive function and a lower risk of dementia.

       More research is needed to elucidate the mechanisms underlying the protective effects of the MIND diet.  Current evidence suggests that adherence to this dietary pattern can be a valuable strategy for reducing the risk of cognitive decline and Alzheimer's disease in older adults.

        

       Diagnosis of Alzheimer's Disease.

       On TikTok, a non-physician said the only way to diagnose dementia was an autopsy. This is false. Alzheimer's disease is diagnosed based on established criteria. These are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Also can be found in the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria.

       • The healthcare provider will conduct a complete history and physical examination
       • Neuropsychological assessment may evaluate cognitive function, memory, attention, language, and executive function.
       • Blood tests can rule out underlying medical conditions, such as vitamin deficiencies (e.g., vitamin B12 deficiency), thyroid disorders, infections, metabolic imbalances, or kidney or liver dysfunction.
       • MRI or CT scans will be ordered to assess structural abnormalities in the brain or detect signs of conditions like stroke, brain tumors, or hydrocephalus. Genetic testing for mutations associated with familial Alzheimer's disease, cerebrospinal fluid analysis to assess for biomarkers associated with Alzheimer's disease (e.g., amyloid beta and tau proteins)
       
       

       Genetics of Dementia

       Several genetic factors are correlated, but not causative of, an increased risk of dementia, including Alzheimer's disease. Lifestyle changes can mitigate these. Hence, the MIND diet is important to those who have a genetic predisposition to dementia.

       1. APOE ε4 Allele

       The apolipoprotein E (APOE) gene ε4 allele is the strongest known genetic risk factor for late-onset Alzheimer's disease. Individuals who inherit one copy of the APOE ε4 allele from one parent have an increased risk of developing Alzheimer's disease. while those who inherit two copies (one from each parent) have an even higher risk. Chris Hemsworth, who plays Thor in Marvel movies, has two copies of these genes.

        

       2. Presenilin Genes (PSEN1 and PSEN2)

       Mutations in the presenilin 1 (PSEN1) and presenilin 2 (PSEN2) genes are associated with early Alzheimer's disease before 65. These mutations can cause abnormal processing of amyloid precursor protein, which leads to the accumulation of amyloid beta plaques in the brain.

       3. Amyloid Precursor Protein (APP) Gene

       Mutations in the amyloid precursor protein (APP) gene are also associated with rare cases of early-onset Alzheimer's disease. APP mutations can lead to the production of abnormal forms of amyloid beta protein, which contributes to the development of Alzheimer's pathology.

       4. TREM2 Gene

       • Variants in the triggering receptor expressed on myeloid cells 2 (TREM2) gene have been identified as risk factors for late-onset Alzheimer's disease and other neurodegenerative diseases.

       • TREM2 is involved in the regulation of the immune response and microglial function in the brain, and variants in this gene may affect the brain's ability to clear amyloid beta and other toxic proteins.

       5. Other Genes

       • Several other genes have been implicated in the risk of developing dementia, including genes involved in inflammation, cholesterol metabolism, synaptic function, and neuronal signaling pathways.

       While genetic factors can increase the risk of dementia, they do not guarantee that an individual will develop the condition. Environmental factors and lifestyle factors (such as diet, physical activity, and cognitive engagement) play significant roles in determining an individual's risk of dementia. Additionally, not all cases of dementia are attributable to genetic factors.

       ]]>e71b60ec-98ef-4c28-8fa3-0b96f333ecf2Thu, 15 Feb 2024 00:00:00 -070013:53falsefull4747DASH, The Best Diet You've Never Heard OfAbstract:

       The Dietary Approaches to Stop Hypertension (DASH) diet is a widely recognized dietary pattern designed to lower blood pressure and promote cardiovascular health. I will attempt to provide an in-depth review of the DASH diet, its origins, key principles, health benefits, and potential limitations. It also explores the scientific evidence supporting its efficacy and applicability in various populations. Furthermore, this paper discusses practical considerations for adopting the DASH diet and its potential future developments in the field of nutrition and health.

       1. Introduction

       The DASH diet, or Dietary Approaches to Stop Hypertension, is a dietary plan primarily developed to combat hypertension (high blood pressure). DASH has since gained recognition for its broader health benefits. Hypertension is a major risk factor for cardiovascular diseases, including heart disease and stroke. Therefore, the DASH diet is essential to reducing these health risks.

       2. Origins and Development

       The National Heart Lung and Blood Institute (NHLBI) developed the DASH diet in a study known as the DASH-Sodium Study. The primary objective of the DASH-Sodium study was to investigate the effect of dietary patterns on blood pressure, in particular, the effects of sodium intake. Researchers aimed to design a diet that could effectively lower blood pressure without medication. The DASH diet emerged from this study as a dietary pattern rich in nutrients and low in sodium, saturated fat, and cholesterol.

        3. Key Principles of the DASH Diet

       The DASH diet emphasizes the consumption of nutrient-rich foods while limiting the intake of sodium, saturated fats, and cholesterol. Key principles of the DASH diet include:

       •  High Consumption of Fruits and Vegetables: The diet encourages individuals to consume a variety of fruits and vegetables, providing essential vitamins, minerals, fiber, and antioxidants.
       • Lean Protein Sources: Lean proteins like poultry, fish, and plant-based options such as beans, lentils, and tofu are recommended to replace high-fat animal proteins.
       • Whole Grains: The DASH diet emphasizes whole grains like brown rice, whole wheat, oats, and quinoa, which are rich in fiber and nutrients.
       • Dairy: Low-fat or fat-free dairy products are included to provide calcium and protein without excess saturated fat.
       • Nuts, Seeds, and Legumes: These foods are encouraged as sources of healthy fats, fiber, and plant-based protein.
       • Limited Sweets and Sugary Beverages: The DASH diet restricts the consumption of sugary foods and beverages, reducing the intake of added sugars.
       • Sodium Restriction: The diet recommends limiting sodium intake to 2,300 milligrams per day (or 1,500 milligrams for individuals with hypertension, certain chronic conditions, or those at high risk).
       
       

       4. Health Benefits of the DASH Diet

       The DASH diet offers a range of health benefits beyond blood pressure reduction:

       • Lowering Blood Pressure: Numerous studies have shown that the DASH diet can effectively lower blood pressure, particularly in individuals with hypertension.
       • Cardiovascular Health: The diet is associated with a reduced risk of heart disease, stroke, and other cardiovascular conditions due to its focus on heart-healthy nutrients and reduced saturated fat intake.
       • Weight Management: The DASH diet can help weight loss and weight management due to its emphasis on nutrient-dense, low-calorie foods.
       • Improved Lipid Profile: The diet can lower levels of LDL cholesterol (bad cholesterol) and improve HDL cholesterol (good cholesterol), further reducing the risk of heart disease.
       • Diabetes Management: The DASH diet may help individuals with diabetes manage blood sugar levels, as it encourages a balanced intake of carbohydrates, fiber, and protein
       
       

        

       5. Scientific Evidence

       The effectiveness of the DASH diet has been supported by numerous clinical trials and epidemiological studies. For instance, the original DASH-Sodium trial demonstrated that the DASH diet could significantly lower blood pressure, with greater reductions observed when combined with sodium restriction. Subsequent research has reaffirmed these findings, highlighting the positive impact of the diet on cardiovascular health and well-being.

       This was one of the few studies in which all the food was made for the participants.

       6. Applicability and Limitations

       While the DASH diet offers substantial health benefits, it may have limitations for some. Its emphasis on whole foods and fresh produce can be costlier and less convenient than processed alternatives. Cultural preferences and dietary restrictions may also pose challenges in adopting the DASH diet. Nevertheless, modifications and adaptations can be made to suit individual needs and preferences while maintaining the core principles of the diet.

       7. Practical Considerations

       For those interested in adopting the DASH diet, practical considerations include meal planning, grocery shopping, and monitoring sodium intake. Consulting with a healthcare professional or registered dietitian can provide personalized guidance and support.

       8. Future Developments

       The DASH diet continues to evolve as new research emerges in nutrition and health. Future developments may focus on tailoring the diet to specific populations, incorporating technological advancements, and exploring the impact of the DASH diet on additional health outcomes beyond hypertension.

       It is America's Mediterranean Diet

       DASH is a version of the Mediterranean Diet. You can see the same requirements for whole grains, vegetables, fruits, dairy, and legumes.  It combines meats and fish depending on the calories and still uses primarily monounsaturated fats. There is no recommendation for or against alcohol in this diet. There is a strong recommendation to decrease sodium in the diet.

       9. Conclusion

       The DASH diet is a well-established dietary pattern with proven benefits for lowering blood pressure and improving cardiovascular health. Its emphasis on nutrient-rich foods, balanced nutrition, and sodium restriction makes it a valuable tool for reducing the risk of hypertension and related health conditions. While challenges may exist in adopting the DASH diet, its adaptability and potential for customization make it a practical and effective choice for individuals seeking to improve their dietary habits and well-being.

       ]]>Abstract:

       The Dietary Approaches to Stop Hypertension (DASH) diet is a widely recognized dietary pattern designed to lower blood pressure and promote cardiovascular health. I will attempt to provide an in-depth review of the DASH diet, its origins, key principles, health benefits, and potential limitations. It also explores the scientific evidence supporting its efficacy and applicability in various populations. Furthermore, this paper discusses practical considerations for adopting the DASH diet and its potential future developments in the field of nutrition and health.

       1. Introduction

       The DASH diet, or Dietary Approaches to Stop Hypertension, is a dietary plan primarily developed to combat hypertension (high blood pressure). DASH has since gained recognition for its broader health benefits. Hypertension is a major risk factor for cardiovascular diseases, including heart disease and stroke. Therefore, the DASH diet is essential to reducing these health risks.

       2. Origins and Development

       The National Heart Lung and Blood Institute (NHLBI) developed the DASH diet in a study known as the DASH-Sodium Study. The primary objective of the DASH-Sodium study was to investigate the effect of dietary patterns on blood pressure, in particular, the effects of sodium intake. Researchers aimed to design a diet that could effectively lower blood pressure without medication. The DASH diet emerged from this study as a dietary pattern rich in nutrients and low in sodium, saturated fat, and cholesterol.

        3. Key Principles of the DASH Diet

       The DASH diet emphasizes the consumption of nutrient-rich foods while limiting the intake of sodium, saturated fats, and cholesterol. Key principles of the DASH diet include:

       •  High Consumption of Fruits and Vegetables: The diet encourages individuals to consume a variety of fruits and vegetables, providing essential vitamins, minerals, fiber, and antioxidants.
       • Lean Protein Sources: Lean proteins like poultry, fish, and plant-based options such as beans, lentils, and tofu are recommended to replace high-fat animal proteins.
       • Whole Grains: The DASH diet emphasizes whole grains like brown rice, whole wheat, oats, and quinoa, which are rich in fiber and nutrients.
       • Dairy: Low-fat or fat-free dairy products are included to provide calcium and protein without excess saturated fat.
       • Nuts, Seeds, and Legumes: These foods are encouraged as sources of healthy fats, fiber, and plant-based protein.
       • Limited Sweets and Sugary Beverages: The DASH diet restricts the consumption of sugary foods and beverages, reducing the intake of added sugars.
       • Sodium Restriction: The diet recommends limiting sodium intake to 2,300 milligrams per day (or 1,500 milligrams for individuals with hypertension, certain chronic conditions, or those at high risk).
       
       

       4. Health Benefits of the DASH Diet

       The DASH diet offers a range of health benefits beyond blood pressure reduction:

       • Lowering Blood Pressure: Numerous studies have shown that the DASH diet can effectively lower blood pressure, particularly in individuals with hypertension.
       • Cardiovascular Health: The diet is associated with a reduced risk of heart disease, stroke, and other cardiovascular conditions due to its focus on heart-healthy nutrients and reduced saturated fat intake.
       • Weight Management: The DASH diet can help weight loss and weight management due to its emphasis on nutrient-dense, low-calorie foods.
       • Improved Lipid Profile: The diet can lower levels of LDL cholesterol (bad cholesterol) and improve HDL cholesterol (good cholesterol), further reducing the risk of heart disease.
       • Diabetes Management: The DASH diet may help individuals with diabetes manage blood sugar levels, as it encourages a balanced intake of carbohydrates, fiber, and protein
       
       

        

       5. Scientific Evidence

       The effectiveness of the DASH diet has been supported by numerous clinical trials and epidemiological studies. For instance, the original DASH-Sodium trial demonstrated that the DASH diet could significantly lower blood pressure, with greater reductions observed when combined with sodium restriction. Subsequent research has reaffirmed these findings, highlighting the positive impact of the diet on cardiovascular health and well-being.

       This was one of the few studies in which all the food was made for the participants.

       6. Applicability and Limitations

       While the DASH diet offers substantial health benefits, it may have limitations for some. Its emphasis on whole foods and fresh produce can be costlier and less convenient than processed alternatives. Cultural preferences and dietary restrictions may also pose challenges in adopting the DASH diet. Nevertheless, modifications and adaptations can be made to suit individual needs and preferences while maintaining the core principles of the diet.

       7. Practical Considerations

       For those interested in adopting the DASH diet, practical considerations include meal planning, grocery shopping, and monitoring sodium intake. Consulting with a healthcare professional or registered dietitian can provide personalized guidance and support.

       8. Future Developments

       The DASH diet continues to evolve as new research emerges in nutrition and health. Future developments may focus on tailoring the diet to specific populations, incorporating technological advancements, and exploring the impact of the DASH diet on additional health outcomes beyond hypertension.

       It is America's Mediterranean Diet

       DASH is a version of the Mediterranean Diet. You can see the same requirements for whole grains, vegetables, fruits, dairy, and legumes.  It combines meats and fish depending on the calories and still uses primarily monounsaturated fats. There is no recommendation for or against alcohol in this diet. There is a strong recommendation to decrease sodium in the diet.

       9. Conclusion

       The DASH diet is a well-established dietary pattern with proven benefits for lowering blood pressure and improving cardiovascular health. Its emphasis on nutrient-rich foods, balanced nutrition, and sodium restriction makes it a valuable tool for reducing the risk of hypertension and related health conditions. While challenges may exist in adopting the DASH diet, its adaptability and potential for customization make it a practical and effective choice for individuals seeking to improve their dietary habits and well-being.

       ]]>92b35691-364f-40e1-8af3-7ba61a0efd1cTue, 06 Feb 2024 00:00:00 -070011:56falsefull4646Health Benefits of Limiting Red MeatDid You Try the Carnivore Diet?

       Did you try the carnivore in January? A month of red meat, eggs, and butter? If you did, you probably lost weight.  If you lost weight, you felt better. The Carnivore crowd will point to weight loss as proof of superiority.

       But did you worry that this might not be the healthiest diet for you long-term?  Is it healthy? In short, the answer is no.

       Perhaps you remember on a previous podcast, we talked about the beer and sausage diet. On that diet, Evo, the pod god who distributes this podcast, lost weight every month he was on the diet. In addition, his weekly lab work -sorry for all the jabs Evo - improved every week he was on the diet.

       Could you argue that drinking beer and eating sausage is a good diet? You could, and that same logic is what the carnivore crowd uses to convince people the carnivore diet has merit.

       Simplicity, is Thy Name Carnivore?

       What could be simpler than eating a diet of just red meat? Who doesn't like a good steak? If you just eat steak or red meat, you will lose weight. When you lose weight, you will feel better. And your labs might improve. You might think it is paradoxical that your cholesterol level went down - it isn't; that is just a result of giving up junk food and weight loss.

       Every diet has a honeymoon phase, where people think they can do the diet "forever."

       Then reality comes home:

       • The diet becomes boring, and one note
       • There is an undeniable increased risk of heart disease and cancer
       • Maybe you got hemorrhoids or developed diverticulitis
       • Finally, in social situations, you become that person - the one who could only eat red meat  - the reverse vegan
       
       

       FORK U

       Today, on Fork U, we will discuss the latest low-carb fad: the Carnivore diet, the denial that goes into those who make up the diet, and the risks of an all-meat diet.

       I'm Dr. Terry Simpson, and this is Fork U.

       Fork University

       Where we make sense of the madness, bust a few myths, and teach you a little about food as medicine.

       Carnivore Diet

       The carnivore diet, which primarily consists of animal products like meat, fish, and eggs, has become the latest low-carb fad. It is a controversial and extreme dietary approach. Proponents of the carnivore diet claim numerous health benefits. To be clear, the scientific evidence supporting these benefits is limited, and that long-term studies on the effects of the carnivore diet are lacking.

       Paul Saladino, Ken Berry, and Shawn Baker are a few doctors who advocate for this diet. And oddly, none of them see private patients, although Saladino and Baker love showing their abs, and spend a lot of time in the gym.

       The Biotruth of Evolution

       Some claim the natural diet of humans is meat. This is a biotruth.

       When someone tells you that “man was meant to eat” this or that – it is part of a logical fallacy known as a biotruth. A biotruth is an argument presented by someone with misunderstood notions of human biology and/or evolution but uses those false arguments to justify their views. In this case, how they eat.

       You can extend that logical fallacy out: man was not meant to fly, so we shouldn’t be in airplanes. Primitive man did not have laboratories, so we should not have antibiotics.

       You will see biotruth arguments from people who practice carnivore diets, as well as those who practice vegetarian (and vegan) diets. Often with photographs of our jaws and those of our ancestors – or they will say how we have a long or short intestine, and on that basis, we “were meant” to eat in whatever their view is.

       As we evolved, were we better as plant eaters or meat eaters? Does it matter? It is an argument based in biotruth.

       Paleolithic Man and Biotruth

       The carnivore diet is based on the premise that man had evolved during the Paleolithic era by eating meat. Furthermore, they state that when agriculture and domestication of animals came (10,000 years ago), man’s metabolism was unable to adapt to these new foods. They assert that the maladies of modern man come from foods such as grains and dairy products. That non-meat diets lead to heart disease, obesity, and diabetes – all from our evolutionary dysfunction.

       Archeology has about 6000 fossils to make these assumptions. From those 6000 fossils, we find that early man:

       • Probably was more of a scavenger than a hunter - taking whatever meat something else killed and left behind
       • Gathering, especially roots and beans, kept humans alive
       • The most common things hunted were frogs and rabbits
       • Neanderthals and Homo Erectus, our cousins but not direct ancestors, did organized hunting; the Neanderthals,  and homo sapiens began organization until perhaps 20,000 years ago.
       • Man ate grains even 30,000 years ago.
       
       

       The view of man as a large game hunter is not from the evidence unless you count comic strips and movies.

       Modern Hunter Gather Societies Eat Meat

       Often, they refer to the Inuit, whose lifespan is about 50 (excluding infant mortality). They eat mostly sea creatures but have mummified evidence of atherosclerotic disease. The Hazda eat honey, fruit, and meat, and their average age of death is 50. Over half of their people don't make the age of 15.

       The use of early man, or hunter societies, to state that we should be eating meat is factually incorrect.

       Humans evolved not by eating meat. Humans evolved by eating anything they could, mostly plants. Early man did not evolve to live into the 90's.

       Vegetables are poison: Lectins, Oxylates, and anti-nutrients

       The other comments go something like the "defense of vegetables against humans." This ignores the long-lived populations, who eat mostly plants and little meat.

       Kidney stones are found more commonly among meat eaters than vegetarians. (ref).

       Despite their protestations, Kale, spinach, beans, and broccoli are healthy for people.

       The Most Bioavailable Food

       The other argument is that meat contains the richest nutrients, and the most bioavailable food.  Meat is a rich source of protein, the liver has a lot of vitamin D, and heme-iron is generally better adapted for iron deficiency. Meat is far from having all the nutrients a person requires. Red meat is rich in iron, zinc, B vitamins, and iron.

       There is minimal fiber in meat. The carnivore crowd waives this off, stating that fiber isn't something humans need. In spite of the clear evidence that fiber decreases colon and rectal cancer, that fiber helps regulate blood sugar and cholesterol. Fiber is important to a healthy gut microbiome, and fiber prevents hemorrhoids as well as diverticulitis. Their assertion is false and painfully so - especially if you've had hemorrhoids.

       Vitamin C is not abundant in meat. This lesson led to the discovery of citrus as a means of avoiding scurvy in sailors during the era of Discovery. A finding attributed to another surgeon, Dr. James Lind.  Modern-day isn't without scurvy found among carnivore aficionados, such as musician James Blunt, who went on the carnivore diet.

       Calcium is more abundant in dairy products and some vegetables, as is Folate. and omega-3 fatty acids. They tend to forget that farm-raised salmon has ten times the amount of omega-3 fatty acids as does the cow raised on and fed with high-quality grass all their life.

       Weight Loss and the Carnivore Diet

       Weight loss occurs in a calorie deficit. There is no diet that cannot produce a calorie deficit. This has been demonstrated in great studies showing the equivalent of low-carb diets, and the Mediterranean diet are equal over time.

       It has also been demonstrated in those showing the McDonald's diet, the cookie diet, the Twinkie diet, and our own - Beer and Sausage diet.

       One simply gets tired of eating red meat, and you eat less of it. So instead of eating three thousand calories of multiple foods, you eat 2200 calories of meat, and you lose weight. Nothing to see here, folks, just another diet.

       But there is a dark side to red meat. Just because you can lose weight and show all the physiological benefits of weight loss doesn't mean that a lot of red meat is good for a human. In fact, there is every evidence to state one should limit red meat.

       Is Red Meat Consumption like Smoking?

       There is always some headline grabber who states that eating red meat has the same risk as smoking. While red meat, as we shall see, has an increased risk of cancer, heart disease, and diabetes, it is not as risky as smoking cigarettes. As much as some anti-meat activists might like to frighten you, we assume you came here for the facts.

       So, where did our studies begin?

       Meat, the Seven Countries Study

       Heart disease was an epidemic in the 1950s in the United States, primarily affecting white-collar men. However, when Ancel Keys heard that certain populations had almost no heart disease, he began a quest that resulted in the Seven Countries Study.

       Briefly, people in some villages in the Mediterranean region ate less red meat. Some because they couldn't afford it, and it wasn't a traditional part of their cuisine.

       Keys group studied 14,000 men from 16 villages in seven countries. Some of those cohorts, like in the United States and Finland, had high levels of red meat and saturated fat...]]>Did You Try the Carnivore Diet?

       Did you try the carnivore in January? A month of red meat, eggs, and butter? If you did, you probably lost weight.  If you lost weight, you felt better. The Carnivore crowd will point to weight loss as proof of superiority.

       But did you worry that this might not be the healthiest diet for you long-term?  Is it healthy? In short, the answer is no.

       Perhaps you remember on a previous podcast, we talked about the beer and sausage diet. On that diet, Evo, the pod god who distributes this podcast, lost weight every month he was on the diet. In addition, his weekly lab work -sorry for all the jabs Evo - improved every week he was on the diet.

       Could you argue that drinking beer and eating sausage is a good diet? You could, and that same logic is what the carnivore crowd uses to convince people the carnivore diet has merit.

       Simplicity, is Thy Name Carnivore?

       What could be simpler than eating a diet of just red meat? Who doesn't like a good steak? If you just eat steak or red meat, you will lose weight. When you lose weight, you will feel better. And your labs might improve. You might think it is paradoxical that your cholesterol level went down - it isn't; that is just a result of giving up junk food and weight loss.

       Every diet has a honeymoon phase, where people think they can do the diet "forever."

       Then reality comes home:

       • The diet becomes boring, and one note
       • There is an undeniable increased risk of heart disease and cancer
       • Maybe you got hemorrhoids or developed diverticulitis
       • Finally, in social situations, you become that person - the one who could only eat red meat  - the reverse vegan
       
       

       FORK U

       Today, on Fork U, we will discuss the latest low-carb fad: the Carnivore diet, the denial that goes into those who make up the diet, and the risks of an all-meat diet.

       I'm Dr. Terry Simpson, and this is Fork U.

       Fork University

       Where we make sense of the madness, bust a few myths, and teach you a little about food as medicine.

       Carnivore Diet

       The carnivore diet, which primarily consists of animal products like meat, fish, and eggs, has become the latest low-carb fad. It is a controversial and extreme dietary approach. Proponents of the carnivore diet claim numerous health benefits. To be clear, the scientific evidence supporting these benefits is limited, and that long-term studies on the effects of the carnivore diet are lacking.

       Paul Saladino, Ken Berry, and Shawn Baker are a few doctors who advocate for this diet. And oddly, none of them see private patients, although Saladino and Baker love showing their abs, and spend a lot of time in the gym.

       The Biotruth of Evolution

       Some claim the natural diet of humans is meat. This is a biotruth.

       When someone tells you that “man was meant to eat” this or that – it is part of a logical fallacy known as a biotruth. A biotruth is an argument presented by someone with misunderstood notions of human biology and/or evolution but uses those false arguments to justify their views. In this case, how they eat.

       You can extend that logical fallacy out: man was not meant to fly, so we shouldn’t be in airplanes. Primitive man did not have laboratories, so we should not have antibiotics.

       You will see biotruth arguments from people who practice carnivore diets, as well as those who practice vegetarian (and vegan) diets. Often with photographs of our jaws and those of our ancestors – or they will say how we have a long or short intestine, and on that basis, we “were meant” to eat in whatever their view is.

       As we evolved, were we better as plant eaters or meat eaters? Does it matter? It is an argument based in biotruth.

       Paleolithic Man and Biotruth

       The carnivore diet is based on the premise that man had evolved during the Paleolithic era by eating meat. Furthermore, they state that when agriculture and domestication of animals came (10,000 years ago), man’s metabolism was unable to adapt to these new foods. They assert that the maladies of modern man come from foods such as grains and dairy products. That non-meat diets lead to heart disease, obesity, and diabetes – all from our evolutionary dysfunction.

       Archeology has about 6000 fossils to make these assumptions. From those 6000 fossils, we find that early man:

       • Probably was more of a scavenger than a hunter - taking whatever meat something else killed and left behind
       • Gathering, especially roots and beans, kept humans alive
       • The most common things hunted were frogs and rabbits
       • Neanderthals and Homo Erectus, our cousins but not direct ancestors, did organized hunting; the Neanderthals,  and homo sapiens began organization until perhaps 20,000 years ago.
       • Man ate grains even 30,000 years ago.
       
       

       The view of man as a large game hunter is not from the evidence unless you count comic strips and movies.

       Modern Hunter Gather Societies Eat Meat

       Often, they refer to the Inuit, whose lifespan is about 50 (excluding infant mortality). They eat mostly sea creatures but have mummified evidence of atherosclerotic disease. The Hazda eat honey, fruit, and meat, and their average age of death is 50. Over half of their people don't make the age of 15.

       The use of early man, or hunter societies, to state that we should be eating meat is factually incorrect.

       Humans evolved not by eating meat. Humans evolved by eating anything they could, mostly plants. Early man did not evolve to live into the 90's.

       Vegetables are poison: Lectins, Oxylates, and anti-nutrients

       The other comments go something like the "defense of vegetables against humans." This ignores the long-lived populations, who eat mostly plants and little meat.

       Kidney stones are found more commonly among meat eaters than vegetarians. (ref).

       Despite their protestations, Kale, spinach, beans, and broccoli are healthy for people.

       The Most Bioavailable Food

       The other argument is that meat contains the richest nutrients, and the most bioavailable food.  Meat is a rich source of protein, the liver has a lot of vitamin D, and heme-iron is generally better adapted for iron deficiency. Meat is far from having all the nutrients a person requires. Red meat is rich in iron, zinc, B vitamins, and iron.

       There is minimal fiber in meat. The carnivore crowd waives this off, stating that fiber isn't something humans need. In spite of the clear evidence that fiber decreases colon and rectal cancer, that fiber helps regulate blood sugar and cholesterol. Fiber is important to a healthy gut microbiome, and fiber prevents hemorrhoids as well as diverticulitis. Their assertion is false and painfully so - especially if you've had hemorrhoids.

       Vitamin C is not abundant in meat. This lesson led to the discovery of citrus as a means of avoiding scurvy in sailors during the era of Discovery. A finding attributed to another surgeon, Dr. James Lind.  Modern-day isn't without scurvy found among carnivore aficionados, such as musician James Blunt, who went on the carnivore diet.

       Calcium is more abundant in dairy products and some vegetables, as is Folate. and omega-3 fatty acids. They tend to forget that farm-raised salmon has ten times the amount of omega-3 fatty acids as does the cow raised on and fed with high-quality grass all their life.

       Weight Loss and the Carnivore Diet

       Weight loss occurs in a calorie deficit. There is no diet that cannot produce a calorie deficit. This has been demonstrated in great studies showing the equivalent of low-carb diets, and the Mediterranean diet are equal over time.

       It has also been demonstrated in those showing the McDonald's diet, the cookie diet, the Twinkie diet, and our own - Beer and Sausage diet.

       One simply gets tired of eating red meat, and you eat less of it. So instead of eating three thousand calories of multiple foods, you eat 2200 calories of meat, and you lose weight. Nothing to see here, folks, just another diet.

       But there is a dark side to red meat. Just because you can lose weight and show all the physiological benefits of weight loss doesn't mean that a lot of red meat is good for a human. In fact, there is every evidence to state one should limit red meat.

       Is Red Meat Consumption like Smoking?

       There is always some headline grabber who states that eating red meat has the same risk as smoking. While red meat, as we shall see, has an increased risk of cancer, heart disease, and diabetes, it is not as risky as smoking cigarettes. As much as some anti-meat activists might like to frighten you, we assume you came here for the facts.

       So, where did our studies begin?

       Meat, the Seven Countries Study

       Heart disease was an epidemic in the 1950s in the United States, primarily affecting white-collar men. However, when Ancel Keys heard that certain populations had almost no heart disease, he began a quest that resulted in the Seven Countries Study.

       Briefly, people in some villages in the Mediterranean region ate less red meat. Some because they couldn't afford it, and it wasn't a traditional part of their cuisine.

       Keys group studied 14,000 men from 16 villages in seven countries. Some of those cohorts, like in the United States and Finland, had high levels of red meat and saturated fat in their diet. Others, like those from Crevalcore and Montegiorgio, had far less saturated fat.

       The Seven Country Study was the first to show that serum cholesterol, blood pressure, diabetes, and smoking are universal risk factors for heart disease. Ancel Keys and colleagues were central to the modern recognition, definition, and promotion of the eating pattern they found in Italy and Greece in the 1950s and ’60s, now popularly called “The Mediterranean Diet.”

       They showed that dietary patterns in the Mediterranean and in Japan in the 1960s were associated with low rates of coronary heart disease and all-cause mortality. The studies on the elderly showed that a healthy diet and lifestyle (sufficient physical activity, non-smoking, and moderate alcohol consumption) is also associated with a low risk of cardiovascular disease and all-cause mortality. A healthy diet and sufficient physical activity may also postpone cognitive decline and decrease the risk of depression.

       While Carnivore like pointing out that Hong Kong has the highest consumption of meat and some of the longest-living people in the world, a closer look shows those who live to be well in their 80's and 90's ate a diet more like the Mediterranean and not much meat.

       Red Meat and Diabetes

       Red meat consumption has been associated with an increased risk of developing type 2 diabetes. Several studies have investigated this relationship, and here are some key findings:

       1. Particularly processed red meat, like sausages, bacon, and hot dogs, is associated with an increased risk of type 2 diabetes. Perhaps from high levels of sodium and preservatives like nitrates may contribute to the development of diabetes.
       2. The high iron content in red meat can lead to elevated iron stores in the body and may interfere with insulin action and glucose metabolism.
       3. Saturated fats, abundant in red meat, increase the accumulation of fat in the muscles and liver, leading to insulin resistance.
       4. Large-scale epidemiological studies have provided evidence of the link between red meat consumption and diabetes risk.
       
       

       Red Meat and Colorectal Cancer

       The International Agency for Research on Cancer (IARC) has classified processed meat as a Group 1 carcinogen and red meat as a Group 2A carcinogen. A significant body of research has linked red meat, especially processed meat, to an increased risk of colorectal cancer. For example, a meta-analysis by Chan et al. (2011) found that each 100g/day increase in red meat intake was associated with a 17% increased risk of colorectal cancer.

       Mechanisms Linking Red Meat to Colorectal Cancer

       Potential mechanisms include the presence of heme iron in red meat, which facilitates the formation of known carcinogens, such as N-nitroso compounds.

       Grilling or barbecuing can lead to the production of heterocyclic amines and polycyclic aromatic hydrocarbons, also carcinogenic compounds.

       Red Meat and Pancreatic Cancer

       A pooled analysis by Larsson and Wolk (2012) indicated that high red meat consumption was modestly associated with an increased risk of pancreatic cancer.

       Red Meat and Prostate Cancer

       The relationship between red meat consumption and prostate cancer is less clear. Alexander et al. (2010) meta-analysis found a weak but statistically significant association between high intake of red meat and increased risk of prostate cancer.

       What is the Strength of Evidence?

       While not all studies have found strong associations, also, the mechanisms are not fully understood.  However, the evidence suggests a link between high red meat consumption and an increased risk of certain types of cancer, particularly colorectal cancer.

        

       Reduced Cancer Risk

       Numerous studies have established a link between red meat consumption, especially processed meat, and an increased risk of certain types of cancer, including colorectal and pancreatic cancer (International Agency for Research on Cancer, 2015).

       Decreasing red meat intake and incorporating various plant-based foods contribute to a lower cancer risk due to the high fiber content and presence of cancer-protective phytonutrients in plants.

       Better Weight Management

       Reducing red meat consumption can help weight management. Red meat is often high in calories and fat, contributing to weight gain. Opting for leaner protein sources and increasing the intake of vegetables and whole grains can help maintain a healthy weight (Wang, Y., & Beydoun, M. A., 2009, Epidemiologic Reviews).

       Your Gut Health

       Reducing red meat consumption can improve gut health. Diets high in red meat are low in fiber. Fiber is essential for a healthy gut microbiome. Incorporating more fiber-rich plant-based foods promotes better digestion and a healthier gut. Especially a reduced risk of diverticulitis and hemorrhoids. Drawbacks of a carnivore diet include nutrient deficiencies (such as fiber, vitamin C, and certain phytonutrients) and the potential impact on gut health due to the lack of dietary fiber.

        

       Conclusion

       The benefits of reducing red meat consumption include a lower risk of cardiovascular diseases, cancer, and type 2 diabetes, better weight management, and improved gut health. Embracing a balanced diet rich in plant-based foods and varied protein sources can lead to a healthier lifestyle and well-being.

       We call that lifestyle The Mediterranean Diet.

       Thank you for listening to this edition of FORK U. You can find the references for this podcast on my blog, yourdoctorsorders.com or forku.com. While I am a doctor, I am not your doctor. If you need a doctor, please see a board-certified western-trained physician, not a naturopath or a chiropractor or some Eastern medicine witch doctor.

       Fork U is distributed by our friends at Simpler Media and thanks to Allie Press and the pod god - Evo Terra.

       Hey Ev0 -  did you know that those mummies in early Alaska had a lot of vascular disease? I wonder what my daddy had.

       References

       1. Chan, D. S., Lau, R., Aune, D., Vieira, R., Greenwood, D. C., Kampman, E., & Norat, T. (2011). Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PloS one, 6(6), e20456.
       2. Larsson, S. C., & Wolk, A. (2012). Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. British Journal of Cancer, 106(3), 603-607.
       3. Alexander, D. D., Mink, P. J., Cushing, C. A., & Sceurman, B. (2010). A review and meta-analysis of prospective studies of red and processed meat intake and prostate cancer. Nutrition Journal, 9, 50.
       4. World Health Organization. (2015). IARC Monographs evaluate consumption of red meat and processed meat.
       5. Micha, R., et al. (2010). Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation.
       6. Pan, A., et al. (2012). Red meat consumption and mortality: results from 2 prospective cohort studies. Archives of internal medicine
       7. O'Connor LE, Paddon-Jones D, Wright AJ, Campbell WW. A Mediterranean-style eating pattern with lean, unprocessed red meat has cardiometabolic benefits for adults who are overweight or obese in a randomized, crossover, controlled feeding trial. Am J Clin Nutr. 2018 Jul 1;108(1):33-40. doi: 10.1093/ajcn/nqy075. PMID: 29901710; PMCID: PMC6600057.
       8. Dominguez LJ, Di Bella G, Veronese N, Barbagallo M. Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity. Nutrients. 2021 Jun 12;13(6):2028. doi: 10.3390/nu13062028. PMID: 34204683; PMCID: PMC8231595.
       9. Ferraro PM, Bargagli M, Trinchieri A, Gambaro G. Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets. Nutrients. 2020 Mar 15;12(3):779. doi: 10.3390/nu12030779. PMID: 32183500; PMCID: PMC7146511.
       
       ]]>c795509c-40ad-4e8b-8daa-01c9dff96ecdThu, 25 Jan 2024 00:00:00 -070017:51falsefull4545Diet Disappointment 2024 VersionSorry It Didn't Work

       This is the time of year when everyone is excited about some change in their life. My neighbors are doing a "dry January" because they want to cut down on their alcohol. Other neighbors committed to more physical activity before a hip replacement. And there is the inevitable "what diet will I do this time?"

       Now, before I go to that, long-time readers of my newsletter will realize that I am drinking my cup of Peet's coffee. Peet's is a story of disappointment, which I will use to illustrate a point:

       Diet Disappointment

       Diets are like that person who disappoints you again and again. The person you invite to events, but they never reciprocate. The diet starts out great. You lose a bit of weight, decide you can eat this way forever, and this is your new lifestyle.  Then something happens. If you are smart, you realize you cannot live that way. Most, though, internalize and think, "It is my fault." Well, it isn't your fault.

        

       Low Carb Disappointment

       Low-carb diets can be disappointing for various reasons. Some people may find it difficult to stick to a low-carb eating plan because they miss certain high-carb foods that they enjoy. This can lead to feelings of deprivation and dissatisfaction with the diet. Additionally, some people may not experience the weight loss or health benefits they were hoping for with a low-carb diet. It's important to remember that everyone's body is different, and what works for one person may not work for another.  Furthermore, it is important to focus on overall health and well-being rather than just weight loss or specific dietary restrictions.

        

       Every year, someone starts a new version of low carb. I've done a few myself. This year's version is carnivore. Some are doing a carnivore January.  The results will be the same as the previous low-carb diets - and let me go back to Peet's coffee.

       Coffee and Diets

       I have been a member of Peet's Coffee Club since 1995. I get it faithfully every couple of weeks. Whole beans. It costs about $36 for two bags. Then I discovered I could get it at Costco for $25, with no shipping charge, the same date of roasting. I wrote Peet's, of course. They told me my coffee is always fresh, unlike the bulk sold to Costco. Except the roasting date is on the package.

        

       Diets are like that. You get some results, then disappointment. You don't get the return for the money. But someone in the low-carb community will tell you that you didn't do it correctly:

       • You were not earnest enough,
       • You didn't get the right kind of grass-fed beef
       • The beef wasn't organic
       • You ate a banana and ruined ketosis
       • If you stop eating carrots, you will maintain ketosis.
       • Oh, does that pasta look delicious
       • Stop eating vegetables and grains, and just eat beef, salt, and water
       
       

       Now What?

       So, some consider weight loss surgery or new drugs. Both of these are reasonable (yes, I have done a lot of weight loss surgery in my time).

       But what I've advocated is that people have to take responsibility for what they eat even after weight loss surgery. Well, you don't have to - but your body is a perfect calorie counter.

       Does that mean a "diet?" No, the goal of weight loss drugs or surgery isn't to put someone on a diet for weight loss. The goal is to give them good food so they can nourish themselves.

       It also means I have to get rid of silly ideas they learned from things like the low-carb diet. The low-carb diet, that friend you always invite into your home, always disappoints.

       My Journey to Culinary Medicine

       About ten years ago, I received certification in Culinary Medicine. Part of that training was long hours reviewing the literature more about food than I could imagine. For my patients, they will remember the day I began to advocate for the Mediterranean Diet.

       I made the journey from some version of a low-carbohydrate diet to a diet that had substantial proof of long-term health.

       Today, the Mediterranean diet is what I recommend to everyone. It is the most well-studied diet on the planet.

       The Mediterranean Diet

       The Mediterranean diet is a way to eat based on the traditional foods and cooking styles of countries bordering the Mediterranean Sea. It has been associated with numerous health benefits, including a reduced risk of heart disease, stroke, and certain types of cancer. The components of the Mediterranean diet include:

       1. Abundance of plant-based foods: The diet emphasizes the consumption of fruits, vegetables, whole grains, legumes, nuts, and seeds. These foods are rich in vitamins, minerals, fiber, and antioxidants.
       2. Olive oil as the primary fat source: Olive oil is the main source of fat in the Mediterranean diet. It is high in healthy monounsaturated fats and has been linked to lower rates of heart disease.
       3. Moderate consumption of fish and poultry: The Mediterranean diet encourages consuming fish and poultry in moderate amounts. Fish, especially fatty fish like salmon and sardines, are rich in omega-3 fatty acids, which have numerous health benefits.
       4. Limited red meat intake: Red meat is limited in the Mediterranean diet, with a focus on leaner options like poultry and fish. This helps reduce saturated fat intake and lower the risk of heart disease.
       5. Moderate consumption of dairy products: The diet includes moderate amounts of dairy products, such as yogurt and cheese.
       6. Red wine in moderation: Moderate consumption of red wine is a common component of the Mediterranean diet. This is believed to be due to the presence of antioxidants in red wine, such as resveratrol, which may have health benefits when consumed in moderation.
       7. Herbs and spices for flavor: The Mediterranean diet relies on herbs and spices, such as garlic, basil, oregano, and rosemary, to flavor foods instead of using excessive amounts of salt or unhealthy condiments.
       8. Regular physical activity: In addition to the dietary components, the Mediterranean lifestyle also emphasizes regular physical activity. This can include activities like walking, cycling, or participating in sports.
       
       

       It is important to note that the Mediterranean diet is not a strict set of foods but rather a flexible and adaptable way of eating.  You can eat in this manner by eating food from India, the Phillippines, or Norway. The emphasis is on whole, unprocessed foods and a balanced approach to nutrition.

       More To Come

       Want to learn more? I have a course coming up - watch this space. For my followers on TikTok you can find the course there.

       Oh, and I will be buying from Costco, although many other coffee companies have come to me and said, "Hey, try our coffee." So I am. Sorry, Peet's - I may still drink you, but I have boundaries.

       Do that with your diet that will disappoint you. Consider instead a diet that will nourish your body and keep you in good shape.

       Good Luck & have fun!

       ]]>Sorry It Didn't Work

       This is the time of year when everyone is excited about some change in their life. My neighbors are doing a "dry January" because they want to cut down on their alcohol. Other neighbors committed to more physical activity before a hip replacement. And there is the inevitable "what diet will I do this time?"

       Now, before I go to that, long-time readers of my newsletter will realize that I am drinking my cup of Peet's coffee. Peet's is a story of disappointment, which I will use to illustrate a point:

       Diet Disappointment

       Diets are like that person who disappoints you again and again. The person you invite to events, but they never reciprocate. The diet starts out great. You lose a bit of weight, decide you can eat this way forever, and this is your new lifestyle.  Then something happens. If you are smart, you realize you cannot live that way. Most, though, internalize and think, "It is my fault." Well, it isn't your fault.

        

       Low Carb Disappointment

       Low-carb diets can be disappointing for various reasons. Some people may find it difficult to stick to a low-carb eating plan because they miss certain high-carb foods that they enjoy. This can lead to feelings of deprivation and dissatisfaction with the diet. Additionally, some people may not experience the weight loss or health benefits they were hoping for with a low-carb diet. It's important to remember that everyone's body is different, and what works for one person may not work for another.  Furthermore, it is important to focus on overall health and well-being rather than just weight loss or specific dietary restrictions.

        

       Every year, someone starts a new version of low carb. I've done a few myself. This year's version is carnivore. Some are doing a carnivore January.  The results will be the same as the previous low-carb diets - and let me go back to Peet's coffee.

       Coffee and Diets

       I have been a member of Peet's Coffee Club since 1995. I get it faithfully every couple of weeks. Whole beans. It costs about $36 for two bags. Then I discovered I could get it at Costco for $25, with no shipping charge, the same date of roasting. I wrote Peet's, of course. They told me my coffee is always fresh, unlike the bulk sold to Costco. Except the roasting date is on the package.

        

       Diets are like that. You get some results, then disappointment. You don't get the return for the money. But someone in the low-carb community will tell you that you didn't do it correctly:

       • You were not earnest enough,
       • You didn't get the right kind of grass-fed beef
       • The beef wasn't organic
       • You ate a banana and ruined ketosis
       • If you stop eating carrots, you will maintain ketosis.
       • Oh, does that pasta look delicious
       • Stop eating vegetables and grains, and just eat beef, salt, and water
       
       

       Now What?

       So, some consider weight loss surgery or new drugs. Both of these are reasonable (yes, I have done a lot of weight loss surgery in my time).

       But what I've advocated is that people have to take responsibility for what they eat even after weight loss surgery. Well, you don't have to - but your body is a perfect calorie counter.

       Does that mean a "diet?" No, the goal of weight loss drugs or surgery isn't to put someone on a diet for weight loss. The goal is to give them good food so they can nourish themselves.

       It also means I have to get rid of silly ideas they learned from things like the low-carb diet. The low-carb diet, that friend you always invite into your home, always disappoints.

       My Journey to Culinary Medicine

       About ten years ago, I received certification in Culinary Medicine. Part of that training was long hours reviewing the literature more about food than I could imagine. For my patients, they will remember the day I began to advocate for the Mediterranean Diet.

       I made the journey from some version of a low-carbohydrate diet to a diet that had substantial proof of long-term health.

       Today, the Mediterranean diet is what I recommend to everyone. It is the most well-studied diet on the planet.

       The Mediterranean Diet

       The Mediterranean diet is a way to eat based on the traditional foods and cooking styles of countries bordering the Mediterranean Sea. It has been associated with numerous health benefits, including a reduced risk of heart disease, stroke, and certain types of cancer. The components of the Mediterranean diet include:

       1. Abundance of plant-based foods: The diet emphasizes the consumption of fruits, vegetables, whole grains, legumes, nuts, and seeds. These foods are rich in vitamins, minerals, fiber, and antioxidants.
       2. Olive oil as the primary fat source: Olive oil is the main source of fat in the Mediterranean diet. It is high in healthy monounsaturated fats and has been linked to lower rates of heart disease.
       3. Moderate consumption of fish and poultry: The Mediterranean diet encourages consuming fish and poultry in moderate amounts. Fish, especially fatty fish like salmon and sardines, are rich in omega-3 fatty acids, which have numerous health benefits.
       4. Limited red meat intake: Red meat is limited in the Mediterranean diet, with a focus on leaner options like poultry and fish. This helps reduce saturated fat intake and lower the risk of heart disease.
       5. Moderate consumption of dairy products: The diet includes moderate amounts of dairy products, such as yogurt and cheese.
       6. Red wine in moderation: Moderate consumption of red wine is a common component of the Mediterranean diet. This is believed to be due to the presence of antioxidants in red wine, such as resveratrol, which may have health benefits when consumed in moderation.
       7. Herbs and spices for flavor: The Mediterranean diet relies on herbs and spices, such as garlic, basil, oregano, and rosemary, to flavor foods instead of using excessive amounts of salt or unhealthy condiments.
       8. Regular physical activity: In addition to the dietary components, the Mediterranean lifestyle also emphasizes regular physical activity. This can include activities like walking, cycling, or participating in sports.
       
       

       It is important to note that the Mediterranean diet is not a strict set of foods but rather a flexible and adaptable way of eating.  You can eat in this manner by eating food from India, the Phillippines, or Norway. The emphasis is on whole, unprocessed foods and a balanced approach to nutrition.

       More To Come

       Want to learn more? I have a course coming up - watch this space. For my followers on TikTok you can find the course there.

       Oh, and I will be buying from Costco, although many other coffee companies have come to me and said, "Hey, try our coffee." So I am. Sorry, Peet's - I may still drink you, but I have boundaries.

       Do that with your diet that will disappoint you. Consider instead a diet that will nourish your body and keep you in good shape.

       Good Luck & have fun!

       ]]>d0c81632-92b4-4139-8f9d-9406d6c86992Tue, 16 Jan 2024 00:00:00 -070012:11falsefull4444Salesmen of Supplements and ScamsThe Scams and Quacks of the Year

       The New Year, the point we all look for a second chance. To get healthy, lose weight, adopt a new habit.  And waiting for you are the hucksters who want to sell you hydrogen in your water, expensive supplements of dubious value, and some choices that might actually harm you. If it sounds too good to be true, you might just be hearing the sound of the duck - or a quack, at least.

        

       TOP SCAMS OF THE YEAR

       1. Carnivore Diet
       2. Magnesium Supplementation
       3. Celtic Salt
       4. MTHFR Gene Mutation
       5. Cold Plunges
       
       

       FORK U

       Today, on Fork U, we will reveal the top scams of 2023 and make sense of the madness that surrounds them.

       I'm Dr. Terry Simpson, and this is FORK U. Fork University.

       Where we teach you a little bit about food as medicine

       Busting myths and making sense of the madness.

       The Liver King and Paul Saladino

       Chief among the shirtless salesmen of supplements and scams, 2023 saw the self-described liver king (Brian Johnson) fall from grace, and his partner, Paul Saladino, tried to say he didn't know.

       Liver King's five-foot-two-inch frame was filled with more steroids and growth hormones than found in a pharmacy. Purchasing somewhere between $12,000 and $20,000 of injectables a month and eating a diet far from the liver he recommended. Ultimately, Johnson admitted this, albeit the evidence was overwhelming. Finally, let us not forget that his business partner, Paul Saladino, loves to yell at spinach and kale while pushing his Heart and Soil supplements.

       Liver King and Saladino jointly own a supplement business, Heart and Soil. They sell supplements and pretend to tell you about health through the carnivore diet.  Moreover, the company "Heart and Soil" is registered in Texas, and Brian Johnson, his wife, and Saladino are all board members.

       The Shirtless Salesmen of Supplements and Scams

       Being shirtless is oddly effective, especially among some men. Whether this comes from "we like alpha males with abs" or homo-erotic fantasy, shirtless sells. Countless times showing studies refuting their claims don't move these supporters. In fact, the response from some males was some version of "Show me your abdominals." My retort, "I'd love their abs, but in time they'd love my arteries," just didn't move them.

       I still find it odd that a grocery store would allow a shirtless person to yell at spinach. Yes, Saladino did train in psychiatry, although he does not see patients.

       While Saladino said, he had "an inkling" his partner was doing steroids. Johnson (Liver King) used to inject insulin and balance it with maple syrup.  Isn't it odd that Saladino's refrigerator is filled with the same maple syrup that Liver King used to balance his insulin to increase glycogen in his muscles?

       The Carnivore Diet - or - Doctors Don't Learn Nutrition in Medical School

       Saladino received a medical degree from The University of Arizona, and I was a faculty member (assistant professor) at the time.  Saladino loves to pander to the anti-medicine crowd with the trope that doctors don't learn the root cause of disease. I pointed out that we taught him pathophysiology, and he must have forgotten that our Western medicine discovered the root cause of many diseases.

       In front of one audience, Saladino claims he learned nutrition in medical school. Then, a few years later, he claims he didn't learn nutrition in medical school. Do we learn nutrition in medical school?

       Do Doctors Learn Nutrition in Medical School?

       As someone who is certified in Culinary Medicine and taught nutrition, I can say yes and no. The basics of nutrition are anatomy, physiology, and biochemistry. While you can get these courses in college, in medical school, these are graduate-level courses.

       The basic pathology of atherosclerosis, or how cholesterol is made, transported, and absorbed, is taught in medical school. The effect of dietary saturated fats causing an increase in low-density lipoprotein is taught in medical school. Moreover, the foods with high levels of saturated fats are taught in medical school.

       Because of those basics, we surgeons can take the sickest patients and feed them with intravenous nutrition. Surgeons developed intravenous nutrition that has kept countless people alive. In addition, surgeons developed the ability to feed directly into the gut through a tube. But we may not learn that Popeye's chicken breast contains 1000 mg of sodium more than a regular chicken breast. We don't learn the practical side of food, but we learn a lot about the basic science, which is the foundation of nutrition. An analogy might be that an architect can design your home but may not know how to build it.

       The Inflammatory Process in Medical School

       The inflammatory process is one of the first series of lectures that medical students learn.  They learn that inflammation is an essential part of healing from injury and disease. That the inflammatory process is necessary to remove bacteria, viruses, parasites, and even cancer from the human body. Further, medical students learn that if the inflammatory process is overdone, destruction remains, such as in auto-immune diseases like rheumatoid arthritis, Sjogren's, or lupus.

       Medical students are not taught to order C reactive protein or sed rates on everyone because that would be a waste of resources. Someone could have high inflammatory markers for various reasons, and blindly ordering tests is often a wasteful practice of doctors without a clue. Sometimes, we are clueless about a patient's condition, but oftentimes, medical students are taught that a history and physical exam will reveal more than a laboratory test.

       Medical students are not taught that the inflammatory process is the basis of all diseases because this isn't true. Nor are they taught that atherosclerosis is all from inflammatory disease because that isn't true.

       Vitamin Deficiencies and Surgeons

       Vitamin deficiencies are taught in medical school. The first one noted, vitamin C and scurvy, was elucidated from the great work of the Scottish Surgeon Dr. James Lind. Scurvy is a disease with multiple parts - wounds reopen, teeth fall out, blood blisters form, and seemingly many symptoms, but is treated with a source of vitamin C. The root cause of disease, indeed.

       The Root Cause of Disease

       Or consider this mysterious constellation of symptoms: a person progressively develops difficulty walking, strange eye movements, muscle weakness, shortness of breath, swelling of the legs and feet, and ultimately death. The disease was called kakke. Eastern-trained physicians had worked on it for 300 years, and it affected the royal household and the elite in Japan. Did they have some ancient remedy? They did not.

       A doctor, Kanehiro Takaki, dissatisfied with his Eastern medical education, decided to learn Western medicine. He apprenticed under a local doctor until the doctor said he couldn't teach him anymore, and the Imperial Navy sent him to St. Thomas in London to learn surgery.  There, he learned "Western" medicine and even epidemiology, as was taught there by John Snow, who elucidated the cause of the cholera outbreaks.

       Using the tools of Western medicine, he showed that the cause of these symptoms was a dietary deficiency of what became known as vitamin B1, or thiamine. If you want to hear a podcast about it or read more, click here.

       What We Don't Teach in Medical School

       What we are not taught in medical school is that a low-carb diet, or keto diet, or paleo diet, or carnivore diet cure diseases. We don't teach that to medical students because it is not true.

       We teach how the DASH diet with low sodium reduces blood pressure and how to encourage patients with hypertension to decrease their diet. Or how the Mediterranean diet decreases the risk of heart disease and cancer.

       While diet is the most empowering thing people can do, often it will not be enough. While physicians can influence some of the health decisions of patients, often the patient will come to us beyond where diet and exercise can help.

       The Carnivore Diet

       The carnivore diet is the latest evolution of the low-carb fad. Saladino does a fruit modification of the diet, which will prevent scurvy. In fact, the musician James Blunt suffered from scurvy. as the carnivore diet is far from a complete diet.

       Carnivore diet sounds great - just eat steak. Saladino will claim this is the most nutrient-dense food in the world. It isn't.

       Others will claim you can get all your nutrients through this - you cannot.

       The health problems of an all-meat diet are clear:

       • Keto vs Mediterranean diet - same weight loss, but Med diet had fiber and lower LDL (ref)
       • A good review of meat-based vs. plant-based show plant-based overall healthier (ref)
       • Another review shows that dietary fiber is associated with improved metabolic health (ref)
       • While Saladino refers to the Hadza, studies show their diet, like most hunter-gatherers, is rich in fiber (ref)
       • The Inuit in Alaska have high rates of heart disease, stomach cancer, and...]]>The Scams and Quacks of the Year

         The New Year, the point we all look for a second chance. To get healthy, lose weight, adopt a new habit.  And waiting for you are the hucksters who want to sell you hydrogen in your water, expensive supplements of dubious value, and some choices that might actually harm you. If it sounds too good to be true, you might just be hearing the sound of the duck - or a quack, at least.

          

         TOP SCAMS OF THE YEAR

         1. Carnivore Diet
         2. Magnesium Supplementation
         3. Celtic Salt
         4. MTHFR Gene Mutation
         5. Cold Plunges
         
         

         FORK U

         Today, on Fork U, we will reveal the top scams of 2023 and make sense of the madness that surrounds them.

         I'm Dr. Terry Simpson, and this is FORK U. Fork University.

         Where we teach you a little bit about food as medicine

         Busting myths and making sense of the madness.

         The Liver King and Paul Saladino

         Chief among the shirtless salesmen of supplements and scams, 2023 saw the self-described liver king (Brian Johnson) fall from grace, and his partner, Paul Saladino, tried to say he didn't know.

         Liver King's five-foot-two-inch frame was filled with more steroids and growth hormones than found in a pharmacy. Purchasing somewhere between $12,000 and $20,000 of injectables a month and eating a diet far from the liver he recommended. Ultimately, Johnson admitted this, albeit the evidence was overwhelming. Finally, let us not forget that his business partner, Paul Saladino, loves to yell at spinach and kale while pushing his Heart and Soil supplements.

         Liver King and Saladino jointly own a supplement business, Heart and Soil. They sell supplements and pretend to tell you about health through the carnivore diet.  Moreover, the company "Heart and Soil" is registered in Texas, and Brian Johnson, his wife, and Saladino are all board members.

         The Shirtless Salesmen of Supplements and Scams

         Being shirtless is oddly effective, especially among some men. Whether this comes from "we like alpha males with abs" or homo-erotic fantasy, shirtless sells. Countless times showing studies refuting their claims don't move these supporters. In fact, the response from some males was some version of "Show me your abdominals." My retort, "I'd love their abs, but in time they'd love my arteries," just didn't move them.

         I still find it odd that a grocery store would allow a shirtless person to yell at spinach. Yes, Saladino did train in psychiatry, although he does not see patients.

         While Saladino said, he had "an inkling" his partner was doing steroids. Johnson (Liver King) used to inject insulin and balance it with maple syrup.  Isn't it odd that Saladino's refrigerator is filled with the same maple syrup that Liver King used to balance his insulin to increase glycogen in his muscles?

         The Carnivore Diet - or - Doctors Don't Learn Nutrition in Medical School

         Saladino received a medical degree from The University of Arizona, and I was a faculty member (assistant professor) at the time.  Saladino loves to pander to the anti-medicine crowd with the trope that doctors don't learn the root cause of disease. I pointed out that we taught him pathophysiology, and he must have forgotten that our Western medicine discovered the root cause of many diseases.

         In front of one audience, Saladino claims he learned nutrition in medical school. Then, a few years later, he claims he didn't learn nutrition in medical school. Do we learn nutrition in medical school?

         Do Doctors Learn Nutrition in Medical School?

         As someone who is certified in Culinary Medicine and taught nutrition, I can say yes and no. The basics of nutrition are anatomy, physiology, and biochemistry. While you can get these courses in college, in medical school, these are graduate-level courses.

         The basic pathology of atherosclerosis, or how cholesterol is made, transported, and absorbed, is taught in medical school. The effect of dietary saturated fats causing an increase in low-density lipoprotein is taught in medical school. Moreover, the foods with high levels of saturated fats are taught in medical school.

         Because of those basics, we surgeons can take the sickest patients and feed them with intravenous nutrition. Surgeons developed intravenous nutrition that has kept countless people alive. In addition, surgeons developed the ability to feed directly into the gut through a tube. But we may not learn that Popeye's chicken breast contains 1000 mg of sodium more than a regular chicken breast. We don't learn the practical side of food, but we learn a lot about the basic science, which is the foundation of nutrition. An analogy might be that an architect can design your home but may not know how to build it.

         The Inflammatory Process in Medical School

         The inflammatory process is one of the first series of lectures that medical students learn.  They learn that inflammation is an essential part of healing from injury and disease. That the inflammatory process is necessary to remove bacteria, viruses, parasites, and even cancer from the human body. Further, medical students learn that if the inflammatory process is overdone, destruction remains, such as in auto-immune diseases like rheumatoid arthritis, Sjogren's, or lupus.

         Medical students are not taught to order C reactive protein or sed rates on everyone because that would be a waste of resources. Someone could have high inflammatory markers for various reasons, and blindly ordering tests is often a wasteful practice of doctors without a clue. Sometimes, we are clueless about a patient's condition, but oftentimes, medical students are taught that a history and physical exam will reveal more than a laboratory test.

         Medical students are not taught that the inflammatory process is the basis of all diseases because this isn't true. Nor are they taught that atherosclerosis is all from inflammatory disease because that isn't true.

         Vitamin Deficiencies and Surgeons

         Vitamin deficiencies are taught in medical school. The first one noted, vitamin C and scurvy, was elucidated from the great work of the Scottish Surgeon Dr. James Lind. Scurvy is a disease with multiple parts - wounds reopen, teeth fall out, blood blisters form, and seemingly many symptoms, but is treated with a source of vitamin C. The root cause of disease, indeed.

         The Root Cause of Disease

         Or consider this mysterious constellation of symptoms: a person progressively develops difficulty walking, strange eye movements, muscle weakness, shortness of breath, swelling of the legs and feet, and ultimately death. The disease was called kakke. Eastern-trained physicians had worked on it for 300 years, and it affected the royal household and the elite in Japan. Did they have some ancient remedy? They did not.

         A doctor, Kanehiro Takaki, dissatisfied with his Eastern medical education, decided to learn Western medicine. He apprenticed under a local doctor until the doctor said he couldn't teach him anymore, and the Imperial Navy sent him to St. Thomas in London to learn surgery.  There, he learned "Western" medicine and even epidemiology, as was taught there by John Snow, who elucidated the cause of the cholera outbreaks.

         Using the tools of Western medicine, he showed that the cause of these symptoms was a dietary deficiency of what became known as vitamin B1, or thiamine. If you want to hear a podcast about it or read more, click here.

         What We Don't Teach in Medical School

         What we are not taught in medical school is that a low-carb diet, or keto diet, or paleo diet, or carnivore diet cure diseases. We don't teach that to medical students because it is not true.

         We teach how the DASH diet with low sodium reduces blood pressure and how to encourage patients with hypertension to decrease their diet. Or how the Mediterranean diet decreases the risk of heart disease and cancer.

         While diet is the most empowering thing people can do, often it will not be enough. While physicians can influence some of the health decisions of patients, often the patient will come to us beyond where diet and exercise can help.

         The Carnivore Diet

         The carnivore diet is the latest evolution of the low-carb fad. Saladino does a fruit modification of the diet, which will prevent scurvy. In fact, the musician James Blunt suffered from scurvy. as the carnivore diet is far from a complete diet.

         Carnivore diet sounds great - just eat steak. Saladino will claim this is the most nutrient-dense food in the world. It isn't.

         Others will claim you can get all your nutrients through this - you cannot.

         The health problems of an all-meat diet are clear:

         • Keto vs Mediterranean diet - same weight loss, but Med diet had fiber and lower LDL (ref)
         • A good review of meat-based vs. plant-based show plant-based overall healthier (ref)
         • Another review shows that dietary fiber is associated with improved metabolic health (ref)
         • While Saladino refers to the Hadza, studies show their diet, like most hunter-gatherers, is rich in fiber (ref)
         • The Inuit in Alaska have high rates of heart disease, stomach cancer, and colon cancer - all diet-related (ref) (ref) (ref)
         
         

          

         The carnivore diet increases the risk of diverticulitis, hemorrhoids, and stomach cancer (Sivasubramanian BP, Dave M, Panchal V, Saifa-Bonsu J, Konka S, Noei F, Nagaraj S, Terpari U, Savani P, Vekaria PH, Samala Venkata V, Manjani L. Comprehensive Review of Red Meat Consumption and the Risk of Cancer. Cureus. 2023 Sep 15;15(9):e45324. doi: 10.7759/cureus.45324. PMID: 37849565; PMCID: PMC10577092.) Although many chiropractors will dispute this. I wonder how chiropractors ever learned to do anything but cherry-pick studies?

         Magnesium Supplementation

         I recently covered this on a previous blog/podcast ( reference ). Suffice it to say that excess magnesium has become one of the more common problems seen in poison control centers. At best, excess magnesium can lead to loose bowels, but worse cases lead to depression of the carotid baroreceptor with POTS  symptoms, cardio-toxicity, and severe cardiac rhythm changes.

         Legitimate reasons for magnesium deficiency include diarrhea, malnutrition, use of some diuretics, hyperaldosteronism, Crohn's disease, alcoholism, and advanced kidney disease. If you have any of these, you need to see a physician.

         If you eat a lousy diet and don't get enough magnesium, it is time to grow up.

         But this leads to the next scam of the year:

         Celtic Salt

         Celtic salt is simply sea salt harvested from the North Atlantic. It costs about $1.66 an ounce, compared to regular salt, which is $0.06 an ounce - six cents. Is there magic to justify this additional expense? To answer this, you can ask the naturopath, Barbara O'Neill.

         For those who haven't seen her, she seems like a kindly lady, a pleasant voice and an easy smile. She is usually filmed while standing next to a whiteboard, explaining her version of reality to an audience who paid thousands of dollars to listen to her.

         Her misinformation was considered so dangerous that she was barred from Australia's health care system.  She claimed cancer could be cured with sodium bicarbonate, that cayenne pepper could reverse atherosclerosis and stop a heart attack, and that infants with strep infections didn't need antibiotics.   If you didn't know, every one of those statements is dangerously incorrect.

         She also states that she can treat high blood pressure with Celtic salt because Celtic salt has magnesium in it.  Celtic salt has 80 mg of magnesium for every 34,000 grams of salt (that is a toxic amount of salt). A serving of spinach will give you the 80 mg, as will almonds or half a serving of pumpkin seeds.

         O'Neill goes on to say that magnesium is a water-hungry molecule and is good for hydration. Magnesium is not useful for rehydration. In severely dehydrated children, we use a combination of water with sugar and a bit of sodium chloride, and not magnesium.

         Cold Plunges, MTHFR Mutations, and Gary Brecka

         The last is a charismatic fellow named Gary Brecka, who is great at self-promotion. Selling people high-priced solutions to non-existent or rare problems. For legitimacy, Brecka calls himself a "human biologist." Brecka received a bachelor's degree from Frostburg State and another bachelor's degree from a chiropractic college.  In summary, Brecka has no formal medical training.

         Often, Brecka starts his talks by making the claim he can tell a person when they will die to the month. Oddly, no one on planet Earth can tell when a person will die, let alone the month, year, day, or hour. Although there is an entire science, actuarial science, where they determine probabilities of surviving in any given year. However, Brecka claims he can tell based on labs or other issues. Yet this bold claim brought Brecka's most noted client, Dana White. Concluding that Dana White had ten years to live, White became an ardent disciple.

         Today, Brecka advocates hydrogen water, cold plunges, and selling overpriced genetic tests for the MTHFR mutation.

          

         Cold Plunges and The Polar Bear Club

         I'm a member of the Polar Bear Club. I've swam from the waters coming from the Mendenhall glacier by Juneau, Alaska. When I did this, I had spent weeks preparing by swimming in other waters and acclimating my body to this. Growing up in Southeast Alaska, cold water swims were the only ones we had. In those days, I was young, athletic, and took many foolish chances. The last time I was in cold water was scuba diving in New Zealand at 60 degrees, and I had a 9 mm wetsuit on - even that was a bit cold for me.

         Acclimation occurs with athletes who competitively swim in cold water.  First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.

         People who do cold water immersions claim this is good for their health and have a cult-like joy in this frigid experience. Such claims are as cold as the water they immerse themselves in.

         Cold Water Immersion Immediate Effects

         In all the advertisements I've seen on TikTok for cold water immersion tubs, I have never seen one of them warn people of the immediate consequences. Here is what we know based on laboratory studies:

         • Increase heart rate
         • Increased blood pressure
         • Increased respiratory rate
         • Increase in troponin levels - indicating heart damage
         • Increased shivering
         • Increased cardiac (heart) arrhythmias
         
         

         Vasoconstriction of skin vessels begins at temperatures of 37.1 (98.78 F) when immersed in cold water or 37.5 (99.5 F) post-exercise (ref). The body attempts to maintain its core temperature by shivering. However, when immersed in cold water, the body loses its ability to protect its core temperature after 36.2 C or 36.5 post-exercise. This is where the danger begins, as heat is lost. exponentially by convection from water more than a cold shower or air ( ref ).

         Because of the immediate effects

         Cold Water Swimming

         Acclimation occurs with athletes who swim in cold water.  First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.

         Sudden Disappearance Syndrome

         Perhaps you've heard about people who have jumped in the water and never returned? This was called "sudden disappearance syndrome." Jumping into cold water will cause some people to have an involuntary gasp. The shock will cause their body to take a sudden large breath underwater, which fills their lungs, and they sink. It is a miserable death.

         Brown Fat and Fat Stripping Effect of the Plunge

         Brecka says, "Nothing strips fat off the body faster than a cold plunge." He is incorrect, as physical exercise is faster, more efficient, and safer. Shivering is faster at producing heat, but once you get below 36.2 degrees, you lose that regulation and are prone to hypothermia.

         What about brown fat, which generates heat from cold water exposure? This is true! But the average human adult male has about two to five ounces of brown fat in their entire body. When examined, brown fat oxidation in an adult is equivalent to two minutes of running (ref).

         While Brecka would love to sell his $6000 cold plunge pool, he overstates the effects of what can be dangerous activity. This is, in my opinion, unethical.

         Cold Water and Acute Injuries

         What about the elite athletes who use cold for injuries? Certainly, they know more about this. To use this logic - let us look at the average career of an NFL player - 27 months; most careers end because of injury. Their lifespan is 56.9 years. Baseball players' lifespan is about ten years longer (ref)

         The RICE protocol (Rest, Ice, Compression, Elevation) was originally coined by Dr. Mirkin in 1978 in "The Sports Medicine Book." While there was not good data to support this protocol, there were plenty of anecdotes. Who doesn't feel better with ice? But the effect of ice is to gate pain. It does not improve healing. Dr. Mirkin recanted his original position on the protocol in 2014.

         More tests need to be done. But to assume the trainers in the NFL know more than the literature shows is dubious. Most NFL coaches consistently over-train their players and believe an injury will make them stronger. It doesn't - as should be seen by how quickly injury ends careers. One of the reasons Jim Harbaugh was more successful than others was his physical therapists, who limited practice injuries and used modern physical therapy to prevent major...]]>89c8b5c4-f17c-4639-a14a-6c04014fe04aFri, 29 Dec 2023 00:00:00 -070028:11falsefull4343Canola Oil is Healthy and InexpensiveCanola Oil is Healthy and Inexpensive

         Did you ever notice there are those people who will tell you how everything is bad for you? Don't eat this and don't eat that?

         They make grand assertions about the modern food system. Often claiming we should return to the age of the caveman. Assuming that health will return when we eat what our ancestors ate.

         The Logical Fallacy of Ancestral Diets / and Humans

         Proponents of ancestral diets are confused by the logical fallacy called a biotruth.

         What is a biotruth? An argument based upon a misunderstanding of natural selection or the evolutionary process. Usually combined with the conclusion that if it was good enough for primitive man, it should be true for now. Ultimately, we forget that primitive man did not have an easy life.

         Canola Oil Podcast Transcript

         Canola oil is today's topic because not everyone wants to buy expensive olive oil. When I mention canola oil on TikTok, the comments go like this:

         • Canola oil was "meant" to be motor oil
         • It comes from the rapeseed plant
         • It is a GMO-crummy oil
         • Chemically extracted with hexane and it can turn rancid and create trans-fats
         
         

         Are those claims valid? Should we avoid Canola oil? Must we avoid Canadians in general?

         Today on Fork U

         We will make sense of the madness that is Canola oil. Is it an evil plant that is only good to make oil for your car, truck, or tank? Or is it a reasonable oil for your body?

         I'm Dr. Terry Simpson, and this is Fork U

         Fork University

         Where we make sense of the madness

         Bust a few myths

         And teach you a little bit about food as medicine.

         What is Canola Oil?

         Canola oil was invented in the 1970s in Canada and is an acronym that stands for Canadian oil's low acid.

         Canola comes from the pressed seeds of rapeseed plants. Granted, that is an unfortunate name. However, not if you know its epistemology.  Rapeseed comes from the Latin rapa, which translates to "turnip." Thus this flowering plant is a member of the turnip, cabbage, and mustard family.

         Latin just isn't taught anymore. But if you think of Rome often, as we men do, Latin might be the new language for you.

         Speaking of Mustard, did you ever wonder why we don't have mustard oil in the United States? Primarily Erucic acid.

         Erucic Acid

         Erucic acid is a monounsaturated fatty acid that is associated with heart disease. In some poorly done experiments in rats, they seemed to have higher levels of heart disease. Rats, not politicians. But the healthy kind of rats you find in sewers, not the vermin found in Washington, DC.

         Erucic acid is why you don't find mustard seed oil in the United States. Those who travel to India will experience delicious foods cooked in mustard oil. But don't fear. It will be just fine (ref).

         In fact, erucic acid decreases the rate of some progressive brain diseases and is being examined to treat cancer and other diseases.

         Rapeseed Oil as a lubricant

         Because of the high erucic acid content, rapeseed oil was originally used as an industrial lubricant. Some rapeseed was cold pressed, seeds gathered, pressed, and not heated, and the oil extracted. This has been used as a cooking oil for years, but there was concern regarding the erucic acid content.

         Canadians Hybrids

         Canadian scientists began to crossbreed the rapeseed with wild cabbage to lower erucic acid. The seeds of this new hybrid plant became the Canola oil. Later, this plant was genetically modified to withstand Round Up. Hence, it is a genetically modified plant (ref).

         GMO Oh No

         As someone who has published about genetic engineering, I find the fear of GMOs to be a fear of the unknown. Modifying genes is what humans have been doing for centuries. Hence, using laboratory techniques is simply faster than cross-breeding. Still, GMOs are a major cause of heartburn for the latte-sipping English major.

         It is human studies that are the gold standard for how a food behaves. Not where it came from or what it has been used as.

         Lyon The Gastronomic Capital of France

         Let us begin in Lyon, France. The capital of fine dining in the world, home of restaurants with over twenty Michelin stars.

         But Lyon? Home of butter? What happens when we take people with heart attacks from Lyon and ask them to change their diet?

         There was a seventy-five percent lower incidence of cardiac deaths in patients with a first heart attack who modified their diet to a Mediterranean-style diet.

         What was the main change? Well, they wanted the French to go from butter to olive oil, but alas, that was not popular. The French, other than those who reside in the Rivera, do not find olive oil attractive. But the French had no trouble adopting canola oil.

         Canola oil was provided as both a cooking oil and a margarin to spread on their famous French bread.

         Mediterranean Diet

         Other changes they adopted included:

         1.  consume whole grains rather than refined grains,
         2. to have fish more than beef,
         3. and to never go a day without fruit.
         
         

         In the first year, the canola group had 73% less risk of having a second heart attack or dying from heart disease. After several years, the final paper (referenced here) showed a similar risk reduction.

         Implementing the Mediterranean Diet

         One of the great conclusions of the Lyon heart study was that adopting the Mediterranean-style diet was not that difficult for these patients. While some doctors might give up, this one dietary change had as much influence as controlling blood pressure in patients with clinically active heart disease.

         Other Human Studies?

         Nine studies showed that patients consuming canola oil had lower LDL cholesterol. The higher the LDL, the more heart disease a person is likely to have, as well as strokes and peripheral vascular disease.

          

         In spite of what the shirtless salesmen of supplements and scams want to tell you, the human trials show:

         • Canola oil is not toxic to humans
         • Canola oil improves biomarkers for the heart
         • Canola oil improves insulin levels.
         • Canola oil over butter and cream is one factor leading to less heart disease in patients with coronary artery disease.
         
         

         Canola Oil is Not Toxic to Humans

         • Lab studies of people improve when consuming canola oil over saturated fat, butter, or beef tallow.
         • Insulin levels are decreased - which is good - with canola oil
         • And as in Lyon, while the butter is delicious, those who consume canola oil have fewer problems with their heart.
         
         

         Implementing the Mediterranean Diet

         If you want to implement the Mediterranean diet into your life, why not do what they did in Lyon?

         If you cannot afford olive oil, use canola oil to cook with. It has fewer trans fats than tallow, lard, butter, or coconut oil and has a neutral flavor.

         Make sure to have a fruit every day or two.

         Use whole grains in your diet, be that for bread or just grains with your meals. Whole grains contain a lot of fiber.

         New Course Coming

         Thank you for listening to this edition of our series on how to adopt the Mediterranean Diet. We will have a course put together soon about adopting the Mediterranean diet, and you can find out when by listening to this podcast or signing up for my newsletter on terrysimpson.com. You can also follow me on TikTok, where I am @drterrysimpson.

         Check out the blog associated with this - either yourdoctorsorders.com or forku.com.

         This podcast was researched and written by me, Dr. Terry Simpson. While I am a real medical doctor, board-certified, I am not your doctor. Before making dietary changes, please check with a real, board-certified western-trained physician. Not an Eastern medicine doctor, not a witch doctor, not a chiropractor, not a naturopath.

         Distribution and audio editing were done by my friends at Simpler Media - run by the pod god Evo Terra and his most able assistance. Thank you, Allie.

         Hey Evo - in the interest of research, we need to go to the Mediterranean - by way of Lyon.

         ]]>Canola Oil is Healthy and Inexpensive

         Did you ever notice there are those people who will tell you how everything is bad for you? Don't eat this and don't eat that?

         They make grand assertions about the modern food system. Often claiming we should return to the age of the caveman. Assuming that health will return when we eat what our ancestors ate.

         The Logical Fallacy of Ancestral Diets / and Humans

         Proponents of ancestral diets are confused by the logical fallacy called a biotruth.

         What is a biotruth? An argument based upon a misunderstanding of natural selection or the evolutionary process. Usually combined with the conclusion that if it was good enough for primitive man, it should be true for now. Ultimately, we forget that primitive man did not have an easy life.

         Canola Oil Podcast Transcript

         Canola oil is today's topic because not everyone wants to buy expensive olive oil. When I mention canola oil on TikTok, the comments go like this:

         • Canola oil was "meant" to be motor oil
         • It comes from the rapeseed plant
         • It is a GMO-crummy oil
         • Chemically extracted with hexane and it can turn rancid and create trans-fats
         
         

         Are those claims valid? Should we avoid Canola oil? Must we avoid Canadians in general?

         Today on Fork U

         We will make sense of the madness that is Canola oil. Is it an evil plant that is only good to make oil for your car, truck, or tank? Or is it a reasonable oil for your body?

         I'm Dr. Terry Simpson, and this is Fork U

         Fork University

         Where we make sense of the madness

         Bust a few myths

         And teach you a little bit about food as medicine.

         What is Canola Oil?

         Canola oil was invented in the 1970s in Canada and is an acronym that stands for Canadian oil's low acid.

         Canola comes from the pressed seeds of rapeseed plants. Granted, that is an unfortunate name. However, not if you know its epistemology.  Rapeseed comes from the Latin rapa, which translates to "turnip." Thus this flowering plant is a member of the turnip, cabbage, and mustard family.

         Latin just isn't taught anymore. But if you think of Rome often, as we men do, Latin might be the new language for you.

         Speaking of Mustard, did you ever wonder why we don't have mustard oil in the United States? Primarily Erucic acid.

         Erucic Acid

         Erucic acid is a monounsaturated fatty acid that is associated with heart disease. In some poorly done experiments in rats, they seemed to have higher levels of heart disease. Rats, not politicians. But the healthy kind of rats you find in sewers, not the vermin found in Washington, DC.

         Erucic acid is why you don't find mustard seed oil in the United States. Those who travel to India will experience delicious foods cooked in mustard oil. But don't fear. It will be just fine (ref).

         In fact, erucic acid decreases the rate of some progressive brain diseases and is being examined to treat cancer and other diseases.

         Rapeseed Oil as a lubricant

         Because of the high erucic acid content, rapeseed oil was originally used as an industrial lubricant. Some rapeseed was cold pressed, seeds gathered, pressed, and not heated, and the oil extracted. This has been used as a cooking oil for years, but there was concern regarding the erucic acid content.

         Canadians Hybrids

         Canadian scientists began to crossbreed the rapeseed with wild cabbage to lower erucic acid. The seeds of this new hybrid plant became the Canola oil. Later, this plant was genetically modified to withstand Round Up. Hence, it is a genetically modified plant (ref).

         GMO Oh No

         As someone who has published about genetic engineering, I find the fear of GMOs to be a fear of the unknown. Modifying genes is what humans have been doing for centuries. Hence, using laboratory techniques is simply faster than cross-breeding. Still, GMOs are a major cause of heartburn for the latte-sipping English major.

         It is human studies that are the gold standard for how a food behaves. Not where it came from or what it has been used as.

         Lyon The Gastronomic Capital of France

         Let us begin in Lyon, France. The capital of fine dining in the world, home of restaurants with over twenty Michelin stars.

         But Lyon? Home of butter? What happens when we take people with heart attacks from Lyon and ask them to change their diet?

         There was a seventy-five percent lower incidence of cardiac deaths in patients with a first heart attack who modified their diet to a Mediterranean-style diet.

         What was the main change? Well, they wanted the French to go from butter to olive oil, but alas, that was not popular. The French, other than those who reside in the Rivera, do not find olive oil attractive. But the French had no trouble adopting canola oil.

         Canola oil was provided as both a cooking oil and a margarin to spread on their famous French bread.

         Mediterranean Diet

         Other changes they adopted included:

         1.  consume whole grains rather than refined grains,
         2. to have fish more than beef,
         3. and to never go a day without fruit.
         
         

         In the first year, the canola group had 73% less risk of having a second heart attack or dying from heart disease. After several years, the final paper (referenced here) showed a similar risk reduction.

         Implementing the Mediterranean Diet

         One of the great conclusions of the Lyon heart study was that adopting the Mediterranean-style diet was not that difficult for these patients. While some doctors might give up, this one dietary change had as much influence as controlling blood pressure in patients with clinically active heart disease.

         Other Human Studies?

         Nine studies showed that patients consuming canola oil had lower LDL cholesterol. The higher the LDL, the more heart disease a person is likely to have, as well as strokes and peripheral vascular disease.

          

         In spite of what the shirtless salesmen of supplements and scams want to tell you, the human trials show:

         • Canola oil is not toxic to humans
         • Canola oil improves biomarkers for the heart
         • Canola oil improves insulin levels.
         • Canola oil over butter and cream is one factor leading to less heart disease in patients with coronary artery disease.
         
         

         Canola Oil is Not Toxic to Humans

         • Lab studies of people improve when consuming canola oil over saturated fat, butter, or beef tallow.
         • Insulin levels are decreased - which is good - with canola oil
         • And as in Lyon, while the butter is delicious, those who consume canola oil have fewer problems with their heart.
         
         

         Implementing the Mediterranean Diet

         If you want to implement the Mediterranean diet into your life, why not do what they did in Lyon?

         If you cannot afford olive oil, use canola oil to cook with. It has fewer trans fats than tallow, lard, butter, or coconut oil and has a neutral flavor.

         Make sure to have a fruit every day or two.

         Use whole grains in your diet, be that for bread or just grains with your meals. Whole grains contain a lot of fiber.

         New Course Coming

         Thank you for listening to this edition of our series on how to adopt the Mediterranean Diet. We will have a course put together soon about adopting the Mediterranean diet, and you can find out when by listening to this podcast or signing up for my newsletter on terrysimpson.com. You can also follow me on TikTok, where I am @drterrysimpson.

         Check out the blog associated with this - either yourdoctorsorders.com or forku.com.

         This podcast was researched and written by me, Dr. Terry Simpson. While I am a real medical doctor, board-certified, I am not your doctor. Before making dietary changes, please check with a real, board-certified western-trained physician. Not an Eastern medicine doctor, not a witch doctor, not a chiropractor, not a naturopath.

         Distribution and audio editing were done by my friends at Simpler Media - run by the pod god Evo Terra and his most able assistance. Thank you, Allie.

         Hey Evo - in the interest of research, we need to go to the Mediterranean - by way of Lyon.

         ]]>10778169-d99b-4362-9efb-4537f4272753Wed, 13 Dec 2023 00:00:00 -070010:38falsefull4242Nuts and Seeds, or SupplementsNuts and Seeds, or Supplements

         People who count calories notice nuts contain about 200 calories per ounce. Nuts are calorie-dense. However, nuts are also nutrient-dense. Moreover, nuts provide fiber, healthy oils, and essential minerals.

         Nuts have been shown to decrease sudden cardiac death, decrease cholesterol, and provide satiety that helps people who wish to control their weight.

         Two Brazil nuts contain enough magnesium to meet the adult daily requirement.

          

         Food Works, Supplements May Not

         The advantage of a healthy diet is that you do not need supplements in your diet. While Magnesium is an essential mineral needed in hundreds of reactions in your body, you can get all the magnesium you need by following a Mediterranean Diet.

         Take Pumpkin Seeds - also known as Pepitas in the US. Kernels: 1 oz, 168 mg or pumpkin seeds in shell: 1 oz, 74 mg

         Other Foods That Work:

         Almonds, dry roasted: 1 oz, 80 mg

         Spinach, boiled: ½ cup, 78 mg

         Cashews, dry roasted: 1 oz, 74 mg

         Peanuts, oil roasted: ¼ cup, 63 mg

         Soymilk, plain or vanilla: 1 cup, 61 mg

         Black beans, cooked: 1⁄2 cup, 60 mg

         Peanut butter, smooth: 2 tablespoons, 49 mg

         Bread, whole wheat: 2 slices, 46 mg

         Avocado: 1 whole one is 44 mg

         Potato, baked with skin: 3.5 oz, 43 mg

         Rice, brown, cooked: 1⁄2 cup, 42 mg

         Yogurt, plain, low fat: 8 oz, 42 mg

         Oatmeal, instant: 1 packet, 36 mg

         Banana: 1 medium, 32 mg

         Salmon, Atlantic, farmed: 3 oz, 26 mg

         Halibut, cooked: 3 oz, 24 mg

         Raisins½ cup, 23 mg

         Chicken breast, roasted: 3 oz, 22 mg

         Beef, ground, 90% lean: 3 oz, 20 mg

         Broccoli, chopped & cooked: ½ cup, 12 mg

         Apple:1 medium, 9 mg

         Carrot, raw: 1 medium, 7 mg

          

         All of those are foods you get in your diet, and all of them are a part of a healthy Mediterranean Diet.

          

         TEXT FROM PODCAST:

         Which is better? Magnesium glycinate three eight citrate or oxide?

         This is one of the most common questions I'm asked during my doc talk live sections on TikTok. Magnesium supplementation is a popular subject probably ever since the disgraced Naturopath published her book The Magnesium Miracle, claiming that magnesium could cure over 60 diseases. It was popular because so many people wanted one thing that they could grab hold of to explain all of their problems.

         And because symptoms of magnesium deficiency are common, fatigue, weakness, insomnia, and heart palpitations, it became a natural reservoir for all of the nonsense that people want to present.

         Barbara O'Neill, the naturopath banned from Australia for dangerous practices, frequently lectures that taking Celtic salt will cure hypertension, but it isn't Celtic sea salt you need.

         If you need magnesium today, I will introduce you to Mediterranean magnesium. It will not only help regulate blood pressure but also improve your life and increase longevity.

         Today on Fork U, we will make sense of the madness of magnesium, and we'll tell you which magnesium supplement you should buy and which you should avoid. And how to take the Mediterranean magnesium miracle and avoid the supplemental magnesium misery of Montezuma.

         I'm Dr. Terry Simpson, and this is Fork Fork University.

         where we make sense of the madness. Bust a few myths and teach you a little bit about food as medicine.

         The Mediterranean magnesium miracle. Where do you get this? Well, first try nuts and seeds, which we include in the fruit section of the Mediterranean diet. Did you know that two Brazil nuts contain enough magnesium for a person for a day? An ounce of pumpkin seed contains about half of what you need. A banana is about 10%. Salmon about a fourth beef. Beef is about 10%. Now, I know the carnival crowd has a hard time accepting that beef, bison, or organ meat doesn't contain sufficient amounts of magnesium to meet minimum data requirements. But I digress. It's just so much fun to call them out about their quackery. No doubt, many of those proponents sell magnesium supplements on their websites. But did you know that a well-rounded diet like the Mediterranean diet, you will consume all of the magnesium you need?

         And speaking of nuts, did you know that increasing walnut consumption has been shown to lead to a reduction in low-density lipoprotein cholesterol and decrease inflammatory and oxidant markers in individuals who are at high risk for coronary disease?

         And do you know that other studies have shown that people who consume nuts and seeds have fewer heart attacks? For example, 40% decrease in heart disease among those people who consume four servings of nuts a week.

         Let's go back to the supplementation stuff. The problem with supplementation is you're just replacing one factor when eating food provides not only that one factor but plenty of other things.

         The second problem with magnesium supplementation is magnesium toxicity.

         Now, oftentimes people may attribute the nausea, cramps, and diarrhea to food poisoning when actually they're getting overdosed on magnesium supplementation. They probably don't know that taking those magnesium supplements could interfere with their medicines, like their diuretics, their heart medicine, or their antibiotics. Magnesium can cause more muscle aches and sleeplessness, and extra magnesium can even stop the heart. They probably don't tell you on those magnesium bottles that it's going to compete with calcium for absorption. So taking excess magnesium will not only overdose you but also decrease calcium absorption.

         Wow, it's hard to believe they actually sell that stuff when you can just take a Mediterranean diet full of nuts and seeds at one portion of it and get plenty of it in your diet. While magnesium is essential, it is far from rare in plants, nuts, and seeds in spite of supplement makers consistently making claims that our food has less magnesium because we're depleting our soil. Did you know that magnesium is the third most common element on the crust of the earth?

         Because of that, one of my favorite mineral waters has 45 mg of magnesium per glass. It is called Socasani, I don't know if you can find it anywhere else, but I get it at Costco here in the Los Angeles area. This is mineral water that bubbles up from springs in the Andes. It is high in magnesium. I like it because they won some water awards and that is how I found it. But a cup of that water is about a quarter of the amount of magnesium because magnesium is the third most common element on the crust of the earth.

         So when I refer to Mediterranean magnesium, it's not a supplement you're going to buy, although I'm sure someone will probably sell it now. But it does come from nuts, seeds, fruits, and vegetables.

         Now let's go back to Celtic Salt. I hear people selling Celtic salt all the time, be that Barbara O'Neill, Santa Cruz Medicininals, or Gary Brecka.

         But Celtic Salt has 34,000 mg of sodium to 200 mg of magnesium in three and a half ounces (100 grams). That is a tone of salt.

         Now contrast Celtic Salt with one ounce of pumpkin seeds, which has 170 mg of magnesium and two milligrams of sodium. Celtic salt is just overpriced salt. It is not a source of magnesium.

         And certainly, if you're going to take three and a half ounces of salt, which contains 34,000 milligrams of sodium, to get 200 milligrams of magnesium, whatever good the magnesium will do to your blood vessels will be more than outdone by the overdose of sodium you're giving to your body.

         The problem with supplement makers and sellers everywhere is that they are constantly trying to sell you something that you can get in a healthy diet, like the Mediterranean diet, and in this case, from nuts and seeds. They are easy to add to a salad from nuts, which makes an incredible snack that you can carry portable with you almost anywhere, containing fiber and protein, along with magnesium, selenium, potassium, and all those things that you need.

         You don't need to spend more money on magnesium supplements, what you really need is to spend more money eating a better diet. Or like I tell people when they tell me, well, I just don't like fruits and vegetables and nuts and seeds. It's time to grow up because there is more in your diet than just magnesium. There are plenty of other things that you need that you can get from a diet that you will never get from a pill.

          

         Now to be clear, there are those people who need magnesium supplementation if required by a board-certified physician. There are people with certain conditions, kidney disease, and people who have taken certain pills that will deplete magnesium and need it.

         How do you test for magnesium deficiency? Not just a blood test. Blood only contains a few percentages of the magnesium in your body. There are several other tests. One of the gold standards is that we give you a bunch of magnesium, check your urine, and see if it all came out. Another one is the red blood cell test for magnesium. There are some good magnesium tests out there, typically not available from your average chiropractic lab, which oversells you on tons of tests.

         So if you overdose on magnesium, like my aunt did when she brought me the book, The Magnesium Miracle. She said, "I think this is what was giving me diarrhea." I said, absolutely. It was also one of the reasons that her anti-hypertensive wasn't working. She was getting too much hypertension. She stopped her magnesium supplement. Her bowels cleared up, and her hypertension got better. She was taking...]]>Nuts and Seeds, or Supplements

         People who count calories notice nuts contain about 200 calories per ounce. Nuts are calorie-dense. However, nuts are also nutrient-dense. Moreover, nuts provide fiber, healthy oils, and essential minerals.

         Nuts have been shown to decrease sudden cardiac death, decrease cholesterol, and provide satiety that helps people who wish to control their weight.

         Two Brazil nuts contain enough magnesium to meet the adult daily requirement.

          

         Food Works, Supplements May Not

         The advantage of a healthy diet is that you do not need supplements in your diet. While Magnesium is an essential mineral needed in hundreds of reactions in your body, you can get all the magnesium you need by following a Mediterranean Diet.

         Take Pumpkin Seeds - also known as Pepitas in the US. Kernels: 1 oz, 168 mg or pumpkin seeds in shell: 1 oz, 74 mg

         Other Foods That Work:

         Almonds, dry roasted: 1 oz, 80 mg

         Spinach, boiled: ½ cup, 78 mg

         Cashews, dry roasted: 1 oz, 74 mg

         Peanuts, oil roasted: ¼ cup, 63 mg

         Soymilk, plain or vanilla: 1 cup, 61 mg

         Black beans, cooked: 1⁄2 cup, 60 mg

         Peanut butter, smooth: 2 tablespoons, 49 mg

         Bread, whole wheat: 2 slices, 46 mg

         Avocado: 1 whole one is 44 mg

         Potato, baked with skin: 3.5 oz, 43 mg

         Rice, brown, cooked: 1⁄2 cup, 42 mg

         Yogurt, plain, low fat: 8 oz, 42 mg

         Oatmeal, instant: 1 packet, 36 mg

         Banana: 1 medium, 32 mg

         Salmon, Atlantic, farmed: 3 oz, 26 mg

         Halibut, cooked: 3 oz, 24 mg

         Raisins½ cup, 23 mg

         Chicken breast, roasted: 3 oz, 22 mg

         Beef, ground, 90% lean: 3 oz, 20 mg

         Broccoli, chopped & cooked: ½ cup, 12 mg

         Apple:1 medium, 9 mg

         Carrot, raw: 1 medium, 7 mg

          

         All of those are foods you get in your diet, and all of them are a part of a healthy Mediterranean Diet.

          

         TEXT FROM PODCAST:

         Which is better? Magnesium glycinate three eight citrate or oxide?

         This is one of the most common questions I'm asked during my doc talk live sections on TikTok. Magnesium supplementation is a popular subject probably ever since the disgraced Naturopath published her book The Magnesium Miracle, claiming that magnesium could cure over 60 diseases. It was popular because so many people wanted one thing that they could grab hold of to explain all of their problems.

         And because symptoms of magnesium deficiency are common, fatigue, weakness, insomnia, and heart palpitations, it became a natural reservoir for all of the nonsense that people want to present.

         Barbara O'Neill, the naturopath banned from Australia for dangerous practices, frequently lectures that taking Celtic salt will cure hypertension, but it isn't Celtic sea salt you need.

         If you need magnesium today, I will introduce you to Mediterranean magnesium. It will not only help regulate blood pressure but also improve your life and increase longevity.

         Today on Fork U, we will make sense of the madness of magnesium, and we'll tell you which magnesium supplement you should buy and which you should avoid. And how to take the Mediterranean magnesium miracle and avoid the supplemental magnesium misery of Montezuma.

         I'm Dr. Terry Simpson, and this is Fork Fork University.

         where we make sense of the madness. Bust a few myths and teach you a little bit about food as medicine.

         The Mediterranean magnesium miracle. Where do you get this? Well, first try nuts and seeds, which we include in the fruit section of the Mediterranean diet. Did you know that two Brazil nuts contain enough magnesium for a person for a day? An ounce of pumpkin seed contains about half of what you need. A banana is about 10%. Salmon about a fourth beef. Beef is about 10%. Now, I know the carnival crowd has a hard time accepting that beef, bison, or organ meat doesn't contain sufficient amounts of magnesium to meet minimum data requirements. But I digress. It's just so much fun to call them out about their quackery. No doubt, many of those proponents sell magnesium supplements on their websites. But did you know that a well-rounded diet like the Mediterranean diet, you will consume all of the magnesium you need?

         And speaking of nuts, did you know that increasing walnut consumption has been shown to lead to a reduction in low-density lipoprotein cholesterol and decrease inflammatory and oxidant markers in individuals who are at high risk for coronary disease?

         And do you know that other studies have shown that people who consume nuts and seeds have fewer heart attacks? For example, 40% decrease in heart disease among those people who consume four servings of nuts a week.

         Let's go back to the supplementation stuff. The problem with supplementation is you're just replacing one factor when eating food provides not only that one factor but plenty of other things.

         The second problem with magnesium supplementation is magnesium toxicity.

         Now, oftentimes people may attribute the nausea, cramps, and diarrhea to food poisoning when actually they're getting overdosed on magnesium supplementation. They probably don't know that taking those magnesium supplements could interfere with their medicines, like their diuretics, their heart medicine, or their antibiotics. Magnesium can cause more muscle aches and sleeplessness, and extra magnesium can even stop the heart. They probably don't tell you on those magnesium bottles that it's going to compete with calcium for absorption. So taking excess magnesium will not only overdose you but also decrease calcium absorption.

         Wow, it's hard to believe they actually sell that stuff when you can just take a Mediterranean diet full of nuts and seeds at one portion of it and get plenty of it in your diet. While magnesium is essential, it is far from rare in plants, nuts, and seeds in spite of supplement makers consistently making claims that our food has less magnesium because we're depleting our soil. Did you know that magnesium is the third most common element on the crust of the earth?

         Because of that, one of my favorite mineral waters has 45 mg of magnesium per glass. It is called Socasani, I don't know if you can find it anywhere else, but I get it at Costco here in the Los Angeles area. This is mineral water that bubbles up from springs in the Andes. It is high in magnesium. I like it because they won some water awards and that is how I found it. But a cup of that water is about a quarter of the amount of magnesium because magnesium is the third most common element on the crust of the earth.

         So when I refer to Mediterranean magnesium, it's not a supplement you're going to buy, although I'm sure someone will probably sell it now. But it does come from nuts, seeds, fruits, and vegetables.

         Now let's go back to Celtic Salt. I hear people selling Celtic salt all the time, be that Barbara O'Neill, Santa Cruz Medicininals, or Gary Brecka.

         But Celtic Salt has 34,000 mg of sodium to 200 mg of magnesium in three and a half ounces (100 grams). That is a tone of salt.

         Now contrast Celtic Salt with one ounce of pumpkin seeds, which has 170 mg of magnesium and two milligrams of sodium. Celtic salt is just overpriced salt. It is not a source of magnesium.

         And certainly, if you're going to take three and a half ounces of salt, which contains 34,000 milligrams of sodium, to get 200 milligrams of magnesium, whatever good the magnesium will do to your blood vessels will be more than outdone by the overdose of sodium you're giving to your body.

         The problem with supplement makers and sellers everywhere is that they are constantly trying to sell you something that you can get in a healthy diet, like the Mediterranean diet, and in this case, from nuts and seeds. They are easy to add to a salad from nuts, which makes an incredible snack that you can carry portable with you almost anywhere, containing fiber and protein, along with magnesium, selenium, potassium, and all those things that you need.

         You don't need to spend more money on magnesium supplements, what you really need is to spend more money eating a better diet. Or like I tell people when they tell me, well, I just don't like fruits and vegetables and nuts and seeds. It's time to grow up because there is more in your diet than just magnesium. There are plenty of other things that you need that you can get from a diet that you will never get from a pill.

          

         Now to be clear, there are those people who need magnesium supplementation if required by a board-certified physician. There are people with certain conditions, kidney disease, and people who have taken certain pills that will deplete magnesium and need it.

         How do you test for magnesium deficiency? Not just a blood test. Blood only contains a few percentages of the magnesium in your body. There are several other tests. One of the gold standards is that we give you a bunch of magnesium, check your urine, and see if it all came out. Another one is the red blood cell test for magnesium. There are some good magnesium tests out there, typically not available from your average chiropractic lab, which oversells you on tons of tests.

         So if you overdose on magnesium, like my aunt did when she brought me the book, The Magnesium Miracle. She said, "I think this is what was giving me diarrhea." I said, absolutely. It was also one of the reasons that her anti-hypertensive wasn't working. She was getting too much hypertension. She stopped her magnesium supplement. Her bowels cleared up, and her hypertension got better. She was taking her anti-hypertensive, and it wasn't being interfered with magnesium. And she loves fruits, seeds, and nuts. I mean, she has to love nuts. I'm her nephew.

         Please listen to the blog or see the blog associated with this called Your doctor's orders.com or for you.com. This was researched by me, Dr. Terry Simpson. And while I am a physician, I am not your physician. If you need a physician's help, please see a board-certified Western-trained physician, not a naturopath, not an Eastern medicine man, not a chiropractor, not a witch doctor. Our friends carried out distribution at Simpler Media, and the pod god, my good friend Evo Terra.

         ]]>b58f4de8-81d7-423a-8a69-e610dbc15c88Wed, 06 Dec 2023 00:00:00 -070010:36falsefull4141The Beautiful BeanWe Love Legumes

         The legume is a powerhouse plant protein. The beautiful bean. Often the source of protein for vegetarians and vegans, and forgotten about in most modern diets today. Thus, we will campaign to bring back the legume.

         In today's gym, you will find people selling protein powders, advocating all meat diets, and flexing their muscles. But in ancient times, the original Greek Gymnasiums, the source of protein for these fellows, were legumes. Their diet was cereals from whole grains, fruits, legumes, vegetables, and occasionally fish. No meat, no protein powder, no pre-workout.

         What is a Legume or Pulse?

         When most think about legumes, they think about the common green bean (Phaseolus vulgaris). Yet there is an entire family of Leguminosae.

         The precise definition of a legume is any plant from the Fabaceae family that would include its leaves, stems, and pods. A pulse is an edible seed from a legume plant. Pulses include beans, lentils, and peas. For example, a pea pod is a legume, but the pea inside the pod is the pulse.

         Rediscovering the Bean

         When Ancel Keys was told there were few cardiac events in Southern Italy, he went to investigate. Legumes have less fat, and thus, a diet rich in legumes should have less fat and, thus, less heart disease.

         In Naples, only 20-25 percent of the calories were from fat. In contrast, Keys noted in England that 35% of the calories were from fat, while in Minnesota, 40 percent of the calories were from fat. Legumes meant plenty of protein, less fat.

         The blood cholesterol reflected some of this.  Naples had cholesterol values of 165 milligrams per 100 milliliters of blood, while England had over 200 and Minnesota had over 230.  Total blood cholesterol was the only measurement at the time.

         What Keys also showed was the wealthy Neapolitans ate a richer diet:

         "Still, a small sample of bankers and professional men in Naples, who lived on a much richer diet than the working class, had cholesterol values of about 200 in their blood serum, and some of them had coronary heart disease." (reference 1)

         Beans and Lower Cholesterol

         Keys then took 24 healthy men and controlled their diet for fat and protein. Keeping calories constant with equal amounts of protein but changing the fat, the cholesterol fell from 225 to 195 on the lower-fat diet. But the Neapolitan diet was not what he followed. The fat in Naples was mainly olive oil, and the fat in the low-fat metabolic ward was from fat in meat and milk.

         At the time, Keys concluded it would be difficult to convince people to eat a diet rich in legumes. Americans love their meat. Today, we have better methods to decrease heart disease risk by using statins often with other drugs. While a diet of legumes replacing meat might reduce blood cholesterol by 10-20%, that is often not enough to decrease the risk of heart disease.

         A combination of modern medications (such as Crestor, Zetia, Repatha) can lower LDL (apo-B levels) to where heart disease can become an "orphan" disease. You can have your steak and eat it too!

         Legumes and the Mediterranean Diet

         Legumes are part of the Mediterranean Diet (ref). The recommended amount includes 3-4 ounces of legumes per day. Or using legumes as a major source of protein for a meal several times a week.

         Legumes: lentils, beans, peas, and peanuts.  The more common ones that humans consume.

         Ancient Peoples and Legumes

         Until about 12,000 years ago, homo sapiens were hunter-gatherers. For almost two million years before that, our evolutionary ancestors subsisted on hunting and gathering. What was the most common protein source? Legumes. Not meat, as much as your carnivore-crazy friends would have you believe.

         Remains of lentils, the tombs of the Twelfth Dynasty (2400-2200 BC).  Archeologists have found peans and lentils from remains in Turkey dating to 5500 BC.

         Even North America has legumes. America is best known for both the kidney bean and the haricot (and you thought it was French). Those were cultivated throughout North, Central, and South America. Dried kidney beans have been found in pre-Inca tombs.

         Want Some Data?

         People who ate legumes four times a week had a 22% reduction in heart disease compared to those who consumed legumes once a week or less. The U.S. Dietary Guidelines emphasize legumes (about 3 cups a week) and the DASH Eating Plan of the National Heart, Lung, and Blood Institute (4-5 half-cup servings a week). The Food and Agriculture Organization (FAO) of the United Nations declared the International Year of Pulses in 2016, focusing on the contribution of pulses to food production and nutritional diversity to help eradicate hunger and malnutrition.

         
         

         Nutritional Value

         Legumes are a significant source of protein, dietary fiber, carbohydrates, and dietary minerals; for example, a half cup of cooked chickpeas contains 18% of the Daily Value (DV) for protein, 30% DV for dietary fiber, 43% DV for folate and 52% DV for manganese. Not much fat and not much sodium in these.

         Legumes are also an excellent source of resistant starch, one of my favorite starches.  Your gut doesn't break down resistant starch but is broken down by bacteria in the large intestine to produce short-chain fatty acids used by intestinal cells for food energy. Those byproducts reduce the risk of colon and rectal cancer.

         Favorite Recipes:

         One of my favorite recipes is life-saving Dahl by Simon Majumdar - my co-host of FORK U. His recipe is here.

         
         

         REFERENCES:

         (1) Keys, Margaret.Keys, Ancel. The Benevolent Bean. United States: Farrar, Straus and Giroux, 1972.

         Gofman JW, Delalla O, Glazier F, Freeman NK, Lindgren FT, Nichols AV, Strisower B, Tamplin AR. The serum lipoprotein transport system in health, metabolic disorders, atherosclerosis and coronary heart disease. J Clin Lipidol. 2007 May;1(2):104-41. doi: 10.1016/j.jacl.2007.03.001. PMID: 21291675.

         LA, He J, Ogden LG, et al. Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study. Arch Intern Med 2001 Nov 26;161 (21):2573-8.

         "Nutrition facts for Chickpeas (garbanzo beans, bengal gram), mature seeds, cooked, boiled, without salt, 100 g, USDA Nutrient Database, version SR-21". Conde Nast. 2014. Retrieved 15 January 2015.

         Birt DF, Boylston T, Hendrich S, et al. Resistant Starch: Promise for Improving Human Health. Advances in Nutrition. 2013;4(6):587-601. doi:10.3945/an.113.004325.

         Am J Hypertens. 2014 Jan;27(1):56-64. doi: 10.1093/ajh/hpt155. Epub 2013 Sep 7.

         Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials.

         Jayalath VH1, de Souza RJ, Sievenpiper JL, Ha V, Chiavaroli L, Mirrahimi A, Di Buono M, Bernstein AM, Leiter LA, Kris-Etherton PM, Vuksan V, Beyene J, Kendall CW, Jenkins DJ.

         Naureen Z, Bonetti G, Medori MC, Aquilanti B, Velluti V, Matera G, Iaconelli A, Bertelli M. Foods of the Mediterranean diet: garlic and Mediterranean legumes. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E12-E20. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2741. PMID: 36479501; PMCID: PMC9710409.

         ]]>We Love Legumes

         The legume is a powerhouse plant protein. The beautiful bean. Often the source of protein for vegetarians and vegans, and forgotten about in most modern diets today. Thus, we will campaign to bring back the legume.

         In today's gym, you will find people selling protein powders, advocating all meat diets, and flexing their muscles. But in ancient times, the original Greek Gymnasiums, the source of protein for these fellows, were legumes. Their diet was cereals from whole grains, fruits, legumes, vegetables, and occasionally fish. No meat, no protein powder, no pre-workout.

         What is a Legume or Pulse?

         When most think about legumes, they think about the common green bean (Phaseolus vulgaris). Yet there is an entire family of Leguminosae.

         The precise definition of a legume is any plant from the Fabaceae family that would include its leaves, stems, and pods. A pulse is an edible seed from a legume plant. Pulses include beans, lentils, and peas. For example, a pea pod is a legume, but the pea inside the pod is the pulse.

         Rediscovering the Bean

         When Ancel Keys was told there were few cardiac events in Southern Italy, he went to investigate. Legumes have less fat, and thus, a diet rich in legumes should have less fat and, thus, less heart disease.

         In Naples, only 20-25 percent of the calories were from fat. In contrast, Keys noted in England that 35% of the calories were from fat, while in Minnesota, 40 percent of the calories were from fat. Legumes meant plenty of protein, less fat.

         The blood cholesterol reflected some of this.  Naples had cholesterol values of 165 milligrams per 100 milliliters of blood, while England had over 200 and Minnesota had over 230.  Total blood cholesterol was the only measurement at the time.

         What Keys also showed was the wealthy Neapolitans ate a richer diet:

         "Still, a small sample of bankers and professional men in Naples, who lived on a much richer diet than the working class, had cholesterol values of about 200 in their blood serum, and some of them had coronary heart disease." (reference 1)

         Beans and Lower Cholesterol

         Keys then took 24 healthy men and controlled their diet for fat and protein. Keeping calories constant with equal amounts of protein but changing the fat, the cholesterol fell from 225 to 195 on the lower-fat diet. But the Neapolitan diet was not what he followed. The fat in Naples was mainly olive oil, and the fat in the low-fat metabolic ward was from fat in meat and milk.

         At the time, Keys concluded it would be difficult to convince people to eat a diet rich in legumes. Americans love their meat. Today, we have better methods to decrease heart disease risk by using statins often with other drugs. While a diet of legumes replacing meat might reduce blood cholesterol by 10-20%, that is often not enough to decrease the risk of heart disease.

         A combination of modern medications (such as Crestor, Zetia, Repatha) can lower LDL (apo-B levels) to where heart disease can become an "orphan" disease. You can have your steak and eat it too!

         Legumes and the Mediterranean Diet

         Legumes are part of the Mediterranean Diet (ref). The recommended amount includes 3-4 ounces of legumes per day. Or using legumes as a major source of protein for a meal several times a week.

         Legumes: lentils, beans, peas, and peanuts.  The more common ones that humans consume.

         Ancient Peoples and Legumes

         Until about 12,000 years ago, homo sapiens were hunter-gatherers. For almost two million years before that, our evolutionary ancestors subsisted on hunting and gathering. What was the most common protein source? Legumes. Not meat, as much as your carnivore-crazy friends would have you believe.

         Remains of lentils, the tombs of the Twelfth Dynasty (2400-2200 BC).  Archeologists have found peans and lentils from remains in Turkey dating to 5500 BC.

         Even North America has legumes. America is best known for both the kidney bean and the haricot (and you thought it was French). Those were cultivated throughout North, Central, and South America. Dried kidney beans have been found in pre-Inca tombs.

         Want Some Data?

         People who ate legumes four times a week had a 22% reduction in heart disease compared to those who consumed legumes once a week or less. The U.S. Dietary Guidelines emphasize legumes (about 3 cups a week) and the DASH Eating Plan of the National Heart, Lung, and Blood Institute (4-5 half-cup servings a week). The Food and Agriculture Organization (FAO) of the United Nations declared the International Year of Pulses in 2016, focusing on the contribution of pulses to food production and nutritional diversity to help eradicate hunger and malnutrition.

         
         

         Nutritional Value

         Legumes are a significant source of protein, dietary fiber, carbohydrates, and dietary minerals; for example, a half cup of cooked chickpeas contains 18% of the Daily Value (DV) for protein, 30% DV for dietary fiber, 43% DV for folate and 52% DV for manganese. Not much fat and not much sodium in these.

         Legumes are also an excellent source of resistant starch, one of my favorite starches.  Your gut doesn't break down resistant starch but is broken down by bacteria in the large intestine to produce short-chain fatty acids used by intestinal cells for food energy. Those byproducts reduce the risk of colon and rectal cancer.

         Favorite Recipes:

         One of my favorite recipes is life-saving Dahl by Simon Majumdar - my co-host of FORK U. His recipe is here.

         
         

         REFERENCES:

         (1) Keys, Margaret.Keys, Ancel. The Benevolent Bean. United States: Farrar, Straus and Giroux, 1972.

         Gofman JW, Delalla O, Glazier F, Freeman NK, Lindgren FT, Nichols AV, Strisower B, Tamplin AR. The serum lipoprotein transport system in health, metabolic disorders, atherosclerosis and coronary heart disease. J Clin Lipidol. 2007 May;1(2):104-41. doi: 10.1016/j.jacl.2007.03.001. PMID: 21291675.

         LA, He J, Ogden LG, et al. Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study. Arch Intern Med 2001 Nov 26;161 (21):2573-8.

         "Nutrition facts for Chickpeas (garbanzo beans, bengal gram), mature seeds, cooked, boiled, without salt, 100 g, USDA Nutrient Database, version SR-21". Conde Nast. 2014. Retrieved 15 January 2015.

         Birt DF, Boylston T, Hendrich S, et al. Resistant Starch: Promise for Improving Human Health. Advances in Nutrition. 2013;4(6):587-601. doi:10.3945/an.113.004325.

         Am J Hypertens. 2014 Jan;27(1):56-64. doi: 10.1093/ajh/hpt155. Epub 2013 Sep 7.

         Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials.

         Jayalath VH1, de Souza RJ, Sievenpiper JL, Ha V, Chiavaroli L, Mirrahimi A, Di Buono M, Bernstein AM, Leiter LA, Kris-Etherton PM, Vuksan V, Beyene J, Kendall CW, Jenkins DJ.

         Naureen Z, Bonetti G, Medori MC, Aquilanti B, Velluti V, Matera G, Iaconelli A, Bertelli M. Foods of the Mediterranean diet: garlic and Mediterranean legumes. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E12-E20. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2741. PMID: 36479501; PMCID: PMC9710409.

         ]]>922e5306-3276-46c0-95d6-3298bcc09966Wed, 29 Nov 2023 00:00:00 -070012:12falsefull4040Turmeric: It Can Kill YouTurmeric: It can kill you

         Turmeric is from the root of a flowering plant (Curcuma longa of the ginger family Zingiberaceae), known for being anti-inflammatory. Because of its anti-inflammatory nature, turmeric is one of the most common supplements I am asked about during my TikTok live sessions. This is because people like a "natural" anti-inflammatory supplement rather than over-the-counter medications.

         Supplements

         Supplements are excluded from "black box warnings." Those warnings you see in the package inserts in pharmaceuticals.  This article is meant to provide references for those interested in doing more research about Tumeric to realize it is not benign.

         Turmeric has many potential applications for cancer, brain injury, and many other diseases. The key is knowing what dose of turmeric is toxic, what dose is effective, and what dose is ineffective. We also need to know how to mitigate potential dangers.

         Contrast with Aspirin

         Aspirin is a known anti-inflammatory agent with many uses. Since aspirin is regulated, we know the dose effect of aspirin. If you have a headache, the 81 mg dose of aspirin will not relieve your headache. But the 325 mg dose will decrease headache. And you know that taking two hundred tablets of aspirin is a toxic dose.

         A single aspirin can cause a bleeding ulcer, which may lead to death. Some people are allergic to aspirin, and an allergic reaction can lead to death.

         What we don't know is the effective dose of Turmeric or the lethal dose of it in that supplement bottle. But we know that turmeric, curcumin can lead to liver injury and death.

         Turmeric and Liver Injury

         Toxicity is always in the dose. High curcumin levels, the active ingredient in turmeric, have caused liver damage (Ref 1-13). To quote from one of the references:

         Liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. (2)

         Turmeric and Cooking

         There is no danger in using turmeric as a spice in cooking. First, because your intestines do not absorb turmeric well. Unlike a supplement, which has high doses of curcumin. In addition, supplements also have black pepper, which increases absorption. Since turmeric has a mild anti-inflammatory component, this might have limited benefits as part of a healthy diet.

          

         Tumeric belongs in the cabinet, not in a capsule.

         TEXT FROM THE PODCAST

         You probably have some turmeric in your herb and spice drawer.

         You’ve probably heard that Turmeric’s active ingredient Curcumin has anti-inflammatory properties and has been used for centuries as an “ancient” medicine.

         That yellow powder comes from the root of the Curcuma longa plant, a member of the ginger family.

         Turmeric has a warm, bitter taste, and I use it in Paella, curry, and add it to salads, rice, or other starches like pearl barley.

         But what you haven’t heard is that too much Turmeric can kill you.

         Today we will make sense of the madness surrounding Turmeric. From its promise as an anti-cancer agent to its toxicity, and who should avoid it for daily use.

         FORK U

         I’m Dr. Terry Simpson, and THIS is FORK U

         Fork University

         Where we make sense of the madness

         Bust a few myths!

         And teach you a little bit about food as medicine.

         Inflammation

         Inflammation is a complex biochemical, physiological, and even pathological process. Inflammation is the basis of our immune system, and acute inflammation allows us to rid our bodies of cancer, viruses, bacteria, yeasts, mold, and parasites. Without the inflammatory process, we would end up being a pile of goo in twenty-four hours – dead as dead can be. Inflammation allows us to repair our body from injury, anything from burning our hand by spilling coffee to major trauma from an automobile accident.

         Chronic Inflammation

         Chronic inflammation can make certain illnesses much worse - from arthritis, heart disease, inflammatory bowel disease, psoriasis, and may even play a part in premature aging.

         So we want some inflammation, but not too much.

         You've Had Inflammation

         Did you ever have the flu and have muscle aches and a fever, only to take an aspirin and feel better in 24 hours? Those muscle aches and fevers were not the result of the virus but of your body fighting it – and fighting it to where you felt poorly. So you added a bit of anti-inflammatory agent – aspirin – and felt better.

         Science and Inflammation

         Science is always looking for anti-inflammatory agents, and curcumin has attracted a lot of interest among legitimate scientists.

         Curcumin has been examined for a potential role in cancer treatments or with inflammatory bowel disease.

         Because inflammation is complex – here is an example about curcumin: “It binds to the toll-like receptors and regulates downstream nuclear factor kappa B, mitogen activate protein kinases, activator protein one and other signaling pathways.”

         Hucksters, Curcumin, and Inflammation

         Curcumin has also attracted the attention of the non-regulated supplement industry. Where they can bottle it up and tell you it “supports heart health, or gut health, or immune function.” All those statements are meaningless – designed to fool someone to buy something with a label of “natural” to believe it might be better than some “drug.”

         Because it is complex, you can have hucksters use the word “inflammation” and sell you a product, an idea, or a supplement for hundreds of dollars. Their science is marketing, and in this case, marketing to you a product with words and extracting dollars from your wallet.

         Do we even have wallets anymore?

         The Most Anti-Inflammatory Diet

         Do you know what the most anti-inflammatory diet is? The Mediterranean diet – the one tested to work well for people with overactive inflammatory diseases – like arthritis, Crohn’s disease, multiple sclerosis, diabetes, obesity, or heart disease.

         Let's take curcumin and turmeric back to the kitchen.

         A part of the Mediterranean diet is cooking with herbs and spices.

         And even if you can’t cook, you can spice things up a bit.

         Turmeric seems to be a worthy candidate.

         Fresh Turmeric or Powder?

         If you buy fresh turmeric from the store, it will look like a root. It is brown on the outside with a deep yellow inside. This turmeric is also great for cooking. But be warned, it will stain your hands a nice yellow color - not permanently. Use a micro plane to shave the root onto your dishes into your dishes. If you follow a recipe, you can substitute fresh turmeric in the ratio of 1 tablespoon fresh is equal to a teaspoon of the dried yellow in any recipe.

         Start with Breakfast!

         If you’ve been to coffee shops lately, you may notice they have started adding turmeric to some drinks, like a turmeric-laced latte. Which has about a quarter to half teaspoon of the powder in the drink. Turmeric will add a deeper flavor to your latte, and some liken it to other spiced drinks – such as the famous pumpkin.

         Turmeric is a great addition to scrambled eggs or a tofu scramble. It provides a color and depth of flavor.

         A quarter teaspoon of the spice is all you need. You can also use it with paprika on top of deviled eggs.

         Moving on from Breakfast

         Adding a teaspoon to your rice will give it a deep yellow color that makes the rice more visually appealing.

         A teaspoon also works well with your bean dishes. That famous cowboy caviar – adding turmeric to it – makes it a bit more earthy.

          

         Some of you have asked me about Ginger/Turmeric /honey teas or “shots” to decrease inflammation.

         But if you consider other anti-inflammatory drugs, like aspirin, and ibuprofen, you know they have side effects.

         So does curcumin.

         In the blog, I have half a dozen references to the deaths of people with liver failure who had high doses of curcumin, some prescribed by Ayurvedic practitioners. Many of these patients died; some were saved when they went to conventional hospitals where they needed liver transplants.

         The Dose is Always in the Poison.

         Be warned about the supplements of curcumin, especially when it has been combined with piperine (pepper) to increase its uptake in the gut.

         Curcumin should not be used if you are pregnant or going to become pregnant. This can cause a loss of pregnancy.

         Nor should curcumin be used if you are breastfeeding.

         Do not take curcumin if you are taking any blood thinners, like warfarin, Plavix, or Eliquis.

         If you tend to bleed more or bruise easily, you should not take this supplement.

         The supplement should not be taken daily if you are over 60 years old, as it can cause bleeding in the brain.

         Do you have some issues with your gallbladder? Curcumin causes inflammation of your gallbladder, which requires urgent surgery.

         Curcumin should not be taken if you have stomach issues – it can cause ulcers in your stomach and make any ulcer you have to bleed more.

         It should not be taken if you are taking aspirin, Motrin, or any anti-inflammatory drug.

         It should not be taken if you are going to undergo surgery – it should be stopped two weeks ahead of time.

         The Non-Regulated Supplement Industry

         The supplement industry is not regulated. Besides people getting too much and causing bleeding issues and death, there have been supplements colored with heavy metals, causing heavy metal accumulation in people who use these supplements.

         If you have a headache or joint ache, we know the dose of aspirin, Naprosyn, or Motrin...]]>Turmeric: It can kill you

         Turmeric is from the root of a flowering plant (Curcuma longa of the ginger family Zingiberaceae), known for being anti-inflammatory. Because of its anti-inflammatory nature, turmeric is one of the most common supplements I am asked about during my TikTok live sessions. This is because people like a "natural" anti-inflammatory supplement rather than over-the-counter medications.

         Supplements

         Supplements are excluded from "black box warnings." Those warnings you see in the package inserts in pharmaceuticals.  This article is meant to provide references for those interested in doing more research about Tumeric to realize it is not benign.

         Turmeric has many potential applications for cancer, brain injury, and many other diseases. The key is knowing what dose of turmeric is toxic, what dose is effective, and what dose is ineffective. We also need to know how to mitigate potential dangers.

         Contrast with Aspirin

         Aspirin is a known anti-inflammatory agent with many uses. Since aspirin is regulated, we know the dose effect of aspirin. If you have a headache, the 81 mg dose of aspirin will not relieve your headache. But the 325 mg dose will decrease headache. And you know that taking two hundred tablets of aspirin is a toxic dose.

         A single aspirin can cause a bleeding ulcer, which may lead to death. Some people are allergic to aspirin, and an allergic reaction can lead to death.

         What we don't know is the effective dose of Turmeric or the lethal dose of it in that supplement bottle. But we know that turmeric, curcumin can lead to liver injury and death.

         Turmeric and Liver Injury

         Toxicity is always in the dose. High curcumin levels, the active ingredient in turmeric, have caused liver damage (Ref 1-13). To quote from one of the references:

         Liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. (2)

         Turmeric and Cooking

         There is no danger in using turmeric as a spice in cooking. First, because your intestines do not absorb turmeric well. Unlike a supplement, which has high doses of curcumin. In addition, supplements also have black pepper, which increases absorption. Since turmeric has a mild anti-inflammatory component, this might have limited benefits as part of a healthy diet.

          

         Tumeric belongs in the cabinet, not in a capsule.

         TEXT FROM THE PODCAST

         You probably have some turmeric in your herb and spice drawer.

         You’ve probably heard that Turmeric’s active ingredient Curcumin has anti-inflammatory properties and has been used for centuries as an “ancient” medicine.

         That yellow powder comes from the root of the Curcuma longa plant, a member of the ginger family.

         Turmeric has a warm, bitter taste, and I use it in Paella, curry, and add it to salads, rice, or other starches like pearl barley.

         But what you haven’t heard is that too much Turmeric can kill you.

         Today we will make sense of the madness surrounding Turmeric. From its promise as an anti-cancer agent to its toxicity, and who should avoid it for daily use.

         FORK U

         I’m Dr. Terry Simpson, and THIS is FORK U

         Fork University

         Where we make sense of the madness

         Bust a few myths!

         And teach you a little bit about food as medicine.

         Inflammation

         Inflammation is a complex biochemical, physiological, and even pathological process. Inflammation is the basis of our immune system, and acute inflammation allows us to rid our bodies of cancer, viruses, bacteria, yeasts, mold, and parasites. Without the inflammatory process, we would end up being a pile of goo in twenty-four hours – dead as dead can be. Inflammation allows us to repair our body from injury, anything from burning our hand by spilling coffee to major trauma from an automobile accident.

         Chronic Inflammation

         Chronic inflammation can make certain illnesses much worse - from arthritis, heart disease, inflammatory bowel disease, psoriasis, and may even play a part in premature aging.

         So we want some inflammation, but not too much.

         You've Had Inflammation

         Did you ever have the flu and have muscle aches and a fever, only to take an aspirin and feel better in 24 hours? Those muscle aches and fevers were not the result of the virus but of your body fighting it – and fighting it to where you felt poorly. So you added a bit of anti-inflammatory agent – aspirin – and felt better.

         Science and Inflammation

         Science is always looking for anti-inflammatory agents, and curcumin has attracted a lot of interest among legitimate scientists.

         Curcumin has been examined for a potential role in cancer treatments or with inflammatory bowel disease.

         Because inflammation is complex – here is an example about curcumin: “It binds to the toll-like receptors and regulates downstream nuclear factor kappa B, mitogen activate protein kinases, activator protein one and other signaling pathways.”

         Hucksters, Curcumin, and Inflammation

         Curcumin has also attracted the attention of the non-regulated supplement industry. Where they can bottle it up and tell you it “supports heart health, or gut health, or immune function.” All those statements are meaningless – designed to fool someone to buy something with a label of “natural” to believe it might be better than some “drug.”

         Because it is complex, you can have hucksters use the word “inflammation” and sell you a product, an idea, or a supplement for hundreds of dollars. Their science is marketing, and in this case, marketing to you a product with words and extracting dollars from your wallet.

         Do we even have wallets anymore?

         The Most Anti-Inflammatory Diet

         Do you know what the most anti-inflammatory diet is? The Mediterranean diet – the one tested to work well for people with overactive inflammatory diseases – like arthritis, Crohn’s disease, multiple sclerosis, diabetes, obesity, or heart disease.

         Let's take curcumin and turmeric back to the kitchen.

         A part of the Mediterranean diet is cooking with herbs and spices.

         And even if you can’t cook, you can spice things up a bit.

         Turmeric seems to be a worthy candidate.

         Fresh Turmeric or Powder?

         If you buy fresh turmeric from the store, it will look like a root. It is brown on the outside with a deep yellow inside. This turmeric is also great for cooking. But be warned, it will stain your hands a nice yellow color - not permanently. Use a micro plane to shave the root onto your dishes into your dishes. If you follow a recipe, you can substitute fresh turmeric in the ratio of 1 tablespoon fresh is equal to a teaspoon of the dried yellow in any recipe.

         Start with Breakfast!

         If you’ve been to coffee shops lately, you may notice they have started adding turmeric to some drinks, like a turmeric-laced latte. Which has about a quarter to half teaspoon of the powder in the drink. Turmeric will add a deeper flavor to your latte, and some liken it to other spiced drinks – such as the famous pumpkin.

         Turmeric is a great addition to scrambled eggs or a tofu scramble. It provides a color and depth of flavor.

         A quarter teaspoon of the spice is all you need. You can also use it with paprika on top of deviled eggs.

         Moving on from Breakfast

         Adding a teaspoon to your rice will give it a deep yellow color that makes the rice more visually appealing.

         A teaspoon also works well with your bean dishes. That famous cowboy caviar – adding turmeric to it – makes it a bit more earthy.

          

         Some of you have asked me about Ginger/Turmeric /honey teas or “shots” to decrease inflammation.

         But if you consider other anti-inflammatory drugs, like aspirin, and ibuprofen, you know they have side effects.

         So does curcumin.

         In the blog, I have half a dozen references to the deaths of people with liver failure who had high doses of curcumin, some prescribed by Ayurvedic practitioners. Many of these patients died; some were saved when they went to conventional hospitals where they needed liver transplants.

         The Dose is Always in the Poison.

         Be warned about the supplements of curcumin, especially when it has been combined with piperine (pepper) to increase its uptake in the gut.

         Curcumin should not be used if you are pregnant or going to become pregnant. This can cause a loss of pregnancy.

         Nor should curcumin be used if you are breastfeeding.

         Do not take curcumin if you are taking any blood thinners, like warfarin, Plavix, or Eliquis.

         If you tend to bleed more or bruise easily, you should not take this supplement.

         The supplement should not be taken daily if you are over 60 years old, as it can cause bleeding in the brain.

         Do you have some issues with your gallbladder? Curcumin causes inflammation of your gallbladder, which requires urgent surgery.

         Curcumin should not be taken if you have stomach issues – it can cause ulcers in your stomach and make any ulcer you have to bleed more.

         It should not be taken if you are taking aspirin, Motrin, or any anti-inflammatory drug.

         It should not be taken if you are going to undergo surgery – it should be stopped two weeks ahead of time.

         The Non-Regulated Supplement Industry

         The supplement industry is not regulated. Besides people getting too much and causing bleeding issues and death, there have been supplements colored with heavy metals, causing heavy metal accumulation in people who use these supplements.

         If you have a headache or joint ache, we know the dose of aspirin, Naprosyn, or Motrin that is effective, the dose that won’t do anything, and the dose that is toxic. We don’t know that with turmeric or curcumin.

         I love cooking with the herb turmeric. It adds a depth of flavor to almost any meal. As with all good food, it has properties that can add to the properties of other whole foods and spices.

         Turmeric belongs in the kitchen, not in the capsule.

         Please see the blog associated with this podcast on yourdoctorsorders dot come.

         This podcast was researched and written by me, Dr Terry Simpson. And while I am a board-certified physician, I am not your physician.

         If you need advice, please seek a board-certified western-trained physician n- not an Ayvurdic healer, not an Eastern medicine man, not a naturopath or chiropractor – but someone who can help you with real conditions.

         Simpler Media distributes the podcast, and the transcript can be found on FORK U. Audio editing and music were inserted by my good friend and pod god – Evo Terra.

         Hey Evo – I wonder if you’ve ever tried turmeric in beer?

          

         REFERENCES:

         1. Drug-Induced Liver Injury Secondary to Turmeric Use https://pubmed.ncbi.nlm.nih.gov/37205206/
         2. Liver Injury Associated with Turmeric-A Growing Problem: Ten Cases from the Drug-Induced Liver Injury Network [DILIN] https://pubmed.ncbi.nlm.nih.gov/36252717/
         3. Acute liver injury following turmeric use in Tuscany: An analysis of the Italian Phytovigilance database and systematic review of case reports https://pubmed.ncbi.nlm.nih.gov/32656820/
         4. Turmeric-Associated Drug-Induced Liver Injury https://pubmed.ncbi.nlm.nih.gov/36600786/
         5. Turmeric Induced Liver Injury: A Report of Two Cases
         6. https://pubmed.ncbi.nlm.nih.gov/31214366/
         7. Turmeric-Associated Liver Injury: A Rare Case of Drug-Induced Liver Injury
         8. https://ncbi.nlm.nih.gov/pmc/articles/PMC10149439/
         9. Turmeric-Induced Hepatotoxicity: Report of 2 Cases
         10. https://ncbi.nlm.nih.gov/pmc/articles/PMC8711139/
         11. Turmeric Induced Liver Injury: A Report of Two Cases
         12. https://ncbi.nlm.nih.gov/pmc/articles/PMC6535872/
         13. Turmeric-Associated Liver Injury
         14. https://pubmed.ncbi.nlm.nih.gov/31283536/
         15. Autoimmune Hepatitis Associated With Turmeric Consumption
         16. https://pubmed.ncbi.nlm.nih.gov/32337301/
         17. A rare case of turmeric-induced hepatotoxicity
         18. https://pubmed.ncbi.nlm.nih.gov/32037709/
         19. Turmeric supplement induced hepatotoxicity: a rare complication of a poorly regulated substance
         20. https://pubmed.ncbi.nlm.nih.gov/31271321/
         21. Drug Induced Liver Injury Attributed to a Curcumin Supplement https://pubmed.ncbi.nlm.nih.gov/31781418/
         22. Peng Y, Ao M, Dong B, Jiang Y, Yu L, Chen Z, Hu C, Xu R. Anti-Inflammatory Effects of Curcumin in the Inflammatory Diseases: Status, Limitations and Countermeasures. Drug Des Devel Ther. 2021 Nov 2;15:4503-4525. doi: 10.2147/DDDT.S327378. PMID: 34754179; PMCID: PMC8572027.
         
         ]]>38bdfeed-5ffc-4f9d-b0c5-fc2e5c687987Wed, 22 Nov 2023 00:00:00 -070010:06falsefull3939Weight Loss Meds: Making Sense of MadnessOzempic, Wegovy, Monjaro, and a host of other drugs – the GLP-1 agonists and near miracles weight loss drugs, and soon a more potent pill form coming.

         These drugs have known side effects, and there have been increased visits to the emergency rooms. Often because people were not told foods to avoid.

         As with any new drug, there are the grifters. After all, since it is a prescription, you will have supplement salesmen that promise a natural solution. What about those who claim they can "compound" the drug for you in their compound pharmacy?

         Weight Watchers and Sequence

         Was it a coincidence that Weight Watchers (WW) bought Sequence? Sequence is a company that prescribes these drugs through a network of physicians that you contact via telemedicine.  Sequence, as it turns out, is one of the more legitimate telemedicine companies, not only trying to get you a prescription but providing a diet plan with it.

         Weight Watchers purchased Sequence for over 100 million dollars. One thing missing from the frequent prescription of the new drugs is a diet plan. Weight Watchers does this.

         And Weight Watchers is partially owned by Oprah Winfrey, who has been open about her weight loss struggles.  Now, Oprah reports she has been on semaglutide and lost over 45 pounds.

         Thus Oprah proved that the drugs, with a good diet, are a powerful tool against obesity.

         It is More Than Willpower - Ask Oprah

         As a weight loss surgeon, I am constantly asked about willpower and obesity.  For example, Oprah Winfrey a person with more willpower than probably anyone you know. Given her resources to have people cook for her, provide her with a workout plan, and any assistance. She even bought a major portion of Weight Watchers. What made the difference? The injectable drug, semaglutide (Wegovy).

         Obesity Management is more than a diet - ask Weight Watchers

         The Weight Watchers diet plan has evolved over the years. Even with the Weight Watchers diet plan ranking among the best diets in the world, they purchased Sequence. Thus repositioning themselves to use their diet with the drugs to provide optimal health.

         Keeping you out of the Emergency Room - Side Effects of the New Drugs

         Emergency room physicians have noted an increase in patients coming to the ER after using these drugs. I was recently interviewed about this, and you can find it here.

         Common side effects include nausea, vomiting, bloating, constipation, and diarrhea. Up to eighty percent of people who take these drugs have symptoms.  Many of those problems can be avoided by following a few simple rules:

         1.  Avoid fatty foods. Fatty foods increase bloating and discomfort with these drugs. Fried chicken has sent many to the emergency room
         2.  Alcohol should be limited to one drink per day. Although best to avoid alcohol altogether with these medications.
         3.  Junk food with lots of sugar, like candy, cookies, and donuts, should be avoided while on these drugs.
         4.  Foods to concentrate on are fruits, vegetables, whole grains, and brothy soups like Minestrone or Dahl.
         
         

         Compound Pharmacies and "generic Ozempic"

         Many compound pharmacies have offered these drugs for sale. They are often at a greatly reduced price. But they are not the same drugs approved and tested by the FDA.

         There is no "generic" form of Ozempic, Wegovy, or Mounjaro.

         Compound pharmacies are telling their customers that, since there is a shortage of these drugs, they can compound the drug and sell it to the public.

         Many of these compound pharmacies import semaglutide from overseas. It is illegal to import a drug from overseas without FDA approval. Furthermore, the drugs they import are not the same formula tested by the FDA. It is often sodium semaglutide and the FDA has warned against the use of this drug on its website (here).

         In our podcast, we talk with a compound pharmacist who warns about these drugs.

         In fact, the FDA has a warning for doctors:

         "Healthcare professionals who are considering working with compounders to obtain semaglutide products should be aware that compounders may be using salt forms of semaglutide. FDA is not aware of any basis for compounding a drug using semaglutide salts that would meet federal requirements."

         Natural Ozempic

         Supplement makers are left out because now we have a drug that can treat obesity almost as well as weight loss surgery. Some claim Berberine is a "natural Ozempic." Berberine is not. Berberine is not a GLP-1 agonist; it has mild weight loss benefits. In one recent study (cited here) people lost about 4 pounds over half a year of taking it. That is nothing compared to any of the GLP-1 agonists.

         But there is a natural GLP-1, and you can find it in the Gila monster.

         From the saliva of the Gila Monster came the drug, Exenatide, which is a GLP-1 agonist. It was the first approved for diabetic use and was noted to have a decrease in weight. The drug is not as effective for weight loss as Ozempic.

         The new weight loss medications are one step to conquer obesity. Obesity is a chronic disease. It's not about losing ten pounds. While the stars on the runway want to use it for short-term use, that is a fad.

         This year, sales of Ozempic are expected to hit 17 billion dollars (ref). All of this from a drug originally developed as a medication for type 2 diabetes.

         ]]>Ozempic, Wegovy, Monjaro, and a host of other drugs – the GLP-1 agonists and near miracles weight loss drugs, and soon a more potent pill form coming.

         These drugs have known side effects, and there have been increased visits to the emergency rooms. Often because people were not told foods to avoid.

         As with any new drug, there are the grifters. After all, since it is a prescription, you will have supplement salesmen that promise a natural solution. What about those who claim they can "compound" the drug for you in their compound pharmacy?

         Weight Watchers and Sequence

         Was it a coincidence that Weight Watchers (WW) bought Sequence? Sequence is a company that prescribes these drugs through a network of physicians that you contact via telemedicine.  Sequence, as it turns out, is one of the more legitimate telemedicine companies, not only trying to get you a prescription but providing a diet plan with it.

         Weight Watchers purchased Sequence for over 100 million dollars. One thing missing from the frequent prescription of the new drugs is a diet plan. Weight Watchers does this.

         And Weight Watchers is partially owned by Oprah Winfrey, who has been open about her weight loss struggles.  Now, Oprah reports she has been on semaglutide and lost over 45 pounds.

         Thus Oprah proved that the drugs, with a good diet, are a powerful tool against obesity.

         It is More Than Willpower - Ask Oprah

         As a weight loss surgeon, I am constantly asked about willpower and obesity.  For example, Oprah Winfrey a person with more willpower than probably anyone you know. Given her resources to have people cook for her, provide her with a workout plan, and any assistance. She even bought a major portion of Weight Watchers. What made the difference? The injectable drug, semaglutide (Wegovy).

         Obesity Management is more than a diet - ask Weight Watchers

         The Weight Watchers diet plan has evolved over the years. Even with the Weight Watchers diet plan ranking among the best diets in the world, they purchased Sequence. Thus repositioning themselves to use their diet with the drugs to provide optimal health.

         Keeping you out of the Emergency Room - Side Effects of the New Drugs

         Emergency room physicians have noted an increase in patients coming to the ER after using these drugs. I was recently interviewed about this, and you can find it here.

         Common side effects include nausea, vomiting, bloating, constipation, and diarrhea. Up to eighty percent of people who take these drugs have symptoms.  Many of those problems can be avoided by following a few simple rules:

         1.  Avoid fatty foods. Fatty foods increase bloating and discomfort with these drugs. Fried chicken has sent many to the emergency room
         2.  Alcohol should be limited to one drink per day. Although best to avoid alcohol altogether with these medications.
         3.  Junk food with lots of sugar, like candy, cookies, and donuts, should be avoided while on these drugs.
         4.  Foods to concentrate on are fruits, vegetables, whole grains, and brothy soups like Minestrone or Dahl.
         
         

         Compound Pharmacies and "generic Ozempic"

         Many compound pharmacies have offered these drugs for sale. They are often at a greatly reduced price. But they are not the same drugs approved and tested by the FDA.

         There is no "generic" form of Ozempic, Wegovy, or Mounjaro.

         Compound pharmacies are telling their customers that, since there is a shortage of these drugs, they can compound the drug and sell it to the public.

         Many of these compound pharmacies import semaglutide from overseas. It is illegal to import a drug from overseas without FDA approval. Furthermore, the drugs they import are not the same formula tested by the FDA. It is often sodium semaglutide and the FDA has warned against the use of this drug on its website (here).

         In our podcast, we talk with a compound pharmacist who warns about these drugs.

         In fact, the FDA has a warning for doctors:

         "Healthcare professionals who are considering working with compounders to obtain semaglutide products should be aware that compounders may be using salt forms of semaglutide. FDA is not aware of any basis for compounding a drug using semaglutide salts that would meet federal requirements."

         Natural Ozempic

         Supplement makers are left out because now we have a drug that can treat obesity almost as well as weight loss surgery. Some claim Berberine is a "natural Ozempic." Berberine is not. Berberine is not a GLP-1 agonist; it has mild weight loss benefits. In one recent study (cited here) people lost about 4 pounds over half a year of taking it. That is nothing compared to any of the GLP-1 agonists.

         But there is a natural GLP-1, and you can find it in the Gila monster.

         From the saliva of the Gila Monster came the drug, Exenatide, which is a GLP-1 agonist. It was the first approved for diabetic use and was noted to have a decrease in weight. The drug is not as effective for weight loss as Ozempic.

         The new weight loss medications are one step to conquer obesity. Obesity is a chronic disease. It's not about losing ten pounds. While the stars on the runway want to use it for short-term use, that is a fad.

         This year, sales of Ozempic are expected to hit 17 billion dollars (ref). All of this from a drug originally developed as a medication for type 2 diabetes.

         ]]>b4c144e9-14fc-4049-9471-b1b7a4e59cc5Wed, 12 Jul 2023 00:00:00 -070021:32falsefull3838Peanut Butter - Don't Feel GuiltySeed Oils, Omega 6, and Inflammation

         Just about everyone in the low-carb community is talking about how bad seed oils are. They claim the medical community has it wrong. The conspiracy-minded folks claim doctors want to keep people sick. Thus dependent on medicine for pills and surgery. Hence, seed oils are the new evil part of the picture.

         The New Sugar Conspiracy

         Seed oils, hydrogenated oils, and omega-6 fatty acids have replaced sugar as the new reason for ill health in America.

         Their logic goes like this:

         Seed oils are high in omega-6 fatty acids. They claim that high Omega 6 fatty acids are pro-inflammatory. Therefore, if you have more seed oils in your diet, you will have more inflammation. Inflammation is the root cause of heart disease.

         Their argument is logical, partially true, and the conclusion is incorrect.  They are selling you snake oil (well, usually supplements).

         It is Peanut Butter

         The keto crowd will say how "real" peanut butter is made with peanuts and salt. Claiming this peanut butter is "candy" or "full of garbage" and isn't fit to be eaten. But is it? Let's break this down.

         Added Sugar

         First, the added sugar, which according to the label is 3 grams per serving (two tablespoons), so the whole thing is 190 calories, of which 12 of those calories come from sugar, the rest from fat.

         Here is the label from Sprouts Pure Peanut Butter. Nothing but ground peanuts. No salt, no oils, no sugar. There are 200 calories from two tablespoons.

         Of the 200 calories from all peanut butter, with no added sugar, you get the same number of calories from the peanut butter with sugar in it. How much sugar? Well, about 3 grams per serving of sugar. How much is that? Not much.  To exceed the recommended dose of sugar from the American Heart Association, you would need to have more than 6% of your calories.  In Skippy, it is 1.5% added sugar.

         Low Carb Sugar Conspiracy

         Sugar was the "evil" that low carbohydrate folks said caused obesity. If you read their literature from twenty-plus years ago, it blamed sugar for obesity. Not just sugar, but any carb that was sugar, they claimed, would become fat. They even had their alternative view of history of obesity in the country.

         They stated that the world was not obese until Ancel Keys blamed heart disease on fat. Then the US government promoted a low-fat diet. The result was obesity bloomed because they replaced fat with sugar. That evil food pyramid caused people to turn away from fat, substituting sugar. That sugar substitution led to obesity.

         It sounds so logical. If you ever go on a low-carb diet (Atkins, South Beach, Paleo, Keto, Carnivore), you stop eating junk food and eat steak. You feel satisfied eating lots of meat.  Then you get tired of steak. You lose weight because you are in a calorie deficit, not because of ketosis. But that weight loss leads to confirmation of the theory that sugar made you fat.

         You go off the restrictive diet. Now you gain weight. You gain weight because you are eating more. But you blame the slice of bread. What you forget is now you are eating more steak because you have more flavors in your mouth. That slice of bread is 100 calories, but you think an 18-ounce Porterhouse (1260 calories) is a diet food? So you blame the bread or the lava cake. But not the extra calories.

         Where It Falls Apart

         But something about your low-carb diet doesn't make sense. You notice that obesity has increased in the United States. But sugar consumption has fallen. How does that work?

         You might wonder how that whole fruit is bad. Your low-carb coach says it's full of sugar. The community says it will "spike your insulin." Concluding that insulin causes you to store fat. But the scientific community shows study after study that people who eat whole fruits live longer and better. In fact, even diabetics who eat whole fruits have lower hemoglobin A1c. How is that? How can fruit be so healthy?

         The latest low carbohydrate fad is the carnivore crowd. They eat fruit now. Maybe that is the answer - the evolution from the Paleo caveman diet to the Carnivore diet. Here is the problem: it is still a fad.

         Longest Living People

         Then you read that the longest-living people eat a lot of carbohydrates. In the Blue Zones, they live long, consuming a diet rich in carbohydrates.

         You go to Italy and see everyone is thin and beautiful, and eating pasta. The Mediterranean diet is the best, but it is 55% carbohydrates.

         You go to Asia and see thin people shoveling in white rice.

         Your eyes open and you think maybe you were just fooled.

         Fructose is the problem

         In 2010 David Lustig came out with his famous YouTube video. Sugar is made of two molecules, fructose, and glucose. Glucose, he said, was not the problem. It was fructose. And high fructose corn syrup was in everything.

         This brief idea was based on mouse metabolism. Not on human metabolism.

         It was a cute fad that allowed you to blame big corn for the world's obesity. But the facts didn't add up here either. On to the next conspiracy.

         Seed oils are the problem

         The data shows that sugar isn't the cause of obesity. So they have come up with a new conspiracy. Seed oils are the problem.

         Canola, safflower, corn, peanut, and just any vegetable oils cause the problem.

         Seed oil consumption has increased worldwide, and so has obesity. There is the correlation. Simple minds like simple correlations.

         While their conclusion is incorrect, it is important to see why they came to these ideas.

         Trans Fats

         Trans fats are truly evil. They are a primary cause of heart disease. But before knowing this, they were the darling of food activists in the United States.

         The movement was from food activists like Phil Sokolof. He suffered from a heart attack and believed saturated fat was evil. He took out full-page ads in major newspapers, and attacked the use of beef tallow in McDonald's french fries. Those fries were so much tastier. As he lobbied fast-food and commercial bakeries to switch to vegetable oils, he didn't understand they were adding trans fats.

         Vegetable oils are healthy for the heart. But vegetable oils are liquid at room temperature. So you have to hydrogenate the vegetable oil, for it to become solid at room temperature. During hydrogenation, you create a lot of trans fatty acids.

         In 2008, the American Medical Association urged the prohibition of trans fats in commercial bakeries and restaurants (reference). Finally, the medical community was listened to, and trans fats were outlawed in the United States (reference).

         Hydrogenated Vegetable Oils Are Not Trans Fats

         Just because you chemically alter vegetable oil does not mean it is a trans fat.  Since the FDA has outlawed trans fats, they are removed from the process.

         Naturally occurring trans-fats are found in animal fats. Like butter, which is 3% trans fats.  Breast milk contains a form of trans fats called vaccenic acid, which has health benefits. Hydrogenation produces many forms of trans fatty acids that cause harm. But currently, hydrogenation does not involve making trans fatty acids.

         What are seed oils?

         Saying something is a seed oil is incorrect. Seed oils are not just one type of oil. Canola oil is much like olive oil, in that the main fatty acid is oleic acid (reference).

         Canola oil is much maligned. Detractors will say it is highly inflammatory. In fact, canola oil decreases inflammation in the human body (reference). Canola oil not only reduces inflammation but also reduces total cholesterol in the blood. Compared to saturated fat, like butter from grass-fed bison or unicorns, it decreases all cardiac risk factors.

         Some point out that canola comes from the rapeseed plant, which has been genetically modified. Thus, it must be filled with pesticides. They further tell you that canola oil has been used to run farm machinery. They fail to point out the obvious - olive oil can do the same. In fact, olive oil was the first electricity in the world, lighting homes, and running farm equipment.

         Seed Oils the new Sugar Conspiracy

         Seed oils, as it turns out, are not inflammatory. They do not cause an increase in heart disease. They decrease the risk of heart disease.

         Seed oils are in a lot of junk food. Some call them the ultra-processed foods. That doesn't make them bad. Junk foods also have a lot of sugar and a lot of salt. It isn't the oil per se, or the sugar, or the salt. It is that you can eat a lot of junk food. Junk food is readily available.

         Back to Peanut Butter

         Don't feel guilty for eating Skippy, Jiff, or whatever brand you like. Peanut oil is healthy for you. The sugar content is minimal. The hydrogenated oil makes the butter creamy without oil separation and decreases the risk of it going bad. As if peanut...]]>Seed Oils, Omega 6, and Inflammation

         Just about everyone in the low-carb community is talking about how bad seed oils are. They claim the medical community has it wrong. The conspiracy-minded folks claim doctors want to keep people sick. Thus dependent on medicine for pills and surgery. Hence, seed oils are the new evil part of the picture.

         The New Sugar Conspiracy

         Seed oils, hydrogenated oils, and omega-6 fatty acids have replaced sugar as the new reason for ill health in America.

         Their logic goes like this:

         Seed oils are high in omega-6 fatty acids. They claim that high Omega 6 fatty acids are pro-inflammatory. Therefore, if you have more seed oils in your diet, you will have more inflammation. Inflammation is the root cause of heart disease.

         Their argument is logical, partially true, and the conclusion is incorrect.  They are selling you snake oil (well, usually supplements).

         It is Peanut Butter

         The keto crowd will say how "real" peanut butter is made with peanuts and salt. Claiming this peanut butter is "candy" or "full of garbage" and isn't fit to be eaten. But is it? Let's break this down.

         Added Sugar

         First, the added sugar, which according to the label is 3 grams per serving (two tablespoons), so the whole thing is 190 calories, of which 12 of those calories come from sugar, the rest from fat.

         Here is the label from Sprouts Pure Peanut Butter. Nothing but ground peanuts. No salt, no oils, no sugar. There are 200 calories from two tablespoons.

         Of the 200 calories from all peanut butter, with no added sugar, you get the same number of calories from the peanut butter with sugar in it. How much sugar? Well, about 3 grams per serving of sugar. How much is that? Not much.  To exceed the recommended dose of sugar from the American Heart Association, you would need to have more than 6% of your calories.  In Skippy, it is 1.5% added sugar.

         Low Carb Sugar Conspiracy

         Sugar was the "evil" that low carbohydrate folks said caused obesity. If you read their literature from twenty-plus years ago, it blamed sugar for obesity. Not just sugar, but any carb that was sugar, they claimed, would become fat. They even had their alternative view of history of obesity in the country.

         They stated that the world was not obese until Ancel Keys blamed heart disease on fat. Then the US government promoted a low-fat diet. The result was obesity bloomed because they replaced fat with sugar. That evil food pyramid caused people to turn away from fat, substituting sugar. That sugar substitution led to obesity.

         It sounds so logical. If you ever go on a low-carb diet (Atkins, South Beach, Paleo, Keto, Carnivore), you stop eating junk food and eat steak. You feel satisfied eating lots of meat.  Then you get tired of steak. You lose weight because you are in a calorie deficit, not because of ketosis. But that weight loss leads to confirmation of the theory that sugar made you fat.

         You go off the restrictive diet. Now you gain weight. You gain weight because you are eating more. But you blame the slice of bread. What you forget is now you are eating more steak because you have more flavors in your mouth. That slice of bread is 100 calories, but you think an 18-ounce Porterhouse (1260 calories) is a diet food? So you blame the bread or the lava cake. But not the extra calories.

         Where It Falls Apart

         But something about your low-carb diet doesn't make sense. You notice that obesity has increased in the United States. But sugar consumption has fallen. How does that work?

         You might wonder how that whole fruit is bad. Your low-carb coach says it's full of sugar. The community says it will "spike your insulin." Concluding that insulin causes you to store fat. But the scientific community shows study after study that people who eat whole fruits live longer and better. In fact, even diabetics who eat whole fruits have lower hemoglobin A1c. How is that? How can fruit be so healthy?

         The latest low carbohydrate fad is the carnivore crowd. They eat fruit now. Maybe that is the answer - the evolution from the Paleo caveman diet to the Carnivore diet. Here is the problem: it is still a fad.

         Longest Living People

         Then you read that the longest-living people eat a lot of carbohydrates. In the Blue Zones, they live long, consuming a diet rich in carbohydrates.

         You go to Italy and see everyone is thin and beautiful, and eating pasta. The Mediterranean diet is the best, but it is 55% carbohydrates.

         You go to Asia and see thin people shoveling in white rice.

         Your eyes open and you think maybe you were just fooled.

         Fructose is the problem

         In 2010 David Lustig came out with his famous YouTube video. Sugar is made of two molecules, fructose, and glucose. Glucose, he said, was not the problem. It was fructose. And high fructose corn syrup was in everything.

         This brief idea was based on mouse metabolism. Not on human metabolism.

         It was a cute fad that allowed you to blame big corn for the world's obesity. But the facts didn't add up here either. On to the next conspiracy.

         Seed oils are the problem

         The data shows that sugar isn't the cause of obesity. So they have come up with a new conspiracy. Seed oils are the problem.

         Canola, safflower, corn, peanut, and just any vegetable oils cause the problem.

         Seed oil consumption has increased worldwide, and so has obesity. There is the correlation. Simple minds like simple correlations.

         While their conclusion is incorrect, it is important to see why they came to these ideas.

         Trans Fats

         Trans fats are truly evil. They are a primary cause of heart disease. But before knowing this, they were the darling of food activists in the United States.

         The movement was from food activists like Phil Sokolof. He suffered from a heart attack and believed saturated fat was evil. He took out full-page ads in major newspapers, and attacked the use of beef tallow in McDonald's french fries. Those fries were so much tastier. As he lobbied fast-food and commercial bakeries to switch to vegetable oils, he didn't understand they were adding trans fats.

         Vegetable oils are healthy for the heart. But vegetable oils are liquid at room temperature. So you have to hydrogenate the vegetable oil, for it to become solid at room temperature. During hydrogenation, you create a lot of trans fatty acids.

         In 2008, the American Medical Association urged the prohibition of trans fats in commercial bakeries and restaurants (reference). Finally, the medical community was listened to, and trans fats were outlawed in the United States (reference).

         Hydrogenated Vegetable Oils Are Not Trans Fats

         Just because you chemically alter vegetable oil does not mean it is a trans fat.  Since the FDA has outlawed trans fats, they are removed from the process.

         Naturally occurring trans-fats are found in animal fats. Like butter, which is 3% trans fats.  Breast milk contains a form of trans fats called vaccenic acid, which has health benefits. Hydrogenation produces many forms of trans fatty acids that cause harm. But currently, hydrogenation does not involve making trans fatty acids.

         What are seed oils?

         Saying something is a seed oil is incorrect. Seed oils are not just one type of oil. Canola oil is much like olive oil, in that the main fatty acid is oleic acid (reference).

         Canola oil is much maligned. Detractors will say it is highly inflammatory. In fact, canola oil decreases inflammation in the human body (reference). Canola oil not only reduces inflammation but also reduces total cholesterol in the blood. Compared to saturated fat, like butter from grass-fed bison or unicorns, it decreases all cardiac risk factors.

         Some point out that canola comes from the rapeseed plant, which has been genetically modified. Thus, it must be filled with pesticides. They further tell you that canola oil has been used to run farm machinery. They fail to point out the obvious - olive oil can do the same. In fact, olive oil was the first electricity in the world, lighting homes, and running farm equipment.

         Seed Oils the new Sugar Conspiracy

         Seed oils, as it turns out, are not inflammatory. They do not cause an increase in heart disease. They decrease the risk of heart disease.

         Seed oils are in a lot of junk food. Some call them the ultra-processed foods. That doesn't make them bad. Junk foods also have a lot of sugar and a lot of salt. It isn't the oil per se, or the sugar, or the salt. It is that you can eat a lot of junk food. Junk food is readily available.

         Back to Peanut Butter

         Don't feel guilty for eating Skippy, Jiff, or whatever brand you like. Peanut oil is healthy for you. The sugar content is minimal. The hydrogenated oil makes the butter creamy without oil separation and decreases the risk of it going bad. As if peanut butter could ever go bad in my house.

         ]]>ba067fa0-0a52-4649-9627-7f8f73a46fb8Tue, 06 Jun 2023 00:00:00 -070015:59falsefull3737Vegetables in the Mediterranean DietImplementing the Mediterranean Diet: Vegetables

         The increase of vegetables in the diet is one way to reduce inflammation.

         Vegetables are an important part of the Mediterranean diet, providing essential nutrients. A diet rich in vegetables that contain antioxidants. As a result, the Med diet reduces the risk of heart disease, cancer, dementia, and anti-inflammatory diseases.

         Vegetables are low in calories, but high in nutrient density. In addition to providing high nutrient value, they provide satiety. Thus making vegetables the cornerstone for weight loss and maintenance.

         How Much is a Serving?

         One serving of vegetables is 3 ounces (85 grams) of raw or double that cooked. Three servings of vegetables a day is the daily goal. Without a doubt, the more vegetables, the better.

         Meal Ideas

         Breakfast ideas for vegetables include what you might put in an omelet:  tomatoes, spinach, onions, and chives. Even the breakfast bites can have multiple vegetables in them.

         While salads are great for lunch, filled with kale, radishes, and carrots, don't forget that you can pile a sandwich with lettuce, cucumbers, sprouts, and tomato.

         Need a snack during the middle of the day, plan on carrots for the afternoon and for the drive home. You can't fall asleep while chewing on carrots.

         Broccoli might be a great snack before dinner. Raw, even if you have a bit of ranch dressing. Buy packets of dry ranch dry ingredients and add to Greek yogurt.

         Don't forget that dinner salad. Make it large and beautiful.

         Supplements Are Not the Same

         Vegetables contain nutrients that your body needs. They are rich in magnesium, potassium, and folate.

         There is no supplement that can replace vegetables.

         Do Vegetables Have Anti-nutrients?

         Every study has shown that an increase in vegetables decreases heart disease, cancer, and inflammation.

         People who sell supplements often point out that vegetables have anti-nutrients in them. I have talked about this in a previous podcast and post (here). Of the various supplement salesmen out there, from the self-described Carnivore and his business partner Liver King to Dr. Gundry.

         Lectins

         Legumes like beans and lentils are nutrient-rich, protein-, and fiber-rich foods whose benefits outweigh any lectin.  High doses of lectins, when fed to animals, lead to diarrhea, inflammation, and other problems. These problems have never been seen in human studies with normal foods. The main lectins are destroyed by cooking, soaking, sprouting, fermenting, boiling, and canning.

         All human trials show that diets rich in legumes, and whole grains, lead to better health.

         Oxalates

         Oxalates can be absorbed from the gut, bind to calcium, and cause calcium kidney stones. They will also bind other minerals, such as zinc. This has led some to avoid healthy foods like spinach, swiss chard, amaranth, taro, sweet potatoes, beets, rhubarb, and sorrel.

         Cooking greatly decreases the oxalate content. In addition, cooking increases the nutrients of the vegetables available for absorption. The higher the vegetable content, the higher the mineral content of the diet, the fewer kidney stones are formed.  People who consume a DASH diet have a 40-50% decreased risk of kidney stones (reference). The DASH diet is the American version of the Mediterranean diet.

         ]]>Implementing the Mediterranean Diet: Vegetables

         The increase of vegetables in the diet is one way to reduce inflammation.

         Vegetables are an important part of the Mediterranean diet, providing essential nutrients. A diet rich in vegetables that contain antioxidants. As a result, the Med diet reduces the risk of heart disease, cancer, dementia, and anti-inflammatory diseases.

         Vegetables are low in calories, but high in nutrient density. In addition to providing high nutrient value, they provide satiety. Thus making vegetables the cornerstone for weight loss and maintenance.

         How Much is a Serving?

         One serving of vegetables is 3 ounces (85 grams) of raw or double that cooked. Three servings of vegetables a day is the daily goal. Without a doubt, the more vegetables, the better.

         Meal Ideas

         Breakfast ideas for vegetables include what you might put in an omelet:  tomatoes, spinach, onions, and chives. Even the breakfast bites can have multiple vegetables in them.

         While salads are great for lunch, filled with kale, radishes, and carrots, don't forget that you can pile a sandwich with lettuce, cucumbers, sprouts, and tomato.

         Need a snack during the middle of the day, plan on carrots for the afternoon and for the drive home. You can't fall asleep while chewing on carrots.

         Broccoli might be a great snack before dinner. Raw, even if you have a bit of ranch dressing. Buy packets of dry ranch dry ingredients and add to Greek yogurt.

         Don't forget that dinner salad. Make it large and beautiful.

         Supplements Are Not the Same

         Vegetables contain nutrients that your body needs. They are rich in magnesium, potassium, and folate.

         There is no supplement that can replace vegetables.

         Do Vegetables Have Anti-nutrients?

         Every study has shown that an increase in vegetables decreases heart disease, cancer, and inflammation.

         People who sell supplements often point out that vegetables have anti-nutrients in them. I have talked about this in a previous podcast and post (here). Of the various supplement salesmen out there, from the self-described Carnivore and his business partner Liver King to Dr. Gundry.

         Lectins

         Legumes like beans and lentils are nutrient-rich, protein-, and fiber-rich foods whose benefits outweigh any lectin.  High doses of lectins, when fed to animals, lead to diarrhea, inflammation, and other problems. These problems have never been seen in human studies with normal foods. The main lectins are destroyed by cooking, soaking, sprouting, fermenting, boiling, and canning.

         All human trials show that diets rich in legumes, and whole grains, lead to better health.

         Oxalates

         Oxalates can be absorbed from the gut, bind to calcium, and cause calcium kidney stones. They will also bind other minerals, such as zinc. This has led some to avoid healthy foods like spinach, swiss chard, amaranth, taro, sweet potatoes, beets, rhubarb, and sorrel.

         Cooking greatly decreases the oxalate content. In addition, cooking increases the nutrients of the vegetables available for absorption. The higher the vegetable content, the higher the mineral content of the diet, the fewer kidney stones are formed.  People who consume a DASH diet have a 40-50% decreased risk of kidney stones (reference). The DASH diet is the American version of the Mediterranean diet.

         ]]>90743dac-467d-4783-a2b4-98fd07e1f400Tue, 23 May 2023 00:00:00 -070007:36falsefull3636Do You Need A Liver Cleanse?Do You Need A Liver Cleanse?

         Fatty liver disease is the most common reason for liver transplantation. Fatty liver disease replaced alcoholic liver disease a decade ago.

         The rise of obesity has contributed to fatty liver disease, and fat, like alcohol, is deadly to your liver.

         So can you clean out your liver?  Simple answer - no. But that doesn't stop the world from making dubious claims.

         History of Liver Scams

         The most famous was Carter's Little Liver pills. They promised to increase the flow of bile in the liver. This would rid the body of toxins.

         Even when it was marketed in 1868, it was known as a "patent" medicine. Thus a medicine without merit was sold by quacks.

         In 1959, the name was changed to "Carter's Little Pills." The FDA, in 1951, filed suit that the pills had nothing to do with the liver.

         The phrase "Someone has more (fill in the blank) than Carter has pills" comes from this product.

         The Master Cleanser

         Stanley Burroughs, a lumber salesman, invented the "master" liver cleanse. The formula was tea or lemonade with cayenne pepper and maple syrup. There was no clinical data this ever worked. In spite of the lack of evidence, it continues to be recycled in the pseudoscience world.

         Burroughs first published the book in 1946, "The Master Cleanse," and re-released it in 1976 under the title "The Master Cleanser".

         Burroughs was convicted of manslaughter in California and fined for practicing medicine without a license.

         This "juice" or "liver cleanse" or liver detoxification program keeps coming around with different ingredients. Some of the latest include olive oil.

         Gallbladder Flush

         The gallbladder flush is the same formula.  People will defecate small round balls of fecal material. Then they are told that these represent gallbladder stones, but they are not. Thus, the flush is useless.

         The Liver's Job

         All the blood from the stomach and small bowel is filtered through the liver. Hence, the liver can be considered a filter.

         Once the food you eat is broken down and digested by the gut, those nutrients go to the liver.  Then the liver determines if you need to use the nutrients, store the nutrients, or get rid of the nutrients.

         The liver gets the first pass at the medicines you take.  Many medicines require the liver to process them to be effective. Those drugs are called "pro-drugs." Aspirin, for example, is a drug whose active ingredient is salicylic acid.

         Liver and Alcohol

         The liver can also take harmful substances and render them harmless.  In spite of the liver's ability to deactivate harmful products, a person can overcome the liver's ability to detoxify substances. The classic case is alcohol.

         Once alcohol is ingested, the liver begins to change it into acetaldehyde. Acetaldehyde is both toxic to the liver and responsible for most hangovers. Acetaldehyde is metabolized into harmless products.

         If a person consumes more alcohol than the liver can metabolize, they will become intoxicated. In addition, they will develop both acute fatty liver and chronic fatty liver. A fatty liver can lead to cirrhosis and liver failure.

         Milk Thistle and The Liver

         Since there are multiple complex metabolic pathways in the liver, there is no one agent that will fix the liver.

         Supplements touted to help the liver include:

         Milk Thistle.  The active ingredient is silymarin. Silymarin has been extensively studied in alcoholic liver disease, fatty liver disease, hepatitis, Tylenol poisoning, and mushroom poisoning. It works as an anti-oxidant and has shown promise, particularly when used early.

         Do Not Party and Detoxify

         There has not been a clinical study showing that one can overcome the sins of a party with any preventive agent. The best preventative against damage to the liver is to avoid the process.

         ]]>Do You Need A Liver Cleanse?

         Fatty liver disease is the most common reason for liver transplantation. Fatty liver disease replaced alcoholic liver disease a decade ago.

         The rise of obesity has contributed to fatty liver disease, and fat, like alcohol, is deadly to your liver.

         So can you clean out your liver?  Simple answer - no. But that doesn't stop the world from making dubious claims.

         History of Liver Scams

         The most famous was Carter's Little Liver pills. They promised to increase the flow of bile in the liver. This would rid the body of toxins.

         Even when it was marketed in 1868, it was known as a "patent" medicine. Thus a medicine without merit was sold by quacks.

         In 1959, the name was changed to "Carter's Little Pills." The FDA, in 1951, filed suit that the pills had nothing to do with the liver.

         The phrase "Someone has more (fill in the blank) than Carter has pills" comes from this product.

         The Master Cleanser

         Stanley Burroughs, a lumber salesman, invented the "master" liver cleanse. The formula was tea or lemonade with cayenne pepper and maple syrup. There was no clinical data this ever worked. In spite of the lack of evidence, it continues to be recycled in the pseudoscience world.

         Burroughs first published the book in 1946, "The Master Cleanse," and re-released it in 1976 under the title "The Master Cleanser".

         Burroughs was convicted of manslaughter in California and fined for practicing medicine without a license.

         This "juice" or "liver cleanse" or liver detoxification program keeps coming around with different ingredients. Some of the latest include olive oil.

         Gallbladder Flush

         The gallbladder flush is the same formula.  People will defecate small round balls of fecal material. Then they are told that these represent gallbladder stones, but they are not. Thus, the flush is useless.

         The Liver's Job

         All the blood from the stomach and small bowel is filtered through the liver. Hence, the liver can be considered a filter.

         Once the food you eat is broken down and digested by the gut, those nutrients go to the liver.  Then the liver determines if you need to use the nutrients, store the nutrients, or get rid of the nutrients.

         The liver gets the first pass at the medicines you take.  Many medicines require the liver to process them to be effective. Those drugs are called "pro-drugs." Aspirin, for example, is a drug whose active ingredient is salicylic acid.

         Liver and Alcohol

         The liver can also take harmful substances and render them harmless.  In spite of the liver's ability to deactivate harmful products, a person can overcome the liver's ability to detoxify substances. The classic case is alcohol.

         Once alcohol is ingested, the liver begins to change it into acetaldehyde. Acetaldehyde is both toxic to the liver and responsible for most hangovers. Acetaldehyde is metabolized into harmless products.

         If a person consumes more alcohol than the liver can metabolize, they will become intoxicated. In addition, they will develop both acute fatty liver and chronic fatty liver. A fatty liver can lead to cirrhosis and liver failure.

         Milk Thistle and The Liver

         Since there are multiple complex metabolic pathways in the liver, there is no one agent that will fix the liver.

         Supplements touted to help the liver include:

         Milk Thistle.  The active ingredient is silymarin. Silymarin has been extensively studied in alcoholic liver disease, fatty liver disease, hepatitis, Tylenol poisoning, and mushroom poisoning. It works as an anti-oxidant and has shown promise, particularly when used early.

         Do Not Party and Detoxify

         There has not been a clinical study showing that one can overcome the sins of a party with any preventive agent. The best preventative against damage to the liver is to avoid the process.

         ]]>ce8f87ae-7f00-450c-adb1-dab9fbf75e2cWed, 12 Apr 2023 00:00:00 -070007:14falsefull3535Erythritol and Heart Attacks: Is It Hype?Erythritol and Heart Attacks: Is It Hype?

         Does the artificial sweetener erythritol increase the risk of heart attacks? In fact, some say that this is just hype.

         The article abstract can be found here.

         Erythritol is an artificial sweetener

         It has been used for years in food as a "non-nutritive sweetener." Erythritol is used in many processed foods, replacing the calories from sugar. The Food and Drug Administration considers erythritol a food additive (GRAS). As a food additive, erythritol has never been tested for its toxicity or long-term use.

         The case for artificial sweeteners

         While artificial sweeteners decrease calories, do they decrease obesity? They have been shown to decrease obesity among teenagers (ref here). By reducing calories, it seems obvious that obesity would decrease. And yet, this has not been a consistent result

         A study showed that increased erythritol led to increased obesity. And that was just the erythritol your body makes.

         But your body makes erythritol

         Since your body makes erythritol. Does that mean it must be safe?

         The human body produces many toxic substances. For example, formaldehyde. Humans produce about 1.5 ounces of formaldehyde a day.

         Acetaldehyde is a breakdown product of ethanol. Drink too much alcohol, and you will produce enough acetaldehyde to kill you.

         The case against artificial sweeteners

         There have been a number of peer-reviewed journal articles showing that artificial sweeteners have adverse consequences:

         • Weight gain and obesity  (ref)
         • Insulin resistance (ref)
         • Type 2 Diabetes (ref)
         • Stroke, heart disease, and all-cause mortality (ref)
         • Increased heart deaths in women (ref)
         
         

         How much we make

         We have about ten micromoles per liter of blood. That would be the baseline level. Blood levels with 1000 times as much erythritol are found in people who consume it as a sweetener.

         One study showed that erythritol led to improved blood vessel function after drinking erythritol for a month (ref). But this was in healthy young adults. What about people with underlying heart disease?

         It's not hype - the study

         The Erythritol study was done by the highly regarded Cleveland Clinic and published in the journal Nature Medicine. It was peer-reviewed, meaning many other scientists looked at that data and concluded the study was worthy of being included in this prestigious journal.

         What this study examined was the correlation of erythritol with people prone to heart disease. They studied people at risk for heart disease. Such as those with high blood cholesterol, diabetes, obesity, or hypertension. They looked at the blood levels of erythritol. Data divided the patients according to how much erythritol was in their blood. What they found was that those with the highest levels of erythritol had the highest incidence of heart disease, strokes, and cardiac deaths of any other group when they followed them for three years.

         They found the same results in both a cohort of people from the United States, which had over 1100 participants, and in an identical cohort of over 2000 people from Europe. The higher the level of erythritol in the blood, the more likely they were to have heart attacks, strokes, or die in the next three years.

         Criticisms

         Some criticized the study for not doing a dietary history of erythritol. This criticism is invalid, as normal levels of erythritol in the blood are 1000 times less than what you get when you use erythritol in food. Blood levels of erythritol are a better validation of what is in the diet than a dietary history. Not only is it hard to remember what products might contain erythritol, but in the US, some products with erythritol are not required to list it in their ingredients.

         Another criticism was that they used people already prone to heart disease. That was the point of the article. By taking the highest risk group, those with high cholesterol, are obese, or have diabetes, you can shorten the time to see the effect. You already have disease, and you want to see if the erythritol makes things worse. In this case, those with high levels of erythritol were prone to a heart attack in three years.

         If you take a group of young healthy people, erythritol tends to make their blood vessels a little more compliant. In contrast, in older people with stiffer arteries, erythritol has a worse effect.

         Overall, the study was well executed and clearly warrants further investigation.

         ]]>Erythritol and Heart Attacks: Is It Hype?

         Does the artificial sweetener erythritol increase the risk of heart attacks? In fact, some say that this is just hype.

         The article abstract can be found here.

         Erythritol is an artificial sweetener

         It has been used for years in food as a "non-nutritive sweetener." Erythritol is used in many processed foods, replacing the calories from sugar. The Food and Drug Administration considers erythritol a food additive (GRAS). As a food additive, erythritol has never been tested for its toxicity or long-term use.

         The case for artificial sweeteners

         While artificial sweeteners decrease calories, do they decrease obesity? They have been shown to decrease obesity among teenagers (ref here). By reducing calories, it seems obvious that obesity would decrease. And yet, this has not been a consistent result

         A study showed that increased erythritol led to increased obesity. And that was just the erythritol your body makes.

         But your body makes erythritol

         Since your body makes erythritol. Does that mean it must be safe?

         The human body produces many toxic substances. For example, formaldehyde. Humans produce about 1.5 ounces of formaldehyde a day.

         Acetaldehyde is a breakdown product of ethanol. Drink too much alcohol, and you will produce enough acetaldehyde to kill you.

         The case against artificial sweeteners

         There have been a number of peer-reviewed journal articles showing that artificial sweeteners have adverse consequences:

         • Weight gain and obesity  (ref)
         • Insulin resistance (ref)
         • Type 2 Diabetes (ref)
         • Stroke, heart disease, and all-cause mortality (ref)
         • Increased heart deaths in women (ref)
         
         

         How much we make

         We have about ten micromoles per liter of blood. That would be the baseline level. Blood levels with 1000 times as much erythritol are found in people who consume it as a sweetener.

         One study showed that erythritol led to improved blood vessel function after drinking erythritol for a month (ref). But this was in healthy young adults. What about people with underlying heart disease?

         It's not hype - the study

         The Erythritol study was done by the highly regarded Cleveland Clinic and published in the journal Nature Medicine. It was peer-reviewed, meaning many other scientists looked at that data and concluded the study was worthy of being included in this prestigious journal.

         What this study examined was the correlation of erythritol with people prone to heart disease. They studied people at risk for heart disease. Such as those with high blood cholesterol, diabetes, obesity, or hypertension. They looked at the blood levels of erythritol. Data divided the patients according to how much erythritol was in their blood. What they found was that those with the highest levels of erythritol had the highest incidence of heart disease, strokes, and cardiac deaths of any other group when they followed them for three years.

         They found the same results in both a cohort of people from the United States, which had over 1100 participants, and in an identical cohort of over 2000 people from Europe. The higher the level of erythritol in the blood, the more likely they were to have heart attacks, strokes, or die in the next three years.

         Criticisms

         Some criticized the study for not doing a dietary history of erythritol. This criticism is invalid, as normal levels of erythritol in the blood are 1000 times less than what you get when you use erythritol in food. Blood levels of erythritol are a better validation of what is in the diet than a dietary history. Not only is it hard to remember what products might contain erythritol, but in the US, some products with erythritol are not required to list it in their ingredients.

         Another criticism was that they used people already prone to heart disease. That was the point of the article. By taking the highest risk group, those with high cholesterol, are obese, or have diabetes, you can shorten the time to see the effect. You already have disease, and you want to see if the erythritol makes things worse. In this case, those with high levels of erythritol were prone to a heart attack in three years.

         If you take a group of young healthy people, erythritol tends to make their blood vessels a little more compliant. In contrast, in older people with stiffer arteries, erythritol has a worse effect.

         Overall, the study was well executed and clearly warrants further investigation.

         ]]>762fb2ca-ad75-49ad-9c9b-23d9a3bce039Wed, 05 Apr 2023 00:00:00 -070008:47falsefull3434Don't Fear the Fruit, Enjoy ItDon't Fear the Fruit, Enjoy It

         Are you afraid that eating fruit will cause your blood sugar to spike? Let us bust that myth right now.

         Only ten percent of adults eat enough whole fruit daily despite the clear benefits of fruit.

         Eating fruit and Living Longer

          My 98-year-old dad eats fruit with breakfast for as long as I have known him. We would have grapefruit every morning. We even had those cute grapefruit spoons to wrestle the goodness out of the half grapefruit.

         Now, dad enjoys a mixed bit of fruit.

         In 28 studies with over 1.6 million people, each serving of fruit led to a 5% lower incidence of death (reference).

         Each serving of fruit

         8% less risk of heart disease

         3% lower risk of cancer

         200 grams (7 ounces) showed the lowest risk of cancer rates and deaths from cancer.

         Even the Low Carb Community is coming around

         Thirty years ago, the low-carb community advised against whole fruits. Their rationale was that fruits spiked blood sugar, which caused insulin to rise, which caused fat storage. They even cautioned against eating carrots for the same reason. But now, even the most extreme members of that community proudly eat fruit.

         What 5 servings looks like

         Breakfast with 1/2 cup of blueberries

         Morning snack of one medium banana

         Lunch with one apple

         Afternoon snack of 1/2 cup of grapes (about 16)

         Evening snack of 1 clementine

         Don't forget the tomato

         The tomato is a fruit. Yes, the Supreme Court said, for taxation purposes, it is a vegetable, but it isn't.

         Other Benefits of Fruit

         • promoting long-term weight management
         • reducing the risk of heart disease
         • reducing the risk of type 2 diabetes
         • decreasing the risk of colon and lung cancer
         • lowering the risk of depression
         • successful aging (like dad)
         • higher bone mineral density
         • decreasing incidence of seborrheic dermatitis
         • less constipation
         • less irritable bowel
         • less inflammatory bowel
         • less diverticular disease
         • less hemorrhoids
         • less stress
         
         

         Fruit is not the enemy - but it is one of the easiest of the nine food groups to add to your Mediterranean Diet and one of the easiest and most delicious to add to the DASH diet.

          

         -----

         Produced by Simpler Media

         ]]>Don't Fear the Fruit, Enjoy It

         Are you afraid that eating fruit will cause your blood sugar to spike? Let us bust that myth right now.

         Only ten percent of adults eat enough whole fruit daily despite the clear benefits of fruit.

         Eating fruit and Living Longer

          My 98-year-old dad eats fruit with breakfast for as long as I have known him. We would have grapefruit every morning. We even had those cute grapefruit spoons to wrestle the goodness out of the half grapefruit.

         Now, dad enjoys a mixed bit of fruit.

         In 28 studies with over 1.6 million people, each serving of fruit led to a 5% lower incidence of death (reference).

         Each serving of fruit

         8% less risk of heart disease

         3% lower risk of cancer

         200 grams (7 ounces) showed the lowest risk of cancer rates and deaths from cancer.

         Even the Low Carb Community is coming around

         Thirty years ago, the low-carb community advised against whole fruits. Their rationale was that fruits spiked blood sugar, which caused insulin to rise, which caused fat storage. They even cautioned against eating carrots for the same reason. But now, even the most extreme members of that community proudly eat fruit.

         What 5 servings looks like

         Breakfast with 1/2 cup of blueberries

         Morning snack of one medium banana

         Lunch with one apple

         Afternoon snack of 1/2 cup of grapes (about 16)

         Evening snack of 1 clementine

         Don't forget the tomato

         The tomato is a fruit. Yes, the Supreme Court said, for taxation purposes, it is a vegetable, but it isn't.

         Other Benefits of Fruit

         • promoting long-term weight management
         • reducing the risk of heart disease
         • reducing the risk of type 2 diabetes
         • decreasing the risk of colon and lung cancer
         • lowering the risk of depression
         • successful aging (like dad)
         • higher bone mineral density
         • decreasing incidence of seborrheic dermatitis
         • less constipation
         • less irritable bowel
         • less inflammatory bowel
         • less diverticular disease
         • less hemorrhoids
         • less stress
         
         

         Fruit is not the enemy - but it is one of the easiest of the nine food groups to add to your Mediterranean Diet and one of the easiest and most delicious to add to the DASH diet.

          

         -----

         Produced by Simpler Media

         ]]>95938f9e-104f-4745-a30e-957e7ef205a6Tue, 28 Feb 2023 00:00:00 -070010:35falsefull3333Salt: Toxicity is in the DoseSalt: Toxicity is in the Dose

         For the human body, salt is both an essential metal and toxic at a high dose.  The most common form of sodium comes from sodium chloride, a salt.  However, too much salt and arteries become stiff, and the risk of heart disease and cardiovascular disease increases. The majority of dietary salt comes from processed foods.

         Salt Toxcity Deniers

         Probably the most famous book is The Salt Fix.  A rambling book claiming low salt is responsible for everything from lower sex drive to insulin resistance. The book is logical and simplistic, with abundant citations taken out of context. In summary, the book is almost completely incorrect.

         Salt and Hypertension

         One of the classic studies about salt and hypertension is the DASH sodium study. In these studies, the study participants were fed the diet with varying amounts of salt. These studies are expensive and often not done, but powerful. Additionally, the lower levels of salt, the lower the blood pressure. In fact, a low-sodium DASH diet led to a reduction of blood pressure equivalent to one blood pressure pill.

         In contrast, "The Salt Fix" states that decreasing levels of salt led to increasing blood pressure and heart disease. The Salt Fix explanation is that lower salt leads to increased levels of renin, angiotensin, and aldosterone (hormones that would increase blood pressure). His conclusion is the opposite of hundreds of articles and much analysis. Such as here, here, and here.

         Salt and Cholesterol

         Another false claim, "The Salt Fix," stated the DASH study showed an increase in LDL, cholesterol, and triglycerides.

         The DASH diet showed no significant impact at all.

         More of "The Salt Fix" Misinformation

         • Our ancestors ate more salt
         • The primitive argument for which there is no proof. Since our ancestors ate mostly plants and no processed foods, this is easily debunked. Meat eaters know that a one-pound chicken contains about 150 mg of salt. A double patty of hamburger has 500 mg. He makes up numbers that don't make sense.
         • He states our ancestors ate from salt licks, but there are few in Africa (he makes up stuff)
         • Other countries have higher salt intake and lower heart disease
         • He cites Korea (which has 50% hypertension or pre-hypertension), Japan (highest incidence of stomach cancer related to salt), and France (hypertension is high, but low levels of heart disease related to the Mediterranean diet practiced by most).
         • Salt doesn't lower blood pressure by a significant amount and makes food bland.
         • The DASH diet studies show significant reductions in blood pressure, and the food is not bland.
         • Lower salt leads to increased death.
         • The opposite has been shown. Increased levels of sodium in the diet show increased levels of death.
         • Lower salt leads to lower iodine levels.
         • Iodized salt was introduced in the US because of the low iodine in Midwest soil. Better sources of iodine include fish and kelp. But the United States also fortifies iodine in bread and dairy products. But too much iodized salt can lead to hypothyroidism.
         • Sodium restriction in failing kidneys leads to worse problems
         • Ask any kidney doctor, the worst thing for failing kidneys is overload with salt. While salt regulation may be diminished with kidney failure, patients with renal failure need more dialysis with higher salt diets.
         • As we age, our kidneys get rid of more salt and need more in our diet.
         • We lose some renal function with age, but increasing dietary salt leads to increasing mortality and aging of blood vessels.
         • Low salt during pregnancy leads to obesity
         • Lower salt in pregnancy yields the opposite
         • There are more bits of misinformation in this book. Suffice it to say those who read this book and chose not to read the primary literature might be convinced that we need more salt than less salt.
         
         

         What Type of Salt

         Salt is salt. It is NaCl. Some have minor amounts of contaminants and other metals in them, which give them color. It is not enough to make a significant impact on your body chemistry or your health.

         Himalayan or Pink Salt

         This salt comes from about 200 miles away from the Himalayas, it is mined in Pakistan. Sounds better to say it is from the Himalayas, but it isn't. Thus, salt is mined much like the salt from Utah. The reason for the pink color is various contaminants. While many tout benefits of this salt, the additional minerals found in Pink salt are insignificant. Thus, the salt is expensive, pink, and mainly decorative.

         Celtic Salt

         Celtic salt is from the coast of France, where the salt water is evaporated to get the salt. In contrast, pink and white salt are mined from the old oceans. Celtic salt has more trace minerals than pink salt or white salt. However, the amount of minerals in these salts is not of consequence to humans.

         Salt and Athletic Performance

         Marathon runners and endurance athletes have died from low salt levels in the blood (hyponatremia). Drinking too much water, or non-salty beverages is one reason for this.

         Sweating is not a major loss of salt in athletes.  The average athlete will sweat about 15-65 mEq/Liter, with a maximum of 2 liters per twenty-four hours.

         The major problem with those with low blood sodium after endurance athletic events is drinking too much water. Adding salt to the fluids does not improve performance, nor does it.

         Salt Anti-Caking Agent

         Some fear the anti-caking agents used in table salt. Sodium and Potassium ferrocyanide sound horrible because of the cyanide. However, ferrocyanide does not break down into toxic cyanide. Still, those who have not taken Chemistry 101 don't understand this. After all, salt itself has "chloride," which kills when it is chlorine gas.

         
         

         ]]>Salt: Toxicity is in the Dose

         For the human body, salt is both an essential metal and toxic at a high dose.  The most common form of sodium comes from sodium chloride, a salt.  However, too much salt and arteries become stiff, and the risk of heart disease and cardiovascular disease increases. The majority of dietary salt comes from processed foods.

         Salt Toxcity Deniers

         Probably the most famous book is The Salt Fix.  A rambling book claiming low salt is responsible for everything from lower sex drive to insulin resistance. The book is logical and simplistic, with abundant citations taken out of context. In summary, the book is almost completely incorrect.

         Salt and Hypertension

         One of the classic studies about salt and hypertension is the DASH sodium study. In these studies, the study participants were fed the diet with varying amounts of salt. These studies are expensive and often not done, but powerful. Additionally, the lower levels of salt, the lower the blood pressure. In fact, a low-sodium DASH diet led to a reduction of blood pressure equivalent to one blood pressure pill.

         In contrast, "The Salt Fix" states that decreasing levels of salt led to increasing blood pressure and heart disease. The Salt Fix explanation is that lower salt leads to increased levels of renin, angiotensin, and aldosterone (hormones that would increase blood pressure). His conclusion is the opposite of hundreds of articles and much analysis. Such as here, here, and here.

         Salt and Cholesterol

         Another false claim, "The Salt Fix," stated the DASH study showed an increase in LDL, cholesterol, and triglycerides.

         The DASH diet showed no significant impact at all.

         More of "The Salt Fix" Misinformation

         • Our ancestors ate more salt
         • The primitive argument for which there is no proof. Since our ancestors ate mostly plants and no processed foods, this is easily debunked. Meat eaters know that a one-pound chicken contains about 150 mg of salt. A double patty of hamburger has 500 mg. He makes up numbers that don't make sense.
         • He states our ancestors ate from salt licks, but there are few in Africa (he makes up stuff)
         • Other countries have higher salt intake and lower heart disease
         • He cites Korea (which has 50% hypertension or pre-hypertension), Japan (highest incidence of stomach cancer related to salt), and France (hypertension is high, but low levels of heart disease related to the Mediterranean diet practiced by most).
         • Salt doesn't lower blood pressure by a significant amount and makes food bland.
         • The DASH diet studies show significant reductions in blood pressure, and the food is not bland.
         • Lower salt leads to increased death.
         • The opposite has been shown. Increased levels of sodium in the diet show increased levels of death.
         • Lower salt leads to lower iodine levels.
         • Iodized salt was introduced in the US because of the low iodine in Midwest soil. Better sources of iodine include fish and kelp. But the United States also fortifies iodine in bread and dairy products. But too much iodized salt can lead to hypothyroidism.
         • Sodium restriction in failing kidneys leads to worse problems
         • Ask any kidney doctor, the worst thing for failing kidneys is overload with salt. While salt regulation may be diminished with kidney failure, patients with renal failure need more dialysis with higher salt diets.
         • As we age, our kidneys get rid of more salt and need more in our diet.
         • We lose some renal function with age, but increasing dietary salt leads to increasing mortality and aging of blood vessels.
         • Low salt during pregnancy leads to obesity
         • Lower salt in pregnancy yields the opposite
         • There are more bits of misinformation in this book. Suffice it to say those who read this book and chose not to read the primary literature might be convinced that we need more salt than less salt.
         
         

         What Type of Salt

         Salt is salt. It is NaCl. Some have minor amounts of contaminants and other metals in them, which give them color. It is not enough to make a significant impact on your body chemistry or your health.

         Himalayan or Pink Salt

         This salt comes from about 200 miles away from the Himalayas, it is mined in Pakistan. Sounds better to say it is from the Himalayas, but it isn't. Thus, salt is mined much like the salt from Utah. The reason for the pink color is various contaminants. While many tout benefits of this salt, the additional minerals found in Pink salt are insignificant. Thus, the salt is expensive, pink, and mainly decorative.

         Celtic Salt

         Celtic salt is from the coast of France, where the salt water is evaporated to get the salt. In contrast, pink and white salt are mined from the old oceans. Celtic salt has more trace minerals than pink salt or white salt. However, the amount of minerals in these salts is not of consequence to humans.

         Salt and Athletic Performance

         Marathon runners and endurance athletes have died from low salt levels in the blood (hyponatremia). Drinking too much water, or non-salty beverages is one reason for this.

         Sweating is not a major loss of salt in athletes.  The average athlete will sweat about 15-65 mEq/Liter, with a maximum of 2 liters per twenty-four hours.

         The major problem with those with low blood sodium after endurance athletic events is drinking too much water. Adding salt to the fluids does not improve performance, nor does it.

         Salt Anti-Caking Agent

         Some fear the anti-caking agents used in table salt. Sodium and Potassium ferrocyanide sound horrible because of the cyanide. However, ferrocyanide does not break down into toxic cyanide. Still, those who have not taken Chemistry 101 don't understand this. After all, salt itself has "chloride," which kills when it is chlorine gas.

         
         

         ]]>987456d5-52f6-4526-8a0b-81d5641dfdb8Sat, 18 Feb 2023 00:00:00 -070013:38falsefull3232Why You Should Ditch Your Gas StoveWhy you should ditch your gas stove

         Did you ever wonder what the controversy is about gas stoves? There is no controversy. Gas range tops are responsible for high levels of indoor pollution. But what should we do? The answer, change to an induction cooking top

         Types of Indoor Cooking

         You can imagine the first time cooking was brought indoors. Probably a fire inside a cave. It turns out that wasn't all that safe. The particulate matter from the wood not only increased the risk of lung disease, but also increased the transmission of respiratory illness.

         Community houses, like this one for the Tlingit Nation from Southeast Alaska, had a fire pit in the center of the house. Your status in the community determined how close you would sit by the fire.

         While the opening in the roof provided some ventilation, it was not enough.

         Particulate Matter and Disease in Native Americans has been well studied. The lung damage from particulate matter predisposed Native Americans to pneumonia, tuberculosis, influenza, and smallpox.

         Wooden Stoves

         The use of wooden stoves with a chimney, and contained fire, were the most popular stoves in America until after the Great Depression.

         America was excited to go electric. But there is something primal about gas and electric cooking.

         Cooking with Gas

         The phrase cooking with gas was from the gas companies competing with electric companies for the new kitchen. The idea that gas was less expensive, faster, and you could see the flame became the basis for their campaign.

         They were trying to compete with "clean electric"

         Indoor pollutants with gas range tops

         Products from indoor gas ranges are highly toxic to lung tissue. Those products

         include:

         • Nitrogen dioxide
         • Carbon dioxide
         • Methane emission
         • Benzene
         
         

         Even with the range off, gas escapes and pollutes the air indoors. Good ventilation decreases the exposure to gas. Most people do not like continuous fans. In addition to the methane, there is also benzene that escapes.

         Culture Wars

         As soon as the United States Consumer Product Safety announced it was considering regulations for indoor gas cooking the vitriole started.

         A Wall Street Journal Editorial stated "Don’t believe for a second Consumer Product Safety Commission member Richard Trumka Jr.’s slippery claim that they aren’t coming for your stove."  She also went on to state that the research was paid for.

         Jim Jordan, the Republican Congressman from Ohio tweeted, "God, Guns, and Gas Stoves."

         Sean Hannity, that famous high school graduate stated that "Biden is coming for your gas stove."

         On my tiktok channel I had lots of people parrot this.

         I never knew so many old white men knew where the stove was? Let alone what it used for fuel

         Research

         We have known about the dangers of nitrogen dioxide since the 1960's. (see here, here, here). Experimental data showed it cause lung damage in animal models, then it was associated with human studies. None of these researchers were concerned about climate change.

         What can you do?

         Even ventilation to the outdoor with a powerful hood may not decrease the nitrogen dioxide enough. And often you won't have the ventilation fan on when the stove is not on.

         Converting to induction stovetop might be expensive, although there is currently a government tax incentive to do so.

         Even though I just bought my house, and it came with a lovely gas stovetop, I am changing to induction. Until then, I am using my induction hotplates (I have two) for most cooking.

         ]]>Why you should ditch your gas stove

         Did you ever wonder what the controversy is about gas stoves? There is no controversy. Gas range tops are responsible for high levels of indoor pollution. But what should we do? The answer, change to an induction cooking top

         Types of Indoor Cooking

         You can imagine the first time cooking was brought indoors. Probably a fire inside a cave. It turns out that wasn't all that safe. The particulate matter from the wood not only increased the risk of lung disease, but also increased the transmission of respiratory illness.

         Community houses, like this one for the Tlingit Nation from Southeast Alaska, had a fire pit in the center of the house. Your status in the community determined how close you would sit by the fire.

         While the opening in the roof provided some ventilation, it was not enough.

         Particulate Matter and Disease in Native Americans has been well studied. The lung damage from particulate matter predisposed Native Americans to pneumonia, tuberculosis, influenza, and smallpox.

         Wooden Stoves

         The use of wooden stoves with a chimney, and contained fire, were the most popular stoves in America until after the Great Depression.

         America was excited to go electric. But there is something primal about gas and electric cooking.

         Cooking with Gas

         The phrase cooking with gas was from the gas companies competing with electric companies for the new kitchen. The idea that gas was less expensive, faster, and you could see the flame became the basis for their campaign.

         They were trying to compete with "clean electric"

         Indoor pollutants with gas range tops

         Products from indoor gas ranges are highly toxic to lung tissue. Those products

         include:

         • Nitrogen dioxide
         • Carbon dioxide
         • Methane emission
         • Benzene
         
         

         Even with the range off, gas escapes and pollutes the air indoors. Good ventilation decreases the exposure to gas. Most people do not like continuous fans. In addition to the methane, there is also benzene that escapes.

         Culture Wars

         As soon as the United States Consumer Product Safety announced it was considering regulations for indoor gas cooking the vitriole started.

         A Wall Street Journal Editorial stated "Don’t believe for a second Consumer Product Safety Commission member Richard Trumka Jr.’s slippery claim that they aren’t coming for your stove."  She also went on to state that the research was paid for.

         Jim Jordan, the Republican Congressman from Ohio tweeted, "God, Guns, and Gas Stoves."

         Sean Hannity, that famous high school graduate stated that "Biden is coming for your gas stove."

         On my tiktok channel I had lots of people parrot this.

         I never knew so many old white men knew where the stove was? Let alone what it used for fuel

         Research

         We have known about the dangers of nitrogen dioxide since the 1960's. (see here, here, here). Experimental data showed it cause lung damage in animal models, then it was associated with human studies. None of these researchers were concerned about climate change.

         What can you do?

         Even ventilation to the outdoor with a powerful hood may not decrease the nitrogen dioxide enough. And often you won't have the ventilation fan on when the stove is not on.

         Converting to induction stovetop might be expensive, although there is currently a government tax incentive to do so.

         Even though I just bought my house, and it came with a lovely gas stovetop, I am changing to induction. Until then, I am using my induction hotplates (I have two) for most cooking.

         ]]>e5257b5e-ccbb-4a03-afef-9ce0f6d3e1d3Fri, 03 Feb 2023 00:00:00 -070010:00falsefull3131Whole Grains Reduce ObesityWhole Grains Reduce Obesity

         While the low-carb world and its extremists will tell you that grains are evil, they are wrong. There is a significant difference between refined and whole grains.

         The difference

         Whole grains contain the bran, a fiber-rich outer sheath. Further whole gains have the germ cell and the endosperm. But the refined grain is just the endosperm.

         Compare whole grain bread, which contains substantially more fiber and vitamins than the white bread. Consuming refined grains increases the risk of heart disease. But consuming whole grains decreases risks of heart disease, diabetes, and cancer.

         The Bran

         Bran is rich in fiber.  Additionally, bran is a source of B vitamins, iron, copper, zinc, magnesium, and phytochemicals.

         Fiber is Essential

         Fiber is an “essential nutrient.” An essential nutrient is defined as a nutrient your body cannot make and must get from your diet.

         But carnivore aficionados disagree; they believe fiber is not an essential nutrient. Carnivores note that you really don’t digest fiber. And they opine that people can live without fiber. However, they forget one key, the microbiome.

         The Microbiome

         The microbiome are the trillions of bacteria, yeast, and fungi that live in your gut.  Many scientists consider the gut microbiota another “organ” of our body.

         There is a clear difference in the type and number of bacteria that occupy the guts of people with obesity compared to those who are not obese.

         Some bacteria will increase hunger hormones. Those same bacteria also decrease satiety hormones, need more food to feel "full." Finally, they increase the ability of fat cells to increase in size, leading to obesity.

         Interesting Functions of Gut Bacteria

         • Synthesize vitamins K and B
         • Make Conjugated Linoleic Acid (CLA) that reduces obesity
         • CLA decreases inflammation
         • Ingestion of some fiber promotes the growth of bacteria that decrease the secretion of ghrelin in obese humans.
         
         

         In the microbiome, what feeds the bacteria that decrease obesity includes the fiber from whole grains. The bran of whole grains contains powerful fibers like oligosaccharides.

         How much to eat?

         What is a serving of whole grains? It seems confusing, especially since some products are a mix of both whole and refined grains. In the Mediterranean Diet, you might notice 9 ounces, but is that grain when it is dry or wet or both?

         So it turns out there is a whole grain council that has done the work for you, and they tell you right on the package.

         This makes your math simple. You either need three stickers of the 100% whole grain or six of the other stickers.

         ]]>Whole Grains Reduce Obesity

         While the low-carb world and its extremists will tell you that grains are evil, they are wrong. There is a significant difference between refined and whole grains.

         The difference

         Whole grains contain the bran, a fiber-rich outer sheath. Further whole gains have the germ cell and the endosperm. But the refined grain is just the endosperm.

         Compare whole grain bread, which contains substantially more fiber and vitamins than the white bread. Consuming refined grains increases the risk of heart disease. But consuming whole grains decreases risks of heart disease, diabetes, and cancer.

         The Bran

         Bran is rich in fiber.  Additionally, bran is a source of B vitamins, iron, copper, zinc, magnesium, and phytochemicals.

         Fiber is Essential

         Fiber is an “essential nutrient.” An essential nutrient is defined as a nutrient your body cannot make and must get from your diet.

         But carnivore aficionados disagree; they believe fiber is not an essential nutrient. Carnivores note that you really don’t digest fiber. And they opine that people can live without fiber. However, they forget one key, the microbiome.

         The Microbiome

         The microbiome are the trillions of bacteria, yeast, and fungi that live in your gut.  Many scientists consider the gut microbiota another “organ” of our body.

         There is a clear difference in the type and number of bacteria that occupy the guts of people with obesity compared to those who are not obese.

         Some bacteria will increase hunger hormones. Those same bacteria also decrease satiety hormones, need more food to feel "full." Finally, they increase the ability of fat cells to increase in size, leading to obesity.

         Interesting Functions of Gut Bacteria

         • Synthesize vitamins K and B
         • Make Conjugated Linoleic Acid (CLA) that reduces obesity
         • CLA decreases inflammation
         • Ingestion of some fiber promotes the growth of bacteria that decrease the secretion of ghrelin in obese humans.
         
         

         In the microbiome, what feeds the bacteria that decrease obesity includes the fiber from whole grains. The bran of whole grains contains powerful fibers like oligosaccharides.

         How much to eat?

         What is a serving of whole grains? It seems confusing, especially since some products are a mix of both whole and refined grains. In the Mediterranean Diet, you might notice 9 ounces, but is that grain when it is dry or wet or both?

         So it turns out there is a whole grain council that has done the work for you, and they tell you right on the package.

         This makes your math simple. You either need three stickers of the 100% whole grain or six of the other stickers.

         ]]>bf0bc554-b0e2-4808-9a91-ed5f76a216e7Wed, 18 Jan 2023 00:00:00 -070008:35falsefull3030Are Vegetables just BS?Are Vegetables BS?

         If you have ever seen Paul Saldino, his famous line is that Kale is BS. He even sells the shirt. But are they? Saldino isn't the only one who proposes this.

         Dr. Gundry, a former heart surgeon, has his own take. Gundry claims modern health problems come from eating lectins. Lectins are compounds found in beans that are natural pesticides.  Thus, Gundry claims lectins harm people. Copying destroys lectins.

         Toxins in Vegetables

         Plants make compounds to protect them against predators - other plants, pests, and the like. But do they harm humans?

         It turns out that some plant defense compounds are beneficial to humans. Take coffee. Yes, coffee - the caffeine is a defense mechanism. Some people will tell you that coffee is bad for you - but they don't get up in the early morning or have kids.

         List of the "Toxins"

         • Gluten
         • People who don't have celiac disease or gluten sensitivity do not need gluten-free diets (ref).
         • Oxalates
         • Potassium-rich vegetables such as Brussels sprouts, broccoli, and kale reduce calcium loss and prevent kidney stones from forming. These vegetables are rich in antioxidants that decrease the risk of bladder, prostate, and kidney cancer. Check with your local dietician for a diet based on the type of kidney stone you have. (ref)
         • Caffeine
         • If you don't drink coffee, you will lose all joy in life. (reference is me)
         • Polyphenols
         •  Plant polyphenols have antioxidant, anti-inflammatory, anti-allergic, anti-atherogenic, anti-thrombotic, and anti-mutagenic effects - they are healthy for you (ref)
         • Phytates
         • Consuming a phytate-rich diet, such as a colorful, plant-based diet, the benefits exceed the impacts on mineral absorption. In addition, phytates are anti-oxidants. (ref)
         • Saponins
         • These compounds are among the most well-studied compounds to decrease risk and help treat cardiovascular diseases. (ref)
         • Isothiocyanates
         • Brassica vegetables contain many valuable metabolites that are effective in chemoprevention of cancer (ref)
         • salicylates
         • These anti-inflammatory compounds are the basis of aspirin
         • Phytosterols
         • phytoestrogen-containing foods, such as legumes, grains, seeds, nuts, fruits, and vegetables, are rich sources of vitamins, minerals, fiber, and other health-promoting phytochemicals.
         • Lectins
         • Cooking destroys lectins. Lectin-rich foods, legumes, and whole grains show reduced inflammatory biomarkers in both animals and humans (ref).
         
         

         What the literature says

         What do human trials say about vegetables? They improve health, reduce the risk of heart disease, and reduce the risk of cancer.

         Do some of them contain anti-nutrients? Well, some do bind them, but health benefits outweigh any potential harm.

         Who to believe?

         You can believe a shirtless salesman of supplements and scams. Someone who was trained as a psychiatrist, who goes into a grocery store shirtless and yells at kale - or you can believe science.

         Fiber as an essential nutrient

         Fiber

         The most abundant solid ingredient in breast milk is a fiber. That fiber is human milk oligosaccharides. These oligosaccharides are a prebiotic that is carbohydrate based. They meet the definition of fiber. This fiber is important to infants, especially neonates.

         When people say fiber is non-essential, they are incorrect. Why? Because the definition of an essential nutrient is:

         “A nutrient required for normal body function that either cannot be made by the body or cannot be made in amounts adequate for good health and therefore must be provided by the diet”

         Fiber is also important in adults.

         Every study looking at increasing fiber has shown an improvement in human health. But what does fiber help with?

         It's more than a good poo

         Fiber will bulk up your stool and make it easier to have bowel movements. This gives you less constipation, fewer hemorrhoids, and less risk of colon diverticular disease.

         If your stool is too loose, you need more fiber. If your stool is too hard, you need more fiber and water.

         But fiber has other important roles

         It Binds Cholesterol

         Your body makes cholesterol, and that cholesterol goes through your gut. When you have increased fiber in your gut, some cholesterol gets bound to it. Thus, increasing fiber means less blood cholesterol.

         It stabilizes blood sugar

         Fiber decreases spikes in blood sugar. Want an example? Take an apple and a doughnut. A doughnut has less sugar than an apple, but a doughnut will spike your blood sugar more than an apple. Why? Part of the reason is the increased fiber in the apple (and fat, a doughnut has 15 grams of fat) – an apple has 3 grams of fiber, a doughnut has 0.9 grams.

         It decreases inflammation

         Fiber binds to bile acids (ref). When you eat meat and increase meat in your diet, you increase fat. To digest fat, your body increases the production of bile acids, which are released into the gut. Your gut reabsorbs 95%, but about 5% makes it to the colon, where other bacteria encounter them, and then bad things happen.

         Bacteria break down these bile acids into pro-inflammatory and pro-carcinogenic compounds. This is in contrast to a plant-based diet with high fiber. Fiber binds to the bile acids allowing them to pass without causing harm to the colon.

         When a person consumes fiber, the fiber is used as food by some bacteria. These bacteria metabolize the fiber and excrete short-chain fatty acids.

         The Gut Microbiome

         Inside your bowels, there are many microorganisms, from bacteria to yeast. What determines which bacteria thrive? There are bad bacteria and bad yeast, and to encourage the growth of the good bacteria, you have to feed them. How do you feed them?

         The favorite food of the good bacteria? Fiber.

         Bacteria "eat" fiber and produce short-chain fatty acids, which are great because:

         They decrease inflammation, improve blood sugar control, and blood lipids.

         ]]>Are Vegetables BS?

         If you have ever seen Paul Saldino, his famous line is that Kale is BS. He even sells the shirt. But are they? Saldino isn't the only one who proposes this.

         Dr. Gundry, a former heart surgeon, has his own take. Gundry claims modern health problems come from eating lectins. Lectins are compounds found in beans that are natural pesticides.  Thus, Gundry claims lectins harm people. Copying destroys lectins.

         Toxins in Vegetables

         Plants make compounds to protect them against predators - other plants, pests, and the like. But do they harm humans?

         It turns out that some plant defense compounds are beneficial to humans. Take coffee. Yes, coffee - the caffeine is a defense mechanism. Some people will tell you that coffee is bad for you - but they don't get up in the early morning or have kids.

         List of the "Toxins"

         • Gluten
         • People who don't have celiac disease or gluten sensitivity do not need gluten-free diets (ref).
         • Oxalates
         • Potassium-rich vegetables such as Brussels sprouts, broccoli, and kale reduce calcium loss and prevent kidney stones from forming. These vegetables are rich in antioxidants that decrease the risk of bladder, prostate, and kidney cancer. Check with your local dietician for a diet based on the type of kidney stone you have. (ref)
         • Caffeine
         • If you don't drink coffee, you will lose all joy in life. (reference is me)
         • Polyphenols
         •  Plant polyphenols have antioxidant, anti-inflammatory, anti-allergic, anti-atherogenic, anti-thrombotic, and anti-mutagenic effects - they are healthy for you (ref)
         • Phytates
         • Consuming a phytate-rich diet, such as a colorful, plant-based diet, the benefits exceed the impacts on mineral absorption. In addition, phytates are anti-oxidants. (ref)
         • Saponins
         • These compounds are among the most well-studied compounds to decrease risk and help treat cardiovascular diseases. (ref)
         • Isothiocyanates
         • Brassica vegetables contain many valuable metabolites that are effective in chemoprevention of cancer (ref)
         • salicylates
         • These anti-inflammatory compounds are the basis of aspirin
         • Phytosterols
         • phytoestrogen-containing foods, such as legumes, grains, seeds, nuts, fruits, and vegetables, are rich sources of vitamins, minerals, fiber, and other health-promoting phytochemicals.
         • Lectins
         • Cooking destroys lectins. Lectin-rich foods, legumes, and whole grains show reduced inflammatory biomarkers in both animals and humans (ref).
         
         

         What the literature says

         What do human trials say about vegetables? They improve health, reduce the risk of heart disease, and reduce the risk of cancer.

         Do some of them contain anti-nutrients? Well, some do bind them, but health benefits outweigh any potential harm.

         Who to believe?

         You can believe a shirtless salesman of supplements and scams. Someone who was trained as a psychiatrist, who goes into a grocery store shirtless and yells at kale - or you can believe science.

         Fiber as an essential nutrient

         Fiber

         The most abundant solid ingredient in breast milk is a fiber. That fiber is human milk oligosaccharides. These oligosaccharides are a prebiotic that is carbohydrate based. They meet the definition of fiber. This fiber is important to infants, especially neonates.

         When people say fiber is non-essential, they are incorrect. Why? Because the definition of an essential nutrient is:

         “A nutrient required for normal body function that either cannot be made by the body or cannot be made in amounts adequate for good health and therefore must be provided by the diet”

         Fiber is also important in adults.

         Every study looking at increasing fiber has shown an improvement in human health. But what does fiber help with?

         It's more than a good poo

         Fiber will bulk up your stool and make it easier to have bowel movements. This gives you less constipation, fewer hemorrhoids, and less risk of colon diverticular disease.

         If your stool is too loose, you need more fiber. If your stool is too hard, you need more fiber and water.

         But fiber has other important roles

         It Binds Cholesterol

         Your body makes cholesterol, and that cholesterol goes through your gut. When you have increased fiber in your gut, some cholesterol gets bound to it. Thus, increasing fiber means less blood cholesterol.

         It stabilizes blood sugar

         Fiber decreases spikes in blood sugar. Want an example? Take an apple and a doughnut. A doughnut has less sugar than an apple, but a doughnut will spike your blood sugar more than an apple. Why? Part of the reason is the increased fiber in the apple (and fat, a doughnut has 15 grams of fat) – an apple has 3 grams of fiber, a doughnut has 0.9 grams.

         It decreases inflammation

         Fiber binds to bile acids (ref). When you eat meat and increase meat in your diet, you increase fat. To digest fat, your body increases the production of bile acids, which are released into the gut. Your gut reabsorbs 95%, but about 5% makes it to the colon, where other bacteria encounter them, and then bad things happen.

         Bacteria break down these bile acids into pro-inflammatory and pro-carcinogenic compounds. This is in contrast to a plant-based diet with high fiber. Fiber binds to the bile acids allowing them to pass without causing harm to the colon.

         When a person consumes fiber, the fiber is used as food by some bacteria. These bacteria metabolize the fiber and excrete short-chain fatty acids.

         The Gut Microbiome

         Inside your bowels, there are many microorganisms, from bacteria to yeast. What determines which bacteria thrive? There are bad bacteria and bad yeast, and to encourage the growth of the good bacteria, you have to feed them. How do you feed them?

         The favorite food of the good bacteria? Fiber.

         Bacteria "eat" fiber and produce short-chain fatty acids, which are great because:

         They decrease inflammation, improve blood sugar control, and blood lipids.

         ]]>016201c5-b6ca-4f33-85a6-284ddcac26d2Wed, 11 Jan 2023 00:00:00 -070011:48falsefull2929The First VitaminThe term vitamin was coined by the chemist Casimir Funk as he revealed the Thiamine structure to the world. So while you may think – isn’t vitamin A (it is the alphabet) the first vitamin – we take our poetic license here to point out that the first compound to be called a vitamin was Thiamine, now known as vitamin B1. But the story of that vitamin was made possible by two individuals – but the most noteworthy was Takaki Kanehiro.

         Our podcast today discusses the education of Kanehiro and how that influenced his view. But let’s work backward a bit.

         Vitamin B1 and Beriberi

         Beriberi is caused by a lack of vitamin B1 (thiamin) in the diet. This vitamin is essential in the biochemical process of utilizing fats, carbohydrates, and proteins for energy. The nerves are particularly affected because of their metabolic pathways – hence, a wide range of symptoms from difficulty with walking (motor function) then sensory function of the legs, and finally, it affects the conduction in the heart, which leads to death.

         White Rice and Beriberi

         White polished rice was the fad food not only in the cities of Japan but also in China. To polish the rice, the husk and germ are removed, but this is also where the vitamins are. When people eat just one food item, they are likely to develop a deficiency disease, and this was the case with sailors and white polished rice.

         The officers would not only eat rice but were given a variety of foods and thus avoided beriberi. But the crew typically only ate white rice.

         Beriberi in Mid-1800’s Japan

         In Japan in the mid-1800s, especially in the city, polished white rice was the calorie source of choice. White rice is easy to store, looks clean, is faster to cook, and eating it is less chewy. White rice was considered what the wealthy people ate – it was beautifully displayed, and unlike brown rice, did not go rancid. What they didn’t know was the processing of the rice led to stripping the rice of the vitamin-rich portion. 

         In the rural areas of Japan, there was little beriberi as they mostly ate brown rice (barley rice). 

         This led to a major problem in their Navy, where beriberi was endemic. White polished rice was the caloric source for the Navy, and often one third of the crew would develop beriberi and be unable to carry out their duties.

         There were many thoughts as to the cause of beriberi, but none of them had panned out well.

         Eastern Traditional Cures for Beriberi

         On occasion, Eastern healers would recommend various teas and herbs. But, some would recommend barley rice. Some of these cures are retrospective, meaning once the traditional Japanese medical folks learned that barley rice was a cure for beriberi, they stated that they had prescribed it for years. Barley rice does have vitamin B1 (1 cup contains a day’s supply). But during the time, the cures from these village doctors were rare and not enough for the Japanese Navy, in spite of losing more people to beriberi than to war – would adopt. Also, note that barley rice is not as transportable as white polished rice and has a shorter shelf life. During this time, Japan was becoming westernized, and they were working on importing medical ideas from Germany, although they had a fair bit of influence from the British method. 

         Kanehiro’s training

         When Kanehiro was being trained, his initial training was from the Eastern Medicine part of his province. This training was apprentice-like, and he heard someone say that “There are no good doctors in Sustama.” When William Wills opened a medical school in his province, he jumped at the chance – but Wills encouraged him to go to London for further training.

         In order to do this, Kanehiro joined the Navy in 1872. He remained in the Japanese Navy for the rest of his life.

         In 1875 Kanehiro went to London and began to study at St Thomas Hospital. To this day, St Thomas hospital sits across the Thames River from Westminster, Big Ben, and parliament.

         Epidemiology – cholera to beriberi

         Just a 30-minute walk from the St Thomas hospital is the Broad Street Pumping station, where 22 years before, John Snow had meticulously shown how cholera had been transmitted through the water. The theory of cholera was not widely accepted at the time, in spite of the guardians removing the pump handle in 1859 and the outbreak stopping. By the time Kanehiro arrived, the methodology of Snow and the field of epidemiology was the most heralded new science of the day.

         Besides learning modern surgical methods of the day, Kanehiro also learned epidemiology and the scientific method.

         Return to Japan and the Study of Diet as a cause of Beriberi

         When Kanehiro returned to Japan, he dedicated himself to finding the cure for beriberi – the disease that killed more Japanese sailors than battle. Using the methods of epidemiology, he developed an experiment to prove that beriberi was secondary to the food they ate and not the other conditions of the ship.

         For the rest of the story – please listen to the podcast – subscribe if you like it. Thank you.

         Vandenbroucke JP. Adolphe Vorderman’s 1897 study of beriberi among prison inmates in the Dutch East Indies: an example of scrupulous efforts to avoid bias. JLL Bulletin: commentaries on the history of treatment evaluation, www.jameslindlibrary.org (2012, accessed 28 June 2013).

         Takaki, K . On the cause and prevention of kak’ke. Trans Sei-I-Kwai 1885; 39(Suppl 4): 29–37.

         Takaki, K . On the preservation of health amongst the personnel of the Japanese Navy and Army. Lecture II, delivered on May 9th. Lancet 1906; 1: 1451–1455.

         Takaki, K . On the preservation of health amongst the personnel of the Japanese Navy and Army. Lecture III, delivered on May 11th. Lancet 1906; 1: 1520–1523.

         ]]>The term vitamin was coined by the chemist Casimir Funk as he revealed the Thiamine structure to the world. So while you may think – isn’t vitamin A (it is the alphabet) the first vitamin – we take our poetic license here to point out that the first compound to be called a vitamin was Thiamine, now known as vitamin B1. But the story of that vitamin was made possible by two individuals – but the most noteworthy was Takaki Kanehiro.

         Our podcast today discusses the education of Kanehiro and how that influenced his view. But let’s work backward a bit.

         Vitamin B1 and Beriberi

         Beriberi is caused by a lack of vitamin B1 (thiamin) in the diet. This vitamin is essential in the biochemical process of utilizing fats, carbohydrates, and proteins for energy. The nerves are particularly affected because of their metabolic pathways – hence, a wide range of symptoms from difficulty with walking (motor function) then sensory function of the legs, and finally, it affects the conduction in the heart, which leads to death.

         White Rice and Beriberi

         White polished rice was the fad food not only in the cities of Japan but also in China. To polish the rice, the husk and germ are removed, but this is also where the vitamins are. When people eat just one food item, they are likely to develop a deficiency disease, and this was the case with sailors and white polished rice.

         The officers would not only eat rice but were given a variety of foods and thus avoided beriberi. But the crew typically only ate white rice.

         Beriberi in Mid-1800’s Japan

         In Japan in the mid-1800s, especially in the city, polished white rice was the calorie source of choice. White rice is easy to store, looks clean, is faster to cook, and eating it is less chewy. White rice was considered what the wealthy people ate – it was beautifully displayed, and unlike brown rice, did not go rancid. What they didn’t know was the processing of the rice led to stripping the rice of the vitamin-rich portion. 

         In the rural areas of Japan, there was little beriberi as they mostly ate brown rice (barley rice). 

         This led to a major problem in their Navy, where beriberi was endemic. White polished rice was the caloric source for the Navy, and often one third of the crew would develop beriberi and be unable to carry out their duties.

         There were many thoughts as to the cause of beriberi, but none of them had panned out well.

         Eastern Traditional Cures for Beriberi

         On occasion, Eastern healers would recommend various teas and herbs. But, some would recommend barley rice. Some of these cures are retrospective, meaning once the traditional Japanese medical folks learned that barley rice was a cure for beriberi, they stated that they had prescribed it for years. Barley rice does have vitamin B1 (1 cup contains a day’s supply). But during the time, the cures from these village doctors were rare and not enough for the Japanese Navy, in spite of losing more people to beriberi than to war – would adopt. Also, note that barley rice is not as transportable as white polished rice and has a shorter shelf life. During this time, Japan was becoming westernized, and they were working on importing medical ideas from Germany, although they had a fair bit of influence from the British method. 

         Kanehiro’s training

         When Kanehiro was being trained, his initial training was from the Eastern Medicine part of his province. This training was apprentice-like, and he heard someone say that “There are no good doctors in Sustama.” When William Wills opened a medical school in his province, he jumped at the chance – but Wills encouraged him to go to London for further training.

         In order to do this, Kanehiro joined the Navy in 1872. He remained in the Japanese Navy for the rest of his life.

         In 1875 Kanehiro went to London and began to study at St Thomas Hospital. To this day, St Thomas hospital sits across the Thames River from Westminster, Big Ben, and parliament.

         Epidemiology – cholera to beriberi

         Just a 30-minute walk from the St Thomas hospital is the Broad Street Pumping station, where 22 years before, John Snow had meticulously shown how cholera had been transmitted through the water. The theory of cholera was not widely accepted at the time, in spite of the guardians removing the pump handle in 1859 and the outbreak stopping. By the time Kanehiro arrived, the methodology of Snow and the field of epidemiology was the most heralded new science of the day.

         Besides learning modern surgical methods of the day, Kanehiro also learned epidemiology and the scientific method.

         Return to Japan and the Study of Diet as a cause of Beriberi

         When Kanehiro returned to Japan, he dedicated himself to finding the cure for beriberi – the disease that killed more Japanese sailors than battle. Using the methods of epidemiology, he developed an experiment to prove that beriberi was secondary to the food they ate and not the other conditions of the ship.

         For the rest of the story – please listen to the podcast – subscribe if you like it. Thank you.

         Vandenbroucke JP. Adolphe Vorderman’s 1897 study of beriberi among prison inmates in the Dutch East Indies: an example of scrupulous efforts to avoid bias. JLL Bulletin: commentaries on the history of treatment evaluation, www.jameslindlibrary.org (2012, accessed 28 June 2013).

         Takaki, K . On the cause and prevention of kak’ke. Trans Sei-I-Kwai 1885; 39(Suppl 4): 29–37.

         Takaki, K . On the preservation of health amongst the personnel of the Japanese Navy and Army. Lecture II, delivered on May 9th. Lancet 1906; 1: 1451–1455.

         Takaki, K . On the preservation of health amongst the personnel of the Japanese Navy and Army. Lecture III, delivered on May 11th. Lancet 1906; 1: 1520–1523.

         ]]>4376a849-ad0d-47de-87f5-b098d901a544Thu, 22 Dec 2022 00:00:00 -070014:54falsefull2828The Green Mediterranean DietThe Green Mediterranean Diet

         Imagine being able to improve the Mediterranean Diet with a few changes. Is the new "Green" Mediterranean Diet the ultimate hack? The Green Mediterranean Diet  (Green-Med) has become the hottest version of the MED diet yet.

         Advantages of the Green Mediterranean Diet

         There are three advantages to Green-Med

         1. Less Fatty Liver
         2. Decreased risk of heart disease
         3. Less Visceral Fat
         
         

         Fatty Liver

         Non-alcoholic fatty liver disease is the number one cause of liver failure in the United States. It surpassed alcoholic liver disease as the number one reason for liver transplants. But how do you get fatty liver?

         Is fatty liver caused by sugar or fat or both?

         Low-Carb enthusiasts blame fructose, or almost any sugar, as the cause of fatty liver disease. Although the latest boogyman is "seed oils." On the other hand, vegans will blame saturated fats.

         But sugars in mice are not the same as sugars in men.

         Fatty liver appears to be a byproduct of obesity, excess calories, and genetics.

         Reducing fatty liver

         After weight loss surgery, people rapidly lose weight, including in their liver.

         But people on the Green Mediterranean Diet lost more weight in their liver than those with the standard Mediterranean diet.

         Visceral Fat

         Belly fat is one of the hardest fats to get rid of. As people age, belly fat increases. So when women go through menopause, they increase belly fat.  And lowering belly fat is best done through weight loss with a high-fiber diet and cardiovascular exercise. But Green-Med appears to lower it even more.

         Cardiovascular Risk Factors

         Although MED is known for reducing the risk of heart disease, Green-Med seems superior.

         Implementing the green Mediterranean Diet

         The difference between the green and standard Mediterranean diet

         • 28 grams of walnuts a day - about one ounce
         • 3-4 cups of green tea per day
         • 100 grams per day of frozen Mankai
         • Reduction in red meat
         
         

         Green Tea is Easy

         There are more polyphenols in it than in black tea - so it's easier to drink.

         Adding walnuts is easy; they are also a great source of omega-3 fatty acids.

         Decreasing red meat isn't difficult.

         Finding Mankai or duckweed - well, you can't in the United States

         No one has reproduced the data about the Green Mediterranean Diet - perhaps because they can't find those frozen cubes of duckweed.

         ]]>The Green Mediterranean Diet

         Imagine being able to improve the Mediterranean Diet with a few changes. Is the new "Green" Mediterranean Diet the ultimate hack? The Green Mediterranean Diet  (Green-Med) has become the hottest version of the MED diet yet.

         Advantages of the Green Mediterranean Diet

         There are three advantages to Green-Med

         1. Less Fatty Liver
         2. Decreased risk of heart disease
         3. Less Visceral Fat
         
         

         Fatty Liver

         Non-alcoholic fatty liver disease is the number one cause of liver failure in the United States. It surpassed alcoholic liver disease as the number one reason for liver transplants. But how do you get fatty liver?

         Is fatty liver caused by sugar or fat or both?

         Low-Carb enthusiasts blame fructose, or almost any sugar, as the cause of fatty liver disease. Although the latest boogyman is "seed oils." On the other hand, vegans will blame saturated fats.

         But sugars in mice are not the same as sugars in men.

         Fatty liver appears to be a byproduct of obesity, excess calories, and genetics.

         Reducing fatty liver

         After weight loss surgery, people rapidly lose weight, including in their liver.

         But people on the Green Mediterranean Diet lost more weight in their liver than those with the standard Mediterranean diet.

         Visceral Fat

         Belly fat is one of the hardest fats to get rid of. As people age, belly fat increases. So when women go through menopause, they increase belly fat.  And lowering belly fat is best done through weight loss with a high-fiber diet and cardiovascular exercise. But Green-Med appears to lower it even more.

         Cardiovascular Risk Factors

         Although MED is known for reducing the risk of heart disease, Green-Med seems superior.

         Implementing the green Mediterranean Diet

         The difference between the green and standard Mediterranean diet

         • 28 grams of walnuts a day - about one ounce
         • 3-4 cups of green tea per day
         • 100 grams per day of frozen Mankai
         • Reduction in red meat
         
         

         Green Tea is Easy

         There are more polyphenols in it than in black tea - so it's easier to drink.

         Adding walnuts is easy; they are also a great source of omega-3 fatty acids.

         Decreasing red meat isn't difficult.

         Finding Mankai or duckweed - well, you can't in the United States

         No one has reproduced the data about the Green Mediterranean Diet - perhaps because they can't find those frozen cubes of duckweed.

         ]]>d7e1b28a-07f4-44f2-898f-af9563244855Tue, 13 Dec 2022 00:00:00 -070012:24falsefull2727LiverKing Falls From GraceLiverKing Falls From Grace

         Not that anyone was surprised the so-called Liverking was using steroids. But he fooled many people that his diet and intense training led to this frame. The diet he recommended was some form of an "ancestral" diet. We have covered the carnivore-type diet before. So how did this all happen?

         The Rise of LiverKing

         LiverKing's rise was meteoric. He began posting on Instagram in 2021 and now has almost 2 million followers.

         His trademark was showing off his abdominal muscles on his five-foot-five-inch frame. All the time advocating eating raw liver.

         Isn't that a hook? Eat raw liver, get abdominal muscles, and look like him.

         But his rise was anything but an accident.

         Powering up the Media

         In his emails, he whines about how he wants to build his following but was concerned that the steroids he had were not enough. So he was begging for help from someone in the UK. He was taking thousands of dollars of steroids a month.

         His plan? Getting over a million followers and selling supplements.

         He had a "live-in" video recorder to follow his antics.

         Guess who his partner was in supplements?

         The Supplement Industry

         How do most scam artists in the medical field make money? Selling supplements. Be that Joseph Mercola, or Mark Hyman, or Ken Berry. All people who make millions a year selling supplements.

         So what to do if you are trained in psychiatry but don't want to see people? You sell supplements. So the business partner is one Dr. Paul Saldino - aka Carnivore MD.

         Since the revelation about Brian Johnson's (LiverKing) steroid use Saldino said he would have to distance himself from him. Good friend, eh? That is a business decision. If you are a friend of mine and have a fall from grace, I will be at your door to help, not distance.

         This was pure theater and pure business - well, not so pure.

         Supplements can kill.

         But so can their diet.

         The Diet They Don't Eat

         Make a following eating raw liver. Yell at the dinner table about how raw liver is good for you. Makes great content for your videos. Eating raw liver can kill you.

         Carnivores and extreme keto types always like pointing to hunter-gatherer societies for optimal "primal health." But my cousins in Alaska don't eat liver.

         There is enough vitamin A in polar bear's liver to kill 52 people. But the biggest outbreak of trichinellosis in the United States came from eating grizzly bear liver.

         Wait, can I get sick from too much Vitamin A?

         Vitamin A toxicity symptoms include drowsiness, irritability, abdominal pain, nausea, and vomiting. Then you lose your hair; then your skin starts to peel. Not to mention it can damage your liver - ironic, eh?

         The tolerable limit of vitamin A is 10,000 units a day. Beef liver has 15,000 units in 3 ounces.

         But LiverKing didn't eat liver in real life. What did he eat?

         The Maple Syrup and Hormone Diet

         LiverKing ate 120 grams of maple syrup, 50 grams of dextrose, and ONLY 2 ounces of red meat a day.

         Why - he was taking insulin and needed to take a lot of sugar.

         He said he was super strict, working out - and his emails had his diet. Almost none of it was organ meat. He was specific and precise.

         -----

         Produced by Simpler Media

         ]]>LiverKing Falls From Grace

         Not that anyone was surprised the so-called Liverking was using steroids. But he fooled many people that his diet and intense training led to this frame. The diet he recommended was some form of an "ancestral" diet. We have covered the carnivore-type diet before. So how did this all happen?

         The Rise of LiverKing

         LiverKing's rise was meteoric. He began posting on Instagram in 2021 and now has almost 2 million followers.

         His trademark was showing off his abdominal muscles on his five-foot-five-inch frame. All the time advocating eating raw liver.

         Isn't that a hook? Eat raw liver, get abdominal muscles, and look like him.

         But his rise was anything but an accident.

         Powering up the Media

         In his emails, he whines about how he wants to build his following but was concerned that the steroids he had were not enough. So he was begging for help from someone in the UK. He was taking thousands of dollars of steroids a month.

         His plan? Getting over a million followers and selling supplements.

         He had a "live-in" video recorder to follow his antics.

         Guess who his partner was in supplements?

         The Supplement Industry

         How do most scam artists in the medical field make money? Selling supplements. Be that Joseph Mercola, or Mark Hyman, or Ken Berry. All people who make millions a year selling supplements.

         So what to do if you are trained in psychiatry but don't want to see people? You sell supplements. So the business partner is one Dr. Paul Saldino - aka Carnivore MD.

         Since the revelation about Brian Johnson's (LiverKing) steroid use Saldino said he would have to distance himself from him. Good friend, eh? That is a business decision. If you are a friend of mine and have a fall from grace, I will be at your door to help, not distance.

         This was pure theater and pure business - well, not so pure.

         Supplements can kill.

         But so can their diet.

         The Diet They Don't Eat

         Make a following eating raw liver. Yell at the dinner table about how raw liver is good for you. Makes great content for your videos. Eating raw liver can kill you.

         Carnivores and extreme keto types always like pointing to hunter-gatherer societies for optimal "primal health." But my cousins in Alaska don't eat liver.

         There is enough vitamin A in polar bear's liver to kill 52 people. But the biggest outbreak of trichinellosis in the United States came from eating grizzly bear liver.

         Wait, can I get sick from too much Vitamin A?

         Vitamin A toxicity symptoms include drowsiness, irritability, abdominal pain, nausea, and vomiting. Then you lose your hair; then your skin starts to peel. Not to mention it can damage your liver - ironic, eh?

         The tolerable limit of vitamin A is 10,000 units a day. Beef liver has 15,000 units in 3 ounces.

         But LiverKing didn't eat liver in real life. What did he eat?

         The Maple Syrup and Hormone Diet

         LiverKing ate 120 grams of maple syrup, 50 grams of dextrose, and ONLY 2 ounces of red meat a day.

         Why - he was taking insulin and needed to take a lot of sugar.

         He said he was super strict, working out - and his emails had his diet. Almost none of it was organ meat. He was specific and precise.

         -----

         Produced by Simpler Media

         ]]>235511a5-5b58-48e1-af39-50ff4804dab6Tue, 06 Dec 2022 00:00:00 -070010:20falsefull2626Leaky Gut: Facts and FadsLeaky Gut: Facts and Fads

         The latest fad of supplement makers is to talk about "gut health." The latest boogyman for the gut is the "leaky gut." The other name for leaky gut is intestinal permeability.

         A Surgeon's View

         As a surgeon, a "leaky gut" is a devastating surgical emergency. Surgeons emergently operate to remove the gut that no longer has a barrier function.

         The dark gut is dead and needs to be surgically removed. This gut has no barrier function and will allow bacteria from the inside of the small bowel to easily enter the patient's bloodstream. Leading to septic shock and death.

         The Non-Surgical Emergency or Chronic Leaky Gut

         But a leaky gut doesn't have to be so dramatic.  Not leading to septic shock or needing to be removed. In this model, the intestinal barrier is "leaky," not to the point of causing sepsis. But the leaky gut enables small molecules to leak out of the gut into the bloodstream. Thus producing chronic inflammation.

         Chronic inflammation may cause obesity. Emphasis on "may."

         Emulsifiers and Obesity

         Rodent studies have provided fascinating insights. Certain emulsifiers, when added to the diet of mice or rats, lead to obesity.  In one experiment, rodents were fed identical amounts of kibble. But one group, emulsifiers, was added to their water.  These emulsifiers, like polysorbate 80, not only produced obesity but also disrupted the microbiome of the gut (ref). But mice are not men.

         When dietary emulsifiers are examined in humans, high levels cause disruption of the gut. However, there is little evidence that small amounts found in the food supply cause issues. (ref 4)

         Non-Humans and Leaky Gut

         While animal models are interesting, human studies provide useful information. That a rat or mouse has a leaky gut based on some intervention is not an equivalence in humans.

         Functional Medicine and Leaky Gut

         If you searched "leaky gut," you will find a host of "functional medicine" doctors providing supplements, bone broth, probiotics, and other scams.  On the shelves of drug stores and "health food stores," you will find abundant supplements to "support gut health."

         Disease States and Leaky Gut

         Functional medicine physicians associate many disease states with leaky gut. The following have little or no good evidence to be caused by a leaky gut:

         • Alcoholic cirrhosis
         • Asthma
         • Autism
         • Chronic fatigue syndrome
         • Depression
         • Eczema
         • Environmental enteropathy
         • Eosinophilic esophagitis
         • Fibromyalgia
         • Kwashiorkor
         • Metabolic syndrome
         • Multiple sclerosis
         • Non-alcoholic fatty liver disease (NAFLD)
         • Obesity
         • Pancreatitis
         • Parkinson's disease
         • Psoriasis
         • Rheumatoid arthritis
         
         

         Non-Controversial Causes of Leaky Gut

         There is no doubt celiac disease, Crohn's disease, radiation, and ulcers from non-steroidal anti-inflammatory drugs; certain bacteria can cause a change in intestinal permeability (another name for leaky gut). Celiac disease and Crohn's disease have been studied for years (ref 2, ref 3). While we know gluten exacerbates the auto-immune function of those with Celiac disease, we do not yet have a mechanism for Crohn's disease.

         Gut Barrier Anatomy and Function

         The small bowel's purpose is primarily for the absorption of nutrients. Some nutrients are actively transported from the gut to the bloodstream, and some are passively absorbed. The gut must also serve as a barrier to prevent bacteria, toxins, and other materials from entering the body.

         The first line of defense is the mucus layer of the gut. Secreted by Goblet cells, mucus prevents bacteria, toxins, and potential antigens from contact with the epithelial cells. There are multiple mucus proteins secreted. Gut immune cells secrete IgA antibodies into the mucus as a further defense against invaders.

         Most research focuses on the tight junctions between intestinal epithelial cells.

         Correlation or Causation

         What if altered permeability is an association and not causation? While stress, antigens, and intense physical activity alter barrier function, there is no evidence it causes a clinical consequence. Finally, there is no evidence that barrier function leads to any disease. Nor is there any evidence that intervention to improve barrier function alters the natural history of disease (ref 4).

         Mediterranean Diet and Barrier Function

         In a recent clinical study, 260 women with the BRCA gene were assigned to the Mediterranean Diet or a control group (ref 5). These women were part of a study examining the effect of the Mediterranean diet and physical activity, who were at high risk for breast and ovarian cancer.

         In the Mediterranean Diet group, there was an increase in short-chain fatty acids and fiber found in the stools.  There was no statistically significant change in the plasma LBP or fecal zonulin. But in multiple-level regression, the change in short-change fatty acids did lead to a decrease in the permeability makers. When looking at the food groups, they found that vegetables, fruit, legumes, nuts, olives, wine, and total fiber were correlated with the shift in short-chain fatty acids and the shift in permeability makers.

         The Mediterranean diet is fiber-rich, producing an increase in bacteria that produce short-chain fatty acids. The short-chain fatty acids appear to alter barrier function in this group of women.

         Conclusions

         While leaky gut is real, the significance is unknown. At the extremes, as surgeons see, it is deadly. In patients with ulcers or celiac disease, or Crohn's disease - it is real. Yes, things can leak from the gut, but what can be done?

          

         Turns out, maybe the Mediterranean Diet is the answer.

         One this is certain - people will sell you all sorts of things -

          

         Eat better, drink wine.

         
         

         -----

         Produced by Simpler Media

         ]]>Leaky Gut: Facts and Fads

         The latest fad of supplement makers is to talk about "gut health." The latest boogyman for the gut is the "leaky gut." The other name for leaky gut is intestinal permeability.

         A Surgeon's View

         As a surgeon, a "leaky gut" is a devastating surgical emergency. Surgeons emergently operate to remove the gut that no longer has a barrier function.

         The dark gut is dead and needs to be surgically removed. This gut has no barrier function and will allow bacteria from the inside of the small bowel to easily enter the patient's bloodstream. Leading to septic shock and death.

         The Non-Surgical Emergency or Chronic Leaky Gut

         But a leaky gut doesn't have to be so dramatic.  Not leading to septic shock or needing to be removed. In this model, the intestinal barrier is "leaky," not to the point of causing sepsis. But the leaky gut enables small molecules to leak out of the gut into the bloodstream. Thus producing chronic inflammation.

         Chronic inflammation may cause obesity. Emphasis on "may."

         Emulsifiers and Obesity

         Rodent studies have provided fascinating insights. Certain emulsifiers, when added to the diet of mice or rats, lead to obesity.  In one experiment, rodents were fed identical amounts of kibble. But one group, emulsifiers, was added to their water.  These emulsifiers, like polysorbate 80, not only produced obesity but also disrupted the microbiome of the gut (ref). But mice are not men.

         When dietary emulsifiers are examined in humans, high levels cause disruption of the gut. However, there is little evidence that small amounts found in the food supply cause issues. (ref 4)

         Non-Humans and Leaky Gut

         While animal models are interesting, human studies provide useful information. That a rat or mouse has a leaky gut based on some intervention is not an equivalence in humans.

         Functional Medicine and Leaky Gut

         If you searched "leaky gut," you will find a host of "functional medicine" doctors providing supplements, bone broth, probiotics, and other scams.  On the shelves of drug stores and "health food stores," you will find abundant supplements to "support gut health."

         Disease States and Leaky Gut

         Functional medicine physicians associate many disease states with leaky gut. The following have little or no good evidence to be caused by a leaky gut:

         • Alcoholic cirrhosis
         • Asthma
         • Autism
         • Chronic fatigue syndrome
         • Depression
         • Eczema
         • Environmental enteropathy
         • Eosinophilic esophagitis
         • Fibromyalgia
         • Kwashiorkor
         • Metabolic syndrome
         • Multiple sclerosis
         • Non-alcoholic fatty liver disease (NAFLD)
         • Obesity
         • Pancreatitis
         • Parkinson's disease
         • Psoriasis
         • Rheumatoid arthritis
         
         

         Non-Controversial Causes of Leaky Gut

         There is no doubt celiac disease, Crohn's disease, radiation, and ulcers from non-steroidal anti-inflammatory drugs; certain bacteria can cause a change in intestinal permeability (another name for leaky gut). Celiac disease and Crohn's disease have been studied for years (ref 2, ref 3). While we know gluten exacerbates the auto-immune function of those with Celiac disease, we do not yet have a mechanism for Crohn's disease.

         Gut Barrier Anatomy and Function

         The small bowel's purpose is primarily for the absorption of nutrients. Some nutrients are actively transported from the gut to the bloodstream, and some are passively absorbed. The gut must also serve as a barrier to prevent bacteria, toxins, and other materials from entering the body.

         The first line of defense is the mucus layer of the gut. Secreted by Goblet cells, mucus prevents bacteria, toxins, and potential antigens from contact with the epithelial cells. There are multiple mucus proteins secreted. Gut immune cells secrete IgA antibodies into the mucus as a further defense against invaders.

         Most research focuses on the tight junctions between intestinal epithelial cells.

         Correlation or Causation

         What if altered permeability is an association and not causation? While stress, antigens, and intense physical activity alter barrier function, there is no evidence it causes a clinical consequence. Finally, there is no evidence that barrier function leads to any disease. Nor is there any evidence that intervention to improve barrier function alters the natural history of disease (ref 4).

         Mediterranean Diet and Barrier Function

         In a recent clinical study, 260 women with the BRCA gene were assigned to the Mediterranean Diet or a control group (ref 5). These women were part of a study examining the effect of the Mediterranean diet and physical activity, who were at high risk for breast and ovarian cancer.

         In the Mediterranean Diet group, there was an increase in short-chain fatty acids and fiber found in the stools.  There was no statistically significant change in the plasma LBP or fecal zonulin. But in multiple-level regression, the change in short-change fatty acids did lead to a decrease in the permeability makers. When looking at the food groups, they found that vegetables, fruit, legumes, nuts, olives, wine, and total fiber were correlated with the shift in short-chain fatty acids and the shift in permeability makers.

         The Mediterranean diet is fiber-rich, producing an increase in bacteria that produce short-chain fatty acids. The short-chain fatty acids appear to alter barrier function in this group of women.

         Conclusions

         While leaky gut is real, the significance is unknown. At the extremes, as surgeons see, it is deadly. In patients with ulcers or celiac disease, or Crohn's disease - it is real. Yes, things can leak from the gut, but what can be done?

          

         Turns out, maybe the Mediterranean Diet is the answer.

         One this is certain - people will sell you all sorts of things -

          

         Eat better, drink wine.

         
         

         -----

         Produced by Simpler Media

         ]]>97b6de28-c928-4a94-82aa-03a1cb141355Wed, 30 Nov 2022 00:00:00 -070007:54falsefull2525The Beer and Sausage DietThe Beer and Sausage Diet

         There are a lot of crazy diets out there. All of them you can lose weight with. Weight loss has many advantages. But the beer and sausage diet was fun. Here is what we learned:

         • A calorie is just a calorie
         • Being in calorie deficit is difficult
         • Meticulous journaling is important
         • Your lab values will improve with weight loss
         • A beer is a good unit measure
         • Weighing your food is important
         
         

         Episode Sponsor: Modifyhealth.com

         I'm The Doctor

         If you hear Evo Terra on national television talking about the beer diet, you will hear my name. I'm the doctor.

         Late one September, I get a call from my friend, Evo Terra. He said, "October is coming; I want to lose some weight and want to do a beer fast. "

         So we devise a diet, not just beer - but let's add sausages. After all, what is beer without sausages?

         Careful Supervision

         This was a medically supervised diet. It ran for the month of October every year for four years. Every week he would come into my clinic.  Every week he would have blood draws.

         •  cholesterol levels
         •  liver enzymes
         • Weekly weight
         • We would check muscle mass vs. fat mass
         •  inflammatory markers
         
         

         We were prepared to stop the experiment and return him to a normal diet. For Evo, a normal diet is maybe not your diet.  Since Evo likes the food I make, I assume he has a great diet.  For many years, one of my great joys in Phoenix was when Evo and his wife would come over for dinner Sunday nights. Damn, I miss those days.

         There are advantages to beer and sausages

         A beer is a single unit. There is little variation in terms of caloric intake.

         Sausage can easily be weighed, and Evo was strict regarding the weight of his sausages.

         We added vitamins and fiber to his regimen.

         He had six beers a day, and a designated driver at all times.

         Science Wins

         For those who say grains are evil and you can never lose weight or you would have horrible inflammation, well, Evo didn't fit with that. Because no one does. The idea that grains are evil is a myth of the low-carb community.

         Vegans didn't like the idea of Evo eating sausages: "Pure processed meat will lead to inflammation and all the evils associated with eating meat."

         It didn't happen.

         Calorie deficit led to weight loss, despite drinking beer and eating sausages.

         His inflammatory markers didn't rise; they went down.

         His cholesterol went down.

         His liver enzymes decreased - not that they were high to begin with.

         Every year he kept his weight off - we are now over ten years past the last experiment.

         Conclusions:

         I don't recommend this as a weight loss method. I do recommend weight loss by the simple principles of calorie restriction, a well-rounded diet, and vigorous exercise. Which diet, you ask? Either the Mediterranean or the DASH diet.

         Evo wrote a book, and you can buy it here.

         ]]>The Beer and Sausage Diet

         There are a lot of crazy diets out there. All of them you can lose weight with. Weight loss has many advantages. But the beer and sausage diet was fun. Here is what we learned:

         • A calorie is just a calorie
         • Being in calorie deficit is difficult
         • Meticulous journaling is important
         • Your lab values will improve with weight loss
         • A beer is a good unit measure
         • Weighing your food is important
         
         

         Episode Sponsor: Modifyhealth.com

         I'm The Doctor

         If you hear Evo Terra on national television talking about the beer diet, you will hear my name. I'm the doctor.

         Late one September, I get a call from my friend, Evo Terra. He said, "October is coming; I want to lose some weight and want to do a beer fast. "

         So we devise a diet, not just beer - but let's add sausages. After all, what is beer without sausages?

         Careful Supervision

         This was a medically supervised diet. It ran for the month of October every year for four years. Every week he would come into my clinic.  Every week he would have blood draws.

         •  cholesterol levels
         •  liver enzymes
         • Weekly weight
         • We would check muscle mass vs. fat mass
         •  inflammatory markers
         
         

         We were prepared to stop the experiment and return him to a normal diet. For Evo, a normal diet is maybe not your diet.  Since Evo likes the food I make, I assume he has a great diet.  For many years, one of my great joys in Phoenix was when Evo and his wife would come over for dinner Sunday nights. Damn, I miss those days.

         There are advantages to beer and sausages

         A beer is a single unit. There is little variation in terms of caloric intake.

         Sausage can easily be weighed, and Evo was strict regarding the weight of his sausages.

         We added vitamins and fiber to his regimen.

         He had six beers a day, and a designated driver at all times.

         Science Wins

         For those who say grains are evil and you can never lose weight or you would have horrible inflammation, well, Evo didn't fit with that. Because no one does. The idea that grains are evil is a myth of the low-carb community.

         Vegans didn't like the idea of Evo eating sausages: "Pure processed meat will lead to inflammation and all the evils associated with eating meat."

         It didn't happen.

         Calorie deficit led to weight loss, despite drinking beer and eating sausages.

         His inflammatory markers didn't rise; they went down.

         His cholesterol went down.

         His liver enzymes decreased - not that they were high to begin with.

         Every year he kept his weight off - we are now over ten years past the last experiment.

         Conclusions:

         I don't recommend this as a weight loss method. I do recommend weight loss by the simple principles of calorie restriction, a well-rounded diet, and vigorous exercise. Which diet, you ask? Either the Mediterranean or the DASH diet.

         Evo wrote a book, and you can buy it here.

         ]]>942c1713-c949-4ec1-9ae8-2cf3e083b182Tue, 22 Nov 2022 00:00:00 -070030:28falsefull2424Losing Weight with AppsLosing Weight With Apps

         Can a phone app help you lose weight? How about with your cholesterol, blood pressure, or waist size?

         Perhaps you've heard the latest Noom ads, where they boast forty publications showing that their app will help you lose weight.

         Apple is coming out with more ways to have their new watch track your heart rate and steps, with apps even looking at your yoga workout and eventually telling your blood glucose.

         Episode Sponsor: Modifyhealth.com

         What the Studies Show

         A recent meta-analysis of randomized controlled trials showed that the average weight loss in the first three months was slightly below five pounds (2.18 kg).

         Unfortunately, the weight loss didn't last.  Nine months later, they had regained a pound and a half for a total loss of 3.5 pounds (1.63 kg).

         Blood Pressure, Cholesterol, and Calories

         There was a slight improvement in blood pressure at three months. But cholesterol and total energy intake, as well as waist circumference and blood glucose, remained the same.

         The Proliferation of Apps

         There are over 500,000 applications on Android and Apple phones to track various health data points. In addition, there are other devices just measuring fitness. The theory of measuring fitness behaviors with calorie tracking to provide feedback to improve health is appealing.

         Many Apps With Poor Quality

         Many apps had a lack of behavioral coaching and poor quality of scientific information. Tracking over a three-day period found that the accuracy of energy intake among apps was only fair in terms of total calories and amounts of macro- and micronutrients.

         What About Noom

         Noom is one of the more popular paid apps. They boast over 40 peer-reviewed articles. A quick glance at the articles showed some surprising flaws:

         One article compared Noom in pancreatic cancer patients to a control group who received no coaching.

         Another article used Noom data for their references.

         Article after article that Noom sites are little more than using Noom's data without dropout rates.

          

         References:

         Chen J, Cade JE, Allman-Farinelli M. The Most Popular Smartphone Apps for Weight Loss: A Quality Assessment. JMIR Mhealth Uhealth. 2015 Dec 16;3(4):e104. doi: 10.2196/mhealth.4334. PMID: 26678569; PMCID: PMC4704947.

         Chew HSJ, Koh WL, Ng JSHY, Tan KK. Sustainability of Weight Loss Through Smartphone Apps: Systematic Review and Meta-analysis on Anthropometric, Metabolic, and Dietary Outcomes. J Med Internet Res. 2022 Sep 21;24(9):e40141. doi: 10.2196/40141. PMID: 36129739; PMCID: PMC9536524.

         Keum J, Chung M, Kim Y, Ko H, Sung M, Jo J, Park J, Bang S, Park S, Song S, Lee H

         Usefulness of Smartphone Apps for Improving Nutritional Status of Pancreatic Cancer Patients: Randomized Controlled Trial JMIR Mhealth Uhealth 2021;9(8):e21088 URL: https://mhealth.jmir.org/2021/8/e21088 DOI: 10.2196/21088

         Pohl, M. "325,000 mobile health apps available in 2017—Android now the leading mHealth platform. Research 2 Guidance." (2017).

         ]]>Losing Weight With Apps

         Can a phone app help you lose weight? How about with your cholesterol, blood pressure, or waist size?

         Perhaps you've heard the latest Noom ads, where they boast forty publications showing that their app will help you lose weight.

         Apple is coming out with more ways to have their new watch track your heart rate and steps, with apps even looking at your yoga workout and eventually telling your blood glucose.

         Episode Sponsor: Modifyhealth.com

         What the Studies Show

         A recent meta-analysis of randomized controlled trials showed that the average weight loss in the first three months was slightly below five pounds (2.18 kg).

         Unfortunately, the weight loss didn't last.  Nine months later, they had regained a pound and a half for a total loss of 3.5 pounds (1.63 kg).

         Blood Pressure, Cholesterol, and Calories

         There was a slight improvement in blood pressure at three months. But cholesterol and total energy intake, as well as waist circumference and blood glucose, remained the same.

         The Proliferation of Apps

         There are over 500,000 applications on Android and Apple phones to track various health data points. In addition, there are other devices just measuring fitness. The theory of measuring fitness behaviors with calorie tracking to provide feedback to improve health is appealing.

         Many Apps With Poor Quality

         Many apps had a lack of behavioral coaching and poor quality of scientific information. Tracking over a three-day period found that the accuracy of energy intake among apps was only fair in terms of total calories and amounts of macro- and micronutrients.

         What About Noom

         Noom is one of the more popular paid apps. They boast over 40 peer-reviewed articles. A quick glance at the articles showed some surprising flaws:

         One article compared Noom in pancreatic cancer patients to a control group who received no coaching.

         Another article used Noom data for their references.

         Article after article that Noom sites are little more than using Noom's data without dropout rates.

          

         References:

         Chen J, Cade JE, Allman-Farinelli M. The Most Popular Smartphone Apps for Weight Loss: A Quality Assessment. JMIR Mhealth Uhealth. 2015 Dec 16;3(4):e104. doi: 10.2196/mhealth.4334. PMID: 26678569; PMCID: PMC4704947.

         Chew HSJ, Koh WL, Ng JSHY, Tan KK. Sustainability of Weight Loss Through Smartphone Apps: Systematic Review and Meta-analysis on Anthropometric, Metabolic, and Dietary Outcomes. J Med Internet Res. 2022 Sep 21;24(9):e40141. doi: 10.2196/40141. PMID: 36129739; PMCID: PMC9536524.

         Keum J, Chung M, Kim Y, Ko H, Sung M, Jo J, Park J, Bang S, Park S, Song S, Lee H

         Usefulness of Smartphone Apps for Improving Nutritional Status of Pancreatic Cancer Patients: Randomized Controlled Trial JMIR Mhealth Uhealth 2021;9(8):e21088 URL: https://mhealth.jmir.org/2021/8/e21088 DOI: 10.2196/21088

         Pohl, M. "325,000 mobile health apps available in 2017—Android now the leading mHealth platform. Research 2 Guidance." (2017).

         ]]>360a1513-3400-4767-b1d9-6a818bdc9948Mon, 21 Nov 2022 15:30:00 -070010:53falsefull2323Decreasing Cholesterol drugs and dietDecreasing cholesterol: drugs and diet

         There is a persistent belief that lifestyle can take care of all cholesterol problems. Lifestyle can make things worse, but once things are worse, it cannot make things better.

         Once you have disease, or cholesterol is higher, you need treatment often beyond lifestyle management.

         This distresses many people, who wish to have control over their fate.

         High cholesterol is one of the main causes of heart attacks, strokes, and peripheral vascular disease. You can lower cholesterol through diet and exercise by as much as 15 percent. Lifestyle changes are the first choice to decrease cholesterol. Modern drugs, however, will lower cholesterol levels far more than diet or exercise.

         The progressive changes of a vessel

         The normal artery, as shown below, is a free-flowing blood vessel. When a person is in their late teens, there is already fatty formation on the inside of the vessel wall.

         As more fat is deposited in the vessel wall, blood flow decreases, leading to ischemia in the end organ.

         Angina, or heart pain, occurs when there is insufficient blood flow to the heart secondary to an artery narrowed by plaque.

         Factors contributing to atherosclerotic plaque formation

         Damage to the blood vessel begins the process of

         • Smoking
         • Hypertension
         • High blood sugars
         • Diets rich in saturated fats and refined grains
         
         

         However, the lower the level of LDL, the less risk those factors become, as you shall see.

         Anatomy of the Blood Vessel

         If you examine the autopsy specimen of the coronary artery above, the blood flows through that lumen. The inner wall, the wall the blood comes into contact with, is called the endothelium. There are three layers to the wall of an artery:

         1. Tunica intima
         2. Tunica Media
         3. Tunica Adventicia
         
         

         Atherosclerosis begins when the cholesterol transport protein enters the wall of the tunica media, whose first layer is the endothelium.

         Discovery of LDL

         In 1954, Dr. John Gofman reported the discovery of LDL and HDL. These were the particles found when he separated plasma cholesterol-carrying lipoproteins with an ultracentrifuge. Gofman was the first to note that heart attack patients had high LDL levels. The correlation of high LDL and heart attacks has been called “one of the most profound epidemiologic correlations in all of medicine.”

         High LDL levels have been shown to correlate with atherosclerosis in all species studied.

         High LDL and Atherosclerosis

         The higher the LDL level, the faster atherosclerosis develops. Factors that increase atherosclerosis are those which injure blood vessels: smoking, hypertension, hyperglycemia, and genetic factors that predispose endothelium to early injury.

         High LDL levels can lead to heart attacks in children as young as 6 years old. This rare form of homozygous familial hypercholesterolemia inspired Brown and Goldstein to elucidate the genetic defect in the receptor for LDL.

         Discovery of the LDL receptor defect

          Brown and Goldstein discovered that when LDL receptors are defective, it leads to the following:

         1. LDL particles circulate for a long time
         2. This leads to an increase in plasma levels of LDL
         3. As a result, more deposits are made into the arteries
         4. Creating atherosclerotic plaques
         
         

         Lowering LDL by feedback

         To keep blood LDL constant, your body uses a feedback mechanism. As your LDL levels increase, the target tissues produce more receptors to take up the LDL. If the LDL receptor is defective, the liver continues to increase production of LDL.

         Brown and Goldstein speculated that an HMG CoA reductase inhibitor would deprive liver cells of endogenous synthesis as a source of cholesterol. This deprivation would relieve the feedback repression of LDL receptors, and the resultant increase in LDL receptors would lower plasma LDL.

         Developing the first statins

         The FDA approved the first statin 1987, Mevacor, which reduced plasma levels of LDL and was well tolerated. It was only theory that lowering LDL would reduce heart attacks.

         Statins Reduce Heart Attacks and Prolong Life

         Statins block cholesterol synthesis, which causes the cell to increase LDL receptors, which further decrease cholesterol in blood plasma.

         The first study showing that statins not only reduce LDL, decrease heart attacks, and prolong life was reported in 1994. These studies have been repeated:

         1. 1996 Sachs reported use of Pravastatin on heart attacks with normal cholesterol levels
         2. 1998, LIPID showed prevention of heart attacks with a wide range of cholesterol levels
         3. 2002, Heart protection by cholesterol lowering in over 20,000 high-risk people in a randomized placebo control trial
         
         

         The 2002 study was large enough to show a reduction in relative risk even when subjects had risk factors such as diabetes, hypertension, and smoking.

         For each reduction of LDL cholesterol by 40 mg /dl, cardiovascular events are reduced by 20%. This even applies to people considered low-risk (ref).

         Better Genetics

         In addition to people who have high cholesterol, there are those who have naturally low levels of cholesterol. These individuals live long lives with abnormally low levels of heart disease, even if they have other risk factors (ref). Yes, I want this mutation!

         This genetic mutation led to a new class of drugs to decrease cholesterol, the PCSK9 class of drugs.

         Lowering LDL over time is the key

         Genetic studies, statin studies, and PCSK9 studies show that lowering LDL longer leads to lower atherosclerotic disease.

         People with PCSK9 mutations may never develop atherosclerotic plaque because they have low LDL levels throughout their lives.

         In many statin studies, patients were treated only when they were at high risk of coronary disease, which means they had already established atherosclerosis. Once the disease is diagnosed, patients may need a much more severe LDL reduction to prevent an event.

         Bringing it back to Ancel Keys

         One of the cohorts that Ancel Keys studied was in a coastal village in Japan. The men in that village had a 90% reduction in their LDL. This lifelong reduction also led to a 90% reduction in their cardiac mortality. (ref) . The PCSk9 mutations also resulted in a 90% reduction in mortality from a similar reduction in LDL.

         Inflammation and cholesterol

         Lowering cholesterol reduces the risk of heart disease, independent of inflammation. While some choose to blame inflammation alone as a cause of atherosclerosis, it is less a cause and more a result. Inflammation is important to repair of tissues but is not the cause of the trauma. Reducing LDL reduces the risk of heart disease.

         Inflammation and oxidized cholesterol have been speculated as a cause of heart disease.

         Red Meat

         Red meat is nutritionally and calorie-rich. But it is also rich in saturated fat. Saturated fat leads to high blood cholesterol. And high blood cholesterol leads to plaque in the arteries. One does not need to give up meat. But, limiting red meat to four ounces a day is protective.

         Vegetables and other fiber-rich foods provide an additional protective effect with the consumption of meat. It appears that the increase in soluble fibers, as well as phytoestrogens from the fiber, reduce the pathway of cholesterol absorption. In addition, they decrease the risk of colon cancer.

         ]]>Decreasing cholesterol: drugs and diet

         There is a persistent belief that lifestyle can take care of all cholesterol problems. Lifestyle can make things worse, but once things are worse, it cannot make things better.

         Once you have disease, or cholesterol is higher, you need treatment often beyond lifestyle management.

         This distresses many people, who wish to have control over their fate.

         High cholesterol is one of the main causes of heart attacks, strokes, and peripheral vascular disease. You can lower cholesterol through diet and exercise by as much as 15 percent. Lifestyle changes are the first choice to decrease cholesterol. Modern drugs, however, will lower cholesterol levels far more than diet or exercise.

         The progressive changes of a vessel

         The normal artery, as shown below, is a free-flowing blood vessel. When a person is in their late teens, there is already fatty formation on the inside of the vessel wall.

         As more fat is deposited in the vessel wall, blood flow decreases, leading to ischemia in the end organ.

         Angina, or heart pain, occurs when there is insufficient blood flow to the heart secondary to an artery narrowed by plaque.

         Factors contributing to atherosclerotic plaque formation

         Damage to the blood vessel begins the process of

         • Smoking
         • Hypertension
         • High blood sugars
         • Diets rich in saturated fats and refined grains
         
         

         However, the lower the level of LDL, the less risk those factors become, as you shall see.

         Anatomy of the Blood Vessel

         If you examine the autopsy specimen of the coronary artery above, the blood flows through that lumen. The inner wall, the wall the blood comes into contact with, is called the endothelium. There are three layers to the wall of an artery:

         1. Tunica intima
         2. Tunica Media
         3. Tunica Adventicia
         
         

         Atherosclerosis begins when the cholesterol transport protein enters the wall of the tunica media, whose first layer is the endothelium.

         Discovery of LDL

         In 1954, Dr. John Gofman reported the discovery of LDL and HDL. These were the particles found when he separated plasma cholesterol-carrying lipoproteins with an ultracentrifuge. Gofman was the first to note that heart attack patients had high LDL levels. The correlation of high LDL and heart attacks has been called “one of the most profound epidemiologic correlations in all of medicine.”

         High LDL levels have been shown to correlate with atherosclerosis in all species studied.

         High LDL and Atherosclerosis

         The higher the LDL level, the faster atherosclerosis develops. Factors that increase atherosclerosis are those which injure blood vessels: smoking, hypertension, hyperglycemia, and genetic factors that predispose endothelium to early injury.

         High LDL levels can lead to heart attacks in children as young as 6 years old. This rare form of homozygous familial hypercholesterolemia inspired Brown and Goldstein to elucidate the genetic defect in the receptor for LDL.

         Discovery of the LDL receptor defect

          Brown and Goldstein discovered that when LDL receptors are defective, it leads to the following:

         1. LDL particles circulate for a long time
         2. This leads to an increase in plasma levels of LDL
         3. As a result, more deposits are made into the arteries
         4. Creating atherosclerotic plaques
         
         

         Lowering LDL by feedback

         To keep blood LDL constant, your body uses a feedback mechanism. As your LDL levels increase, the target tissues produce more receptors to take up the LDL. If the LDL receptor is defective, the liver continues to increase production of LDL.

         Brown and Goldstein speculated that an HMG CoA reductase inhibitor would deprive liver cells of endogenous synthesis as a source of cholesterol. This deprivation would relieve the feedback repression of LDL receptors, and the resultant increase in LDL receptors would lower plasma LDL.

         Developing the first statins

         The FDA approved the first statin 1987, Mevacor, which reduced plasma levels of LDL and was well tolerated. It was only theory that lowering LDL would reduce heart attacks.

         Statins Reduce Heart Attacks and Prolong Life

         Statins block cholesterol synthesis, which causes the cell to increase LDL receptors, which further decrease cholesterol in blood plasma.

         The first study showing that statins not only reduce LDL, decrease heart attacks, and prolong life was reported in 1994. These studies have been repeated:

         1. 1996 Sachs reported use of Pravastatin on heart attacks with normal cholesterol levels
         2. 1998, LIPID showed prevention of heart attacks with a wide range of cholesterol levels
         3. 2002, Heart protection by cholesterol lowering in over 20,000 high-risk people in a randomized placebo control trial
         
         

         The 2002 study was large enough to show a reduction in relative risk even when subjects had risk factors such as diabetes, hypertension, and smoking.

         For each reduction of LDL cholesterol by 40 mg /dl, cardiovascular events are reduced by 20%. This even applies to people considered low-risk (ref).

         Better Genetics

         In addition to people who have high cholesterol, there are those who have naturally low levels of cholesterol. These individuals live long lives with abnormally low levels of heart disease, even if they have other risk factors (ref). Yes, I want this mutation!

         This genetic mutation led to a new class of drugs to decrease cholesterol, the PCSK9 class of drugs.

         Lowering LDL over time is the key

         Genetic studies, statin studies, and PCSK9 studies show that lowering LDL longer leads to lower atherosclerotic disease.

         People with PCSK9 mutations may never develop atherosclerotic plaque because they have low LDL levels throughout their lives.

         In many statin studies, patients were treated only when they were at high risk of coronary disease, which means they had already established atherosclerosis. Once the disease is diagnosed, patients may need a much more severe LDL reduction to prevent an event.

         Bringing it back to Ancel Keys

         One of the cohorts that Ancel Keys studied was in a coastal village in Japan. The men in that village had a 90% reduction in their LDL. This lifelong reduction also led to a 90% reduction in their cardiac mortality. (ref) . The PCSk9 mutations also resulted in a 90% reduction in mortality from a similar reduction in LDL.

         Inflammation and cholesterol

         Lowering cholesterol reduces the risk of heart disease, independent of inflammation. While some choose to blame inflammation alone as a cause of atherosclerosis, it is less a cause and more a result. Inflammation is important to repair of tissues but is not the cause of the trauma. Reducing LDL reduces the risk of heart disease.

         Inflammation and oxidized cholesterol have been speculated as a cause of heart disease.

         Red Meat

         Red meat is nutritionally and calorie-rich. But it is also rich in saturated fat. Saturated fat leads to high blood cholesterol. And high blood cholesterol leads to plaque in the arteries. One does not need to give up meat. But, limiting red meat to four ounces a day is protective.

         Vegetables and other fiber-rich foods provide an additional protective effect with the consumption of meat. It appears that the increase in soluble fibers, as well as phytoestrogens from the fiber, reduce the pathway of cholesterol absorption. In addition, they decrease the risk of colon cancer.

         ]]>5a858545-02b3-4e15-89bf-997b6777eeb6Fri, 04 Nov 2022 00:00:00 -070013:40falsefull2222Alcohol and the Mediterranean DietAlcohol and the Mediterranean Diet

         Alcohol consumption is controversial.  No one disputes that excess alcohol consumption leads to dire consequences. But what about moderate alcohol consumption? Can we define moderate alcohol consumption? Is there a safe and therapeutic level of alcohol consumption?

         Alcohol is a component of the Mediterranean Diet. However, the consumption is limited to 10 ounces of red wine for men, which translates to 14 grams of alcohol. Half that amount for women. In a number of articles, this amount of alcohol is beneficial.

         Bias from Authors

         Confirmation bias is ingrained in all humans.  Treatment programs for alcohol addiction teach that there is no safe level of alcohol consumption.  Fundamentalist Christians, Muslims, and other organized religions have taboos regarding alcohol consumption. Finally, consumers of alcohol will be biased against abstinence.

         Components of Wine

         In their article, Wine, Polypenols and Mediterranean Diet, the authors note that one can get polyphenols from other sources in the diet, and thus the alcohol may be unnecessary.  They conclude that moderate consumption is likely an important component of a mechanistic as well as social norm.

         Dose Dependent Effects of Polyphenols on the Body

         • Decreased risk of cardiovascular disease
         • Dose-dependent reduction of LDL-C
         • Increase HDL-C and decrease triglycerides in patients with diabetes
         • Reduction of Blood Pressure
         • Increase production of nitric oxide (NO), which increases blood flow and reduces blood pressure
         • Improve LDL/HDL ratio
         • Resveratrol inhibition of pro-inflammatory agents
         • lower risk of type 2 diabetes
         • Resveratrol improves glucose homeostasis
         • Modulate gut microbiota
         • Improvement in blood vessel wall function (endothelial function)
         • Reduction of drugs in diabetic patients
         
         

         Mechanistic vs Holistic

         The issue with the Mediterranean Diet is always those who approach from a mechanistic view versus those who approach nutrition and lifestyle from a holistic view. The original data from the Mediterranean Diet came from the Seven Countries Study. This was a holistic examination, not only of their diet but also their lifestyle.

         Alcohol Toxicity is in the Dose

         A bit of wine is good, a lot of wine is not.

         If you look at every improvement in human physiology with alcohol listed above, the opposite effect happens when the dose is beyond about 50 grams of alcohol.

         -----

         Produced by Simpler Media

         
         

         ]]>Alcohol and the Mediterranean Diet

         Alcohol consumption is controversial.  No one disputes that excess alcohol consumption leads to dire consequences. But what about moderate alcohol consumption? Can we define moderate alcohol consumption? Is there a safe and therapeutic level of alcohol consumption?

         Alcohol is a component of the Mediterranean Diet. However, the consumption is limited to 10 ounces of red wine for men, which translates to 14 grams of alcohol. Half that amount for women. In a number of articles, this amount of alcohol is beneficial.

         Bias from Authors

         Confirmation bias is ingrained in all humans.  Treatment programs for alcohol addiction teach that there is no safe level of alcohol consumption.  Fundamentalist Christians, Muslims, and other organized religions have taboos regarding alcohol consumption. Finally, consumers of alcohol will be biased against abstinence.

         Components of Wine

         In their article, Wine, Polypenols and Mediterranean Diet, the authors note that one can get polyphenols from other sources in the diet, and thus the alcohol may be unnecessary.  They conclude that moderate consumption is likely an important component of a mechanistic as well as social norm.

         Dose Dependent Effects of Polyphenols on the Body

         • Decreased risk of cardiovascular disease
         • Dose-dependent reduction of LDL-C
         • Increase HDL-C and decrease triglycerides in patients with diabetes
         • Reduction of Blood Pressure
         • Increase production of nitric oxide (NO), which increases blood flow and reduces blood pressure
         • Improve LDL/HDL ratio
         • Resveratrol inhibition of pro-inflammatory agents
         • lower risk of type 2 diabetes
         • Resveratrol improves glucose homeostasis
         • Modulate gut microbiota
         • Improvement in blood vessel wall function (endothelial function)
         • Reduction of drugs in diabetic patients
         
         

         Mechanistic vs Holistic

         The issue with the Mediterranean Diet is always those who approach from a mechanistic view versus those who approach nutrition and lifestyle from a holistic view. The original data from the Mediterranean Diet came from the Seven Countries Study. This was a holistic examination, not only of their diet but also their lifestyle.

         Alcohol Toxicity is in the Dose

         A bit of wine is good, a lot of wine is not.

         If you look at every improvement in human physiology with alcohol listed above, the opposite effect happens when the dose is beyond about 50 grams of alcohol.

         -----

         Produced by Simpler Media

         
         

         ]]>620122c8-8659-447c-b245-d146c619dcb6Wed, 12 Oct 2022 00:00:00 -070005:11falsefull2121Mediterranean Diet After Weight Loss SurgeryMediterranean Diet after weight loss surgery

         Success after weight loss surgery doesn't end with an operation. It just gets started.

         The most recalcitrant people to diets are those who undergo weight loss surgery. Weight loss surgery patients were on multiple diets prior to surgical intervention.  The Mediterranean Diet is the best post-operative diet one can have.

         Weight Loss and the Mediterranean Diet

         The Med Diet is favorable for health. Multiple studies have shown decreased risk of cardiovascular disease, cancer, and autoimmune disease. What about weight loss? Systematic reviews have shown the Med Diet is equal or superior to other diets for weight loss. However, we found no post-operative program to adopt the Med Diet after weight loss surgery.

         Preoperative Med Diet

         We began coaching patients with the Med Diet before surgery. Many insurance companies require a preoperative, physician-supervised diet. In 2010, we began to use the Mediterranean Diet as a template for our patients using the 9-point scale.  Contrary to weight loss plans, our emphasis was learning the Med Diet.

         Weight Loss Surgery Protocol Liquid Phase

         The immediate post-operative diet emphasized soups and smoothies rich in legumes, vegetables, and fruits. Modular, unflavored protein supplements (whey or pea-based) were used to augment the protein content during this time, as were standard chewable vitamins.  Thus, the beginning of the post-operative plan was already a rich Mediterranean-style diet.

         Early Solid Food Phase

         Legumes and fish were emphasized during the early solid food phase, which were universally easy to digest. One of the favorite Mediterranean-style foods were tacos.  Contrary to popular belief, the Med Diet is not foods commonly eaten in the Mediterranean. Instead, it consists of foods rich in whole grains (corn tacos), fruits (homemade salsa), legumes (lentils), some dairy products (cheese), and fish.

         We noted lettuce was problematic for some in the early phase, but spinach was easy to digest. Thus salads were based upon spinach rather than lettuce.

         Later Solid Food Phase

         As the stomach continued to heal, we stressed the increase in food with multiple fiber types.  We de-emphasized red meats, cautioned against excess alcohol, and worked on olive oil as the primary source for fats.

         Follow up

         Cooking classes were a constant feature of our support group, often bringing in guest chefs from the area and the Food Network. We emphasized the importance of patients learning to cook.  Many of our patients believed that cooking was the most important aspect of their postoperative care. We found that those who learned to cook their meals had better weight loss than those who did not.

         Validated Food Frequency Questionnaires (FFQ) were used to follow a group of patients. The FFQ were validated using dietary logs during follow-up with patients.

         Getting in that quantity of food

         Stomach capacity after weight loss surgery is limited. How, then, does one get in the required amount of food? It is not difficult.

         All food is measured pre-cooked. Take broccoli. If you take nine ounces of broccoli and bake it, you end up with a small amount of volume but still have the one Mediterranean Diet point.

         The increase of vegetables in the diet is one way to reduce inflammation.

         Food increases over time

         Food volume increases over time with both the Gastric Sleeve, Lap-Band, and RNY gastric bypass. The answer is not to eat less or take more protein shakes. The answer is to eat better. To have a balanced diet.

         Putting someone on yet another low-carb plan does not provide a healthy long-term solution. 

         Protein Deficiency

         Since meat is not emphasized in the Mediterranean Diet, some patients were concerned about protein intake. Lab tests did not show any patient with protein deficiency.

         The Study

         Over 220 patients agreed to long-term follow-up with FFQ, but we obtained consistent data on 134 patients after surgery, with a minimum seven-year follow-up.

         The FFQ were converted to the nine-point Med Diet, and the results were analyzed.

         Of the 134 patients, there were 65 which had scores of 5-9 Mediterranean Diet points. They showed an absolute reduction of weight of 54% total weight loss. Those patients who scored 0-3 points had a total weight loss of 32%.

         What About Poor Adherence to Med Diet

         Of the patients studied, 74 had the Lap-Band, 50 had the Vertical Sleeve Gastrectomy, and ten had the RNY gastric bypass. There was no weight loss difference regarding the type of weight loss surgery.

         Alcohol

         Those patients who did not do well with weight loss all had >50 grams of alcohol per day. In contrast, those who did well reported less than 50 grams of alcohol per day.

         ]]>Mediterranean Diet after weight loss surgery

         Success after weight loss surgery doesn't end with an operation. It just gets started.

         The most recalcitrant people to diets are those who undergo weight loss surgery. Weight loss surgery patients were on multiple diets prior to surgical intervention.  The Mediterranean Diet is the best post-operative diet one can have.

         Weight Loss and the Mediterranean Diet

         The Med Diet is favorable for health. Multiple studies have shown decreased risk of cardiovascular disease, cancer, and autoimmune disease. What about weight loss? Systematic reviews have shown the Med Diet is equal or superior to other diets for weight loss. However, we found no post-operative program to adopt the Med Diet after weight loss surgery.

         Preoperative Med Diet

         We began coaching patients with the Med Diet before surgery. Many insurance companies require a preoperative, physician-supervised diet. In 2010, we began to use the Mediterranean Diet as a template for our patients using the 9-point scale.  Contrary to weight loss plans, our emphasis was learning the Med Diet.

         Weight Loss Surgery Protocol Liquid Phase

         The immediate post-operative diet emphasized soups and smoothies rich in legumes, vegetables, and fruits. Modular, unflavored protein supplements (whey or pea-based) were used to augment the protein content during this time, as were standard chewable vitamins.  Thus, the beginning of the post-operative plan was already a rich Mediterranean-style diet.

         Early Solid Food Phase

         Legumes and fish were emphasized during the early solid food phase, which were universally easy to digest. One of the favorite Mediterranean-style foods were tacos.  Contrary to popular belief, the Med Diet is not foods commonly eaten in the Mediterranean. Instead, it consists of foods rich in whole grains (corn tacos), fruits (homemade salsa), legumes (lentils), some dairy products (cheese), and fish.

         We noted lettuce was problematic for some in the early phase, but spinach was easy to digest. Thus salads were based upon spinach rather than lettuce.

         Later Solid Food Phase

         As the stomach continued to heal, we stressed the increase in food with multiple fiber types.  We de-emphasized red meats, cautioned against excess alcohol, and worked on olive oil as the primary source for fats.

         Follow up

         Cooking classes were a constant feature of our support group, often bringing in guest chefs from the area and the Food Network. We emphasized the importance of patients learning to cook.  Many of our patients believed that cooking was the most important aspect of their postoperative care. We found that those who learned to cook their meals had better weight loss than those who did not.

         Validated Food Frequency Questionnaires (FFQ) were used to follow a group of patients. The FFQ were validated using dietary logs during follow-up with patients.

         Getting in that quantity of food

         Stomach capacity after weight loss surgery is limited. How, then, does one get in the required amount of food? It is not difficult.

         All food is measured pre-cooked. Take broccoli. If you take nine ounces of broccoli and bake it, you end up with a small amount of volume but still have the one Mediterranean Diet point.

         The increase of vegetables in the diet is one way to reduce inflammation.

         Food increases over time

         Food volume increases over time with both the Gastric Sleeve, Lap-Band, and RNY gastric bypass. The answer is not to eat less or take more protein shakes. The answer is to eat better. To have a balanced diet.

         Putting someone on yet another low-carb plan does not provide a healthy long-term solution. 

         Protein Deficiency

         Since meat is not emphasized in the Mediterranean Diet, some patients were concerned about protein intake. Lab tests did not show any patient with protein deficiency.

         The Study

         Over 220 patients agreed to long-term follow-up with FFQ, but we obtained consistent data on 134 patients after surgery, with a minimum seven-year follow-up.

         The FFQ were converted to the nine-point Med Diet, and the results were analyzed.

         Of the 134 patients, there were 65 which had scores of 5-9 Mediterranean Diet points. They showed an absolute reduction of weight of 54% total weight loss. Those patients who scored 0-3 points had a total weight loss of 32%.

         What About Poor Adherence to Med Diet

         Of the patients studied, 74 had the Lap-Band, 50 had the Vertical Sleeve Gastrectomy, and ten had the RNY gastric bypass. There was no weight loss difference regarding the type of weight loss surgery.

         Alcohol

         Those patients who did not do well with weight loss all had >50 grams of alcohol per day. In contrast, those who did well reported less than 50 grams of alcohol per day.

         ]]>9cef8639-79b3-482c-9913-5dad99e474feTue, 20 Sep 2022 00:00:00 -070008:54falsefull2020Implementing the Med Diet - Part OneImplementing the Med Diet - Part One

         Do you think you eat enough plants in your diet? How many plants do you eat in a week? Not refined grains, but plants. You can cook them, boil, bake, microwave, roast them or even eat them raw. How many? Further, it's not just eating more volume of plants, it's diversity.

         Mediterranean Diet and Plants

         Adherence to the Mediterranean diet depends more on plants.

         • Vegetables
         • Fruits, Tree Nuts, Seeds
         • Legumes
         • Whole Grains
         • Olive oil
         
         

         When it comes to plants, more is better. But not just in quantity of plants, but also diversity.

         Think about this: there is no one plant that can provide all the micronutrients and macronutrients a person needs. We tell vegetarians to use several plant sources for complete proteins, the same is true for any nutrient.

         Gut Bugs and Plants

         Your gut contains a trillion bugs. There are more of them than of us. But what do they eat? It turns out, most of what they eat are the things we don't. Gut bugs eat plant parts. Without them eating those plant parts, we would be far worse off. Thus, the gut microbiome is an exciting research field.

         Guts break down fiber to chemicals shown to:

         • Decrease the risk of colon cancer
         • Lower cholesterol
         • Decrease blood sugar spikes
         • Decrease depression
         • Allow absorption of polyphenols
         
         

         Fiber is an Essential Nutrient

         Plants provide vitamins, minerals, macro and micronutrients. A single source of plants cannot provide the nutrients a person requires, which has been the main reason we recommend a diversified diet. Fiber is also a nutrient, an essential nutrient, one that humans cannot make, but without it there is clearly an increase in disease. While those on the extreme of low-carb diets will disagree, the literature is unambiguous.

         Myth

         Fiber supplements are not a substitute. Some are expensive, one selling for over $150 a month. But no supplement gives you the diversity of nutrients that you can get from your diet. Mother Nature gives you a better deal. So, eat your fiber, don't buy a supplement.

         Now begin to chart your diversity

         Today's assignment is simple: begin to chart the diversity in your diet, so that you increase the sources of your plants. One of my favorite dieticians, Dr. Megan Rossie, suggests a person has 30 plant-based foods per week. Sound impossible? Let's try it using the Meditereanean Diet.

         Why 30?

         It isn't that difficult to implement, but consider that you want to consume the vitamins, minerals, antioxidants, and other nutrients, and there is no one plant that does this. But many will.

         Vegetables:

         One Mediterranean diet point is achieved by consuming 9 ounces of vegetables per day.  Run through the list of vegetables that you can add to your diet in any given week.

         1. Asparagus
         2. Beets
         3. Bok Choi
         4. Broccoli
         5. Brussels Sprouts
         6. Cabbage
         7. Cauliflower
         8. Carrots
         9. Celery
         10. Cucumbers
         11. Eggplant
         12. Jicama
         13. Kale
         14. Leeks
         15. Lettuce
         16. Onions
         17. Parsnips
         18. Peppers
         19. Spinach
         20. Squash
         21. Tomatillos
         22. Zucchini
         
         

         Fruits:

         1. Apples
         2. Apricots
         3. Avocado
         4. Bananas
         5. Blueberries
         6. Cherries
         7. Coconuts
         8. Dates
         9. Grapes
         10. Grapefruit
         11. Jackfruit
         12. Kiwi
         13. Lemon
         14. Lime
         15. Mangos
         16. Melons
         17. Nectarines
         18. Peaches
         19. Pears
         20. Pineapple
         21. Pomegranates
         22. Plumbs
         23. Prunes
         24. Oranges
         25. Tomato
         26. Watermelon
         
         

         Legumes:

         1. Black beans
         2. Butter beans
         3. Chickpeas
         4. Green beans
         5. Kidney beans
         6. Navy beans
         7. Pinto beans
         8. Navy beans
         9. Lentils
         10. Peanuts
         
         

         Whole Grains:

         1. Barley
         2. Brown Rice
         3. Buckwheat
         4. Bulgur
         5. Corn
         6. Millet
         7. Oatmeal
         8. Whole wheat
         9. Red rice
         
         

         Nuts:

         1. Acorns
         2. Almonds
         3. Brazil nuts
         4. Cashews
         5. Chesnuts
         6. Hazelnuts
         7. Macadamias
         8. Pecans
         9. Pine nuts
         10. Pistachios
         11. Walnuts
         
         

         Seeds:

         1. Chia
         2. Flax seeds
         3. Hemp
         4. Pomegranate
         5. Poppy seeds
         6. Pumpkin
         7. Sesame seeds
         8. Squash seeds
         9. Sunflower
         
         

         These provide a diversity of micronutrients, macronutrients and fiber.

         All of which provide a healthy diet.

         But let's not forget one of the most important plants:

          Perhaps the most important part of the Mediterranean Diet is this plant.

          

          

         Breakfast ideas:

         Overnight oats, which in my recipe has oats, chia seeds, and in the morning I add blueberries and peanut butter. There are four different plants.

          

         Lunch ideas:

         A whole grain sandwich to which I add: tomatoes, cucumbers, lettuce

         Add an apple

         The whole grain can have multiple grains in it.Snack:

         A handful of almonds

         Dinner:

         Want some pasta - how about the sauce? Start the sauce with onions, mushrooms, carrots, garlic, all in olive oil.

         You haven't even had a salad yet.

         On this day, we have 15.

          

         Tips:

         Salads are a great way to add seeds, nuts, and even some legumes.

         Buy the mixed vegetables not just the broccoli.

         Terry's Tacos

         The standard fast-food taco is a lot of ground beef, a lot of cheese, and a smear of sauce.

         My taco is: lots of cabbage which I have for a slaw and other great crunch

         My salsa has some amazing fresh ingredients in it like my mango salsa

         And cheese and meat are more of a condiment. But you can reduce the meat by using lentils and mushrooms.

         Soups:

         Vegetable soups in the winter! Lots of additions here for vegetables.

          

         Diversity is not only healthy, but it is delicious.

         ]]>Implementing the Med Diet - Part One

         Do you think you eat enough plants in your diet? How many plants do you eat in a week? Not refined grains, but plants. You can cook them, boil, bake, microwave, roast them or even eat them raw. How many? Further, it's not just eating more volume of plants, it's diversity.

         Mediterranean Diet and Plants

         Adherence to the Mediterranean diet depends more on plants.

         • Vegetables
         • Fruits, Tree Nuts, Seeds
         • Legumes
         • Whole Grains
         • Olive oil
         
         

         When it comes to plants, more is better. But not just in quantity of plants, but also diversity.

         Think about this: there is no one plant that can provide all the micronutrients and macronutrients a person needs. We tell vegetarians to use several plant sources for complete proteins, the same is true for any nutrient.

         Gut Bugs and Plants

         Your gut contains a trillion bugs. There are more of them than of us. But what do they eat? It turns out, most of what they eat are the things we don't. Gut bugs eat plant parts. Without them eating those plant parts, we would be far worse off. Thus, the gut microbiome is an exciting research field.

         Guts break down fiber to chemicals shown to:

         • Decrease the risk of colon cancer
         • Lower cholesterol
         • Decrease blood sugar spikes
         • Decrease depression
         • Allow absorption of polyphenols
         
         

         Fiber is an Essential Nutrient

         Plants provide vitamins, minerals, macro and micronutrients. A single source of plants cannot provide the nutrients a person requires, which has been the main reason we recommend a diversified diet. Fiber is also a nutrient, an essential nutrient, one that humans cannot make, but without it there is clearly an increase in disease. While those on the extreme of low-carb diets will disagree, the literature is unambiguous.

         Myth

         Fiber supplements are not a substitute. Some are expensive, one selling for over $150 a month. But no supplement gives you the diversity of nutrients that you can get from your diet. Mother Nature gives you a better deal. So, eat your fiber, don't buy a supplement.

         Now begin to chart your diversity

         Today's assignment is simple: begin to chart the diversity in your diet, so that you increase the sources of your plants. One of my favorite dieticians, Dr. Megan Rossie, suggests a person has 30 plant-based foods per week. Sound impossible? Let's try it using the Meditereanean Diet.

         Why 30?

         It isn't that difficult to implement, but consider that you want to consume the vitamins, minerals, antioxidants, and other nutrients, and there is no one plant that does this. But many will.

         Vegetables:

         One Mediterranean diet point is achieved by consuming 9 ounces of vegetables per day.  Run through the list of vegetables that you can add to your diet in any given week.

         1. Asparagus
         2. Beets
         3. Bok Choi
         4. Broccoli
         5. Brussels Sprouts
         6. Cabbage
         7. Cauliflower
         8. Carrots
         9. Celery
         10. Cucumbers
         11. Eggplant
         12. Jicama
         13. Kale
         14. Leeks
         15. Lettuce
         16. Onions
         17. Parsnips
         18. Peppers
         19. Spinach
         20. Squash
         21. Tomatillos
         22. Zucchini
         
         

         Fruits:

         1. Apples
         2. Apricots
         3. Avocado
         4. Bananas
         5. Blueberries
         6. Cherries
         7. Coconuts
         8. Dates
         9. Grapes
         10. Grapefruit
         11. Jackfruit
         12. Kiwi
         13. Lemon
         14. Lime
         15. Mangos
         16. Melons
         17. Nectarines
         18. Peaches
         19. Pears
         20. Pineapple
         21. Pomegranates
         22. Plumbs
         23. Prunes
         24. Oranges
         25. Tomato
         26. Watermelon
         
         

         Legumes:

         1. Black beans
         2. Butter beans
         3. Chickpeas
         4. Green beans
         5. Kidney beans
         6. Navy beans
         7. Pinto beans
         8. Navy beans
         9. Lentils
         10. Peanuts
         
         

         Whole Grains:

         1. Barley
         2. Brown Rice
         3. Buckwheat
         4. Bulgur
         5. Corn
         6. Millet
         7. Oatmeal
         8. Whole wheat
         9. Red rice
         
         

         Nuts:

         1. Acorns
         2. Almonds
         3. Brazil nuts
         4. Cashews
         5. Chesnuts
         6. Hazelnuts
         7. Macadamias
         8. Pecans
         9. Pine nuts
         10. Pistachios
         11. Walnuts
         
         

         Seeds:

         1. Chia
         2. Flax seeds
         3. Hemp
         4. Pomegranate
         5. Poppy seeds
         6. Pumpkin
         7. Sesame seeds
         8. Squash seeds
         9. Sunflower
         
         

         These provide a diversity of micronutrients, macronutrients and fiber.

         All of which provide a healthy diet.

         But let's not forget one of the most important plants:

          Perhaps the most important part of the Mediterranean Diet is this plant.

          

          

         Breakfast ideas:

         Overnight oats, which in my recipe has oats, chia seeds, and in the morning I add blueberries and peanut butter. There are four different plants.

          

         Lunch ideas:

         A whole grain sandwich to which I add: tomatoes, cucumbers, lettuce

         Add an apple

         The whole grain can have multiple grains in it.Snack:

         A handful of almonds

         Dinner:

         Want some pasta - how about the sauce? Start the sauce with onions, mushrooms, carrots, garlic, all in olive oil.

         You haven't even had a salad yet.

         On this day, we have 15.

          

         Tips:

         Salads are a great way to add seeds, nuts, and even some legumes.

         Buy the mixed vegetables not just the broccoli.

         Terry's Tacos

         The standard fast-food taco is a lot of ground beef, a lot of cheese, and a smear of sauce.

         My taco is: lots of cabbage which I have for a slaw and other great crunch

         My salsa has some amazing fresh ingredients in it like my mango salsa

         And cheese and meat are more of a condiment. But you can reduce the meat by using lentils and mushrooms.

         Soups:

         Vegetable soups in the winter! Lots of additions here for vegetables.

          

         Diversity is not only healthy, but it is delicious.

         ]]>fc60986d-21a3-4569-a67b-b243e6848442Fri, 16 Sep 2022 00:00:00 -070009:08falsefull1919Mediterranean Diet - FatsMediterranean Diet - Fats

         Perhaps the most important part of the Mediterranean Diet is this plant.

         Olive oil is the single ingredient most associated with the Mediterranean Diet. It is the one single food substitution you can do that will improve your health immediately and have great consequences. But not all olive oil is the same.

         Olive oil and your heart

         There are many types of fat that you can find in your diet. Saturated fat will raise your LDL level, increasing your risk of heart disease and stroke. Olive oil, which is unsaturated, decreases the risk of heart disease.

         Types of Fat

         Fats are confusing. You will hear saturated, poly unsaturated, monounsaturated, and trans fats. First, we won't look at the chemical structure of fats. Second, we will look at the evidence that the food is associated with fat and how it influences our bodies. Finally, we will dismantle some bad arguments against certain fats.

         Saturated Fats - it's the source, not the ingredient

         Sources: butter, red meat, dairy.

         What the Mediterranean Diet showed us what that the total diet mattered more than the individual ingredient. In spite of the revolutionary approach to using cohort studies with complete diets, many have insisted on pulling that apart to find out if one ingredient is "bad." For years, saturated fat was considered the "bad" part of what we ate. The American Heart Association recommended limiting saturated fat to just ten percent of what you eat.  The AHA recommended changing from saturated fat to polyunsaturated fat or monounsaturated fat. There has never been a question about olive oil, but a few concerns have been raised about some polyunsaturated fat.

         But it isn't as simple as the saturated fat molecule. We don't eat pure saturated fat, it turns out we eat food containing that fat. Depending on the food, it depends on how saturated fat affects you.

         Dairy and Fish vs Red Meat

         Adding more fish and dairy to your diet decreases the risk of heart disease. Adding more red meat to your diet increases your risk of heart disease. This study, from the EPIC group, was impressive in its size, and its ability to factor out other issues that might increase heart disease. Once again, cohort studies show it isn't as important.

         Cheese

         Besides heart disease, cheese decreased the risk of dementia among a cohort of Finnish men followed for 22 years.

         Perhaps the greatest snack of all time (my opinion - not science).

         Another cohort study found that cheese was associated with a lower risk of pre-diabetes. Other forms of dairy products did not have this same benefit. This flies in the face of some vegans, who insist diabetes comes from saturated fat.

         Finally, non-dairy cheese is not a great source of nutrients. I know my fellow vegans want to find a good alternative for cheese, but there simply isn't one.

         Proving again that the whole food is greater than its parts, fish.

         Fatty fish have been shown to decrease not only cardiovascular mortality, but all causes of mortality. But not fish oil.

         Who doesn't love a good salmon?

         Fish consumption has been associated with a lower risk of heart disease. Further, fatty fish decreases the risk of all-cause mortality.

         Fatty fish contain high quantities of omega-3 fatty acids.  Our body cannot make these fats, we must get them from our diet. Here are the fish that are high in omega-3 fatty acids:

         • salmon
         • sardines
         • mackerel
         • herring
         • lake trout
         • canned light tuna
         
         

         Even tilapia has some omega-3 fatty acids, in fact, it has about four times as much omega-3 fatty acids as grass-fed beef. However, tilapia has ten times less omega-3 fatty acid as salmon. Some have discouraged the consumption of tilapia, but it remains an inexpensive, sustainable type of fish. Just for reference, tilapia has the same amount of omega-3 fatty acid as cod, scallops, shrimp, and wild lobster.

         Different types of Omega-3 fatty acids

         There are two kinds of omega-3 fatty acids in fish — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).  One of the few supplements that all physicians recommend are DHA for pregnant women. This is essential to the brain of the child.

          Yes, he is a smart kid - was it genetics or the DHA his mother took during pregnancy?

         Polyunsaturated Fatty Acids

         • They are anti-inflammatory
         • They are extracted with hexane
         • They are healthy
         • There is less hexane if you consumed from your diet for a year than one whiff of the gas you put into your automobile
         
         

          

         Olive Oil

         • You can cook with it, this is the only oil used in cooking in most homes in Italy and Greece
         • Extra Virgin Olive oil standards are the highest from those produced in the United States
         • Over 80% of the Extra Virgin Olive oil imported is contaminated with other oils
         • The smoke point is around 400, but up to 475 F when you used "refined" olive oil
         • My favorite olive oil is from the US, but the tastiest is from Liguria in Italy (my opinion)
         
         

         Olive oil, balsamic vinegar, sardines all provide elements of taste - the sour, salty, and savory, combine with bread - the sweet and you have a perfect balance.

         ]]>Mediterranean Diet - Fats

         Perhaps the most important part of the Mediterranean Diet is this plant.

         Olive oil is the single ingredient most associated with the Mediterranean Diet. It is the one single food substitution you can do that will improve your health immediately and have great consequences. But not all olive oil is the same.

         Olive oil and your heart

         There are many types of fat that you can find in your diet. Saturated fat will raise your LDL level, increasing your risk of heart disease and stroke. Olive oil, which is unsaturated, decreases the risk of heart disease.

         Types of Fat

         Fats are confusing. You will hear saturated, poly unsaturated, monounsaturated, and trans fats. First, we won't look at the chemical structure of fats. Second, we will look at the evidence that the food is associated with fat and how it influences our bodies. Finally, we will dismantle some bad arguments against certain fats.

         Saturated Fats - it's the source, not the ingredient

         Sources: butter, red meat, dairy.

         What the Mediterranean Diet showed us what that the total diet mattered more than the individual ingredient. In spite of the revolutionary approach to using cohort studies with complete diets, many have insisted on pulling that apart to find out if one ingredient is "bad." For years, saturated fat was considered the "bad" part of what we ate. The American Heart Association recommended limiting saturated fat to just ten percent of what you eat.  The AHA recommended changing from saturated fat to polyunsaturated fat or monounsaturated fat. There has never been a question about olive oil, but a few concerns have been raised about some polyunsaturated fat.

         But it isn't as simple as the saturated fat molecule. We don't eat pure saturated fat, it turns out we eat food containing that fat. Depending on the food, it depends on how saturated fat affects you.

         Dairy and Fish vs Red Meat

         Adding more fish and dairy to your diet decreases the risk of heart disease. Adding more red meat to your diet increases your risk of heart disease. This study, from the EPIC group, was impressive in its size, and its ability to factor out other issues that might increase heart disease. Once again, cohort studies show it isn't as important.

         Cheese

         Besides heart disease, cheese decreased the risk of dementia among a cohort of Finnish men followed for 22 years.

         Perhaps the greatest snack of all time (my opinion - not science).

         Another cohort study found that cheese was associated with a lower risk of pre-diabetes. Other forms of dairy products did not have this same benefit. This flies in the face of some vegans, who insist diabetes comes from saturated fat.

         Finally, non-dairy cheese is not a great source of nutrients. I know my fellow vegans want to find a good alternative for cheese, but there simply isn't one.

         Proving again that the whole food is greater than its parts, fish.

         Fatty fish have been shown to decrease not only cardiovascular mortality, but all causes of mortality. But not fish oil.

         Who doesn't love a good salmon?

         Fish consumption has been associated with a lower risk of heart disease. Further, fatty fish decreases the risk of all-cause mortality.

         Fatty fish contain high quantities of omega-3 fatty acids.  Our body cannot make these fats, we must get them from our diet. Here are the fish that are high in omega-3 fatty acids:

         • salmon
         • sardines
         • mackerel
         • herring
         • lake trout
         • canned light tuna
         
         

         Even tilapia has some omega-3 fatty acids, in fact, it has about four times as much omega-3 fatty acids as grass-fed beef. However, tilapia has ten times less omega-3 fatty acid as salmon. Some have discouraged the consumption of tilapia, but it remains an inexpensive, sustainable type of fish. Just for reference, tilapia has the same amount of omega-3 fatty acid as cod, scallops, shrimp, and wild lobster.

         Different types of Omega-3 fatty acids

         There are two kinds of omega-3 fatty acids in fish — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).  One of the few supplements that all physicians recommend are DHA for pregnant women. This is essential to the brain of the child.

          Yes, he is a smart kid - was it genetics or the DHA his mother took during pregnancy?

         Polyunsaturated Fatty Acids

         • They are anti-inflammatory
         • They are extracted with hexane
         • They are healthy
         • There is less hexane if you consumed from your diet for a year than one whiff of the gas you put into your automobile
         
         

          

         Olive Oil

         • You can cook with it, this is the only oil used in cooking in most homes in Italy and Greece
         • Extra Virgin Olive oil standards are the highest from those produced in the United States
         • Over 80% of the Extra Virgin Olive oil imported is contaminated with other oils
         • The smoke point is around 400, but up to 475 F when you used "refined" olive oil
         • My favorite olive oil is from the US, but the tastiest is from Liguria in Italy (my opinion)
         
         

         Olive oil, balsamic vinegar, sardines all provide elements of taste - the sour, salty, and savory, combine with bread - the sweet and you have a perfect balance.

         ]]>fb42236b-463b-43ef-b71a-35967b10f49aThu, 15 Sep 2022 00:00:00 -070006:48falsefull1818Inflammation and the Mediterranean DietInflammation and the Mediterranean Diet

         The Mediterranean Diet is the most anti-inflammatory diet studied.

         The inflammatory response is the body's mechanism to fight infection, repair itself and rid itself of cancer.  Inflammation is a coordinated response to trauma, infection, and cancer. Without inflammation, we would be dead within twenty-four hours.

         Too little or too much

         Too much inflammation results in wanton destruction of tissues, pain, fevers, and misery. It is associated with heart disease, cancer, aging. It is that delicate balance of inflammation we need.

         Does diet play a role with inflammation? The answer is "sort of."

         Short Course about Inflammation

         Inflammation is involved in:

         • Wound healing, removing dead cells - breaking them down into components so they can be recycled
         • Removing and destroying bacteria
         • Inactivating and eliminating viruses
         • Destroying cells that have changed into cancer cells
         • Repairing injury from infection
         • Destroying parasites
         • Removes toxic chemicals
         • The immune system is one branch of the inflammatory response.
         
         

         Five Signs of Inflammation

         The five signs of acute inflammation and their Latin names:

         • Redness - in Latin this is called rubor.
         • Swelling - in Latin this is called tumor.
         • Fever - in Latin this is called calor
         • Pain - in Latin this is called dolor
         • Secretion - in Latin this is called fluor
         
         

         Medical school teaches inflammation as one of the first series of lectures.

         Simple Inflammation

         Your finger was hit with a hammer. You have an injury to your finger. Some cells are injured. The cells send a distress signal, and immediately white blood cells begin to swarm into the area to help the injured cells.  All that extra blood flowing to the area will lead to redness (rubor) and swelling (tumor). Soon, the finger will feel a bit hot (calor) and will have pain (dolor).

         Some cells are so badly injured that they are no longer viable. Your inflammatory reaction breaks down these cells, removes the debris, and recycles the parts to create new tissue in the area.

         Unwanted Inflammation

         I love nature walks but like to avoid Poison Ivy.

         Sometimes, we want to decrease the immune response. Inflammation is the response of our skin to poison ivy.  We reduce the immune response by reducing hives and itching.

         Rheumatoid arthritis is another example of unwanted inflammation.  Rheumatoid arthritis is an auto-immune disease.  The resulting inflammation leads to pain, fever, and joint destruction. The aim of the treatment is to reduce the inflammatory response that saves joints and improves well-being.

         The inflammatory response of COVID, influenza, or the common cold is reduced by the use of non-steroidal anti-inflammatory drugs, such as aspirin or Motrin.

         Acute Disease and Inflammation

         Heart disease is partially the result of inflammation. When you have a heart attack, the coronary arteries are blocked. As a result, a part of your heart muscle is without oxygen. The cells send out inflammatory signals, and you begin to feel pain (dolor). If the blood flow is restored, your cells can heal, but if it takes too long, some of those cells will die. Then your body will get rid of those dead cells and replace them with scar tissue. The result is that your heart becomes less effective.

         Cardiovascular disease and inflammation

         Plaque formation in the arteries is the result of genetics, diet, and inflammation. The increased cholesterol, either from the genetics or from a diet high in saturated fat, is deposited in the arteries.  When cholesterol enters the artery wall, the body's inflammatory response tries to get rid of it, causing inflammation in the arteries. Did you know that 18-year-olds already have signs of early plaque formation in their arteries?

         Chronic Inflammation

         Chronic inflammation is when your body continues to send inflammatory signals, even when there is no acute injury or danger. This is what happens in rheumatoid arthritis, lupus, long Covid, and is involved in diabetes, obesity, dementia, and premature aging.

         Western Diet and Inflammation

         It is easy to obtain calories in western societies. In human history, we have gone from people on the verge of starvation to being overfed. We have also increased lifespan because of sanitation, vaccination, clean water, availability of food, and modern medicine. Living longer means seeing more chronic diseases. The role of diet in those diseases has never been in doubt since Hippocrates said, "Let thy food be thy medicine." The result has been an increase in inflammatory diseases

         How Diet Has Changed in the US

         Contrary to the Mediterranean diet, the typical US diet has changed to a diet rich in fats. Fat consumption has risen by 11% at the expense of healthy carbohydrates.

         Refined sugars have increased from 18 pounds a year in 1800 to over 180 pounds per year in 1999. Since 1999 sugar consumption has been decreasing in the United States.

         The typical western diet has decreased in the amounts of fruits, nuts, seeds, vegetables, legumes, and fish. All while increasing meats, ultra-processed foods, dairy, and alcohol.

         Increasing Inflammatory Diseases

         Diseases caused by inflammation have increased in the United States. Obesity is now considered an inflammatory disease. But other diseases of inflammation have increased:

         • Inflammatory Bowel Disease
         • Rheumatoid arthritis, lupus, and other auto-immune diseases
         • Hidradenitis suppurativa and other skin diseases
         • Food allergies, such as allergies to peanuts
         • Dementia, Alzheimer's, and Vascular dementia, as well as cognitive decline with age
         • Asthma
         • Diabetes, both type 1 and type 2
         • Multiple Sclerosis and Amyotrophic Lateral Sclerosis
         • Diabetic complications, such as neuropathy, cardiovascular disease, kidney disease
         
         

          

         Summary

         Diet contributes to inflammatory conditions. If inflammation is like a fire, then some dietary components are adding kindling to the fire of inflammation. The Mediterranean diet has led to reduced inflammation and improved quality of life.

         Antiinflammatory components of the Mediterranean Diet include anti-oxidants, polyphenols, omega 3 fatty acids, vitamins, potassium, magnesium, zinc, fiber, and lower sodium and saturated fat consumption.

          

         References for diet and disease:

         Tsigalou C, Konstantinidis T, Paraschaki A, Stavropoulou E, Voidarou C, Bezirtzoglou E. Mediterranean Diet as a Tool to Combat Inflammation and Chronic Diseases. An Overview. Biomedicines. 2020 Jul 8;8(7):201. doi: 10.3390/biomedicines8070201. PMID: 32650619; PMCID: PMC7400632.

         Malesza IJ, Malesza M, Walkowiak J, Mussin N, Walkowiak D, Aringazina R, Bartkowiak-Wieczorek J, Mądry E. High-Fat, Western-Style Diet, Systemic Inflammation, and Gut Microbiota: A Narrative Review. Cells. 2021 Nov 14;10(11):3164. doi: 10.3390/cells10113164. PMID: 34831387; PMCID: PMC8619527.

         Obesity Society. (2014, November 4). U.S. adult consumption of added sugars increased by more than 30% over three decades. ScienceDaily. Retrieved August 27, 2022 from www.sciencedaily.com/releases/2014/11/141104141731.htm

         Drews G, Krippeit-Drews P, Düfer M. Oxidative stress and beta-cell dysfunction. Pflugers Arch. 2010 Sep;460(4):703-18. doi: 10.1007/s00424-010-0862-9. Epub 2010 Jul 23. PMID: 20652307.

         Joseph A, Ackerman D, Talley JD, Johnstone J, Kupersmith J. Manifestations of coronary atherosclerosis in young trauma victims--an autopsy study. J Am Coll Cardiol. 1993 Aug;22(2):459-67. doi: 10.1016/0735-1097(93)90050-b. PMID: 8335815.

          

         References for chronic diseases:

         Saltiel AR, Olefsky JM. Inflammatory mechanisms linking obesity and metabolic disease. J Clin Invest. 2017 Jan 3;127(1):1-4. doi: 10.1172/JCI92035. Epub 2017 Jan 3. PMID: 28045402; PMCID: PMC5199709.

         Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, Panaccione R, Ghosh S, Wu JCY, Chan FKL, Sung JJY, Kaplan GG. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017 Dec 23;390(10114):2769-2778. doi: 10.1016/S0140-6736(17)32448-0. Epub 2017 Oct 16. Erratum in: Lancet. 2020 Oct 3;396(10256):e56. PMID: 29050646.

         Raghupathi W, Raghupathi V. An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach. Int J Environ Res Public Health. 2018 Mar 1;15(3):431. doi: 10.3390/ijerph15030431. PMID: 29494555; PMCID: PMC5876976.

         D'Antona S, Caramenti M, Porro D, Castiglioni I, Cava C. Amyotrophic Lateral Sclerosis: A Diet Review. Foods. 2021 Dec 17;10(12):3128. doi: 10.3390/foods10123128. PMID: 34945679; PMCID: PMC8702143.

         References for Specific Diseases:

         Yarla NS, Polito A, Peluso I. Effects of Olive Oil on TNF-α and IL-6 in Humans: Implication in Obesity and Frailty. Endocr Metab Immune Disord Drug Targets. 2018;18(1):63-74. doi: 10.2174/1871530317666171120150329. PMID: 29165098.

         Esposito S,...]]>Inflammation and the Mediterranean Diet

         The Mediterranean Diet is the most anti-inflammatory diet studied.

         The inflammatory response is the body's mechanism to fight infection, repair itself and rid itself of cancer.  Inflammation is a coordinated response to trauma, infection, and cancer. Without inflammation, we would be dead within twenty-four hours.

         Too little or too much

         Too much inflammation results in wanton destruction of tissues, pain, fevers, and misery. It is associated with heart disease, cancer, aging. It is that delicate balance of inflammation we need.

         Does diet play a role with inflammation? The answer is "sort of."

         Short Course about Inflammation

         Inflammation is involved in:

         • Wound healing, removing dead cells - breaking them down into components so they can be recycled
         • Removing and destroying bacteria
         • Inactivating and eliminating viruses
         • Destroying cells that have changed into cancer cells
         • Repairing injury from infection
         • Destroying parasites
         • Removes toxic chemicals
         • The immune system is one branch of the inflammatory response.
         
         

         Five Signs of Inflammation

         The five signs of acute inflammation and their Latin names:

         • Redness - in Latin this is called rubor.
         • Swelling - in Latin this is called tumor.
         • Fever - in Latin this is called calor
         • Pain - in Latin this is called dolor
         • Secretion - in Latin this is called fluor
         
         

         Medical school teaches inflammation as one of the first series of lectures.

         Simple Inflammation

         Your finger was hit with a hammer. You have an injury to your finger. Some cells are injured. The cells send a distress signal, and immediately white blood cells begin to swarm into the area to help the injured cells.  All that extra blood flowing to the area will lead to redness (rubor) and swelling (tumor). Soon, the finger will feel a bit hot (calor) and will have pain (dolor).

         Some cells are so badly injured that they are no longer viable. Your inflammatory reaction breaks down these cells, removes the debris, and recycles the parts to create new tissue in the area.

         Unwanted Inflammation

         I love nature walks but like to avoid Poison Ivy.

         Sometimes, we want to decrease the immune response. Inflammation is the response of our skin to poison ivy.  We reduce the immune response by reducing hives and itching.

         Rheumatoid arthritis is another example of unwanted inflammation.  Rheumatoid arthritis is an auto-immune disease.  The resulting inflammation leads to pain, fever, and joint destruction. The aim of the treatment is to reduce the inflammatory response that saves joints and improves well-being.

         The inflammatory response of COVID, influenza, or the common cold is reduced by the use of non-steroidal anti-inflammatory drugs, such as aspirin or Motrin.

         Acute Disease and Inflammation

         Heart disease is partially the result of inflammation. When you have a heart attack, the coronary arteries are blocked. As a result, a part of your heart muscle is without oxygen. The cells send out inflammatory signals, and you begin to feel pain (dolor). If the blood flow is restored, your cells can heal, but if it takes too long, some of those cells will die. Then your body will get rid of those dead cells and replace them with scar tissue. The result is that your heart becomes less effective.

         Cardiovascular disease and inflammation

         Plaque formation in the arteries is the result of genetics, diet, and inflammation. The increased cholesterol, either from the genetics or from a diet high in saturated fat, is deposited in the arteries.  When cholesterol enters the artery wall, the body's inflammatory response tries to get rid of it, causing inflammation in the arteries. Did you know that 18-year-olds already have signs of early plaque formation in their arteries?

         Chronic Inflammation

         Chronic inflammation is when your body continues to send inflammatory signals, even when there is no acute injury or danger. This is what happens in rheumatoid arthritis, lupus, long Covid, and is involved in diabetes, obesity, dementia, and premature aging.

         Western Diet and Inflammation

         It is easy to obtain calories in western societies. In human history, we have gone from people on the verge of starvation to being overfed. We have also increased lifespan because of sanitation, vaccination, clean water, availability of food, and modern medicine. Living longer means seeing more chronic diseases. The role of diet in those diseases has never been in doubt since Hippocrates said, "Let thy food be thy medicine." The result has been an increase in inflammatory diseases

         How Diet Has Changed in the US

         Contrary to the Mediterranean diet, the typical US diet has changed to a diet rich in fats. Fat consumption has risen by 11% at the expense of healthy carbohydrates.

         Refined sugars have increased from 18 pounds a year in 1800 to over 180 pounds per year in 1999. Since 1999 sugar consumption has been decreasing in the United States.

         The typical western diet has decreased in the amounts of fruits, nuts, seeds, vegetables, legumes, and fish. All while increasing meats, ultra-processed foods, dairy, and alcohol.

         Increasing Inflammatory Diseases

         Diseases caused by inflammation have increased in the United States. Obesity is now considered an inflammatory disease. But other diseases of inflammation have increased:

         • Inflammatory Bowel Disease
         • Rheumatoid arthritis, lupus, and other auto-immune diseases
         • Hidradenitis suppurativa and other skin diseases
         • Food allergies, such as allergies to peanuts
         • Dementia, Alzheimer's, and Vascular dementia, as well as cognitive decline with age
         • Asthma
         • Diabetes, both type 1 and type 2
         • Multiple Sclerosis and Amyotrophic Lateral Sclerosis
         • Diabetic complications, such as neuropathy, cardiovascular disease, kidney disease
         
         

          

         Summary

         Diet contributes to inflammatory conditions. If inflammation is like a fire, then some dietary components are adding kindling to the fire of inflammation. The Mediterranean diet has led to reduced inflammation and improved quality of life.

         Antiinflammatory components of the Mediterranean Diet include anti-oxidants, polyphenols, omega 3 fatty acids, vitamins, potassium, magnesium, zinc, fiber, and lower sodium and saturated fat consumption.

          

         References for diet and disease:

         Tsigalou C, Konstantinidis T, Paraschaki A, Stavropoulou E, Voidarou C, Bezirtzoglou E. Mediterranean Diet as a Tool to Combat Inflammation and Chronic Diseases. An Overview. Biomedicines. 2020 Jul 8;8(7):201. doi: 10.3390/biomedicines8070201. PMID: 32650619; PMCID: PMC7400632.

         Malesza IJ, Malesza M, Walkowiak J, Mussin N, Walkowiak D, Aringazina R, Bartkowiak-Wieczorek J, Mądry E. High-Fat, Western-Style Diet, Systemic Inflammation, and Gut Microbiota: A Narrative Review. Cells. 2021 Nov 14;10(11):3164. doi: 10.3390/cells10113164. PMID: 34831387; PMCID: PMC8619527.

         Obesity Society. (2014, November 4). U.S. adult consumption of added sugars increased by more than 30% over three decades. ScienceDaily. Retrieved August 27, 2022 from www.sciencedaily.com/releases/2014/11/141104141731.htm

         Drews G, Krippeit-Drews P, Düfer M. Oxidative stress and beta-cell dysfunction. Pflugers Arch. 2010 Sep;460(4):703-18. doi: 10.1007/s00424-010-0862-9. Epub 2010 Jul 23. PMID: 20652307.

         Joseph A, Ackerman D, Talley JD, Johnstone J, Kupersmith J. Manifestations of coronary atherosclerosis in young trauma victims--an autopsy study. J Am Coll Cardiol. 1993 Aug;22(2):459-67. doi: 10.1016/0735-1097(93)90050-b. PMID: 8335815.

          

         References for chronic diseases:

         Saltiel AR, Olefsky JM. Inflammatory mechanisms linking obesity and metabolic disease. J Clin Invest. 2017 Jan 3;127(1):1-4. doi: 10.1172/JCI92035. Epub 2017 Jan 3. PMID: 28045402; PMCID: PMC5199709.

         Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, Panaccione R, Ghosh S, Wu JCY, Chan FKL, Sung JJY, Kaplan GG. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017 Dec 23;390(10114):2769-2778. doi: 10.1016/S0140-6736(17)32448-0. Epub 2017 Oct 16. Erratum in: Lancet. 2020 Oct 3;396(10256):e56. PMID: 29050646.

         Raghupathi W, Raghupathi V. An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach. Int J Environ Res Public Health. 2018 Mar 1;15(3):431. doi: 10.3390/ijerph15030431. PMID: 29494555; PMCID: PMC5876976.

         D'Antona S, Caramenti M, Porro D, Castiglioni I, Cava C. Amyotrophic Lateral Sclerosis: A Diet Review. Foods. 2021 Dec 17;10(12):3128. doi: 10.3390/foods10123128. PMID: 34945679; PMCID: PMC8702143.

         References for Specific Diseases:

         Yarla NS, Polito A, Peluso I. Effects of Olive Oil on TNF-α and IL-6 in Humans: Implication in Obesity and Frailty. Endocr Metab Immune Disord Drug Targets. 2018;18(1):63-74. doi: 10.2174/1871530317666171120150329. PMID: 29165098.

         Esposito S, Sparaco M, Maniscalco GT, Signoriello E, Lanzillo R, Russo C, Carmisciano L, Cepparulo S, Lavorgna L, Gallo A, Trojsi F, Brescia Morra V, Lus G, Tedeschi G, Saccà F, Signori A, Bonavita S. Lifestyle and Mediterranean diet adherence in a cohort of Southern Italian patients with Multiple Sclerosis. Mult Scler Relat Disord. 2021 Jan;47:102636. doi: 10.1016/j.msard.2020.102636. Epub 2020 Nov 22. PMID: 33333418.

         Bianchi VE, Herrera PF, Laura R. Effect of nutrition on neurodegenerative diseases. A systematic review. Nutr Neurosci. 2021 Oct;24(10):810-834. doi: 10.1080/1028415X.2019.1681088. Epub 2019 Nov 4. PMID: 31684843.

         Forsyth C, Kouvari M, D'Cunha NM, Georgousopoulou EN, Panagiotakos DB, Mellor DD, Kellett J, Naumovski N. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int. 2018 May;38(5):737-747. doi: 10.1007/s00296-017-3912-1. Epub 2017 Dec 18. PMID: 29256100.

         Pocovi-Gerardino G, Correa-Rodríguez M, Callejas-Rubio JL, Ríos-Fernández R, Martín-Amada M, Cruz-Caparros MG, Rueda-Medina B, Ortego-Centeno N. Beneficial effect of Mediterranean diet on disease activity and cardiovascular risk in systemic lupus erythematosus patients: a cross-sectional study. Rheumatology (Oxford). 2021 Jan 5;60(1):160-169. doi: 10.1093/rheumatology/keaa210. PMID: 32594173.

         Castro-Rodriguez JA, Garcia-Marcos L. What Are the Effects of a Mediterranean Diet on Allergies and Asthma in Children? Front Pediatr. 2017 Apr 21;5:72. doi: 10.3389/fped.2017.00072. PMID: 28484688; PMCID: PMC5399020.

         Grahovac M, Kumric M, Vilovic M, Martinovic D, Kreso A, Ticinovic Kurir T, Vrdoljak J, Prizmic K, Božić J. Adherence to Mediterranean diet and advanced glycation endproducts in patients with diabetes. World J Diabetes. 2021 Nov 15;12(11):1942-1956. doi: 10.4239/wjd.v12.i11.1942. PMID: 34888018; PMCID: PMC8613665.

         Velluzzi F, Anedda J, Pisanu S, Dell'Antonia M, Deledda A, Boi A, Ferreli C, Atzori L. Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa. J Public Health Res. 2021 Nov 29;11(2):2706. doi: 10.4081/jphr.2021.2706. PMID: 34850622; PMCID: PMC8958440.

         Castiglione D, Platania A, Conti A, Falla M, D'Urso M, Marranzano M. Dietary Micronutrient and Mineral Intake in the Mediterranean Healthy Eating, Ageing, and Lifestyle (MEAL) Study. Antioxidants (Basel). 2018 Jun 23;7(7):79. doi: 10.3390/antiox7070079. PMID: 29937504; PMCID: PMC6071131.

         ]]>0dbd2d2d-6e53-40aa-a56c-ceee903908b6Fri, 02 Sep 2022 00:00:00 -070005:16falsefull1717Cancer and The Mediterranean DietAdherence to the Mediterranean Diet decreases the risk of cardiovascular disease. The Seven Country Cohort Study clearly showed this.

         But what about cancer? Does the Mediterranean Diet impact cancer or cancer prevention? To study this, another cohort study began called the EPIC study. Uniquely, the EPIC showed not only a decreased risk of cancer but also mortality from cancer.

         All vegetables, even the green ones, have nitrates. It turns out that the components of The Mediterranean Diet decreases the risk of cancer, decreases the risk of cancer recurrence, improves survival from cancer, and decreases overall mortality.

         EPIC Study

         The European Prospective Investigation into Cancer and Nutrition (EPIC) is a large cohort study involving over 521,000 individuals from 23 centers from ten countries.

         Adherence to the Mediterranean Diet and Longevity

         The EPIC researchers developed a simple scoring system to determine adherence to the Mediterranean Diet.  Greater adherence to the Mediterranean Diet was associated with longevity.

         The Scoring System

         The Mediterranean Diet is scored on a scale of one to nine. Nine being a perfect Mediterranean Diet Score, and zero being poor. Great adherence to the Mediterranean Diet is a score of seven points or more.

         Eating more of these foods gives you points

         The Mediterranean diet is rich with vegetables, legumes, fruits and nuts, whole grains, and fish.

         • You get a point for consuming 9 ounces or more of vegetables a day. If you consume less than nine ounces, you get a score of zero.
         • Legumes will net you a point if you consume two ounces or more per day.
         • Fruits and nuts are one point for nine ounces or more.
         • Likewise, whole grains are worth a point for nine ounces or more.
         • Fish is an average of an ounce a day, or two main meals per week. Thus,  by consuming a diet rich in these five components can score five points.
         
         

         The weight is based on pre-cooked food.

         Lentils are a legume, and if you consume more than 2 ounces per day, you will score one Mediterranean Diet point. They are high in protein and fiber and low in saturated fat.

         Eat Less for More

         People from the Mediterranean didn't eat much meat or dairy.  By consuming less of these, you can achieve Mediterranean Diet points.

         • Eating less than  4 ounces of meat a day  is worth one point
         • Consuming 1.5 ounces of hard cheese a day or LESS is worth one point
         • Consuming less than 8 ounces of dairy is worth one point (mostly consume yogurt).
         
         

         Thus by eating less dairy and meat, or none, you can score two additional points.

         You might think that 6-ounce burger is small, but if you eat less than four ounces of meat a day, you get one Mediterranean Diet point. Eat more than four ounces, and you get zero points.

         Alcohol

         Alcohol is a component of the Mediterranean Diet but in moderation.

         For ethanol, a value of 1 was assigned to men who consumed between 10 and 50 g per day and to women who consumed between 5 and 25 g per day. This corresponds to 5 ounces of wine for women or 10 ounces for men.

         Olive Oil

         Olive oil is an important component of the Mediterranean Diet. The type of fat in olive oil is mainly monounsaturated. The ideal ratio of olive oil or monounsaturated fats to saturated fats should be at least 60%.

         The best olive oils come from the US.

         Interventions in the Mediterranean Diet

         Increasing the score in the Mediterranean Diet by two points in the Mediterranean diet led to an 8% reduction in mortality.

         Imagine a simple dietary intervention leading to a decrease in mortality.

         Colorectal Cancer and the Mediterranean Diet Components

         In a recent update of the Mediterranean Diet they found a higher consumption of fruits and vegetables combined led to a decrease in colorectal cancers. But just eating fruits alone or just vegetables alone didn't do it.  Proving again, the entire dietary pattern is important.

         A Mediterranean Diet score of 6-9 led to an 11% decrease risk of colorectal cancer!

         If you eat a lot of red meat but eat a lot of vegetables, your risk of colon cancer decreases.

         Breast Cancer and the Mediterranean Diet

         The  Mediterranean Diet was found to protect against breast cancer. In addition, it improved overall survival of those who developed breast cancer.

         Alcohol consumption increases the risk of breast cancer. While the Mediterranean Diet is a low in alcohol consumption, it is still a factor.  Thankfully, coffee consumption is protective against breast cancer. Of interest, sugar-sweetened and artificially sweetened beverages were not associated with an increase in breast cancer.

         Lung Cancer and the Mediterranean Diet

         Whole grains, fruits, and vegetables were associated with less risk of lung cancer.  Smokers decreased their risk of breast cancer with increasing vegetable consumption. Lung cancer even decreased with higher consumption of apples and pears.

         There was no association with meat or fish consumption and lung cancer.  Alcohol was also not associated with an increased risk of lung cancer.

         Other Cancers

         Adherence to the Mediterranean Diet lowers the risk of cancer, cancer recurrence, and improves survival from cancers.  The Mediterranean diet leads to a lower risk of many cancers:

         • colorectal
         • lung
         • breast
         • stomach
         • pancreas
         • prostate
         • liver
         • head and neck cancers
         
         

         Keto Diet and Cancers

         In contrast, there is not much evidence that the keto diet has a positive impact on cancers. The number of clinical studies have been small and unimpressive. While it clearly has proponents, clinical outcomes in humans are lacking.

         Conclusion

         Cancer isn't fixed from a  diet. But a healthy diet is the only empowering thing that many cancer patients have.

         Augmenting conventional treatment with a healthy Mediterranean diet provides a powerful defense against cancer.

         -----

         Produced by Simpler Media

         ]]>Adherence to the Mediterranean Diet decreases the risk of cardiovascular disease. The Seven Country Cohort Study clearly showed this.

         But what about cancer? Does the Mediterranean Diet impact cancer or cancer prevention? To study this, another cohort study began called the EPIC study. Uniquely, the EPIC showed not only a decreased risk of cancer but also mortality from cancer.

         All vegetables, even the green ones, have nitrates. It turns out that the components of The Mediterranean Diet decreases the risk of cancer, decreases the risk of cancer recurrence, improves survival from cancer, and decreases overall mortality.

         EPIC Study

         The European Prospective Investigation into Cancer and Nutrition (EPIC) is a large cohort study involving over 521,000 individuals from 23 centers from ten countries.

         Adherence to the Mediterranean Diet and Longevity

         The EPIC researchers developed a simple scoring system to determine adherence to the Mediterranean Diet.  Greater adherence to the Mediterranean Diet was associated with longevity.

         The Scoring System

         The Mediterranean Diet is scored on a scale of one to nine. Nine being a perfect Mediterranean Diet Score, and zero being poor. Great adherence to the Mediterranean Diet is a score of seven points or more.

         Eating more of these foods gives you points

         The Mediterranean diet is rich with vegetables, legumes, fruits and nuts, whole grains, and fish.

         • You get a point for consuming 9 ounces or more of vegetables a day. If you consume less than nine ounces, you get a score of zero.
         • Legumes will net you a point if you consume two ounces or more per day.
         • Fruits and nuts are one point for nine ounces or more.
         • Likewise, whole grains are worth a point for nine ounces or more.
         • Fish is an average of an ounce a day, or two main meals per week. Thus,  by consuming a diet rich in these five components can score five points.
         
         

         The weight is based on pre-cooked food.

         Lentils are a legume, and if you consume more than 2 ounces per day, you will score one Mediterranean Diet point. They are high in protein and fiber and low in saturated fat.

         Eat Less for More

         People from the Mediterranean didn't eat much meat or dairy.  By consuming less of these, you can achieve Mediterranean Diet points.

         • Eating less than  4 ounces of meat a day  is worth one point
         • Consuming 1.5 ounces of hard cheese a day or LESS is worth one point
         • Consuming less than 8 ounces of dairy is worth one point (mostly consume yogurt).
         
         

         Thus by eating less dairy and meat, or none, you can score two additional points.

         You might think that 6-ounce burger is small, but if you eat less than four ounces of meat a day, you get one Mediterranean Diet point. Eat more than four ounces, and you get zero points.

         Alcohol

         Alcohol is a component of the Mediterranean Diet but in moderation.

         For ethanol, a value of 1 was assigned to men who consumed between 10 and 50 g per day and to women who consumed between 5 and 25 g per day. This corresponds to 5 ounces of wine for women or 10 ounces for men.

         Olive Oil

         Olive oil is an important component of the Mediterranean Diet. The type of fat in olive oil is mainly monounsaturated. The ideal ratio of olive oil or monounsaturated fats to saturated fats should be at least 60%.

         The best olive oils come from the US.

         Interventions in the Mediterranean Diet

         Increasing the score in the Mediterranean Diet by two points in the Mediterranean diet led to an 8% reduction in mortality.

         Imagine a simple dietary intervention leading to a decrease in mortality.

         Colorectal Cancer and the Mediterranean Diet Components

         In a recent update of the Mediterranean Diet they found a higher consumption of fruits and vegetables combined led to a decrease in colorectal cancers. But just eating fruits alone or just vegetables alone didn't do it.  Proving again, the entire dietary pattern is important.

         A Mediterranean Diet score of 6-9 led to an 11% decrease risk of colorectal cancer!

         If you eat a lot of red meat but eat a lot of vegetables, your risk of colon cancer decreases.

         Breast Cancer and the Mediterranean Diet

         The  Mediterranean Diet was found to protect against breast cancer. In addition, it improved overall survival of those who developed breast cancer.

         Alcohol consumption increases the risk of breast cancer. While the Mediterranean Diet is a low in alcohol consumption, it is still a factor.  Thankfully, coffee consumption is protective against breast cancer. Of interest, sugar-sweetened and artificially sweetened beverages were not associated with an increase in breast cancer.

         Lung Cancer and the Mediterranean Diet

         Whole grains, fruits, and vegetables were associated with less risk of lung cancer.  Smokers decreased their risk of breast cancer with increasing vegetable consumption. Lung cancer even decreased with higher consumption of apples and pears.

         There was no association with meat or fish consumption and lung cancer.  Alcohol was also not associated with an increased risk of lung cancer.

         Other Cancers

         Adherence to the Mediterranean Diet lowers the risk of cancer, cancer recurrence, and improves survival from cancers.  The Mediterranean diet leads to a lower risk of many cancers:

         • colorectal
         • lung
         • breast
         • stomach
         • pancreas
         • prostate
         • liver
         • head and neck cancers
         
         

         Keto Diet and Cancers

         In contrast, there is not much evidence that the keto diet has a positive impact on cancers. The number of clinical studies have been small and unimpressive. While it clearly has proponents, clinical outcomes in humans are lacking.

         Conclusion

         Cancer isn't fixed from a  diet. But a healthy diet is the only empowering thing that many cancer patients have.

         Augmenting conventional treatment with a healthy Mediterranean diet provides a powerful defense against cancer.

         -----

         Produced by Simpler Media

         ]]>a24060af-bf3d-4296-bdc0-f03b9c8fdee3Fri, 26 Aug 2022 00:00:00 -070006:15falsefull1616Ancel Keys and Revisionist HistoryWas Ancel Keys responsible for the modern epidemic of obesity?

         If you have read any low carb blog lately, you would think so.

         Their revisionist history is broken down to this:

         • Ancel Keys was an influential scientist who thought fat was to blame for heart disease
         • He did a study of diet and correlated fat and heart disease in those people of the seven countries
         • But Dr. Keys left out countries that would have proven his hypothesis wrong
         • The influence of Dr. Keys work turned the US away from saturated fat and to sugar
         • Sugar causes obesity and all the lifestyle illness of the world
         • Dr. Keys brought us snackwells instead of pork rinds and we are all obese with diabetes
         
         

         You will find versions of this in blogs, books, and videos.  Low-carb bloggers plagiarize one another. Nor have they never the primary source material.

         The Mediterranean Diet Founder and the Study

         Keys is the founder of the Mediterranean Diet. He was a pioneer physiologist, one of the first to show that diet was an important component of heart disease.

         In the 1950's few considered diet an important component of heart disease.

         Rich People and Diets

         "In 1952 when Margaret and I were making surveys in Naples and then Madrid. It seemed quite clear that there was some relationship between diet and the incidence of coronary heart disease. Rich people had different diets and different blood cholesterols, and they had the only heart attacks in town. When those findings were written up and presented at a meeting in Amsterdam, some people were impressed and some didn't believe anything about it. " - Ancel Keys

         This early observation by Keys  was the impetus for  the Seven Country Study.

         That diet was responsible for heart disease was contrary to the prevailing theory: in the 1950's heart disease was hypothesized to be phenomenon of aging.  Dr. Keys meticulous research revealed the strong correlation between heart disease and a diet rich in saturated fat.

         The First Graph

         The graph below is a result of looking at macro dietary statistics of a country compared with death rates from heart disease. Keys presented this data at a WHO meeting in the early 1950's. The conclusion about fat and heart disease,  was met with a great deal of skepticism. Diet was not considered a factor in heart disease.

         While this data points to a potential cause, to examine this hypothesis one must perform a cohort study.

         Some assume that Keys collected country wide data about diet and heart disease, but he did not. Bloggers probably assume this based on this graph, as well as the name, Seven Countries Study. But the Seven Country Study was far more precise. The Study was a Cohort type study.

         Cohort Studies

         A cohort study follows subjects for a long period of time. The Seven Countries Study followed over 12,000 men for nearly 50 years.

         Following these men involved yearly physical examinations, blood work, hospital and death records, as well as very specific dietary follow up.

         Of all the factors examined, saturated fat and blood cholesterol were most correlated with  heart disease.

         One of the more common myths about the Seven Country Study was that sugar was not examined. In fact, sugar was examined as an independent dietary factor. Sugar was not an primary variable for heart disease, unless combined with saturated fat.

         Testing both low and high fat countries

         The low-carb bloggers assume that Keys only tested those countries whose diet was rich in carbs, and low in fat. Keys chose his cohorts based on different diets, from those who were low fat, to high fat. Total fat, as it turns out, was not a factor for heart disease. Greeks had 40% of their dietary calories from fat but a low heart disease rate.Most of their fat came from monounsaturated fat,  olive oil.

         The Finish Cohort

         The Finland cohort was chosen precisely because of their high fat diet:

         "Loggers’ lunches, even today, are things of wonder, unsurpassed in caloric density: Large hunks of meat are suspended in congealed fat, enveloped in a dark bread loaf fully permeated by fat. The whole – at 250 grams of fat and well over 2,000 calories – is packaged in aluminum foil and tied with a ribbon. This hefty fare is preceded by a breakfast of fish soup, containing fifty percent butter fat calories and several grams of salt. The evening meal provides the rest of the 6,000 calories the logger needs to work outdoors all day." - Henry Blackburn

         Finland had a high level of coronary heart disease. The Fins also have a very active lifestyle, which didn't prevent them from the ravages of atherosclerosis.

         Reversing the Diets - Fins to Italians

         "Though the picture in Finland confirms the major causal hypothesis about the role of dietary saturated fatty acids, a basic issue remains, as exposed in a practical dietary experiment completed some years ago. Can the picture be changed? East Finns were placed on an Italian diet and Italian farmers on a Finnish diet. As in the black and white prisoners that Keys and John Brock of Capetown studied in Southern Africa forty years before; the groups rapidly approached the blood lipid characteristics of those in the adopted eating pattern." - Henry Blackburn

         Dietary intervention, having a group of Fins eat a more Mediterranean diet, changed their lipid profile. Italians were placed on a high saturated fat diet and their blood lipid levels became worse. This was one of the first reported dietary interventions showing the benefits of the Mediterranean diet.

         The Fins remind me of the Cross-Fit types: young, seemingly healthy and eating a lot of fat. Then struck down by heart disease as a result of poor dietary choices.

         The French Paradox

         Does the French Paradox refute the work of The Seven Country Study and Dr. Keys?  The paradox is that France has a low rate of heart disease and a high consumption of saturated fat.

         The accusation that France was not included in the Seven Country Study was dismissed based upon three facts: First, France was invited to participate. They were at the initial pilot study. Second, France chose not to participate because they lacked funding. Third, later studies from France did confirm the conclusions from the Seven Country Study.

         The French Paradox makes great debate, but isn't supported by the data. Finally, the  French diet was essentially Mediterranean through the mid 1970's, not a diet high in saturated fat.

         Exclusion of other Countries

         No country was excluded from the investigation of heart disease and diet.

         The diets of the US and Finish cohorts showed there was more than just correlation between diet and heart disease.

         The other Graph

         Did Keys cherry pick the data? Knowing that countries that didn't agree with his thesis, did Keys exclude those countries?

         Here is data from 22 counties regarding diet and disease published in 1957 (reference).  Many low-carb bloggers have reproduced this graph. They conclude that Keys left out countries whose data would be contrary to his hypothesis. They also conclude that this graph, does not show correlation between fat and heart disease.  In fact, both assumptions are incorrect.

         No country was left out of the study. In fact, some cohorts were studied precisely because they had high fat diets. High fat diet combined with an active lifestyle (today we call this "metabolically healthy") did not decrease heart disease. The data from Finland showed as "metabolically healthy" as the loggers were, they suffered from an alarming rate of sudden death from cardiovascular disease.

         In Summary

         The Seven Country study WAS NOT a study of  broad dietary habits of people from those seven countries. Rather, it was a study of specific cohorts, from villages in those countries.

         Studying those cohorts involved meticulously recording their diet (even weighing portions), taking blood samples, physical examinations, and recording their lifestyle. The result was the strong correlation between saturated fat and blood cholesterol to heart disease.

         No country was excluded from involvement.

         Cohorts were chosen because they had different dietary patterns. This demonstrated the effect of diet on the heart health over time.

         Sugar was studied as an independent variable and was not found to be associated with an increased risk of heart disease. Sugar combined with saturated fat was found to be impactful.

         Food and Dietary Guidelines Don't Lead to Obesity

         In 1977 the United States guidelines for diet stated "consume only as much energy as you expend, eat more naturally occurring sugars, consume more fruits and vegetables and go easy on eggs and butter. "  The 1980 guidelines admonished people to cut down on saturated fat and sugars. Were those guidelines were followed the United States would not have an obesity epidemic.

         Low Carb bloggers plagiarize one another freely. But those bloggers clearly do not read the primary sources.

         Mediterranean Diet Today

         The diet that provides optimal cardiovascular health continues to be]]>Was Ancel Keys responsible for the modern epidemic of obesity?

         If you have read any low carb blog lately, you would think so.

         Their revisionist history is broken down to this:

         • Ancel Keys was an influential scientist who thought fat was to blame for heart disease
         • He did a study of diet and correlated fat and heart disease in those people of the seven countries
         • But Dr. Keys left out countries that would have proven his hypothesis wrong
         • The influence of Dr. Keys work turned the US away from saturated fat and to sugar
         • Sugar causes obesity and all the lifestyle illness of the world
         • Dr. Keys brought us snackwells instead of pork rinds and we are all obese with diabetes
         
         

         You will find versions of this in blogs, books, and videos.  Low-carb bloggers plagiarize one another. Nor have they never the primary source material.

         The Mediterranean Diet Founder and the Study

         Keys is the founder of the Mediterranean Diet. He was a pioneer physiologist, one of the first to show that diet was an important component of heart disease.

         In the 1950's few considered diet an important component of heart disease.

         Rich People and Diets

         "In 1952 when Margaret and I were making surveys in Naples and then Madrid. It seemed quite clear that there was some relationship between diet and the incidence of coronary heart disease. Rich people had different diets and different blood cholesterols, and they had the only heart attacks in town. When those findings were written up and presented at a meeting in Amsterdam, some people were impressed and some didn't believe anything about it. " - Ancel Keys

         This early observation by Keys  was the impetus for  the Seven Country Study.

         That diet was responsible for heart disease was contrary to the prevailing theory: in the 1950's heart disease was hypothesized to be phenomenon of aging.  Dr. Keys meticulous research revealed the strong correlation between heart disease and a diet rich in saturated fat.

         The First Graph

         The graph below is a result of looking at macro dietary statistics of a country compared with death rates from heart disease. Keys presented this data at a WHO meeting in the early 1950's. The conclusion about fat and heart disease,  was met with a great deal of skepticism. Diet was not considered a factor in heart disease.

         While this data points to a potential cause, to examine this hypothesis one must perform a cohort study.

         Some assume that Keys collected country wide data about diet and heart disease, but he did not. Bloggers probably assume this based on this graph, as well as the name, Seven Countries Study. But the Seven Country Study was far more precise. The Study was a Cohort type study.

         Cohort Studies

         A cohort study follows subjects for a long period of time. The Seven Countries Study followed over 12,000 men for nearly 50 years.

         Following these men involved yearly physical examinations, blood work, hospital and death records, as well as very specific dietary follow up.

         Of all the factors examined, saturated fat and blood cholesterol were most correlated with  heart disease.

         One of the more common myths about the Seven Country Study was that sugar was not examined. In fact, sugar was examined as an independent dietary factor. Sugar was not an primary variable for heart disease, unless combined with saturated fat.

         Testing both low and high fat countries

         The low-carb bloggers assume that Keys only tested those countries whose diet was rich in carbs, and low in fat. Keys chose his cohorts based on different diets, from those who were low fat, to high fat. Total fat, as it turns out, was not a factor for heart disease. Greeks had 40% of their dietary calories from fat but a low heart disease rate.Most of their fat came from monounsaturated fat,  olive oil.

         The Finish Cohort

         The Finland cohort was chosen precisely because of their high fat diet:

         "Loggers’ lunches, even today, are things of wonder, unsurpassed in caloric density: Large hunks of meat are suspended in congealed fat, enveloped in a dark bread loaf fully permeated by fat. The whole – at 250 grams of fat and well over 2,000 calories – is packaged in aluminum foil and tied with a ribbon. This hefty fare is preceded by a breakfast of fish soup, containing fifty percent butter fat calories and several grams of salt. The evening meal provides the rest of the 6,000 calories the logger needs to work outdoors all day." - Henry Blackburn

         Finland had a high level of coronary heart disease. The Fins also have a very active lifestyle, which didn't prevent them from the ravages of atherosclerosis.

         Reversing the Diets - Fins to Italians

         "Though the picture in Finland confirms the major causal hypothesis about the role of dietary saturated fatty acids, a basic issue remains, as exposed in a practical dietary experiment completed some years ago. Can the picture be changed? East Finns were placed on an Italian diet and Italian farmers on a Finnish diet. As in the black and white prisoners that Keys and John Brock of Capetown studied in Southern Africa forty years before; the groups rapidly approached the blood lipid characteristics of those in the adopted eating pattern." - Henry Blackburn

         Dietary intervention, having a group of Fins eat a more Mediterranean diet, changed their lipid profile. Italians were placed on a high saturated fat diet and their blood lipid levels became worse. This was one of the first reported dietary interventions showing the benefits of the Mediterranean diet.

         The Fins remind me of the Cross-Fit types: young, seemingly healthy and eating a lot of fat. Then struck down by heart disease as a result of poor dietary choices.

         The French Paradox

         Does the French Paradox refute the work of The Seven Country Study and Dr. Keys?  The paradox is that France has a low rate of heart disease and a high consumption of saturated fat.

         The accusation that France was not included in the Seven Country Study was dismissed based upon three facts: First, France was invited to participate. They were at the initial pilot study. Second, France chose not to participate because they lacked funding. Third, later studies from France did confirm the conclusions from the Seven Country Study.

         The French Paradox makes great debate, but isn't supported by the data. Finally, the  French diet was essentially Mediterranean through the mid 1970's, not a diet high in saturated fat.

         Exclusion of other Countries

         No country was excluded from the investigation of heart disease and diet.

         The diets of the US and Finish cohorts showed there was more than just correlation between diet and heart disease.

         The other Graph

         Did Keys cherry pick the data? Knowing that countries that didn't agree with his thesis, did Keys exclude those countries?

         Here is data from 22 counties regarding diet and disease published in 1957 (reference).  Many low-carb bloggers have reproduced this graph. They conclude that Keys left out countries whose data would be contrary to his hypothesis. They also conclude that this graph, does not show correlation between fat and heart disease.  In fact, both assumptions are incorrect.

         No country was left out of the study. In fact, some cohorts were studied precisely because they had high fat diets. High fat diet combined with an active lifestyle (today we call this "metabolically healthy") did not decrease heart disease. The data from Finland showed as "metabolically healthy" as the loggers were, they suffered from an alarming rate of sudden death from cardiovascular disease.

         In Summary

         The Seven Country study WAS NOT a study of  broad dietary habits of people from those seven countries. Rather, it was a study of specific cohorts, from villages in those countries.

         Studying those cohorts involved meticulously recording their diet (even weighing portions), taking blood samples, physical examinations, and recording their lifestyle. The result was the strong correlation between saturated fat and blood cholesterol to heart disease.

         No country was excluded from involvement.

         Cohorts were chosen because they had different dietary patterns. This demonstrated the effect of diet on the heart health over time.

         Sugar was studied as an independent variable and was not found to be associated with an increased risk of heart disease. Sugar combined with saturated fat was found to be impactful.

         Food and Dietary Guidelines Don't Lead to Obesity

         In 1977 the United States guidelines for diet stated "consume only as much energy as you expend, eat more naturally occurring sugars, consume more fruits and vegetables and go easy on eggs and butter. "  The 1980 guidelines admonished people to cut down on saturated fat and sugars. Were those guidelines were followed the United States would not have an obesity epidemic.

         Low Carb bloggers plagiarize one another freely. But those bloggers clearly do not read the primary sources.

         Mediterranean Diet Today

         The diet that provides optimal cardiovascular health continues to be optimized .

         The Mediterranean Diet has over 13,000 publications about it in the last decade. It is consistently rated as the number one diet in surveys of physicians, nutrition scientists, and dieticians.

         Since the Seven Country study, multiple other studies of the Mediterranean diet have been reported showing:

         • Decrease incidence of cancer
         • Decrease incidence of second heart attacks
         • Reduced incidence of Cognitive decline (dementia)
         • Most anti-inflammatory diet
         
         

         Keys was not responsible for the modern epidemic of metabolic syndrome, insulin resistance, diabetes, obesity and heart disease. But The Mediterranean diet might just prove a path away from it.

         ]]>83f42ab8-a543-4aa2-8e5d-9c2cec436b54Fri, 19 Aug 2022 00:00:00 -070009:33falsefull1515The Modern Mediterranean DietScientists and dieticians consistently  rank The Modern Mediterranean Diet (MED diet) as the diet most recommended.  But often people don't know what the MED diet is. This post will  define the Med diet.

         Critics of the Med Diet

         Critics  argue that there is no uniform MED diet. They make these assertions based on one of these three arguments:

         1. That there is no uniform diet of the Mediterranean Region. There are over 20 countries on the 26,000 miles of coastline of the Mediterranean Sea. Each country with their own unique diets. Many of which have adopted a more modern American style diet.
         2. The diet is simply made up and therefore should be ignored.
         3. Finally some point out that there are many Med Diets as the literature.
         
         

         
         

         Heart disease and Diet

         Ancel Keys is the scientist most responsible for not only the Med diet but the relationship of heart disease to diet. In the 1950's, heart disease was thought to be a disease of aging, and smoking but not diet or lifestyle.

         In the 1950's, much like today, heart disease was the number one cause of death among of middle aged executives. While there was a clear association between smoking and heart disease, there were far more deaths than could be explained from smoking.  Then an Italian scientist told Dr. Keys about the low incidence of cardiovascular deaths of men in Naples.

         Heart Disease and Diet in Europe

         Keys confirmed this claim when he took a sabbatical in Oxford in 1952.  Keys found there was a difference of heart disease between the poor and the executives of Italy. He developed the hypothesis that diet might explain difference  between the two groups.  To confirm this Keys, and his wife, then traveled throughout Europe catalog different diets and rates of heart disease.

         In 1955 Keys presented his data to the World Health Organization, concluding  that diet played a significant role in heart disease.  Many members of the WHO mocked his  "diet-heart theory."  Keys then organized the seven countries study (click here).

         Seven Countries Study

         The seven countries study was an observational study looking at biomarkers, lifestyles and their relationship to heart disease.  Those countries were Greece, Italy, former Yugoslavia, Finland, The Netherlands, Japan, and the United States. The cohorts were chosen because of diverse diets, lifestyle, and risk factors. Dietary and lifestyle influence on cardiovascular disease was unknown at the time.

         The seven country study was to answer the question about dietary influence and heart disease.

         The French Paradox

         Low-carb bloggers accuse the seven country study of leaving out France. They cite the French Paradox, that the French eat a diet high in saturated fat but have a low incidence of heart disease.

         However, France was not left out of the study.  French investigators were present at the original pilot study in Nicotera Italy, but ultimately decided not to participate in the study.  France was recovering from World War 2 and simply didn't have the resources to commit to such a study.

         In fact, The French Paradox was "coined" in the 1980s, over twenty years after the  start of the seven country study. The investigators didn't have access to that data, or the term. Low-carb bloggers  didn't read the seven country study or the French paradox.

         French Paradox Explained

         Two factors explain the French Paradox.

         The high fat diet was not widely adopted by the French prior to the mid 1970's. It  takes time for a  habit to have an effect on cardiovascular disease. For example, one doesn't develop heart disease after the first cigarette. The primary French diet in the 1950's through 70's was a Mediterranean Diet.  Thus, the effect of the high fat diet would not be evident for twenty plus years after it was adopted.

         The second explanation is that French physicians consistently underreported heart disease. Of note, Wine consumption has been the most studied aspect of the French Paradox. Red wine sales increased dramatically after the airing of the "French Paradox" on Sixty Minutes.  Wine is an important component of the Med diet.

         Seven Country Study and The Med Diet

         From 1958 to 1970  over 12,000 men were tracked for diet, weight, smoking, physical activity, vital signs, cholesterol, and lung capacity. During that time there were about 2300 deaths, 27% from heart disease. Different countries had different rates of deaths from heart disease: USA 50%, Northern Europe 40%, Southern Europe 17%, Japan 5%.  The dietary pattern that was identified in this study became the basis of what Keys would call The Mediterranean Diet. Key's book became a bestseller, describing not only the first version of the Mediterranean Diet, but providing healthy recipes for a country trying to fight the number one killer. Keys even wrote a best selling cookbook with his wife touting the benefit of the diet.

         Adopting the Mediterranean Diet

         Keys died shortly before his 101'st birthday. There are a number of great articles written about Keys, but the obituary here is one of the finest.

         The Nine Point Scale

         The first scoring system for the Med diet was proposed in 1995 (here). Other studies began to arise to determine the Med diet for cancer, autoimmune diseases, longevity, dementia, and other disease states.

         One of the more famous was a meta analysis of twelve studies looking at longevity. Greater adherence in this scale also showed lower incidence of Parkinson's disease, Alzheimer's disease as well as cardiovascular mortality.

         This scale gave points for increased consumption of vegetables, fruits, legumes, cereals, fish, and moderate red wine consumption. While those who had "above the median" of red and processed meats and dairy were given zero points. Ultimately this was refined further with the use of monounsaturated fatty acids (olive oil) as the primary fat (60% or greater).

         EPIC Study

         Trichopoulou, and her colleagues began the European Prospective Investigation into Cancer and Nutrition (EPIC) study in 1994 after the pilot study in 1991. The study enrolled more than 521,000 participants from 23 centers in 10 western European countries, detailing diet, lifestyle, medical history, and vital signs.

         They used a validated food frequency questionnaire of over 150 foods commonly consumed in Greece. "For this analysis, we focused on nine nutritional variables: vegetables, legumes, fruits and nuts, dairy products, cereals, meat and meat products, fish and seafood, monounsaturated to saturated lipid ratio, and ethanol." (11).

         Conclusions of the EPIC study

         A two point increase in the Mediterranean diet score  led to a decrease in mortality of 14%.

         Diet Pyramids

         Diet pyramids were common in the 1990's . One of the more famous was from Oldways where they developed a pyramid in 1994 to describe the Mediterranean Diet. (12). This pyramid was based primarily on the diet from the Island of Crete and southern Italy from the 1960's.

         Diet pyramids are of little use in scientific studies, as they don't quantify the amounts of foods consumed. Some argue that diet pyramids are a useful way to display the data.

         Lyon Heart Study

         The Lyon heart study was a randomized secondary trial testing the Mediterranean Diet against the French Prudent diet. After 46 months there were 1.24 per one hundred patients who had either a cardiac death or nonfatal infarction. This compared to 4.07 per one hundred who had the standard cardiac diet. They also noted that most patients, after a few years, were still following the Mediterranean Diet, showing that adoption and compliance was not difficult.

         Obesity and the Mediterranean Diet

         The Mediterranean Diet is useful not only for disease, but for weight management. The latest drugs for obesity are GLP-1 agonists (Wegovy, Ozempic) there is a clear benefit from polyunsaturated fatty acids (PUFA) and raising GLP-1. While obese patients have lower GLP-1 response to glucose than non-obese, the PUFAs in the Mediterranean diet provide an increase in GLP-1.

         Further the polyphenolic compounds of the Mediterranean Diet provide another benefit. People with the highest intake of polyphenols (especially the flavonoids) were associated with...]]>Scientists and dieticians consistently  rank The Modern Mediterranean Diet (MED diet) as the diet most recommended.  But often people don't know what the MED diet is. This post will  define the Med diet.

         Critics of the Med Diet

         Critics  argue that there is no uniform MED diet. They make these assertions based on one of these three arguments:

         1. That there is no uniform diet of the Mediterranean Region. There are over 20 countries on the 26,000 miles of coastline of the Mediterranean Sea. Each country with their own unique diets. Many of which have adopted a more modern American style diet.
         2. The diet is simply made up and therefore should be ignored.
         3. Finally some point out that there are many Med Diets as the literature.
         
         

         
         

         Heart disease and Diet

         Ancel Keys is the scientist most responsible for not only the Med diet but the relationship of heart disease to diet. In the 1950's, heart disease was thought to be a disease of aging, and smoking but not diet or lifestyle.

         In the 1950's, much like today, heart disease was the number one cause of death among of middle aged executives. While there was a clear association between smoking and heart disease, there were far more deaths than could be explained from smoking.  Then an Italian scientist told Dr. Keys about the low incidence of cardiovascular deaths of men in Naples.

         Heart Disease and Diet in Europe

         Keys confirmed this claim when he took a sabbatical in Oxford in 1952.  Keys found there was a difference of heart disease between the poor and the executives of Italy. He developed the hypothesis that diet might explain difference  between the two groups.  To confirm this Keys, and his wife, then traveled throughout Europe catalog different diets and rates of heart disease.

         In 1955 Keys presented his data to the World Health Organization, concluding  that diet played a significant role in heart disease.  Many members of the WHO mocked his  "diet-heart theory."  Keys then organized the seven countries study (click here).

         Seven Countries Study

         The seven countries study was an observational study looking at biomarkers, lifestyles and their relationship to heart disease.  Those countries were Greece, Italy, former Yugoslavia, Finland, The Netherlands, Japan, and the United States. The cohorts were chosen because of diverse diets, lifestyle, and risk factors. Dietary and lifestyle influence on cardiovascular disease was unknown at the time.

         The seven country study was to answer the question about dietary influence and heart disease.

         The French Paradox

         Low-carb bloggers accuse the seven country study of leaving out France. They cite the French Paradox, that the French eat a diet high in saturated fat but have a low incidence of heart disease.

         However, France was not left out of the study.  French investigators were present at the original pilot study in Nicotera Italy, but ultimately decided not to participate in the study.  France was recovering from World War 2 and simply didn't have the resources to commit to such a study.

         In fact, The French Paradox was "coined" in the 1980s, over twenty years after the  start of the seven country study. The investigators didn't have access to that data, or the term. Low-carb bloggers  didn't read the seven country study or the French paradox.

         French Paradox Explained

         Two factors explain the French Paradox.

         The high fat diet was not widely adopted by the French prior to the mid 1970's. It  takes time for a  habit to have an effect on cardiovascular disease. For example, one doesn't develop heart disease after the first cigarette. The primary French diet in the 1950's through 70's was a Mediterranean Diet.  Thus, the effect of the high fat diet would not be evident for twenty plus years after it was adopted.

         The second explanation is that French physicians consistently underreported heart disease. Of note, Wine consumption has been the most studied aspect of the French Paradox. Red wine sales increased dramatically after the airing of the "French Paradox" on Sixty Minutes.  Wine is an important component of the Med diet.

         Seven Country Study and The Med Diet

         From 1958 to 1970  over 12,000 men were tracked for diet, weight, smoking, physical activity, vital signs, cholesterol, and lung capacity. During that time there were about 2300 deaths, 27% from heart disease. Different countries had different rates of deaths from heart disease: USA 50%, Northern Europe 40%, Southern Europe 17%, Japan 5%.  The dietary pattern that was identified in this study became the basis of what Keys would call The Mediterranean Diet. Key's book became a bestseller, describing not only the first version of the Mediterranean Diet, but providing healthy recipes for a country trying to fight the number one killer. Keys even wrote a best selling cookbook with his wife touting the benefit of the diet.

         Adopting the Mediterranean Diet

         Keys died shortly before his 101'st birthday. There are a number of great articles written about Keys, but the obituary here is one of the finest.

         The Nine Point Scale

         The first scoring system for the Med diet was proposed in 1995 (here). Other studies began to arise to determine the Med diet for cancer, autoimmune diseases, longevity, dementia, and other disease states.

         One of the more famous was a meta analysis of twelve studies looking at longevity. Greater adherence in this scale also showed lower incidence of Parkinson's disease, Alzheimer's disease as well as cardiovascular mortality.

         This scale gave points for increased consumption of vegetables, fruits, legumes, cereals, fish, and moderate red wine consumption. While those who had "above the median" of red and processed meats and dairy were given zero points. Ultimately this was refined further with the use of monounsaturated fatty acids (olive oil) as the primary fat (60% or greater).

         EPIC Study

         Trichopoulou, and her colleagues began the European Prospective Investigation into Cancer and Nutrition (EPIC) study in 1994 after the pilot study in 1991. The study enrolled more than 521,000 participants from 23 centers in 10 western European countries, detailing diet, lifestyle, medical history, and vital signs.

         They used a validated food frequency questionnaire of over 150 foods commonly consumed in Greece. "For this analysis, we focused on nine nutritional variables: vegetables, legumes, fruits and nuts, dairy products, cereals, meat and meat products, fish and seafood, monounsaturated to saturated lipid ratio, and ethanol." (11).

         Conclusions of the EPIC study

         A two point increase in the Mediterranean diet score  led to a decrease in mortality of 14%.

         Diet Pyramids

         Diet pyramids were common in the 1990's . One of the more famous was from Oldways where they developed a pyramid in 1994 to describe the Mediterranean Diet. (12). This pyramid was based primarily on the diet from the Island of Crete and southern Italy from the 1960's.

         Diet pyramids are of little use in scientific studies, as they don't quantify the amounts of foods consumed. Some argue that diet pyramids are a useful way to display the data.

         Lyon Heart Study

         The Lyon heart study was a randomized secondary trial testing the Mediterranean Diet against the French Prudent diet. After 46 months there were 1.24 per one hundred patients who had either a cardiac death or nonfatal infarction. This compared to 4.07 per one hundred who had the standard cardiac diet. They also noted that most patients, after a few years, were still following the Mediterranean Diet, showing that adoption and compliance was not difficult.

         Obesity and the Mediterranean Diet

         The Mediterranean Diet is useful not only for disease, but for weight management. The latest drugs for obesity are GLP-1 agonists (Wegovy, Ozempic) there is a clear benefit from polyunsaturated fatty acids (PUFA) and raising GLP-1. While obese patients have lower GLP-1 response to glucose than non-obese, the PUFAs in the Mediterranean diet provide an increase in GLP-1.

         Further the polyphenolic compounds of the Mediterranean Diet provide another benefit. People with the highest intake of polyphenols (especially the flavonoids) were associated with an 11 percent decrease risk of developing type 2 Diabetes.

         Finally the antioxidant rich Mediterranean Diet has been seen as a potent tool against the inflammatory cascade seen in obese patients.

         Closer adherence to the Mediterranean Diet has been shown to have decreased rates of obesity, as well as better lipid profiles.

         Weight Loss Surgery Patients

         We took over 180 patients who had various forms of weight loss surgery and calculated their Mediterranean Diet Score. We then compared those scores to their postoperative weight loss after five years. Those patients who had a score of 5 or more all were in the greater than 50% of weight loss regardless of the type of weight loss surgery. Those patients who had a score of 0-3 were in the lowest quarter of weight loss or even weight regain. The score of 4 seemed to be all over the scale.

         Type 2 Diabetes Mellitus and the Mediterranean Diet

         The Mediterranean Diet has been found to both decrease the risk of type 2 Diabetes, but a potent reversal of type 2 diabetes. This occurs through lifestyle intervention, and has been found best for long term weight loss.

         Current Adoption of the Mediterranean Diet

         Click the link below to see the modern Med Diet score card.

         MedDietScoreCard

         Most papers have discussed the 9 point system and this is consistent throughout the literature in the last fifteen years. The scoring is reasonably simple,  or can be completed through a validated food frequency questionnaire.

         The Mediterranean Diet continues to be the most studied diet on the planet, with the most reproducible results for chronic diseases from obesity, diabetes, heart disease, dementia and autoimmune diseases.

         Closer adherence to the Mediterranean Diet is associated with longevity.

          

         
         

         REFERENCES:

         1. My podcast and writing about The Mediterranean Diet: https://www.yourdoctorsorders.com/2018/09/the-mediterranean-diet/
         2. https://www.sevencountriesstudy.com/about-the-study/history/
         3. Keys A, Aravanis C, Blackburn HW, Van Buchem FS, Buzina R,
         4. Djordjević BD, Dontas AS, Fidanza F, Karvonen MJ, Kimura N, Lekos D,
         5. Monti M, Puddu V, Taylor HL. Epidemiological studies related to coronary
         6. heart disease: characteristics of men aged 40-59 in seven countries.
         7. Acta Med Scand Suppl. 1966;460:1-392. PMID: 5226858.
         8. Renaud S, de Lorgeril M. Wine, alcohol, platelets, and the French
         9. paradox for coronary heart disease. Lancet. 1992 Jun
         10. 20;339(8808):1523-6. doi: 10.1016/0140-6736(92)91277-f. PMID: 1351198.
         11. Burr ML. Explaining the French paradox. J R Soc Health. 1995 Aug;115(4):217-9. doi: 10.1177/146642409511500404. PMID: 7562866.
         12. Iwasaki M, Murakami M, Ijiri Y, Shimizu M, Yamamoto J. Are all wines
         13. made from various grape varieties beneficial in the prevention of
         14. myocardial infarction and stroke? Future Sci OA. 2020 Nov 9;7(2):FSO649.
         15. doi: 10.2144/fsoa-2020-0098. PMID: 33437515; PMCID: PMC7787155.
         16. Keys, Margaret, and Keys, Ancel. Eat Well & Stay Well. United Kingdom, Doubleday, 1959. Revised 1963.
         17. Aboul-Enein BH, Puddy WC, Bernstein J. Ancel Benjamin Keys
         18. (1904-2004): His early works and the legacy of the modern Mediterranean
         19. diet. J Med Biogr. 2020 Aug;28(3):139-147. doi:
         20. 10.1177/0967772017727696. Epub 2017 Nov 14. PMID: 29134858.
         21. Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou
         22. P, Polychronopoulos E, Vassilakou T, Lipworth L, Trichopoulos D. Diet
         23. and overall survival in elderly people. BMJ. 1995 Dec
         24. 2;311(7018):1457-60. doi: 10.1136/bmj.311.7018.1457. PMID: 8520331;
         25. PMCID: PMC2543726.
         26. Trichopoulou A, Bamia C, Trichopoulos D. Anatomy of health effects
         27. of Mediterranean diet: Greek EPIC prospective cohort study. BMJ. 2009
         28. Jun 23;338:b2337. doi: 10.1136/bmj.b2337. PMID: 19549997; PMCID:
         29. PMC3272659.000
         30. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to
         31. Mediterranean diet and health status: meta-analysis. BMJ. 2008 Sep
         32. 11;337:a1344. doi: 10.1136/bmj.a1344. PMID: 18786971; PMCID: PMC2533524.
         33. Trichopoulou A, Bamia C, Trichopoulos D. Anatomy of health effects
         34. of Mediterranean diet: Greek EPIC prospective cohort study. BMJ. 2009
         35. Jun 23;338:b2337. doi: 10.1136/bmj.b2337. PMID: 19549997; PMCID:
         36. PMC3272659.
         37. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A,
         38. Helsing E, Trichopoulos D. Mediterranean diet pyramid: a cultural model
         39. for healthy eating. Am J Clin Nutr. 1995 Jun;61(6 Suppl):1402S-1406S.
         40. doi: 10.1093/ajcn/61.6.1402S. PMID: 7754995.
         41. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N.
         42. Mediterranean diet, traditional risk factors, and the rate of
         43. cardiovascular complications after myocardial infarction: final report
         44. of the Lyon Diet Heart Study. Circulation. 1999 Feb 16;99(6):779-85.
         45. doi: 10.1161/01.cir.99.6.779. PMID: 9989963.
         46. Gioia C, Lucchino B, Tarsitano MG, Iannuccelli C, Di Franco M.
         47. Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence
         48. Disease Development and Clinical Manifestations? Nutrients. 2020 May
         49. 18;12(5):1456. doi: 10.3390/nu12051456. PMID: 32443535; PMCID:
         50. PMC7284442.
         51. Petersson SD, Philippou E. Mediterranean Diet, Cognitive Function,
         52. and Dementia: A Systematic Review of the Evidence. Adv Nutr. 2016 Sep
         53. 15;7(5):889-904. doi: 10.3945/an.116.012138. PMID: 27633105; PMCID:
         54. PMC5015034.
         55. Martín-Peláez S, Fito M, Castaner O. Mediterranean Diet Effects on
         56. Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms.
         57. A Review. Nutrients. 2020 Jul 27;12(8):2236. doi: 10.3390/nu12082236.
         58. PMID: 32726990; PMCID: PMC7468821.
         59. Schellenberg ES, Dryden DM, Vandermeer B, Ha C, Korownyk C.
         60. Lifestyle interventions for patients with and at risk for type 2
         61. diabetes: a systematic review and meta-analysis. Ann Intern Med. 2013
         62. Oct 15;159(8):543-51. doi: 10.7326/0003-4819-159-8-201310150-00007.
         63. PMID: 24126648.
         64. Mancini JG, Filion KB, Atallah R, Eisenberg MJ. Systematic Review of
         65. the Mediterranean Diet for Long-Term Weight Loss. Am J Med. 2016
         66. Apr;129(4):407-415.e4. doi: 10.1016/j.amjmed.2015.11.028. Epub 2015 Dec
         67. 22. PMID: 26721635.
         68. Romagnolo DF, Selmin OI. Mediterranean Diet and Prevention of
         69. Chronic Diseases. Nutr Today. 2017 Sep;52(5):208-222. doi:
         70. 10.1097/NT.0000000000000228. Epub 2017 Aug 15. PMID: 29051674; PMCID:
         71. PMC5625964.
         72. Álvarez-Álvarez I, Martínez-González MÁ, Sánchez-Tainta A, Corella
         73. D, Díaz-López A, Fitó M, Vioque J, Romaguera D, Martínez JA, Wärnberg J,
         74. López-Miranda J, Estruch R, Bueno-Cavanillas A, Arós F, Tur JA,
         75. Tinahones FJ, Serra-Majem L, Martín V, Lapetra J, Más Fontao S, Pintó X,
         76. Vidal J, Daimiel L, Gaforio JJ, Matía P, Ros E, Ruiz-Canela M, Sorlí
         77. JV, Becerra-Tomás N, Castañer O, Schröder H, Navarrete-Muñoz EM, Zulet
         78. MÁ, García-Ríos A, Salas-Salvadó J, Díez-Espino J, Toledo E. Adherence
         79. to an Energy-restricted Mediterranean Diet Score and Prevalence of
         80. Cardiovascular Risk Factors in the PREDIMED-Plus: A Cross-sectional
         81. Study. Rev Esp Cardiol (Engl Ed). 2019 Nov;72(11):925-934. English,
         82. Spanish. doi: 10.1016/j.rec.2018.08.010. Epub 2018 Oct 2. PMID:
         83. 30287240.
         
         

         
         

         ]]>b1fb2103-a62b-4265-be43-7846e68f7cb6Thu, 04 Aug 2022 00:00:00 -070009:11falsefull1414Continuous Blood Glucose Monitors for Non-DiabeticsIf you don’t have diabetes, should you even consider a blood glucose monitor? Well, here is the science behind this new tiktok trend and why these Continuous Blood Glucose Monitors (CGM) are here to stay and what we know about them.

         The device

         First, the device – a continuous blood glucose monitor is a device that you place on your body and it measures the blood glucose level and reports that data typically to an application on your phone. The first blood glucose monitors were used to help patients with type 1 diabetes regulate their blood sugar. They were revolutionary, but expensive, not covered by many insurance companies, and cumbersome. As the technology has improved, the price has decreased, the comfort level has improved, and the accuracy of the monitoring has improved. As with most technology, blood glucose monitors are now less expensive, better, and widely available.

         You can read more about the history of the blood glucose monitor here.

         Most diabetics use a fingerstick to see what their blood glucose is, and use that information to determine the medicine they need to help regulate their blood glucose. The CGM allows real-time data which can be checked against food logs to allow a person to see impact of their diet on their regulation of food. As the epidemic of diabetes grows, about 55 million predicted with diabetes by 2030, we know that the less variability in glucose, the better long-term outcome (reference here) and here.

         Variability in blood glucose with non-diabetics

         It turns out that even people who are not diabetic, have wide variations of blood glucose (reference here). Further, the variations in blood glucose have real time effects and we should care about those effects.  For example, high glucose spikes lead to inflammation of the arteries, even in non-diabetics, which lead to atherosclerosis, heart disease, strokes and peripheral vascular disease (click here). A study published in Journal of the American Medical Association (here) concluded “Providing individuals with tools to manage their glycemic responses to food based on personalized predictions of their PPGRs may allow them to maintain their blood glucose levels within limits associated with good health.”

         What is best?

         Avoiding the large variability in blood glucose is clearly important to health whether one has diabetes or not. Trying to predict what variability will be based on fasting blood glucose or hemoglobin A1C cannot be done.

         Using a healthy diet like the Mediterranean or DASH diet – this has been found in studies with CGM on young people with type 1 diabetes (reference ) 

         Even variations of the Mediterranean Diet and CGM have found improvement in glucose variability.

         Economies of Scale

         Continuous Glucose monitors are getting less expensive, more accurate, and more comfortable to wear. This is good news for patients who have diabetes, and as demand raises among all to use these tools the price will drop further. The economies of scale work with medical devices. Consider the pulse oximeter that you can purchase from a local pharmacy for $25 – they used to cost over $900 and were used to manage patients with lung disease. Now, for less than a copay, you can have one of these devices and they not only help manage patients with lung disease, but also keep people with COVID out of the hospital when they are doing well, or provide a warning to get patients into the hospital.

         The original pulse oximeters were large, expensive and cumbersome. The modern pulse oximeter is available at any pharmacy for $25.

         These are another tool in our toolbox.

         Disclosure: I received a continuous glucose monitor from Nutrisense. They do not manufacture the device but provide the device as a part of the service with registered dietitians to help people navigate what the data means. They have a subscription model which may, or may not be good for you.

         ]]>If you don’t have diabetes, should you even consider a blood glucose monitor? Well, here is the science behind this new tiktok trend and why these Continuous Blood Glucose Monitors (CGM) are here to stay and what we know about them.

         The device

         First, the device – a continuous blood glucose monitor is a device that you place on your body and it measures the blood glucose level and reports that data typically to an application on your phone. The first blood glucose monitors were used to help patients with type 1 diabetes regulate their blood sugar. They were revolutionary, but expensive, not covered by many insurance companies, and cumbersome. As the technology has improved, the price has decreased, the comfort level has improved, and the accuracy of the monitoring has improved. As with most technology, blood glucose monitors are now less expensive, better, and widely available.

         You can read more about the history of the blood glucose monitor here.

         Most diabetics use a fingerstick to see what their blood glucose is, and use that information to determine the medicine they need to help regulate their blood glucose. The CGM allows real-time data which can be checked against food logs to allow a person to see impact of their diet on their regulation of food. As the epidemic of diabetes grows, about 55 million predicted with diabetes by 2030, we know that the less variability in glucose, the better long-term outcome (reference here) and here.

         Variability in blood glucose with non-diabetics

         It turns out that even people who are not diabetic, have wide variations of blood glucose (reference here). Further, the variations in blood glucose have real time effects and we should care about those effects.  For example, high glucose spikes lead to inflammation of the arteries, even in non-diabetics, which lead to atherosclerosis, heart disease, strokes and peripheral vascular disease (click here). A study published in Journal of the American Medical Association (here) concluded “Providing individuals with tools to manage their glycemic responses to food based on personalized predictions of their PPGRs may allow them to maintain their blood glucose levels within limits associated with good health.”

         What is best?

         Avoiding the large variability in blood glucose is clearly important to health whether one has diabetes or not. Trying to predict what variability will be based on fasting blood glucose or hemoglobin A1C cannot be done.

         Using a healthy diet like the Mediterranean or DASH diet – this has been found in studies with CGM on young people with type 1 diabetes (reference ) 

         Even variations of the Mediterranean Diet and CGM have found improvement in glucose variability.

         Economies of Scale

         Continuous Glucose monitors are getting less expensive, more accurate, and more comfortable to wear. This is good news for patients who have diabetes, and as demand raises among all to use these tools the price will drop further. The economies of scale work with medical devices. Consider the pulse oximeter that you can purchase from a local pharmacy for $25 – they used to cost over $900 and were used to manage patients with lung disease. Now, for less than a copay, you can have one of these devices and they not only help manage patients with lung disease, but also keep people with COVID out of the hospital when they are doing well, or provide a warning to get patients into the hospital.

         The original pulse oximeters were large, expensive and cumbersome. The modern pulse oximeter is available at any pharmacy for $25.

         These are another tool in our toolbox.

         Disclosure: I received a continuous glucose monitor from Nutrisense. They do not manufacture the device but provide the device as a part of the service with registered dietitians to help people navigate what the data means. They have a subscription model which may, or may not be good for you.

         ]]>f6ad5e9c-b3a3-44b9-a42d-6c966113c199Thu, 21 Jul 2022 00:00:00 -070005:10falsefull1313Bioidentical Hormones Cause Weight GainAbout 15 years ago physician came to me telling me that she was opening a new venture, distributing plant-based bioidentical hormones, and surgically implanting those hormones as pellets. She wanted me to send her all of my patients who presented in menopause because "with bioidentical hormones they won't need weight loss surgery." She went on to say how every woman would be tested for their hormones and then a compounding pharmacy would make up the exact hormones to replace the ones the person was not producing enough of. This would, "almost reverse aging and cause weight loss." In fact, those bioidentical hormones cause weight gain.

         Bioidentical hormones, from whatever source, cause weight gain, not weight loss (reference) . In spite of a number of "advertisement" from providers who wish to provide you with "compounded" bioidentical hormones that propose they will cause weight loss - they don't.  This physician was not an Ob-Gyn, nor was she a board certified endocrinologist, in fact her specialty was about as far from treatment of complex menopausal hormone replacement or obesity as one could imagine.

         The red flags for this clinic were (a) proposing weight loss (b) associating with a compound pharmacy (c) offering anti aging treatments (d) a provider that is not an expert in the field of endocrinology or gynecology.

         Bioidentical hormones made by any compounding pharmacies do not meet rigorous FDA standards. In fact, compounded forms of bio-identical hormones are similar to supplements, and have the same issues that supplement industries have had that we have outlined previously.

         Menopausal Hormone Replacement is Medicine, Compounded bioidentical hormones are ?

         With every scam there is a separation of the chaff from the wheat. Here is the current evidence about hormones and changes that occur as women enter menopause. Accepted sources for this information include The Menopause Society as well as The American College of Obstetrics and Gynecology.

         Women undergoing menopause they decrease their production of certain hormones. This can lead to severe symptoms of menopause that hormone replacement therapy can alleviate. Symptoms of menopause such as hot flashes, sleep disturbances, joint aches and pains, mood changes, vaginal dryness. That is undisputed and the improvement in quality of life is why many seek hormone replacement therapy. There is also potential benefit to decreasing risk of cardiovascular disease, if started within ten years of symptoms and before the age of 60 years.

         The major concern of hormone replacement therapy came from the study published in 2002, the Women’s Health Initiative, showing that hormone replacement, with the most commonly prescribed medicine, Prempro, led to an increase in heart attacks, strokes, deep venous thrombosis and pulmonary embolism as well as breast cancer.

         The concern among gynecologists led to a rapid decrease in the prescription of Prempro by nearly 70%. This also led to a decrease in the quality of life by women going through menopause. Some gynecologists and endocrinologists continued to prescribe hormone replacement therapy.

         Compound Pharmacies Filling the Gap

         Bioidentical hormones made by any compounding pharmacies do not meet rigorous FDA standards. In fact, compounded forms of bio-identical hormones are similar to supplements, and have the same issues that supplement industries have had that we have outlined previously.

         To quote from the FDA "Compounded drugs are not FDA-approved. This means that FDA does not verify the safety or effectiveness of compounded drugs. Consumers and health professionals rely on the drug approval process for verification of safety, effectiveness, and quality. Compounded drugs also lack an FDA finding of manufacturing quality before such drugs are marketed." - from June 29, 2022 (reference here)

         Throughout this blog I will be speaking of compound bioidentical hormone therapies (cBHT). There are hormone replacement pharmaceuticals that have undergone testing for toxicity, safety, efficacy and have follow up programs with the FDA to look for long-term issues, those are not cBHT. Some of those pharmaceuticals   call their products bioidentical – those are different. Unless otherwise stated, please assume that the drugs made by the compounding pharmacies do not meet quality and purity of the FDA nor do they carry the warnings. In addition, they are provided often by clinics whose physicians are not board certified in gynecology or endocrinology.

         In 2013, after a major breach in sterilization led to meningitis from spinal injections made from a compounded pharmacy, new guidelines were established for better manufacturing processes and control. This is the 503B of the Food and Drug and Cosmetic Act. Some compounding pharmacies have attempted to state these were an equivalent of FDA approved drugs, but as you can see from June of 2022 reference above, this is not the case.

         There is more than safety standards (as addressed in 503A and 503B) when dealing with drugs. What is not covered by those standards are efficacy, safety, clinical utility and follow up reporting for adverse events.

         Filling the Need for Menopausal Symptoms

         The hesitancy of some gynecologists to prescribe menopausal hormone treatment to women entering menopause greatly increased the need for women who were suffering from symptoms of menopause. To fill that role came the mass marketing of compounded “bioidentical” hormones, derived from plants.

         In 2004, Suzanne Somers published “The Sexy Years: Discover the Hormone Connection” featured on Oprah and becoming an immediate best seller. Other books written by physicians provided more fodder to the claim that these hormones were “better” than the “synthetic” hormones of “Big Pharma” and would allow women to return to their youth complete with increased libido, better skin, no vaginal dryness, and even weight loss (weight gain is a in fact common with hormone replacement even with the compounded doses ).

         The rise of “bio-identical” hormones, was complete with the inference that because these were derived from compounds in plants that they were safer. The second bit of marketing was that the provider could could tailor the amounts of these hormones to the woman’s particular needs.

         Marketing to the many women entering menopause were compounding pharmacies, which had associated with a number of “anti-aging” clinics, that had nearly been put out of business when the FDA cracked down on the cracks selling human growth hormone to people who didn’t need it. These providers with their attendant compound pharmacies were more than happy to get into the larger market of women entering menopause. Of note, many of the anti-aging clinics also sold compounded HCG for weight loss, which was also disproven to work (see here).

         There is no data that exists to show that compounded bio-identical hormones are safer. These compounds cannot be obtained by simply eating yams or fenugreek seeds, but must be extracted and undergo chemical synthesis to become biologically active in humans. When shown the chemical processes that these plant derived sterols undergo, a number of their “proponents” are shocked. Chemistry is difficult for some.

         As an aside, Diosgenin (DSG), the active plant chemical which undergoes synthesis to become an active steroid,  has its own interesting development as a sterol (found in Fenugreek seeds and wild yams) as anti-inflammatory, anti-atherogenic, and brain protective. While DSG has those interesting features, when it is chemically modified to an active estrogen like sterol those properties appear to be mostly lost.

         There are other potential risks of hormone replacement include increased risk of weight gain, increased risk of blood clots, increased risk of stroke.

         Men  - let's not forget the men

         Male  hypogonadism is another diagnosis which is treated by cBHT, often with testosterone replacement. Found in those same "anti-aging" clinics, where men are bombarded with testosterone replacement in the form of cBHT. Male hypogonadism is, like menopause, a condition which may cause men to have lower free testosterone levels that can impact libedo. And much like the over-sell of women, men are often promised weight loss, increased libedo, return of hair growth all with cBHT.

         Testosterone was the most frequently prepared compounded hormone by 503B outsourcing pharmacies. Progesterone and testosterone were the most commonly compounded as capsules and pellets

         Individualized Therapy

         Individualization comes with the provider taking a saliva sample to test for hormone levels. This adds to the allure of science. Saliva testing is NOT indicative of hormones levels in the blood, at the tissue or organ level. In fact, saliva testing is rather in exact and the amounts of hormones found in saliva vary...]]>About 15 years ago physician came to me telling me that she was opening a new venture, distributing plant-based bioidentical hormones, and surgically implanting those hormones as pellets. She wanted me to send her all of my patients who presented in menopause because "with bioidentical hormones they won't need weight loss surgery." She went on to say how every woman would be tested for their hormones and then a compounding pharmacy would make up the exact hormones to replace the ones the person was not producing enough of. This would, "almost reverse aging and cause weight loss." In fact, those bioidentical hormones cause weight gain.

         Bioidentical hormones, from whatever source, cause weight gain, not weight loss (reference) . In spite of a number of "advertisement" from providers who wish to provide you with "compounded" bioidentical hormones that propose they will cause weight loss - they don't.  This physician was not an Ob-Gyn, nor was she a board certified endocrinologist, in fact her specialty was about as far from treatment of complex menopausal hormone replacement or obesity as one could imagine.

         The red flags for this clinic were (a) proposing weight loss (b) associating with a compound pharmacy (c) offering anti aging treatments (d) a provider that is not an expert in the field of endocrinology or gynecology.

         Bioidentical hormones made by any compounding pharmacies do not meet rigorous FDA standards. In fact, compounded forms of bio-identical hormones are similar to supplements, and have the same issues that supplement industries have had that we have outlined previously.

         Menopausal Hormone Replacement is Medicine, Compounded bioidentical hormones are ?

         With every scam there is a separation of the chaff from the wheat. Here is the current evidence about hormones and changes that occur as women enter menopause. Accepted sources for this information include The Menopause Society as well as The American College of Obstetrics and Gynecology.

         Women undergoing menopause they decrease their production of certain hormones. This can lead to severe symptoms of menopause that hormone replacement therapy can alleviate. Symptoms of menopause such as hot flashes, sleep disturbances, joint aches and pains, mood changes, vaginal dryness. That is undisputed and the improvement in quality of life is why many seek hormone replacement therapy. There is also potential benefit to decreasing risk of cardiovascular disease, if started within ten years of symptoms and before the age of 60 years.

         The major concern of hormone replacement therapy came from the study published in 2002, the Women’s Health Initiative, showing that hormone replacement, with the most commonly prescribed medicine, Prempro, led to an increase in heart attacks, strokes, deep venous thrombosis and pulmonary embolism as well as breast cancer.

         The concern among gynecologists led to a rapid decrease in the prescription of Prempro by nearly 70%. This also led to a decrease in the quality of life by women going through menopause. Some gynecologists and endocrinologists continued to prescribe hormone replacement therapy.

         Compound Pharmacies Filling the Gap

         Bioidentical hormones made by any compounding pharmacies do not meet rigorous FDA standards. In fact, compounded forms of bio-identical hormones are similar to supplements, and have the same issues that supplement industries have had that we have outlined previously.

         To quote from the FDA "Compounded drugs are not FDA-approved. This means that FDA does not verify the safety or effectiveness of compounded drugs. Consumers and health professionals rely on the drug approval process for verification of safety, effectiveness, and quality. Compounded drugs also lack an FDA finding of manufacturing quality before such drugs are marketed." - from June 29, 2022 (reference here)

         Throughout this blog I will be speaking of compound bioidentical hormone therapies (cBHT). There are hormone replacement pharmaceuticals that have undergone testing for toxicity, safety, efficacy and have follow up programs with the FDA to look for long-term issues, those are not cBHT. Some of those pharmaceuticals   call their products bioidentical – those are different. Unless otherwise stated, please assume that the drugs made by the compounding pharmacies do not meet quality and purity of the FDA nor do they carry the warnings. In addition, they are provided often by clinics whose physicians are not board certified in gynecology or endocrinology.

         In 2013, after a major breach in sterilization led to meningitis from spinal injections made from a compounded pharmacy, new guidelines were established for better manufacturing processes and control. This is the 503B of the Food and Drug and Cosmetic Act. Some compounding pharmacies have attempted to state these were an equivalent of FDA approved drugs, but as you can see from June of 2022 reference above, this is not the case.

         There is more than safety standards (as addressed in 503A and 503B) when dealing with drugs. What is not covered by those standards are efficacy, safety, clinical utility and follow up reporting for adverse events.

         Filling the Need for Menopausal Symptoms

         The hesitancy of some gynecologists to prescribe menopausal hormone treatment to women entering menopause greatly increased the need for women who were suffering from symptoms of menopause. To fill that role came the mass marketing of compounded “bioidentical” hormones, derived from plants.

         In 2004, Suzanne Somers published “The Sexy Years: Discover the Hormone Connection” featured on Oprah and becoming an immediate best seller. Other books written by physicians provided more fodder to the claim that these hormones were “better” than the “synthetic” hormones of “Big Pharma” and would allow women to return to their youth complete with increased libido, better skin, no vaginal dryness, and even weight loss (weight gain is a in fact common with hormone replacement even with the compounded doses ).

         The rise of “bio-identical” hormones, was complete with the inference that because these were derived from compounds in plants that they were safer. The second bit of marketing was that the provider could could tailor the amounts of these hormones to the woman’s particular needs.

         Marketing to the many women entering menopause were compounding pharmacies, which had associated with a number of “anti-aging” clinics, that had nearly been put out of business when the FDA cracked down on the cracks selling human growth hormone to people who didn’t need it. These providers with their attendant compound pharmacies were more than happy to get into the larger market of women entering menopause. Of note, many of the anti-aging clinics also sold compounded HCG for weight loss, which was also disproven to work (see here).

         There is no data that exists to show that compounded bio-identical hormones are safer. These compounds cannot be obtained by simply eating yams or fenugreek seeds, but must be extracted and undergo chemical synthesis to become biologically active in humans. When shown the chemical processes that these plant derived sterols undergo, a number of their “proponents” are shocked. Chemistry is difficult for some.

         As an aside, Diosgenin (DSG), the active plant chemical which undergoes synthesis to become an active steroid,  has its own interesting development as a sterol (found in Fenugreek seeds and wild yams) as anti-inflammatory, anti-atherogenic, and brain protective. While DSG has those interesting features, when it is chemically modified to an active estrogen like sterol those properties appear to be mostly lost.

         There are other potential risks of hormone replacement include increased risk of weight gain, increased risk of blood clots, increased risk of stroke.

         Men  - let's not forget the men

         Male  hypogonadism is another diagnosis which is treated by cBHT, often with testosterone replacement. Found in those same "anti-aging" clinics, where men are bombarded with testosterone replacement in the form of cBHT. Male hypogonadism is, like menopause, a condition which may cause men to have lower free testosterone levels that can impact libedo. And much like the over-sell of women, men are often promised weight loss, increased libedo, return of hair growth all with cBHT.

         Testosterone was the most frequently prepared compounded hormone by 503B outsourcing pharmacies. Progesterone and testosterone were the most commonly compounded as capsules and pellets

         Individualized Therapy

         Individualization comes with the provider taking a saliva sample to test for hormone levels. This adds to the allure of science. Saliva testing is NOT indicative of hormones levels in the blood, at the tissue or organ level. In fact, saliva testing is rather in exact and the amounts of hormones found in saliva vary greatly depending on time of day, diet, and other factors.

         Individualized or personal testing sounds great. Get hormones that you need to replace the hormones that you are deficient in. There are no studies showing that one can precisely provide the replacement for hormones – this does not stop unscrupulous providers or clinics from implying and advertising such.

         Even if clinics use blood tests or other tests, there is no data that shows increased efficacy or safety of these products.

         Follow up Safety

         Boxed Warnings are found on all FDA approved prescriptions, but they are not found from the compound pharmacists. That lack of information may lead some to believe that there is a magic to the compound prescriptions, even though there is not. That black box warning is not found from compounding pharmacies – and often it is those black box warnings that bring patients back to their primary care physician to discuss those warnings.

         Proponents of these compounded ingredients often state that these ingredients are safe based upon the data from pharmaceutical grade drugs. This is a false equivalence, as different drugs, even in the same class, can have widely different safety and efficacy data, but the compound pharmacies are not collecting that data.

         Request by the FDA regarding cBHT

         The success of not only women, but men who use cBHT, the FDA requested the National Academies to assess the clinical utility of treating patients with cBHT and convened an expert committee. They issued a 311 page report in 2020 which is available online (click here).

         The National Academies consensus report concluded that there was insufficient evidence to support the overall clinical utility of cBHT in the absence of safety and effectiveness data. There is a distinct lack of reliable, non-anecdotal information supporting safety and efficacy. In addition there is a lack of well-controlled clinical trials across all cBHT hormones (estradiol, estrone, estradiol cypionate, estriol, dehydroepiandrosterone, pregnenolone, progesterone, testosterone, testosterone cypionate, testosterone propionate).

         While many facilities make the claim that these products are safer and that some preparations of estrogens, for example, cause fewer side effects than others, there is no data to substantiate that.  All that data confirms that any estrogenic material can cause serious cardiovascular and tumorigenic effects.

         Marketing Works

         The appeal of cBHT comes from direct to consumer marketing found on websites, celebrity endorsement, influencers, and televisions. Practitioners who prescribe cBHT and sell cBHT has a direct conflict of interest. What is not found in their literature, websites, or comments are the safety warnings, and sometimes even what are found is the common lie that cBHT leads to weight loss - when in fact, it leads to weight gain.

         The boutique medical appeal, the out-of-mainstream approach, combined with the lack of trust for the pharmaceutical industry and the FDA have led women and men to seek solutions that are not backed by the data. Even if these solutions cost more money than if they were to have standard pharmaceuticals which are covered by insurance.

         ]]>88cc50de-6448-4259-8a51-039e9cdf5d1fTue, 12 Jul 2022 00:00:00 -070012:55falsefull1212Vitamins and Supplements for Prevention of Heart Disease and Cancer 

         The US Preventative Task Force updated their recent recommendations about vitamins and supplements in The Journal of the American Medical Association - reference here.

         Their conclusion was: "Conclusions and Relevance Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer."

         We have published about how misleading labels of supplements are before - click here.

         The appeal of vitamins and supplements is the ability to extract the vital chemicals (like vital amines) antioxidants, and anti-inflammatory ingredients, place them into a pill so you can avoid having a healthy diet. Trust me, a healthy diet is clinically proven to work but it is a lot easier to eat a burger and pop a pill than to remember to eat some vegetables (I like Habit Burger).

         [caption id="attachment_9745" align="aligncenter" width="640"]V Yes, I do love a good burger - Habit is my favorite[/caption]

         But let's go back in history for a second and let you know that surgeons love vitamins. If you haven't listened to one of my favorite stories- listen to this about the first vitamin - click here. And let us not forget that the first evidence based study in the history showed that citrus fruits prevented scurvy - who was that person that showed that - was it a "nutritionist" or was it a surgeon? Oh yes, it was Dr. James Lind - a surgeon.

         Why the appeal of vitamins, besides my fantasy about eating burgers and popping a pill?

         First there is the "natural" fallacy - I don't know, I think natural is more eating fruits and vegetables than pills. People tend to think of vitamins as "good" or healthy, and they are. They seem to think of a vitamin as "natural" even though they were brought to us from the golden age of biochemistry. It is clear that the vitamin and supplement companies have taken advantage of that and use terms like "support gut health" or "support immune function" or "good for cardiovascular health, " - even if those statements are meaningless.

         Second, it is easier to think of things we believe we understand. Heart disease and cancer are complex topics (not that the true chemistry of vitamins aren't but they seem easy). We want to make things easy - like take vitamins and supplements for prevention or cure of cancer or heart disease, because if we start talking about scary statins or chemotherapy not only are there real side-effects but bad press. Of course with vitamins and supplements there can be real side effects - check here. My aunt's son, a Ph.D. in nuclear physics, died after taking a supplement that was to help him be "fit."

         But the simple truth is this: however the polychemistry there is in fruits, vegetables, legumes, whole grains, as well as balancing dairy, meats, fats and alcohol has proven effect - we call that the Mediterranean Diet (for more see here)

         [caption id="attachment_9746" align="aligncenter" width="640"]i Instead of vitamins and supplements from a pill - eat this[/caption]

         For whatever reason, eating a Mediterranean Diet or DASH diet continue to be the proven way to maintain your health.

         References

         1.

         Mishra S, Stierman B, Gahche JJ, Potischman N. Dietary Supplement Use Among Adults: United States, 2017-2018. NCHS Data Brief. National Center for Health Statistics; 2021. doi:10.15620/cdc:101131

         2.

         North America dietary supplements market report, 2021-2028. Accessed May 26, 2022. https://www.grandviewresearch.com/industry-analysis/north-america-dietary-supplements-market

         3.

         Arnett DK, Blumenthal RS, Albert MA, et al 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11). doi:10.1161/CIR.0000000000000678Google ScholarCrossref

         4.

         Aune D, Giovannucci E, Boffetta P, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46(3):1029-1056. doi:10.1093/ije/dyw319PubMedGoogle ScholarCrossref

         5.

         Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. JAMA Intern Med. 2013;173(5):355-361. doi:10.1001/jamainternmed.2013.2299

         ArticlePubMedGoogle ScholarCrossref

         6.

         Alissa EM, Ferns GA. Dietary fruits and vegetables and cardiovascular diseases risk. Crit Rev Food Sci Nutr. 2017;57(9):1950-1962. doi:10.1080/10408398.2015.1040487PubMedGoogle ScholarCrossref

         7.

         Bibbins-Domingo K, Grossman DC, Curry SJ, et al; US Preventive Services Task Force. Folic acid supplementation for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. JAMA. 2017;317(2):183-189. doi:10.1001/jama.2016.19438

         ArticlePubMedGoogle ScholarCrossref

         8.

         American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Anemia in pregnancy: ACOG Practice Bulletin, Number 233. Obstet Gynecol. 2021;138(2):e55-e64. doi:10.1097/AOG.0000000000004477PubMedGoogle ScholarCrossref

         9.

         US Preventive Services Task Force. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer: US Preventive Services Task Force recommendation statement. JAMA. Published June 21, 2022. doi:10.1001/jama.2022.8970

         ArticleGoogle Scholar

         10.

         O’Connor EA, Evans CV, Ivlev I, et al. Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. Published June 21, 2022. doi:10.1001/jama.2021.15650

         ArticleGoogle Scholar

         11.

         Gestational hypertension and preeclampsia. Accessed May 26, 2022. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/06/gestational-hypertension-and-preeclampsia

         12.

         White CM. Dietary supplements pose real dangers to patients. Ann Pharmacother. 2020;54(8):815-819. doi:10.1177/1060028019900504PubMedGoogle ScholarCrossref

         13.

         Tarn DM, Karlamangla A, Coulter ID, et al. A cross-sectional study of provider and patient characteristics associated with outpatient disclosures of dietary supplement use. Patient Educ Couns. 2015;98(7):830-836. doi:10.1016/j.pec.2015.03.020PubMedGoogle ScholarCrossref

         14.

         Liss DT, Uchida T, Wilkes CL, Radakrishnan A, Linder JA. General health checks in adult primary care: a review. JAMA. 2021;325(22):2294-2306. doi:10.1001/jama.2021.6524

         ArticlePubMedGoogle ScholarCrossref

         15.

         US Preventive Services Task Force. Accessed May 26, 2022. https://www.uspreventiveservicestaskforce.org/uspstf/

         ]]> 

         The US Preventative Task Force updated their recent recommendations about vitamins and supplements in The Journal of the American Medical Association - reference here.

         Their conclusion was: "Conclusions and Relevance Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer."

         We have published about how misleading labels of supplements are before - click here.

         The appeal of vitamins and supplements is the ability to extract the vital chemicals (like vital amines) antioxidants, and anti-inflammatory ingredients, place them into a pill so you can avoid having a healthy diet. Trust me, a healthy diet is clinically proven to work but it is a lot easier to eat a burger and pop a pill than to remember to eat some vegetables (I like Habit Burger).

         [caption id="attachment_9745" align="aligncenter" width="640"]V Yes, I do love a good burger - Habit is my favorite[/caption]

         But let's go back in history for a second and let you know that surgeons love vitamins. If you haven't listened to one of my favorite stories- listen to this about the first vitamin - click here. And let us not forget that the first evidence based study in the history showed that citrus fruits prevented scurvy - who was that person that showed that - was it a "nutritionist" or was it a surgeon? Oh yes, it was Dr. James Lind - a surgeon.

         Why the appeal of vitamins, besides my fantasy about eating burgers and popping a pill?

         First there is the "natural" fallacy - I don't know, I think natural is more eating fruits and vegetables than pills. People tend to think of vitamins as "good" or healthy, and they are. They seem to think of a vitamin as "natural" even though they were brought to us from the golden age of biochemistry. It is clear that the vitamin and supplement companies have taken advantage of that and use terms like "support gut health" or "support immune function" or "good for cardiovascular health, " - even if those statements are meaningless.

         Second, it is easier to think of things we believe we understand. Heart disease and cancer are complex topics (not that the true chemistry of vitamins aren't but they seem easy). We want to make things easy - like take vitamins and supplements for prevention or cure of cancer or heart disease, because if we start talking about scary statins or chemotherapy not only are there real side-effects but bad press. Of course with vitamins and supplements there can be real side effects - check here. My aunt's son, a Ph.D. in nuclear physics, died after taking a supplement that was to help him be "fit."

         But the simple truth is this: however the polychemistry there is in fruits, vegetables, legumes, whole grains, as well as balancing dairy, meats, fats and alcohol has proven effect - we call that the Mediterranean Diet (for more see here)

         [caption id="attachment_9746" align="aligncenter" width="640"]i Instead of vitamins and supplements from a pill - eat this[/caption]

         For whatever reason, eating a Mediterranean Diet or DASH diet continue to be the proven way to maintain your health.

         References

         1.

         Mishra S, Stierman B, Gahche JJ, Potischman N. Dietary Supplement Use Among Adults: United States, 2017-2018. NCHS Data Brief. National Center for Health Statistics; 2021. doi:10.15620/cdc:101131

         2.

         North America dietary supplements market report, 2021-2028. Accessed May 26, 2022. https://www.grandviewresearch.com/industry-analysis/north-america-dietary-supplements-market

         3.

         Arnett DK, Blumenthal RS, Albert MA, et al 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11). doi:10.1161/CIR.0000000000000678Google ScholarCrossref

         4.

         Aune D, Giovannucci E, Boffetta P, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46(3):1029-1056. doi:10.1093/ije/dyw319PubMedGoogle ScholarCrossref

         5.

         Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. JAMA Intern Med. 2013;173(5):355-361. doi:10.1001/jamainternmed.2013.2299

         ArticlePubMedGoogle ScholarCrossref

         6.

         Alissa EM, Ferns GA. Dietary fruits and vegetables and cardiovascular diseases risk. Crit Rev Food Sci Nutr. 2017;57(9):1950-1962. doi:10.1080/10408398.2015.1040487PubMedGoogle ScholarCrossref

         7.

         Bibbins-Domingo K, Grossman DC, Curry SJ, et al; US Preventive Services Task Force. Folic acid supplementation for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. JAMA. 2017;317(2):183-189. doi:10.1001/jama.2016.19438

         ArticlePubMedGoogle ScholarCrossref

         8.

         American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Anemia in pregnancy: ACOG Practice Bulletin, Number 233. Obstet Gynecol. 2021;138(2):e55-e64. doi:10.1097/AOG.0000000000004477PubMedGoogle ScholarCrossref

         9.

         US Preventive Services Task Force. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer: US Preventive Services Task Force recommendation statement. JAMA. Published June 21, 2022. doi:10.1001/jama.2022.8970

         ArticleGoogle Scholar

         10.

         O’Connor EA, Evans CV, Ivlev I, et al. Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. Published June 21, 2022. doi:10.1001/jama.2021.15650

         ArticleGoogle Scholar

         11.

         Gestational hypertension and preeclampsia. Accessed May 26, 2022. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/06/gestational-hypertension-and-preeclampsia

         12.

         White CM. Dietary supplements pose real dangers to patients. Ann Pharmacother. 2020;54(8):815-819. doi:10.1177/1060028019900504PubMedGoogle ScholarCrossref

         13.

         Tarn DM, Karlamangla A, Coulter ID, et al. A cross-sectional study of provider and patient characteristics associated with outpatient disclosures of dietary supplement use. Patient Educ Couns. 2015;98(7):830-836. doi:10.1016/j.pec.2015.03.020PubMedGoogle ScholarCrossref

         14.

         Liss DT, Uchida T, Wilkes CL, Radakrishnan A, Linder JA. General health checks in adult primary care: a review. JAMA. 2021;325(22):2294-2306. doi:10.1001/jama.2021.6524

         ArticlePubMedGoogle ScholarCrossref

         15.

         US Preventive Services Task Force. Accessed May 26, 2022. https://www.uspreventiveservicestaskforce.org/uspstf/

         ]]>92853aff-e27e-4b26-8719-f341d55dcd51Tue, 05 Jul 2022 00:00:00 -070003:11falsefull1111Can You Beet Hypertension?It turns out that the juice from beets may lower blood pressure in a sustained and lovely manner. Beets, you see, besides being a colorful vegetable, contain a high level of Nitrate (NO3-). And this is absorbed by the body and converted into nitric oxide. Nitric oxide is that amazing molecule that relaxes blood vessels and improves blood flow.

         How Your Body Gets Nitric Oxide

         The conversion of nitrate into nitrite, which is then converted into nitric oxide is a fun pathway.

         When you eat your greens (yes even lettuce has nitrates) your intestines absorb it and then it is secreted back into saliva where those bacteria in your mouth digest the nitrate (NO3-) into nitrite (NO2-) <-- for you chemistry major nerds. It is that nitrite that is converted to nitric oxide in the body as it needs it - and often it needs it.

         This particular study gave volunteers 250 ml of beet juice (what happens if you say that three times and fast?) - 34 of whom were on blood pressure medicine and 34 who were not (four people dropped out of the study).

         These people were randomized to receive, daily, one cup (250 ml) of beetroot juice (same as beet juice) daily, or the placebo which was nitrate free beet juice. No one could tell the difference in taste. BMI was constant in both groups, about 25-26. They measured, besides blood pressure, nitrates.

         What happened?

         There was a large increase in NOX (nitrates and nitrites) and cGMP (the signaling molecule ) but more importantly there was a sustained and real drop in blood pressure by 7.7 mm of Hg which was NOT seen in the nitrate free beet juice.

         The drop in systolic blood pressure was seen after the first week and the ultimate reduction of 8.1/3.6 Hg reduction was not altered by a change in heart rate.

         Two weeks after stopping this regimen the blood pressure returned to normal.

         Did you know that every increase of systolic blood pressure by 2 mm of Hg increases mortality of heart disease and stroke by about ten percent? This showed a reduction of 7.7 mm of Hg in systolic blood pressure.

         Dietary Implications

         Nitrates are not only found in beets, but also in many other vegetables. One of the clearest and classic papers for the use of the DASH diet showed that the adoption of this diet lead to blood pressure reduction in adults. While this diet was using salt as the major effector, it is clear that the increased use of vegetables with their high nitrate component is an additional determinant in nitrates and blood pressure reduction.

          

         [caption id="attachment_9737" align="aligncenter" width="640"]

         All vegetables, even the green ones have nitrates[/caption]

         It may be that the increase in vegetable servings in the DASH diet may be a secondary and important factor for blood pressure reduction in both the DASH and Mediterranean Diets. For a review of the diet and hypertension click here.

         But what is even more impressive is if we look back at people who have increasing vegetable intake with ultimate cardiovascular disease. The Danish report looked at this and concluded, " Moderate vegetable nitrate intake was associated with 12%, 15%, 17% and 26% lower risk of ischemic heart disease, heart failure, ischemic stroke and peripheral artery disease hospitalizations respectively." - see the reference below or click here.

          

         This goes against the Carnivore diet where they state there is no need for vegetables. Showing that vegetables are needed and produce improved quality of life.

          

         REFERENCES:

         Kapil V, Khambata RS, Robertson A, Caulfield MJ, Ahluwalia A. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. 2015 Feb;65(2):320-7. doi: 10.1161/HYPERTENSIONAHA.114.04675. Epub 2014 Nov 24. PMID: 25421976; PMCID: PMC4288952.

         Bahadoran Z, Mirmiran P, Kabir A, Azizi F, Ghasemi A. The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis. Adv Nutr. 2017 Nov 15;8(6):830-838. doi: 10.3945/an.117.016717. Erratum in: Adv Nutr. 2018 May 1;9(3):274. PMID: 29141968; PMCID: PMC5683004.

         Jakubcik EM, Rutherfurd-Markwick K, Chabert M, Wong M, Ali A. Pharmacokinetics of Nitrate and Nitrite Following Beetroot Juice Drink Consumption. Nutrients. 2021 Jan 20;13(2):281. doi: 10.3390/nu13020281. PMID: 33498220; PMCID: PMC7908977.

         Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, Chrysochoou CA, Nihoyannopoulos PI, Tousoulis DM. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020 Sep 1;11(5):1150-1160. doi: 10.1093/advances/nmaa041. PMID: 32330233; PMCID: PMC7490167.

         Bondonno CP, Dalgaard F, Blekkenhorst LC, Murray K, Lewis JR, Croft KD, Kyrø C, Torp-Pedersen C, Gislason G, Tjønneland A, Overvad K, Bondonno NP, Hodgson JM. Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study. Eur J Epidemiol. 2021 Aug;36(8):813-825. doi: 10.1007/s10654-021-00747-3. Epub 2021 Apr 21. PMID: 33884541; PMCID: PMC8416839.

         ]]>It turns out that the juice from beets may lower blood pressure in a sustained and lovely manner. Beets, you see, besides being a colorful vegetable, contain a high level of Nitrate (NO3-). And this is absorbed by the body and converted into nitric oxide. Nitric oxide is that amazing molecule that relaxes blood vessels and improves blood flow.

         How Your Body Gets Nitric Oxide

         The conversion of nitrate into nitrite, which is then converted into nitric oxide is a fun pathway.

         When you eat your greens (yes even lettuce has nitrates) your intestines absorb it and then it is secreted back into saliva where those bacteria in your mouth digest the nitrate (NO3-) into nitrite (NO2-) <-- for you chemistry major nerds. It is that nitrite that is converted to nitric oxide in the body as it needs it - and often it needs it.

         This particular study gave volunteers 250 ml of beet juice (what happens if you say that three times and fast?) - 34 of whom were on blood pressure medicine and 34 who were not (four people dropped out of the study).

         These people were randomized to receive, daily, one cup (250 ml) of beetroot juice (same as beet juice) daily, or the placebo which was nitrate free beet juice. No one could tell the difference in taste. BMI was constant in both groups, about 25-26. They measured, besides blood pressure, nitrates.

         What happened?

         There was a large increase in NOX (nitrates and nitrites) and cGMP (the signaling molecule ) but more importantly there was a sustained and real drop in blood pressure by 7.7 mm of Hg which was NOT seen in the nitrate free beet juice.

         The drop in systolic blood pressure was seen after the first week and the ultimate reduction of 8.1/3.6 Hg reduction was not altered by a change in heart rate.

         Two weeks after stopping this regimen the blood pressure returned to normal.

         Did you know that every increase of systolic blood pressure by 2 mm of Hg increases mortality of heart disease and stroke by about ten percent? This showed a reduction of 7.7 mm of Hg in systolic blood pressure.

         Dietary Implications

         Nitrates are not only found in beets, but also in many other vegetables. One of the clearest and classic papers for the use of the DASH diet showed that the adoption of this diet lead to blood pressure reduction in adults. While this diet was using salt as the major effector, it is clear that the increased use of vegetables with their high nitrate component is an additional determinant in nitrates and blood pressure reduction.

          

         [caption id="attachment_9737" align="aligncenter" width="640"]

         All vegetables, even the green ones have nitrates[/caption]

         It may be that the increase in vegetable servings in the DASH diet may be a secondary and important factor for blood pressure reduction in both the DASH and Mediterranean Diets. For a review of the diet and hypertension click here.

         But what is even more impressive is if we look back at people who have increasing vegetable intake with ultimate cardiovascular disease. The Danish report looked at this and concluded, " Moderate vegetable nitrate intake was associated with 12%, 15%, 17% and 26% lower risk of ischemic heart disease, heart failure, ischemic stroke and peripheral artery disease hospitalizations respectively." - see the reference below or click here.

          

         This goes against the Carnivore diet where they state there is no need for vegetables. Showing that vegetables are needed and produce improved quality of life.

          

         REFERENCES:

         Kapil V, Khambata RS, Robertson A, Caulfield MJ, Ahluwalia A. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. 2015 Feb;65(2):320-7. doi: 10.1161/HYPERTENSIONAHA.114.04675. Epub 2014 Nov 24. PMID: 25421976; PMCID: PMC4288952.

         Bahadoran Z, Mirmiran P, Kabir A, Azizi F, Ghasemi A. The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis. Adv Nutr. 2017 Nov 15;8(6):830-838. doi: 10.3945/an.117.016717. Erratum in: Adv Nutr. 2018 May 1;9(3):274. PMID: 29141968; PMCID: PMC5683004.

         Jakubcik EM, Rutherfurd-Markwick K, Chabert M, Wong M, Ali A. Pharmacokinetics of Nitrate and Nitrite Following Beetroot Juice Drink Consumption. Nutrients. 2021 Jan 20;13(2):281. doi: 10.3390/nu13020281. PMID: 33498220; PMCID: PMC7908977.

         Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, Chrysochoou CA, Nihoyannopoulos PI, Tousoulis DM. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020 Sep 1;11(5):1150-1160. doi: 10.1093/advances/nmaa041. PMID: 32330233; PMCID: PMC7490167.

         Bondonno CP, Dalgaard F, Blekkenhorst LC, Murray K, Lewis JR, Croft KD, Kyrø C, Torp-Pedersen C, Gislason G, Tjønneland A, Overvad K, Bondonno NP, Hodgson JM. Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study. Eur J Epidemiol. 2021 Aug;36(8):813-825. doi: 10.1007/s10654-021-00747-3. Epub 2021 Apr 21. PMID: 33884541; PMCID: PMC8416839.

         ]]>707a80d7-ba61-4cae-8b72-5f97c2208235Mon, 27 Jun 2022 00:00:00 -070003:28falsefull1010Collagen Supplements: Powders, Liquids, Potions, & ScamsCommon Collagen Claims (taken from actual websites selling collagen supplements):
         • “improves skin elasticity,”
         • “support bone and joint health,”
         • “strengthen hair, skin, and nails,”
         •  “may benefit the bodies cellular structure,”
         • “support healthy skin, bone, and joints.”
         • “will feed your skin health”
         • “will improve nail appearance and strength”
         • “lead to a noticeable hair thickness”
         
         

         Collagen as a supplement is not regulated by the Drug division of The Food and Drug Administration

         If you look at the bottom of the websites, or on the bottles, you will see a disclaimer that the claims “have not been evaluated by the U.S. Food and Drug Administration. ” More telling is “these products are not intended to treat, diagnose, cure, or prevent any disease.” Such a disclaimer is provided by the lawyers because if one claims to cure, treat, or diagnose an actual medical condition then it must have passed a rigorous FDA approval. To be clear, there have been no FDA studies that show collagen as a supplement treats any disease.

         Supplements commonly will use “support xyz health” – where you can fill in the blank with hair, nails, joints, skin – in the case of collagen.

         One of the main issues with supplements is “If the composition and quality of ingredients cannot be reliably ensured, the validity of research on dietary supplements is questionable. Moreover, the health of the US public is put at risk.”

         Starr RR. Too little, too late: ineffective regulation of dietary supplements in the United States. Am J Public Health. 2015;105(3):478-485. doi:10.2105/AJPH.2014.302348

         As such, even when you look at the studies which promote collagen, or collagen byproducts, they do not meet the most basic of studies which are done to evaluate pharmaceuticals. In order to have an evaluation of a pharmaceutical you must have three phases in the trial:

         • phase one is determining the dose for safety. While the supplement industry is happy if you think all supplements are good and all pharmaceuticals are evil – everything, every drug, every chemical from water to salt to formaldehyde has a toxic dose
         • phase two is to test the drug for efficacy and side effects. Some people will react poorly to a supplement just as they will a drug. WE need to know what those side effects are. With a supplement people who don’t feel well often just stop it – or, like my cousin, die (yes, I had a cousin who died from a supplement).
         • phase three testing is to determine if there is truly efficacy, what is the effectiveness and what is the safety.
         • phase four is post-marketing surveillance in the public because even though you have gone through trials with a number of phases and under strict supervision when a drug is released to the public you have the chance to see millions of reactions.
         
         

         Thalidomide, for example, was released in Europe and even had two drug trials in the United States but was NEVER approved in the United States by the FDA because of insufficient data.

         Vioxx was a drug used worldwide and was taken off the market in 2004 because of the risk of a fatal heart attack, but was taken off after it had passed multiple drug tests previously.

         FDA testing is rigorous and specific, with the highest standards in the world. Collagen has NEVER had such rigorous testing performed. These tests have not risen to the level and in 2022 one report noted “More research is needed to establish knowledge of the effects and physiologic mechanism of collagen supplementation. Dermatologists should be aware of the unsubstantiated proclamations of collagen made by companies and in social media, as well as what evidence is established thus far, to be equipped to discuss collagen supplementation with patients.”

         Rustad AM, Nickles MA, McKenney JE, Bilimoria SN, Lio PA. Myths and media in oral collagen supplementation for the skin, nails, and hair: A review. J Cosmet Dermatol. 2022 Feb;21(2):438-443. doi: 10.1111/jocd.14567. Epub 2021 Oct 25. PMID: 34694676.

         One of the most quoted meta-analysis looked at 19 studies with 1125 participants – which is barely enough in any given study to make bold statements about safety, efficacy, toxicity, and side effects of hydrolyzed collagen supplementation.

         de Miranda RB, Weimer P, Rossi RC. Effects of hydrolyzed collagen supplementation on skin aging: a systematic review and meta-analysis. Int J Dermatol. 2021 Dec;60(12):1449-1461. doi: 10.1111/ijd.15518. Epub 2021 Mar 20. PMID: 33742704.

         So when someone states that study as the basis for use of the product, one has to have caution that there is not enough data, not enough rigorous data, and when studies do not include toxicity, this should be a major red flag.

         Collagen is regulated by the Center for Food Safety and Applied Nutrition

         Meaning, collagen, like most supplements, is regulated as a food, not as a drug. This is not the celebrated division that worked hard to get a COVID vaccine or anti-viral medications, this is the division that is responsible for food safety. This is the division of the FDA that is slow-moving, filled with bureaucracy, and has not even responded in a timely manner to any of the recent bacterial contaminations of our food. Take the spinach contamination, where people across ten states became ill, by the time the FDA came out with a recall the shelf life for that spinach was long overdue.

         The same division tasked with reducing salt in our diets, but fears industry so much that no regulations have been put into place.

         This is the same division that does not have leadership, budget, or inspectors to police our food supply.

         The only time the FDA has become involved in any supplements is when a proven threat to the public has been discovered, or if someone complains that a claim made by the company alleges to “treat a disease.” Which is why collagen manufacturers make the claims above.

         The undisputed science of collagen

         Collagen is the main protein that forms the connective tissue of our body: skin, muscles, tendons, bones, blood vessels, even our heart valves. There have been 28 different types of collagen identified in humans, but over 90% of the collagen is called “Type 1.”  Type 1 collagen is a huge molecule with thousands of amino acids, and coded for by over 40 genes.  Two chains are formed from the translation and these polypeptide chains are assembled, cut, arranged, glycosylated, and packaged in different parts of a cell called a fibroblast and then transported out of the cell where it is further trimmed, combined with other molecules of collagen and begins to form and reform and cross-link with other collagen molecules.

         Gauza-Włodarczyk M, Kubisz L, Włodarczyk D. Amino acid composition in determination of collagen origin and assessment of physical factors effects. Int J Biol Macromol. 2017 Nov;104(Pt A):987-991. doi: 10.1016/j.ijbiomac.2017.07.013. Epub 2017 Jul 4. PMID: 28687386.

         Brodsky B, Persikov AV. Molecular structure of the collagen triple helix. Adv Protein Chem. 2005;70:301-39. doi: 10.1016/S0065-3233(05)70009-7. PMID: 15837519.

         Hulmes DJ. Building collagen molecules, fibrils, and suprafibrillar structures. J Struct Biol. 2002 Jan-Feb;137(1-2):2-10. doi: 10.1006/jsbi.2002.4450. PMID: 12064927.

         In order to form in an orderly manner and to be strong, it must link with other collagen molecules in an organized manner and needing the help of Vitamin C to do this. Without vitamin C, the collagen doesn’t have strength and everywhere you have collagen you will suffer. Scurvy, the old name for Vitamin C deficiency, leads to loss of teach, wounds that come open again, blood vessels that break under the skin.

         Peterkofsky B. Ascorbate requirement for hydroxylation and secretion of procollagen: relationship to inhibition of collagen synthesis in scurvy. Am J Clin Nutr. 1991 Dec;54(6 Suppl):1135S-1140S. doi: 10.1093/ajcn/54.6.1135s. PMID: 1720597.

         Orgel JP, Irving TC, Miller A, Wess TJ. Microfibrillar structure of type I collagen in situ. Proc Natl Acad Sci U S A. 2006 Jun 13;103(24):9001-5. doi: 10.1073/pnas.0502718103. Epub 2006 Jun 2. PMID: 16751282; PMCID: PMC1473175.

         While collagen contains 19 amino acids, 17% of the amino acids are proline, and glycine is found usually in every third amino acid. Some of the amino acids are modified to others after the collagen has been formed, for example, hydroxyproline is derived from proline and hydroxylysine from lysine – and both of these require Vitamin C to assist in that modification.

         What happens when you eat, drink, or otherwise consume collagen

         Let’s say you eat some chicken skin that is rich in collagen, or you buy liquid collagen, or collagen peptides (short chains of amino acids bonded together).

         The large molecule of collagen is broken down starting with the teeth, the enzymes in the mouth, the acid in the stomach as well as the enzymes in the stomach. Once these byproducts reach the small bowel they are further broken down by the pancreatic and bile from the liver into small chains of 2-3 amino acids.  The small bowel can transport simple amino acids, as well as dipeptides (two amino acids bonded together) or tri-peptides (three amino acids bonded together) into the portal circulation. Through the portal system, even some five peptide units have been found. These amino acids are not passively absorbed, but rather actively transported by membrane proteins found on the brush borders of the small intestine designed just to transport amino acids.

         Kleinnijenhuis AJ, van Holthoon FL, Maathuis AJH, Vanhoecke B, Prawitt J, Wauquier F, Wittrant Y. Non-targeted and...]]>Common Collagen Claims (taken from actual websites selling collagen supplements):

         • “improves skin elasticity,”
         • “support bone and joint health,”
         • “strengthen hair, skin, and nails,”
         •  “may benefit the bodies cellular structure,”
         • “support healthy skin, bone, and joints.”
         • “will feed your skin health”
         • “will improve nail appearance and strength”
         • “lead to a noticeable hair thickness”
         
         

         Collagen as a supplement is not regulated by the Drug division of The Food and Drug Administration

         If you look at the bottom of the websites, or on the bottles, you will see a disclaimer that the claims “have not been evaluated by the U.S. Food and Drug Administration. ” More telling is “these products are not intended to treat, diagnose, cure, or prevent any disease.” Such a disclaimer is provided by the lawyers because if one claims to cure, treat, or diagnose an actual medical condition then it must have passed a rigorous FDA approval. To be clear, there have been no FDA studies that show collagen as a supplement treats any disease.

         Supplements commonly will use “support xyz health” – where you can fill in the blank with hair, nails, joints, skin – in the case of collagen.

         One of the main issues with supplements is “If the composition and quality of ingredients cannot be reliably ensured, the validity of research on dietary supplements is questionable. Moreover, the health of the US public is put at risk.”

         Starr RR. Too little, too late: ineffective regulation of dietary supplements in the United States. Am J Public Health. 2015;105(3):478-485. doi:10.2105/AJPH.2014.302348

         As such, even when you look at the studies which promote collagen, or collagen byproducts, they do not meet the most basic of studies which are done to evaluate pharmaceuticals. In order to have an evaluation of a pharmaceutical you must have three phases in the trial:

         • phase one is determining the dose for safety. While the supplement industry is happy if you think all supplements are good and all pharmaceuticals are evil – everything, every drug, every chemical from water to salt to formaldehyde has a toxic dose
         • phase two is to test the drug for efficacy and side effects. Some people will react poorly to a supplement just as they will a drug. WE need to know what those side effects are. With a supplement people who don’t feel well often just stop it – or, like my cousin, die (yes, I had a cousin who died from a supplement).
         • phase three testing is to determine if there is truly efficacy, what is the effectiveness and what is the safety.
         • phase four is post-marketing surveillance in the public because even though you have gone through trials with a number of phases and under strict supervision when a drug is released to the public you have the chance to see millions of reactions.
         
         

         Thalidomide, for example, was released in Europe and even had two drug trials in the United States but was NEVER approved in the United States by the FDA because of insufficient data.

         Vioxx was a drug used worldwide and was taken off the market in 2004 because of the risk of a fatal heart attack, but was taken off after it had passed multiple drug tests previously.

         FDA testing is rigorous and specific, with the highest standards in the world. Collagen has NEVER had such rigorous testing performed. These tests have not risen to the level and in 2022 one report noted “More research is needed to establish knowledge of the effects and physiologic mechanism of collagen supplementation. Dermatologists should be aware of the unsubstantiated proclamations of collagen made by companies and in social media, as well as what evidence is established thus far, to be equipped to discuss collagen supplementation with patients.”

         Rustad AM, Nickles MA, McKenney JE, Bilimoria SN, Lio PA. Myths and media in oral collagen supplementation for the skin, nails, and hair: A review. J Cosmet Dermatol. 2022 Feb;21(2):438-443. doi: 10.1111/jocd.14567. Epub 2021 Oct 25. PMID: 34694676.

         One of the most quoted meta-analysis looked at 19 studies with 1125 participants – which is barely enough in any given study to make bold statements about safety, efficacy, toxicity, and side effects of hydrolyzed collagen supplementation.

         de Miranda RB, Weimer P, Rossi RC. Effects of hydrolyzed collagen supplementation on skin aging: a systematic review and meta-analysis. Int J Dermatol. 2021 Dec;60(12):1449-1461. doi: 10.1111/ijd.15518. Epub 2021 Mar 20. PMID: 33742704.

         So when someone states that study as the basis for use of the product, one has to have caution that there is not enough data, not enough rigorous data, and when studies do not include toxicity, this should be a major red flag.

         Collagen is regulated by the Center for Food Safety and Applied Nutrition

         Meaning, collagen, like most supplements, is regulated as a food, not as a drug. This is not the celebrated division that worked hard to get a COVID vaccine or anti-viral medications, this is the division that is responsible for food safety. This is the division of the FDA that is slow-moving, filled with bureaucracy, and has not even responded in a timely manner to any of the recent bacterial contaminations of our food. Take the spinach contamination, where people across ten states became ill, by the time the FDA came out with a recall the shelf life for that spinach was long overdue.

         The same division tasked with reducing salt in our diets, but fears industry so much that no regulations have been put into place.

         This is the same division that does not have leadership, budget, or inspectors to police our food supply.

         The only time the FDA has become involved in any supplements is when a proven threat to the public has been discovered, or if someone complains that a claim made by the company alleges to “treat a disease.” Which is why collagen manufacturers make the claims above.

         The undisputed science of collagen

         Collagen is the main protein that forms the connective tissue of our body: skin, muscles, tendons, bones, blood vessels, even our heart valves. There have been 28 different types of collagen identified in humans, but over 90% of the collagen is called “Type 1.”  Type 1 collagen is a huge molecule with thousands of amino acids, and coded for by over 40 genes.  Two chains are formed from the translation and these polypeptide chains are assembled, cut, arranged, glycosylated, and packaged in different parts of a cell called a fibroblast and then transported out of the cell where it is further trimmed, combined with other molecules of collagen and begins to form and reform and cross-link with other collagen molecules.

         Gauza-Włodarczyk M, Kubisz L, Włodarczyk D. Amino acid composition in determination of collagen origin and assessment of physical factors effects. Int J Biol Macromol. 2017 Nov;104(Pt A):987-991. doi: 10.1016/j.ijbiomac.2017.07.013. Epub 2017 Jul 4. PMID: 28687386.

         Brodsky B, Persikov AV. Molecular structure of the collagen triple helix. Adv Protein Chem. 2005;70:301-39. doi: 10.1016/S0065-3233(05)70009-7. PMID: 15837519.

         Hulmes DJ. Building collagen molecules, fibrils, and suprafibrillar structures. J Struct Biol. 2002 Jan-Feb;137(1-2):2-10. doi: 10.1006/jsbi.2002.4450. PMID: 12064927.

         In order to form in an orderly manner and to be strong, it must link with other collagen molecules in an organized manner and needing the help of Vitamin C to do this. Without vitamin C, the collagen doesn’t have strength and everywhere you have collagen you will suffer. Scurvy, the old name for Vitamin C deficiency, leads to loss of teach, wounds that come open again, blood vessels that break under the skin.

         Peterkofsky B. Ascorbate requirement for hydroxylation and secretion of procollagen: relationship to inhibition of collagen synthesis in scurvy. Am J Clin Nutr. 1991 Dec;54(6 Suppl):1135S-1140S. doi: 10.1093/ajcn/54.6.1135s. PMID: 1720597.

         Orgel JP, Irving TC, Miller A, Wess TJ. Microfibrillar structure of type I collagen in situ. Proc Natl Acad Sci U S A. 2006 Jun 13;103(24):9001-5. doi: 10.1073/pnas.0502718103. Epub 2006 Jun 2. PMID: 16751282; PMCID: PMC1473175.

         While collagen contains 19 amino acids, 17% of the amino acids are proline, and glycine is found usually in every third amino acid. Some of the amino acids are modified to others after the collagen has been formed, for example, hydroxyproline is derived from proline and hydroxylysine from lysine – and both of these require Vitamin C to assist in that modification.

         What happens when you eat, drink, or otherwise consume collagen

         Let’s say you eat some chicken skin that is rich in collagen, or you buy liquid collagen, or collagen peptides (short chains of amino acids bonded together).

         The large molecule of collagen is broken down starting with the teeth, the enzymes in the mouth, the acid in the stomach as well as the enzymes in the stomach. Once these byproducts reach the small bowel they are further broken down by the pancreatic and bile from the liver into small chains of 2-3 amino acids.  The small bowel can transport simple amino acids, as well as dipeptides (two amino acids bonded together) or tri-peptides (three amino acids bonded together) into the portal circulation. Through the portal system, even some five peptide units have been found. These amino acids are not passively absorbed, but rather actively transported by membrane proteins found on the brush borders of the small intestine designed just to transport amino acids.

         Kleinnijenhuis AJ, van Holthoon FL, Maathuis AJH, Vanhoecke B, Prawitt J, Wauquier F, Wittrant Y. Non-targeted and targeted analysis of collagen hydrolysates during the course of digestion and absorption. Anal Bioanal Chem. 2020 Feb;412(4):973-982. doi: 10.1007/s00216-019-02323-x. Epub 2019 Dec 24. PMID: 31872275; PMCID: PMC7005076.

         The first part of the small intestine is responsible for about 96 percent of the absorption of amino acids.

         A number of non-digested collagen has been recovered in stool, or has been found to be metabolized by bacteria in the large intestine where they have been used by the gut microbiome as prebiotics, and may exert an influence on the body in that manner.

         Larder CE, Iskandar MM, Kubow S. Gastrointestinal Digestion Model Assessment of Peptide Diversity and Microbial Fermentation Products of Collagen Hydrolysates. Nutrients. 2021;13(8):2720. Published 2021 Aug 7. doi:10.3390/nu13082720

         That 57% of amino acids in collagen are hydroxyproline, glycine and proline. Hydroxy-proline is not actively transported across into the portal system, rather it is passively absorbed depending upon the concentration. While hydroxyproline is used in the synthesis of collagen, if there is an excess of this in the bloodstream it is filtered out through the kidneys. The synthesis of collagen typically takes proline to and once the molecule is formed will alter into the hydroxyproline. Meaning hydroxy-proline offers no benefit to the building of collagen in the human body.

         Hueckel HJ, Rogers QR. Prolylhydroxyproline absorption in hamsters. Can J Biochem. 1972 Jul;50(7):782-90. doi: 10.1139/o72-109. PMID: 5050935.

         Li P, Wu G. Roles of dietary glycine, proline, and hydroxyproline in collagen synthesis and animal growth. Amino Acids. 2018 Jan;50(1):29-38. doi: 10.1007/s00726-017-2490-6. Epub 2017 Sep 20. PMID: 28929384.

         In summary: most of the collagen is broken down into amino acids or multiples of amino acids which are either transported or passively absorbed into the body. While food intake will briefly increase blood levels of amino acids, excess amino acids are oxidized and excreted into the urine.

         Bröer S, Bröer A. Amino acid homeostasis and signaling in mammalian cells and organisms. Biochem J. 2017 May 25;474(12):1935-1963. doi: 10.1042/BCJ20160822. PMID: 28546457; PMCID: PMC5444488.

         The ability of people to absorb and use dietary protein-derived amino acids for muscle protein synthesis is not impaired in healthy older men.  Further studies showed that supplementation with whey protein brought greater increases in muscle protein synthesis and supported skeletal muscle retention more than collagen proteins.

         Oikawa SY, Kamal MJ, Webb EK, McGlory C, Baker SK, Phillips SM. Whey protein but not collagen peptides stimulate acute and longer-term muscle protein synthesis with and without resistance exercise in healthy older women: a randomized controlled trial.

         Am J Clin Nutr. 2020 Mar 1;111(3):708-718. doi: 10.1093/ajcn/nqz332. Erratum in: Am J Clin Nutr. 2020 Dec 10;112(6):1656. PMID: 31919527; PMCID: PMC7049534.

         Does taking collagen supplements increase collagen synthesis, change hydration, or improve elasticity

         Since collagen makes up 80 percent of our skin and with another protein, elastin, provides the elasticity of our skin. Does the absorption of collagen peptides increase collagen synthesis in some people?

         In one non-blinded study of older adults in convalescent rehabilitation wards in Japan, the study did not study trans epidermal water loss, nor did they have a control group of the oral supplementation without collagen. The skin tears during the study were less, but this did not continue after the study. The oral supplementation not only included collagen peptides but other ingredients, such as vitamin C, Vitamin A,  biotin, as well as other amino acids. Yet this study is often cited as proof that collagen supplementation works.

         Nomoto T, Iizaka S. Effect of an Oral Nutrition Supplement Containing Collagen Peptides on Stratum Corneum Hydration and Skin Elasticity in Hospitalized Older Adults: A Multicenter Open-label Randomized Controlled Study. Adv Skin Wound Care. 2020;33(4):186-191. doi:10.1097/01.ASW.0000655492.40898.55

         While aging does decrease collagen, it appears to be less a function of collagen synthesis and more a function of collagen breakdown by specific enzymes. There are clinically proven treatments to prevent this such as topical retinoic acid, laser resurfacing, and intradermal injection of cross-linked hyaluronic acid, that increase production of new collagen. However, ingestion of oral collagen supplements does not appear to make a difference.

         Fisher GJ, Varani J, Voorhees JJ. Looking older: fibroblast collapse and therapeutic implications. Arch Dermatol. 2008 May;144(5):666-72. doi: 10.1001/archderm.144.5.666. PMID: 18490597; PMCID: PMC2887041.

         Szoka L, Karna E, Hlebowicz-Sarat K, Karaszewski J, Palka JA. Exogenous proline stimulates type I collagen and HIF-1α expression and the process is attenuated by glutamine in human skin fibroblasts. Mol Cell Biochem. 2017 Nov;435(1-2):197-206. doi: 10.1007/s11010-017-3069-y. Epub 2017 May 19. PMID: 28526934; PMCID: PMC5632346.

         In tissue culture (meaning, cells grown in a laboratory) the fibroblast cell is the cell responsible for collagen synthesis. It has been noted that higher levels of proline-hydroxyproline increased the synthesis of collagen. This does NOT indicate that if you take collagen, of which this dipeptide will be absorbed, that you will increase collagen synthesis. It probably is reasonable to assume that as collagen is broken down (something that happens in wounds, scar tissue, injury to tissue, or normal aging), that the breakdown products of that collagen would turn on both synthesis of collagen by fibroblasts, as well as stimulate more fibroblasts to come into the area. The level of hydroxyproline in the blood is stable, and excess hydroxyproline is excreted by the kidney.

         That this dipeptide is carefully excreted when in excess makes sense from a feedback loop perspective. It is not helpful to a body to increase the production of collagen constantly. Thus the body would tightly regulate stimulation by the dipeptide. In other words, the excess collagen, or peptide you take, will be excreted into the skin, or not absorbed at all and sent to feed the colonic bacteria.

         Ohara H, Ichikawa S, Matsumoto H, Akiyama M, Fujimoto N, Kobayashi T, Tajima S. Collagen-derived dipeptide, proline-hydroxyproline, stimulates cell proliferation and hyaluronic acid synthesis in cultured human dermal fibroblasts. J Dermatol. 2010 Apr;37(4):330-8. doi: 10.1111/j.1346-8138.2010.00827.x. PMID: 20507402.

         Scientists from a Korean cosmetic company published a paper where skin moisture increased by 7.3% when given peptides from fish collagen. While this may not appear to be much of a change, it is worth noting that the change comes not from the collagen in the stratum corneum of the skin (which is the final layer of dead skin cells that serve to protect underlying tissue) by increasing something called natural moisturizing factor (this have hydrophilic amino acids) and provide a water gradient for the stratum corneum. In addition, the skin lipids, ceramides, form a permeability barrier which, when there is a loss of these two, leads to dry skin and increased transepidermal water loss.

         Jung K, Kim SH, Joo KM, et al. Oral Intake of Enzymatically Decomposed AP Collagen Peptides Improves Skin Moisture and Ceramide and Natural Moisturizing Factor Contents in the Stratum Corneum. Nutrients. 2021;13(12):4372. Published 2021 Dec 6. doi:10.3390/nu13124372

         This is similar to other industry studies showing that peptides derived from a Korean catfish provide increased moisture to the skin in a small sample of only 53 participants between the two groups. This is, in fact, the Achilles heel of all randomized studies involving collagen and its efficacy, a low number of individuals in all the studies performed to date.

         Kim DU, Chung HC, Choi J, Sakai Y, Lee BY. Oral Intake of Low-Molecular-Weight Collagen Peptide Improves Hydration, Elasticity, and Wrinkling in Human Skin: A Randomized, Double-Blind, Placebo-Controlled Study. Nutrients. 2018;10(7):826. Published 2018 Jun 26. doi:10.3390/nu10070826

         There have been a number of industry-sponsored studies showing beneficial effects of the hydrolysates with the addition of vitamin A, C, and other ingredients against a placebo. Amino acid supplements appear to improve skin, regardless of their origin.

         We don’t know, but many will claim we do

         The low quality of studies, most funded by industry, and the basic science, make it skeptical at best to look at collagen supplements for their role in skin, hair, nails, and other growth. Probably best summed up by the article from

         Rustad AM, Nickles MA, McKenney JE, Bilimoria SN, Lio PA. Myths and media in oral collagen supplementation for the skin, nails, and hair: A review. J Cosmet Dermatol. 2022 Feb;21(2):438-443. doi: 10.1111/jocd.14567. Epub 2021 Oct 25. PMID: 34694676.

         In their conclusion: “Although some studies have demonstrated that collagen supplementation can enhance skin qualities such as elasticity and hydration, dermatologic claims in the media surpass any evidence currently supported by the literature.” They went on to say, “More research is needed to establish knowledge of the effects and physiologic mechanism of collagen supplementation. Dermatologists should be aware of the unsubstantiated proclamations of collagen made by companies and in social media, as well as what evidence is established thus far, to be equipped to discuss collagen supplementation with patients.”

         What about bone broth?

         The subject of a best selling book and the claim it has plenty of collagen in it to “heal...]]>b4e54f9e-952a-4e3f-bed4-5bfadbc09b33Wed, 04 May 2022 00:00:00 -070013:00falsefull99Bill Lagakos and The Trouble With DietsDiets. They work for some, but not for others. "You're just not on the right diet," purveyors of the latest trend will tell you. "You're just not on the right diet for your blood type, ethnicity, age, hair color," says another set of true believers.

         So what's right and what's wrong?

         Today on Fork U, a conversation between Dr. Terry Simpson, weight loss physician, and Dr. Bill Lagakos, nutritional biochemist and physiologist, where they expose the truth behind diets and why they may, and may not, work for you.

         And check out Bill's book, The Poor Misunderstood Calorie.

         TRANSCRIPT:

         Terry Simpson: Bill, there are a lot of weight loss programs out there. The one that I'm hearing the most about most often is the Keto movement, which says that they're going to cure everything from heart disease and cancer.

         Bill Lagakos: I think from a 30,000-foot view, Keto works for a lot of people. So does low fat. I like some of the recent work, the studies showing it's more about the level of processing of the food.

         So you can have a vegan diet or you can have a Ketogenic diet and as long as it is excluding a lot of processed foods, it tends to not be over eaten. And people that tout the magical benefit effects of any of these diets, 99% of the time it's due to weight loss.

         Terry Simpson: We actually had an experiment with Evo, who you met. He uhh did it several years, three or four years in a row for one month, Evo would go on a beer and sausage diet, rigorously kept his calories to 1500. We measured his liver function tests, his lipid panel.

         Every year he lost weight, kept it off, and every year his liver function was fine, surprising with the number of beers he had a day, which was limited to six. But it was, he had weight loss and he had sustained weight loss over the year with a, kind of this funky diet we sort of made up.

         Bill Lagakos: Well, that's terrific. And that's an awesome diet. I'm jealous.

         But, uh, yeah, that, that basically proves the point. I mean, even if it's not a lot of weight he lost, I think a weight loss is a major driver in a lot of the health improvements that people like to attribute to particular dietary trends.

         Terry Simpson: There doesn't seem to be a lot of long-term data in these diets. When I look at the sort of metadata, I see that if you eat really high on the low-fat side, you have a little lower lifespan. If you eat really high on the high-fat side, you have a little lower lifespan. If you have your carbs at about 55%, you seem to have a little longer lifespan.

         Is there much good data saying one diet versus another, other than the Mediterranean, has great long-term results?

         Bill Lagakos: I don't think so. I don't think it comes down to macros at all. I think that there's the confounding in those studies is so deep that I don't think the macronutrient composition of your diet is going to be what kills you in the end.

         Terry Simpson: Part of your job is helping people lose weight. What are sort of the big messages you try and get through to people?

         Bill Lagakos: One of the biggest things is the importance of adherence, which is why I try to say, you know, what do I know that, that you can adhere to 100%? It's what you've been doing because you've been doing it. So let's try and find the lowest hanging fruit that we can change so it doesn't turn your whole world upside down, which is something that would probably never work.

         Terry Simpson: So in other words, you're not going to change a Keto into a vegan or a vegan into a Keto.

         Bill Lagakos: Correct. However, I don't like to put those two at odds because there is, there have been a few studies on the vegan Ketogenic diet.

         Terry Simpson: So give me an example of some of the things for our audience, some of the things that they can do to incorporate it in their life now to help them lose weight and just feel a little better about themselves.

         Bill Lagakos: Well, feeling better about yourself and health outcomes and health profile, exercise can help with that a lot. I like to advocate all kinds of exercise. Cardio is good for the heart. Weights is good for quality of life and muscle mass, which also seems to bode well for quality of life.

         In terms of diet, probably nix the ultra-processed foods. Nobody needs single serves bags of potato chips lying around the house.

         Terry Simpson: Is that, that big, that great big bag? Is that the single serve?

         Bill Lagakos: [Laughing] No, no, but I know people that will go through multiple single serves in one sitting.

         Terry Simpson: Like when you see the Oreo cookie's just a hundred calories that you'd probably say it'd be better to have the apple?

         Bill Lagakos: Uh, yes. Yeah. And actually, even when it comes to the apple, one of the studies that was comparing processed to unprocessed foods, it was very interesting. I was trying to figure out how are they going to do this? And it was like an apple versus apple sauce. And that's sort of not an obvious comparison, but the people in the apple group tended to eat a little bit less.

         Terry Simpson: And when you start looking at, at some of the ultra-processed foods, are there some that you find that it has a lot of bang for the buck when you get people to sort of move away from them?

         Bill Lagakos: Yes. Uh, the lowest hanging fruit there is obviously potato chips because, you know, it's all too common that someone will sit down for lunch, have a sandwich, you know, a diet soda, thinking they're doing something great, and then instead of taking a couple potato chips and putting them on the plate, they'll just open the bag and sit down in front of it and generally overeat a lot because of that. The potato chips just don't seem to hit the satiety button.

         Terry Simpson: How about candy bars?

         Bill Lagakos: Candy bars are, I don't know, for kids maybe, but I don't think adults should be eating candy bars. Or, if they do, very rarely.

         Terry Simpson: That's the wrong answer, Bill. [Laughter]

         Bill Lagakos: Hey, I'm okay with the sausage and beer diet. Isn't that enough?

         Terry Simpson: When they hear us talk about that people will, you know, and Evo wrote a book about it, people say, "Oh, I can have all I want." And it's like, it's not all you want it. You know? I mean, Evo was...

         Bill Lagakos: Right, as soon as you told me that he lost weight on it, I was instantly convinced that that could definitely happen. That's very feasible for your health to improve because you're losing weight. You can eat pretty much every diet.

         I think there was a, there was a McDonald's diet where the guy over ate everything and it was a TV show and he got very sick, and somebody else did the McDonald's diet and they underrate at every opportunity and they lost weight and got healthier.

         Terry Simpson: What you're saying is, increasing fiber in the diet seems to not only help you from a satiety sense, which then keeps your appetite smaller, but provides a lot of health benefits because you're going to lose weight.

         Bill Lagakos: Yeah, I'm trying to move away from the word fiber, because if that was the plainest form, then Metamucil would've solved the obesity epidemic decades ago. And it seems to be like whole food based fibers seem to be the way to go. Not like an isolated fiber powder, for example.

         Terry Simpson: We see some of this problem in our weight loss surgery patients. So we start out weight loss surgery patients on what I call "formula," which is our version of some protein shake of which there are about a thousand out there that'll sell.

         But when patients come in and they haven't lost weight, they'll say, "Well, I'm going to just have more shakes," and it's like that's, you know, we, we, we would rather have them have some beans or, or something rather than the shakes.

         Bill Lagakos: I agree with that. That's, that's good, sound advice. The other thing that you mentioned is the shakes is something that I tend to, I don't rail against this movement on the social media, as people are starting to catch onto higher protein diets, which I tend to like that. You know, have a couple, three servings of protein a day seems to do well. Protein does seem to hit the satiety button quite well.

         And all of the hysteria about the kidney health leeching calcium from your bones, any of that stuff, I mean, the only thing that might be remotely true is from the KDOQI studies on the people with end-stage renal disease might have improved outcomes changing their protein intake. But even that is not 100%.

         Terry Simpson: We're pretty good at processing and breaking down protein and eliminating too much of it. We don't store it. So it tends to be when we can store my macronutrients that we have problems.

         Bill Lagakos: That's a good way to look at it.

         Terry Simpson: I want to talk to you a little bit about fatty liver disease. Uh, it's something that we in weight loss surgery see a lot of and, and we're usually the first ones to diagnosis. We're never surprised when we see it. We open up people and take a look]]>Diets. They work for some, but not for others. "You're just not on the right diet," purveyors of the latest trend will tell you. "You're just not on the right diet for your blood type, ethnicity, age, hair color," says another set of true believers.

         So what's right and what's wrong?

         Today on Fork U, a conversation between Dr. Terry Simpson, weight loss physician, and Dr. Bill Lagakos, nutritional biochemist and physiologist, where they expose the truth behind diets and why they may, and may not, work for you.

         And check out Bill's book, The Poor Misunderstood Calorie.

         TRANSCRIPT:

         Terry Simpson: Bill, there are a lot of weight loss programs out there. The one that I'm hearing the most about most often is the Keto movement, which says that they're going to cure everything from heart disease and cancer.

         Bill Lagakos: I think from a 30,000-foot view, Keto works for a lot of people. So does low fat. I like some of the recent work, the studies showing it's more about the level of processing of the food.

         So you can have a vegan diet or you can have a Ketogenic diet and as long as it is excluding a lot of processed foods, it tends to not be over eaten. And people that tout the magical benefit effects of any of these diets, 99% of the time it's due to weight loss.

         Terry Simpson: We actually had an experiment with Evo, who you met. He uhh did it several years, three or four years in a row for one month, Evo would go on a beer and sausage diet, rigorously kept his calories to 1500. We measured his liver function tests, his lipid panel.

         Every year he lost weight, kept it off, and every year his liver function was fine, surprising with the number of beers he had a day, which was limited to six. But it was, he had weight loss and he had sustained weight loss over the year with a, kind of this funky diet we sort of made up.

         Bill Lagakos: Well, that's terrific. And that's an awesome diet. I'm jealous.

         But, uh, yeah, that, that basically proves the point. I mean, even if it's not a lot of weight he lost, I think a weight loss is a major driver in a lot of the health improvements that people like to attribute to particular dietary trends.

         Terry Simpson: There doesn't seem to be a lot of long-term data in these diets. When I look at the sort of metadata, I see that if you eat really high on the low-fat side, you have a little lower lifespan. If you eat really high on the high-fat side, you have a little lower lifespan. If you have your carbs at about 55%, you seem to have a little longer lifespan.

         Is there much good data saying one diet versus another, other than the Mediterranean, has great long-term results?

         Bill Lagakos: I don't think so. I don't think it comes down to macros at all. I think that there's the confounding in those studies is so deep that I don't think the macronutrient composition of your diet is going to be what kills you in the end.

         Terry Simpson: Part of your job is helping people lose weight. What are sort of the big messages you try and get through to people?

         Bill Lagakos: One of the biggest things is the importance of adherence, which is why I try to say, you know, what do I know that, that you can adhere to 100%? It's what you've been doing because you've been doing it. So let's try and find the lowest hanging fruit that we can change so it doesn't turn your whole world upside down, which is something that would probably never work.

         Terry Simpson: So in other words, you're not going to change a Keto into a vegan or a vegan into a Keto.

         Bill Lagakos: Correct. However, I don't like to put those two at odds because there is, there have been a few studies on the vegan Ketogenic diet.

         Terry Simpson: So give me an example of some of the things for our audience, some of the things that they can do to incorporate it in their life now to help them lose weight and just feel a little better about themselves.

         Bill Lagakos: Well, feeling better about yourself and health outcomes and health profile, exercise can help with that a lot. I like to advocate all kinds of exercise. Cardio is good for the heart. Weights is good for quality of life and muscle mass, which also seems to bode well for quality of life.

         In terms of diet, probably nix the ultra-processed foods. Nobody needs single serves bags of potato chips lying around the house.

         Terry Simpson: Is that, that big, that great big bag? Is that the single serve?

         Bill Lagakos: [Laughing] No, no, but I know people that will go through multiple single serves in one sitting.

         Terry Simpson: Like when you see the Oreo cookie's just a hundred calories that you'd probably say it'd be better to have the apple?

         Bill Lagakos: Uh, yes. Yeah. And actually, even when it comes to the apple, one of the studies that was comparing processed to unprocessed foods, it was very interesting. I was trying to figure out how are they going to do this? And it was like an apple versus apple sauce. And that's sort of not an obvious comparison, but the people in the apple group tended to eat a little bit less.

         Terry Simpson: And when you start looking at, at some of the ultra-processed foods, are there some that you find that it has a lot of bang for the buck when you get people to sort of move away from them?

         Bill Lagakos: Yes. Uh, the lowest hanging fruit there is obviously potato chips because, you know, it's all too common that someone will sit down for lunch, have a sandwich, you know, a diet soda, thinking they're doing something great, and then instead of taking a couple potato chips and putting them on the plate, they'll just open the bag and sit down in front of it and generally overeat a lot because of that. The potato chips just don't seem to hit the satiety button.

         Terry Simpson: How about candy bars?

         Bill Lagakos: Candy bars are, I don't know, for kids maybe, but I don't think adults should be eating candy bars. Or, if they do, very rarely.

         Terry Simpson: That's the wrong answer, Bill. [Laughter]

         Bill Lagakos: Hey, I'm okay with the sausage and beer diet. Isn't that enough?

         Terry Simpson: When they hear us talk about that people will, you know, and Evo wrote a book about it, people say, "Oh, I can have all I want." And it's like, it's not all you want it. You know? I mean, Evo was...

         Bill Lagakos: Right, as soon as you told me that he lost weight on it, I was instantly convinced that that could definitely happen. That's very feasible for your health to improve because you're losing weight. You can eat pretty much every diet.

         I think there was a, there was a McDonald's diet where the guy over ate everything and it was a TV show and he got very sick, and somebody else did the McDonald's diet and they underrate at every opportunity and they lost weight and got healthier.

         Terry Simpson: What you're saying is, increasing fiber in the diet seems to not only help you from a satiety sense, which then keeps your appetite smaller, but provides a lot of health benefits because you're going to lose weight.

         Bill Lagakos: Yeah, I'm trying to move away from the word fiber, because if that was the plainest form, then Metamucil would've solved the obesity epidemic decades ago. And it seems to be like whole food based fibers seem to be the way to go. Not like an isolated fiber powder, for example.

         Terry Simpson: We see some of this problem in our weight loss surgery patients. So we start out weight loss surgery patients on what I call "formula," which is our version of some protein shake of which there are about a thousand out there that'll sell.

         But when patients come in and they haven't lost weight, they'll say, "Well, I'm going to just have more shakes," and it's like that's, you know, we, we, we would rather have them have some beans or, or something rather than the shakes.

         Bill Lagakos: I agree with that. That's, that's good, sound advice. The other thing that you mentioned is the shakes is something that I tend to, I don't rail against this movement on the social media, as people are starting to catch onto higher protein diets, which I tend to like that. You know, have a couple, three servings of protein a day seems to do well. Protein does seem to hit the satiety button quite well.

         And all of the hysteria about the kidney health leeching calcium from your bones, any of that stuff, I mean, the only thing that might be remotely true is from the KDOQI studies on the people with end-stage renal disease might have improved outcomes changing their protein intake. But even that is not 100%.

         Terry Simpson: We're pretty good at processing and breaking down protein and eliminating too much of it. We don't store it. So it tends to be when we can store my macronutrients that we have problems.

         Bill Lagakos: That's a good way to look at it.

         Terry Simpson: I want to talk to you a little bit about fatty liver disease. Uh, it's something that we in weight loss surgery see a lot of and, and we're usually the first ones to diagnosis. We're never surprised when we see it. We open up people and take a look at them with our scopes, and we see these, this fatty liver disease and we take biopsies and some of these people are fairly far advanced.

         Then, sometimes we have to go back and look at them again, and all of these people who have lost weight. And there will be some people who have, still have bad fatty liver disease. And there are other people who have not. We'd like to think that it's, uh, some dietary thing between them. But, but clearly there's a combination of diet and genetics that are there. It's not just all weight loss. What're your thoughts?

         Bill Lagakos: There, there's an interesting overlap. I saw, it was a correlational study and it was alcohol consumption and post uh bariatric surgery, and there seems to be sub, the sub-population that tends to drink a little bit more alcohol, and alcohol is definitely an independent risk factor for fatty liver.

         Terry Simpson: Yeah, there is a slight increase in alcoholism, one of the things that we have to screen for is alcohol abuse, and then afterwards is alcoholism. Because with some of the weight loss surgeries, when you drink, especially the ones that are, like the Roux-en-Y Gastric Bypass, or the One Anastomostic Gastric Bypass, the alcohol hits the small bowel much faster. People feel better much faster. And then, as all of us know, once you feel better with the alcohol, you want to keep it going. The difference is is that if you have a full stomach, you're not going to feel that right away and you can absorb more and you're not going to drink as much. These patients, we think, we give them a much faster avenue to that high.

         Bill Lagakos: That's interesting. That's unfortunate. And I'm glad to see that, you know, it's on your radar and you're doing the screening. But that's also going to put them at much greater risk of that fatty liver.

         I once heard a doctor who, similar to your case, I think I was a student when I asked this, I said, well, what's the difference? Why do they call it non-alcoholic fatty liver disease versus alcoholic fatty liver disease? What's the difference? And he told me patient history.

         Terry Simpson: What do you think about Lustig's comment about the highly unprocessed fructose causing, in some people, a high degree of fatty liver disease?

         Bill Lagakos: I don't know. It has to be consumed disproportionately very high. It is rarely found like that in nature. Like, you know, I guess Lustig said, it's just the high fructose corn syrup. If it's in a big energy excess, possibly contributing to fatty liver? By restricting fructose you're probably also restricting glucose and hopefully, and if you're creating an energy deficit in that context that could help clear the fatty liver.

         I think, uh, the, his, his stance on the whole, whole food based fruits and stuff, that's a good take, a good avenue. Even on the low carbohydrate approach I don't think that people should be, be abandoning, you know, low carbohydrate, low starch fruits and vegetables.

         Terry Simpson: But I do remember my first foray into the Atkins diet, which was many, many years ago, you know, it's sort of like don't eat these fruits, don't eat these vegetables. And I always wondered why would you say that?

         Bill Lagakos: Right, right. And I think it's sometimes some of the more recent Atkins advocates took it a little bit too far and said, you know, no fruits and vegetables at all because there's no carbs in eggs and poultry and steak, so we'll just stick to those.

         I think that sort of took the movement a little bit too far because even the Zone diet study was a low carbohydrate, what I would say would be a well-balanced low carbohydrate diet versus a Ketogenic diet, and the people on the low carb actually did a little bit better.

         Terry Simpson: And do you think that was because of the satiety with the whole foods?

         Bill Lagakos: Could be, it could be. I mean, fat is, uh, dietary fat doesn't seem to be like a super satiating nutrient, and it also seems very easy to passively over consume.

         Terry Simpson: Yeah, my brother-in-law brought a whole bunch of baklava over. I can, I can atest to that.

         Bill Lagakos: [Laughing] Delicious.

         Terry Simpson: I remember the, you know, when I, I think I was a college student when Atkins came out and I thought I had to lose five pounds because in those days that seemed to be the thing I had to do. Oh to have those days back again.

         But, I remember I was shocked when I went to Italy my very first time and here are all these beautiful people eating pasta and not getting fat. And it's like, this can't be. How can this be?

         Bill Lagakos: Yeah, I think the food environment has a lot to do with it. Like, you know, the, the memes, you see these on the internet, you know, when you go to the grocery store, you're bombarded with all these colorful flashy ads to get all this junk food as much as possible. And the food companies are trying to sell their product, so of course you're going to be advertising and have focus groups and whatnot. I do think that the food environment has something to do with it.

         Terry Simpson: Well, I also think that when you look at what they're actually eating with their pasta, they have a lot more vegetables and a lot less fat in it. And their fat is predominantly olive oil. Whereas with our pasta in the United States, I mean, when you look at spaghetti and meatballs in the United States there's an awful lot of meatballs. Where they might have one in a dish, we'll have half a dozen.

         Bill Lagakos: And that's also going to contribute to the calorie imbalance.

         Terry Simpson: It's coming down to calories in some sense, is that what the calorie man is saying?

         Bill Lagakos: [Laughing] It's hard to get around that. I mean, people get that, people get there in different ways. Like some people will feel a lot of satiety on like a whole food plant-based diet and that'll drive their calories down. Some people will get that way with the Ketogenic diet and that gives them an incredible amount of satiety. So it drives the, the calorie intake down.

         It's kind of like how you get to that end point is the purpose. I have seen some debates that showed there might be some differences in sort of metabolic efficiency, calorie absorption efficiency, but I tend to think that might account for a couple hundred calories tops? And it seems that might not have a huge influence if somebody is over eating 500 calories, but then maybe 200 calories aren't absorbed as well. Or they have a greater thermic effect of feeding, I guess it could put a dent in it.

         Do you know how gastric bypass cures this, cures diabetes so quickly?

         Terry Simpson: Well, I don't know that it's the gastric bypass that does it. I think that because every weight loss surgery does it, whether it's the lap band that we hardly do any anymore, or the gastric sleeve, which is the most common, or the bypass or the One Anastomosis bypass, or the Duodenal Switch, what they all have in common is you're eating so little. You're in such a huge calorie deficit for the first couple of months that you're going to burn through your glycogen.

         Bill Lagakos: Oh, from day one.

         Terry Simpson: Yeah, and so you're burning through your glycogen very quickly, and then you're starting to use up your fat stores. So I think that's kind of the magic. So, you know, for awhile we thought there was something we bypass in the first part of the intestine that did it. And it seemed to work out in mice, but it's never worked out in humans.

         Bill Lagakos: I met, I met a girl who was a wizard surgeon and she was taking one part of the intestine, putting it in a different part of the intestine, taking, you know, an inch of mouse intestine, reversing it. And she, she provided a compelling case that in the mouse, it could be when the nutrients are hitting which part of the intestine was having some of the effect, but it -

         Terry Simpson: But it never works out in people.

         Bill Lagakos: Right. In people, in people it just seems it's such an easier, what do they say, Occam's razor, you know, you're in an instant energy deficit. It's something that you probably haven't been in in years, maybe decades, and now you're finally seeing shack clearing out of, uh, ectopic sites like the liver, muscle.

         Terry Simpson: Yeah. And they just seem to, and they just seem to get better. And so we , if you're in the Roux-en-Y Gastric Bypass camp, you will repeat the mantra that the Roux-en-Y Gastric Bypass is a cure for diabetes. But if you're in a camp of, we will do whatever weight loss surgery will, they're all in our toolbox, you see every single weight loss - Or when you have weight loss, cures diabetes.

         There, obviously, there are those patients who you can do a gastric bypass on, and after a few months they regained, they regain their weight. That's not a majority, but those people don't tend to cure their diabetes.

         So I do think the magic is the body weight. That, I think, is a great cure for insulin resistance. I sort of look at it like your fat cell is a sponge which will soak up insulin. The smaller you make your fat cells, the less surface area there is, your insulin will work better.

         Bill Lagakos: Sure, sure. And insulin is very good at making fat cells grow. It does it at a much lower concentration in the blood, than, for example, it causes glucose uptake in muscle.

         Terry...]]>a56deae5-9426-44fb-b236-2db6ce20d68cThu, 31 Mar 2022 00:00:00 -070026:58falsefull88Is It The Mediterranean Diet Or The Mediterranean Lifestyle?In science, we don’t look to confirm what we know; we want to find out something that we don’t know. We love it when science proves us wrong.

         If your doctor told you that you have heart disease, were pre-diabetic, or said you should eat healthier, they likely will tell you to follow the Mediterranean Diet.

         When I introduce the Mediterranean Diet to my patients I get a response like this:

         “Sounds great!  Who doesn’t love red wine, olive oil, and fresh Italian tomatoes?”

         This is followed by asking for a recommendation of a book of recipes from the Mediterranean.

         The Mediterranean Diet seems to invoke sitting on a rooftop restaurant in Positano sipping wine while munching on fruit and waiting for pasta. The food and wine are part of the lifestyle, as is relaxing and breathing in the surroundings. You might not be on a rooftop restaurant in Positano (lucky if you are). You might be looking in your yard and seeing a squirrel or rabbit or flowers, and taking in that time to breathe and relax and maybe the glass of wine and thus transporting that lifestyle to your home.

         Which do you think is better for your heart and your brain: rushing home from a stressful day at work, grabbing a martini and letting the alcohol calm you or going outside, taking a deep breath of fresh air, maybe having a glass of wine?

         In the original Greek, the word “diata” was used to describe how one should live, what one should eat, how to maintain a healthy body. It is from diata that our word “diet” derives. There is no doubt what you eat impacts your health.

         While the origin of the Mediterranean Diet is what ‘some’ people in the Mediterranean ate, but that isn’t what we (doctors, scientists, registered dieticians) mean today.   Over the last fifty years over 150 foods have been studied to see their effect on humans, for better or for ill.  

         Years of research, studied on millions of people, and yet most people have the view of the Mediterranean lifestyle as hummus and fish. So let me introduce this diet, and this lifestyle to you, and why it may be the most important lifestyle you should understand.

         In spite of all the noise on the internet about low carb/keto, vegan, or other diets/lifestyles you will find that the Mediterranean Diet is consistently ranked as the number one or two diet in the United States. 

         That is based on many studies showing how the diet leads to a decrease in heart disease, lower blood pressure, better control of diabetes, fewer strokes, and lowering the risk of dementia.

         The Mediterranean diet is neither low carbohydrate (it is about 50% carbohydrate) nor low fat (it is about 30% fat). It is not high protein (it is about 20% protein). Improvement in your health comes from eating certain foods, and not from counting macros (proteins, carbs, fats, and alcohol). Weight loss and better health are both touted from those who profess “low carb” or “low fat” and yet weight loss with the Mediterranean lifestyle is equal to or better than the low fat or low carb “diets”.

         Those who claim low-carbohydrate diets are the best for diabetes are often stunned that the Mediterranean diet provides superior long-term results for diabetes and insulin resistance. While they rightly point out that a diet rich in whole grains and fruits, will produce transient spikes in blood glucose levels, the long-term results from the Mediterranean lifestyle are superior to avoiding those foods – providing better control for diabetes.

         Back to those categories: Vegetables, Fruit and nuts, legumes, whole grains, meats, dairy, fats and oils, fish, and alcohol.

         Each one of those categories is worth a point, so you have a chance to get nine points total. For some categories, you get a point for eating a given quantity of food (more for some, less for others). We determine adherence to the diet based on how many points a day a person gets on average. The closer to nine points a person has on a daily basis, the healthier they are over the long term. 

         Vegetables: The target is 9-10 ounces a day of vegetables. 

         We count the pre-cooked weight of vegetables. If you bake 9 ounces of broccoli it will weigh about 4 ounces when cooked, but you still get credit for the 9 ounces. A medium carrot is 4 ounces - so two carrots a day gets you almost to your goal!

         There is a long list of vegetables and recipes in here to add them, but in case you want a refresher Asparagus, Beets, Brussels Sprouts, Cabbage, Celery, Collard Greens, Cucumber, Eggplants, Peas, Leeks, Lettuce, Onions, Peppers, Shallots, Spinach, Squash, Zuchinni... and those are just a few of them. 

         Don't think of vegetables as a side dish - think of how you can incorporate them. One of my favorite is to put in cabbage in fish tacos to give it a lot of crunch. Add carrots, onions, peppers, celery to your tomato sauce for pasta. Your kids like chili? Any idea how many vegetables you can toss in there and they won't even know it? Add them to your chicken soup, or your dahl.

         Vegetable tip: Recommended intake for Vegetables: 4 or more servings each day (one portion should be raw vegetables). A serving is 1 cup raw or 1/2 cup cooked. Always best to eat a variety of colors and textures. 

         Fruits and Nuts (not politicians): Target is 8-9 ounces. A medium apple is 6 ounces. 

          Fruits are portable, delicious, filled with fiber and a part of a great diet. The nuts in here are tree nuts (peanuts are a legume). Which are a better snack than a bag of chips.

         So how to get this in? Easy to have a handy fruit at lunch, some fruit in the morning, and even some for dessert. While you know apples  - did you know there used to be over 14,000 varieties of apples in the United States? Most common apples sold in most supermarkets are not that great, but I like Honey Crisp. My absolute favorite apple is the Knobby Russet - which is hard to find, unless you have someone with a tree.

         Don't forget the berries: blueberries, blackberries, salmon berries, Huckle berries.

         This also includes seeds - and I love putting chia seeds into my overnight oats. Seeds have a lot of magnesium. Magnesium seems to be today's buzz element for health, and it is important. Nuts have more calories, but with their mono-unsaturated fats and fiber they make a  healthy portable snack. I like walnuts, as they are a great source of vitamin D.

         If you have diabetes and notice that fruits will spike your blood glucose level you should know that in long-term studies people with diabetes who ate whole grains and fruits had lower Hemoglobin A1C than others. Short term glucose spikes are not as important as a healthy diet.

         Fruit tip: make fruit your dessert. 

         Legumes: The target is 2 ounces a day. 

         Think beans, lentils, and even okra. In culinary medicine a legume is any plant that seeds are lined up in a pod, but if you talk to a botonist they will tell you how okra is not of the legume family. We

         will count okra here. Chickpeas are my favorite snack - bake them in the oven or an airfryer and you have a great snack. Peanuts, in contrast to tree nuts, are a legume. This means you can get a Mediterranean point by just eating some peanut butter!

         Legumes are a great source of protein and fiber and low in fat. Did you know that people who eat legumes as a primary source of protein in meals at least four times a week have 22% less heart attacks?

         Lentils are great, and my Dahl for a great soup is a wonderful filling dish. 

         Green beans, like haricot verts, are a great side dish - I like mine with a mix of dijon mustard and olive oil (see my recipe).

         Vegetarians often find that legumes are a major source of protein.

         Legume tip: 1 ounce or 1 serving is 23 almonds or 14 walnut halves. 1 serving of beans is 1/2 cup.

         Cereals and Grains: The target is 9-10 ounces a day.

         Whole grains are associated with a decrease risk of heart disease, diabetes, and obesity. Refined grains (white four, white rice) is associated with an increased risk of heart disease, diabetes, and obesity. Quite a contrast.

         Grains, more than any other food group, have been held in contempt by the low-carbohydrate types and rightfully so when it comes to the refined variety. 

         Breakfast is a place where I get a lot of my whole grains - I love overnight oats (made with rolled oats). But on the days when I forget to make then there are some great whole grain cereals like bran flakes, cheerios, life cereal. 

         Whole wheat bread is an easy way to add fiber and nutrients to the highly demonized bread. 

         Let us not forget about whole wheat pasta. It is finally available everywhere, and provides a filling meal and is worth some points. I didn't like the spirlized vegetable substitute for pasta, I like pasta. 

         It seems easy, right? 

         Gain tip: the other way is to look at servings which is 4 or more servings per day of whole grains. 1 serving is 1 slice of bread or 1/2 cup of cooked oatmeal. 

         Fish: Target is 2 ounces a day OR two to three meals a week.

         The Mediterranean diet is more fish than meat or poultry. The reason is fish are high in Omega 3 fatty acids, which are missing in many traditional diets. 

         Give fish a chance. A few fish tips about buying fish: never buy fish that smells fishy. Buy from trusted sources. Worried about mercury - check to see that most sustainable fish are low in mercury. Buy the light tuna (yellow) instead of albecore. Or buy from a place like Oregon's Choice, where their mercury levels are low. 

         Heart disease and risk of heart...]]>In science, we don’t look to confirm what we know; we want to find out something that we don’t know. We love it when science proves us wrong.

         If your doctor told you that you have heart disease, were pre-diabetic, or said you should eat healthier, they likely will tell you to follow the Mediterranean Diet.

         When I introduce the Mediterranean Diet to my patients I get a response like this:

         “Sounds great!  Who doesn’t love red wine, olive oil, and fresh Italian tomatoes?”

         This is followed by asking for a recommendation of a book of recipes from the Mediterranean.

         The Mediterranean Diet seems to invoke sitting on a rooftop restaurant in Positano sipping wine while munching on fruit and waiting for pasta. The food and wine are part of the lifestyle, as is relaxing and breathing in the surroundings. You might not be on a rooftop restaurant in Positano (lucky if you are). You might be looking in your yard and seeing a squirrel or rabbit or flowers, and taking in that time to breathe and relax and maybe the glass of wine and thus transporting that lifestyle to your home.

         Which do you think is better for your heart and your brain: rushing home from a stressful day at work, grabbing a martini and letting the alcohol calm you or going outside, taking a deep breath of fresh air, maybe having a glass of wine?

         In the original Greek, the word “diata” was used to describe how one should live, what one should eat, how to maintain a healthy body. It is from diata that our word “diet” derives. There is no doubt what you eat impacts your health.

         While the origin of the Mediterranean Diet is what ‘some’ people in the Mediterranean ate, but that isn’t what we (doctors, scientists, registered dieticians) mean today.   Over the last fifty years over 150 foods have been studied to see their effect on humans, for better or for ill.  

         Years of research, studied on millions of people, and yet most people have the view of the Mediterranean lifestyle as hummus and fish. So let me introduce this diet, and this lifestyle to you, and why it may be the most important lifestyle you should understand.

         In spite of all the noise on the internet about low carb/keto, vegan, or other diets/lifestyles you will find that the Mediterranean Diet is consistently ranked as the number one or two diet in the United States. 

         That is based on many studies showing how the diet leads to a decrease in heart disease, lower blood pressure, better control of diabetes, fewer strokes, and lowering the risk of dementia.

         The Mediterranean diet is neither low carbohydrate (it is about 50% carbohydrate) nor low fat (it is about 30% fat). It is not high protein (it is about 20% protein). Improvement in your health comes from eating certain foods, and not from counting macros (proteins, carbs, fats, and alcohol). Weight loss and better health are both touted from those who profess “low carb” or “low fat” and yet weight loss with the Mediterranean lifestyle is equal to or better than the low fat or low carb “diets”.

         Those who claim low-carbohydrate diets are the best for diabetes are often stunned that the Mediterranean diet provides superior long-term results for diabetes and insulin resistance. While they rightly point out that a diet rich in whole grains and fruits, will produce transient spikes in blood glucose levels, the long-term results from the Mediterranean lifestyle are superior to avoiding those foods – providing better control for diabetes.

         Back to those categories: Vegetables, Fruit and nuts, legumes, whole grains, meats, dairy, fats and oils, fish, and alcohol.

         Each one of those categories is worth a point, so you have a chance to get nine points total. For some categories, you get a point for eating a given quantity of food (more for some, less for others). We determine adherence to the diet based on how many points a day a person gets on average. The closer to nine points a person has on a daily basis, the healthier they are over the long term. 

         Vegetables: The target is 9-10 ounces a day of vegetables. 

         We count the pre-cooked weight of vegetables. If you bake 9 ounces of broccoli it will weigh about 4 ounces when cooked, but you still get credit for the 9 ounces. A medium carrot is 4 ounces - so two carrots a day gets you almost to your goal!

         There is a long list of vegetables and recipes in here to add them, but in case you want a refresher Asparagus, Beets, Brussels Sprouts, Cabbage, Celery, Collard Greens, Cucumber, Eggplants, Peas, Leeks, Lettuce, Onions, Peppers, Shallots, Spinach, Squash, Zuchinni... and those are just a few of them. 

         Don't think of vegetables as a side dish - think of how you can incorporate them. One of my favorite is to put in cabbage in fish tacos to give it a lot of crunch. Add carrots, onions, peppers, celery to your tomato sauce for pasta. Your kids like chili? Any idea how many vegetables you can toss in there and they won't even know it? Add them to your chicken soup, or your dahl.

         Vegetable tip: Recommended intake for Vegetables: 4 or more servings each day (one portion should be raw vegetables). A serving is 1 cup raw or 1/2 cup cooked. Always best to eat a variety of colors and textures. 

         Fruits and Nuts (not politicians): Target is 8-9 ounces. A medium apple is 6 ounces. 

          Fruits are portable, delicious, filled with fiber and a part of a great diet. The nuts in here are tree nuts (peanuts are a legume). Which are a better snack than a bag of chips.

         So how to get this in? Easy to have a handy fruit at lunch, some fruit in the morning, and even some for dessert. While you know apples  - did you know there used to be over 14,000 varieties of apples in the United States? Most common apples sold in most supermarkets are not that great, but I like Honey Crisp. My absolute favorite apple is the Knobby Russet - which is hard to find, unless you have someone with a tree.

         Don't forget the berries: blueberries, blackberries, salmon berries, Huckle berries.

         This also includes seeds - and I love putting chia seeds into my overnight oats. Seeds have a lot of magnesium. Magnesium seems to be today's buzz element for health, and it is important. Nuts have more calories, but with their mono-unsaturated fats and fiber they make a  healthy portable snack. I like walnuts, as they are a great source of vitamin D.

         If you have diabetes and notice that fruits will spike your blood glucose level you should know that in long-term studies people with diabetes who ate whole grains and fruits had lower Hemoglobin A1C than others. Short term glucose spikes are not as important as a healthy diet.

         Fruit tip: make fruit your dessert. 

         Legumes: The target is 2 ounces a day. 

         Think beans, lentils, and even okra. In culinary medicine a legume is any plant that seeds are lined up in a pod, but if you talk to a botonist they will tell you how okra is not of the legume family. We

         will count okra here. Chickpeas are my favorite snack - bake them in the oven or an airfryer and you have a great snack. Peanuts, in contrast to tree nuts, are a legume. This means you can get a Mediterranean point by just eating some peanut butter!

         Legumes are a great source of protein and fiber and low in fat. Did you know that people who eat legumes as a primary source of protein in meals at least four times a week have 22% less heart attacks?

         Lentils are great, and my Dahl for a great soup is a wonderful filling dish. 

         Green beans, like haricot verts, are a great side dish - I like mine with a mix of dijon mustard and olive oil (see my recipe).

         Vegetarians often find that legumes are a major source of protein.

         Legume tip: 1 ounce or 1 serving is 23 almonds or 14 walnut halves. 1 serving of beans is 1/2 cup.

         Cereals and Grains: The target is 9-10 ounces a day.

         Whole grains are associated with a decrease risk of heart disease, diabetes, and obesity. Refined grains (white four, white rice) is associated with an increased risk of heart disease, diabetes, and obesity. Quite a contrast.

         Grains, more than any other food group, have been held in contempt by the low-carbohydrate types and rightfully so when it comes to the refined variety. 

         Breakfast is a place where I get a lot of my whole grains - I love overnight oats (made with rolled oats). But on the days when I forget to make then there are some great whole grain cereals like bran flakes, cheerios, life cereal. 

         Whole wheat bread is an easy way to add fiber and nutrients to the highly demonized bread. 

         Let us not forget about whole wheat pasta. It is finally available everywhere, and provides a filling meal and is worth some points. I didn't like the spirlized vegetable substitute for pasta, I like pasta. 

         It seems easy, right? 

         Gain tip: the other way is to look at servings which is 4 or more servings per day of whole grains. 1 serving is 1 slice of bread or 1/2 cup of cooked oatmeal. 

         Fish: Target is 2 ounces a day OR two to three meals a week.

         The Mediterranean diet is more fish than meat or poultry. The reason is fish are high in Omega 3 fatty acids, which are missing in many traditional diets. 

         Give fish a chance. A few fish tips about buying fish: never buy fish that smells fishy. Buy from trusted sources. Worried about mercury - check to see that most sustainable fish are low in mercury. Buy the light tuna (yellow) instead of albecore. Or buy from a place like Oregon's Choice, where their mercury levels are low. 

         Heart disease and risk of heart disease is greatly reduced by eating at least two meals a week in fish. The oil capsules do not have the same advantage. 

         Salmon, sardines, and tuna are all rich in Omega-3 fatty acids. 

         Olive Oil and other fats:

         Olive oil is life! It was the first form of light, electricity, and used for cosmetics in the ancient world. Olive oil is still used by some for an aftershave!

         These are high in monounsaturated fat, and other oils that are just as healthy include Canola, Grapeseed (which I use for a lot of cooking) Sesame oil, Tahini, Peanut butter, and Safflower oil. Be careful of avocado oil as it is recommended because of a high smoke point, but often is contaminated with other oils -- food fraud. Know your sources. 

         Did you know the highest purest standards for extra virgin olive oil are in the United States. You can argue about your favorite olive oil, but the high standards are met when the US growers submit their oils for testing. I buy California and Arizona olive oil. I hear Georgia has some good olive oil also.

         Before you get too upset, my favorite olive oil in the world is from Liguria in Italy.

         The goal is to have over 60 percent of the food you cook come from monounsaturated fats.

         I like extra virgin olive oil (EVOO) and use it in salad dressings, cooking. Instead of butter or margarine choose natural peanut butter or an avocado.

         Dairy: Target is less than 7 ounces per day of liquid or less that 1.5 ounces a day of hard cheese.

         This means you use cheese for its flavor - sprinkle some great parmesan cheese and you can taste it. 

         Yogurt is great, you can make your own or be careful about what you buy.

         Meats: The target is less than 4 ounces a day.

         I know it doesn't seem like much, but the latest studies confirm that a little meat is ok, but the more meat you have the greater the risk of heart disease. Protein sources from fish, vegetables, and legumes are important - meat is more of an extra bit on the side. I love red meat, especially lamb, but to cut down on the meat is a great way to remove calories while enjoying far more flavor.

         Alcohol: Target: one serving for women, two for men. A serving is 5 ounces of wine, 1 ounce of hard liquids, or one beer.

         Toxicity is in the dose. Too much is bad, too little is ineffective - but wine has some great polyphenols in it and associated with a lot of health benefits. But too much is never a good thing. 

         You do not need to drink alcohol on the Mediterranean Diet - so don't start. If you have been told to avoid alcohol because of a liver or other issue, please listen to your medical team. 

         You get a point if you don't drink alcohol. You cannot save up your drinks for the weekend! 

         ]]>7ebf4ead-de6a-4868-af21-d42309f49f5eWed, 16 Mar 2022 00:00:00 -070008:45falsefull77Wine: Terroir Tales and Fables, You Can't Taste the SoilIn Vino, Veritas – or In Wine, Truth – by Pliny the Elder

         When the Holy Roman Empire was forming Charlemagne gave lands to the monks in order for them to plant vineyards to make wine for the Eucharist. Those first vineyards, planted by Benedictine monks, make some of the classic wines of all time.  Wine was in France centuries prior to Charlemagne, but it was those monks that we have a provenance of today’s wine. It was also from those Monks that we got the concept of terroir.

         Today terroir is the “in” thing that wine sommeliers will talk about. One of the myths is that you can taste the soil of the wine.  This traces back to those monks who would taste the soil in order to determine where the best wines would come from. What those monks didn’t know was that the vines get their ingredients from carbon dioxide and sunlight.

         Wine geology is complex, and recently Alex Maltman, a distinguished professor emeritus of geology, published a book about the geology of wine.  His book: Vineyards, Rocks, and Soils The Wine Lover’s Guide to Geology is a reference guide for those who want to know more about the geology of the wines they are drinking.

         Dr. Maltman was also a guest on the podcast where we talked about wine geology and dispelled the myth about tasting the soil.

         Dr. Maltman notes that the chalk of Champagne is the soil, and the soil is important to drainage of the vine, but the plant doesn’t take up chalk (which is a silicate compound), and when the inorganic compounds of chalk are broken down, and some of those minerals are taken up they are tasteless.

         What people taste are the many organic compounds that the plant makes from the carbon from carbon dioxide through photosynthesis and coded on the vineyards DNA. You also taste the byproducts of fermentation – as those compounds are put through yeast, bacteria. Where the confusion lies is that some of the organic compounds of the soil smell like some of the products of fermentation of the wine.

         The monks didn’t know about photosynthesis, nor did they know about DNA encoding for the proteins and organic chemicals, nor did they understand the complex chemistry of fermentation. They just knew wine is delicious- and sometimes the soil tastes a bit like the wine, so they assumed that the vine took up the soil and put it into the grape (the wine takes up the water, not the soil).

         Today Sommeliers everywhere love to talk about the geology of where the wine you are buying came from. They love telling you a story – because we love stories about our food. As Maltman points out, we love to know the provenance of our food, and in an era of large multinational corporations, wine is one of the few places you can know about where a grape was grown, harvested, what were the conditions that year, what is the makeup of the land – even what side of the mountain that wine came from.

         But what you cannot taste, is the soil from the rocks. That, my friends, is not only impossible because of how and what the plant takes from the soil (water and ionic forms of inorganic compounds, as Maltman points out in his book) but ignores the most glorious and complex part of wine.

         In our conversation, Maltman talks about the grapes that no one has heard of that are making a comeback in Greece, Croatia, and Eastern Europe.

         Oh, and we bust the myths of resveratrol and people who want to add this as a supplement for weight loss, long life, etc.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions. 

         ]]>In Vino, Veritas – or In Wine, Truth – by Pliny the Elder

         When the Holy Roman Empire was forming Charlemagne gave lands to the monks in order for them to plant vineyards to make wine for the Eucharist. Those first vineyards, planted by Benedictine monks, make some of the classic wines of all time.  Wine was in France centuries prior to Charlemagne, but it was those monks that we have a provenance of today’s wine. It was also from those Monks that we got the concept of terroir.

         Today terroir is the “in” thing that wine sommeliers will talk about. One of the myths is that you can taste the soil of the wine.  This traces back to those monks who would taste the soil in order to determine where the best wines would come from. What those monks didn’t know was that the vines get their ingredients from carbon dioxide and sunlight.

         Wine geology is complex, and recently Alex Maltman, a distinguished professor emeritus of geology, published a book about the geology of wine.  His book: Vineyards, Rocks, and Soils The Wine Lover’s Guide to Geology is a reference guide for those who want to know more about the geology of the wines they are drinking.

         Dr. Maltman was also a guest on the podcast where we talked about wine geology and dispelled the myth about tasting the soil.

         Dr. Maltman notes that the chalk of Champagne is the soil, and the soil is important to drainage of the vine, but the plant doesn’t take up chalk (which is a silicate compound), and when the inorganic compounds of chalk are broken down, and some of those minerals are taken up they are tasteless.

         What people taste are the many organic compounds that the plant makes from the carbon from carbon dioxide through photosynthesis and coded on the vineyards DNA. You also taste the byproducts of fermentation – as those compounds are put through yeast, bacteria. Where the confusion lies is that some of the organic compounds of the soil smell like some of the products of fermentation of the wine.

         The monks didn’t know about photosynthesis, nor did they know about DNA encoding for the proteins and organic chemicals, nor did they understand the complex chemistry of fermentation. They just knew wine is delicious- and sometimes the soil tastes a bit like the wine, so they assumed that the vine took up the soil and put it into the grape (the wine takes up the water, not the soil).

         Today Sommeliers everywhere love to talk about the geology of where the wine you are buying came from. They love telling you a story – because we love stories about our food. As Maltman points out, we love to know the provenance of our food, and in an era of large multinational corporations, wine is one of the few places you can know about where a grape was grown, harvested, what were the conditions that year, what is the makeup of the land – even what side of the mountain that wine came from.

         But what you cannot taste, is the soil from the rocks. That, my friends, is not only impossible because of how and what the plant takes from the soil (water and ionic forms of inorganic compounds, as Maltman points out in his book) but ignores the most glorious and complex part of wine.

         In our conversation, Maltman talks about the grapes that no one has heard of that are making a comeback in Greece, Croatia, and Eastern Europe.

         Oh, and we bust the myths of resveratrol and people who want to add this as a supplement for weight loss, long life, etc.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions. 

         ]]>0eb8f57a-1b80-4a16-9169-977728ea6529Sat, 08 Jan 2022 00:00:00 -070026:42falsefull1661Ten Day Holiday Diet - Again!This episode originally aired for the holidays in 2018. But it's solid advice, so we're playing it again, Sam!

         Diet season is soon upon us, but what happens if we have a system where you can lose weight during the times when you are most vulnerable: holidays, vacations, new relationships.

         Not a “lifestyle” or “long term” diet - but a simple ten-day plan to lose weight during the times when you need it.

         Full details: https://www.yourdoctorsorders.com/2018/12/10-day-holiday-diet/

         -----

         Produced and distributed by Simpler Media

         Follow Dr. Terry Simpson on Twitter

         ]]>This episode originally aired for the holidays in 2018. But it's solid advice, so we're playing it again, Sam!

         Diet season is soon upon us, but what happens if we have a system where you can lose weight during the times when you are most vulnerable: holidays, vacations, new relationships.

         Not a “lifestyle” or “long term” diet - but a simple ten-day plan to lose weight during the times when you need it.

         Full details: https://www.yourdoctorsorders.com/2018/12/10-day-holiday-diet/

         -----

         Produced and distributed by Simpler Media

         Follow Dr. Terry Simpson on Twitter

         ]]>7cc6d629-2617-4d51-b47b-ed459ed14d42Tue, 21 Dec 2021 14:00:00 -070009:20falsebonusMicroplastics in Fish, in Fruit, in WaterThe term "microplastics" was originally described in 2004 for plastic particles that are less than 5 millimeters in diameter, originally being seen on beaches. But everywhere scientists have looked on planet earth, they have been found. From fruit, vegetables, nuts, beer, baby bottles, in the air, in our water.

         Some have estimated that we ingest 100,000 microplastic particles per day or the equivalent of a credit card of microplastic in a year. That number will only increase, as we are producing over 400 million tons of plastics a year, and we have over 5 billion tons of plastics in landfills. Plastic degrades over time, from sunlight, from ocean water, from wind. Some of those plastics become so small they cross the blood-brain barrier in humans.

         These plastics come in all shapes and sizes. As they are exposed to the environment and degrade, they become smaller and smaller. They come with different types of plastics with different reactions, but mostly we don't know.

         The problem is we don't know what these plastics are doing to us. We don't know what the toxic levels of microplastics are. We don't know what, if any, physiological systems that microplastics would interfere with. We don't know if they increase cancer, heart disease, auto-immune disease, dementia, liver cirrhosis - we just don't know. We don't know if they inhibit the growth of children if they cause the loss of fetuses in women who are pregnant.

         We do know on larger levels; plastics cause issues with marine mammals. Shopping bags in the water look like the turtle's favorite feast, a jellyfish, and they will consume those, and those plastics become stuck in the turtle's digestive system clogging up their intestines and leading to their death. Most have seen the turtle whose nose was stuffed with a plastic straw. What we don't know is what happens when the small microplastics enter into cells, or cross the blood-brain barrier, or land in our lungs. Those finds led to the laws to decrease plastic one-use bags and plastic straws, but that is just the tip of what might be a more serious problem.

         We know that mice fed microplastics had lower sperm counts, smaller offspring, but again, mice are not men. We also don't know what the different types of microplastics will do - one type might be harmful, another type might be benign.

         Some plastics might pass through us like fiber, indigestible matter that has no consequence other than moving stool along.

         What can you do if you are worried? If you feed your child formula, use bottles instead of plastic. If you use your microwave, don't reheat food in plastic containers. Try not to use plastic containers for storage, and don't dispose of them so quickly. Water bottles - well, time to use reusable water bottles made of metal or glass.

         For now, we can do a small part, but it isn't the entire part. It is a problem that may be a larger problem or less of a problem. But it probably is an issue. We already know that some plastics do cause endocrine disruption, and those products have been outlawed.

         But it isn't just a marine problem; whether you are a vegan, pescatarian, vegetarian, omnivore, or carnivore, there will be plastics in everything you eat.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by the noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.

         ]]>The term "microplastics" was originally described in 2004 for plastic particles that are less than 5 millimeters in diameter, originally being seen on beaches. But everywhere scientists have looked on planet earth, they have been found. From fruit, vegetables, nuts, beer, baby bottles, in the air, in our water.

         Some have estimated that we ingest 100,000 microplastic particles per day or the equivalent of a credit card of microplastic in a year. That number will only increase, as we are producing over 400 million tons of plastics a year, and we have over 5 billion tons of plastics in landfills. Plastic degrades over time, from sunlight, from ocean water, from wind. Some of those plastics become so small they cross the blood-brain barrier in humans.

         These plastics come in all shapes and sizes. As they are exposed to the environment and degrade, they become smaller and smaller. They come with different types of plastics with different reactions, but mostly we don't know.

         The problem is we don't know what these plastics are doing to us. We don't know what the toxic levels of microplastics are. We don't know what, if any, physiological systems that microplastics would interfere with. We don't know if they increase cancer, heart disease, auto-immune disease, dementia, liver cirrhosis - we just don't know. We don't know if they inhibit the growth of children if they cause the loss of fetuses in women who are pregnant.

         We do know on larger levels; plastics cause issues with marine mammals. Shopping bags in the water look like the turtle's favorite feast, a jellyfish, and they will consume those, and those plastics become stuck in the turtle's digestive system clogging up their intestines and leading to their death. Most have seen the turtle whose nose was stuffed with a plastic straw. What we don't know is what happens when the small microplastics enter into cells, or cross the blood-brain barrier, or land in our lungs. Those finds led to the laws to decrease plastic one-use bags and plastic straws, but that is just the tip of what might be a more serious problem.

         We know that mice fed microplastics had lower sperm counts, smaller offspring, but again, mice are not men. We also don't know what the different types of microplastics will do - one type might be harmful, another type might be benign.

         Some plastics might pass through us like fiber, indigestible matter that has no consequence other than moving stool along.

         What can you do if you are worried? If you feed your child formula, use bottles instead of plastic. If you use your microwave, don't reheat food in plastic containers. Try not to use plastic containers for storage, and don't dispose of them so quickly. Water bottles - well, time to use reusable water bottles made of metal or glass.

         For now, we can do a small part, but it isn't the entire part. It is a problem that may be a larger problem or less of a problem. But it probably is an issue. We already know that some plastics do cause endocrine disruption, and those products have been outlawed.

         But it isn't just a marine problem; whether you are a vegan, pescatarian, vegetarian, omnivore, or carnivore, there will be plastics in everything you eat.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by the noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.

         ]]>543ba006-59e1-44df-b58e-0682e577e019Thu, 02 Dec 2021 00:00:00 -070003:34falsefull1551Fructose: Evil or Misunderstood?Ever since the YouTube video of Dr. Lustig and the evils of fructose went viral in 2010, many have advocated that fructose is the single most common cause of obesity in the United States.

         The video had metabolic pathways that had the hypothesis that most fructose either becomes fat in the liver, or that it might go down a pathway to cause joint issues, leaky gut, and inflammation causing obesity.

         Here are the two chemical structures of glucose, also known as the "good sugar" and fructose, or the bad sugar. I cannot help but thinking of the good witch and the bad witch on the Wizard of Oz.

         Dr. Lustig's hypothesis was based on studies done in mice and rats. In those studies, published two years before the viral video, found that high fructose diets in mice lead to increased "gut leak" and led to liver damage (1). This was even confirmed with a small study of 8 men (2) who had their complex carbohydrates replaced by fructose and fed normal caloric diets - meaning, these eight men had increased liver fat, more de novo fat formation (de novo lipogenesis) .

         This all makes that logical sense since sugar-sweetened beverages are associated with chronic inflammation and these days everything to do with chronic inflammation increases the risk of obesity, diabetes, heart disease, and aging.

         Then came a double-blinded, randomized, crossover study where a group of people were fed a standard diet but drank 25% of their calories as either fructose (the evil sugar), or glucose (the good one) or a high fructose corn syrup sweetened beverage. Oddly, there was no difference in any of those groups with regard to markers of inflammation, intestinal permeability, or inflammation in the fat tissue.

         To quote from the study: "Excessive amounts of fructose, HFCS, and glucose from SSBs consumed over 8 d did not differentially affect low-grade chronic systemic inflammation in normal-weight to obese adults." SSB = sugar sweetened beverages.

         There have been a number of human trials looking at sugar-sweetened beverages and inflammation, and the results are not consistent. Even finding that people who drink large amounts of either glucose of fructose didn't find changes in inflammation or visceral fat.

         Mice are not men, and the link between gut permeability, leading to systemic and chronic inflammation, occurs in mice, but not men. And while in mice fructose can lead to inflammation and liver issues, this doesn't happen in human beings. (4)

         The key may not be fructose itself, but increased caloric intake.  If you eat more, you will increase in weight, but it is not fructose alone. It is, in fact, high caloric intake combined with sugars. Meaning, that great tasting snack with the high levels of sugars and fats act in concert with the increased calories consumed to give you that portly look.

         To be fair, all of the studies were short term, less than a couple of weeks. Fructose, over the long term, may still be a bad actor.

         What about fruit? It is exceedingly difficult to eat enough whole fruits to make this a problem. To eat the excess amount in some of these studies you would have to eat several pounds of apples, and most people simply cannot do that in a day. And whole fruit consumption, as a part of the Mediterranean diet reduces the burden of cardiovascular disease, diabetes, and even erectile dysfunction.(5)

         In fact less than 10% of most Western dieters have adequate levels of fruit (6) leading to a serious threat to human health. Maybe a couple of apples a day will keep the doctor away.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.  

         REFERENCES:

         (1)  Bergheim I, Weber S, Vos M, Krämer S, Volynets V, Kaserouni S, McClain CJ, Bischoff SC. Antibiotics protect against fructose-induced hepatic lipid accumulation in mice: role of endotoxin. J Hepatol. 2008 Jun;48(6):983-92. doi: 10.1016/j.jhep.2008.01.035. Epub 2008 Mar 14. PMID: 18395289.

         (2)  Schwarz JM, Noworolski SM, Wen MJ, Dyachenko A, Prior JL, Weinberg ME, Herraiz LA, Tai VW, Bergeron N, Bersot TP, Rao MN, Schambelan M, Mulligan K. Effect of a High-Fructose Weight-Maintaining Diet on Lipogenesis and Liver Fat. J Clin Endocrinol Metab. 2015 Jun;100(6):2434-42. doi: 10.1210/jc.2014-3678. Epub 2015 Mar 31. PMID: 25825943; PMCID: PMC4454806.

         (3)  Kuzma JN, Cromer G, Hagman DK, Breymeyer KL, Roth CL, Foster-Schubert KE, Holte SE, Weigle DS, Kratz M. No differential effect of beverages sweetened with fructose, high-fructose corn syrup, or glucose on systemic or adipose tissue inflammation in normal-weight to obese adults: a randomized controlled trial. Am J Clin Nutr. 2016 Aug;104(2):306-14. doi: 10.3945/ajcn.115.129650. Epub 2016 Jun 29. PMID: 27357093; PMCID: PMC4962158.

         (4)  Chung M, Ma J, Patel K, Berger S, Lau J, Lichtenstein AH. Fructose, high-fructose corn syrup, sucrose, and nonalcoholic fatty liver disease or indexes of liver health: a systematic review and meta-analysis. Am J Clin Nutr. 2014 Sep;100(3):833-49. doi: 10.3945/ajcn.114.086314. Epub 2014 Aug 6. PMID: 25099546; PMCID: PMC4135494.

         (5)  Widmer RJ, Flammer AJ, Lerman LO, Lerman A. The Mediterranean diet, its components, and cardiovascular disease. Am J Med. 2015 Mar;128(3):229-38. doi: 10.1016/j.amjmed.2014.10.014. Epub 2014 Oct 15. PMID: 25447615; PMCID: PMC4339461.

         (6)  Dreher ML. Whole Fruits and Fruit Fiber Emerging Health Effects. Nutrients. 2018 Nov 28;10(12):1833. doi: 10.3390/nu10121833. PMID: 30487459; PMCID: PMC6315720.

         ]]>Ever since the YouTube video of Dr. Lustig and the evils of fructose went viral in 2010, many have advocated that fructose is the single most common cause of obesity in the United States.

         The video had metabolic pathways that had the hypothesis that most fructose either becomes fat in the liver, or that it might go down a pathway to cause joint issues, leaky gut, and inflammation causing obesity.

         Here are the two chemical structures of glucose, also known as the "good sugar" and fructose, or the bad sugar. I cannot help but thinking of the good witch and the bad witch on the Wizard of Oz.

         Dr. Lustig's hypothesis was based on studies done in mice and rats. In those studies, published two years before the viral video, found that high fructose diets in mice lead to increased "gut leak" and led to liver damage (1). This was even confirmed with a small study of 8 men (2) who had their complex carbohydrates replaced by fructose and fed normal caloric diets - meaning, these eight men had increased liver fat, more de novo fat formation (de novo lipogenesis) .

         This all makes that logical sense since sugar-sweetened beverages are associated with chronic inflammation and these days everything to do with chronic inflammation increases the risk of obesity, diabetes, heart disease, and aging.

         Then came a double-blinded, randomized, crossover study where a group of people were fed a standard diet but drank 25% of their calories as either fructose (the evil sugar), or glucose (the good one) or a high fructose corn syrup sweetened beverage. Oddly, there was no difference in any of those groups with regard to markers of inflammation, intestinal permeability, or inflammation in the fat tissue.

         To quote from the study: "Excessive amounts of fructose, HFCS, and glucose from SSBs consumed over 8 d did not differentially affect low-grade chronic systemic inflammation in normal-weight to obese adults." SSB = sugar sweetened beverages.

         There have been a number of human trials looking at sugar-sweetened beverages and inflammation, and the results are not consistent. Even finding that people who drink large amounts of either glucose of fructose didn't find changes in inflammation or visceral fat.

         Mice are not men, and the link between gut permeability, leading to systemic and chronic inflammation, occurs in mice, but not men. And while in mice fructose can lead to inflammation and liver issues, this doesn't happen in human beings. (4)

         The key may not be fructose itself, but increased caloric intake.  If you eat more, you will increase in weight, but it is not fructose alone. It is, in fact, high caloric intake combined with sugars. Meaning, that great tasting snack with the high levels of sugars and fats act in concert with the increased calories consumed to give you that portly look.

         To be fair, all of the studies were short term, less than a couple of weeks. Fructose, over the long term, may still be a bad actor.

         What about fruit? It is exceedingly difficult to eat enough whole fruits to make this a problem. To eat the excess amount in some of these studies you would have to eat several pounds of apples, and most people simply cannot do that in a day. And whole fruit consumption, as a part of the Mediterranean diet reduces the burden of cardiovascular disease, diabetes, and even erectile dysfunction.(5)

         In fact less than 10% of most Western dieters have adequate levels of fruit (6) leading to a serious threat to human health. Maybe a couple of apples a day will keep the doctor away.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.  

         REFERENCES:

         (1)  Bergheim I, Weber S, Vos M, Krämer S, Volynets V, Kaserouni S, McClain CJ, Bischoff SC. Antibiotics protect against fructose-induced hepatic lipid accumulation in mice: role of endotoxin. J Hepatol. 2008 Jun;48(6):983-92. doi: 10.1016/j.jhep.2008.01.035. Epub 2008 Mar 14. PMID: 18395289.

         (2)  Schwarz JM, Noworolski SM, Wen MJ, Dyachenko A, Prior JL, Weinberg ME, Herraiz LA, Tai VW, Bergeron N, Bersot TP, Rao MN, Schambelan M, Mulligan K. Effect of a High-Fructose Weight-Maintaining Diet on Lipogenesis and Liver Fat. J Clin Endocrinol Metab. 2015 Jun;100(6):2434-42. doi: 10.1210/jc.2014-3678. Epub 2015 Mar 31. PMID: 25825943; PMCID: PMC4454806.

         (3)  Kuzma JN, Cromer G, Hagman DK, Breymeyer KL, Roth CL, Foster-Schubert KE, Holte SE, Weigle DS, Kratz M. No differential effect of beverages sweetened with fructose, high-fructose corn syrup, or glucose on systemic or adipose tissue inflammation in normal-weight to obese adults: a randomized controlled trial. Am J Clin Nutr. 2016 Aug;104(2):306-14. doi: 10.3945/ajcn.115.129650. Epub 2016 Jun 29. PMID: 27357093; PMCID: PMC4962158.

         (4)  Chung M, Ma J, Patel K, Berger S, Lau J, Lichtenstein AH. Fructose, high-fructose corn syrup, sucrose, and nonalcoholic fatty liver disease or indexes of liver health: a systematic review and meta-analysis. Am J Clin Nutr. 2014 Sep;100(3):833-49. doi: 10.3945/ajcn.114.086314. Epub 2014 Aug 6. PMID: 25099546; PMCID: PMC4135494.

         (5)  Widmer RJ, Flammer AJ, Lerman LO, Lerman A. The Mediterranean diet, its components, and cardiovascular disease. Am J Med. 2015 Mar;128(3):229-38. doi: 10.1016/j.amjmed.2014.10.014. Epub 2014 Oct 15. PMID: 25447615; PMCID: PMC4339461.

         (6)  Dreher ML. Whole Fruits and Fruit Fiber Emerging Health Effects. Nutrients. 2018 Nov 28;10(12):1833. doi: 10.3390/nu10121833. PMID: 30487459; PMCID: PMC6315720.

         ]]>3b3f29e9-5239-469f-801a-11e8823bb4d3Wed, 10 Nov 2021 00:00:00 -070002:47falsefull1441Red Meat: Is it good or bad? The answer is... sometimesOn my tiktok channel (@drterrysimpson or terrysimpson309) putting up a review of red meat the comments are reflective of the polarization that makes politics look like gentle disagreements.

         Nutrition is nuanced - meaning, it is rare that something is good or bad for us, except for Death Cap Mushrooms, they will kill you, although I hear they are delicious. The same is true for red meat. What we have are rarely the types of nutrition studies where we feed people precise amounts of food and see the results (the DASH diet studies were great with this -ref 1 ). Instead we rely on what people tell us, which can be accurate, or not - and we look at markers for disease instead of the disease itself (looking at end points of heart disease we look at LDL, cholesterol, C-reactive protein, and rather non-specific markers.

         Red Meat and Glycemic Control and Inflammation

         In this study (ref 2) they examined the premise that red meat's has an effect on inflammatory markers and glycemic control. So the study  was a meta analysis of randomized control of glycemic control and inflammatory markers.

         Adults that were studied were given various quantities of red meats and then checked for glycemic control and inflammation. The end result "Total red meat consumption, for up to 16 weeks, does not affect changes in biomarkers of glycemic control or inflammation for adults free of, but at risk for, cardiometabolic disease. "

         Does this put this to bed - not really, but the proposed ill effect of red meat is not something that is seen in these studies.  Here are the markers they studied: glucose, insulin levels, HOMA-R, Hemoglobin A1c, C-reactive protein, IL-6, and TNF-alpha.

         This was a group of studies that went to about 16 weeks (four months) so any longer term issues with red or even red processed meats, were not seen. But there were clearly no indication found in these studies.

         What about other markers for heart disease?

         So the next question is the effect of red meat on lipids, lipoproteins and blood pressure(ref 3)? It turned out that increasing red meat did not affect those variables for heart disease.

         What if you check not just red meat, but "red meat with diets that replaced red meat with a variety of foods. We stratified comparison diets into high-quality plant protein sources (legumes, soy, nuts); chicken/poultry/fish; fish only; poultry only; mixed animal protein sources (including dairy); carbohydrates (low-quality refined grains and simple sugars, such as white bread, pasta, rice, cookies/biscuits); or usual diet. We performed random-effects meta-analyses comparing differences in changes of blood lipids, apolipoproteins, and blood pressure for all studies combined and stratified by specific comparison diets."- from ref 4.  They found that changing red meat for plant protein had a minimal effect, and yet other studies (ref 2) found that plant protein had no significant difference at all.

         Those short term studies, which are clear changes with specific amounts over a short period of time, appear to contrast with the studies of various groups where they look at the risk of type 2 diabetes and red meat consumption. Take reference 5, where they looked at the increase of diabetes in different groups based on self-reporting of red meat intake. These studies are not as powerful as the controlled trials above, and they are confounded by other variables - people who eat more red meat have higher caloric intake and more obesity, they also tend to drink more and to smoke more. It is not easy to isolate, statistically, those variables out and this is always the issue with large cohort studies.

         Take the many studies of the Seventh Day Adventist group, who are considered America's Blue Zone in Loma Linda, California. They don't eat meat, they live longer -- but there is more, that group tends to exercise more, they do not smoke, they do not drink, and they have a strong sense of community. When studied (reference 6) it appears to have an increased in all cause mortality with an increase in red meat and processed meat. But again, a cohort study where it is difficult to refine the variables is not as strong as a study where you feed people precise amounts and look for surrogate markers of disease.

         The other issue with following cohort groups is what else they consume. Red meat eaters who increase vegetables have lower long term risk of colo-rectal cancer or as we say - the risk of colon cancer is mitigated by increased vegetable and fibrous foods.  While looking at cohorts of meat eaters they tend not to eat much in the way of this food, in some studies they can account for this, in some studies they cannot and it becomes all the more confusing (ref 7).

         When looking at red meat and heart disease, researchers have wondered why poultry doesn't seem to cause an increase in heart disease as red meat. One thought is that it is the increased iron with red meat, or the heme protein. While this has never been proven, and there are no good animal models for this, one unique theory is the reason people who exercise more have less issue with red meat is not only being in shape, but that exercise causes a faster turnover of blood cells allowing less build up of iron and thus less issues with heart disease (reference 8). I know, it is a long way around for a hypothesis that seems interesting and novel but doesn't quite make it out of any laboratory model. But from so many studies in medicine and science, while we can make a perfectly good logical argument, biology often is more elegant than our sense of logic.

         Another novel idea is that red meat is as a source of glycation end products which can lead to inflammation.  So stick with me here - " Advanced glycation end products (AGEs) are proteins or lipids that become glycated after exposure to sugars. AGEs are prevalent in the diabetic vasculature and contribute to the development of atherosclerosis." - from ref 9. These are thought to be a marker, or even one of the terminal pathways for atherosclerosis and perhaps even neuropathy from diabetes. And while it again, makes a logical argument to decrease red meat and inflammation, the studies do not show that a decrease in red meat will actually do this. Again, logic doesn't make biology.

         Is it Good or is it Bad?

         Isn't that what we all want to know? When the Annals of Internal Medicine published five papers looking at red meat it caused quite a stir, because many were thinking red meat was bad.

         The first one (ref 10) looked at 61 articles with 55 cohorts and they found: "Low-certainty evidence was found that a reduction in unprocessed red meat intake of 3 servings per week is associated with a very small reduction in risk for cardiovascular mortality, stroke, myocardial infarction (MI), and type 2 diabetes. Likewise, low-certainty evidence was found that a reduction in processed meat intake of 3 servings per week is associated with a very small decrease in risk for all-cause mortality, cardiovascular mortality, stroke, MI, and type 2 diabetes." So giving up a bit of meat doesn't have a lot of evidence that it makes a large difference.

         What about Cancer?

         No one wants cancer, so what about red meat and cancer? Well this brings us to reference 11.  To quote: "Of 118 articles (56 cohorts) with more than 6 million participants, 73 articles were eligible for the dose-response meta-analyses, 30 addressed cancer mortality, and 80 reported cancer incidence. Low-certainty evidence suggested that an intake reduction of 3 servings of unprocessed meat per week was associated with a very small reduction in overall cancer mortality over a lifetime. Evidence of low to very low certainty suggested that each intake reduction of 3 servings of processed meat per week was associated with very small decreases in overall cancer mortality over a lifetime; prostate cancer mortality; and incidence of esophageal, colorectal, and breast cancer." So we think, with a lot of uncertainty, that reducing intake of meat or processed meat may have a small decrease in mortality from cancer. Is it worth that decrease in risk - we are not certain.

         Are you willing to give up red meat?

         I mean, it is delicious, but let's look at the data in reference 12. If we cannot say for certain that meat will cause you a problem then most people are not willing to give it up - to quote: "Low-certainty evidence suggests that omnivores are attached to meat and are unwilling to change this behavior when faced with potentially undesirable health effects." So for all the preaching that vegans might do to give up meat, it turns out that meat lovers are not going to change behavior especially given the evidence is pretty weak.

         Cancer and Heart Disease and Death

         The final of the great five papers was looking at the effect of lower vs higher intake of meat have little or no impact on mortality from heart disease or cancer. To quote "Of 12 eligible trials, a single trial enrolling 48 835 women provided the most credible, though still low-certainty, evidence that diets lower in red meat may have little or no effect on all-cause mortality (hazard ratio [HR], 0.99 [95% CI, 0.95 to 1.03]), cardiovascular mortality (HR, 0.98 [CI, 0.91 to 1.06]), and cardiovascular disease (HR, 0.99 [CI, 0.94 to 1.05]). That trial also provided low- to very-low-certainty evidence that diets lower in red meat may have little or no effect on total cancer mortality (HR, 0.95 [CI, 0.89 to 1.01]) and the incidence of cancer, including colorectal cancer (HR, 1.04 [CI, 0.90 to 1.20]) and breast cancer (HR, 0.97 [0.90 to 1.04])." This is reference 13.

         So can I enjoy the steak?

         In conclusion]]>On my tiktok channel (@drterrysimpson or terrysimpson309) putting up a review of red meat the comments are reflective of the polarization that makes politics look like gentle disagreements.

         Nutrition is nuanced - meaning, it is rare that something is good or bad for us, except for Death Cap Mushrooms, they will kill you, although I hear they are delicious. The same is true for red meat. What we have are rarely the types of nutrition studies where we feed people precise amounts of food and see the results (the DASH diet studies were great with this -ref 1 ). Instead we rely on what people tell us, which can be accurate, or not - and we look at markers for disease instead of the disease itself (looking at end points of heart disease we look at LDL, cholesterol, C-reactive protein, and rather non-specific markers.

         Red Meat and Glycemic Control and Inflammation

         In this study (ref 2) they examined the premise that red meat's has an effect on inflammatory markers and glycemic control. So the study  was a meta analysis of randomized control of glycemic control and inflammatory markers.

         Adults that were studied were given various quantities of red meats and then checked for glycemic control and inflammation. The end result "Total red meat consumption, for up to 16 weeks, does not affect changes in biomarkers of glycemic control or inflammation for adults free of, but at risk for, cardiometabolic disease. "

         Does this put this to bed - not really, but the proposed ill effect of red meat is not something that is seen in these studies.  Here are the markers they studied: glucose, insulin levels, HOMA-R, Hemoglobin A1c, C-reactive protein, IL-6, and TNF-alpha.

         This was a group of studies that went to about 16 weeks (four months) so any longer term issues with red or even red processed meats, were not seen. But there were clearly no indication found in these studies.

         What about other markers for heart disease?

         So the next question is the effect of red meat on lipids, lipoproteins and blood pressure(ref 3)? It turned out that increasing red meat did not affect those variables for heart disease.

         What if you check not just red meat, but "red meat with diets that replaced red meat with a variety of foods. We stratified comparison diets into high-quality plant protein sources (legumes, soy, nuts); chicken/poultry/fish; fish only; poultry only; mixed animal protein sources (including dairy); carbohydrates (low-quality refined grains and simple sugars, such as white bread, pasta, rice, cookies/biscuits); or usual diet. We performed random-effects meta-analyses comparing differences in changes of blood lipids, apolipoproteins, and blood pressure for all studies combined and stratified by specific comparison diets."- from ref 4.  They found that changing red meat for plant protein had a minimal effect, and yet other studies (ref 2) found that plant protein had no significant difference at all.

         Those short term studies, which are clear changes with specific amounts over a short period of time, appear to contrast with the studies of various groups where they look at the risk of type 2 diabetes and red meat consumption. Take reference 5, where they looked at the increase of diabetes in different groups based on self-reporting of red meat intake. These studies are not as powerful as the controlled trials above, and they are confounded by other variables - people who eat more red meat have higher caloric intake and more obesity, they also tend to drink more and to smoke more. It is not easy to isolate, statistically, those variables out and this is always the issue with large cohort studies.

         Take the many studies of the Seventh Day Adventist group, who are considered America's Blue Zone in Loma Linda, California. They don't eat meat, they live longer -- but there is more, that group tends to exercise more, they do not smoke, they do not drink, and they have a strong sense of community. When studied (reference 6) it appears to have an increased in all cause mortality with an increase in red meat and processed meat. But again, a cohort study where it is difficult to refine the variables is not as strong as a study where you feed people precise amounts and look for surrogate markers of disease.

         The other issue with following cohort groups is what else they consume. Red meat eaters who increase vegetables have lower long term risk of colo-rectal cancer or as we say - the risk of colon cancer is mitigated by increased vegetable and fibrous foods.  While looking at cohorts of meat eaters they tend not to eat much in the way of this food, in some studies they can account for this, in some studies they cannot and it becomes all the more confusing (ref 7).

         When looking at red meat and heart disease, researchers have wondered why poultry doesn't seem to cause an increase in heart disease as red meat. One thought is that it is the increased iron with red meat, or the heme protein. While this has never been proven, and there are no good animal models for this, one unique theory is the reason people who exercise more have less issue with red meat is not only being in shape, but that exercise causes a faster turnover of blood cells allowing less build up of iron and thus less issues with heart disease (reference 8). I know, it is a long way around for a hypothesis that seems interesting and novel but doesn't quite make it out of any laboratory model. But from so many studies in medicine and science, while we can make a perfectly good logical argument, biology often is more elegant than our sense of logic.

         Another novel idea is that red meat is as a source of glycation end products which can lead to inflammation.  So stick with me here - " Advanced glycation end products (AGEs) are proteins or lipids that become glycated after exposure to sugars. AGEs are prevalent in the diabetic vasculature and contribute to the development of atherosclerosis." - from ref 9. These are thought to be a marker, or even one of the terminal pathways for atherosclerosis and perhaps even neuropathy from diabetes. And while it again, makes a logical argument to decrease red meat and inflammation, the studies do not show that a decrease in red meat will actually do this. Again, logic doesn't make biology.

         Is it Good or is it Bad?

         Isn't that what we all want to know? When the Annals of Internal Medicine published five papers looking at red meat it caused quite a stir, because many were thinking red meat was bad.

         The first one (ref 10) looked at 61 articles with 55 cohorts and they found: "Low-certainty evidence was found that a reduction in unprocessed red meat intake of 3 servings per week is associated with a very small reduction in risk for cardiovascular mortality, stroke, myocardial infarction (MI), and type 2 diabetes. Likewise, low-certainty evidence was found that a reduction in processed meat intake of 3 servings per week is associated with a very small decrease in risk for all-cause mortality, cardiovascular mortality, stroke, MI, and type 2 diabetes." So giving up a bit of meat doesn't have a lot of evidence that it makes a large difference.

         What about Cancer?

         No one wants cancer, so what about red meat and cancer? Well this brings us to reference 11.  To quote: "Of 118 articles (56 cohorts) with more than 6 million participants, 73 articles were eligible for the dose-response meta-analyses, 30 addressed cancer mortality, and 80 reported cancer incidence. Low-certainty evidence suggested that an intake reduction of 3 servings of unprocessed meat per week was associated with a very small reduction in overall cancer mortality over a lifetime. Evidence of low to very low certainty suggested that each intake reduction of 3 servings of processed meat per week was associated with very small decreases in overall cancer mortality over a lifetime; prostate cancer mortality; and incidence of esophageal, colorectal, and breast cancer." So we think, with a lot of uncertainty, that reducing intake of meat or processed meat may have a small decrease in mortality from cancer. Is it worth that decrease in risk - we are not certain.

         Are you willing to give up red meat?

         I mean, it is delicious, but let's look at the data in reference 12. If we cannot say for certain that meat will cause you a problem then most people are not willing to give it up - to quote: "Low-certainty evidence suggests that omnivores are attached to meat and are unwilling to change this behavior when faced with potentially undesirable health effects." So for all the preaching that vegans might do to give up meat, it turns out that meat lovers are not going to change behavior especially given the evidence is pretty weak.

         Cancer and Heart Disease and Death

         The final of the great five papers was looking at the effect of lower vs higher intake of meat have little or no impact on mortality from heart disease or cancer. To quote "Of 12 eligible trials, a single trial enrolling 48 835 women provided the most credible, though still low-certainty, evidence that diets lower in red meat may have little or no effect on all-cause mortality (hazard ratio [HR], 0.99 [95% CI, 0.95 to 1.03]), cardiovascular mortality (HR, 0.98 [CI, 0.91 to 1.06]), and cardiovascular disease (HR, 0.99 [CI, 0.94 to 1.05]). That trial also provided low- to very-low-certainty evidence that diets lower in red meat may have little or no effect on total cancer mortality (HR, 0.95 [CI, 0.89 to 1.01]) and the incidence of cancer, including colorectal cancer (HR, 1.04 [CI, 0.90 to 1.20]) and breast cancer (HR, 0.97 [0.90 to 1.04])." This is reference 13.

         So can I enjoy the steak?

         In conclusion you can. The difficulty with red meat is that everyone looks at cigarettes and thinks we have that kind of association, but we don't. You can cherry pick data, but when you look at all the data it is small. Look at the relative risk of eating red meat - it doesn't get to 2, where as the relative risk of cancer from smoking is 20 - and this is a log scale.

         This is not the end, we still need real studies with more variables that are able to be controlled in a tight environment, or statistically removed.

         If you are obese, don't exercise, and don't otherwise eat well it is different

         One thing is clear from a number of studies - if you are overweight, if you don't exercise, if you don't eat a lot of vegetables, legumes, whole grains, and fruits, then eating red meat is not the best choice. Not only is it filled with saturated fat and calorie dense, so it will increase all risk factors - the other variables in your life probably need to change, as they all have their own mortality and morbidity associated with them.

         Hey - hit me up on tiktok for comments - join the fray - and listen to the podcast

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.  

         REFERENCES

         (1).  Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER 3rd, Simons-Morton DG, Karanja N, Lin PH; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001 Jan 4;344(1):3-10. doi: 10.1056/NEJM200101043440101. PMID: 11136953.

         (2).  O'Connor LE, Kim JE, Clark CM, Zhu W, Campbell WW. Effects of Total Red Meat Intake on Glycemic Control and Inflammatory Biomarkers: A Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2021 Feb 1;12(1):115-127. doi: 10.1093/advances/nmaa096. PMID: 32910818; PMCID: PMC7850054.

         (3).  O'Connor LE, Kim JE, Campbell WW. Total red meat intake of ≥0.5 servings/d does not negatively influence cardiovascular disease risk factors: a systemically searched meta-analysis of randomized controlled trials. Am J Clin Nutr. 2017 Jan;105(1):57-69. doi: 10.3945/ajcn.116.142521. Epub 2016 Nov 23. PMID: 27881394; PMCID: PMC5183733.

         (4).  Guasch-Ferré M, Satija A, Blondin SA, Janiszewski M, Emlen E, O'Connor LE, Campbell WW, Hu FB, Willett WC, Stampfer MJ. Meta-Analysis of Randomized Controlled Trials of Red Meat Consumption in Comparison With Various Comparison Diets on Cardiovascular Risk Factors. Circulation. 2019 Apr 9;139(15):1828-1845. doi: 10.1161/CIRCULATIONAHA.118.035225. PMID: 30958719.

         (5).  Pan A, Sun Q, Bernstein AM, Manson JE, Willett WC, Hu FB. Changes in red meat consumption and subsequent risk of type 2 diabetes mellitus: three cohorts of US men and women. JAMA Intern Med. 2013 Jul 22;173(14):1328-35. doi: 10.1001/jamainternmed.2013.6633. PMID: 23779232; PMCID: PMC3847817.

         (6). Alshahrani SM, Fraser GE, Sabaté J, Knutsen R, Shavlik D, Mashchak A, Lloren JI, Orlich MJ. Red and Processed Meat and Mortality in a Low Meat Intake Population. Nutrients. 2019 Mar 14;11(3):622. doi: 10.3390/nu11030622. PMID: 30875776; PMCID: PMC6470727.

         (7) Turner ND, Lloyd SK. Association between red meat consumption and colon cancer: A systematic review of experimental results. Exp Biol Med (Maywood). 2017 Apr;242(8):813-839. doi: 10.1177/1535370217693117. Epub 2017 Jan 1. PMID: 28205448; PMCID: PMC5407540.

         (8).  Qi L, van Dam RM, Rexrode K, Hu FB. Heme iron from diet as a risk factor for coronary heart disease in women with type 2 diabetes. Diabetes Care. 2007 Jan;30(1):101-6. doi: 10.2337/dc06-1686. PMID: 17192341.

         (9).  Goldin A, Beckman JA, Schmidt AM, Creager MA. Advanced glycation end products: sparking the development of diabetic vascular injury. Circulation. 2006 Aug 8;114(6):597-605. doi: 10.1161/CIRCULATIONAHA.106.621854. PMID: 16894049.

         (10). Zeraatkar D, Han MA, Guyatt GH, Vernooij RWM, El Dib R, Cheung K, Milio K, Zworth M, Bartoszko JJ, Valli C, Rabassa M, Lee Y, Zajac J, Prokop-Dorner A, Lo C, Bala MM, Alonso-Coello P, Hanna SE, Johnston BC. Red and Processed Meat Consumption and Risk for All-Cause Mortality and Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med. 2019 Nov 19;171(10):703-710. doi: 10.7326/M19-0655. Epub 2019 Oct 1. PMID: 31569213.

         (11).  Han MA, Zeraatkar D, Guyatt GH, Vernooij RWM, El Dib R, Zhang Y, Algarni A, Leung G, Storman D, Valli C, Rabassa M, Rehman N, Parvizian MK, Zworth M, Bartoszko JJ, Lopes LC, Sit D, Bala MM, Alonso-Coello P, Johnston BC. Reduction of Red and Processed Meat Intake and Cancer Mortality and Incidence: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med. 2019 Nov 19;171(10):711-720. doi: 10.7326/M19-0699. Epub 2019 Oct 1. PMID: 31569214.

         (12).  Valli C, Rabassa M, Johnston BC, Kuijpers R, Prokop-Dorner A, Zajac J, Storman D, Storman M, Bala MM, Solà I, Zeraatkar D, Han MA, Vernooij RWM, Guyatt GH, Alonso-Coello P; NutriRECS Working Group. Health-Related Values and Preferences Regarding Meat Consumption: A Mixed-Methods Systematic Review. Ann Intern Med. 2019 Nov 19;171(10):742-755. doi: 10.7326/M19-1326. Epub 2019 Oct 1. PMID: 31569219.

         (13). Zeraatkar D, Johnston BC, Bartoszko J, Cheung K, Bala MM, Valli C, Rabassa M, Sit D, Milio K, Sadeghirad B, Agarwal A, Zea AM, Lee Y, Han MA, Vernooij RWM, Alonso-Coello P, Guyatt GH, El Dib R. Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes: A Systematic Review of Randomized Trials. Ann Intern Med. 2019 Nov 19;171(10):721-731. doi: 10.7326/M19-0622. Epub 2019 Oct 1. PMID: 31569236.

         ]]>e0732581-c510-4e07-82cf-e1f27fcc01fdTue, 26 Oct 2021 00:00:00 -070003:32falsefull1331The Carnivore Diet and MythsThe Carnivore diet is the most extreme of the low-carbohydrate diets, with its expressed point that humans did great on a diet of flesh and evolved to eat a diet high in fats.

         While we cannot make up what people ate in the past, we can see about the diet of the Yupik’s of Alaska.  These people have been studied extensively by the Center for Alaska Native Health Research (CANHR) at the University of Alaska in Fairbanks who partnered with Genetics of Coronary Artery Disease in Alaska Native people.

         First the CANHR found that Alaska Natives who ate processed meats (hot dogs, lunch meat, fried chicken) had higher triglycerides. Those Yupik’s who consumed lots of omega-3 fatty acids and ate lots of meats with saturated fats developed coronary artery disease. As much as we like to get our omega-3 fatty acids from the sources, and few in the world eat as many as the Yupik’s, that cannot protect you from coronary artery disease in the presence of the over-consumption of saturated and trans fatty acids. It further showed that, at least for the Yupik’s, consuming processed meats, and meats high in saturated fats like beef, pork, lamb and chicken with skin was not healthy for the Alaska Natives.

         The Carnivore diet excludes greens and berries, however sea greens and berries are a large part of the traditional Yupik diet. The diet that they have is high in marine mammals, fish, game animals, greens and berries that provide high levels of fat soluble vitamins (A,D,E, and K) as well as iron.

         The Biotruth of the Carnivore Diet:

         A biotruth is a logical fallacy, usually found to be a misunderstanding of evolution. In this case the idea that early human ancestors were meat eaters and that the adaptation of cultivation of crops led to chronic disease.

         When CT scans were looked at from 137 mummified remains from four geographical regions, ancient Egypt, Peru, the Pueblo, and Unangan from the Aleutian Islands were examined they found atherosclerosis in all of them. 

         “Interpretation: Atherosclerosis was common in four preindustrial populations including preagricultural hunter-gatherers. Although commonly assumed to be a modern disease, the presence of atherosclerosis in premodern human beings raises the possibility of a more basic predisposition to the disease.”

         It should be noted that those were diverse diets from those who ate primarily marine mammals and fish to those whose diet was composed primarily of vegetation with little meat.

         The Myths of LDL

         The low carbohydrate community propose that LDL isn’t an issue with heart disease. This flies in the face of the recent article in JAMA looking at 34 clinical trials and finding that lowering LDL-C not only decreased the risk of heart disease, but all causes of mortality. While the low-carb crowd likes to point out how sugar indeed has a role in development of heart disease, they quietly forget to point out that diets rich in meats are overwhelmingly an issue.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.  

         -----

         REFERENCES

         Brand-Miller JC, Griffin HJ, Colagiuri S. The carnivore connection hypothesis: revisited. J Obes. 2012;2012:258624. doi: 10.1155/2012/258624. Epub 2011 Dec 22. PMID: 22235369; PMCID: PMC3253466.

         Bersamin A, Luick BR, King IB, Stern JS, Zidenberg-Cherr S. Westernizing diets influence fat intake, red blood cell fatty acid composition, and health in remote Alaskan Native communities in the center for Alaska Native health study. J Am Diet Assoc. 2008 Feb;108(2):266-73. doi: 10.1016/j.jada.2007.10.046. PMID: 18237575; PMCID: PMC6542563.

         Ryman TK, Boyer BB, Hopkins S, Philip J, Beresford SA, Thompson B, Heagerty PJ, Pomeroy JJ, Thummel KE, Austin MA. Associations between diet and cardiometabolic risk among Yup'ik Alaska Native people using food frequency questionnaire dietary patterns. Nutr Metab Cardiovasc Dis. 2015 Dec;25(12):1140-5. doi: 10.1016/j.numecd.2015.08.003. Epub 2015 Aug 21. PMID: 26607703; PMCID: PMC4684467.

         Thompson RC, Allam AH, Lombardi GP, Wann LS, Sutherland ML, Sutherland JD, Soliman MA, Frohlich B, Mininberg DT, Monge JM, Vallodolid CM, Cox SL, Abd el-Maksoud G, Badr I, Miyamoto MI, el-Halim Nur el-Din A, Narula J, Finch CE, Thomas GS. Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations. Lancet. 2013 Apr 6;381(9873):1211-22. doi: 10.1016/S0140-6736(13)60598-X. Epub 2013 Mar 12. PMID: 23489753.

         Bersamin A, Zidenberg-Cherr S, Stern JS, Luick BR. Nutrient intakes are associated with adherence to a traditional diet among Yup'ik Eskimos living in remote Alaska Native communities: the CANHR Study. Int J Circumpolar Health. 2007 Feb;66(1):62-70. doi: 10.3402/ijch.v66i1.18228. PMID: 17451135.

         Ebbesson SO, Risica PM, Ebbesson LO, Kennish JM. Eskimos have CHD despite high consumption of omega-3 fatty acids: the Alaska Siberia project. Int J Circumpolar Health. 2005 Sep;64(4):387-95. doi: 10.3402/ijch.v64i4.18015. PMID: 16277122.

         Bjerregaard P, Young TK, Hegele RA. Low incidence of cardiovascular disease among the Inuit--what is the evidence? Atherosclerosis. 2003 Feb;166(2):351-7. doi: 10.1016/s0021-9150(02)00364-7. PMID: 12535749.

         Navarese, E. P., Robinson, J. G., Kowalewski, M., Kolodziejczak, M., Andreotti, F., Bliden, K., Tantry, U., Kubica, J., Raggi, P., & Gurbel, P. A. (2018). Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis. JAMA, 319(15), 1566–1579. https://doi.org/10.1001/jama.2018.2525

         ]]>The Carnivore diet is the most extreme of the low-carbohydrate diets, with its expressed point that humans did great on a diet of flesh and evolved to eat a diet high in fats.

         While we cannot make up what people ate in the past, we can see about the diet of the Yupik’s of Alaska.  These people have been studied extensively by the Center for Alaska Native Health Research (CANHR) at the University of Alaska in Fairbanks who partnered with Genetics of Coronary Artery Disease in Alaska Native people.

         First the CANHR found that Alaska Natives who ate processed meats (hot dogs, lunch meat, fried chicken) had higher triglycerides. Those Yupik’s who consumed lots of omega-3 fatty acids and ate lots of meats with saturated fats developed coronary artery disease. As much as we like to get our omega-3 fatty acids from the sources, and few in the world eat as many as the Yupik’s, that cannot protect you from coronary artery disease in the presence of the over-consumption of saturated and trans fatty acids. It further showed that, at least for the Yupik’s, consuming processed meats, and meats high in saturated fats like beef, pork, lamb and chicken with skin was not healthy for the Alaska Natives.

         The Carnivore diet excludes greens and berries, however sea greens and berries are a large part of the traditional Yupik diet. The diet that they have is high in marine mammals, fish, game animals, greens and berries that provide high levels of fat soluble vitamins (A,D,E, and K) as well as iron.

         The Biotruth of the Carnivore Diet:

         A biotruth is a logical fallacy, usually found to be a misunderstanding of evolution. In this case the idea that early human ancestors were meat eaters and that the adaptation of cultivation of crops led to chronic disease.

         When CT scans were looked at from 137 mummified remains from four geographical regions, ancient Egypt, Peru, the Pueblo, and Unangan from the Aleutian Islands were examined they found atherosclerosis in all of them. 

         “Interpretation: Atherosclerosis was common in four preindustrial populations including preagricultural hunter-gatherers. Although commonly assumed to be a modern disease, the presence of atherosclerosis in premodern human beings raises the possibility of a more basic predisposition to the disease.”

         It should be noted that those were diverse diets from those who ate primarily marine mammals and fish to those whose diet was composed primarily of vegetation with little meat.

         The Myths of LDL

         The low carbohydrate community propose that LDL isn’t an issue with heart disease. This flies in the face of the recent article in JAMA looking at 34 clinical trials and finding that lowering LDL-C not only decreased the risk of heart disease, but all causes of mortality. While the low-carb crowd likes to point out how sugar indeed has a role in development of heart disease, they quietly forget to point out that diets rich in meats are overwhelmingly an issue.

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.  

         -----

         REFERENCES

         Brand-Miller JC, Griffin HJ, Colagiuri S. The carnivore connection hypothesis: revisited. J Obes. 2012;2012:258624. doi: 10.1155/2012/258624. Epub 2011 Dec 22. PMID: 22235369; PMCID: PMC3253466.

         Bersamin A, Luick BR, King IB, Stern JS, Zidenberg-Cherr S. Westernizing diets influence fat intake, red blood cell fatty acid composition, and health in remote Alaskan Native communities in the center for Alaska Native health study. J Am Diet Assoc. 2008 Feb;108(2):266-73. doi: 10.1016/j.jada.2007.10.046. PMID: 18237575; PMCID: PMC6542563.

         Ryman TK, Boyer BB, Hopkins S, Philip J, Beresford SA, Thompson B, Heagerty PJ, Pomeroy JJ, Thummel KE, Austin MA. Associations between diet and cardiometabolic risk among Yup'ik Alaska Native people using food frequency questionnaire dietary patterns. Nutr Metab Cardiovasc Dis. 2015 Dec;25(12):1140-5. doi: 10.1016/j.numecd.2015.08.003. Epub 2015 Aug 21. PMID: 26607703; PMCID: PMC4684467.

         Thompson RC, Allam AH, Lombardi GP, Wann LS, Sutherland ML, Sutherland JD, Soliman MA, Frohlich B, Mininberg DT, Monge JM, Vallodolid CM, Cox SL, Abd el-Maksoud G, Badr I, Miyamoto MI, el-Halim Nur el-Din A, Narula J, Finch CE, Thomas GS. Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations. Lancet. 2013 Apr 6;381(9873):1211-22. doi: 10.1016/S0140-6736(13)60598-X. Epub 2013 Mar 12. PMID: 23489753.

         Bersamin A, Zidenberg-Cherr S, Stern JS, Luick BR. Nutrient intakes are associated with adherence to a traditional diet among Yup'ik Eskimos living in remote Alaska Native communities: the CANHR Study. Int J Circumpolar Health. 2007 Feb;66(1):62-70. doi: 10.3402/ijch.v66i1.18228. PMID: 17451135.

         Ebbesson SO, Risica PM, Ebbesson LO, Kennish JM. Eskimos have CHD despite high consumption of omega-3 fatty acids: the Alaska Siberia project. Int J Circumpolar Health. 2005 Sep;64(4):387-95. doi: 10.3402/ijch.v64i4.18015. PMID: 16277122.

         Bjerregaard P, Young TK, Hegele RA. Low incidence of cardiovascular disease among the Inuit--what is the evidence? Atherosclerosis. 2003 Feb;166(2):351-7. doi: 10.1016/s0021-9150(02)00364-7. PMID: 12535749.

         Navarese, E. P., Robinson, J. G., Kowalewski, M., Kolodziejczak, M., Andreotti, F., Bliden, K., Tantry, U., Kubica, J., Raggi, P., & Gurbel, P. A. (2018). Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis. JAMA, 319(15), 1566–1579. https://doi.org/10.1001/jama.2018.2525

         ]]>afd919c1-c87f-43a4-aa36-c5e1d12ec69eSun, 10 Oct 2021 00:00:00 -070003:26falsefull1221Fish Oil and Atrial FibrillationFish oil is the bomb - Greenland Yupik and the rise of fish oil

         Fish oil first became a "hot topic" when a 1980 publication showed that Yupik in Greenland had a lower incidence of cardiovascular disease.

         Their paper concluded, "The rarity of ischemic heart disease in Greenland Eskimos may partly be explained by the antithrombotic effect of the long-chained polyunsaturated fatty acids, especially eicosapentaenoic acid prevalent in diets rich in marine oils." (Bang HO, Dyerberg J, Sinclair HM. The composition of the Eskimo food in north western Greenland. Am J Clin Nutr. 1980 Dec;33(12):2657-61. doi: 10.1093/ajcn/33.12.2657. PMID: 7435433).

         This led to more scientific bodies looking at the evidence for fish oil, and ultimately omega 3 fatty acids, and if it did reduce the incidence of cardiovascular disease. And even 22 years after the publication of that study, the American Heart Association put out a statement that fish oil was protective against cardiovascular disease. (Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002 Nov 19;106(21):2747-57. doi: 10.1161/01.cir.0000038493.65177.94. Erratum in: Circulation. 2003 Jan 28;107(3):512. PMID: 12438303)

         The other predictable tract this led on was the inevitable marketing of fish oils in the supplement industry trying to sell fish oil capsules, from whatever source, as a "must take" to prevent the number one killer in the United States. As with most supplements, being unregulated, they would make claims that their oil was better than others - because it came from krill, or it was vegan-based, or from cod, or pick something that sounds like it can be marketed. Some would claim their fish oil was more pure omega 3 fatty acids. Radio and television spots were secured, and when it was confirmed that the "good cholesterol" or HDL was indeed raised by omega 3 fatty acids it raised their game and intensity of marketing.

         Back in the world of science, testing continued and the results that came back didn't match the conclusions.

         Some papers would conclude that fish oil didn't produce a significant decrease in first time cardiac events but might help prevent secondary cardiac events (Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K; Japan EPA lipid intervention study (JELIS) Investigators. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomized open-label, blinded endpoint analysis. Lancet. 2007 Mar 31;369(9567):1090-8. doi: 10.1016/S0140-6736(07)60527-3. Erratum in: Lancet. 2007 Jul 21;370(9583):220. PMID: 17398308).

         In 2004 the Cocharane database looked at 48 randomized controlled trials and concluded that taking fish oils did not reduce mortality from cardiovascular disease. It also concluded that it didn't matter where the fish oil came from, fish or plant sources, or other sources. This, as you might imagine, throws a monkey wrench into the statement by the American Heart Association that fish oils were good for you, especially coming two years later.

         Marketing moves faster than medicine, so while doctors and scientists were working to find out why there were inconsistent results, the marketing of fish oils continued to expand. Given that there was no regulation in the supplement industry, they continued to market the "benefits" of their product. By 2020 the sales of over-the-counter fish oil products became to a SIX BILLION dollar industry, (https://www.grandviewresearch.com/industry-analysis/omega-3-supplement-market).

         Scientists worked at looking at the different components of dietary, or essential fatty acids. Because the literature was confusing, and the American Heart Association had a bit of salmon egg on their face, they decided to get their best and brightest to review the data and come to a conclusion. They did come to some interesting conclusions: 8 percent of the US population in 2012 had consumed fish oil capsules in the previous 30 days. When they looked at the purity of the supplement they were pleased to find that "the analytical content of EPA and DHA was for the most part reflective of the labeled amounts." They found that free fatty acids were more bioavailable than the products containing ethyl esters. But the more interesting conclusions were:

         (a) people who have not had a heart attack, the supplementation with fish oils will not prevent one.

         (b) people who have diabetes, and thus at a higher risk of heart attacks, also had no benefit from taking fish oils

         (c) people who have a high risk of cardiovascular disease could not conclude that they would have a benefit from taking fish oils

         (d) they did recommend people who had had a previous heart attack might benefit from a lower dose of fish oil but their recommendation was a class 2b - meaning the evidence is weak and the usefulness or effectiveness is not known.

         (e) There was no reduction in stroke risk by taking fish oil

         (f) For people who had a stroke, taking fish oil capsules did not offer protection against a second stroke

         (g) For people with heart failure they concluded it was "reasonable" to take fish oil but thought further randomized control trials were needed

          This should have been a nail in the coffin for the marketing of fish oil, or fish oil frenzy, but alas, it was not. If you wish to see the full report, it is available online. (Siscovick DS, Barringer TA, Fretts AM, Wu JH, Lichtenstein AH, Costello RB, Kris-Etherton PM, Jacobson TA, Engler MB, Alger HM, Appel LJ, Mozaffarian D; American Heart Association Nutrition Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association. Circulation. 2017 Apr 11;135(15):e867-e884. doi: 10.1161/CIR.0000000000000482. Epub 2017 Mar 13. PMID: 28289069; PMCID: PMC6903779)

         But that was just conclusions based on many other reports, so the American Heart Association enrolled over 77,000 people in their own trial to quantify the effects of omega-3 fatty acid supplementation on fatal coronary heart disease (CHD), nonfatal heart attacks, stroke, major vascular events, and all-cause mortality. The study was well designed, and it showed no benefit from taking fish oil capsules. From their own words: "This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease."

         Their full report is available if you wish to see it: Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, Geleijnse JM, Rauch B, Ness A, Galan P, Chew EY, Bosch J, Collins R, Lewington S, Armitage J, Clarke R; Omega-3 Treatment Trialists’ Collaboration. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiol. 2018 Mar 1;3(3):225-234. doi: 10.1001/jamacardio.2017.5205. PMID: 29387889; PMCID: PMC5885893.

         Ultimately it was FISH and not fish oil that has the beneficial effect for cardiac diseases, and to this day you can see the recommendation to have fish in your diet twice a week, which is still in the American Heart Association guidelines.

         The role of fish oil and atrial fibrillation

         Even to this day, studies will disagree about the value of fish oil for cardiac health. For example, the studies looking at pharmaceutical-grade fish oil, came to different conclusions however there is one conclusion both studies came to: there is an increased risk of atrial fibrillation.

         The one study was called REDUCE-IT (Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, Doyle RT Jr, Juliano RA, Jiao L, Granowitz C, Tardif JC, Ballantyne CM; REDUCE-IT Investigators. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019 Jan 3;380(1):11-22. doi: 10.1056/NEJMoa1812792. Epub 2018 Nov 10. PMID: 30415628) which concluded that " Among patients with elevated triglyceride levels despite the use of statins, the risk of ischemic events, including cardiovascular death, was significantly lower among those who received 2 g of icosapent ethyl twice daily than among those who received placebo."

         The other study was called STRENGTH which concluded "Among statin-treated patients at high cardiovascular risk, the addition of omega-3 CA, compared with corn oil, to usual background therapies resulted in no significant difference in a composite outcome of major adverse cardiovascular events. These findings do not support use of this omega-3 fatty acid formulation to reduce major adverse cardiovascular events in high-risk patients." That paper can be seen in its full version (Nicholls SJ, Lincoff AM, Garcia M, Bash D, Ballantyne CM, Barter PJ, Davidson MH, Kastelein JJP, Koenig W, McGuire DK, Mozaffarian D, Ridker PM, Ray KK, Katona BG, Himmelmann A, Loss LE, Rensfeldt M, Lundström T, Agrawal R, Menon V, Wolski K, Nissen SE. Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial. JAMA. 2020 Dec 8;324(22):2268-2280. doi:...]]>Fish oil is the bomb - Greenland Yupik and the rise of fish oil

         Fish oil first became a "hot topic" when a 1980 publication showed that Yupik in Greenland had a lower incidence of cardiovascular disease.

         Their paper concluded, "The rarity of ischemic heart disease in Greenland Eskimos may partly be explained by the antithrombotic effect of the long-chained polyunsaturated fatty acids, especially eicosapentaenoic acid prevalent in diets rich in marine oils." (Bang HO, Dyerberg J, Sinclair HM. The composition of the Eskimo food in north western Greenland. Am J Clin Nutr. 1980 Dec;33(12):2657-61. doi: 10.1093/ajcn/33.12.2657. PMID: 7435433).

         This led to more scientific bodies looking at the evidence for fish oil, and ultimately omega 3 fatty acids, and if it did reduce the incidence of cardiovascular disease. And even 22 years after the publication of that study, the American Heart Association put out a statement that fish oil was protective against cardiovascular disease. (Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002 Nov 19;106(21):2747-57. doi: 10.1161/01.cir.0000038493.65177.94. Erratum in: Circulation. 2003 Jan 28;107(3):512. PMID: 12438303)

         The other predictable tract this led on was the inevitable marketing of fish oils in the supplement industry trying to sell fish oil capsules, from whatever source, as a "must take" to prevent the number one killer in the United States. As with most supplements, being unregulated, they would make claims that their oil was better than others - because it came from krill, or it was vegan-based, or from cod, or pick something that sounds like it can be marketed. Some would claim their fish oil was more pure omega 3 fatty acids. Radio and television spots were secured, and when it was confirmed that the "good cholesterol" or HDL was indeed raised by omega 3 fatty acids it raised their game and intensity of marketing.

         Back in the world of science, testing continued and the results that came back didn't match the conclusions.

         Some papers would conclude that fish oil didn't produce a significant decrease in first time cardiac events but might help prevent secondary cardiac events (Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K; Japan EPA lipid intervention study (JELIS) Investigators. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomized open-label, blinded endpoint analysis. Lancet. 2007 Mar 31;369(9567):1090-8. doi: 10.1016/S0140-6736(07)60527-3. Erratum in: Lancet. 2007 Jul 21;370(9583):220. PMID: 17398308).

         In 2004 the Cocharane database looked at 48 randomized controlled trials and concluded that taking fish oils did not reduce mortality from cardiovascular disease. It also concluded that it didn't matter where the fish oil came from, fish or plant sources, or other sources. This, as you might imagine, throws a monkey wrench into the statement by the American Heart Association that fish oils were good for you, especially coming two years later.

         Marketing moves faster than medicine, so while doctors and scientists were working to find out why there were inconsistent results, the marketing of fish oils continued to expand. Given that there was no regulation in the supplement industry, they continued to market the "benefits" of their product. By 2020 the sales of over-the-counter fish oil products became to a SIX BILLION dollar industry, (https://www.grandviewresearch.com/industry-analysis/omega-3-supplement-market).

         Scientists worked at looking at the different components of dietary, or essential fatty acids. Because the literature was confusing, and the American Heart Association had a bit of salmon egg on their face, they decided to get their best and brightest to review the data and come to a conclusion. They did come to some interesting conclusions: 8 percent of the US population in 2012 had consumed fish oil capsules in the previous 30 days. When they looked at the purity of the supplement they were pleased to find that "the analytical content of EPA and DHA was for the most part reflective of the labeled amounts." They found that free fatty acids were more bioavailable than the products containing ethyl esters. But the more interesting conclusions were:

         (a) people who have not had a heart attack, the supplementation with fish oils will not prevent one.

         (b) people who have diabetes, and thus at a higher risk of heart attacks, also had no benefit from taking fish oils

         (c) people who have a high risk of cardiovascular disease could not conclude that they would have a benefit from taking fish oils

         (d) they did recommend people who had had a previous heart attack might benefit from a lower dose of fish oil but their recommendation was a class 2b - meaning the evidence is weak and the usefulness or effectiveness is not known.

         (e) There was no reduction in stroke risk by taking fish oil

         (f) For people who had a stroke, taking fish oil capsules did not offer protection against a second stroke

         (g) For people with heart failure they concluded it was "reasonable" to take fish oil but thought further randomized control trials were needed

          This should have been a nail in the coffin for the marketing of fish oil, or fish oil frenzy, but alas, it was not. If you wish to see the full report, it is available online. (Siscovick DS, Barringer TA, Fretts AM, Wu JH, Lichtenstein AH, Costello RB, Kris-Etherton PM, Jacobson TA, Engler MB, Alger HM, Appel LJ, Mozaffarian D; American Heart Association Nutrition Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association. Circulation. 2017 Apr 11;135(15):e867-e884. doi: 10.1161/CIR.0000000000000482. Epub 2017 Mar 13. PMID: 28289069; PMCID: PMC6903779)

         But that was just conclusions based on many other reports, so the American Heart Association enrolled over 77,000 people in their own trial to quantify the effects of omega-3 fatty acid supplementation on fatal coronary heart disease (CHD), nonfatal heart attacks, stroke, major vascular events, and all-cause mortality. The study was well designed, and it showed no benefit from taking fish oil capsules. From their own words: "This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease."

         Their full report is available if you wish to see it: Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, Geleijnse JM, Rauch B, Ness A, Galan P, Chew EY, Bosch J, Collins R, Lewington S, Armitage J, Clarke R; Omega-3 Treatment Trialists’ Collaboration. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiol. 2018 Mar 1;3(3):225-234. doi: 10.1001/jamacardio.2017.5205. PMID: 29387889; PMCID: PMC5885893.

         Ultimately it was FISH and not fish oil that has the beneficial effect for cardiac diseases, and to this day you can see the recommendation to have fish in your diet twice a week, which is still in the American Heart Association guidelines.

         The role of fish oil and atrial fibrillation

         Even to this day, studies will disagree about the value of fish oil for cardiac health. For example, the studies looking at pharmaceutical-grade fish oil, came to different conclusions however there is one conclusion both studies came to: there is an increased risk of atrial fibrillation.

         The one study was called REDUCE-IT (Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, Doyle RT Jr, Juliano RA, Jiao L, Granowitz C, Tardif JC, Ballantyne CM; REDUCE-IT Investigators. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019 Jan 3;380(1):11-22. doi: 10.1056/NEJMoa1812792. Epub 2018 Nov 10. PMID: 30415628) which concluded that " Among patients with elevated triglyceride levels despite the use of statins, the risk of ischemic events, including cardiovascular death, was significantly lower among those who received 2 g of icosapent ethyl twice daily than among those who received placebo."

         The other study was called STRENGTH which concluded "Among statin-treated patients at high cardiovascular risk, the addition of omega-3 CA, compared with corn oil, to usual background therapies resulted in no significant difference in a composite outcome of major adverse cardiovascular events. These findings do not support use of this omega-3 fatty acid formulation to reduce major adverse cardiovascular events in high-risk patients." That paper can be seen in its full version (Nicholls SJ, Lincoff AM, Garcia M, Bash D, Ballantyne CM, Barter PJ, Davidson MH, Kastelein JJP, Koenig W, McGuire DK, Mozaffarian D, Ridker PM, Ray KK, Katona BG, Himmelmann A, Loss LE, Rensfeldt M, Lundström T, Agrawal R, Menon V, Wolski K, Nissen SE. Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial. JAMA. 2020 Dec 8;324(22):2268-2280. doi: 10.1001/jama.2020.22258. PMID: 33190147; PMCID: PMC7667577)

         So a meta-analysis of those studies combined with four other trials looking at omega 3 found that omega-3 supplementation led to a 30 percent increase in the risk of atrial fibrillation. (Lombardi M, Carbone S, Del Buono MG, Chiabrando JG, Vescovo GM, Camilli M, Montone RA, Vergallo R, Abbate A, Biondi-Zoccai G, Dixon DL, Crea F. Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials. Eur Heart J Cardiovasc Pharmacother. 2021 Jul 23;7(4):e69-e70. doi: 10.1093/ehjcvp/pvab008. PMID: 33910233; PMCID: PMC8302253)

         It is a dose-response curve, but even doses as low as 1 gram per day still increased risk of this.

         The answer is never over in science because other studies show that the evidence is low, but that there might be positive outcomes from supplementation. (Khan SU, Lone AN, Khan MS, Virani SS, Blumenthal RS, Nasir K, Miller M, Michos ED, Ballantyne CM, Boden WE, Bhatt DL. Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis. EClinicalMedicine. 2021 Jul 8;38:100997. doi: 10.1016/j.eclinm.2021.100997. PMID: 34505026; PMCID: PMC8413259)

         Overall?

         For those who look at the science of literature, the risk of atrial fibrillation brings to the level of harm for omega-3 supplementation, but not for eating it in food. Meaning, food doesn't cause this as an issue but clearly, the supplements do. Further, it does not matter where the supplements come from.

         What food sources are there for omega-3?

         Mackerel is a small fatty fish, typically 100 grams (or 3.5 ounces) contains 4100 mg of omega 3 fatty acid per serving. Mackerel also has 200 % of the daily B12 requirement and 100 percent of the selenium requirement.

         Salmon is perhaps my favorite. Salmon has 4123 mg per 100 grams or 3.5 ounces. Salmon will lower the risk of heart disease, as well as provide a great source of vitamin D, B, and selenium.

         Herring has 946 grams per serving (100 grams or 3.5 ounces) and has 100% of your vitamin D requirement per day.

         Those allergic to seafood and to crustaceans often can take mollusks (although please check with your allergists first). But oysters have 370 mg in 6 raw oysters per 100 grams or 3.5 ounces.

         Sardines are also helpful with 2,200 in 100 grams or 3.5 ounces. And Anchovies have 351 mg per 100 grams (so that Cesar salad made in the original manner is going to be good for you.

         For those that want a non-fish substitute Chia seeds have 5060 per ounce (28 grams) or 2 tablespoons. So 1 tablespoon, which is my typical amount in overnight oats, has 2500 mg.

         Flax seeds are also good having 2350 mg per tablespoon in whole seeds.

         Walnuts, 2570 mg of omega-3 per 7 walnuts or ounce.

         Even soybeans, which are a healthy legume, contain 670 mg in 1/2 cup or 1443 per 100 grams. Edamame is more than a snack!

         -----

         Fork U is part of the Your Doctors Orders network of podcasts and is hosted by noted physician and surgeon Dr. Terry Simpson.

         • Follow Dr. Terry Simpson on TikTok for bite-sized content on  healthy eating
         • Visit TerrySimpson.com for additional details on Dr. Simpson
         • Follow @DrTerrySimpson on Twitter for skepticism, travel, and much more.
         
         

         Fork U is produced by Simpler Media and is recorded in the studios of ProducerGirl Productions.  

         ]]>fdde44cc-fd98-4fea-95ed-de677d1b3981Sat, 25 Sep 2021 00:00:00 -070003:23falsefull1111Fork U: The latest podcast from Dr. Terry SimpsonWelcome to Fork U, the latest podcast from Dr. Terry Simpson.

         If you enjoyed the previous episodes of Culinary Medicine and Your Doctors Orders, you'll love these quick, impactful bits of information that are easily digestible. (See what I did there?)

         No need to adjust your podcast or subscribe to anything new, you are already here!

         With that, here is the first episode of the new podcast, Fork U, where you can learn a bit about food and medicine.

         ]]>Welcome to Fork U, the latest podcast from Dr. Terry Simpson.

         If you enjoyed the previous episodes of Culinary Medicine and Your Doctors Orders, you'll love these quick, impactful bits of information that are easily digestible. (See what I did there?)

         No need to adjust your podcast or subscribe to anything new, you are already here!

         With that, here is the first episode of the new podcast, Fork U, where you can learn a bit about food and medicine.

         ]]>e3fba51e-7e10-4e8a-85d9-a0c1d8d410b1Mon, 20 Sep 2021 00:00:00 -070005:44falsefull