Happy (Post) Thanksgiving!

What a wonderful, family-filled day of love, warmth and great food! I certainly hope your day was as enjoyable as mine!

However, with that said, I’ve been awake since 4 a.m. not feeling so good. My head was screaming at me, I was itching, coughing, and my bowels were making uncomfortable, loud noises and making me feel somewhat nauseous. Clearly, I enjoyed myself way too much on Thanksgiving. And while it cost me, I’m learning to interpret and understand what happens when I indulge the way I did yesterday.

Let’s recap…

What happened to contribute to me feeling less than optimally this morning?  To begin, I haven’t eaten that many carbs since our last family gathering on the 4th of July. You see, over the past three years I’ve been low carb, then keto, then very strict keto, and now zero carb (carnivore) – including intermittent fasting and some extended fasting in each of those regimes. In all that time, I’ve felt better and better, and most recently, I feel especially good. As a matter of fact, my blood work not only reflects improved blood markers, but also validates the way I feel: excellent lipid ratio panel (i.e., low triglycerides, high HDL (high density lipoprotein, aka the ‘good’ cholesterol), & good LDL (low density lipoprotein, aka the ‘bad’ cholesterol to the ill-informed); reduced inflammation score; and ideal A1c (blood sugar/diabetes marker); and my CAC (Coronary Artery Calcium) scan is 0 (the best you can score), and my visceral fat (fat accumulated in the abdominal cavity including the pancreas, intestines and liver) is at 4%. Other improvements: excellent dental health; alert, clearer thinking; silkier feeling skin (itching and skin tags - gone); joint pain - gone; & chronic sciatica pain - gone. In all, I’ve learned that it really is this simple: it’s all due to our diet – that what we put in our mouths does indeed impact our overall metabolic health from head to toe, including the way we feel and think.

To say these lifestyle choices have improved my quality of life would be an understatement. For many others these same eating choices (dietary guidelines based on high carb/low fat & minimal protein) have reversed ailments in many people, including Type II Diabetes, cancer, autoimmune conditions, mental & emotional health, heart health, and food addiction to name a few (Lots more to follow on each of these illnesses later).

At any rate, rest assured that I will be giving my overworked gut a much-needed rest by fasting all day, drinking lots of water, and maybe drinking some bone broth to assist my body from the ill effects of my carb coma.

So… would I do it all again? You bet!

The Elephant in the room....

This month’s AARP Bulletin’s cover story, Could Decreasing Inflammation Be the Cure for Everything?  certainly caught my attention. Similar to the movie, The Theory of Everything, this title suggests a fairly comprehensive cure or answer if you will, for the very problems causing all of our body’s metabolic illnesses.

This is huge.

For me, its one thing to have amassed an overload on this topic (while remaining continually open to further research), while realizing the relationship of inflammation to the rampant escalation of obesity, Type II diabetes, cancer and other autoimmune diseases. But to see this in a title: ‘…the cure for everything’ in a mainstream magazine, to say the least, nonplussed me on the one hand, but gave me hope on the other. I believe that indeed, by doing just what the title asks is entirely possible.

But…It’s the HOW TO decrease inflammation that remains a challenge for most people.

So what do the experts believe causes inflammation in the first place?

Difficult infections (i.e., hepatitis C or Lyme disease) &

Genetics (both significant in 20% of the population)

Environment (pollution)

Lifestyle (obesity, unregulated stress, tobacco use, drinking too much, lack of physical activity, lousy sleep & poor diet)

Aging (longer exposure to all of the above)

Looking over this list, while all are definitely relevant, I would suggest that of all those listed I would put poor diet at the top, followed by some of the other Lifestyle challenges & choices, followed by any of the first three listed (if relevant), with Aging the natural end-stage, as this is where all of us are headed whether we like it or not.

When inflammation creeps into our bodies, it may percolate for many years as a low-grade problem, often minimally noticed and/or annoying at first until things escalate.

When cells are in distress, they release chemicals that alert the immune system. White blood cells then flood the scene, where they work to eat up bacteria, viruses, damaged cells and debris from an infection or injury. If the damage is too great, they call in backup cells known as neutrophils, which are the hand grenades of the immune system — they blow up everything in sight, healthy or not. Each neutrophil has a short life span, but in chronic inflammation, they continue to be sent in long after the real threat is gone, causing damage to the healthy tissue that remains. The inflammation can start attacking the linings of your arteries or intestines, the cells in your liver and brain, or the tissues of your muscles and joints. This inflammation-caused cellular damage can trigger diseases like diabetes, cancer, dementia, heart disease, arthritis and depression. (pp. 13-14) [emphasis mine]

So what leads to or finally triggers chronic inflammation and its subsequent effects on your body?

•        Something triggers the immune system. Whether it's a chronic disease, an autoimmune disorder, weight gain, psychological stress, poor nutrition, exposure to chemicals or allergens — something puts your body in a state of stress and keeps it there.

•        The immune system responds. The body goes into attack mode with its inflammatory response, which also includes blood vessel expansion to increase blood flow to the problem areas. Blood is the primary delivery system for all these substances.

•        And responds … and responds … and responds. An endless cycle of pro-inflammatory foods, rampant stress, bad sleep and more keeps this process in constant motion because we never give the body a break. (p. 14)

While I was impressed that this article brought the idea front and center that inflammation leads to illness & disease, it missed the mark regarding the root cause of inflammation itself in terms of HOW FOODS AFFECT US hormonally & metabolically. As such, they have unfortunately overlooked the proverbial the elephant in the room. The elephant in the room, aka the key root cause of inflammation itself is of course the role INSULIN plays with regard in particular to the carbohydrates and sugar it governs, and how those specific foods in a poor diet affect our mitochondria – the power houses of our energy.

We don't fully understand it yet but now we know our gut microbiome, made up of trillions of bacteria, influences physiologic processes throughout the body. We're born with a balance between good and bad bacteria in the gut. When that balance is thrown off — known as dysbiosis — it can lead to trouble. A dysregulated microbiome has been associated with metabolic diseases, pulmonary diseases, nervous system conditions, Alzheimer's — and these associations grow as we learn more and more. (p. 14)

“We don't fully understand it yet…” Really?

While it’s true that we're born with a balance between good and bad bacteria in our gut (we are after all born in a state of mild ketosis, and if breastfed, mother’s milk is rich in the fats and nutrients to continue that balance), and that anti-inflammatory foods are a great place to start for reducing inflammation. But while good-intended, this article and mainstream medicine still don’t openly address the key root cause of the inflammation… what specific foods in a poor diet are causing that - and why??

…too much sugar in your blood damages your body. As your sugars rise, your body will protect you from toxic sugar levels at all costs. How is sugar toxic?

Each sugar molecule attracts nearly 100 water molecules as it floats around your system. This creates a toxic inflammatory state. As your blood sugars rise and rise, so does the level of inflammation. If your system does not reduce sugars, soon every part of your body will swell with inflammation. The end results [in a diabetic for example] are a coma and death due to the swollen inflamed brain led by the toxic amounts of sugar.

[So when you remove the processed carbs, junk food, sugar & grains] Your blood glucose lowers along with the extra inflammation. That toxic level of sugar disappears as does the inflammation.

Bosworth, A. (2018). Anyway You Can, p. 40.

Once it becomes a mainstream narrative that today’s out of control illnesses and diseases (not of a bacterial nature of course) are understood as a negative outcome of our mitochondria’s malfunctioning and insulin’s response to repeated processed carbohydrates and sugar in any form – leading to out of control blood sugar and our gut microbiome becoming off-balance (dysbiosis), creating inflammation (& water retention) raging through our bodies, leading to problems associated with various metabolic diseases (including complaints of feeling fatigue, depression, irritable, general aches & pains) – will doctors be able to implement positive change. When doctors can process and understand how & why these foods in particular are part of the key root cause of inflammation, will they will be able to more effectively and accurately diagnose and treat (rather than manage) their patient’s illnesses and disease. (Rabbit hole alert: doctors are not trained in nutrition.)

“Nobody…ever told me junk food was bad for me. Four years of medical school, and four years of internship and residency, and I never thought anything was wrong with eating sweet rolls and doughnuts, and potatoes, and bread, and sweets.” ~ Dr. Robert Atkins

In fairness, the doctors in this article did mention two of the biggest inflammation culprits such as sugar and fried foods – which I wholeheartedly agree with. But again, and in summary, central to the entire key root cause of inflammation issue, they should have also discussed in greater detail carbohydrate overload, especially processed carbohydrates & grains, and the role pro-inflammatory oils known as PUFAs (polyunsaturated fatty acids) play in our bodies, and how THOSE FOODS (used in virtually ALL PACKAGED & PROCESSED FOOD & RESTAURANTS to FRY & COOK) help to contribute to the root cause of the havoc in our guts and pancreas (where insulin is made), leading to a dysregulated microbiome and inflammation associated with skin problems, metabolic diseases, pulmonary diseases, nervous system conditions, Alzheimer's disease, among others. This is a huge area, but for now, realize that these are the very ‘poor’ foods in our diet at the heart of all our inflammatory metabolic problems. Stop eating them!

With that said, even with the exclusion in this article of the actual key root causes of inflammation itself from these foods (due to havoc they play internally/metabolically), as well as the omission of some of the best bio-available sources of protein and fat known to help support overall good health and sense of well-being (which should have been included with their recommendations to avert inflammatory issues); it was still a valuable contribution in terms of the inflammation-leading-to-illness & disease-connection!

Just for fun – here’s a documentary written and produced by a young mom who was fed up with feeling like s*** and took control to reverse her chronic inflammation: “Through her journey to become well, she learned about a whole new medical world and how to naturally combat America's #1 killer - chronic inflammation.”

Un-Inflame Me: Reversing the American Diet & Lifestyle

Are we in a health crisis?

When I was in college I had a roommate who was obsessed with her weight. She kept a fastidious cataloguing of her daily calories attempting to consume no more than 500-1000 calories per day. She had an iron-will determination and was somehow able to stick with it, at least during the years I knew her. You might ask how she looked with so few calories coming in. Remember, we were in college – studying, reading, writing papers, taking exams, and all that being in school entailed, aka brain overload. In truth, she was the vision of the walking dead, with terrible acne, low energy, string-bean figure, and zero muscle tone. In a word, she was starving - and exhausted all the time.

I share this little bit of background because she was fighting her own demons related to fear of fat and aging and believed controlling her weight in such a severe way would help her in the long run. She once said to me, “I’m dreading growing old, and will do anything in my power to avoid it.” Bear in mind that we were only 21, and never hearing anyone our age lament the aging process replied, “I’m actually looking forward to it. It’ll be a challenge!” I don’t know why I said that – surely it was my bullet-proof youth talking – but what I said at the time has stayed with me ever since.

Whether I realized it consciously or not, I would soon be on a quest of sorts – wondering how I could prevent the aging things my roommate feared so much: becoming fat, and/or sick and/or decrepit before my time. Sure, I wasn’t skinny like her, but for a college co-ed I thought I was doing ok. But I wondered if to avert the things she feared, I would have to ultimately starve myself too. After all, I was eating low fat foods, whole grains/starches, using vegetable and seed oils, eating fruits and vegetables, and avoiding most meat; all with the idea that a calorie is a calorie, move more, eat less, and above all use portion control.

But that advice has not worked for most people, including me, and there is a direct correlation from the 1960s when food guidelines were proposed, to the 1970s when the Food Pyramid was adopted leading to the out-of-control rise in obesity and diabetes epidemic (Shanahan, 2107; Fung, 2016; Teicholz, 2014).

Briefly…

When the low-fat, low-cholesterol diet was first officially recommended to the public by the American Heart Association (AHA) in 1961, roughly one in seven adult Americans was obese. Forty years later, that number was one in three…. During these decades, we’ve also seen rates of diabetes rise drastically from less than 1 percent of the adult population to more than 11 percent, while heart disease remains the leading cause of death for both men and women. In all, it’s a tragic picture for a nation that has, according to the government, faithfully been following all the official dietary guidelines for so many years. If we’ve been so good, we might fairly ask, why is our health report card so bad?

Teicholz, 2014 (p. 5)

But…

Medical school teaches us to believe that we’re living longer now, and so today’s diet must beat the diets of the past, hands down. This argument had me so convinced that I never considered questioning the dietary dogma I’d absorbed throughout my schooling. But we need to take into account the fact that today’s eighty-year-olds grew up on an entirely different, more natural diet. They were also the first generation to benefit from antibiotics, and many have been kept alive thanks only to technology. Today’s generation has yet to prove its longevity, but given that many forty-year-olds already have joint and cardiovascular problems that their parents didn’t get until much later in life (as I found in my practice), I don’t think we can assume they have the same life expectancy. And the millennium generation’s lifespan may be ten to twenty years shorter.

Shanahan, 2107 (p. 11)

Due to…

Our own disastrous, misguided dietary changes since the 1970s have created the diabesity debacle. We have seen the enemy, and it is ourselves. Eat more carbohydrates. Eat more often. Eat breakfast. Eat more. Ironically, these dietary changes were prescribed to reduce heart disease, but instead, we’ve encouraged it since diabesity is one of the strongest risk factors for heart disease and stroke. We’ve been trying to put out a fire with gasoline.

Fung, 2016 (p. 135)

Sadly, America’s most obese (and diabetic) people are growing by leaps and bounds.

An annual obesity report shows that 68.7% of U.S. adults are now considered overweight or obese -- and that's not even the scariest finding….Between 1976 and 1980, the number of extremely obese adults -- quantified as those with a body mass index over 40 -- totaled 1.4% of the population. According to the latest study figures, the number of extremely obese adults has climbed 350% to 6.3%! (Williams, 2013)

Since then I’ve learned of the cascade of diseases that may be directly and indirectly affected by elevated insulin levels (hyperinsulinemia) and excessive polyunsaturated vegetable and seed oils (found in virtually all commercially packaged foods and restaurants) consumed as a result of excessive and prolonged intake over the past 40 years. In other words, could diets laden with too much of these processed foods overwhelm our bodies and lead to Type II Diabetes, Alzheimer’s (now referred to as Type III Diabetes), obesity, heart disease, non-alcoholic fatty liver disease, certain types of cancer, and/or a myriad of other metabolic related conditions?  Or is our health just the luck of the draw? Does bad (s***) just happen to us no matter what we do?

Consider this 2017 obesity map…it’s something to contemplate.

I contend that the overarching root cause for the escalation of illness and disease is due to INFLAMMATION; as this seemingly innocuous, insidious condition is at the heart of all metabolic diseases. From what I understand, obesity, diabetes, brain, respiratory, autoimmune, skin, oral health and bowel/digestive issues, diseases and illnesses have their foundations with inflammation, and as such, can be reversed, or at minimum, mitigated to stack the deck in our favor as we age. To do that, with respect to not only our Epigenetics (body/mind/spirit lifestyle choices), it may be especially critical to consider what we are putting in our mouths in terms of how those foods contribute or not to inflammation and the downstream ramifications in our bodies.

But why isn't this stuff more widely known?

A couple of blogs ago I asked, why our basic metabolic, hormonal response to food (fat storage v. fat burning) is not more widely known and accepted as basic human physiology in the nutrition world, let alone from our doctors?

2500 years ago Hippocrates, the Father of Medicine proclaimed that it was incumbent upon physicians to 1.) Prevent disease 2.) Cure disease & 3.) Relieve pain in their patients. We have spent little to no time on #1, and our current paradigm with #2 & #3 is to be best friends with our pharmacists. But the overarching theme for doctors is to ‘do no harm.’ It is on this point that while good intentioned, many doctors simply spend their days writing prescriptions to allay patient’s maladies with little thought to any of the root causes of their patient’s illnesses.

A short time ago two doctors wrote editorials in the WSJ (June 29, 2019) responding to a feature article, “Heart Disease Roars Back” (page one, June 22, 2019). Their commentary fairly succinctly summarizes the current dietary mess, metabolic dysfunction and ill health our country is in:

 “Only when we accept as a society that it isn’t obesity or diabetes, but carbohydrates-sugar – and starch – that are killing us are we truly going to be able to address the problem. Until then, we will remain trapped in an eat-less-do-more, calories-in, calories-out and exercise, ‘statins and metformin in our muesli’ environment that will result in billions more people world-wide suffering and dying.” – Rob Cywes, M.D., Ph.D.

And this…

“Perhaps the medical establishment needs to reconsider its war on animal fat. Humans evolved for a fatty diet; only recently have sugars and starches become widely available. Most adults won’t restrict fats without increasing carbohydrates – we have to get our calories somewhere. A diet without either animal fat or sweeteners is very boring, so we’ve gotten millions of Americans off meat and onto a high-carb diet. I would like to see more research on low-glycemic-load diets in our population of overweight adults, especially diabetics.” – John M. Rathbun, M.D.

Heads up…there are many, many studies that have accomplished this, and are hiding in plain sight. For example, the RCTs (random control trials – the gold standard for research studies) that researchers at Virta Health employ are available for all to see (including a long list of previous trials related to low carb diets for diabetics prior to Virta’s work) and clearly demonstrates that diabetes is a completely reversible disease. Hundreds and hundreds of people have reclaimed their lives by following their simple, healthy, savory low carbohydrate menus back to health.

Like the doctors at Virta Health, slowly but surely, there are more and more practitioners who are becoming acutely aware of our counterproductive dietary guidelines (based on epidemiological studies, not real science & headed by committee members who have significant conflicts of interest) and standard of care causing a myriad of problems – and who are able and willing to do something about it. But they are the exceptions, not the rule at this point. And who can blame them really when there is so much conflicting and weak science undermining them by none other than the AHA, ACC, & National Academy of Science? But similar to any political leanings you may have, this is one hot topic area where these groups continue to use weak science (and in some cases outright fake news) rather than evidence based science to substantiate their claims – and to bolster the status quo and big pharma.

Meanwhile, could the root cause for the myriad of illnesses and maladies we experience be from nothing more than what we’re putting in our mouths? Could it really be that simple? I contend that indeed it is.

~ A note to my daughters ~

In the movie The Princess Bride, the protagonist Westley (aka Dread Pirate Robert) was being held in the Pit of Despair to be used as a human guinea pig for Count Rugen’s ‘pain tolerance’ machine. As he lay on the table, The Albino was administering first aid to Westley’s severely gouged shoulder from the attack of a ‘rodent of unusual size’ from the Fire Swamp. Looking dubiously at Count Rugen, Westley questions him about being healed only to ultimately suffer pain on the machine. Very calmly, Count Rugen replies, “If you don’t have your health, you don’t have anything.”

I thought of my own three children and what that might entail with regard to attaining our full health potential and what stacking the deck for healthy aging could look like. I’ve spent many hours communicating my thoughts about nutrition choices with my children over the course of their young lives (sometimes to their interest, and more currently, their dismay), especially now that they have children of their own. And now more than ever, realizing the mess our nation is in with regard to our health, and the observation that aging seems to be in and of itself its own disease, I penned this note to my two daughters attempting to simplify as best I could the often complex nutrition puzzle message:

Dear Kristi & Jodee,

I know you guys think I’m a radical about this stuff, but I cannot help myself when it comes to your health, and your children’s health. I’ve learned that virtually every medical condition or symptom we have that negatively impact our bodies is a result of what we eat. Period.

This will take just a few moments, but this link is a good place to begin to learn about the foods that cause inflammation which leads to food allergies, skin conditions, asthma, autoimmune diseases, to name a few - - and what to do about it in terms of the foods we should be eating - at least it’s a place to start.

Of note, the inflammation message is critical to understand because I’ve learned that EVERYTHING that happens negatively to our bodies stems from this concept – and this concept alone.

Where to begin?  Besides being aware of the foods we should be eating, it’s possibly simpler to consider what NOT to eat as we descend further into the global health crisis we’re now facing.

Consider eliminating one food from your diet at a time:

• sugar, then

• grains, then

• vegetable oils 

For me, I began by eliminating sugar, followed with grains, then vegetable oils. Since my initial forays into this way of eating, I’ve read many more books and research including: The Big Fat Surprise & Deep Nutrition, with regard to the deleterious effects of sugar and grains, and have especially learned how vegetable & seed oils (corn, soy, canola/rapeseed, sunflower, safflower) deeply affect us. These are all Omega 6 polyunsaturated oils which completely throw off our microbiome along with a milieu of downstream problems, as these are truly foreign oils to our bodies, and as such, we have trouble digesting them. This creates the perfect storm making them the primary brain killers over time that can compromise you as you age & are especially pro-inflammatory for your skin, respiratory & autoimmune systems. These oils can also lead to a whole host of other metabolically compromising problems and illnesses I’ll discuss later. Just know that these oils are in virtually ALL processed/packaged foods (breads, doughnuts, cakes, cereals, snack foods) & used by ALL restaurants & fast food places, because it is cheap and stores well. This is in large part why we eat at home most of the time now, and carefully select menu items when we are out.

I could go on and on, but consider some of the ideas presented here…you won’t regret it.

I love you and want you to live long, HEALTHY, productive lives!

~ Love, Mom

So how do we become metabolically compromised (fat, sick and nearly dead)?

Since the days after Ancel Keys’ Seven Countries Study, people have been loath to the idea of eating cholesterol containing foods fearing it would lead to accumulated fat in our arteries and demise.

In addition to causing atherosclerosis, Keys thought that fat must make people fat. Because fat contains a little more than 9 calories per gram, whereas protein and carbohydrates contain only about 4 calories per gram, nutrition experts have long reasoned that a low-fat diet enables weight loss due to its reduced calorie content. In other words, if we eat fat, we will be fat…Cutting back on calories was one of several competing theories at this time about how people should lose weight, and since fat packed more calories, many doctors advised their patients to cut back on this part of the diet. Since then, fat in all forms has simply come to be commonly understood as something to be avoided.

Teicholz, N. (2014). The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet Simon & Schuster. (p. 29).

Overeating and eating fat makes you fat? From what I understand now, it’s not that simplistic. At a recent presentation, 'The quality of calories: Competing paradigms of obesity pathogenesis,’ Gary Taubes elaborates that this idea remains the prevailing logic. He explains that Tautology is the repetition and redundancy of Circular Logic (and is at the core of fat shaming - which this blog is not in any way shape or form - about). For example:

Why do we get fat? Because we are overeating.

How do we know we’re overeating? Because we’re getting fatter.

And why are we getting fatter? Because we’re overeating.

From this same presentation, Taubes reveals at least four of the top medical schools in the U.S. (Standford, Cornell, Harvard, & Chicago) and one in England (Oxford) were already promoting Diets for Obesity based on low carbohydrate foods. In fact, in 1951 from The Practice of Endocrinology, Raymond Greene, University of Oxford, England wrote:

Foods to be avoided:

1.      Bread, and everything else made with flour

2.      Cereals, including breakfast cereals and milk puddings

3.      Potatoes and all other white root vegetables

4.      Foods containing sugar

5.      All sweets

Foods to eat as much as you like:

1.      Meat, fish, birds

2.      All green vegetables

3.      Eggs

4.      Cheese

5.      Fruit (except bananas & grapes)

Of note, even before these low carbohydrate diet recommendations from these leading medical schools in the 1940s and 50s (suggesting that this way of eating has been around and recommended for decades), Vance Thompson wrote “Eat and Grow Thin” in 1914, touted as the first-ever low carbohydrate diet recommendations in the early 20th century. Thompson based the menus in his book on the “dietary charts issued by the United States Department of Agriculture…prepared by Mr. C.F. Langworthy, expert in charge of Nutrition Investigations” (p.94). Interestingly, the forbidden foods listed on the USDA ‘avoid’ chart in his book include the very same foods on the ‘Foods to be avoided’ list above – all due to the high sugar/carbohydrate content in these foods leading to their addictive, obesogenic effects on the body.

So, how do the foods we eat promote either weight gain/illness or good health?

It’s vital that we understand the metabolic processes a body goes through when it ingests certain macro-nutrients (protein, fat, carbohydrates). Chief among the vanguards in this arena is Jason Fung (The Obesity Code) and Gary Taubes (Why We Get Fat) who postulate that weight gain is a hormonal metabolic process driven by insulin. This is key because the current belief is that weight gain (or loss) is simply a CICO (calories in/calories out), eat less/move more issue and that we all just need to simply eat less, avoid fat (especially saturated fat), and eat lots of ‘heart healthy foods’ (translation: whole grains, legumes, polyunsaturated oils/fats, fruits, veg & limited lean only poultry/fish) and exercise a lot to stay fit, trim and healthy.

So the question that needs to be asked is, How’s that working for you?

Not well…not well at all.

Let’s consider the metabolic processes your body exhibits with respect to certain macro-nutrients (proteins, carbohydrates, fats). It’s important to note that the body’s hormonal physiology with regard to weight gain is no secret and has been well known for more than 100 years.

DR. ALFRED FROHLICH from the University of Vienna first began to unravel the neuro-hormonal basis of obesity in 1890; he described a young boy with the sudden onset of obesity who was eventually diagnosed with a lesion in the hypothalamus area of the brain. It would be later confirmed that hypothalamic damage resulted in intractable weight gain in humans. This established the hypothalamic region as a key regulator of energy balance, and was also a vital clue that obesity is a hormonal imbalance. Neurons in these hypothalamic areas were somehow responsible for setting an ideal weight, the body set weight. Brain tumors, traumatic injuries and radiation in or to this critical area cause massive obesity that is often resistant to treatment, even with a 500-calorie-per-day diet.

Fung, J. (2016). The Obesity Code: Unlocking the Secrets of Weight Loss. Greystone Books. (p. 65).

But in the absence of brain injury or disease, what mitigating factor(s) could help with regard to satiety in terms of preventing weight gain?

Discovered in 1994, this factor was leptin, a protein produced by the fat cells. The name leptin was derived from “lepto,” the Greek word for thin. The mechanism was very similar to that proposed by [Romaine] Hervey in 1959. Higher levels of fat tissue produce higher levels of leptin. Traveling to the brain, it turns down hunger to prevent further fat storage….Leptin is one of the primary hormones involved in weight regulation in the normal state. However, in obesity, it is a secondary hormone because it fails the causality test. Giving leptin doesn’t make people thin. Human obesity is a disease of leptin resistance, not leptin deficiency.

(Fung, pp. 65-66)

So the body’s hormonal response with regard to satiety requires a nod from leptin. In the absence of satiating foods that include natural fats for example, leptin resistance ensues, resulting in almost constant hunger. But what triggers hunger in the first place? Ghrelin. Ghrelin is the hormone that regulates hunger, and is triggered when insulin is routinely high/low, and especially out of control due to the ingestion of carbohydrates (especially processed carbs) and protein (especially lean protein).

Briefly, insulin is a fat storing hormone, and its opposite is glucagon, the fat burning hormone. Both hormones serve as signals to either store or burn fat. In other words, when insulin is low by reducing or eliminating sugar and carbohydrates from the diet, glucagon is secreted to shore up low blood sugar and burn fat for fuel.

But how does glucagon get the “signal” to burn fat? In the absence of insulin surging through the body to store incoming sugar and carbohydrate foods, glucagon is secreted (with the help of a fat-burning enzyme called hormone sensitive lipase, aka, HSL) and goes into the cells that are storing fat, and releases it breaking down triglycerides into fatty acids and glycerol for fuel. So when the glucagon to insulin ratio is high, you burn your body fat (Bikman). In other words, insulin tells your body to store away nutrients, and glucagon signals to your body to mobilize them out of storage for energy. When this happens, fat burning and subsequent weight loss occurs.

The crucial point to understand, however, is not how insulin causes obesity, but that insulin does, in fact, cause obesity. Once we understand that obesity is a hormonal imbalance, we can begin to treat it. If we believe that excess calories cause obesity, then the treatment is to reduce calories. But this method has been a complete failure. However, if too much insulin causes obesity, then it becomes clear we need to lower insulin levels. The question is not how to balance calories; the question is how to balance our hormones. The most crucial question in obesity is how to reduce insulin.

(Fung, pp. 87-88)

In other words… reduce the foods in your diet that spike insulin, and stop eating all the time. When you do eat, make sure the foods you eat are very nutrient dense. If you can do that, you’ll be satiated for longer periods, and your body will burn its stored fat for energy.

But why is this basic metabolic, hormonal response to food (fat storage v. fat burning) not widely known and accepted as basic human physiology in the nutrition world, let alone from our doctors?

How did we get here? Part II

You may ask, “But wait, certainly there was some other research contradicting the low fat hypothesis and its relationship to heart health. Isn’t there anyone out there whose research supported the way our ancestors ate for thousands of years? Does dietary saturated fat & cholesterol really cause heart disease?”

The short answer to these two questions is yes(es) & no.

Yes. Professor John Yudkin, a British professor and founder of the nutrition department at the University of London's Queen Elizabeth College, wrote Pure, White and Deadly (1972), was the one voice who stood out in opposition to Keys, questioning whether there was any causal link at all between fat and heart disease.

Instead of laying the blame at the door of fat, he claimed there was a much clearer correlation between the rise in heart disease and a rise in the consumption of sugar. Rodents, chickens, rabbits, pigs and students fed sugar and carbohydrates, he said, invariably showed raised blood levels of triglycerides (a technical term for fat), which was then, as now, considered a risk factor for heart disease. [He believed] Sugar also raised insulin levels, linking it directly to type 2 diabetes….[questioning] whether there was any causal link at all between fat and heart disease. After all, he said, we had been eating substances like butter for centuries, while sugar, had, up until the 1850s, been something of a rare treat for most people. ‘If only a small fraction of what we know about the effects of sugar were to be revealed in relation to any other material used as a food additive,’ he wrote, ‘that material would promptly be banned.’

Additionally, and very important to the booming processed food industry, this was NOT the message that would help food manufacturers make profits.

This was not what the food industry wanted to hear. When devising their low-fat products, manufacturers had needed a fat substitute to stop the food tasting like cardboard, and they had plumped for sugar. The new "healthy" foods were low-fat but had sugar by the spoonful and Yudkin's findings threatened to disrupt a very profitable business.

With the combined message of sugar as the culprit to heart health, in opposition to Key’s message, along with food manufacturers not being able to bank on Key's anti-fat message, a full-on bullying campaign against Yudkin began in earnest.

Yudkin was ‘uninvited’ to international conferences. Others he organized were cancelled at the last minute, after pressure from sponsors, including, on one occasion, Coca-Cola. When he did contribute, papers he gave attacking sugar were omitted from publications….By the end of the Seventies, he had been so discredited that few scientists dared publish anything negative about sugar for fear of being similarly attacked. As a result, the low-fat industry, with its products laden with sugar, boomed.

But wasn’t there any other research out there that anyone with half a brain (and guts) could use to refute Key’s work?

Yes. Also in the 1960’s the Framingham Diet Study was set up to specifically look for a connection between dietary fat and cholesterol. The results of this study yet again clashed with the prevailing wisdom/popular thought of the time, and so they were suppressed and never published in a major journal. What happened to them? The results were tabulated - - but forgotten because the findings of this study showed no correlation between dietary fat and cholesterol to heart disease whatsoever.

All these findings should have buried the diet-heart hypothesis. But no amount of data could dissuade the diehards that dietary fat caused heart disease. Researchers saw what they wanted to see. Instead, researchers saved the [diet-heart] hypothesis and buried the results. Despite the massive effort and expense, the Framingham Diet Study was never published in a peer-reviewed journal. Instead, results were tabulated and quietly put away in a dusty corner—which condemned us to fifty years of a low-fat future that included an epidemic of diabetes and obesity.

Fung, J. (2016). The Obesity Code: Unlocking the Secrets of Weight Loss (p. 208).

And Yes. Unfortunately, the final nail in the coffin sealing the fate of the type of fat used in our diets came with the Minnesota Coronary Survey (1968-1973), a RCT (randomized control trials – the gold standard for proving or disproving a hypothesis) study, BUT was also completely suppressed at the time because the director of the study did not agree with its outcome, and as such, remained hidden for almost 30 years. The irony is that the researchers were hopeful their largest-ever clinical trial of the heart-lipid hypothesis would support the claim that Keys was right. Instead, the trial proved the exact opposite.

[emphasis mine]

There has been a lot of selective reporting and ignoring of the methodological problems over the years. But probably the most astonishing example of selection bias was the near-complete suppression of the Minnesota Coronary Survey, which was an outgrowth of the National Diet Heart Study. Also funded by NIH [National Institute of Health], the Minnesota Coronary Survey is the largest-ever clinical trial of the diet-heart hypothesis and therefore certainly belongs on the list along with Oslo, the Finnish Mental Hospital Study, and the LA Veterans Trial [both also ignored], but it is rarely included, undoubtedly because it didn’t turn out the way nutrition experts had hoped.

After four-and-a-half years [of trials]…the researchers were unable to find any differences between the treatment and control groups for cardiovascular events, cardiovascular deaths, or total mortality. Cancer was higher in the low-saturated-fat group... [And] The diet low in saturated fat had failed to show any advantage at all. Frantz, [a research colleague] who worked in Keys’ university department, did not publish the study for sixteen years, until after he retired, and then he placed his results in the journal “Arteriosclerosis, Thrombosis, and Vascular Biology,” which [was] unlikely to be read by anyone outside the field of cardiology. When asked why he did not publish the results earlier, Frantz replied that he didn’t think he’d done anything wrong in the study. “We were just disappointed in the way it came out,” he said. In other words, the study was selectively ignored by its own director. It was another inconvenient data point that needed to be dismissed.

Teicholz, N. (2014). The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet Simon & Schuster, (pp. 95-96).

Had Yudkin’s study been supported, along with the results from the Minnesota Coronary Survey & Framingham Diet Study been blazoned all over Time Magazine like Ancel Keys’ Seven Countries Study was, today’s nutritional guidelines might look quite different than they do now, with a more evidence based recommendation for the inclusion of animal-sourced proteins and saturated fats.

So all told, in the end, No. Without the mass publication of Yudkin’s findings, the Framingham Diet Study AND the results from the Minnesota Coronary Survey trials in the major journals of the time, our country would soon be entrenched with the idea that saturated fat caused heart disease and should therefore be removed or at minimum significantly reduced, with sugar, grains and vegetable oils getting a free pass.

The rest as they say is history.

With our country’s nutritional guidelines (and it’s war on meat) not backed by hard science, aka, evidence, and the suppression of the key studies noted above (among many not listed here), the McGovern Commission established the Food Pyramid Guidelines in 1977 based on the lone observational data from Keys’ heart-lipid hypothesis study - and - the persistence of Keys self-promotion with the newly established American Heart Association (in which Keys was by then a board member).

• Low-fat foods and polyunsaturated oils are now promoted by the newly organized American Heart Association, replacing centuries-old food selection, cooking and baking practices.

• The food guidelines establish a diet with up to 60% carbohydrates (foods that are naturally metabolized as sugar once they are consumed), and recommend minimal saturated fat and protein as a ‘logical’ way to minimize the nutrient density calories of these foods.

• The American Dietetic Association* (ADA) becomes accredited in 1957, with Nutritionists and Registered Dietitians becoming certified with high carb/low fat, calories in/calories out mentality. By 1977 the Food Pyramid has established the national food guidelines based on the ADA recommendations for all major (government) organizations including hospitals, nursing homes, schools, and the military as the go-to for our food recommendations, including the guidelines for heart disease and type 2 diabetes, including snacking throughout the day.

• Big Food companies become established and capitalize with special interest funding and backing with the Food Pyramid’s foundation that our diet should be based on carbohydrates, followed with some vegetables & fruits, limited lean meat, eggs & low fat dairy (little to no saturated fats), and polyunstaturated fats. This validates the inclusion and consumption of processed foods laden with sugar and polyunsaturated seed oils (which are very cost effective because they are inexpensive to produce and transport because they don’t spoil). Big Food promotes the massive production of processed foods, which include the increased use of sugar to compensate for the lack of flavor because saturated fat is either gone, replaced with polyunsaturated fats.

• Big Pharma rushes in as the saviors (who market their drugs to us on TV, and most alarmingly to our medical schools) in response to the rise of metabolic diseases and cash in big time because people are becoming sicker with skyrocketing medical costs.

And now, several decades later, we have epidemics of obesity, Type II diabetes, mental health issues, cancer and heart disease that were almost unheard of a century ago. Unfortunately, in the years that followed, the roots of the obesity epidemic were firmly established contributing to our present day metabolic problems, aka, metabolic syndrome* that more than half our population suffers.

———————————-

*Metabolic syndrome is classified as having 3 or more of the conditions listed – all of which are exacerbated with increasing carbohydrate consumption:

• Obesity

• High Triglycerides

• Low HDL

• High Blood Pressure

• High Blood Sugar

Metabolic syndrome increases the risk of many/most chronic diseases including cancer and dementia, and is a top predictor of cardiovascular disease and death. One of the best ways to improve metabolic syndrome is to reduce carbohydrates.

———————————-

*The American Dietetic Association (ADA) was co-founded in 1917 by Lenna Francis Cooper, a devout Seventh Day Adventist (SDA), serving as the first lead dietitian at the Battle Creek Sanitarium in Michigan supporting and promoting Kellogg’s Cereal. Kathleen Zolber, PhD, nutrition professor at Loma Linda University, became the first SDA president of the ADA in 1982–1983. She was instrumental in establishing the SDA Evidence Analysis Library, a source for promoting the SDA doctrine about food information for RDs, and the SDA publication Food For All, authored by SDA Lydia Sonnenberg, MS, RD. This SDA publication led the way promoting vegetarian diets by virtually all nutrition professionals. [By] 1988 the ADA governed and supported by the SDA, issued a position statement favoring vegetarian diets, and have reaffirmed that position every four or five years since then, usually expanding the length of the position each time - all in the absence of RCTs - but based on solely on epidemiology and church doctrine. (The Global Influence of the Seventh-Day Adventist Church on Diet)

How did we get here? Part I

So how did our nation’s dietary guidelines come into being in the first place guiding us to where we are today? There was a seminal moment in our collective history where the norm of consuming reasonable amounts of dietary fat and protein took a pivotal turn to low fat and high carbohydrate foods. But I’m getting ahead of myself.

It’s a stretch to believe that this may have all started with a bunch of refuse seeds, and someone whose life’s work was studying fish…

What you are about to read is a very brief synopsis of the events that have led to today’s food guidelines (with respect to dietary fats - - grains & sugars will be covered later), and as such, may give you pause in terms of understanding why you eat the foods you do, and why perhaps our nation is so fat, sick and nearly dead.

Here goes.

Up until the industrial revolution and the turn of the 20th century, whale oil was widely used for energy and manufacturing, but was replaced with petroleum and cottonseed oil.

• Widely used in general manufacturing, cottonseed oil and petroleum get a huge boost in WWI for manufacturing weapons, making and powering war craft and war machines; including using cottonseed oil in paint & paint thinners among other industrial uses. Through the cottonseed oil extraction process however, mounds and mounds of cottonseed seed refuse result. The seeds are sold to Proctor & Gamble (used initially for making soap) who figure out a way to use them in food. Presto! Crisco is born, but not widely used - yet.

• Fast forward to post WWII, and President Eisenhower's heart attack 1952. People were nervous and scared that their sitting president was out of the oval office for an extended period of time. Doctors were searching for answers as the public awaited answers. Cardiology was a nonexistent medical specialty at the time. President Eisenhower was prescribed the newly popular high carb/low cholesterol diet, but continued to smoke and drink. He suffered seven more heart attacks from 1955 until his death, and ironically died from a heart attack due to high blood pressure & elevated blood glucose complications in 1969.

• Up until this time obesity, type 2 diabetes, and heart disease are virtually unheard of, and represent a footnote in terms of percentages of people who have these diseases.

Enter Dr. Ancel Keys, a Ph.D. marine biologist (specialty: zoology) who studied the physiology of fish in Copenhagen, Denmark. Years later at the University of Minnesota, he utilizes and establishes the standard for epidemiological studies, which do not follow the scientific method, nor are they scientific experiments, and above all, are not the same as randomized control trials researchers use to establish causation and death.

• In 1952 Dr. Keys postulates that saturated fat (primarily from animal sources) in our diet would collect and stick in our arteries leading to heart failure from his epidemiological Seven Countries Study known today as the “heart-lipid hypothesis” based on food frequency questionnaires.

• Without taking into consideration multi-factorial data points (see graph below), let alone establishing causation from fat in the diet to establish the cause of heart disease and death (because he cherry-picked his data points selecting only those countries that met his preconceived ideas on saturated animal-sourced fats, rather than revealing what the complete data from all 22 countries revealed), Dr. Keys fakes it and vigorously promotes himself and his observational survey study’s results as factual evidence, which ultimately leads to the establishment of our nation’s food guidelines via the Food Pyramid.

In a 1952 presentation at Mt. Sinai in New York (later published in several papers that together received enormous attention), Keys formally introduced this idea, which he called his “diet-heart hypothesis.” His graph showed a close correlation between fat intake and death rates from heart disease in six countries. It was a perfect upward curve, like a child’s growth chart. Keys’ graph suggested that if you extended the curve back down to zero fat intake, your risk of heart disease would nearly disappear. This connect-the-dot exercise in 1952 was the acorn that grew into the giant oak tree of our mistrust of fat today. All of the ailments that have been ascribed to eating fat over the years—not just heart disease but also obesity, cancer, diabetes, and more—stem from the implantation of this idea in the nutrition establishment by Ancel Keys and his perseverance in promoting it. Now, as you eat a salad with a lean chicken breast for lunch and choose pasta over steak for dinner, those choices can be traced back to him. The influence of Keys on the world of nutrition has been unparalleled.

Teicholz, N. (2014). The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet Simon & Schuster. (p. 28).

After President Eisenhower's heart attack, and the widely published results of Ancel Keys’ study, Procter & Gamble (who in 1911 uses for cottonseeds to create Crisco) figured out a way to promote Crisco, an inexpensive cooking fat. Seeing a prospective gold mine opportunity, they soon capitalized on Ancel Keys’ unchallenged ‘proof’ that saturated fat causes heart attacks.

How?

Proctor & Gamble were able to successfully promote the use of Crisco, an inexpensive manufactured polyunsaturated fat that had a consistency similar to expensive butter by providing a free cookbook using their product. Crisco soon becomes the new standard for all cooking and baking needs in American homes, instead of ‘old fashioned’ butter, tropical oils, tallow and suet (all saturated fats used for centuries), as a way to ‘help’ Americans avert heart disease.

Soon, other manufacturers begin making other alternatives to saturated fat including margarine from other polyunsaturated seed and vegetable oils including corn, soy, rapeseed (aka canola) among others. We now see these highly inflammatory, omega 6 polyunsaturated oils used to cook with in all restaurants, and is in virtually ALL canned, jarred, and processed packaged foods across our country.

Next… Part II

Wait... I’m following the dietary advise

My husband doesn’t let a day go by until he figures out ways to keep moving, no matter what. How did he arrive at this decision? Years ago he read the book, Younger Next Year* Live strong, fit, and sexy – Until you’re 80 and Beyond by Chris Crowley & Henry S. Lodge, M.D. Crowley provides the inspiration and color commentary to motivate movement and exercise goals while Dr. Lodge provides the physiology and biology of what happens internally to a body when it achieves and maintains certain levels of fitness – and why it’s so important to move in ways that make you happy and fulfilled.

I think what appealed to my husband in the book’s message was the idea that he didn’t need to become an elite tri-athlete or body builder, but rather could simply make sure he did something every day that involved moving as many muscle groups as possible, and was something he enjoyed doing. To that end, mission accomplished. However, the extra pounds accumulated year after year were not going anywhere no matter how religious he was with regard to his daily workouts. He was generally in good health (with the exception of statins his doctor wanted him to take), following most of the dietary guidelines with the idea that a calorie is a calorie, and to lose weight all he had to do to ‘burn off’ the calories ingested was exercise. In spite of doing most everything right, he was gaining, not losing weight, and was heading towards insulin resistance, and so was I.

This reminds me of another, quite severe case. The other day my hair stylist handed me a book written by a friend of hers. Lance (not his real name) details his horrific decades-long battle with Type II Diabetes. From his late twenties to his current mid-sixties, Lance has endured a cascade of ailments including debilitating pain, nerve damage (peripheral neuropathy), amputations, numerous surgeries, vision issues, skin and fungal infections, gum disease, bone loss, sleep apnea, suicidal thoughts, erectile dysfunction, digestion issues (gastroparesis), kidney damage, job losses, and permanent disability status. All the while, his doctors simply managed his diabetes with surgeries, pain medicines, and increased levels of insulin - - never once mentioning, or discussing with him his diet related to sugar and starch overload, but just told him to simply watch his calories, and exercise to mitigate his rising need for increased dosages of insulin. That didn’t work…at all. He blames himself and praises his doctors - all five of them.

Someone once said that you cannot exercise your way out of a bad diet. Could it be that there is something deeper going on here? Like many of you, I have tried and failed at many diets throughout my life – all the while following the dietary guidelines with portion and calorie control from many a dietician’s and doctor’s advice. But, in spite of those guidelines, and the calories in, calories out (CICO), eat less, move more narrative, many of us are fat, sick and nearly dead – or rapidly heading that way.

Why?

Let's Do This!

A Preamble

Years ago I watched the movie Julie & Julia. It’s the story of how Julie Powell, an aspiring writer & “foodie by night” turned her love of cooking into a blog, which was subsequently made into a movie. She set a goal that over the course of exactly one year she would cook every single recipe from Julia Child’s Mastering the Art of French Cooking. Her motivation was two-fold: first, she really did love to cook, but more importantly, she wanted and needed to set a goal, and what iconic chef and cookbook could set the bar so high?

Since then, I have watched “Julie & Julia” many times possibly because I too have been searching for a nugget of inspiration…inspiration to do what I’m about to do now…write a blog.

So what has held me back? This brings me to another movie that actually helped me to clarify and face the answer to that question. In a scene from the movie Patsy & Loretta, Patsy Cline is attempting to ascertain why Loretta Lynn is hesitant to spread her wings and share her musical talent. Loretta simply says, “Who would want to listen to me? I’m a simple nobody from nowhere.”

Therein lies the heart of my hesitation, even though I have been a teacher, college professor, researcher and author of several books for the span of my professional life.

With that said, like Julie and Loretta, I have friends and family that have encouraged me to share my knowledge based on what I’ve learned over the course of many years (and because they’re tired of being my ‘cornered’ audience). My message? Understanding how and why people are fat and sick, while our pharmaceutical and processed food industries get rich at the expense of our health - and more importantly, what we can do about it!

As I look back on my life so far, I realize that I’ve been working toward one simple goal: optimal health. Similar to a deck of playing cards, I’ve been attempting to out-maneuver the ugly side of aging while attempting to live it as healthy and happy and gracefully as possible by learning whatever I can, wherever I can.

Finally, in another parody from Under the Tuscan Sun, Katherine, who just before passing out after attempting to drink a magnum of champagne “to put you right” looks to Frances who is distraught over a failed relationship says something to the effect of, “You have to live spherically in many directions. Never lose your childish enthusiasm – and good things will come your way.”

So…. through the lens of living spherically in multiple directions – this blog will offer a compilation or a “player’s guide” if you will, for stacking the deck of life for you, by attempting to encourage an attitude of optimism, gratitude and curiosity – including observations, life experiences, science and explorations with regard to the optimal food we need to flourish!