In the past, I have discussed with relatively broad brush strokes the topic of the 5 so-called ‘Blue Zones’, regions of the world where folks tend to live freakishly long and productive lives.  Today, I will be blogging about one specific Blue Zone, Sardinia.  What captured my attention about the Sardinian Blue Zone is much the same as that of the other Blue Zones, i.e. none of the dietary components leapt out at me as a ‘secret elixir’ as independent variables in the longevity equation.  Rather what stood out were lifestyle factors:

  • The men and women both stay physically active throughout their lives and do not reduce their level of activity as they grow older, treating age strictly as a meaningless number.  Life is to be celebrated with equal veracity at any age!


  • The men walk daily over rocky terrain tending their sheep, they breathe in fresh unpolluted air, drink pure uncontaminated water, and make lots of vitamin D as they regularly expose their skin to sunlight, maintaining a healthy protective tan that safeguards them against skin cancer (believe it or not, the sun is not your enemy, Vitamin D deficiency is!).


  • The women can be found tending the garden, washing clothes and milling grain, and of course going everywhere on foot, not by car.


  • The Sardinians do not stress about anything and their pace of life is much slower than ours, quieter than ours, less distracted than ours (no iPhones!).


  • They have a strong sense of family and community, cultivating loving enduring relationships till the end of their lives.  No need for Facebook or Twitter.  If they want to talk to someone, they do not text them or even call them on the phone.  They walk over to their house and chat with them over a glass of wine.

So here’s my “Sardinian Theory”.  If you’re not eating highly processed junk foods and fast food and you’re living a Sardinian-like lifestyle, as described above, then it does not really matter all that much whether or not you are eating the same exact foods as the Sardinians, e.g. Goat’s Milk, lamb, eggs, flat bread, sourdough bread, barley, fennel, fava beans and chickpeas, Milk Thistle and Cannonau Wine.  You will be successful in maximizing your health and longevity mainly through a process of elimination, a recurring theme throughout most of my blog posts.  In other words, it’s more about what you are not doing, i.e. stressing over trivial crap such as how many “likes” you got on your last Facebook or Instagram post, sleep depriving yourself to binge-watch your favorite shows on Netflix, sitting in front of a computer or television all day, then blowing yourself up in the gym for an hour 4-5 days a week (“Active Couch Potato Syndrome”), pulling up at the drive thru window of McDonald’s on your way home from work most days, overindulging in sweets, snacks and alcohol, etc.  The Sardinians are healthy and long-lived primarily via exclusionary practices, not via an orthorexic obsession over every bite of food that they consume.  They live happy and carefree lives, not because they are rich and have expensive toys, but because they know what truly matters in life: family, friends and one’s mental and physical health.  Happiness is merely the byproduct of the aforementioned.

Live long and prosper, my friends!



The subject of fluoride and dental health are now unfortunately ubiquitously associated with each other in the collective consciousness of the general public, especially as we humans have foolishly abandoned the core principles of our traditional ancestral diets in favor of a modern diet replete with sugar-laden pseudo foods.  I’m pretty sure that cavemen never brushed their teeth, yet we can examine their skulls and marvel at the splendid dentition and structural beauty of their teeth and jaws.  No dentists needed back then!  In the first half of the last century, Weston A. Price, a dentist himself, conducted an epic decades-long investigation of indigenous peoples around the world to uncover how such folks living in abject poverty could sport such magnificent teeth and jaws consuming their traditional diets, people who did not own toothbrushes and had no access to fluoride (see picture at the bottom of this post).

Ironically, the same reports that hint that the alleged benefit from fluorides are due to ingestion are inconsistent with evolutionary biology, i.e. fluoride’s caries-preventive properties were initially attributed to changes in enamel during tooth development because of the link between fluoride and cosmetic changes in enamel and a belief that fluoride incorporated into enamel during tooth development would result in a more acid-resistant mineral.  A recent CDC report acknowledges new studies which indicate that the effects are “topical” rather than “systemic.”  Laboratory and epidemiological data also suggest that fluoride prevents dental caries predominately after eruption of the tooth into the mouth, reaffirming that its actions are indeed topical for both adults and children.

The obvious question is this: How can the CDC consider the addition of fluoride to public water supplies a public health success while admitting at the same time that fluoride’s benefits are not “systemic”?  In other words, no benefits are obtained from drinking fluoride.  The emerging truth, now becoming increasingly evident, is that fluoridation and the proclaimed benefit of fluoride as a means of preventing dental decay is perhaps the greatest “scientific” fraud ever perpetrated upon an unsuspecting populace, aside from perhaps the dietary fat/cholesterol heart health hypothesis that has killed millions of Americans since the 1980s.

Even worse, the relentless promotion of fluoride as a “dental benefit” is directly responsible for the neglect by public health authorities in properly assessing its toxicity when ingested by humans over a prolonged period, an issue that has become a major concern for many nations.  As there is no substance as biochemically active in the human organism as fluoride, excessive total intake of fluoride compounds might well be contributing to many diseases currently afflicting mankind, particularly those involving thyroid dysfunction.  In the United States, most citizens are kept entirely ignorant of any adverse effect that might occur from exposure to fluorides.  Dental fluorosis, the first visible sign that fluoride poisoning has occurred, is declared a mere “cosmetic effect” by the dental profession, although the biochemical events which result in dental fluorosis are still unknown.  The quantity and frequency of application of topical fluoride that is needed to prevent caries but avoid dental fluorosis is also unknown.  Does this mean that we should all stop brushing our teeth with toothpaste containing fluoride, especially if we are consuming a Standard American Diet (SAD)?  No.  But I certainly wouldn’t drink tap water anywhere in America unless I was dying of thirst!  Neither should you.



Studies have shown that Seventh-day Adventists in Loma Linda, California, from diverse genetic haplogroups, tend to live as much as a decade longer than the rest of us, which led to Loma Linda’s inclusion by author Dan Buettner as one of the five global longevity hot spots, which he calls “Blue Zones”, the only one in the United States.  It is indeed noteworthy and somewhat surprising that there exists but one “Blue Zone” in a country of over 350 million people.  One would think, with our economic prosperity and advanced healthcare technologies relative to most of the world, that we would have several other Blue Zones in our midst, yet we do not as of this writing.  It may therefore behoove us to make an effort to identify the specific dietary and behavioral characteristics of Seventh Day Adventists that appear to contribute as ubiquitous influences on their extraordinary vitality and longevity.

The following features emerge as most pertinent:

  • Low-meat diets, which we can take one-step further by proposing that what Adventists are really minimizing is not just meat per say, but rather the consumption of highly processed meats obtained from CAFO (Concentrated Animal Feeding Operations), i.e. animals pumped full of hormones/antibiotics and fed grains that are unnatural and harmful to them.


  • Weekly fasting as a religious practice, which happens to facilitate autophagy, the metabolic process through which damaged or senescent cells are destroyed in vacuoles within the cells, preventing them from mutating into dangerous senescent cells that accelerate the aging process or, worse yet, the proliferation of cancer cells.


  • Adventists tend to socialize only with other likeminded Adventists, thus less likely to engage in risky health behaviors because of their religion and more likely to be cared for by immediate family and a tight knit community as they grow older.


  • Regular low-level aerobic exercise such as walking and bicycling, seniors exercising in groups, enjoying physically active hobbies such as gardening and home improvement projects.


  • Frequent social events with peers, usually faith-based community events.  In Buettner’s study of the Blue Zones, it was found that religious denomination did not seem to matter.  Research shows that attending faith-based services four times per month adds 4-14 years of life expectancy, independent of other factors.  Social interactions with others, in person (not social media), is essential to our emotional well being and survival.  Humans are pack animals by nature!


  • No alcohol, no drugs, no smoking, no junk food. Any questions?

As stated repeatedly in this and other of my blog posts, a recurring theme which is surely worth repeating is that the true “secret” to longevity is mostly exclusionary in nature, a feature common to all the Blue Zones regions, including Loma Linda, i.e. their success is achieved primarily through the diligent elimination of harmful toxins and negative influences on their exposome.  The exposome can be defined as the measure of all the dietary, chemical, and environmental exposures of an individual in their lifetime and how those exposures relate to health and longevity.  It is noteworthy that 100 years ago, before the mass adoption of the deadly Standard American Diet (SAD), most Americans lived and ate much like Seventh Day Adventists do today, simply because modern processed foods and CAFOs did not exist back then.  “Free range eggs” were just called “eggs” and “grass fed beef” was called “beef”.  Want to live a long healthy life?  Just roll the clock back to 1918 in your kitchen and be physically active throughout the day.  Nobody sat on their butt all day in front of a computer in 1918!




I have ruminated in the past on the fascinating topic of Dan Buettner’s decades-long obsession with the cheerful folks in the so-called ‘Blue Zones’ regions around the world who live freakishly long and productive lives that put us all to shame here in our self-absorbed financially prosperous nation.  Here then are a few random thoughts on some of the less commonly discussed longevity ‘secrets’ of these amazing centenarians and super-centenarians:

  • Exercising daily, preferably swimming in cold water, as do the Abkhasians, which not only improves circulation and muscular function but also activates SIRT1 longevity genes via cold thermogenesis. Caveat: a senior with a heart condition should probably refrain from jumping into freezing water if they want to avoid a heart attack!


  • Retirement is an unknown concept amongst Abkhasians. This one is huge!  Personally, I have never understood the logic of retiring from being a productive member of society, unless you are holding down a job that you have hated your entire adult life, in which case you could still “retire into” more fulfilling work, instead of transitioning to an unproductive vegetative state in which you “retire” your sense of purpose and meaning.  In other words, why would any sane person choose to stop working altogether if they are healthy and vital, unless they wish to become no longer being healthy and vital?  I myself chose nutrition science as my livelihood specifically because I am so enamored with the subject/profession that it is something I would do for free, as a hobby, were I independently wealthy.  The point is that the Blue Zones illustrate the reality that retirement is a virtual death sentence.


  • Eating real food, mostly plants, not too much.  Thank you, Michael Pollan!


  • Vilcabamba is known as “The Valley of Peace and Tranquility“.  Enough said.  With peace and tranquility in your life, your HPA (Hypothalamic/Pituitary/Adrenal) axis is never dysregulated, your immune system is strong as a bull, resistant to infections and cancer, and you are virtually “bulletproof” to chronic and acute disease states precipitated by stress that are the bane of modern Westernized societies.


  • Trading a preoccupation with material things for laughter, pure and simple.  People who laugh and live in a state of almost perpetual joy, independent of less-than-ideal external circumstances tend to live longer and with higher quality of life, regardless of how much money they have in their bank account, or even if they don’t have a bank account!


  • Viewing aging as a natural transition in life, something beautiful and joyous, instead of dreading growing old, as we do here in America.  Elderly people are held in the highest respect in the Blue Zones.  I can assure you that a wrinkle-removing skin cream company would not do well if they set up shop in the Blue Zones regions!

Please note that, although this is a nutrition blog, I have not once brought up the topic of diet in this particular post, because I am trying to emphasize the critical point that factors such as one’s state of mind and priorities, emotional well-being, a sense of purpose and meaning, are at least as important in the healthful longevity equation (if not more so) as diet and exercise.  You are not just what you eat, you are who you love, how deeply you love, how often you laugh, and whether or not you have the disposition to expect nothing, accept everything, and celebrate all that is pure and good in your life!



Oddly enough, the topic of healthy aging first became an interest of mine in 1981, at the “tender” age of 19, mostly because my best friend at the time was 60 and I wanted to help him stay vital and robust and stave off the inevitable decay of the aging process.  I therefore took it upon myself to read and digest a voluminous treatise on this subject, first published that year, “Life Extension: A Practical Scientific Approach” by researchers Dirk Pearson and Sandy Shaw.  My good friend did eventually survive mostly intact to the impressive age of 94 (he passed 3 years ago), so I would like to think that my efforts to assist him in preserving his health were at least partially successful.  However, in the 37 years since the publication of that groundbreaking book, I have learned that much of the information contained therein was either scientifically presumptive or completely erroneous, based upon fresh data gleaned from thousands of new studies.

All these years later, as I myself creep up on the Big 60, I have discovered that age-related research itself is subject to what I like to call intellectual senescence, hence it is with a skeptical but open mind that I approach fresh scientific conclusions on the mechanistic nuances of the aging process in mammalian physiology.  Most importantly, I think that it is crucial to exercise critical thinking if one’s intention is to differentiate between ‘normal aging’ (cellular senescence and extreme age-related organ failure), as opposed to avoidable chronic conditions that compromise quality of life and longevity caused by decades of accumulated cellular/DNA damage resulting from the ravages of a harmful diet and self-destructive lifestyle factors, i.e. the “exposome“, as opposed to the genome.  I get a bit tired of people complaining to me about their various chronic conditions and ailments that they are dealing with as they grow older, blaming it all on their age, instead of on their own accountability and lifelong neglect of their health, namely every alcoholic beverage and cigarette they smoked, every cheeseburger and slice of pizza they shoveled down their gullet, every opportunity to exercise that they traded for couch time binge watching their favorite TV show, every night they went to bed late and woke up sleep-deprived, etc.  Age is “only a number” for folks who made the effort to care for and respect their bodies as the birthdays piled on, instead of indulging every opportunity for hollow fleeting pleasures that damaged their health and shortened their lives.  Indeed, having worked as a Clinical Nutritionist treating elderly people who had trashed their bodies through neglect, it took a concerted effort on my part to demonstrate compassion for them, often having to remind myself that I too had not always taken good care of myself and was once 80 pounds overweight!

Aside from the aforementioned lifestyle choices which influence our longevity, there are 3 particular focal points that I find remarkable about recent findings in gerontology, all of which revolve around the compression of morbidity principle, e.g. the surprising fact that middle-aged mothers live longer and the genetic variants that appear to play a role in longevity:

  • ‘Compression of morbidity’ is just another way of defining that superior quality of life preceding one entering the super-elite centenarian club is, metaphorically speaking, a “bridge” that a person must cross in order to survive to their 100th birthday and is the most notable reason why some individuals make it to the age of 100 (aside from, obviously, favorable genetics), because they incurred the least amount of cellular/DNA damage in the first 80-90 years of their lives, i.e. epigenetic influences on longevity.


  • Genetic variants (alleles) are a good starting point for investigations, but one must keep in mind that genes are only a blueprint.  It is good to have a great blueprint before you begin to build a house, but if the construction workers are lazy and neglectful as the house is being built, it will be in a state of disrepair long before a house that was well-built and well-maintained over the years.


  • I have a theory about the middle-aged mothers as well, from an evolutionary biology perspective. I would posit that once a woman (or even a man) passes the customary age of reproduction, dispassionate Mother Nature has no further use for us, since our primary genetic purpose is to reproduce and pass on our DNA.  Nature cares little about the individual.  Propagation of the species is everything!  Some of my friends who are around my age sometimes joke that the reason they think I have aged slower than them is because I never had kids.  They may indeed be right, but that too is an oversimplification.

In the final analysis, I would guesstimate that living to 100 is 80% lifestyle, 20% genetics.  Lifestyle defined as diet, exercise, sleep, stress resilience, hormonal health, social connections, life purpose, and even how much we laugh.  Genetics defined by a panoply of known alleles, most of which can be turned “on” or “off” by the previously mentioned lifestyle factors.  You are what you eat, what you do, how much you love, and your attitude toward life, and ultimately those are the factors that can gently nudge you toward a happy healthy 80-100+ years on Earth.  Live long and prosper!


The tragically mislabeled “Caveman Diet”

Today, I would like to present a fresh perspective on the popular but vastly misunderstood “Caveman Diet”, aka Paleo, Primal, Ancestral, Evolutionary Biology diet, a way of eating that has been around for approximately 200,000 years, or about the age of the most recent genus of humans, homos sapiens.  It’s kind of hard to label this a “fad diet” if it strives to follow a pattern of food consumption that has sustained our species for hundreds of thousands of years prior to the development of agriculture.  Although I myself generally adhere to most of the concepts built into this diet, I shall nonetheless refrain from injecting observer bias into my observations and keep this conversation firmly grounded in solid science, presenting both the pros and cons of the theories upon which this diet is based.  My intention is to present an objective alternate point-of-view and avoid the temptation of “cherry-picking” studies that support my hypothesis, focusing instead on investigating criticisms in respect to this diet through the lens of evolutionary biology.  It also strikes me as noteworthy that calling this diet the “Caveman Diet” is akin to calling the wild game consumed by lions on the prairies of Africa the “Lion Diet”.

The basic premise of the Paleo diet is to focus on consuming only foods similar to what our hunter-gather ancestors had access to prior to the advent of farming and processed foods, i.e. fruits, vegetables, meat, seafood, and nuts.  The foundational logic underlying the evolutionary biology diet is that, by following the aforementioned nutritional guidelines, we are choosing a diet that is more in line with the evolutionary pressures that shaped our genetics, which in turn may positively influence health and wellbeing.  This diet lessens the body’s overall glycemic load, has a healthy ratio of saturated-to-unsaturated fatty acids, increases micronutrient density, and contains an optimal balance of protein, fat, and carbohydrates that helps preserve a healthy body weight and sufficient metabolic flexibility to support an active lifestyle.  As is the case with all efficacious diets, much of the success of the Paleo Diet can be identified as exclusionary in nature, i.e. attributed not as much to what it includes but rather what it excludes: fast food and junk food, hybridized grains, pro-inflammatory cooking oils, additives, preservatives, and generally anything produced by Monsanto!

In contrast to the “hunter-gatherer” diet, which dominated for 98% of human evolution, modern agriculture does indeed produce 10 to 100 times more calories per acre than the foraging posited by the Paleo diet, hence a more realistic solution (if not the healthiest) for feeding over 7 billion humans.  Over the period from 10,000 BC to AD 1, the world’s population increased exponentially about a hundredfold; estimates range from 40 to 170 times.  An accelerated rate of evolution may be a direct result of the much larger human population.  More people will of course have more mutations, thereby increasing and accelerating the opportunity for evolutionary change under natural selection, far beyond the speed at which such changes occurred in the pre-agricultural era.  The spread of rapidly expanding populations eventually outpaced the spread of favorable mutations in populations, thus for the first time in human history favorable mutations could not fully disperse throughout the species.  Two excellent examples of this are regional adaptations of salivary amylase transcriptors for starch digestion and the relatively recent ability to produce lactase in adulthood for the digestion of lactose found in cow’s milk.  In addition, natural selection pressures changed once farming was adopted, favoring distinctive adaptations in different geographic areas.  For example, farming, rather than merely reduced sunlight in Northern Europe has been hypothesized as having helped trigger pale skin in modern Europeans.  As illuminated by a 2007 study, almost all Africans and East Asians have one allele of the SLC24A5 gene, whereas 98% of Europeans studied had the alternate allele.  These data suggest that a “selective sweep” of evolutionary adaptations occurred as recently as 5,300 to 6,000 years ago, replacing darker skins with light skins at an astonishing speed.  This implies that Europeans had been dark-skinned for tens of thousands of years prior to this “emergency adaptation”.  Several decades ago, a researcher at Stanford argued convincingly that European hunter-gatherers, herders and fishers could have survived from the vitamin D content of their diet alone.  Only after farming took hold did it become necessary for Europeans to absorb more sunlight to produce vitamin D in their skin, having mostly replaced meat and fish with grains.

As for what these findings suggest about the evolutionary premise behind the Paleo diet, they clearly show that we are in fact complex combinations of both ancient adaptations and recent adaptations to global changes to traditional diets in the past 10 millennia.  Picking a single point in human history and trying to conform our diet to that particular time period, e.g. Paleolithic, may not be realistic, nor reflect our complexity.  That said, I still consider it a far safer choice to reach for an organic non-GMO apple than a bag of Doritos, regardless of any recent genetic adaptations to highly processed junk foods.  If we were fully adapted to consuming Doritos, we would not be currently mired in a global pandemic of obesity, diabetes, and heart disease, chronic diseases which were notably absent in our Paleolithic ancestors.  Speaking for myself personally, I’d much rather be eaten by a saber-toothed tiger than suffer for decades with debilitating health problems that could have been easily avoided had I respected the dietary and environmental inputs that my genes expected of me.

For further exploration of this fascinating topic, I encourage you to click on the link below to access an in-depth article published in “Scientific American” a few years ago:


Finally, the truth about weight loss!

I’m finally back from the holidays, as I’m sure are most of you.  I put on a few pounds in the past month, so sue me.  I may be a nutritionist but I’m also human!  We all want to lose a little or a lot of weight at this time of year (a boom time for health clubs and gyms), as our holiday indulgences eat away at our guilt, pun intended.  In my last post of 2017, I promised to address the pertinent issue of how to lose weight and keep it off, and I shall now make good on that promise.

First, it seems apropos to first discuss the economics of weight loss and the multi-billion-dollar industry built around this ubiquitous ambition that pervades the very fabric of our society, personally, economically, psychologically, sexually, and even politically.  Weight loss is not just a personal goal, it’s a big business, one which promotes financially lucrative modalities, not science.  The metabolic biology of burning adipose tissue as a fuel source has nothing whatsoever to do with Jenny Craig, Nutrasystem, or Oprah Winfrey!

So here’s the skinny on weight loss (I have many more bad puns where that came from!).  At its most fundamental level, weight loss is simply about the laws of thermodynamics and E=mc2.  Matter converts to energy.  That matter can either come from food or from stored adipose tissue.  Any questions?  Good.  Let’s move on.

Now one might posit, based on what I just said, an overly simplistic notion of weight loss.  Eat less food, burn more calories than you consume, and you will lose weight.  Seems simple, right?  I wish it were.  For indeed there are numerous confounding variables embedded into the metabolic equation.  In fact, there are circumstances in which one can actually consume fewer calories than one burns and still put on body fat, such as when we consume foods that spike our insulin levels, such as high-glycemic carbohydrates.  Insulin is an energy storage hormone.  If you are a Tour de France cyclist riding 100+ intense miles/day, insulin will tell your body to store circulating glucose as glycogen in your hard-working muscles.  But if you’re a sedentary sloth binge-watching Game of Thrones, that same quantity of circulating glucose will be converted to triglycerides and stored as body fat, even in the context of a caloric deficit.  Bummer, isn’t it?  Here’s one more thought that will blow up your brain.  We are ALWAYS, throughout the day, either in a state of fat burning (lipolysis) or fat storage (lipogenesis), like it or not.  When in fact you do lose weight, all it means is that you spent more time in a state of lipolysis than lipogenesis within any given 24-hour period.  But this also does not mean that our bodies operate on a strict 24-hour cycle of fat burning and fat storage that is partitioned from one day to the next.  In fact, recent studies have shown that caloric deficits and excess span a quantifiable period of 5-7 days in terms of metabolic impact.

So now let’s bump this up another level and talk some more about hormones.  The laws of thermodynamics are great but our bodies are not steam engines.  The main thing that differentiates us from steam engines is hormones.  Hormones can do some weird stuff to our bodies.  They can become schizophrenic and sabotage our efforts to lose weight.  A few that are worthy of mention include insulin, as mentioned previously, leptin, which tells our fat cells to stop taking in triglycerides (such as when we try to starve ourselves), stress-induced cortisol, which increases blood sugar and carb cravings, grehlin, which tells our brain that we are satiated (broken in most overweight folks), adiponectin, which lowers blood sugar and burns body fat, and Hormone-Sensitive Lipase (HSL), which in adipose tissue is normally inhibited by low levels of insulin.  Catecholamine, cortisol, growth hormone and glucagon activate this enzyme.  Fasting and an energy deficit tend to progressively reduce insulin and elevate the abovementioned counter-regulatory hormones, which triggers lipolysis, i.e. weight loss.  Confused yet?  Don’t worry.  I’ll break it down for you in a moment.

The proverbial bottom line is this.  Burning body fat is not about eating less and exercising more, although that does create a favorable environment in which our hormones can communicate with each other.  Mostly it’s about telling our hormones that we are not starving to death, because our body’s Number One priority is always self-preservation, but when we don’t quite have enough to eat to sustain our daily activities, we must discretely tap into our precious reserves of body fat to keep us going.  Now please keep in mind that this all needs to be viewed through the evolutionary lens of our ancient ancestors relying on stored body fat to get them through harsh winters when food sources were scarce, so stored body fat is not a biological aberration, it is in fact a survival mechanism.  These days, our higher brain functions compel us to look like lean mean fitness models, however our hormones are still stuck in the Paleolithic era.  But please don’t get me wrong.  I am not advocating the wildly popular “Paleo Diet”.  I’m merely saying that every organism on Earth evolved to survive and thrive within a specific ecosystem, be they insect or human.  When we screw with our millennia-old ecosystem by putting up a McDonald’s on every other street corner, we have created the equivalent of stuffing a pride of lions into a hockey rink filled with Snickers bars.  How long do you think those lions would survive?

So what should you do to lose weight and keep it off in this new year?  Reread this blog post and use your critical thinking skills to come up with an action plan that is consistent with your genetic blueprint as a homo sapien!


Obesity is itself a disease!

Why is obesity so out of control in our country?  Is it just that people are pounding down too many calories?  Should we blame it all on McDonald’s?  Is it due to lack of exercise and physical activity in general?  Is it genetic?  Are some of us just born to be overweight?  A loaded topic for sure!  The epidemiological etiology of obesity on a population level is an enormously complex issue on which a book of 1000 pages could easily be published and would barely skim the surface of this subject.  We know that obesity has been around, albeit in scarcity, for at least 25,000 years, but today it has morphed into a pandemic of epic proportions, especially here in the United States.

We could analyze to death the biochemistry and endocrinology of obesity, but we cannot blame it all on genetics either, i.e. the so-called “thrifty gene”, since the human genome has only infinitesimally changed over the past 25 millennia.  I therefore propose an alternate hypothesis, from an ecological perspective, which examines the causality behind obesity as mostly a product of behaviors and environmental inputs consistent with cultural norms reflecting a modern lifestyle dominated by convenience and technology, a “disease of affluence” if you will.

My argument is best served by a bullet point list of what I believe are the top 10 factors underlying the ongoing proliferation of obesity and the chronic comorbidities associated with it, collectively known as ‘Metabolic Syndrome’ within the culture of enlightened clinicians and nutritionists:

  • A sedentary lifestyle overrun by electronic distractions.


  • Highly processed ‘Frankenfoods’.


  • Excess carbohydrate and refined sugar intake, especially the dreaded High Fructose Corn Syrup (HFCS).


  • The obesogenic consequences of a long-term energy imbalance, i.e. the Laws of Thermodynamics driving hyperplasia and hypertrophy of human adipocytes.


  • Hyperinsulinemia and insulin resistance.


  • Modern modes of transportation that encourage sedentary habits.


  • ‘Convenience foods’, e.g. pizza, fast food and “TV dinners”, emotionally-driven snacking of comfort foods throughout the day, i.e. eating disorders as a form of self-medication for undiagnosed psychiatric disorders.


  • Too much stress and not enough sleep, causing ‘fight-or-flight lipogenesis’ via HPA axis dysregulation, and excessive cortisol production in particular.


  • Prediabetes and Type II diabetes propagated by visceral adiposity/NAFLD (Non-Alcoholic Fatty Liver Disease) and perpetuated via hormonally-induced metabolic derangement, e.g. insulin and leptin resistance. This means that an individual can appear thin superficially, yet still be carrying dangerous visceral fat around their internal organs, sometimes referred to as “skinny fat”.


  • Excess alcohol consumption and smoking.

It is because of all the aforementioned that nothing irks me more than “quick & easy” diet plans such as Jenny Craig (sue me, Jenny, sue me!) or Oprah’s latest fad diet, as she keeps climbing on and off the obesity rollercoaster like a gleeful kid at a theme park.  So what is the best way to lose weight and keep it off?  I’ll be covering that topic in my next blog post.  In the meanwhile, be happy and healthy, folks.  You can’t be one without the other!


Revisiting the “Blue Zones”

For my topic today, I wish to propose an incendiary hypothesis on the “Blue Zones” diet, which has gotten a lot of press lately.  For the purpose of this discussion, I plan to compare the diet and lifestyle choices of two out of the five long-lived cultures examined by Dan Buettner in his iconic book, i.e. the Ikarians and Okinawans.  After reading about the diet/lifestyle of the Ikarians, I noticed right away that the staples in their diet comprised mostly wild greens, potatoes, feta cheese, black-eyed peas, chickpeas and lemons, Mediterranean herbs, coffee, honey, occasional meat and poultry, and of course fish, whereas the Okinawan diet consisted mostly of bitter melons, tofu, sweet potatoes, garlic, turmeric, brown rice, green tea, shiitake mushrooms, seaweeds, and of course fish as the primary protein source.  With the exception of the commonality of potatoes, we can see that these two long-lived societies are not consuming any particular “magic foods” common to both that are getting them to their 100th birthday.

I therefore propose that the true success underlying both diets and lifestyles is in fact exclusionary in nature.  The Ikarians and Okinawans are not surviving happily and healthily into their tenth and eleventh decade only because of the foods that they are eating, but even more so because of the foods that they are not eating, i.e. highly processed “edible food-like substances”, as I call them, such as Twinkies, Big Macs and Papa John’s pizza.  Neither do these folks sit around all day on their rear ends glued to the television or a computer.  They are not stuck in rush hour traffic and smog inside cars or texting and obsessively Tweeting or Facebooking.  They don’t sweat the small stuff.  They are mentally strong and resilient, without having to take antidepressants.  They don’t drink too much alcohol or swallow a dozen pharmaceuticals every day to deal with the symptoms of a lifestyle that is an evolutionary mismatch.  They abide in close-knit communities in loving relationships.  As they grow older, they are treated with affection and reverence by younger members of their community.  They live in harmony with nature.  Their exposome is not polluted with carcinogenic toxins.  They are not obsessed with the accumulation of objects and material wealth.  In other words, they live lives that are pretty much the complete opposite of our Western debauched consumerist culture that so many of us arrogantly declare is the “greatest country on Earth”.

Please don’t get me wrong.  I love the indomitable spirit and tireless innovations of Americans.  I owe this country an immeasurable debt of gratitude, after she took me in as a refugee from Communist Hungary back in 1969.  But let’s not kid ourselves!  We Americans could learn a great deal from “Blue Zone” cultures like Ikaria and Okinawa, as previously delineated in this post.  We have a tendency here in the West to confuse economic prosperity with genuine happiness and contentment, and most of us do not attend to our mental and physical wellbeing.  If you want to live to see your ninth or tenth decade, in good health, you should start by first eliminating the specific foods and environmental inputs that are clearly harmful to your health, before obsessing over exactly which healthful foods are better than others.  Chickpeas or sweet potatoes?  Just set down the bag of Doritos and you’re already halfway to where you need to be!  By taking this simple exclusionary approach, I guarantee that the foods which will be left in your diet are all good for your health.  I would welcome some feedback on my ‘exclusionary hypothesis’.

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The magic of psyllium

Psyllium husk is pretty amazing stuff, mostly because of its unique dual-action potential to benefit both GI health and cardiometabolic health via its cholesterol-lowering effect. Seems almost miraculous in some ways, i.e. as a natural laxative and as a “natural statin”.  Surely, such a snake oil claim should raise eyebrows in academia, right? Yet, upon further investigation, there do appear to be numerous factors worthy of serious consideration.  Before I delve too deeply into the science, I would first like to discuss psyllium anecdotally.  Indeed, psyllium husk, when I was taking it regularly a few years ago, did keep me very regular, but it also made me feel a bit bloated.  My wife in fact complained that the water retention side effect made her “look fat”.  An interesting German observational study from 2008 examined the issue of compliance in regards to fiber-containing supplements in general and psyllium husks specifically.  As a nutritionist, it may indeed present as a “hard sell” if I have to tell my clients that I have a gentle natural solution for their constipation, but it may also make them feel like a hot air balloon and clear out any room with explosive flatulence, especially if the psyllium is ingested in tandem with a high-protein diet from animal sources.  Legumes of course receive honorable mention in this department, as always!

Psyllium is used clinically as a bulk laxative, an agent with laxative effects that are secondary to increasing fecal size, a much milder laxative relative to diuretics such as caffeine.  The bulk occurs due to water and gas absorption in the small intestine and the colon, giving chyme (made from digested food) more size and softness. This bulk is retained in the colon despite microflora, since psyllium is generally poorly fermented. Although psyllium has been proven to increase fecal size and moisture, the most common characteristics of stool following supplementation with psyllium tend to be generally soft and easily passable, hence an indirect cure for transient and long-term constipation, but cannot be accurately equated with diarrhea by any stretch.

Beyond the fecal benefits (yes, I said fecal benefits!), psyllium appears to also reduce cholesterol and LDL in individuals with high total cholesterol, secondary to the gel forming properties leeching bile acids and cholesterol that is used to replace hepatic bile acids. There is also a slight reduction in the most dangerous form of LDL cholesterol, i.e. VLDL, which is most strongly associated with arteriosclerosis.  However, in all fairness, this property is associated with all dietary fibers, not just psyllium.  Additionally, there appear to be some glucose-reducing effects attributable to psyllium supplementation as well, which may benefit Type II diabetics.  This effect is not overly potent, but does appear to be reliable as long as psyllium is ingested regularly.  Cessation of psyllium usage results in quick loss of glucose reduction, as in the case of all sources of soluble fiber.  In a future post, I will discuss the larger topic of optimizing the ratio of soluble/insoluble fiber to achieve the greatest health benefits and least side effects.

As for the actual numbers, Psyllium husk contains about 5 grams of soluble fiber per 1 tablespoon serving.  This provides 20 percent of the recommended daily value of fiber relative to a 2000 calorie-per-day diet.  As my uncle in his 90s once reminded me, the older we get the more we start to appreciate the guilty pleasure of a healthy prodigious bowel movement every morning!  But enough poop talk for now.  Have a healthy week!