What’s the ‘skinny’ on trans fat?

As always, I feel that my primary purpose of this blog is to debunk myths and dissect nutritional oversimplifications.  It is in that vein that I am approaching today’s topic, trans fat.  Although I feel that the ban on trans fats by the FDA is a definite step in the right direction, I wish to posit that there is a deeper level of complexity to this topic, as tag lines and generalizations are not particularly useful in any discussion that is firmly grounded in science.  The fact is that not all “trans fats” are created equal.  Yes, I know, I can already “hear” the gasps from my readers as I type these scandalous words!  But that does not make my statement any less true.

Trans fat is one of the few components in food that is widely (and blindly) accepted by all as being unhealthy for us, and not without some legitimate cause.  Industrial trans fats are created by pumping hydrogen molecules into liquid vegetable oil, radically changing the chemical structure and causing the oil to become a solid fat that can potentially clog our arteries.  Trans fats are generally considered especially harmful because they raise total cholesterol while lowering HDL cholesterol, the so-called “good” cholesterol.  However, as we dig deeper, we uncover an important nuance inherent to trans fat that is often overlooked.  Naturally occurring trans fats in ruminant animal products are not at all harmful to our health, and may actually reduce the incidence of numerous chronic diseases states.  Natural trans fats are formed when rumen bacteria in the stomachs of ruminant animals (e.g. healthy non-CAFO cows, sheep, etc.) digest the grass that the animal has eaten, thus forming trans-rumenic and trans-vaccenic acid via biohydrogenation of polyunsaturated fats in the grass.  Conjugated linoleic acid, or CLA, is a trans-rumenic acid found abundantly in grass-fed meat and dairy products in particular.  It is also produced in our bodies from the conversion of trans-vaccenic acid (VA) from those same animal products.

Industrial trans fats however have critically different chemical structures than those of trans fats found in grass-fed beef and butter, namely the location of the molecular double bond.  And now that we’ve put on our propeller hats, let’s geek out even more!  CLA (Conjugated Linoleic Acid), a natural trans fat, contains both cis- and trans- bonds, whereas industrial trans fats have only trans bonds, which is a big problem mainly because this is not a molecular configuration that occurs in Nature, and if there is anything that I have harped on in this blog, it is that any unnatural edible food-like substance that we keep putting into our bodies will most likely slowly kill us over time.  These seemingly minor differences in chemical structure lead to significantly different effects in the human body, as has been demonstrated by numerous clinical and epidemiological studies.  While industrial trans fats have been shown to increase the risk of heart disease, cancer and obesity, CLA and naturally-occurring trans fats found in healthy animal products may actually decrease the risk of those same diseases.

The takeaway is this: the trans fat contained in a bag of Doritos circa 1995 is indeed “bad” for us, whereas the trans fat in good old Irish Kerrygold butter is in fact “good”.  So is it best for the FDA to ban industrial trans fats?  Absolutely!  But should we then avoid all trans fats, even if they are naturally-occurring?  Absolutely not!

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What’s up with gluten really?

Why is it that much of our society seems obsessed with gluten these days, hence “gluten-free” is now virtually a religion!  But is this preoccupation with gluten scientifically justified or just another diet cult?  Let’s explore.  As brilliantly illuminated a few years ago by renowned clinician/researcher Dr. Alesio Fasano, the true culprit underlying the etiology of numerous digestive disorders, including IBS and autoimmunity, is not gluten per say, but rather the indigestible gliadin peptide contained in modern wheat that is a health hazard to varying degrees in respect to all humans, regardless of whether they present with Non-Celiac Gluten Sensitivity (NCGS) or full-blown Celiac Disease or neither of the aforementioned.  Gluten is essentially a type of protein comprised of the peptides gliadin and glutenin, which are found in many modern strains of grains such as wheat, semolina, spelt, kamut, rye and barley.

Additionally noteworthy is that today’s highly-processed wheat has also been deaminated, allowing it to be water soluble and capable of being mixed into virtually every type of packaged food you could think of.  This deamination process has been shown to produce a significant immune response in many people.  In our modern world of ubiquitous fast food, we are eating far more wheat than our ancestors ever dreamt of eating.  When our immune system’s antibodies try to defend us against attacks by gliadin and glutenin, the microvilli in our digestive tract can atrophy and erode, decreasing our natural ability to absorb nutrients, thus making the walls of our intestines “leaky”, aptly-named by gastroenterologists as Leaky Gut Syndrome (LGS).  This intestinal erosion can manifest itself as numerous unpleasant digestive symptoms including bloating, constipation, diarrhea, weight loss, fat malabsorption, and malnutrition, e.g. iron deficiency anemia, low vitamin D, and even osteoporosis.  The blunting of microvilli is a hallmark of Celiac disease, which is a chronic, not acute, condition that develops over many years, not something that you’re genetically born with and stuck with no matter what you do or what you eat.  The bottom line is that our gut can only handle X number of years of relentless assault by the pernicious peptides gliadin and glutenin.

Tightly regulating intestinal permeability is one of the basic functions of the cells that line the intestinal wall.  Gliadin can cause the gut cells to release zonulin, a protein that can break apart the tight junctions holding our intestines together.  Once these tight junctions get broken apart, the gut is officially considered “leaky”.  A leaky gut allows toxins, microbes, undigested food particles, and antibodies to escape from the intestines and travel throughout the body via the bloodstream.  The antibodies that escape are the ones which the body produced to attack the gliadin in the first place.  Celiac Disease is therefore the result of many years of assault upon the gut by the toxic effects of gliadin and the resulting “zonulin effect” described earlier.  The true takeaway is that the human digestive tract simply did not evolve to digest wheat any more than it did to digest grass that free-range cows are able to consume (we cannot absorb and digest cellulose), yet we “clever” humans have managed to find a way to process indigestible organic matter that we should not have been putting in our mouths to begin with.  I plan to cover other such examples of “evolutionary mismatch” in future blog posts.

What this all amounts to is that, whether or not we are gluten-sensitive or Celiac or neither, it makes about as much sense to eat foods that we did not evolve to eat as it does to feed Snickers bars instead of meat to a lion in a zoo.  I’m pretty sure the animal rights folks would be up in arms if a zoo keeper did that!

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Beauty and health, not the same thing!

I would posit that “beauty”, as it relates to thinness and fatness, is not only specific to a culture and a particular historical era, it is also very context-specific.  For instance, athletes in a specific sport tend to rate each other’s physical attributes and the attractiveness of those attributes as consistent with a physique considered most functional and conducive to their sport.  Admittedly, a perfect example of this phenomenon can be found within the subculture of my own somewhat creepy sport of road cycling, in which we envy other riders in direct proportion to the girth and veininess of their thighs and calves, which is just one of the unspoken reasons that cyclists shave their legs, aside from the dubious physics of body hair as a significant contributing factor in aerodynamics.  There are members of my cycling team who scoff at the comical homoerotic implications of straight men secretly admiring each other’s glutes and thighs, yet this happens silently on every group ride.  Ironically, women who come to bike races as spectators often giggle at the sight of a man with tree-trunk legs and a scrawny upper body!  Yet this is the preferred aesthetic in my sport.

On the flip side of my observation, gymnasts, swimmers, ballet dancers and Sumo wrestlers all have starkly contrasting perceptions of the ideal “beautiful body” in relation to the physical demands of their sporting aspirations.  Separate from the context of the sporting life, cultural definitions of “beauty” outside the athletic realm make me a tad nauseous, such as the unrealistic cliched version of “beauty” promoted by Madison Avenue and Hollywood, e.g. Victoria’s Secret super models and perfectly-proportioned fitness models with six-pack abs who look as though they were genetically engineered by the Tyrrell Corporation.  It’s all nonsense!

In the final analysis, all that matters really is how we feel about our own bodies when we look in the mirror, within the context of our age, genetics, lifestyle, and goals, as well as whether or not the people that truly matter in our lives perceive us as “attractive”, which is unfortunate if you happen to be a movie star like Tom Cruise or Jennifer Aniston, because the entire world is judging you on the basis of your physical appearance.  But the rest of us should not be held to the same standard.  We don’t get paid millions of dollars to look astonishing every time a camera is pointed at us.  Speaking for myself personally, I only care whether or not my wife finds me physically attractive.  The rest of the world can smooch my wrinkled old 55-year-old tush, which is not half bad for a guy my age, I think.  Cycling does after all have its aesthetic benefits, but I also make sure to keep up with my push-ups, so that my legs don’t end up looking like Schwarzenegger’s while my upper body looks like someone who was just liberated from a concentration camp!

Not only is “beauty in the eyes of the beholder”, I propose that beauty is whatever you think it is, which should not be dictated by the media and popular culture.  It’s far more important to be healthy than to be considered attractive by a consensus of the population at large.

Vitamin supplements useless?

A few years ago, the news media reveled in erroneously reporting the contentious notion that multivitamin supplements are useless and ineffective, based upon the dubious findings of one single study that was contaminated by egregious study design and wildly broad conclusions.  Where do I even begin?  Here’s a short list of bullet points that serve to highlight the utter stupidity and lack of science in this so-called “breaking news”:

 

  • Pre-existing health and nutritional status was not screened for the study participants, e.g. existence of or absence of micronutrient deficiencies, their overall health, genomic influences, medications, lifestyle, stress, sleep, endocrine health, or inflammatory markers.

 

  • The study was ripe with numerous confounding variables that were not taken into consideration, such as supplement efficacy and absorption, intracellular uptake, participants’ varied absorptive capacities, the biochemical properties of the supplement’s ingredients (i.e. natural versus synthetic forms of the vitamins), possible sub-clinical dosages of the individual micronutrients contained in the supplement, the wrong ratios of specific vitamins and co-factors that interact positively or negatively with each other, depending on timing and dosing, individual differences in bile-related lipid absorption of the fat soluble vitamins in the supplement, the hydration status of study participants, which can affect water-soluble vitamin absorption. I could go on and on, but I won’t.

 

  • The duration of the study is also relevant, presenting as yet another potentially confounding variable, in terms of assessing long-term chronic disease risk, e.g. cancer and heart disease.

 

  • Most important of all, it is notable that the supplement evaluated in the study was Centrum, which is just about the most garbage synthetic multivitamin available to consumers. It is the multivitamin equivalent of a Big Mac compared with grass-fed filet mignon.  Centrum is manufactured by Pfizer, one of the corporations making 70% of the pharmaceuticals that Americans are taking daily.  In 2015, Pfizer published profits coming in at $48 billion.  I would never go so far as to suggest that they make shoddy supplements to keep consumers needing their medications, but they are making shoddy supplements.  All supplements are simply not created equal!

 

I’m going to cease and desist now, because my blood pressure is going through the roof just thinking about this stuff.  I was employed in a doctor’s office when this “news story” hit the media outlets and it is noteworthy that even most of our patients believed that the story was utter nonsense.  It took quite a lot of nerve for these so-called “researchers” to conclude that decades of scientific data pertaining to multivitamin supplementation had all been invalidated by them based on a study of a single questionable product, especially when taken in the context of a Standard American Diet (SAD) that is woefully deficient in fruits, vegetables, and nutritionally dense foods.  I guess they expect people to get their daily RDA of vitamins from Big Macs, Doritos, and sugar-laden breakfast cereals.  Good luck with that, folks.  In the meantime, I would respectfully suggest that you invest in a high-quality multivitamin/mineral supplement as a kind of “health insurance policy”, unless of course you happen to consume a diet that is so exceptional that Michael Pollan himself would genuflect in your presence!

 

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The most important vitamin is not a vitamin!

Winter is here.  Brrrrrrr!  The days are getting shorter and sunlight is growing scarcer, thus our thoughts naturally turn to Vitamin D (if we happen to be nutritionists).  There are basically two key areas to focus on in any useful discussion of Vitamin D, which to start with is not actually a vitamin per say, but a pro-hormone that is required by the cells of your body for virtually every process of cellular metabolism.  The fact that 1 out of 3 Americans is woefully deficient in this critical micronutrient is nothing short of a criminal offense against Nature.  There are many popular myths about Vitamin D, so I shall seek to debunk a few of them in my blog post today.

First off, it is not true that you can get all of your required Vitamin D from the orange dwarf star around which our tiny planet revolves every 365 days.  It is true that you can synthesize about half your requirement of this Vitamin via sunlight, which of course is even more challenging at this time of year, when UV is low, unless you’re a guy who happens to work outdoors every day for 8-10 hours without a shirt on, in which case you will have also increased your skin cancer risk, a topic that now brings me to a screeching halt in this discussion, as we take a slight detour to explore the dangers of Vitamin D deficiency versus skin cancer.  Let me put it bluntly.  You are about 20 times more likely to suffer the adverse effects of Vitamin D deficiency than develop a malignant melanoma as a result of moderate exposure to direct sunlight, i.e. 1-2 hours a day (at any time of year).  So do yourself a favor and redirect your sunscreen lotion budget toward the purchase of a good quality Vitamin D supplement, because no matter who you are (even if you do work outdoors all day), you will only be able to get about half your daily serving of Vitamin D from the sun.  The other half has to come from your diet or supplements.  Also, one particular observation that you won’t hear from the mouths of most conventionally-trained dietitians and nutritionists is that if Vitamin D is ‘Batman’, then ‘Robin’ is Vitamin K (the last vitamin to be discovered), a mostly overlooked but critical biochemical sidekick to Vitamin D, so make sure that your Vitamin D supplement also contains a small amount of Vitamin K.

OK, so now I’m going to bring up some biohacking geeky stuff, for those of my readers proudly wearing a propeller hat!  In other words, let’s take a look at how to evaluate your lab work, on the outside chance that your primary care physician is actually astute enough to check your serum levels of Vitamin D at your annual physical (if he or she doesn’t, fire them!).  It is vital to differentiate between minimal blood levels of Vitamin D required to prevent Vitamin D deficiency-related pathologies such as bone loss and rickets, as opposed to optimal blood levels necessary for the optimization of health.  The conventionally accepted “cutoff” for minimal Vitamin D is 32 ng/ml, but numerous recent studies have established that the most desirable range is actually somewhere between 60-80 ng/ml, widely considered as the “sweet spot” for Vitamin D by enlightened Functional Medicine physicians.  It is also very important to keep in mind that Vitamin D is one of the few micronutrients that you also do not want to get too much of due to dangers of toxicity (especially in the absence of Vitamin A supplementation), hence the upper cutoff is 100 ng/ml.  To keep one’s level of Vitamin D within that “sweet spot” range, one must supplement a bit more aggressively in the wintertime, as we cannot absorb sufficient Vitamin D from sunlight in the winter, and this also depends on one’s skin tone and where one resides in terms of latitude.

The critical role of Vitamin D as a pro-hormone cannot be overstated!  Speaking anecdotally, when I worked as a Clinical Nutritionist, my physician-employer and I uncovered ubiquitous hormonal deficiencies and imbalances in our patients that all turned out to be a direct result of severe Vitamin D deficiency, requiring an aggressive prescription of high-dose Vitamin D and K supplementation, sublingual DHEA and pregnenelone, and increasing dietary cholesterol (yes, cholesterol!).  The body is unable to adequately manufacture almost all of its hormones in the absence of sufficient Vitamin D and cholesterol serving as hormonal precursors, an often-overlooked consideration in endocrinology.  We found that many of our new patients came to us after years on a so-called “healthy” low-fat low-cholesterol diet, and who had avoided sun exposure like the plague, brainwashed into thinking that they would surely get skin cancer from any amount of sun exposure.  Some had Vitamin D levels below 10 nanograms per milliliter, which was about the same level as prisoners of war that had spent years in solitary confinement.

So if you want to get sick and wreck your hormonal health, feel free to do the same as the person in the picture below, while consuming a Standard American Diet (SAD) that is low in Vitamin D!

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Health education is NOT health promotion!

There exists a panoply of pretentious academic definitions of “health education” and “health promotion” as a vehicle for intellectual debate imbued with only a scant semblance of real-world applicability.  The parameters of any cogent discussion of these nomenclatures comprises a deeply personal reflection of whether we, as academicians, believe that our efforts are promoting change or educating people on how to change, if indeed they are in the mood to change!  In the spirit of this thought experiment, I have chosen in this post to convey an anecdotal viewpoint of this duality and let the reader decide where they stand on the issue.  Having been employed as a Clinical Nutritionist working in a Functional Medicine physician’s office a few years ago, I have had the luxury of exploring firsthand the nuances that differentiate health education from health promotion, both in the direct counseling of patients, as well as interacting with groups of individuals within the context of community outreach health promotion programs that were innovated by myself and my former physician-employer.

Although the mechanistic nuances of health education and health motivation are somewhat overlapping and interrelated, one distinct difference that emerges between the two is that health education is exactly that, i.e. education, and may not necessarily provide a compelling motivation for an individual or population group to implement actual changes in diet and lifestyle that will result in positive health outcomes.  Some may argue that effective health education is by its nature a vehicle for eliciting an intrinsic motivation to change, but such a presumption conflicts directly with the perspective of an individual for whom social and cultural factors are a far more powerful influence on their behavior than the practical considerations of maintaining or optimizing their health.  In a clinical setting, working day-to-day with patients who were referred to me by my physician-employer, I encountered an alarming number of people (age, gender and ethnicity irrelevant) who considered unhealthful social activities with friends and family, including the routine consumption of traditional unhealthful foods, and sometimes even American junk food, as indispensable components of their cultural identity.  These same patients often considered any type of health education as a personal attack on their culture and way of life, sometimes exclaiming that “If I have to give up ‘this or that’, my life would not be worth living”.  This was exactly the point at which I had to transition my modus operandi from that of health educator to health motivator, usually by trying to convince the person sitting across from me that giving up a particular food that was harming their health was in fact an act of love and sacrifice made for their children, grandchildren, and loved ones, all of whom want them to be healthy and around for as long as possible to contribute to the family dynamic and pass their wisdom on to younger generations.

In my role as a Clinical Nutritionist, I often found myself confronted with two distinct challenges in health education and health promotion.  My first challenge, as a health educator, was to overcome the deluge of misinformation on what constitutes “healthy eating” as disseminated by popular media, in an effort to convince patients that my advice on health and nutrition was more scientifically valid than the myths they had heard on their favorite daytime talk shows or had read on Facebook.  The second challenge, as a health promoter, was to get to know them as individuals and customize a motivational plan for each of them that was most likely to illicit positive lifestyle changes directed at achieving quantifiable improvements in health outcomes, as measured through lab tests ordered by their doctor.

My closing thought on all this is simply to delineate that the fundamental difference between “health education” and “health promotion” is analogous to two sides of the same coin, i.e. one must educate at the same time as promote.  In other words, in the same breath in which we dole out advice to someone on what to eat, we should also provide a why which is more compelling than the why of why they had been eating as they had in the first place, choices that had compromised their health.  The truest definition of an effective health educator and promoter, in my opinion, is a well-informed nutrition professional who educates compellingly, provides actionable information to their target audience, motivates individuals and population groups to pursue health as a core value, and does so with an emphasis on sensitivity toward cultural differences and individual proclivities.

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The economics of childhood obesity

Full disclosure.  I have no children of my own, but that does not preclude me from caring about the health and welfare of the children of America.  I therefore wish to discuss a specific permutation of the “consumer sovereignty” principle proposed by economists, as specific to a population of children.  I do acknowledge empirically that “consumer sovereignty” is markedly applicable, to varying degrees, in a discussion of adult populations, but the same concept is easily deconstructed as a myth in respect to children.  It presents as a truism that children, though possessed of unique and distinct personalities and proclivities, are nonetheless far more impressionable than adults.  Psychologists refer to this as “imprinting”, which occurs in the psyche of a child via numerous external influences, including of course advertising that is manipulatively directed at them specifically.  It strikes me as stunningly disturbing that legislative restrictions have to be imposed on monolithic processed food corporations (‘Big Food’) to prevent them from promoting the consumption of unhealthful obesogenic pseudo foods to a child population, when simple human decency and morality should be sufficient to discourage corporate entities from irresponsibly damaging the health of our children to garner profits, yet apparently we live in a society in which capitalist gains are prized above all other considerations.  A classic example of this egregious paradigm was well-illustrated by an interview I heard a few years ago on a podcast in which the inventor and co-founder of “SnackWells“, one of the unhealthiest snacks directed at children, openly admitted after having left the company that he does not allow his own kids to consume SnackWells products, simply because he is well-acquainted with the toxic list of ingredients.  Let us pause for a moment to let this sink in.  The guy said that he left the company because he could no longer live with himself, knowing what products like SnackWells, as well as candy and sodas, were doing to wreck the health of the first generation of children that are expected to live shorter lives than their parents!

Speaking anecdotally, a few weeks ago, I was in my car stuck at a long red light next to a school and observed children playing at a playground, most of whom were between 7-10 years of age.  At least half of them were obese.  I distinctly recall that, when I was their age, there was only the rare overweight child in my classes, and they were looked upon as a “freak” by other children, often cruelly treated.  But nowadays, overweight and obese children appear to be the norm.  Meanwhile, Big Food continues to aggressively market unhealthful “edible food-like substances” (as I like to call it) to our child population and our public schools continue to install vending machines loaded with this crap food in the hallways of said schools.  Where does all this end?  Certainly, it could be argued that the aforementioned societal burden falls first and foremost on the shoulders of parents, but it could also be argued that the parental task of getting children to consume healthful foods is made far more difficult by irresponsible food advertising, both on television and on the Internet, especially in a time when children are inundated non-stop by the “imprinting” I mentioned earlier in my post, not just during Saturday morning cartoons, as I vividly recall from my own childhood.

My final thought on this epic Greek tragedy is the long-held psychological theorem that once a child has been brainwashed by Big Food and fast food corporations throughout their childhood, by the time they are adults, the imprinting is in fact permanent and they will forever nostalgically associate edible food-like substances like Big Macs, Doritos and soft drinks as inextricably intertwined with their quality of life.  By that point, a consumer is indelibly robbed of their “consumer sovereignty”, while soulless processed food corporations laugh all the way to the bank.  My point in this diatribe is simply that no amount of government-subsidized “nutrition education” programs can reverse the insidious pervasive influence of corporate marketing, which has had decades to refine its subconscious brainwashing of consumers, especially young impressionable minds, through the power of manipulative marketing.  I would therefore posit that real change must be enacted within the microcosm of family and local community, because we certainly will never convince corporations to take a cut in profits, even for the sake of our children, our most precious resource.

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The myth of “healthy eating”

I’m back from vacation and eager to continue my daily mission of disrupting the nutritional status quo!  On that note, I recently asked my mother-in-law, who is 74, what she knows about the Dietary Guidelines for Americans (DGA).  She said she wasn’t sure what they were but that she thought it meant eating lots of whole wheat bread, vegetables and fruit, lean chicken breast, tuna and low-fat milk, and to stay away from eggs and butter because they can cause a heart attack.  Unfortunately, her idea of fresh fruit is canned fruit drowned in a pool of high fructose corn syrup.  She dutifully downs a tall glass of Sunny Delight orange juice every morning and a bowl of corn flakes with low-fat milk.  But there is something else that she also swallows every morning, i.e. a 500mg tablet of a prescription blood-sugar lowering medication called Metformin, which is akin to taking a hangover pill with your tequila shots!  It is noteworthy that since she started “eating healthy” and gave up eggs & bacon for breakfast 10 years ago, she is now officially a non-Insulin dependent Type II diabetic and her cholesterol numbers are even worse than they were a decade ago, so now her doctor has also put her on a statin, which increases the probability that she will develop dementia and Alzheimer’s Disease!  Good times, right?

Meanwhile, she refuses to listen to any of my dietary recommendations, in spite of my two college degrees in nutrition science that now hang on the wall, because she’s absolutely convinced that her physician, who received a grand total of 1 week of nutrition education 30 years ago in med school, knows more about healthy nutrition than her son-in-law because, as we all know, doctors are all-knowing and infallible!

In my opinion, a much better approach to implementing government-sponsored nutritional guidelines would be to disseminate a comprehensive list of processed foods and ingredients (especially those containing refined sugars) that people should try to avoid entirely, but of course that will never happen while the FDA and USDA are allowed to continue to prioritize the economic interests of Big Agra and Big Food over the health of consumers, while maintaining the illusion that they actually care about our well being by propagating spurious manipulative initiatives such as the DGA. Not to mention that a healthier generation of Americans would also detrimentally impact the bottom line of Big Pharma, corporate entities that have nothing to gain and everything to lose from Americans’ improving their health.  They need us alive but sick, so they give us drugs that do just that, instead of making us healthy.  They profit from treating symptoms, not from curing diseases that were preventable in the first place.  What we have in today is a disease care system, not a health care system!  The only people who have anything to lose in this socioeconomic equation is the health insurance companies, but they don’t care because they’ll just keep raising our insurance rates to keep themselves in the black, so in the end it is we the public who end up paying for all the evolutionarily-mismatched DGA recommendations that only protect the economic health of the agricultural industry, not the physical health of consumers.  It is for this reason that my eyes glaze over when someone says to me, “I try to eat healthy” or “I try to eat clean”.  These are both meaningless phrases if we cannot accurately and meaningfully define adjectives such as “healthy” and “clean”, a topic which I will cover in greater detail in future posts.

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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!

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Paleo reality check

Happy Friday, everyone!  I’d like to indulge in some “nutritional blasphemy” this morning, by debunking a particular diet that I myself was a huge fan of in the long ago time before I had a Bachelors and Masters diploma hanging on the wall behind me.  Popularly known as the “Paleo” or “Primal” diet, I do not take particular objection to either of these similar dietary approaches as exclusionary methodologies for eliminating modern processed foods from one’s diet.  They are both certainly a good starting point in the personal journey of restoring oneself to optimal health, as the Primal diet was for myself 7 years ago, but I cannot ignore, having learned what I’ve learned the past few years, the numerous inherent pitfalls of attempting to replicate an ancient ancestral diet or a way of life that is now as extinct as the dinosaurs!

A few years ago, I had the honor and privilege of meeting in person the “founding father” of the Paleolithic Diet, the esteemed Dr. Loren Cordain, at the Ancestral Health Symposium in Berkeley.  After his fascinating lecture, he was gracious enough to give me a few minutes of his time to answer a few questions that lay heavy on my mind.  He made some interesting observations that were unexpectedly critical of the diet that he himself had “invented” over three decades ago.  He told me that, in its current consumerized incarnation, the “Paleo Diet” does not in fact accurately represent the anthropological record, which I shall attempt to delineate with a few pertinent bullet points:

  • It is nearly impossible to properly replicate a true Paleolithic diet and lifestyle in modern times, simply because we no longer have access to the same abundance and variety of wild-growing fruits, tubers, nuts and seeds that Paleolithic humans consumed, i.e. hundreds of nutritionally dense foods and animals, as compared with a relatively narrow range of options available to us today.

 

  • The Paleo Diet’s popular emphasis on fatty cuts of meat and fats in general is inconsistent with the far leaner animals that would have been hunted by Paleolithic humans.  Animals were lean because they were not ingesting a deliberately obesogenic diet, as are modern grain and corn-fed CAFO animals, and such animal protein would have been a rare “luxury feast” at best.

 

  • The Paleo Diet is little more than a modern-day approximation of a pre-agricultural menu of options, most of the benefits of which are attributable primarily to exclusionary food choices that cut out processed and packaged foods, proinflammatory cooking oils, chemical additives, synthetic pesticides, and refined sugars.

 

  • The Paleo Diet does not take into account that one cannot realistically isolate a specific period in history without also factoring in regional variations in diet within that epoch, e.g. Paleolithic humans were not consuming the same foods in Northern Africa as humans of the same period in Northern Europe.

 

  • The Paleo Diet’s emphasis on a low-carbohydrate, high-fat macronutrient ratio is inconsistent with the historical record.  Paleolithic humans would have had far greater access to a variety of carbohydrate sources than the popularized version of the Paleo Diet asserts.  As for simple sugars, a bee hive of honey was a delicacy so greatly prized in that era that humans were willing to get stung just to get their sticky fingers on that high-octane energy source.  However, in all fairness, they did not dine on such simple sugars every single day, as does a modern human pounding down glazed donuts with their double mochaccino latte every morning!

 

  • And the most important point that Dr. Cordain highlighted was that, just because Paleolithic humans ate a particular way, it does not necessarily follow that it was the absolute healthiest possible diet that they could have been consuming.  It is simply that they were eating the food sources available to them in that time and place, foods that kept them from starving to death!

 

  • An additional thought worth mentioning, which Dr. Cordain did not point out, but which I uncovered in the course of my own explorations into this topic is that the average life expectancy of humans in the Paleolithic era (not counting infant mortality and those who were killed violently in their youth) was approximately 33 years, as opposed to 79 years in the United States as of 2017. Therefore, folks did not generally live long enough during the Paleolithic to have developed any of the degenerative chronic disease states synonymous with advanced age in our era.  So in other words, unless you’re only planning to live to 33, please proceed with caution when it comes to eating like a caveman or cavewoman, especially if you happen to have a genetic proclivity such as familial hypercholesterolemia or a family history of heart disease.

In the final analysis, my numero uno criticism against the Paleo Diet is essentially the same as it is in regard to any other “one-size-fits-all” eating plan or fad diet, i.e. it is not personalized!  If you decide to forego an individualized diet plan designed by a qualified nutritionist or dietitian who has factored in your personal genetics and biomarkers, and you decide to try a diet such as Paleo, please make sure to consult with your physician first and get bloodwork done, such as a lipid panel, at least every couple of months to make sure that your lab values and disease risk are not headed in the wrong direction.  Like the old saying goes, “The road to hell is paved with good intentions”.  Have a happy healthy weekend and eat sensibly!

Also, here’s a link to a voluminous critique of the Paleo Diet published in Scientific American a few years ago, if you’re interesting in a more detailed exploration of this topic:  https://www.scientificamerican.com/article/why-paleo-diet-half-baked-how-hunter-gatherer-really-eat/

Paleo-evolution