Wednesday, June 29, 2011

Fake Fat Makes Fat Humans

The study that follows is very interesting for a geek like me, and holds the standard caveat about rat studies: rat feeding studies don't always translate to humans, even though we have similar biological responses to food.

The BLUF:  rats who ate fake fat got fatter, and had more trouble losing the extra fat, even though the fake fat was zero calorie, undigestible matter which passes through the body, never leaving the digestive tract.  Even if you think to yourself "hmm, perhaps it might not be smart to ingest large quantities of an absurdly non-food substance", the low fat fad has led many to think otherwise.  Those are the kinds of results one might expect from the low fat fad and its necessary cognitive dissonance. 

If you know that fat is not the boogeyman, you can eat and enjoy quite a lot of fat - assuming you also restrict carb intake.  This formula - adequate protein, <100g/day of carbs, and high intake of saturated and monounsaturated fats - yeilds satiety, healthy body composition, a well regulated appetite and energy level, and improved health markers.  From this model, there's no reason to even consider fake fat.  Perhaps the poor rats subjected to this experiment will help some people from suffering a like fate.

The results showed that the rats on the high-fat diet that ate both the high-fat and the fake-fat Pringles ate more food, put on more weight, and gained more body fat than their counterparts on the high-fat diet that were given only the high-fat Pringles.

In fact, even when the researchers stopped feeding them the Pringles, the heavier rats did not shed the extra weight.

Tuesday, June 28, 2011

Eades: Low Carb Transition Tips

Summary of part one:
In the last post we discussed ramping up the fat intake as the single best way to hurry the low-carb or keto adaptation along.  I didn’t mention it in the previous post, but another little secret is to keep an eye on the protein intake. Too much protein will prevent the shift into ketoses because the liver will convert some of the protein into glucose – this glucose will then be used first and slow down the ketogenic process.  Which, if course, prompts the question, how much protein is too much?  As long as you’re getting your protein from meat, especially fatty cuts of meat, you’re probably okay.

"Money" tip two: 
As I said, you need to really crank up the fat intake to push yourself over the adaptation divide as quickly as possible.  If you don’t like fatty cuts of meat, you can add a little medium-chain triglycerides (MCT) to your diet.  MCT are absorbed more like carbohydrates and are used quickly by the body.  They are almost never incorporated into the fat cells, so they burn quickly, and any extra that might be hanging around are converted to ketones.  So, MCT will drive the ketone production process.  And so will coconut oil if you prefer that.

You can find MCT oil at most health food or natural grocery stores.  It has never bothered me, but some people can get a little nauseated if they take too much of it, so if you decide to give it a try, start out slowly.  Or go with the coconut oil.

The rest of this post is a gold mine of information, and I recommend you read and re-read it.  Electrolytes, bone broth, the criticality of magnesium, why it is great to lose water weight, and a host of other topics - Dr. Eades covers them and makes them "digestible" and directly applicable to your own or a loved one's low carb transition. 

Thursday, June 23, 2011

Davis: Eat Triglycerides

Many physicians are frightened of dietary triglycerides, i.e, fats, for fear it will increase blood levels of triglycerides. It’s true: Consuming triglycerides does indeed increase blood levels of triglycerides–but only a little bit. Following a fat-rich meal of, say, a 3-egg omelet with 2 tablespoons of olive oil and 2 oz whole milk mozzarella cheese (total 55 grams triglycerides), blood triglycerides will increase modestly. A typical response would be an increase from 60 mg/dl to 80 mg/dl–an increase, but quite small.                        
Counterintuitively, it’s the foods that convert to triglycerides in the liver that send triglycerides up, not 20 mg/dl, but 200, 400, or 1000 mg/dl or more. What foods convert to triglycerides in the liver? Carbohydrates.

While all of the above is true and easily observed when an individual reduces their carbohydrate intake, the real issue is not "high triglycerides."  In other words, neither triglycerides, or LDL, or some other particle floating around are causing vascular disease or accellerating aging.  I think the driver for all of that, for all of the diseases of "civilization", is the inflammatory cascade that results from excess glucose. All of the other markers and results we recognize - CRP, H1C, small dense LDL, low HDL, high triglycerides, excessive abdominal circumference, high blood pressure, obesity, metabolic syndrome, diabetes, heart disease, stoke, kidney disease, gout, lupus, rheumatoid arthritis, cancer, erectile disfunction, depression, Alzheimer's, ALS, MS, Parkinson's - may very well be driven by genetically driven and therefore highly varied responses to the completely novel inflammatory states created by the neolithic agents of disease.  

Even if your MD would not agree that these disease states have a common cause, I suspect they would all agree that 'losing weight' will reduce your risks for most of aforementioned unfortunate ends.

Yes - it's a little more complicated than one could summarize in a paragraph!  But I hope the point was made.  So in return for eating meat, vegetables, nuts and seeds, little fruit or starch, and no sugar or wheat, you get a shot at dodging all these nasties, while you look feel and perform better.  

As the philosopher would say, you gotta ask yourself one thing - do you feel lucky?  

Space Doc On Statins

A healthy 50 year old male ponders this current ad for Lipitor®. "80% of people who have had a heart attack have high cholesterol" it says. This sounds very persuasive yet it is misleading because it all depends upon your definition of high cholesterol.

During my 23 years of general practice, before the era of cholesterol causality, the normal range of cholesterol was 100 to 300. Then overnight it seems, a new disease was created known as hypercholesterolemia and everyone with a cholesterol level of 200 or higher was afflicted with it.

This was the beginning of what I have come to call the cholesterol craze and the drug companies' progressive development of cholesterol lowering drugs, culminating in 1988 with the statins. Since then the acceptable, lower level of cholesterol has fallen from 200 to 170, then 150 and now 130, so this "80% of people who have had heart attacks have high cholesterol" is now true because nearly all people are "caught" by this newest lower value of 130.  
At the rate of change seen these past twenty years, soon our acceptable level of cholesterol will be 110 and statin makers will be able to say with complete honesty that almost 100 percent of people who have heart attacks have high cholesterol simply because nearly everyone has high cholesterol if you lower the desirable level sufficiently.

The reality that cholesterol levels are completely normal in more than half of new heart attack cases is what convinced Uffe Ravnskov, MD ( The Cholesterol Myths ) and Kilmer McCully, MD ( The Homocysteine Revolution ) that the theory of cholesterol causation was wrong. It just did not fit the facts.

Dr. G says it well.  There is a lot of misinformation about statins.  The real risk to manage is out of control blood glucose.  If you can stabilize your glucose, you reduce the other symptoms of disease and your risk of contracting them.  Not to mention - while you are alive, you live, instead of limping along preserved by statins and other meds.

When a statin commercial says something as banal as "80% of people who have had heart attacks have high cholesterol" you should listen for what that means (nothing, correlation is not causation), as well as for what they do not say - which is that lowering cholesterol has not been proven to reduce all cause mortality.  All cause mortality is the only meaningful statistic when evaluating a therapy.  Bottom line:  statins should only be used for a specific population with specific criteria, not for every SOB with "high cholesterol".  Caveat emptor.

Wednesday, June 22, 2011

William Davis on the Gluten/Gliadin Free Commercial Options

Problem: These gluten-free ingredients, while lacking gliadin and gluten, make you fat and diabetic. They increase visceral fat, cause blood sugar to skyrocket higher than nearly all other foods (even higher than wheat, which is already pretty bad), trigger formation of small LDL and triglycerides, and are responsible for exaggerated postprandial (after-eating) lipoprotein distortions. They cause heart disease, cataracts, arthritis, and a wide range of other conditions, all driven by the extreme levels ofglycation they generate.
You can take the boy out of the country, but you can't take the country out of the boy.  

Likewise - you can try to dejunk junk food, but ... it's still junk, there's still no reason to eat it.  Unless ... you are cursed with liking food high in starch and low in nutrition.  If so, I feel for you. 

How could you tell whether this imitation bread, etc, is harmful to you?  Try the glucose meter.  My guess is it will tell you that your blood sugar skyrockets after consumption.

Eat meat, vegetables, nuts and seeds, little fruit and starch, no sugar/wheat.

Tuesday, June 21, 2011

Sprint Training

This is a manifesto about how humans sprint.  It's a game changer in terms of how to train for speed.  It's worth a look if you like teasing apart how the body works.

Walking - Better Than Bad

Mark's Guide To Walking
Who recommends walking?  I don't actually know of anyone who does not.  Nonetheless, I like Mark Sisson's perspective on the matter and recommend his column. 

In my experience, it’s the easy, seemingly inconsequential stuff that’s the hardest sell. The crazier, more unconventional stuff gets all the attention. Tons of people get out there and do heavy squats, order grass-fed cows, buy the latest Vibram model, learn to love liver, and proudly stride barefoot into the grocery store – but they drove to get there. It’s the easy things, like walking regularly and often, that are somehow the hardest to do. They’re the easiest to ignore. Walking? Yeah, it’s nice, it’s relaxing, but it won’t put on the mass and elicit the hormonal response of a set of heavy deadlifts. It isn’t sexy.
Walking matters, folks. Big time. If we stop moving, even if we’re standing at our desks and hitting the gym every other day, we’re dying. We’re telling our bodies that we’ve given up, that it’s okay to shut down, that all those millions of years of daily, constant walking were an aberration, a mistake, a fluke. That’s folly. I think you know it, but I don’t know if you know it.

Powerlifters say walking makes them stronger.

Art De Vany says walking is an essential element in the program that has him, a 70+ year old man, running sub 5.0 second 40s and deadlifting over 400 pounds.

The Chinese, at a minimum, have a version of meditation based on walking.

One of the things I like most about hunting is that, in the context of the hunt, I walk "all over the place."  Until my knee injury, the way I would get to know virtually any place I lived was via jogging.  Now, walking has to suffice, but I've run through the streets of a dozen states and half as many countries.  I don't know if I am laid back enough to enjoy walking as much as I enjoyed running, but I'm learning.
Is there anything not to like about walking?  Not that I know of.  My point in this post is pretty simple, which is that in a world of fighting about what the science does and doesn't say about science, health and longevity, walking speaks for itself as a requisite human activity.  Vigorous, long walks, or just short strolls to loosen up and move around, walking is a chance to be mindful, to enjoy the feel of movement, and to relish.  I think it is also good for you, but it would be it's own reward even if it is not "good for you." 

So yes, I like Olypic weightlifting and butterfly kipping pullups and multi modal metabolic conditioning and knowing four different ways to deadlift, and such - but it's just as important to get up and go walk.

Monday, June 20, 2011

Neolithic Deficiency

One of the side effects of being a fitness coach is that when looking at a human, I notice things I never used to.  What I notice these days - aside from how many people don't seem to know how or what to eat and are therefore either obese, or just 'heavy', or skinny but sick - is how many of us don't have any awareness of, or strength in, our hips and our backs. 

When you climb a flight of stairs, what muscles feel fatigue in the effort?  If you sit, stand or walk, where are your shoulders in relationship to an imaginary line rising through the center of your torso? 
A Fitness Coach is a person aspiring to be expert in;
-how humans exert force
-how to help humans exert more force with less effort (aka "how to move well")
-how to develop a comprehensive training approach that enables training adaptation in strength, speed, endurance, stamina, flexibility, power, speed, coordination, agility, balance and accuracy, by definition maximizing fitness
Watching a movie last night, it was apparent that the leading man was very attentive to his appearance - why not?  He was apparently taking good care of himself based on his ability to look like a movie star.  But it was also apparent that his phyisical training was all about the appearance side of the body, not the performance side.  That is to say, he had body builder pecs and abs, but neolithic-chair-sitting man's back and hips.  His shoulders were rounded (shoulders pulled forward to tight pecs, and ignored upper back muscles).  The minimal hip function was like most every person over college age (and many under college age) that we see -the hips appear to generate very little force as the person with the diminished hip function will do all of their 'work' with their quads, which have smaller levers and less force generating capacity.  In other words, the quad dominant human works harder to create the same force, and becomes force limited sooner.  Generally, quad dominance accompanies hamstring and glute deficiency, and often spinal erector deficiency.  Wrap up the whole package - suboptimal hip function, weak back muscles from the hips to the shoulders - and you get folks who have pain in their knees, backs, shoulders and necks.  When and if they exercise - jogging, cyling, swimming, sport, or just yard work - they face increased risk of injury. 

Everything is growth or death, and I know of no exception.  And this is why you care.  You don't have to be that guy/gal with the stooped, rounded shoulders, shuffling along trying to take it easy on your knees/back, wondering why they call that post-retirement life "the golden years." 

What to do to remain physically vibrant as you age - that is the question. 

Dance?  Heck yes.  Swim?  Of course.  Ride a bike and jog and play around on a eliptical trainer?  Those things are a good start, but if you've lost your hip function and the strength in your torso, these activities will not repair those deficiencies.

Do what you were built for - run, climb, pick up heavy stuff, move it around, throw things, jump and play physical games.  Think you are too old for that stuff?  Tell that to these ladies (60+ female contenders for the CrossFit Games Open): 
Or this gent:

Friday, June 17, 2011

Primal's Essential Foods

Supreme summary of Mark Sisson's top ten foods - good read.

Speed Is Life

HUMAN RUNNERS CAN ATTAIN SPEEDS for a few seconds that are two to three times greater than those they can maintain for several hours. In relation to the duration of all-out running, these speed decrements are not uniform. Speed decreases markedly with increases in the duration of shorter efforts (i.e., <180 s) but only modestly with the same relative increases in the duration of longer ones (1112). Accordingly, top sprinters attain race speeds nearly twice as fast as those achieved by the best milers, but mile runners race only moderately faster than marathon runners do. The negative exponential relationship between all-out speed and run duration is generally attributed to differences in the metabolic power available from anaerobic vs. aerobic sources in relation to time (8922,24). Specifically, peak rates of anaerobic energy release, which fuel brief maximal efforts, decline rapidly as the duration of the trial increases (1521). In contrast, the peak rates of aerobic energy release during prolonged efforts vary relatively little with event duration. For example, well-trained athletes can maintain >80% of their maximum aerobic power for events from 10 to 120 min (5-7).

This is a fascinating paper, which Tim Ferriss highlights in the Four Hour Body during his profile of Barry Ross.

The hook:  he has female high school athletes the break records for track events and who - at 130 pounds of body weight - can deadlift over 400 pounds.

How does he do it?  They do a brief workout, they perform a 3 rep set of heavy (~95% 1RM) deadlifts to knee height only.  They follow within 1 minute with a set of plyometric movements (box jumps), rest five minutes, and repeat with a 5 rep set (~85% 1RM).  Afterward, the run the ASR based number of sprints.  They do this three days a week (also doing the bench press to the same set/rep scheme).

Why do you care?  The short version: if you want to run faster at any distance their program will get you up to speed with three short workouts of very few sprints, three times/day.  They work "inside out", run short, hard as little as possible - "Do as little as necessary, not as much as possible" is their guiding principle.  Training for a 400m race or shorter, for example, they never run over 70m.

Seems like a very useful protocol for developing improved physical capacity with efficient training.

More info here:

Thursday, June 16, 2011

Paleolithic Sleep?

Yes, even that has a paleolithic model.  BLUF:  Sleep when the sun's down, and since NO ONE does that any more, at least sleep nine hours per night.  But I can't even fit that in most days, so ... what to do?

Nap, baby, or as we called it when underway on one of our nation's big grey fighting ships, "entering the horizontal time accelerator."

I've heard many a rumor about napping, such as "don't nap more than 45 minutes in order to avoid trouble waking up again."  I follow that one when I nap.  But I just read a short piece in the Costco Connection (June 2011, p. 67) which points to taking slightly longer naps to get a specific effect.

Naps lasting 30 to 60 minutes trigger slow wave sleep that helps brains recall information already stored there.  "To avoid sleep inertia, try to nap at least 50 minutes," says Mednick (author of "Take a Nap!  Change Your Life!), "It's good to sleep beyond the slow wave sleep, so you get past it and can wake up more easily."

Tim Ferriss, of Four Hour Body fame, included a chart that shows how you can 'buy back' decreased night time sleep through various nap strategies - including polyphasic sleep, by which you can sleep for 2 hours per day but feel well rested and still be mentally sharp.  The nugget for me was that my cat naps are not just a bandaid for not getting enough sleep, they may actually help meet my need for sleep.

One thing I've noticed by my own accidental experiments is that if I sleep more, my body stores less body fat.  The science, such as it is, supports that observation, due to the decreased disfunction of cortisol as sleep levels reach the best levels - and probably for other reasons too.  No doubt, sleep has a profound impact on many aspects of our health, as has been passionately articulated in "Lights Out."

I don't have any grandiose plans for how to design my life around a paleolithic caliber 11 hours of sleep daily - yet.  But I do follow a fairly paleolithic approach to sleep in that if I get sleepy, I work in a nap.  I set an alarm to keep them short enough, and whether or not they work like Mednick describes or not, and I thoroughly enjoy them.

Wednesday, June 15, 2011

High Fat Heals Brain

The author's comments are useful for perspective.  It's good to know these studies are underway.  There's good reason to believe that they will show a positive effect on all of these conditions by changing the diet to resemble the paleolithic model.

So we have over 80 years experience with this ketogenic, low-carb high-fat diet, and no records of these kids developing heart disease due to the diet. Just tons of data showing how they could go from 5000 plus seizures a day, in some instances, to none. Without drugs. And now we are seeing that this low carb high fat ketogenic diet is being investigated for curing other diseases (See: Low Carbohydrate High Fat Ketogenic Diet May Reverse Kidney Failure in People with Diabetes), as Thiele comments:
Right now there’s some preliminary evidence in Parkinson’s disease and Alzheimer’s disease that a diet similar to the ketogenic diet may be very effective. And there’s actually a critical trial, ongoing, in ALS, or Lou Gehrig’s, disease of using a similar diet and there’s a lot of evidence, mainly animal model evidence, that similar diets may be very effective in helping to treat cancer. There’s evidence in prostate cancer and there’s a lot of evidence in some brain cancers, like neuroblastoma. And I think that’s because cancer cells are rapidly dividing so they have a very high metabolic rate and they use a lot of energy. And so the ketogenic diet basically shuts down the cell’s energy production and makes the cells rely more heavily on fat metabolism, and cancer cells, I think, are not thought to do that as effectively.

Tuesday, June 14, 2011

Animals, Fat, Carbs, and Cognitive Dissonance

Newswise — Obesity among people who eat a high-fat diet may involve injury to neurons, or nerve cells, in a key part of the brain that controls body weight, according to the authors of a new animal study.

Now that's a catchy start eh?  Surely this isn't another "make rats sick to prove high fat is bad study"?

“The possibility that brain injury may be a consequence of the overconsumption of a typical American diet offers a new explanation for why sustained weight loss is so difficult for most obese individuals to achieve,” said presenting author Joshua Thaler, MD, PhD.
Thaler and his colleagues studied the brains of rodents for the short-term and long-term effects of eating a high-fat diet. After giving groups of six to 10 rats and mice a high-fat diet for periods from one day to eight months, the researchers performed detailed biochemical, imaging and cell sorting analyses on the animals’ brains.

OK, I guess maybe it is just another "make rats sick to prove high fat is bad study".  And because it is high fat, it gets uncritical coverage.

Here's a guess - there's too much omega-6 fats in the chow, or there's too much saturated fat in the chow - either way, while rats and humans have much in common, humans do quite well on diets consisting of monounsaturated and saturated fats, and rats generally do not.  As Taubes pointed out in Good Calories Bad Calories, for folks who really need to get fat, it's low fat and high carb that does the trick best (or milk).

If you want to make a human fat, however, you can't do it with a high fat diet, which is the point these "high fat rat" study authors don't get.  And feeding these rats a diet like the "typical American diet" would mean they get about 20% of their calories as HFCS, and another "healthy" dose of easily oxidizable omega-6 fats, not to mention hearty servings of potatoes, regular sugar, rice, beans, and grains.  Newsflash, if you feed rats neolithic frankenfoods they get sick, just like humans.
The strange thing is that these studies continue to be made and reported on.  We already have many many studies showing that humans flourish on high fat diets.  Unless the point of this study is to show that HFCS, poly unsaturated fats and transfats are just as bad for rats as they are for humans, this kind of study is beyond pointless.  However, this kind of study is also relatively cheap, and since folks can get these things funded, you'll see more.

But just to prove not every scientist that studies food and diet is completely wasting time, here's an example of an interesting, noteworthy, if small, study, which shows how to improve a basic human life function:  fertility.

Polycystic ovary syndrome (PCOS) affects the fertility of women and is associated with obesity, hyperinsulinemia, and insulin resistance.  The Low carbohydrate/Ketogenic Diet led to significant improvement in weight and fasting insulin in women with obesity and PCOS, and some became pregnant despite previous infertility problems.

Monday, June 13, 2011

Solar Powered Human?

Fascinating correlations between vitamin D and athletic performance, based on nearly 100 years of published work.

I began to supplement vitamin D in the fall, and found an immediate and palpable improvement in work capacity.  I do not think this is because vitamin D gelcaps are magic pills; it is because I was deficient.  My levels have improved to the 50s (ng/ml) over the last two years with supplementation and some natural exposure to sunlight.  There are arguments both ways about whether or not to supplement once vitamin D levels reach 30 ng/ml, but below that level should be considered pathological.

MERSA, bone disease, cancer, infectious disease - vitamin D is indicated in prevention and minimization of all of these.  There's just no way we could avoid getting vitamin D throughout most of human history, and now that we do avoid getting enough, there's a price.

Friday, June 10, 2011

Exercise For Brain Health, Maybe

An interesting study with some predictable findings and some findings that were a bit of a surprise.

The study involved 1,238 people who had never had a stroke. Participants completed a questionnaire about how often and how intensely they exercised at the beginning of the study and then had MRI scans of their brains an average of six years later, when they were an average of 70 years old.

The brain scans showed that 197 of the participants, or 16 percent, had small brain lesions, or infarcts, called silent strokes. People who engaged in moderate to intense exercise were 40 percent less likely to have the silent strokes than people who did no regular exercise. The results remained the same after the researchers took into account other vascular risk factors such as high blood pressure, high cholesterol and smoking. There was no difference between those who engaged in light exercise and those who did not exercise.
Because this was not an intervention study, we don't know how much or how "intensely" the participants were exercising - and because I didn't look the study up, I don't know how "intensity" was quantified in this study.  I have met people who were convinced they were strong and worked out intensely who were in fact nearly pathologically weak. 

Further, there's kind of a chicken and egg thing - if you start having mini-strokes, do you think that might have an effect on how often and how hard you work out?  It reminds me of the study that showed that all of the 80+ year old folks in some big city or another lived in apartments for which there was no elevator, and they lived on the 2nd floor or above.  Does that mean if you walk up a flight of stairs every day you'll live to 80+?  Maybe, but it might mean that if you are healthy enough to walk stairs, you can stay in your 2nd floor apartment and if you aren't, you moved out.

Another chicken and egg issue involves diet.  If, as Taubes et al suspect, a poor diet affects activity level in the same way it affects health (short summary:  High carb diets create the starvation effect and therefore reduce activity level while accelerating metabolic derrangement), the folks who are eating a high carb, low fat diet will not be exercising as much or as hard - they'll be "too tired" and "won't feel like it" and they will also likely have higher inflammation levels ("I'm hurting today, I don't think we can work out"). 

IOW - the poor diet (which in my book means high carb, low fat) drives low activity level AND other negative health outcomes from metabolic derrangement.

Further, the high intensity folks, although they suffered these mini strokes at a much lower rate, were not immune.

In short, while the study shows a significant statisitical correlation with intense exercise and brain health, it cannot tell us why that correlation exists. 

However, I still advocate frequent, intense, and relatively short workouts for all the other benefits which can be quantified by the results those types of workouts create - more muscle mass, improved health bio markers, faster and more significant adaptation to the higher intensity stimulus, and reduction of the negative adaptation associated with excessive amounts of "cardio" training (muscle consumption, inflammation, joint trauma, inferior range of motion, and too much time spent working out).

For more on how the paleolithic model applies to aging well, I recommend Art De Vany's book, "The New Evolution Diet", which provides a potent mix of anecdotal perspective (Art is 70+ and strong as a bull after 30 years of living like a hunter/gatherer) and science (Art's a PHD and provides a plethora of science that comports with his premise).

Thursday, June 9, 2011

Statin Risks

As a population we’re living longer. Generally speaking, older individuals are more prone to chronic conditions such as heart disease. With statin drugs continuing to be a mainstream mainstay in the prevention of heart disease, the elderly represent a growing market for these drugs.

While this may be lucrative for pharmaceutical companies, are there any real benefits to be had from prescribing statins to elderly individuals?
One of the most significant trials of statin therapy in the elderly is known as the PROSPER study [1]. In this study, almost 6,000 men and women aged 70-82 were treated with a statin (pravastatin) or placebo for over three years. Each of the individuals in this trial had either a history of cardiovascular disease (e.g. a previous heart attack) or significant risk factors for cardiovascular disease. In this sense, the individuals were deemed to be at relatively high risk of cardiovascular events such as heart attack or stroke. This is relevant as relatively high-risk individuals stand to gain more from statin therapy compared to low-risk individuals.
Risk reduction of non-fatal and fatal heart attacks (added together) was 19 per cent in the group taking the statin. Stroke incidence was not affected. Cancer rates were 25 per cent higher in the group taking pravastatin.
Risk trade offs are a factor to consider.

Wednesday, June 8, 2011

Thin Equals Well?

Many overweight and obese people are metabolically healthy, while large numbers of slim people have health problems typically associated with obesity, a new study shows.
The findings, based on national health data collected from 5,440 adults, shows that weight often is not a reliable barometer for health. In addition to looking at height and weight, the study, published this week in The Archives of Internal Medicine, tracked blood pressure, “good” cholesterol, triglycerides, blood sugar and an inflammatory marker called c-reactive protein, all of which are viewed as indicators of cardiovascular health.
Overall, thin people were still metabolically healthier than people who were overweight or obese. But being a normal weight was not a reliable indicator of health. In the study, about 24 percent of thin adults, or about 16 million people, posted unhealthy levels for at least two of the risk factors.
By comparison, among the overweight, about half the people had two or more of the risk factors. But half of them were also metabolically healthy. And nearly one out of three obese people were also metabolically fit.
While it’s long been known that it’s better to be fit and fat than being thin and sedentary, the new data are believed to be the first time researchers have documented the unreliability of body size as an indicator for overall health.

This is another report documenting the "fat but healthy" population, which has been reported on in various studies for at least five years.  The challenge is that with epidemiological studies - the assumption define the results.  If you decide that people with blue warts are more likely to die, aka blue warts are a risk factor, then fat people with blue warts are not "healthy".  Does that mean they are really more likely to die?  Who knows  - because most of the "risk factors" are the results of sophisticated calculations that are very rarely confirmed via intervention studies.  That said, Mike Eades ( published a post recently that explains how the "skinny fat/unhealthy" idea could very well be true.

The basic idea is that we each become insulin resistant on a different genetic template.  Suppose a person's fat cells are the last part to become insulin resistant - if they are eating poorly, they can continue to sock away excess blood sugar in their fat cells (after conversion, by the action of insulin, to fat).  In fact, these folks can and will accumulate more fat than the rest of us, and it seems to have almost a protective effect - because they can continue to sequester excess blood sugar long after many of us would not be able to.

On the other end of the spectrum, imagine a person who's fat cells become insulin resistant at essentially the same time as other tissues - these folks will not be able to buffer their excess blood sugars, and will wind up with a large quantity of visceral fat, which is "associated" with higher mortality.  They will suffer more damage from their overconsumption of carbs and the resulting high blood glucose.

What's the bottom line?  There's no getting around the fact that a large abdomen and high blood sugars are signals of damage and causes of damage respectively.  This is why carb restriction is such a powerful tool for those already wrestling with the damage the results from too many years of a typical neolithic diet.

Tuesday, June 7, 2011

Many Ways Up The Mountain

Before he embraced natural movement, the founder of R. E. Taylor Associates Inc., a sales and consulting firm for the hospitality furniture- and fixture-manufacturing industry, logged about 70 miles a week training for marathons and ultramarathons (races longer than 26.2 miles). After nearly seven years of marathon training, Mr. Taylor had developed plantar fasciitis, an irritation of the thick tissue on the bottom of the foot that causes heel pain. He also had constant pain in his shins.
In December, Mr. Taylor got a wake-up call after a pick-up basketball game with friends. "I had crazy blisters, and my legs were killing me," he says. Despite his prime cardiovascular shape, he realized the long-distance running only worked a few muscles. "If I wanted to be a well-rounded athlete, I had to focus more on the rest of my body," he says."

MovNat is hardly part of CrossFit, but what is clear from the post above is that there are many ways up the mountain, but eventually they all converge - as my martial arts instructor used to like to say.

Monday, June 6, 2011

The Plate

While I agree that the plate is a better means to represent a desired meal than was the pyramid, especially when the message sender is the US Government who by definition must design a message that can be digested by that 50% of the population which has a below average intelligence, if the message is a bastardization of the science, it should still not be sent.  IOW, this is just "lipstick on a pig".  (I do not mean to belittle the appearance of pigs, but would note that I find the idea of lipstick on bacon is not appealing to the eye or the palate.  Editor's note). 

Please indulge me, dear reader, in a not so bold prediction:  This "plate" will have zero effect on the propensity of the US population to gain an unhealthy amount of body fat, no matter how much money our government, via the USDA, has paid for this product's development, or will pay for its marketing. 

Here's another:  If our Surgeon General follows this eating plan, she will be just as heavy when she leaves office is as she was when she took office.  However, she will actually deserve this fate because she's educated enough to know better.

Here's a third:  at some point, someone in the government will be presented with the fact that grains rapidly raise blood sugars, regardless of their "wholeness" or lack thereof.  Someone will, eventually, announce that grains of any kind have a glycemic impact which is deleterious and particularly to diabetics and pre-diabetics who already have glycemic control issues as their most significant health driver.  No one will be required to take responsibility for the fact that our government has proclaimed all these years that so called whole grains are 'heart healthy.'  Perhaps some will realize how much of the "health care crisis" was created and perpetuated by the USDA driven low fact dogma, but the damage will have been done.

Friday, June 3, 2011

Four Hour Body

Tim Ferriss' latest is the Four Hour Body and it is a fat tome with a fascinating premise - you can learn something from many years and many episodes of an creatively OCD man's experiments in human performance.

Ferriss loves to discover a premise, quantify it in an experimental protocol, and observe/measure the outcomes in his own or others' bodies.

There's a bunch in Ferriss' book into which a nutrition junkie could delve, including how to binge with damage control, how to "cheat" the NFL combine, how to swing a bat for power, and how to execute Ferriss' "slow carb" diet.  Truly, that only scratches the surface of the book's goodies.  But after digging through nearly 400 fascinating pages, there's only a little that I'm willing to apply to myself.

Short list:  cold showers; a super low volume strength protocol designed by a sprint coach for sprint athletes and thus quite applicable to a guy like me who's doing strength to be a better CrossFitter vice a strength guy; why cinnamon can help your blood sugar levels; why spinach really was helping Popeye get strong; and how you can use ten reps a day for rapid improvement.

At the macro level, the book's biggest lesson is how to design and execute an "N=1" experiment.

I'm working on the application of several of TF's ideas, focusing on those ideas that might have an application to continued improvement of work capacity across broad time and modal domains.  I'm looking forward to seeing how they work!

There's no part of the book that wasn't interesting to me, and don't think that I've in any way summed up all that could be learned from "The Four Hour Body".  If you have the time and inclination, it's worth the $$ to buy/read.

Thursday, June 2, 2011

Eat Fat, Stay Healthy

With the memory of Memorial Day cheeseburgers and bratwursts still lingering, many of us may be relieved to hear that a new study suggests that a meaty, high-fat, Atkins-style diet can do more than contribute to rapid weight loss. It may also be less unhealthy for the heart than many scientists had feared — provided you chase the sausage with a brisk walk.

What's the news?  Another group on a high fat diet fares well?  Hardly.  What's news is this is commented on with a fairly even handed tone in the NYT.
“It took people less time to lose 10 pounds” on a high-fat diet-and-exercise program, about 45 days on average, than the 70 days it took for those who exercised and followed a high-carbohydrate, low-fat diet constructed using guidelines from the American Heart Association, said Kerry J. Stewart, director of clinical and research exercise physiology at Johns Hopkins University School of Medicine and lead author of the report. And at least in the short term, there were no apparent harmful effects. 

Here's where the article goes where most mainstream articles go when discussing science and food - to the junk bin:
To date, however, scientific data have been inconsistent. Some studies have reported that such diets contribute to cardiovascular disease, while others found no increased risk
Show me those studies, and I'll show you that the "studies" they cite are observational studies, which as most of you know, is only useful for establishing a hypothesis (really, only useful for establishing a baby hypothesis, a conjecture).  When tested via intervention study, high fat diets virtually always win, as is the high fat diet in this still ongoing study.

These comments can only be considered amusing, though:
And like most of the recent studies about the health effects of low-carbohydrate diets, “these are very short-term results,” said Dr. Dena Bravata, an internist and research associate at the Center for Primary Care and Outcomes Research at Stanford University, who was not involved with this experiment but has conducted dietary studies. “Those on the high-fat diets showed no harmful impacts” after 45 days or so, she said. “But what about in 5 or 10 years, if they remain on the diet?”

Where was all this scientific rigor and skepticism about the long term impacts of diets when the government and many non profits - like the AHA and ADA - jumped "whole hog" on the low fat fad diet?  If there's one thing that's certain in the science of diet and health it is that there was no scientific basis or long term evaluation of the effects of eliminating fat from the diet and substituting carbohydrates.  And there still is not!

Interestingly, one of the conjectures Gary Taubes introduces in Good Calories Bad Calories, and Why We Get Fat, is that those on a high carb diet will exercise less when in caloric restriction, because low fat low cal low protein diets induce the starvation response much more quickly than protein adequate and fat adequate diets.  In other words, they get lazy because of their diet.  The same thing happens with a high carb diet which is not calorie restricted when people exercise - if the exercise puts them into caloric restriction, they will eat more.  

Lucky for us, we don't need a billion dollar long term study to evaluate the health impact of a high fat, adequate protein, carb restricted plan.  Give yourself an N=1 experiment, which will be more convincing than any number of NYT articles.

Wednesday, June 1, 2011

Measuring Health

Friday's post addressed how difficult it is to quantify what causes the diseases of the West, and how to measure whether one is more or less likely to suffer that variety of afflictions.  Summary:  discrete biomarkers may be manipulated via drugs or even just vitamins or foods (e.g. niacin or olive oil), but those manipulations do not seem to change disease risks.  

So what biomarker can you manipulate and measure that WILL control your health?

Glucose, thanks to the epidemic of diabetes in our country, which has created such a demand for glucose meters that you and I can get one for $50 with a month's worth of strips.

If you control your glucose, your BP will normalize (lose those BP meds), your lipid profile will normalize (no more statins), you'll lose weight from around your belly (innumerable benefits from this), you will most likely eliminate the need for gout meds if you use them, and in short - it'll all be good.  

If you eat meat and vegetables, some nuts and seeds, little fruit and starch and no sugar/no wheat, you will control your blood glucose, and when you confirm that with a glucose meter (take a measure just before you eat and one hour later) if will reinforce your choices.  It will also reinforce which foods that send your glucose levels into the stratosphere.

What's the downside?  The G meters are not perfect.  It's not fun poking holes in your fingers.  In other words, very little compared to the power the tool gives you to evaluate your health.  As with everything, there's a caveat.  If you are over-consuming fructose, your short term glucose readings won't necessarily be high, but long term, as the fructose accelerates your insulin resistance, the G readings will always be higher than you would hope for.   

Tim Ferriss illustrates in the Four Hour Body just how much you can do with a G meter, but all you really need to know is less G is better for your health.