I had a 55 average in Pathology class over the first two exams, and there were three more to go. I needed a 75% average total over those five exams in order to pass the class. There were six tests total in that class, 5 exams and one final exam worth the weight of the other five. A below 75% average on either the final or the average score of the first five would result in a failing grade.

My motivation was at an all time low, and I was not enjoying what I was doing. But never one to give up, I pushed myself to pass the class. Under surmounting pressure and the influence of nootropics, I achieved a 97% average over the next three exams to pass the class. Nootropics include synthetic compounds like 1-p-anisoyl-2-pyrrilidinone (aniracetam), 2-[(Diphenylmethyl) sulfinyl]acetamide (modafinil), and N-phenylacetyl-L-prolylglycine ethyl ester (noopept), and naturally occurring substances like caffeine, berberine, or gingko extract.

The few days before before the exams, I took 500 mg berberine, 80mg or so of caffeine from a cup of coffee, gingko, and if I recall correctly, Huperzine A. I felt very focused for a few hours on those supplements and was able to sift through a lot of information and retain it. Adderall was a no-no for me because I felt it would drain my body. I was open to trying modafinil, but I needed a prescription for it and didn’t want to put in the effort to obtain any at the time.

What these stressful cramming sessions reinforced was that nootropics work. There are drugs and natural compounds that greatly boost cognition, flooding our synapses with neurotransmitters that improve retention of information and increase our ability to focus.

But I never wanted to do that again. I’m not a burnt out Silicon Valley techpreneur and will never again be a burnt out student. The demand for nootropics comes from a culture that is very stressed and pressured. I have nothing against them, but do think the reason they’re in demand reinforces the need to seek balance. If nootropics are yang, yin is sleeping enough. There must be a balance or something will collapse.

As I explained years ago in this Youtube video, nootropic supplements simply don’t work as well for me when I’m burnt out. At the time, I was exercising intensely without eating enough. My sport involved getting stronger without gaining weight. I did it the wrong way, by consuming a fairly limited diet that did not fully satisfy my body. This resulted in adrenal fatigue and subclinical hypothyroidism (I diagnosed this myself, so I’m not 100% sure it was the case, but it’s going into the book).

After changing my diet, my symptoms improved. Whatever the case was, I was burnt out. By the time I had entered medical school I still was not fully recovered. After days where I would sit in lectures for 400 minutes, I often could not go to the gym afterwards because I felt too drained.

I took various supplements to decrease my stress and hopefully offset this, but they weren’t enough. My body needed recovery. Ultimately, I simply could not work out as intensely in medical school. Now that I’m out, I’ve made consistent progress in my workouts and unfortunately have ripped two pairs of pants because my hip adductors are getting larger from squatting.

So where’s the balance? I know that people reading this aren’t going to all of a sudden decide to become hunter-gatherers who don’t experience as much stress as someone working in an office trying to meet deadlines. And that’s not the solution anyway; it’s escaping.

The solution is to focus on the fundamentals first and foremost. Here they are:

  • Sleep:
    • use blue-blocking glasses at night, and keep your lights dim.
    • Do not stare directly into your phone, tablet, or laptop late at night. Use flu.x and other software to lower the blue-light.
    • Sleep on time and sleep enough.
  • Diet:
    • Consume a variety of nutrient dense foods like egg yolks, organ meats, broths, green vegetables, fish, nuts, and lentils.
    • Do not excessively restrict any type of macronutrient like fat, sugar, or protein.
    • Do not avoid cholesterol or salt, they are good for the brain.
    • Eat high quality protein. The amino acid tyrosine is the precursor to dopamine, norepinephrine (the “deficient” neurotransmitter in ADHD), and epinephrine, and tryptophan is the precursor to serotonin.
    • Seek balance in your diet and eat intuitively.
    • Eat spices and herbs in your food: turmeric, ginger, garlic, or rosemary, oregano, and thyme (all are neuroprotective which means they enhance cognition).
    • Limit refined sugar, refined salt, refined grains, and vegetable oils.
  • Exercise in moderation. Move. Stretch. Breathe.
  • Meditate, because it promotes neurogenesis (and because it feels amazing).
  • Spend time in nature.
  • Get grounded: allow your feet to touch the earth. This connects you to the earth’s magnetic field which reduces inflammation. Read “Earthing,” Dr. Jack Kruse, and follow Matt Blackburn on Instagram.
  • Have sex in moderation. Good sex, with someone that makes you feel good all around ideally.
  • Don’t be a procrastinator like me and do things earlier.

When you have a crutch to rely on, you will always forget the fundamentals. Nootropics will only work as long as you aren’t deficient in nutrients, and not too stressed or burnt out. Once those two things occur, they can’t work effectively because the reactions in the neurons necessary to for cognition to take place rely on minerals like magnesium and B vitamins. This perhaps explains why people who take adderall for a long time feel unable to focus when they are not on it anymore. This is also why I’m reluctant to try modafinil.

Naturally occurring substances that promote brain function however likely won’t deplete neurons/synapses or whatever it is as much. I need to look into this much more on a biochemical level to further understand how true this theory is. In some instances, what I just said may not be true. But from my own personal experience, it certainly seems to be.

Lastly, receptors in the brain can acclimate to nootropics very quickly. I experienced this with raw cacao beans and spirulina, naturally occurring substances that I’ve used in the past to enhance brainpower. They worked the best initially, but if I used them too often I did not get the same effect. The solution there is to cycle them, and again, focus on fundamentals first and foremost.

Conclusion

It takes work to practice prevention. It takes work to take care of yourself too. Make it a priority and see how it changes your health!

The fact that some people believe in a “plant-based diet” and that that’s even a phrase shows me how confused people really are. Every diet humans have ever eaten on this earth was plant-based. Let’s break down a few things real quick. As always, it’s important to define our terms. Have you ever witnessed or participated in a Facebook discussion that went no where because people did not define their terms? It happens all the time. So what is a plant-based diet? Because I ate potatoes this morning and potatoes are plants…

What the plant-based diet really is:

  • vegan
  • vegetarian
  • semi-vegetarian
  • low in red meat
  • low in saturated fat
  • low in dairy
  • low in eggs
  • low in sugar
  • low in vegetable oils
  • high in legumes
  • high in whole grains
  • high in starchy carbohydrates
  • high in vegetables

The plant-based diet is actually an effort to limit meat and be as vegan as possible. No positive health benefits of animal foods are discussed in plant-based circles. The reason is twofold: the China study, and sustainability.

I’ve been reading various things about nutrition since 2008. Back then, Michael Pollan was very popular. His stance on a plant-based diet (let’s abbreviate it as PBD for now) was informed by the wastefulness of factory farming, the negative health consequences of processed foods, and the lack of connection to food. I don’t think Pollan was ever against eating meat, he just advised not eating too much of it in this famous quote:

“Eat food. Not too much. Mostly plants.”

Now, reading through the Omnivore’s Dilemma, I have realized one more reason why people are so often confused. With the plethora of uninformative information on the internet, it’s much easier for our minds to stick to a phrase that clicks in our minds. The intricate details in Pollan’s books don’t filter their way through the average vegan’s consciousness. Instead only the eating plants part does. Perhaps one reason this was appreciated by the plant-based community is that “The China Study” was published just a year before “The Omnivore’s Dilemma.”

T. Colin Campbell claims to have conducted the largest epidemiological investigation into meat eating that ever existed, and claimed that meat eating, in China, a nation where meat has a strong place in the diet, increased mortality. Vegans around the world cheered.

I was vegan for an entire year, but I had a difficult time believing that red meat was inherently unhealthy based on my research. Nevertheless, Michael Pollan’s words amplified the PBD, and people immediately forgot that adding plants to meat isn’t wrong, and being vegan isn’t healthier than eating meat in moderation.

We live in a melting pot, in America at least. There is no traditional recipe for colds, flus, migraines, and no traditional food culture. This I believe is one inevitable reason why confusion exists. Pollan says the same thing, adding that this dearth of unifying beliefs increases individuals’ susceptibility to fad diets. Let me explain now why I think the PBD is just a massively confusing idea that should be discarded from your consciousness immediately.

Forget the plant-based diet, a balanced diet is better

As I explained in 2012 in this video, there is one single reason why the China Study fails. Denise Minger’s data analysis seemed to discredit many of the conclusions drawn from the observational study well enough, but I still had lingering questions. Below are the main ones:

  • What are the net health effects of eating meat as part of a balanced meal containing plants?
  • How is it even possible to statistically adjust for increased patterns of unhealthy behavior in people who eat too much meat?

I’m going to start with the second question. In large observational studies, we may conclude that eating more meat is unhealthy. But with statistics we can kind of take away the effects of smoking and a sedentary lifestyle. These adjusted analyses seem to find no evidence that eating more red meat is unhealthy. I’m not a statistician, so I’m not sure how math can figure this out honestly.

When one smokes, doesn’t move much, and eats more red meat, which in America implies more fast food, and likely more sugar and vegetable oil, how is it possible even to distinguish this type of meat eating from someone who eats meat with herbs, olive oil, salads, and is physically active?

There are synergistic effects of our lifestyle choices on our health. If eating a balanced diet results in “X” improvement to our health, and exercising results in “Y” improvement, a balanced diet and exercise together may result in something beyond just X and Y. Statistics however adds up X and Y, or in our case, subtracts it from the equation to determine what the effect of just eating meat is.

You can eat meat and be plant-based at the same time

Now let me answer the first question. I think most readers would agree that a double-patty cheeseburger from any chain fast food restaurant in America is a highly processed meal low in nutritional value that is not ideal for health.

But how healthy is it to eat a steak cooked with rosemary, with some salad, and baked potatoes? This is a fairly typical meal. We could argue about this all day and night, but the rosemary offers protection against any excess fatty acid oxidation in the meat as its cooked, while turning on anti-inflammatory pathways in the body like Nrf2. If the meat is grass-fed, it likely contains higher amounts of omega-3 and vitamin E. The steak in addition contains B-vitamins, zinc, carnosine, carnitine, and other health-promoting nutrients (I’m only isolating them because that’s how we’ve been taught to think about nutrition). The salad contains folate and stimualtes bitter receptors on your tongue that enhance the secretion of digestive enzymes.

The fast food meal containing red meat is high in refined carbohydrates, low in fiber, low in bitter tastes, contains cheap vegetable oils that are likely oxidized, and high-fructose corn syrup (in the ketchup). The meat is not good quality nor is it grass-fed. The overall effect of this meal is likely very very different from the overall effect of the second meal.

Here are some pictures of meals that I made recently (except for the lunch picture) that were plant and animal based at the same time. Let’s just call it a balanced diet.

Baked Oxtail and Potato
Shallots, garlic, soy sauce, and beef broth (cooked with carrots, onion, and shiitake mushrooms) went into the oxtail. Mustard oil was used to coat the potato wedges as they baked. This meal is certainly much more than just meat-based.

 

 

 

 

Lunch at an Indian Restaurant

This typical Indian restaurant lunch comes with chicken curry, chickpeas (chana), yoghurt with some veggies in it (raita), and a dessert. Many flavors balance this meal out from an Ayurveda perspective. It’s not anywhere close to being as balanced as a home-cooked meal, but I digress.

Tacos With Salsa, Radishes, Lime, and Onion

Tongue tacos served with tomatillo-haberno salsa. As in Mexico, I served this with raw radish slices. I garnished the tacos with cilantro and white onion (next picture).

Tacos de Lengua (Cow Tongue Tacos)

I sent this photo to a friend who replied “nice pinterest photo.” In case anyone else thinks that, I will just add that this photo was taken with an iphone6. It’s not even that great as parts of it are blurry since the lens can’t focus perfectly. Anyway, these tacos tasted like Mexico and I was proud of myself. The corn tortillas were non-GMO, and everything else was organic. This meal is at least 50% plant-based.

Conclusion

So although PBD advocates learn more towards veganism, and plants constitute perhaps upwards of 70% in their diets, for me, 30-50% is enough (from total calories). Perhaps in the future I will track based on calories and volume how plant-based my diet is, but a ballpark estimate seems good enough for this issue, as I’m not sure what the point of doing that would be anyway.

Adding herbs, spices, and vegetables to meals containing meat raised sustainably and healthfully is plant-based in my opinion. Not only that, the combination of plants and meat creates delicious meals that the vegan cannot emulate. There’s an instinctual drive to come elements in our environment to feed ourselves and our tribe, and I believe this universal predilection is quite health-promoting.

In contrast, cutting the meat out and focusing just on plants is shutting the door to millions of person-years of cultural wisdom (ok person-years is an epidemiological term but it applies here). Yes we are living longer than humans who lived in unsanitary conditions in the past. The diseases that kill us tend to show up after our reproductive years are over, so maybe people think that eating meat increases the likelihood of these diseases. But it’s possible to eat meat healthfully, as meat raised in an open environment eating grass has antioxidants, anti-aging nutrients like carnosine, and is nutrient-dense, and it can be flavored with herbs and spices, and then finally served with more plants. Thus, I am all for combining plants and meats together. I need my turmeric.

As you filter through the swath of information on health, I hope articles like this help you make sense of things and encourage critical thinking. What are your thoughts? How plant-based are you? Comment below and continue seeking balance!

In India, beef is rarely eaten. Cows are rarely slaughtered, and if they are, violence may ensue over it. As an American-born Indian man, I never took up Hinduism, and I eat beef. (Funnily, those back in the motherland call us “American-born confused desis,” desi meaning Indian).

Traditional wisdom regarding how to eat food does not imply that we must abide by rules and regulations. At least, that’s how I see it. Considering the melting pot that is the world, why not blend the creativity and knowledge from different peoples to create a NEW product?

Well that’s kind of what we have here today. In this post I will share the basics of cooking an Indian style curry.

I don’t have all the pictures unfortunately, but I will make more detailed posts in the future.

For this recipe you will need the following ingredients:

  • Beef liver, chopped into cubes
  • Bay leaves (3-4)
  • Cardamom seeds, whole (1 tsp)
  • Turmeric, powdered
  • Ginger, chopped finely
  • Garlic, chopped finely
  • 1 small tomato, chopped.
  • Dried or fresh chili pepper
  • Water
  • Rice or Apple cider vinegar

Note that I have some quantities listed above, but please eyeball it and adjust accordingly. The above quantities are for a one-person meal. I am working on refining my methods so that I have more precise amounts of ingredients used so I can consistently make the same dish over and over as well as teach it.

Remember to source organically as much as you can. The liver in this picture came from an animal that I had the privilege of seeing slaughtered that same day. The animal lived happily on a local farm and ate a wide variety of grasses and other plants. Go to a local farmer’s market or find a farmer near you who provides fresh foods. Source tomatoes organically as well, as these crops have some of the most pesticides on them when raised conventionally. Below is a picture of the liver…very fresh.

I grew up in an American suburb. I never hung out on farms, hunted, fished, or grew my own food. But now, I'm spending time doing these things. Today, I witnessed multiple animals get slaughtered for the first time ever. When I saw the bull get opened up, I realized that the insides looked quite juicy, healthy, and nourishing as a food. This led me to conclude that I am on the right path as a conscious meat eater. Put yourself in the shoes of a pre-modern human trying to get some meat. Meat isn't an unlimited resource in this environment (unless it is farmed/herded/raised). It takes more work than sliding a credit card before you can cook the meat yourself and eat it. This leads to a better understanding of how valuable an animal's meat is. Using all parts of the animal just seems to me like a respectful thing to do after you kill an animal for its meat. Not overeating meats also seems like a good choice for long term health and sustainability. When a massive population needs to be fed, it's not as likely to happen this way. I'm glad though there are conscious farmers out there who still practice this way. #connect #to #the #source #food #health #conscious #meat #protein

A post shared by Avishek Saha (@sbcahealth) on

Now there are many ways to cook an Indian-style meal. The difference between a seasoned cook and an amateur lies in the taste of the product, rather than the look. It’s easy to make it look good, but it may be too watery, too dry, too hot, or too mild. The blend of spices must create a palatable sauce that does not overpower the senses. Many people think of Indian food as very spicy; it can be, but not all spices are hot. Since many people seem to interchange spicy with hot, this leads to a lot of confusion. Cardamom is not hot, but it is a spice. A spiced sweet chai with cardamom and ginger however wouldn’t have many people calling it spicy. But order some spicy food at an Indian restaurant, and you will expect something hot, even though everything on the menu has spices in it.

Never overdo the spices in a curry dish. Seek a balance. That being said, here is the recipe.

Step by step recipe:

  1. First, coat the liver cubes in turmeric powder and salt (I prefer Himalayan pink sea salt) and mix well. I prefer to coat the meat in turmeric lightly. This is a standard step in many Indian dishes.
  2. Add some oil to the pan and turn up the heat to medium or medium-high. I used mustard oil, a common oil used in India (you can find it in an Indian grocery store). I often use coconut oil as well. Avoid canola, soy, safflower, and corn oil. Those cheap vegetable oils are not healthy.
  3. Add bay leaf, cumin, and whole cardamom seeds to the pan. Let the spices heat in the oil for a few minutes.
  4. Add tomato slices. This adds some juice to the curry. Adjust the heat so that it’s not too hot unless you’re a frying expert.
  5. Add chopped onions, garlic, and ginger.
  6. Add vinegar, about 1 tbsp should do.
  7. After a minute of frying, add enough water (I prefer spring water) so that all the ingredients are simmering in a layer of it. Cook everything in the mixture for another 10 minutes, adding water periodically so that nothing goes dry.
  8. Add the liver cubes. Keep heat on medium and cook until meat is finished. (Approximately 15 minutes).
  9. Make sure to add water periodically, and add salt to taste (I like to take a spoon and taste a small amount of sauce to determine if it needs salt. Sometimes the amount of the salt that was added to the meat before adding it to the pan is enough, sometimes not).

You should end up with a yellow-ish curry! That’s it for now. Enjoy.

 

Beef Liver Curry - Indian Style! Sub Heading

The other day in homeopathy class the idea of the holographic universe popped into my head once again. There is this idea in homeopathy called “layers.” Some people have layers that need to be peeled before the disease can be treated with homeopathy.

But according to newer schools of thought, this layer idea doesn’t make sense. If there is a pathology somewhere, it will be reflected in those layers. It won’t just hide, dormant, until exposed by the peeling back of layers.

Regardless of whether or not you believe homeopathy makes sense, this discussion in class reminded me that in a holographic universe, it would be impossible for the layer theory to be true. Pathology would have to be reflected to the outside.

Then I started thinking about other things I learned. I remember reading in a book or perhaps hearing at a talk somewhere that there is an energy body, an astral body, and an etheric body. Disease begins in the energy body much of the time before manifesting in the physical body.

I can’t say I’ve ever seen disease manifest in the energy body, but I read in “Anatomy of the Spirit” by Caroline Myss that this is how things worked. She was a medical intuitive, and could tell what was going on with someone just by looking at their picture. She was looking at the energy body.

Then I thought about iridology, a way of diagnosing disease that looks at patterns of the iris. The idea is that pathology shows up in the iris in a predictable way. This belief is shared in biological dentistry; different teeth correspond to different organs, just like different parts of the iris do. In reflexology different points on the foot correspond to different organ systems. With acupuncture and Chinese medicine it’s the same.

The information in a holograph is found throughout the entire holograph. If you take a slice of it out, all the information about the universe is contained in that slice, albeit less of it the smaller the slice is. It seems as if the body is a holograph and we can deduce information about the health of our internal organs without invasive methods.

I’m reading a book on pendulums now and it claims that you can use them to detect the sex of a baby in the womb!

My goal here is to discover the truth. And my life’s experiences are leading me to believe that the universe is truly holographic and there already seems to be robust study on this topic.

I read “The Holographic Universe” by Michael Talbot years ago (I think 2012). I can’t say it made any sense until recently.

Here’s a little backstory. Both of my parents are from India. They emphasized education; after all, it’s how they got here (to the states). Growing up, education was a big part of my life. I learned to be extremely logical. Part of that certainly was my own personality but the way I was raised played a large role in this as well.

Anyway, growing up, I tended to fight my instincts, only to realize they were right. I had no idea how to stop doing this but I made the intention to listen to my instincts. In my early twenties I started getting better at it. Eventually, I started seeing what an instinct was (I’ll make another post about it and update this). Instincts are the signals that come to you immediately. You don’t have to think about it for a long time. It just comes to you, immediately. It’s a sense and a feeling.

As my instinctual abilities grow stronger, I notice that other people can read me better. I told the grocery clerk “I’m cleaning shit today” after he asked me how I was doing, and he correctly guessed that I was moving. That day I had two other experiences like this where people pretty much read me accurately.

Instinct is highly related to the concept of the holographic universe. If you have an instinct about something, you are picking up an energy from whatever that thing is, and you then have a feeling about it. It doesn’t have to make any sense, but it’s there and it’s inarguable.

So if we’re all connected it means we have more information than we ever realized. We have a lot of awareness and knowledge. Modern science doesn’t have any more to tell us than what we have discovered collectively as a species already since we evolved into who we are.

Deepak Chopra was right, and some people just seem to get this stuff. They’re on a certain wavelength, frequency, and whatever you may call it. Everyone else just thinks this is crazy. But my question is if it’s crazy, why are these experiences and ideas so universal?

Why do people around the world use cod liver oil, spices, herbs, and have knowledge on healing from existing in harmony with nature? Why did physicians in India and China believe that the body was electric (another good book “The Body Electric“). How do shamans talk to plants (I believe this may be answered in “The Cosmic Serpent” which I will read once my friend finishes it). And why is it that fighting nature, the way modern medicine does, leads to so much confusion? New drugs, new vaccines, and new theories can be expected every few years.

There are no laws in modern medicine. But the laws that govern natural medicine are the same laws that govern the universe. I don’t have any studies proving this right now, but it’s just a thought.

 

Saturated fat…here is part three, where we will discuss the research on the topic.

Recap

In part one I discussed the problems with relying on science in general. Some people like accepting the “scientific consensus” on something because it seems safe to go along with majority opinion. The problem with this strategy is that you don’t end up doing the research yourself. When you do, you may find something the majority did not. Also, the conventional point of view regarding all public health related matters is not always based on evidence. We could debate that all day.

In part two I described the idea of food synergy, and why this is a missing link in nutrition science research.

In this final segment I will share what the actual research shows regarding saturated fat intake and cholesterol intake on your health. In addition, I will show you how to find this research easily.

What is the research question?

We will shortly go to pubmed to search for studies on saturated fat and cholesterol consumption. Before we go to pubmed, let’s first clarify our research question. The research question I am answering in this post is “what is the effect of saturated fat and cholesterol intake on cardiovascular disease (CVD) and all-cause mortality?” This is a specific question. “Is saturated fat bad for you” is NOT a specific question. In the research world you need specific questions for a few reasons.

For one, a specific question is easier to study and the results are easier to draw a conclusion from. If we were to design a research study to answer if saturated fat was good for you in general we would probably be answering a lot of other specific questions. We could assess if it’s good for your health, which leads to more specific questions about health. But we could also ask if it makes you feel good to eat it, which is an entirely different question. If we didn’t ask specific questions, and say just designed a survey that asked people if they thought saturated fat was good for you, and they could answer in an open ended way, our data would be quite jumbled and not as meaningful to interpret.

The effect of saturated fat, if any, on cardiovascular disease outcomes and all-cause mortality asks two different questions. The first question is looking at saturated fat and cardiovascular disease outcomes. We could define those outcomes as total heart attacks, deaths from heart attacks, number of strokes, deaths from stroke, and diagnosis of cardiovascular disease.

The second question asks if there is a relationship between saturated fat intake and all-cause mortality. All-cause mortality means death from any cause. Smoking, being sedentary, and eating a standard American diet (high sugar, high amount of processed foods, low antioxidant intake) increases your chances of dying in general from any cause. Generally, unhealthy things make you die sooner, so that is the idea this question is getting at.

Death from a specific cause or any cause is arguably the most important outcome from a medical standpoint. I personally care about all the things leading to death (because we may be living somewhat longer in modern times but it’s questionable if we are healthier), but getting wrapped up in the details sometimes isn’t very fruitful. Drugs for example may reduce risk factors for a disease but make you die sooner from that disease through some unknown mechanism or from some other disease, making the drug pointless.

The other research question is the same, but we will replace saturated fat with cholesterol to get this: “what is the effect of cholesterol intake on cardiovascular disease and all cause mortality?”

What is cardiovascular disease…

The next point I want to make before discussing the research is that cardiovascular disease is sometimes interchanged with heart disease and neither are a single entity. There are a multitude of afflictions affecting the heart, including coronary artery disease (CAD), peripheral artery disease (PAD), ischemic heart disease (IHD), angina pectoris, stroke, arteriosclerosis, hypertension, cardiomyopathies, aortic aneurysm, congestive heart failure, and valvular disorders. Many of them may involve atherosclerosis (plaque build up inside arteries, impeding blood flow). Cardiovascular disease affects the heart, either due to a dysfunction with the heart itself, plaque buildup in the coronary artery, or plaque buildup throughout the vasculature, making it harder for the heart to do its job.

So what is heart health?

In general, if something improves heart health it helps the heart do its job better. If you have lower extremity artery disease (LEAD), something good for promoting blood flow in the lower extremity arteries may improve the return of blood to the heart which could help it pump more effectively. In congestive heart failure, depending on what is causing it, treating that root cause will help the heart pump blood better, reducing stress on the myocytes (name of the cells composing the heart). Off the top of my head, I’m thinking maybe beet juice could help with this, as it promotes blood flow and nitric oxide signaling (many things do this), which dilates the arteries, enhancing blood flow. This might work. It depends on the type of CHF and cause, along with the individual person.

What is mostly true is that many heart diseases can be prevented by not smoking, limiting alcohol intake, exercising regularly, and eating a varied diet rich in antioxidants and nutrients. Most of the diseases that kill people most likely can be prevented this way.

Finding the research

Let’s go to pubmed now and look for some research. I’ve learned a few things from my research classes about getting a good search result here. It takes practice. So watch first what happens when I type in “saturated fat” in the search box.

Not bad actually, when you have “best match” chosen (circled). If you chose instead “most recent” you would get less relevant results. Try it out yourself. We will definitely look at articles 2 and 4 (check marked).

The thinner circles at the bottom bring up the next subject. Instead of pouring through individual studies, we can look for systematic reviews or meta-analyses. Dr. Uman defines these two terms in her article as follows:

“Systematic reviews, as the name implies, typically involve a detailed and comprehensive plan and search strategy derived a priori, with the goal of reducing bias by identifying, appraising, and synthesizing all relevant studies on a particular topic. Often, systematic reviews include a meta-analysis component which involves using statistical techniques to synthesize the data from several studies into a single quantitative estimate or summary effect size (Petticrew & Roberts, 2006).”

Reviews just review what’s out there, and a meta-analysis takes a bunch of studies, pools their data, and performs a new statistical analysis.

Refining the search

We will now search “saturated fat intake cardiovascular disease all cause mortality,” checking just systematic reviews and meta analyses. 13 results show up.

Not bad. Now we will go one step further and go to the advanced search. Click “advanced” below the search box. We are now going to tell the search feature to look for all studies matching two different search phrases. You can simultaneously search for two things at once with one search by using the phrase OR. My search query is now “saturated fat intake AND cardiovascular disease OR saturated fat intake AND all cause mortality.”

17 results! WOW. Just kidding…the 4 additional studies here aren’t really answering our question. So in this case the advanced search wasn’t necessary.

Now let’s compare this to google searching. To my surprise, there is one article (circled below) that did not show up in my pubmed search results. I’ll have to ask my professor about that. One of the other articles that shows up was in my search results.

We will talk about the article shortly. Next, let’s click on “scholarly articles” (where the arrows are pointing). To my surprise, most of the articles on the first page aren’t answering my question.

I’m not interested in flavonoid intake google! Well atually I am but not right now. I am drinking some pour over coffee I made myself and there are flavonoids and polyphenols in there.

Article discussion time

One of the articles google found was not in my pubmed search. This article is titled “Food Sources of Saturated Fat and the Association With Mortality: A Meta-Analysis.” The researchers here set out to answer a few different questions. They were interested in whether or not a high consumption of foods containing saturated fat increased all cause mortality, cardiovascular disease mortality, or cancer mortality. They found a slight inverse association with milk, a low positive association with meat, and a moderately positive association with processed meat consumption. In general they said the evidence is too weak to support the idea that eating meat promotes mortality from all causes. They reviewed 26 different studies. That study deserves a separate post. I will keep it brief here as we still have to talk about cholesterol after this.

The second study I want to discuss is titled “Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies” (it’s a free article). They answered the same questions I want to answer (we can decide if their answer is definitive or not) and a few more. They look for an association with saturated and trans unsaturated fat with all cause mortality, CHD mortality, CVD mortality, CVD incidence, ischemic stroke, and diabetes incidence. They found no association with saturated fat and all cause mortality or cardiovascular disease. For trans fat though it’s a different story; they differentiated between natural trans fats (the ones found in grass fed meat and milk) and industrial trans fats (products of hydrogenation of vegetable oils commonly found in processed foods). Total trans fat intake was associated with a statistically significant increase in all cause mortality. Ruminant trans fats were inversely associated with diabetes (but no association was seen with cardiovascular disease). This association was the strongest out of any other association in the study, and warrants a future post.

There are plenty of other articles like these you can find from the pubmed search we went through. In general it seems as if there is no association whatsoever with saturated fat intake and cardiovascular disease or all cause mortality. In part four we will discuss the strength of these findings and come to a conclusion on whether or not we should agree with this.

Cholesterol intake

Using the methods above, I searched for “cholesterol intake cardiovascular disease.” I found a paper titled “Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis.” This paper answered many questions. One of them was if cholesterol intake had an effect on VLDL (very low density lipoprotein). This is one of the “bad” cholesterols, but it’s not so simple. They evaluated three different trials to answer this question and basically found no association. They also didn’t find much association with cholesterol intake and other serum lipids in general.

They found six different trials investigating cholesterol intake on coronary artery disease (CAD). Only one (a study in a Japanese population) found a statistically significant association. For the rest no positive association was found. Cholesterol intake also had no effect on death from CAD, except in one study where an effect was seen in men who consumed about 430 mg of cholesterol per day. This study had more vegetarians than omnivores, so there could be something else mediating this relationship. 430 mg of cholesterol a day is about a few eggs worth. This may sound alarming but it’s not, as it was just one study, and many other factors could have potentiated this positive relationship. I will have to look into that study separately.

Other studies they evaluated found no association with cholesterol intake and any CVD. Whether its CAD or CVD the results are pretty consistent that there is no positive relationship between cholesterol intake and those diseases. I don’t think they answered all cause mortality so we will just skip over that for now and say don’t worry about it!

Conclusion: In general when studies are discussed we should look at their methods, the population studied, and the outcomes they assessed, in more detail. Here I am just sharing the overall conclusions from some of the most robust analyses on the questions we chose to answer. If there was a huge effect of eating more saturated fat, which is naturally found in milk, cheese, butter, meat, and coconuts, on your heart health, we would expect to see its effect in such large studies where tens of thousands of people are evaluated. There is strength in numbers; the larger the population size the stronger the conclusion from statistical analyses one can draw.

The downside is that individuality is lost. What about meat eating among those who follow a paleo diet versus meat eating in those who follow a standard American diet versus those who eat meat in moderation and try to be healthy but aren’t strict about following a diet? Those are all different populations and I’d have to do more digging to see if studies have been done on these populations. For now, it’s settled. Saturated fat won’t kill you. Eating cholesterol doesn’t cause heart attacks and likely has no relationship with all cause mortality. Emphasize whole food once again and try to connect to nature as much as you can. Choose grass-fed meat whenever possible. Choose pasture-raised eggs. Be proactive about what’s going in to your dinner plate. I know I could even improve in that with my busy lifestyle! I have a quiz tomorrow morning I have barely studied for!

In part four I will talk more about statistics and how to draw conclusions from studies like the ones we analyzed. Hope you learned something.

Stay tuned!

I’m also on Instagram, Twitter, and Facebook @sbcahealth. There is no newsletter at the current time. I may start one eventually but right now it’s not necessary! If you have questions about health you can also email me (stopbeingconfusedabouthealth@gmail.com).

I read the blood type diet years ago. I then read the Genotype Diet, an updated version of that book. In the latter one, naturopathic physician Dr. Peter J. D’Adamo devised a litany of physical measurements to determine what type of diet is best for one’s health in addition to the detailed reasons he outlined supporting his Blood Type Diet book published years before.

His work, based off of years of research and experimentation, was deemed debunked. People read about it online in press articles and decided that it wasn’t worth looking into. The BTD was now unscientific, just like all naturopaths apparently! Dr. Michael Greger, a highly biased vegan-diet-promoting doctor who cherry picks scientific studies and who I have even found to manipulate data to support his viewpoints published a critique. There was one on quackwatch too which is not a site I find trustworthy, to say the least.

As I have outlined in previous posts, like in a recent one about the saturated fat myth, science is often unable to study the complexities of reality. The study that “debunked” the blood-type diet did not really use the blood type diet. Dr. D’Adamo’s response to it addressed this and much more. His critique included that skeptics tend to never express curiosity. They come from a place of dismissiveness.

This was part of his response:

“A look at the core data used in the PLOS Study [1] debunking the Blood Type Diet (BTD) finds support for the researcher’s conclusions that if your experimental subjects eat potato chips, sandwiches, pizza, ‘beans,’ mac-and-cheese, French Fries and processed meat products while doing 13.7% of the Blood Type Diet, their final cardiometabolic markers will probably not vary much by blood type.”

If you want to learn about the blood type diet one day and read about how it was debunked but never do any research beyond that yourself, you have not honored your curiosity. You have not followed the scientific method. You have relied on “science” that someone else did to arrive at your conclusion about how things work. And you are wrong.

End of story.

I am not going to provide a detailed explanation on why I like the blood type diet. The main reason is that it is idividualized and based on trial, error, and lots of experimentation. Although I have no idea why some types can eat manchengo cheese and others cannot, I am open to the idea that some types may be more sensitive to certain proteins. I think that was his theory but I’ll have to save this discussion for a future post. There may be flaws to it but unlike other diets, it was devised by someone who seemed to put in more time and effort into it than people usually do it diet books. Based on these observations I do not think that the blood type diet debunking study came anywhere close to debunking the success stories people have had with it.

 

In part one, I rambled about how modern science has flaws and thus cannot be trusted in nutrition research sometimes. With saturated fat and cholesterol science, the research is often on people who have unhealthy lifestyles. As a result, red meat has become the villain. Eggs and steak aren’t bad for you folks. From these studies people will say eat more fruits and vegetables for nutrition. Eggs and meat are some of the most nutrient-dense foods out there. Have you ever eaten a steak and felt like your brain worked better afterwards? I have. That is science folks. Science isn’t just going to pubmed and finding articles to support your theories. That’s reading science. Doing science involves experimentation. Your career description does not need to read “scientist” for you to practice science. Your career may be listed as “scientist” and you may not be doing science sometimes because of your biases.

Knowing that I feel better sometimes from eating meat shows me that on some level it is good for me. In other ways, it certainly may not be good for me and I am open to multiple possibilities. Unfortunately people with their heads up their asses call this anecdotal evidence, ranking it too low to be considered legitimate on the hierarchy of evidence. BULLSHIT! I am completely opposed to that idea. Anecdote is often not reliable. But it can become reliable with careful experimentation.

Now one way eating lots of red meat may not be good for me is because I am only eating the muscle component of the animal most of the time. I am not eating the collagen-rich parts like organ means and making broth from the bones. Lately, I’ve been lazy and have been feeling too busy in medical school to devise a holistic nutrition plan for myself that involves organ meat consumption and use of the whole animal. I don’t farm and am not as connected to my food as I should be. Modern science that concludes meat consumption in Americans on the standard American diet is bad for everyone is also coming from a place of extreme disconnectedness to food. We are modern and fashionable but disconnected to the dirt underneath the cement underneath the carpet underneath the sock underneath our feet supporting our bodyweight.

So that in a gist is part one. In this post I will go through a different thought experiment to prove to you why you cannot rely on studies on meat consumption.

Why epidemiological studies on saturated fat consumption should not be trusted

First of all, these studies actually show no association with heart disease. STILL however people condemn saturated fat. Like HELLO PEOPLE. READ THE LITERATURE YOURSELF. Nevertheless, back in the day when the sugar companies made fat the public enemy to increase the epidemic of obesity in America while profiting off of sugar sales, people went on low fat diets. Large studies like the Nurses Health Study (NHS) and Health Professionals Follow-Up Study (HPFS) have attempted to answer questions about how to live healthfully. Briefly, epidemiology is about studying a population (like nurses in the NHS) and attempting to find a pattern between a factor in their lifestyle and an outcome. Outcomes might include death for example which is the most important one, or maybe a risk factor for death like low HDL and high triglycerides.

Now, it’s clear that low fat diets don’t do much for your health except in certain situations. I only believe in individualized and intuitive eating for optimal health. I believe in the Blood Type Diet by Dr. D’Adamo. It’s individualized. I don’t believe in Whole30. That is a one-size fits all kapha-reducing weight-loss program (kapha is basically like obesogenic in Ayurveda. Diets that eliminate heavy foods are kapha-reducing from that perspective and I think the lingo is easy to understand. People who diet and exercise too much lower their kapha and yin to unhealthy levels and suffer health problems). Whole30 caught on because people mistakenly associate weight loss with health (even medical students fall for this trap). Only true in some cases. Like the person on the standard American diet.

So take my diet. I will make a dinner like in this photo frequently.

Dinner: random vegetables, garlic, meat, some other spices perhaps.

I’ll take some healthy oil, like coconut oil, toasted sesame oil, butter, ghee, and NOT canola oil, corn, safflower, or soy oil (avoid vegetable oils as if your life depended on it) and heat it up. I may have spices on the pan already dry roasting like cumin. I add vegetables to it like onions and tomatoes perhaps. I may add some more spices. I will add more vegetables and meat and salt and just cook that food.

I will eat this meal with some type of carbohydrate like rice (brown, red, and white) or buckwheat noodles or starch-rich yellow potatoes. Once in a while I’ll have lentils (daal made bengali style, one of my comfort foods) with this meal to reduce carbohydrate consumption (unfortunately my extended family despite eating a spice-rich diet that protects DNA also enjoys a high white rice diet without accompanying physical activity resulting in obesity and diabetes).

Now please tell me this. Has a study ever been done evaluating how the effect of cumin, coriander, black pepper, onions, spinach, mushrooms, and tomatoes, cooked together in a meal with RED MEAT the VILLAIN hurts my health? HAS THAT STUDY THEN CONSIDERED THE REST OF OUR LIFESTYLES (LIKE EXERCISE HABITS, STRESS, ETC.) AND BEEN ABLE TO PROVIDE AN APPLICABLE CONCLUSION FOR MY HEALTH???

The WHOLE POINT, or RAISON D’ÊTRE (I love how expressive the French are with anger) of epidemiology is to find something that APPLIES TO THE GENERAL POPULATION. When the grandfather of epidemiology found in 1853 after meticulously tracking the public water supply in London that water contaminated with people’s shit and piss was causing the vast majority of illness from cholera, he found something applicable to the whole population. There were two water companies in town. One had pipes right next to shit and piss and the other did not. The ratio of illnesses was like 71:5. Pretty god damn obvious there. Correlation does not equal causation in epidemiology. But to common sense, it does. When the correlation is that high and people are dying of cholera, you should just assume causation.

Meat consumption fortunately doesn’t cause people to drop dead like drinking eight glasses of shit and piss-infused water (might as well call it tea at this point or a tincture) does. Unfortunately, it is harder to find cause and effect relationships with foods, herbs, exercise, and so on. You can exercise and still be unhealthy if the rest of your lifestyle is. So if we cannot rely on epidemiology to tell us if meat is healthy how can we answer the effect of meat on our health?

Synergy

The answer to this question lies in the concept of synergy. When you mix red with blue you get purple. Purple contains both red and blue, but the effect it has on you when you look at it is not simply a mix of the effect of viewing the color red and viewing the color blue. Purple is a relaxing yet luring color to me. I associate it with mysticism (what do you feel when you see purple?) Red is more fiery, sensual, and loud. Blue is cooling, stable, and chill, yet powerful. Of course, this is very subjective but hear me out (science actually is more subjective than people realize). The feeling I get when I look at something purple is not the feeling I get from viewing blue plus the feelings I get from viewing red divided by two. The effect is entirely different. It is new. it is not 1 + 1 = 2.

Thus, when determining how eating red meat and spinach together affects health, we should expect some additive properties (one plus one equals two), some cancelling effects (one minus one equals zero), and some novel synergistic effects (one plus A equals god knows what) that cannot be explained by adding together studies looking solely at meat consumption with studies looking solely at spinach or dark leafy green consumption (or n of one experiments where you just eat meat and see you how feel and just eat spinach and see how you feel then add those up and average them–of course adding up qualitative things to average makes no sense but you get the point). Add stress to the equation and physical activity and you have more room for synergy. There are a million, literally, additional factors that can affect this process.

Red meat itself has so many synergistic compounds in it. Yes there is some saturated fat and cholesterol. Rats and mice fed high cholesterol and high saturated fat diets may end up with clogged arteries, but that is not because just of the saturated fat and cholesterol but because of the unnaturalness of the diet, the inability to process those fats and metabolize them like humans do, and for a variety of other reasons. Regardless that diet does not contain vitamin B12 found in red meat, or alpha-lipoic acid a powerful anti-aging anti-oxidant compound, nor does it contain L-carnitine which helps shuttle fatty acids to the mitochondria for fat oxidation, nor does it contain carnosine another energy-promoting anti-aging nutrient, nor does that diet contain heme-iron which is a highly absorbable and digestible form of iron, nor does that disgusting abominable diet off of which so much catastrophe has ensued from inapplicable laboratory research contain the other combination of B-vitamins in red meat, nor OLEIC ACID THE HEART-HEALTHY fat in OLIVE OIL of which there is almost as much of as saturated fat in red meat (Gary Taubes talked about this a lot and although I think his low-carb hysteria wasn’t entirely true he is a pioneer in nutrition science without even having a degree–goes to show you who you can trust, as while he discusses the evils of carbohydrates the Dean of nutrition programs at top universities condemn organic food and tell you breakfast cereal from Kellogg is healthy because it is enriched with vitamins but mainly because those companies are affiliated with the university somehow…yea don’t study nutrition at a big university or become a registered dietician if you aren’t ready to swallow conventional bullcrap), nor the omega-3 fatty acids present in GRASS-FED beef, and how there is actually less arachidonic acid in grass-fed meat, as well as more vitamin E. Oh man, the list goes on and on.

I’m taking a nutrition class right now that discusses the effects of supplemental minerals and vitamins on health. The studies have examined one nutrient at a time but your body never works that way. Yea sure supplemental vitamin C may reduce this this and that but the whole food will do the same and more things many of which are unpredictable due to the concept of synergy.

Conclusion on synergy

I have rambled a lot so here is the take away about synergy, which was the entire point of part II. Synergy happens when you eat a whole food versus a supplemental vitamin. Red meat for example contains many vitamins and minerals, antioxidant and anti-aging compounds, and omega-3 fatty acids if grass-fed. The synergistic effect of this on your health cannot be predicted from studying the scientific literature on each one of these single nutrients. You may gain an idea but will not know the exact effect.

Part of the reason why you’ll never know is because the synergy also involves how the whole food interacts with the WHOLE YOU. You are a combination of your genetics and environment. Nature and nurture. Your stress levels, physical activity, social actiites, personality, overall happiness, television usage, phone usage, and other factors will affect how red meat affects you physiologically and energetically. This will sound like mumbo jumbo to people who only know how to think reductionistially, like my former self years ago. But lets look at physical activity. Eating carbohydrates after exercising has a different effect than eating those same amount of carbohydrates resting. Although other factors don’t have such noticeably strong effects, there is something happening. I honestly ate dinner today while psychologicaly stressed about something that happened to me reently at school. I very likely did not digest that food as well as I would have if I were at peace mentally, as the mind is connected ot the heart which is connected to the lungs, which is connected to everything else. Indeed as I tried to fall asleep I realized I hadn’t eaten enough and this was mildly stressful as it’s harder to fall asleep. I practiced some stress reduction techniques and slept well.

Final statements for part II.

I am once again not citing any literature, because that is a diversion from doing science yourself. You must take it upon yourself to practice observation, hypothesis formation, experimentation, analysis, then reproduction and expansion of previous experiments, to form valid concludions about what works for your health. Unfortunately, no one is going to figure it out for you.

The studies are limited in design by how much they can truly see. A good scientific study has to have a simple research question that can isolate the effect of one treatment/condition. In this case that would be say, red meat consumption. That study will not factor in exercise, smoking, and all the other factors. The statistial analysis will aim to remove those variables but still, the conclusion will not apply to the guy like me who exercises, eats spices, vegetables, meditates from time to time and tries to be healthy and eats meat. I’m too rare, even though my I shouldn’t be as my diet should be much much better. It’s just that those studies will look at average people who really aren’t doing much for their health. Of course, if red meat was a potent neurotoxin, we would see an effect no matter what and it would be strong. But when the effects aren’t like that, it gets way murkier and that’s why I have shied away from analyzing that kind of literature. I still read nutrition science literature from time to time but always think about how applicable it truly is to the general population. Not much usually I don’t think.

That’s it for part two. In part three I will share the latest research on the subject of dietary cholesterol and saturated fat. Stay tuned!

On a recent instagram post about red meat, where I suggested that meat is not bad for you, someone commented that I was a charlatan and that the science was in consensus about the health dangers of red meat consumption.

Now I’ve received comments like this before, from having a youtube channel and discussing non-mainstream views on health. Calling naturopaths quacks and charlatans is done without thought by those who get their medical education from the internet or spend too much time believing what they learned through conventional routes of medical education.

What I did find interesting was the term he used–“scientific consensus.” It reminded me of the scientific consensus that climate change is happening.

Without reading the literature on climate change I am inclined to believe that the scientific consensus is onto something. I’ve heard many times that the sea level is rising, glaciers are melting, and animals are going extinct because of climate change. I can believe that. I’ve watched planet earth on netflix and short films by National Geographic that have clearly shown me that there is a change in the climate. Beyond that, I have no idea as I have not studied the details. I just recycle and aim to reuse what I can.

But is there a scientific consensus that red meat consumption is bad for your health? Well, I am going to break down the science for you, without citing it, because it’s a huge waste of time. If I cite research for you, I will have you making the same mistake the Instagram commenter did. Instead of talking about science that has been published, we are going to think about our own unique scientific experiment (in part two especially). If I cited research that shows no association between saturated fat consumption and all-cause mortality, you might be more likely to believe me, but would you keep reading and be stimulated to construct the big picture as we will do now? I doubt it. Most likely, people will say, “okay cool I can eat red meat” and move on. Well yes you definitely can but here’s why.

Why people think red meat is bad

The two bad things in red meat that are mistakenly attributed to be the cause of its alleged negative health effects are saturated fat and cholesterol. Since pharmaceutical companies have successfully spent billions of dollars convincing patients that cholesterol is a bad guy and that lowering it will improve cardiovascular disease outcomes, red meat seems like a bad idea. It’s mind-boggling that all of this is a huge lie.

The other day a middle-aged gray-haired male was reading side effects of a statin his doctor was interested in him taking at an Indian restaurant where I indulged in a buffet after fasting. This man was also seeing a naturopath, since we were in Oregon where a lot of insurance companies cover naturopathic primary care (they do what MD’s do, and prescribe some herbs along the way depending on how naturopathic they are; unfortunately many have compromised their values but that is another discussion). I started a conversation with him.

“Have you heard of red yeast rice (RYR)?”

“Ah yes, I have! What are your thoughts on that?”

“Well, I recommend it. It actually contains lovastatin. 40 mg of RYR will contain about 10 mg lovastatin, while working just as well as 40 mg of lovastatin. You also get other compounds in there so instead of just one that blocks the crap out of one enzymatic pathway you have more than just one mechanism of action. Furthermore, since you use less statin, you have less muscle cramping and more CoQ10, an important mitochondrial factor that aids in energy production and declines with age. See if you’re on a statin you might have less exercise tolerance because of your reduced CoQ10. It’s just a theory as there aren’t a whole lot of studies on this but exercse is very good for heart health so it’s ironic to me that being on a statin can inhibit your ability to derive the benefits of something you should be doing for your health.”

This individual was very happy I spoke with him.

People who like listening to the “scientific consensus” tend to place too much trust in published research and don’t seem to investigate the matter on their own. They hope that things are right but there are always missing pieces of information. They will say that statins have shown reduced risk of major adverse cardiovascular events and that the benefit of treatment outweighed the risks. It sounds wonderful, but they don’t think holistically, as I attempted to demonstrate above in my conversation with this man. If we are interested in health, we need to go beyond outcome measures and look inwards.

That should answer whether or not saturated fat is bad for you. The research shows X, or Y, or Z, but doesn’t consider everything in between. Research may have shown in the past that a high fat diet fed to mice led to increased aortic plaques and a reduced lifespan. Substitution of the saturated fats with polyunsaturated fats diminished this increased adverse effect. Although compelling, we don’t eat the way mice and rats do in these studies. And that’s why the large studies have found no effect from saturated fat consumption and heart attacks (to be discussed in part three).

Studying a real diet is often too complicated for research purposes. Research must have clearly defined outcome measures, interventions, populations, and control groups. What goes on your plate is not as clearly defined as a saturated fat.

In part two of this segment, I will begin the discussion on why red meat actually isn’t bad for you with an emphasis on holistic thinking. This post was meant to I guess get the thinking process started. Stay tuned!

Coffee pops up in the news every now and then, especially when large population-based studies like the one we are about to discuss are published. Usually people have no reason to fear, but skeptics exist.

There has been research showing increased mortality in folks consuming upwards of 6 cups of coffee a day. The thing is, those people smoke a lot more. Once the effects of smoking are removed from the equation (in a type of statistical analysis called a regression analysis) these ill effects disappear.

The study, titled “Association of Coffee Consumption with Total and Cause-Specific Mortality in Three Large Prospective Cohorts,” investigated the relationship between smoking and coffee consumption on mortality (death). They also looked at cause-specific mortality: deaths from specific diseases.

So here’s what happened. They took data from three different prospective cohort studies. These types of studies take a group (a cohort) of ideally randomly selected people, take some kind of measurement or collect data from a survey, then check up with them way later in the future and see what happened to them. In this case they looked just at death (these people were followed up for a long time).

The researchers collected data from three different studies: the Nurses’ Health Study (NHS), the Nurses’ Health Study II (NHSII), and the Health Professionals Follow-up Study (HPFS). These large studies began collecting data many years ago. They consist of medical professionals like nurses and doctors. The details if you are interested are listed under “study population” in the paper. It’s very important to know what population was studied when you read a paper and then ask yourself if the results of the study are generalizable to the rest of the population.

The NHS collected data from women only, and the HPFS, men only. Together, these three studies followed over 200,000 people for 28 years and 4,690,072 person-years (the amount of people times the number of years, something like that) of follow-up.

Here’s what they found:

Proportion of those who never drank coffee and never smoked:

  • NHS: 63%
  • NHS II: 80%
  • HPFS: 71

Proportion of those who drank >5 cups/day of coffee and never smoked:

  • NHS: 24%
  • NHS II: 35%
  • HPFS: 25%

All-cause mortality (death from any cause):

There were five total groups based on amount of coffee consumption: 0 cups per day, less than one cup a day, between 1-3 cups, between 3-5 cups, and over 5 cups a day.

A lot of associations tend to follow a non-linear curve, meaning the effect of whatever is being studied doesn’t simply go up with higher doses of it (or down with higher doses or lower doses). In fact for exercise and all-cause mortality the curve is J-shaped; those who don’t exercise at all have increased mortality, then those that exercise moderately have decreased mortality, and the heaviest exercisers see a small increase in their mortality but not as much as the non-exercisers (it’s a sideways J..I’ll add it in here later perhaps as an update).

The shape of the curve for coffee consumption and all-cause mortality is similar; those who consume a lot of coffee see a slight increase in their mortality, and those that drink moderately see a decrease in their mortality relative to those that do not drink coffee at all.

The thing is, those people who drink a lot of coffee smoke more too.

As a result, increased lung cancer and respiratory disease cases were observed in the groups that drank more than even 1 cup of coffee. Once this relationship was studied in never smokers, there was no more trend for lung cancer with increased coffee consumption. Smoking in this case is a huge confounding variable; it interacts with what we’re looking at making it harder to see a true effect from what we are interested in studying.

All right, well there you have it! I will update this post later with some more statistical information and pictures, but for now, all you need to know is that these three large prospective cohort studies found that drinking between 1-5 cups a day reduced mortality rates from all causes as well as cardiovascular disease (death rates among coffee drinkers was cut in half for those who suffered from diabetes and neurological diseases as well as suicide).

This means that without respect to individuality, or personalized medicine, or constitutions, overall, a cup or five of java is likely to help you live longer. Your chances of death are around 10-20% less from any cause if you are a regular coffee-drinker (For the exact numbers you need to look at the hazard ratios, provided in the tables at the bottom of the paper around page 50 onwards. You will see that the HR’s are between 0.8-0.9. If the HR is 0.9 for 1-3 cups a day of coffee then it means the risk of death is reduced by 10%).

Now I find those people who never drank coffee to be pretty interesting people. Would they live slightly longer if they drank coffee? See that’s not a question that this paper can really answer. You can say that those people who did drink coffee died less often than those who did not drink any coffee whatsoever. But to say that those people who did not drink any coffee at all would live longer is different because as usual the chicken and egg question comes up.

Are the people who don’t drink coffee genetically different than those who prefer coffee? What about those people that drink more than five cups of coffee a day and smoke a lot? Are those people constitutionally different? This is interesting to me because I like the personalized aspect of medicine; it allows us to fine tune information from large studies like this and think about the greater context of a god damn person (excuse my language).

In general, since there were a large number of people in the study, it is assumed that they are mostly similar and that they would actually live longer with coffee. But since no genotype analyses were done I think that question is unanswerable. My 23andMe results did tell me that I have some gene that predicts that I would consume less caffeine than average, so there is a genetic basis to this. Also those people that smoke and drink a lot of coffee perhaps need more stimulation. There are theories that differences in the dopamine receptor subtype 2 are responsible for explaining these differences.

Furthermore, the population studied was probably more stressed out than the average population I would imagine as they are mostly nurses and doctors. How does that add to the equation? Maybe those that drank coffee were better able to withstand the stresses of their job better than those that did not drink any coffee at all. Stress can cause free radical damage and if you’re not taking anything to alleviate that then those free radicals could accelerate the aging process. Also, those that drank the most coffee drank fewer sugar-sweetened beverages. They did do some separate analyses looking at that I believe but didn’t find anything noteworthy to report. But if those people that didn’t drink any coffee drank more sugar, we have another confounding variable to add to the equation, because this data almost makes it sound like if you DON’T drink coffee you will die sooner than those people that do drink coffee.

Out of all the mechanistic explanations for why coffee may prevent mortality, I can tell you there is a substitute. Antioxidants? Well a gazillion things have antioxidants. Big whoop. Caffeine is a stimulant and improves circulatory function? Big whoop a bunch of things did that.

And that is one problem with interpreting large studies like this: you study what most people do and you don’t study what is possible because that is something fewer people do and there aren’t enough of them to inform larger studies. What is nice thogh is that if there is a one-size-fits-all effect from anything and you see it in a very large sample, something is very likely to be actually going on.

So with that being said, coffee is definitely good for you especially considering that risk of cardiovascular disease-related deaths was less in those that drank a lot of coffee because those people smoked more too (if I find the exact statistics on that I will share but I don’t see it anywhere in the paper).

If you don’t drink coffee are you at risk of dying sooner? No, unless you consume more soda or take part in unhealthy activities. People who drink coffee may need to move around more and be more active in general so the anti-sedentary factor likely plays a large role as well.

Anyway, I hope you learned something and are interested in the big picture like I am!

I will soon discuss different types of coffee preparation methods as well as the results of my new pour-over filter…it should arrive tomorrow. Stay tuned, check out the gram, and sleep well because that is really important. So don’t check out the gram with or without nightmode on your phone right before bed in the dark unless you want to suppress your melatonin and GH production!

 

Once upon a time the nutrition blogosphere I enjoyed participating in was lit with a debate on whether or not fasting was hurtful to your metabolism. The age old adage that eating six meals a day was better for your metabolism was spit on by the intermittent fasting (IF) enthusiasts. They argued that short term fasting had no effect on your metabolism, because in the long run you would be receiving the same amount of nutrition.

Theories are wonderful, but if they don’t hold up in practice, they are useless. Theories like these are rampant in the nutrition science world but real life practice will tell you what works best.

Maybe the theory is true. But what if there are other factors that lower metabolism that are affecting the intermittent fasting enthusiast? It is still useless to hope that the theory will work because those other confounding factors need to be sorted out.

Here’s a little bit of a backstory:

I swallowed the intermittent fasting bug whole. I started fasting for 18-22 hours (sometimes 24) five days a week. The successful IF trainers however seemed to advocate 16 hour fasts. By the 16 hour period, I decided that I could go longer. I had a lot of energy. This was because my body, young and fresh, had a lot of reserves, or yin. Whether or not you like the concept of yin and yang, it’s a nice model for what’s about to happen.

With time, I had less and less energy from fasting; my yin was being depleted. I talk about this in an old youtube video of mine (enjoy the ponytail look I am sporting).

I remember the FIRST DAY I tried intermittent fasting. I was apprehensive and honestly a little bit nervous (I know pretty innocent and cute back then). I was scared of not eating for so long.

After a few hours, working at the grocery store, I exclaimed in my head: “this is like crack!!!” (I was probably 18…me and my friends thought jokes like that were funny but I guess my sense of humor is much more refined now…I sound like a snob don’t I).

I felt so energized. Stimulated. Intense. Excited. Scattered but I felt focused. I never felt anything like it.

That feeling was my fresh young body, relatively unstressed, living a simple life under a steady roof, activating a healthy stress response to the stressor of fasting. This stress response serves to tap into existing energy stores (adipose tissue and glycogen) to raise blood sugar levels.

From an energetic perspective this makes a whole lot of sense. If you don’t have food at the moment, you need to find some or you will die of starvation eventually. Being able to have MORE energy from fasting is a pretty cool way to deal with not having food.

I regularly started fasting for 18-22 hours. The more the better I figured. But I didn’t want to fast for too long because I was afraid of losing muscle mass and strength. Unlike other IF’ers, I didn’t take any amino acid supplements to prevent muscle breakdown. I wanted to be all natural. My stubbornness taught me some important lessons about health and about myself.

Working Out While Fasting

My goal with IF was body recomposition, or getting shredded. I wanted abs and muscle. I also was intensely focused on improving my vertical jump and 100m dash times. My training involved low-rep strength training and explosive lifting emphasizing my lower body. Deadlifts, squats, lunges, and various plyometrics were my mainstay. For my upper body I just lifted everything heavy, including bicep curls which didn’t make my arms any bigger (my arms really don’t grow easy…my ideal physique is a well-built athletic look…basically Andy Whitfield in Spartacus).

After 16-20 hours I would work out TRAIN. I released a lot of aggression in the gym in my college days. I looked forward to working out intensely and posting on this forum about my progress.

Eventually, the high from fasting faded. My workouts became less aggressive.

Energetically it felt like I was getting beat down from these workouts and the fasting whereas previously I felt like I was on TOP.

This little distinction may not make much sense scientifically, but that’s exactly what I felt. I would perform my deadlifts calmly and try to survive the weights more instead of destroying the workout metaphorically.

Fast-forward to the present day and heavy weight lifting sometimes makes me lightheaded. I am intolerant to the training regimen I had before that kept me at 10-11% body fat with decent abs and some impressive lifts.

The Stress Equation

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The rigors of school, a part-time job with a commute, and some financial stress meant that I had a lot more stress than a full-time athlete. In addition I didn’t have regular massages or sports medicine doctors taking care of me. I did everything myself which takes more energy. I trained however very often and very intensely, and I would have trained even harder if I had more time. I had the drive of a champion, and this led to me burning out completely to the point where I literally became intolerant to intense exercise.

Even playing some tennis would make me lightheaded after a while. The mechanisms are beyond the scope of this post, but I can share some theories. When you lift heavy, your blood pressure rises a LOT. The systolic value gets to the 400s (reference definitely needed; I read it a while ago). Something in the nervous system is responsible for raising that blood pressure adequately. Without adequate recovery, that thing in the nervous system got tired. I was not able to raise blood pressure as much and started feeling light headed. I never came close to passing out but I had to sit down and sometimes I saw stars.

I would also experience some lightheadedness from simply standing up. I knew I had a problem so I eventually lowered the intensity and frequency of my lifting and solved those problems. I haven’t attempted any heavy deadlifts in a while and don’t plan to still. I remember my resting blood pressure declined to 100/55 mmHg back in those days of adrenal fatigue. Now I’m back at around 120/80 and have more energy.

The point here is that the stresses of intense exercise training compounded the acute stresses of fasting. The amount of cortisol my body had to secrete to deal with that type of training while FASTED was probably very very high.

Not only did that high not feel as good, I felt worse from fasting. I would feel strangely calm, tired, and not as focused. If fasting is good for you why should you feel like shit?? I realized I needed to end my fasts when I started feeling these symptoms. I INSTANTLY felt better. The changes in my mood and energy levels were night and day when I ended those unhealthy fasts in a stressed state and ate some food, no matter what it was.

Incomplete Theories

Fasting and strength training was supposed to be an acute stress. The blogosphere enjoyed this idea of acute stress. It was better than endurance training long term which in theory could evoke a chronic stress response. I swallowed the pill and realized this was a short-sighted view. Clearly for me dieting and very intense strength training became a chronic stress. I knew this wasn’t healthy but I kid you not, I did not know how to fucking stop. I use strong language because this was a very interesting period of my life.

Back to the Main Question: Do Regular Meals Improve Your Metabolism?

This post was supposed to be about regular meals and your metabolism. Unfortunately I am not the type of person that can keep things succinct but I’m working on it.

So, in the short term, not eating any food for a long time can lower your metabolism. At first your metabolism is increased, but after that high goes away, your body will slowly shut down. Then, you will die from starvation.

Similarly, going on a low calorie diet to lose weight also lowers your metabolism. This is manifested by cold hands and feet and a general decline in vitality. It’s a smart thing for your body to do in order to compensate for the reduction in calorie intake. Your libido also slows down because your body doesn’t want to raise a child if there isn’t much energy to do so.

Skipping one meal however probably won’t do much to slow down your metabolism. You will simply want to eat more later.

But if you do it all the time, maybe eating more later won’t be enough. Maybe that chronic stress (assuming that it does in fact become chronic) is NOT adequately balanced by simply eating the same amount of calories later. If you ate regularly, you’d receive the same amount of calories but would you have the same level of stress? I am not sure but I suspect that there would be more stress. I should look into the literature to find more answers to this.

I can tell you this though. I crave sugar after my first meal of the day when I fast. This won’t happen if I eat regularly. Who knows, maybe I eat the same amount of sugar overall in one day, but I crave an Izze or another kind of fruit soda usually after I fast. I’ll eat a meal but my stomach won’t be able to fit too much food so I become hungry quickly after. Then sometimes I need to take a nap.

Clearly something is going on that involves my body trying to undo the damage from the stress associated with fasting. Everyone is different, but my body is a bit stressed out too so maybe it’s more intense.

The Microcosm Within the Macrocosm

I believe that things that happen on a very small scale (the microcosm) resemble things that happen on a very large scale (macrocosm). Something a cell is experiencing may be analogous to something you are experiencing in your body.

Me skipping breakfast today in this example is the microcosm. Me starving to death is the macrocosm. The action of skipping one meal, versus every meal till death, is very different. But it resembles starvation quite a bit as well.

Thus, doesn’t it make sense that on a microcosm there are cellular changes occurring that directly resemble the changes occurring in starvation?

I think it does. It’s debatable for sure but it makes sense to me based on my experiences, which I trust more than the rabbit hole you can go down from trying to understand the literature.

Conclusion

My goal is to STOP skipping breakfast. I don’t want the microcosmic changes of skipping one meal anymore. I feel full but want sugar. I feel like there’s something missing. I am in graduate school and am recovering from years of intense lifting which caused adrenal stress. I need to make a concerted effort in healing my metabolism.

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I don’t skip breakfast anymore to lose fat. I do it due to time constraints and because I know I can handle it and I’ll have a little high off of it. My body just needs more rest than stimulation, so for my metabolism’s sake, regular meals, including even a tasty cinnamon roll I snacked on for breakfast, is better than just the coffee I’d normally drink.

In addition, the regular meals will prevent the fatigue, distractibility, and stress I experience when the hunger from not eating does NOT lead to a seemingly healthy stress response. How can that be good for me? It’ll take a while to have the full answer on that, but for now I trust my instincts on that one.

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