Robert L. Blum, MD, PhD

 

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Optimal Nutrition:
Are Fats Killers
or Saviors?

The Mystery of CONSCIOUSNESS

Consciousness Video:
Who, What, When?

Near Death Experiences: In the Desert With Pim Van Lommel

Is the UNIVERSE
Fine-Tuned for Life?

Neuron Videos Say
Forget Realistic AI

EUV 2014 - Future of Moore's Law

BAM: Brain Activity Map of Spikes

Beating Jeopardy!
What is Watson?
AI Overlord or Tool?

SETI: Search for Extraterrestrial Intelligence

KEPLER Seeks Earth-like Worlds

STEVE PINKER in the Amazon: photos

Billion Year Plan:
AI Formulation

AI Awakens

CONSCIOUSNESS as Global Resonance

SEAN's Accident

Coronary Artery CT
Scan: A Life Saver

Book Review: TRANSCEND

Book Review:
Create a Mind

Does Drug X
REALLY WORK?

TRANSCEND
DRUGS!!!

Total Recall:
Everything, Always

Ralph Triumphs:
Elbot Cheers

Scientists &
Evangelicals Unite

Thomas Berry,
Geologian: Obituary

Calorie Restriction
Works in Monkeys!

TheBrain &
WebBrain: Review

 

Optimal Nutrition:

Are Fats Killers or Saviors?

 

            As a physician scientist, I've been interested in nutrition for decades.

Both my grandfather and my father died around age 70 of heart attacks,

so I've always been keenly aware of the much touted causal relationship between

fats and atherosclerosis.   Everything I had read in the medical literature

confirmed that relationship.

 

            So, I never thought I would have to defend NOT eating saturated fat -

or not eating fats in general.

 

            Not eating saturated fats (= satfats) has been a central tenet of

mainstream medicine and cardiology for decades.  Why am I even

bothering to address this issue? Has anything changed?  Perhaps, so.
(2013 addendum: large New England J Med. randomized trial just confirmed
cardiovascular benefits of Mediterranean diet compared to low-fat diet.)

 

The old USDA food pyramid

 (One (idiotic) version of the traditional USDA food pyramid with bread, cereals, and pasta at the base.)

 

            Many of my friends are very bright Silicon Valley engineers

and scientists, and some of them have experimented with "paleo" diets -

eating like our paleolithic hunter-gatherer ancestors did - and my friends have
lost weight and appear to have gained health. It also seems to have worked
for me. I dropped from my usual 158 lbs down to 148 lbs in 3 months and have
even more energy than usual. 148 lbs is what I weighed in med school 40 years ago. 


The central claim of the paleo movement is that we humans were doing fine

for millions of years eating freshly killed fish and meat. (A majority of our paleolithic

ancestors did die by age 18 of infections and other causes.) But, then the agricultural revolution

came along 10,000 years ago and suddenly our diets changed to wheat and barley,

a diet for which we were not evolved.  This sudden shift accelerated for the worse

in the twentieth century with the introduction of packaged foods, high-frucose corn
syrup, margarine and other trans fats, refined vegetable oils, twinkies, ding-dongs, and boom! -

the resulting epidemic of massive obesity, diabetes, and cardiovascular disease.

 

            Many of the teachings of paleo are definitely a part of mainstream

medicine,  and hence are non-controversial:  staying away from high-glycemic

simple sugars, processed foods, and trans fats, for example.

 

            This interest in "paleo" nutrition was given a huge thrust in 2007 by

science writer Gary Taubes with his best-seller Good Calories, Bad Calories,

which I will discuss below.  Taubes leveled his gun squarely at carbs

as the source of all our problems, and (controversially) he gave satfats a big OK..

He, and the paleo crowd, say the main culprit causing the modern world's
burden of chronic disease is insulin release caused by carbs, not by fats. Who is right?
(Taubes and the paleos also take aim at imitation fats: trans fats, refined vegetable oils,
and the omega-6 PUFAs. This indictment enjoys greater support by cardiologists
than does the complete exoneration of satfats.)

 

            Getting nutrition right is critical.  The body is comprised of

a tightly knit community of ten trillion cells in dynamic equilibrium with the
foods we eat. How should we eat to live long and prosper?

 

            There are three (and only three) macronutrient food groups:

carbs, fats, and protein.  Let's suppose you eat 2400 calories per day.

Given a fixed amount of protein, let's say 400 calories worth (100 grams),

then the real question is "where should the other 2000 calories come from -

CARBS or FATS???"  That's the central issue of this article. (I also deal with

the crucial issue of whether eating 2400 calories a day is good for you or

whether you're better off eating a lot less.

 

            Mainstream medicine has traditionally spoken with one voice on this topic::

most of those remaining 2000 calories should come from complex carbs,

specifically whole grains, fruits, and vegetables. (That includes the second tier
of the USDA food pyramid (in its traditional form) shown above. The base of that
pyramid (6 to 11 servings of bread, cereal, rice, and pasta) is so brain-dead that it
really does call into question the epidemiologic scholarship of the 1960s and 1970s.
Anybody who's tried to diet knows that that stuff should be the first to get dumped -
right after the candies, cookies, cakes, pies, rice, potatoes, and breakfast cereals.


            The paleo authors - here I'm including Gary Taubes and

Loren Cordain (and his many disciples) - correctly dispute the wisdom of the
pyramid shown above. More controversially, they also argue that perhaps
half or more of the remaining 2000 calories should come from fatty foods like

meat, fish, eggs, nuts, and seeds. (Taubes and some paleos also favor lots of dairy.)
Taubes and many paleo advocates inspired by Cordain's work - Professor Cordain
himself appears to be somewhat more circumspect - feel that
saturated fats have been falsely
accused of causing atherosclerosis,

the grim reaper of the modern world.

 

            So, who's right? That's my focus.  And, what should you be eating
for optimal health? At the conclusion of this essay, I'll also show you in detail
what I eat, having read all the recommendations.


 

Evolution of Obesity

If you eat 11 servings of bread, white rice, breakfast cereal, and pasta and
four servings of fruit, you'll look like the guy with the supersized drink, even
if you don't eat high-fructose corn syrup. Has HFCS been falsely accused of
causing obesity? You decide after viewing this "ad" from SNL.

 

            As a physician for many decades, the saturated fat claim

made by the paleo advocates initially struck me as being preposterous

and even dangerous. It flies in the face of a half century of medical dogma
portraying satfats as the chief villain promoting atherosclerosis.

But could there be a grain of truth in the claim made by the paleo crowd?

 

            For me finding out the truth is absolutely essential.

I found out serendipitously about seven years ago that I already have

early atherosclerotic calcifications in my coronary and carotid arteries,
despite a lifetime of vigorous exercise and attention to diet. Although I've
never had any symptoms, and I blast up 12,000 foot Sierra peaks every summer,
my carotid ultrasound and coronary CT scan said that trouble was lurking.
If you have risk factors and you're a man over 45 or a woman over 55,
I heartily recommend those tests
. If you have to cancel your cable tv
for six months to pay for it, do it anyway. It may save your life.

 

            In the course of an extended correspondence over several months,

 I examined hundreds of online articles, studies, and videos that address

the satfat = saturated fatty acid issue. (Special thanks to my brilliant friends -

scientist/engineers Steve Omohundro and Dan Hunter for their many contributions.)
I've also done a lot of self-experimentation with my diet, and discussing this
with my son, Sean, a budding, cell biology guru, is an added delight.

 

            My purpose in writing is to share with you the many
excellent online videos and links that I"ve found,  and to tell you what
 I consider to be the take-home lessons.  BTW, I'm not an expert, but
the researchers in the videos are. Watch their lectures and draw your
own conclusions. BTW, you cannot get through all this in one day. Right now -
I MEAN NOW!- tape a note to your refrigerator reminding you to watch
every video that I've linked to. It's all free. Nobody, especially me, is trying
to make money from you. It's about only one thing - giving you long life and health.
Your doctor cannot make you healthy; only you can by what you do everyday.


            Here's another reason to watch all the videos - the recommended foods
span the spectrum from pure vegan to bloody carnivore + lard + dairy. You need to
appreciate the history and evidence backing all the various recommendations.


            If you can't stand the suspense, here's the bottom line.

 

          1)  What really matters is achieving your optimal weight (read THIN -
a bmi of perhaps 20 to 22) with a nutritious diet. (I'm loathe to advise a bmi under 20 -
that gives you no fat reserves if you get sick. Also, a "normal" bmi of 24 is not apt
to optimize your lipid panel, but it's a start if you're fat.) Being obese is a killer.
Being sedentary is a killer. Daily exercise is important.
(The evidence, however,
does NOT support running marathons as the path to cardiovascular health and longevity.)
Following the diet below I lost 10 pounds in 3 months. (I've always exercised a lot
- no change there. I bike 3,000 miles a year; hike 2 miles a day with a 15 pound weight
in each hand; and dance 3 nights a week. I only put 4,000 miles per year on the car.)

 

           2) Calorie Restriction with Optimal Nutrition (CRON) is the way to go.
It's indisputable that it helps prevent cardiovascular disease. It's also the only
intervention that has been shown in many species to extend lifespan.

(But, what do you eat to make it possible? It simply won't happen

if you're trying to do it just by eating lettuce and weak tea -

unless you're in a prison camp. I lasted about 5 hours on the Lemonade Diet.)

 

            3) Protein should range from roughly 1 gram to 2 grams per kg per day .

(no more than say about 60- 160 grams per day (that's the weight of the protein,
not the fish), say, a portion of meat or fish about the size of your palm per day.
Some body-builders and athletes go up to 2 grams/kg per day, and those who
exercise moderately but are not trying to build muscle may eat perhaps 1.25 gm/kg/day.)
Excess protein may lead to gout and acidic urine resulting in renal stones.
These articles by Laura Dobson on About.com are clear and accurate:
how much protein should be in your diet and protein based on lean body mass
and body fat calculator - just measure your waist, neck, and height.

 

4) Fast carbs (like sugar) promote weight gain and need to be greatly curtailed

(initially, even including fruit!) .  Fast carbs = high-glycemic index carbs promote
insulin release and fat storage.  To lose weight you must dump all of them.
Even "good carbs" like oatmeal may cause a spike in your blood sugar.

 

5) Fats make it a lot easier to eat less: they suppress insulin release

and kill your appetite.  Suppressing your appetite is critical; so is getting
away from food, restaurants, and TV snacks. Fats, in general,
promote weight loss (yes, weight LOSS) - a paradox
. (The real issue
though, of course, is whether you are thinner and healthier or thinner and dead.)

 

6) Trans fats are horrible. They are more atherogenic than satfats.
They were invented by the food industry to increase the shelf life of food.

They need to be buried with the people they killed. Shop from the outer aisles
of the supermarket. Avoid everything in a box, or at least read the label.

 

7) Satfats need to be limited, but replacing all satfats with simple carbs (possibly even
fruit in excess) may be worse and is the path to weight gain, obesity, and disease.
Exactly what foods people eat, as they have striven to replace satfats, has created
an impenetrable fog in the medical literature. The issue is incredibly complex.
The safety of satfats depends on the particular molecular species and the dose in your diet.

That is, particular foods of a certain type (eg satfats or PUFAs) differ considerably.

(And this has still NOT been sorted out in the medical literature.)

 

8) Replacing satfats with PUFAs (and probably MUFAs) is better, but this also depends
on the type of PUFA (omega-3 is best) and MUFA (oleic, as in olive oil, is best).

(That is, eat fish rather than meat, and eat olives or avocados rather than cream.)

The weight of the evidence supports limiting satfats. (I consider the total exoneration of

satfats by some bloggers (who recommend unlimited dairy, eg) to be
unsupported and irresponsible, despite this 2010 AJCN study often cited by them.)

Mediterranean fat sources (PUFAs and MUFAs,

eg fish, olives, and avocados) are better for you than satfats.

 

9) Only those researchers who advocate an extremely low fat,
high complex carb
diet, have demonstrated that coronary artery

atherosclerosis can be reversed. (I personally will only believe that the

high satfat advocates are right when they have also done similar trials.)

A vegetarian diet may be the best way to prevent atherosclerosis, and
only vegan diets have been shown to reverse atherosclerosis without statins.

Vegetarians (eg, 7th Day Adventists) have demonstrable longevity.

It's also good for the animals and for the planet. (I myself have tried

vegetarian diets through the years. Somehow, it's always a "no go.") Note: I'm
talking about the published evidence, not about what I do or recommend.

 

10) Celiac disease is far more common (1% of Americans) than
traditionally supposed. Irritable bowel syndrome (IBS) is far more common than that.

Wheat, barley, rye (but not rice) and also soy and legumes may need to be

restricted to curtail IBS. Fruit needs to be restricted to avoid obesity.

 

11) Fish or supplements containing DHA and EPA should be a part

 of everyone's diet. Increasing omega 3 fats (fish or flax seeds) and

decreasing omega 6 fats (vegetable oils) is crucial to brain health and to
reducing inflammation that contributes to a variety of chronic disease.
Get rid of salad oils (except olive oil) and most salad dressings: they're brain-dead.

 

balance scale with fruit

            You're not gonna lose weight by eating all that fruit. Big, fat error!

 

            That's the summary. Now on to the articles,

the evidence, the videos, and what I eat. 

 

My Dietary Goal: Longevity

 

            My personal dietary goal is longevity - to live as long as possible.

Why?  As a lifetime science and technology buff, every day brings

exciting new developments. What incredible biomedical advances
await humanity by 2030 and beyond? I want to stick around to find out.

That is not, however, the purpose of everyone's diet.

Some young men, for example, want to increase muscle as fast as possible. 

Some people love going to fancy restaurants or eating exotic cuisines.

I won't address their dietary preferences here.

My exclusive interest is in achieving optimal health and longevity.

 

I'll start with the view of mainstream medicine and focus on just one problem.

 

ATHEROSCLEROSIS

 

            Dietary advice from every medical, scientific, and nutritional society

must  first and foremost emphasize the prevention of atherosclerosis.

It is the number one killer in developed countries, exceeding cancer and

infectious diseases combined.  The definitive American source for info is the CDC,

which publishes the annual statistics every year in Circulation.

 

            Here are the mortality statistics for the USA (source: CDC; year 2009)

 

                        Total deaths      2,436,652          (out of about 300 million Americans)

            1)         heart disease       598,607         

            2)         cancer                 568,668

            3)         respiratory dis.    137,082

            4)         stroke                 128,603

 

            Adding heart disease and stroke (most often caused by atherosclerosis),

we get 727,210 deaths per year in the USA - about a third of all USA deaths.

It kills both men and women, although men get it (and die from it) about ten years earlier

than women.  Visit a senior residence (old folks home), then ask yourself,

"where are all the men?" Answer: almost all have died.

 

Atherosclerosis is the process in which arteries of the heart or brain plug up

over decades, leading to a sudden heart attack or stroke in the brain.

Diet (and fat, in particular) has been implicated as a major contributor to this process.
(But exactly which foods are the villains is, of course, the focus of this discussion.)

 

 Atherosclerotic Plaque

After the fibrous cap on the fatty plaque has ruptured, a blood clot forms.

 

            This 3d animation shows in great detail how the plaque forms.

 

            How and why does plaque form in the arteries? After decades and
billions of dollars in research, the answer is still being worked out.
But, here is one of the most widely accepted mechanisms.


a)  if LDL = low density lipoprotein cholesterol (ie, "bad cholesterol")

 is persistently high,

b) it becomes oxidized and deposits underneath the endothelium

 (the inside lining) of arteries.

c) There it is gobbled up by macrophages (" big eaters"), whose
bloated corpses are foam cells: fat deposits in the arteries.

d) Over the years, these fatty deposits, push the outer wall

 of the artery further out.

e) At the same time the foam cells cause the smooth muscle cells

in the endothelium  to secrete collagen to form a  dense fibrous cap (scar tissue)

 that narrows the blood flow channel in the artery.

f)  if the process continues, inflammation inside the fibrous cap

 may weaken it such that the blood flow suddenly lifts it up.

g) As a result, a blood clot forms that completely closes off the artery,

 cutting off blood flow to the heart muscle.

i)  Deprived of oxygenated blood, the heart muscle dies (a heart attack).
(When this process plugs up the carotids, the result is a stroke (death of neurons).

 

While this pathway is widely acknowledged to be the principal mechanism

of atherosclerosis, which is the leading cause of death, various researchers
place more or less emphasis on differing parts of the atherosclerotic mechanism.
While high triglycerides and LDL-cholesterol have clearly been implicated
as "bad guys" and HDL-cholesterol, which carries cholesterol out of the plaque,
is one of the "good guys," even when they are taken into account,
a lot of disease still remains unexplained. This lovely video shows the daunting
complexity of transmembrane migration of inflammation-mediating cells
.

Some authors in the popular press - notably science writer Gary Taubes

and biochemist Mary Enig have questioned the role of dietary fat in causing

atherosclerosis, as I mentioned above..  See, eg, this discussion of the

"saturated fat and cardiovascular disease controversy" in wikipedia.

I'll discuss the viewpoint and evidence cited by the skeptics toward

the close of this article.   (However note: they are vastly out-numbered by the

believers . But, how many skeptics does to it take to prevail - only one,

if he or she is right.  Every scientific theory can be overturned by sufficient evidence.)


            Now, on to the experts, what they recommend, and why.

 I'm going to start with Loren Cordain, because of all the videos I've seen,
his most convincingly presents the big picture: what humanity ate
while we evolved over millions of years in Africa, and what problems
have been created by our post-industrial, Western diet.


Loren Cordain

LOREN CORDAIN: Master of Paleo


            (Note: this is our first MUST WATCH video -
just click the links - it's all online and free.
)

 

            My favorite paleo advocate is Professor Loren Cordain of

Colorado State University. This one hour YouTube video of Prof. Cordain

gives the complete rationale for paleo nutrition. Cordain did much of the

 paleoanthropologic research that provides the evidence for paleo eating.

Whether or not you believe that paleo eating is nutritious (or harmful),

his presentation on the history of human foods is a must.  He, as much

 as anyone, knows what our ancestors ate, and also what present day

hunter-gatherer (HG) societies eat. He analyzed data on 229 HG societies:
2/3s of their calories come from animal-based foods. (Whether eating
that way promotes longevity is, of course, an entirely separate question.)

 

paleo pyramid

 The Paleo Pyramid has fish and meat at its base. Dairy is not part of it.

 

            So, what did our ancestors (and present day hunter-gatherers (HGs)) eat?

Answer: everything!  Whatever they could get their hands on.

 They and we are omnivores. Eating by us (and by almost every creature)

is determined  by calories obtained versus effort expended.

Grains? Forget it!  Ancestral grains were scrimy, indigestible weeds

before agriculture (and horticulture) 10,000 years ago.

Fruit? Fine! But these were also apt to be small, wild varieties, not giant

juicy apples. Vegetables?  Same comment.

Fish? Played a large role in our ancestral diet and that of many modern HGs.

Animals? Cordain shows that wild animals and fish form about 2/3's of the diet of modern HGs.

If you lived in Northern Europe during the glaciations, you ate like the

wolves and other predators. But, he shows the difference between

wild venison (pure meat) versus a factory farm steer (loads of fat).

The cavemen were slim, as were the animals they ate.

 

Dairy? Here, Cordain wisely disagrees with the recommendations of his

young disciples some of whom advocate unlimited saturated fats from cheese,

cream, butter and animal fat. They're on thin ice.  Their evidence is preliminary

and controvertible. As Cordain points out, the paleolithics did NOT have access

to dairy before animals were domesticated He shows an angry wildebeast:

 "just try to milk that!"

 

Sugar: Fructose: Fast Carbs  Here Cordain and the medical establishment are

in total agreement.  Our ancestors rarely ate simple sugars (simply because they were

not available (other than honey)).  Consumption of these sugars has gone
through the roof in the past hundred years, hitting 150 pounds per person
per year recently
. Sweet death from obesity, diabetes, and cadiovascular disease.


I linked to Loren Cordain's lecture first, because 1) it is essential for you
to understand humanity's ancestral diet, and 2) I agree with his list of problems
created by the modern Western diet.


            However, look at all that meat, fish, and fat in the paleo diet he recommends.
Won't that lead to atherosclerosis, heart attacks, and strokes? The vegetarian
advocates say that it will. We'll try to decide who's right later.


Vegetarians and Vegans: The Importance of Vegetables

 

            After reading scores of articles and books, I found it hard to

ignore the evidence presented by the vegetarian advocates.  These are

 physician researchers who have studied the issue over decades,
and who have come to a simple conclusion: to avoid

heart disease and strokes (and to reduce cancer risk), eat mainly

 a vegetarian diet (if you can).

 

            My favorite video, The Last Heart Attack, was made

 by Dr. Sanjay Gupta, a professor of neurosurgery at Emory University,

 Atlanta, and best known as CNN's chief medical correspondent.

This free, one hour video is mandatory viewing for all my readers.

(All the videos and articles on my entire website are free and open access.
Did you put a note on your refrigetor to watch these? If not, DO IT NOW!)

In this video Dr. Gupta interviews former President Bill Clinton, among others.

Clinton had a 4 vessel coronary bypass in 2004.  Then, in 2010 he had

two coronary stents placed.

 

            That second coronary intervention forced Clinton to really

get serious about his diet.  Here is Bill Clinton explaining his diet

to comedian David Letterman (who also in 2000 had a 5 vessel bypass).

For dietary advice Clinton turned to physicians Dean Ornish

and Caldwell Esselstyn.

 

             I have been a fan of Dr. Dean Ornish for years.

Both Dr. Ornish and Dr. Esselstyn have worked for decades with patients

(including Bill Clinton) who have had heart attacks. Both physicians have

 demonstrated by angiography that their 100% vegetarian, very low fat diets,

can arrest and even partially reverse coronary atherosclerosis.  This was

formerly thought to be impossible.

 

Dean Ornish on the cover of Newsweek

 

            Here is Dean Ornish in a 17 minute TED video: Help the Body Heal Itself

(another of my favorites).  And, here's his argument in just 3 minutes at TED.

 And, here is his website: PMRI, the Preventive Medicine Research Institute.

Besides eating vegetables, Dr. Ornish also advocates stress reduction and

 meditation. It takes huge motivation and self-control to eat a 10% fat diet,

but Ornish has decades of data and publications to show that it works.

 

            Next, among the vegetarian advocates is physician

Caldwell Esselstyn. Like Ornish he has worked for decades with patients

(including Bill Clinton) who have had heart attacks and has shown that

he can arrest and partially reverse their disease.

 

President Clinton turned to both Ornish and Esselstyn after

his second heart attack in 2010. Clinton is now a vegan (only vegetables:

not only no meat, no chicken, no fish, but also no dairy, no eggs, no avocado

 and no nuts!).  Is it hard to adhere to a diet that low in fat? You bet.

But like Yoda in Star Wars, Dr. Esselstyn hates moderation: "do not try - do!"

His article is a must-read "Resolving the Coronary Artery Disease Epidemic

through Plant-Based Nutrition."  And here is Dr. Esselstyn in an 8 minute video.

 

            Dr. Joel Fuhrman is another physician who strongly advocates a vegetarian diet.
He presents his case in this brief video on fats and micronutrients.

I also read and recommend his carefully documented best seller Eat to Live,

2nd edition 2011.  Like Ornish and Esselstyn he has worked with hundreds of

patients with heart disease, obesity, metabolic syndrome, and adult diabetes

and reversed their disease. His book, papers, and website present the argument.

By the way, Dr. Fuhrman was a world champion figure skater in his youth.

 

            I also read biochemist Colin Campbell's book The China Study,

which compares provinces and cities in China in which meat is eaten

to those on a vegetarian diet.  This study, which has received NIH funding

for three decades, carefully documents the salutory effects of an all vegetarian diet.

Campbell presents abundant evidence that not only shows an atherosclerotic effect

of a diet rich in animal fats but, surprisingly, a strong carcinogenic effect.

His conclusions are even more compelling considering his background:

growing up on a dairy farm in the Midwest. Only the power of his study data

persuaded him that vegetables are the way to go.  Here Dr. Campbell presents

the China Study.  Both he and Dr. Esselstyn are in their late seventies and look terrific.

 

            My favorite website on vegetarianism is VegSource.com  .

I discovered it after noting that several of the videos above

were posted by VegSource on YouTube. (See the video link from VegSource.) 

 

            Another crucial part of vegetarianism is how animals are "processed"

on the way to your dinner table. Here is an interview with comedian

Ellen Degeneres about why she is a vegan.  In it she recommends

the movie Earthlings, commenting  that it made Food Inc

(another similar movie) seem like a Disney production. It does.

 

Earthlings, the video

 

            Earthlings is a (free, online) hard-hitting documentary about the cruelty

inflicted on factory farm animals.  My reaction was "how could I live six decades

in America and not be aware of this story."  It needs to be seen by every man,
woman, and child who eats meat. Narrated by Joaquin Phoenix, it is a riveting account.

(That's not to say that it's 100% accurate, but it's a sad indictment

of our supposedly  free society that the monstrous treatment of factory

farm animals has been so hidden from view.) If you believe that

farm animals are conscious (they are!), then their welfare is crucial.

 

CRON:  Calorie Restriction Optimal Nutrition

 

            Calorie restriction (CR) is spectacularly successful in decreasing

the rate of atherosclerosis, diabetes, and perhaps even cancer.

A 2004 study in the prestigious journal PNAS reported a 6 year study of

18 people on a calorie-restriced diet (bmi 19.6) compared to controls

with normal BMIs (avg bmi of 26).  The calorie restricted group ate

only 1,100 to 1,950 calories per day vs 1,975 to 3,550 per day for the controls).

The restricted group had spectacular reductions in their LDL and triglyceride levels

 and marked increases in their HDL levels. Notably, they experienced a 40% reduction

 in their carotid intima media thickness (IMT) - a direct measure of atheroma.

 

            The many benefits of calorie restriction are touted on the

CR Society website . This wikipedia article on calorie restriction is comprehensive.

I became interested in CR perhaps 15 years ago

 when I read a book by renowned physician Roy Walford,

a professor of pathology at UCLA and a noted pioneer of CR research.

 His research, since replicated in many species, showed that

mice fed a calorie-restricted diet almost doubled their lifespan. 

 

             The health-inducing effects of CRON were confirmed in

a crucial 20 year study on rhesus monkeys reported in Science in 2009.

That study showed a marked decrease in diabetes, cancer, heart,

and brain disease. It appears that the voracious eaters are dying

at a rate three times as fast (total of 14 dead) as the dieters (5 dead).

 

Monkeys in calorie restriction experiment

(The monkey who ate to his heart's content is on your right.)


            A new study of calorie restriction in humans was begun in 2007.

The new study, called CALERIE and sponsored by the NIH,

is being conducted at three medical centers and has about 250 participants.

It is a two year study that completed enrollment in February 2010.

A preliminary study reported in 2006 showed reduced levels of insulin resistance,

reduced LDL, and less oxidative damage to DNA. CALERIE is described on wiki.

 

            Another potential benefit of cutting calories is improved cognition and
memory, reported here in PNAS in 2009 and also in the New York Times.

 

Okinawan Diet of the World's Longest-Lived People

 

            One journal article on the Okinawan Diet provides key support

 for a calorie-restriced, vegetarian diet. Okinawa is one of Japan's islands,

known to Americans because of our military base there.  The Okinawans

are among the world's longest-lived and healthiest people.  In modern times,

their diet has shifted toward a more western (higher calorie, higher fat) diet,

but the authors of this study looked back several decades

at how much and what they used to eat.

 

            Their diet is listed in Table 1 on page 443 of the study.

It has a total of 1785 calories per day from 1262 grams of food

for a calorie density of 1.4 - that's really low.

85% of their calories are from complex carbs; 9% from vegetable protein;

and only 6% from fat. (Look at a bottle of supposedly healthy olive oil

(or any other oil).  It has 9 calories of fat per gram of oil.

(A past version of the USDA's Food Pyramid had "healthy oils" at the base.

Forget it!  Fortunately, that's no longer recommended.)

 

            Here's what the Okinawans eat:  69% of their diet was sweet potatoes;

12% from rice; 7% from other grains; and 6% from soy dishes.

There was almost NO meat, no dairy, no eggs, no animal fat,

no sugar, no nuts, no seeds. 

 

            Their longevity and diseases were studied in the

Okinawa Centenarian Study .  Okinawa has an unusually large

centenarian population , and they are remarkably disease-free.

Their  death rate from coronary heart disease is the lowest in the world at

18 per 100,000  (compared to America at 100 per 100,000) and

their rate of cancer is 2/3's of ours.

 

Saturated Fats: Killers or Saviors

 

            So, let's return to the question that started this article and

initiated my recent exploration of this literature.

Are saturated fats killers or saviors?

 

            The above literature would seem to leave little doubt.

 Too many calories of food and of saturated fats, in particular, are killers.

That partially explains the heavy predominance of anti-fat statements

in the wiki article entitled "saturated fat and cardiovascular disease controversy."

The article accurately conveys the views of the medical academic establishment,

the American College of Cardiology, and the American Heart Association: fat is bad.

 The so-called 'controversy' has arisen only in the popular press and as a result

 of publicity efforts by dairy producers, oil producers, and meat producers.

 

            But, lest we be hasty, it's wise to consider the arguments and evidence

 brought forth  in favor of saturated (and unsaturated) fat. As you will see, they do
have a role. Interestingly, I now consume more than I did a year ago (mainly as fish).

 

            For that let’s return to Gary Taubes whose 2007 book

Good Calories, Bad Calories was a best seller and created a firestorm.

I'll summarize his arguments starting with the least controversial

(most generally accepted) and end with his most controversial positions.

 

            By the way, Gary Taubes provided a springboard

 and popular voice for the Paleo movement - those writers and bloggers

who advocate eating more meat and virtually unrestricted saturated fat.

Here I’m lumping together Taubes and the paleo advocates for now.

(Loren Cordain, as we’ll see below, is quite clear - dairy products were NOT
a part of the paleolithic diet. Whether they are healthy to eat is a separate question.)

           

            In common with academic medicine, Taubes strongly condemns "fast carbs:"

 those easily digestible, refined carbs that are a huge part of  the American diet:

cookies, cakes, breakfast cereals, etc. Those  high glycemic foods stimulate

insulin release and are converted to fat.  He rightfully condemns

high-fructose corn syrup as being a key contributor to our current epidemic of obesity.

 

            Now, on to the controversial positions.  Taubes attributes

the high incidence of atherosclerosis in Europe and America

not to a high intake of saturated fat but rather (and exclusively) to our high intake

of carbs including starches. In his view insulin release is the universal culprit,

 and it is only provoked by carbs  and not by fats or protein.

He believes that America has been grossly misled

 by the medical establishment: in his view, carbs are the real culprit, not fats.

 

Gary Taubes Book

 

            And finally, his most controversial positions:

1) Chronic diseases like atherosclerosis are caused exclusively by refined carbs

 and starches and not by fats. (The paleo gang blames inflammation and not fats.)

2) The following foods can be eaten without restraint:

meat, fish, fowl, cheese, eggs, butter, and non-starchy vegetables. Really?

3) Consuming excess calories does not cause us to grow fatter.

4) The obesity epidemic is not due to overeating nor to our sedentary lifestyle.

 

            While these positions seem ludicrous (especially considering the

mountains of evidence presented by the vegetarian and CR advocates,

there is a grain of truth in some of them - just a grain.

(taken out of context, they are each grossly inaccurate.)

 

            Is atherosclerosis caused by fats or by carbs? 

The answer is probably both, when consumed in excess.

A) Decades of evidence have correlated saturated fat with atherosclerosis.

B) However, the recommendation that was advocated by the USDA in the 1960s

 and 70s to replace fats with pasta, bread, and cereal is dead wrong.

(The USDA is so heavily influenced by food industry lobbyists that it must be ignored.)

 

            Being a lifetime athlete, I was intrigued by Taubes' position on

 the futility of exercise as a means of weight loss.  He argues that

 appetite is tightly controlled by the brain.  In the course of a year,

we take in literally a million calories and burn the same.

 Obviously, calorie expenditure must be about equal to calorie consumption.

When you exercise, you just eat more to make up for it.

 It's really hard to lose weight just by exercising. Everybody knows that.

 Score one major point for Taubes.  You can bust your fanny on the treadmill,

but if you eat tons of fruit and pasta afterward, your weight is going nowhere but(t) up.)

 

            However, the combination of Taubes' positions,

 is where his argument breaks down. 

You cannot just sit in an easy chair and eat an excess of anything

and expect to lose weight or be healthy.

 

            My lifestyle every August is the closest I come to a paleolithic style:

 backpacking for weeks in the Sierras. There are no grocery stores, no refrigerators,

 no cars, no pantries, no tv or internet.  Every meal is a job; every bottle

of water means finding a lake or creek.  Dairy foods, which spoil, are non-existent.

The real paleo lifestyle is hard work; every calorie counts.

 

           One unusual feature of my Sierra hiking trips is that I frequently encounter
Seventh Day Adventists, and I enjoy discussing health issues with them.
The Adventists are vegetarians, and their health greatly benefits as a result.
There have been several studies demonstrating a
salutary effect of the vegetarian diet practiced by Adventists. (We also discuss -
but don't agree on - who or what created the Universe. But we do agree that
the natural world needs to be preserved at all cost.)

 

            By the way, almost no one recommends eating more than

 about 2 grams of protein per kg of body weight per day
- say, a quarter pound - about the size of your palm.

 At four calories per gram, if you eat 100 grams of protein, that's 400 calories..

 The real question is this: if your diet is (NOT should be) about 2,400 calories per day,

 then what should make up the remaining 2000 calories: complex carbs or fats?

 

            Again, here's an interim summary of what I've read

(coupled with my own experiences).

1) it's very important to achieve your ideal weight (for me, that's a bmi of 22

(weight 150 lbs at a height = 5' 10";).  It's hard work.

2) Getting rid of fattening snack food is crucial.  It cannot be in your house.

That includes fruit!  Modern fruits - grapes, oranges, apples - are just giant sugar bags.

Get rid of 'em.   (First dump the cakes, cookies, cereals, bread, and pasta.)

3)  Eat whatever kills your appetite.  What it is exactly, probably doesn't matter much.

Sardines, a giant salad or plate of vegetables (but not grease-soaked french fries).

4) No mindless eating: sitting is one thing but watching tv or a movie

and mindlessly shoveling calories of any kind is bad.

 

That's where Dean Ornish's mindfulness comes in.  You should be

 aware of every biteful. Is it bringing you closer to life (lower weight)

 or closer to death (promoting atherosclerosis)?

5) If you're eating a calorie-restricted diet and are at your ideal weight,

does it really matter whether 10% or 30% of your calories are from fat?

 Possibly not, according to Taubes; Ornish and Esselstyn would say, it DOES matter

if you want to reverse heart disease. (I take Lipitor and say "bless you, Pfizer."
The bloggers who rail against it are ignoring hundreds of studies showing
that statins reduce heart attacks and strokes.)

 

Where do people trip up with what they eat? Do your own research
in the supermarket. I can tell by looking at a shopper, what will be in his or her cart.

But let's return to the issue of fat consumption.

 

Fish, Fish Oil, and Omega-3 Fatty Acids

 

            This is a crucial part of the story not only for weight loss but also for

reduction of cardiovascular disease and a host of other problems

 including depression and cognitive impairment.

 

            The most authoritative source on the topic of omega-3 fatty acids  is

Prof. Bill Lands, a renowned NIH researcher, who did the original studies

that showed exactly why omega-3s are beneficial. Why not hear the argument

straight from Prof. Lands, as he lectures military physicians at the NIH.

This is a four-part YouTube video that totals about 40 minutes. Note that
omega-6 fatty acids directly compete with omega-3s for entry into your cell membranes.

 

            The bottom line is that the Western diet includes far too much omega-6 fat

by a factor of ten. It's in all our salad dressings (including olive oil), in peanuts,
and peanut butter, and in lots of packaged foods. Omega-6s are pro-inflammatory

and contribute to heart disease, stroke, and an array of common diseases.

Lands refers to omega-6s as the insurgents (like the Taliban), while lecturing to the cadets.

 

            Omega-3s, in contrast to omega-6s, are benign bystanders (peaceful villagers).

They are anti-inflammatory.  Our cell membranes and tissues are directly composed of

what we eat, and we Americans are loaded with omega-6s from our diet.

 

            Take a look at this graph that Prof. Lands uses in his lectures. It shows
a direct correlation between cardiac death and the pro-inflammatory
omega-6 fat, arachidonic acid. You could just as well graph lack of fish intake and cardiac death.
Eat fish! Dump vegetable oils and anything that contains them.

 omega 6 consumption and cadiac death

 

            I also recommend these brief videos by Dr. Joe Hibbeln, a principal investigator
in Nutrition and Psychiatry at NIH, extolling the virtues of omega-3s and DHA for
improving mental health, specifically alleviating depression and cognitive impairment:
Omega-3s for Brain Health, and Joe Hibbeln Part 1 - also listen to part 2.

 

            Look at the white matter in the brain below. It is white because

it is almost entirely made of fat: the phospholipids and sphyingolipids that make up the

myelin sheathes that surround your one million miles of neural axons. That insulation,
which surrounds the cables, is directly composed from the cell membranes of brain
oligodendrocytes. How long it lasts is determined by the fats in your diet, DHA in particular.
The richest source of omega-3s and DHA is fish. (My mother used to say,
"fish is bene-fish-al." For vegans, the best source of omega-3s is flax seeds.

 

white matter

 

 

 

Jaminet's Perfect Health Diet

 

            In their book The Perfect Health Diet, Paul Jaminet (a physicist) and

 his wife Janet (a PhD biochemist) take the highly controversial position that

saturated fats may be eaten in unlimited amounts without causing harm.
Needless to say, its a conclusion I have a hard time swallowing. But,
their presentation draws extensively from the medical literature.


They also present evidence against eating four groups of foods they consider toxic:

 a) wheat and other cereal grains, b) legumes - especially soy beans and

 particularly the "textured vegetable protein" found in so many imitation meat products,

c) liquid vegetable oils like corn oil, soy oil, and safflower oil, and

 finally d) fructose, especially high-fructose corn syrup. Let's first consider
the evidence that saturated fats are not the villains that cause atherosclerosis.

 

            A) Are Saturated Fats Actually OK?

 

            A 2011 study that appeared after the Jaminet's book came out serves
to drive home their point and is similar to several other studies exculpating satfats.
This 2011 study appeared in the American Journal of Clinical Nutrition and the senior authors,
Professors Frank Hu and Ron Krauss, are two of the top scientists in this field.
This was a meta-analysis of 21 separate prospective studies evaluating the
association of satfats with cardiovascular disease: the authors found no association.

Say, what? No association? After decades of epidemiologic, clinical, and animal feeding

 studies showing a consistent atherogenic effect (or at least an elevation

 of biomarkers like cholesterol), how is it that a study that combines

 21 separate studies including over 348,000 patients shows no association?

 

            My belief, shared by critics of the study and certainly by

 the likes of Gary Taubes, is that when you eat less of one food (like saturated fats),

you eat more of something else.  Exactly what that something else is

 (the replacement food), matters considerably.  Replacing saturated fats

with trans fats, for example, is definitely worse.   Furthermore, it seems

that replacing saturated fats with simple carbs is not helpful and may even be worse.
That is my guess, but whatever the reason, this lack of association is a stunning result.

 

            But, that lack of association between satfats and atherosclerosis
would come as no surprise to Sally Fallon (or colleague Mary Enig), who presents
her argument in this video called The Oiling of America
. The video claims that
the real perpetrators of atherogenesis are imitation foods (shortenings,
margarines, refined vegetable oils, trans fats, fast carbs, and other staples
of a Western diet). She also tells a fascinating story of the influence of
the food industry and medical orthodoxy in distorting the truth. Her video
is worth watching and contains important truths. Like her, I believe that the imitation foods
are atherogenic. However, I don't believe that that exonerates satfats. The evidence that they
are atherogenic is too abundant to ignore. The evidence that statins like Lipitor prevent
atherosclerosis and lessen coronary heart disease is also overwhelming. (I take Lipitor, and
I'm not about to stop. There are hundreds of papers showing that statins prevent heart attacks.
In this 2011 NEJM study high dose statins were shown to cause regression of atheroma volume.)

 

            So, before you start swilling cream, consider another paper from AJCN in 2011
that includes two of the same senior authors from the "no association" study: Hu and Krauss.
This is a "white paper," a consensus document
that tries to lay out definitively where
the issue stood in 2011. Interestingly the meeting was paid for by the national dairy councils
of several countries. Despite that, the consensus leaves little doubt about the vast weight
of the evidence. Here are some key points from their abstract.


 1) the evidence from epidemiologic, clinical and mechanistic studies is consistent in finding
that the risk of CHD (coronary heart disease) is reduced when
SFAs (satfats) are replaced with PUFAs.
2) In populations who consume a Western diet, the replacement of 1% of energy
from SFAs with PUFAs lowers LDL cholesterol and is likely to produce
a reduction in CHD incidence of > 2-3%.
3) No clear benefit of substituting carbohydrates for SFAs has been shown.

 

            So, there you have it. The conclusion reached by the world's top nutritional
epidemiologists: replace satfats by PUFAs. But note: that does NOT mean that
substituting corn oil for beef is helpful, It is NOT. As Bill Lands pointed out above,
omega-6 PUFAs (vegetable oils) are killers; omega-3 PUFAs (fish) are saviors.


            While the medical establishment may have overdid their
prohibition of satfats, I'm NOT convinced by the full exoneration
espoused by Mary Enig/Sally Fallon nor by the young paleo bloggers
like Stephen Guyenet or Chris Kresser. Far more persuasive is veteran
lipoprotein pioneer, Ron Krauss, who recommends limiting satfats to
10% of calories, despite the fact that his lab is financed by the National Dairy Council.
And, here's a final study that appears to firmly correlate blood cholesterol
and vascular mortality
. High blood cholesterol is not innocuous!
This meta-analysis analyzed 900,000 patients; University of Oxford's
Sir Richard Peto was the epidemiologist
(knighted for his contributions to this field)!


            It is also instructive to watch Dean Ornish and Gary Taubes debate this issue,
as in this video
. As Ornish points out, they agree on most points of the debate.

They even agree that eating a high fat diet may lead to weight loss as least as rapidly as eating

a low fat diet.  The real issue, as Ornish states, is whether the end result is more

heart disease.  Ornish's studies rigorously demonstrate that the patients who are able to follow

his ultralow fat diet, can partially reverse their heart disease.  Taubes makes the excellent point

that most ordinary mortals may not be able to follow a diet with almost no fat.

 

I return now to the other issues raised by the Jaminets that are important and less controversial.


            B) "Toxic Foods:"  Cereal Grains, Soy Beans,

             Liquid Vegetable Oils, and Fructose

 

            When I was in med school around 1970 we were taught

that  celiac disease was a very rare disease. The latest estimate is

that it is probably present in about 1% of Americans, and possibly many

more in the form of IBS, irritable bowel syndrome. This 2005 paper from Nature,
for example, makes it clear how incredibly complex the gut really is
(so complex that it is still largely terra incognita - the result of the
interaction of thousands of mucosal proteins and signal transduction pathways
with trillions of bacteria and partially digested foods.) The gut has one hundred
million neurons and an absorptive area the size of a football field
.

 

            Cereal grains like wheat and barley are "new" in our diet,

 having only appeared since the agricultural revolution of 10,000 years ago

 that transformed us from paleolithic hunter-gatherers to neolithic farmers.

 Our genes have not caught up. The result is an epidemic of obesity

 and gluten sensitivity  due to several wheat-borne antigens

 that result in gut inflammation.

 

            What goes for wheat, also goes for soy beans and other legumes.

This 1999 letter by a couple of NIH researchers

spells out a part of the argument against soy beans.
And here is a comprehensive list of problems with dietary soy.

 

            About a decade ago I was stunned by a revision of the

 USDA's Food Pyramid that showed vegetable oils at the

base of the food pyramid with suggestions that the path to

health consisted in drenching ones food in olive oil.

Fortunately, that idiocy has passed.

 (I'm not knocking a Mediterranean diet, just this one misconstrual.)

The Jaminets nicely summarize the many problems with vegetable oils:
atherogenesis, plant toxins, rancidity of the oils due to industrial processing, etc.
Vegetable oils (including olive oil) are a recent innovation- stay away from them.

 

            Similarly misguided in early iterations of the USDA Food Pyramid

are versions showing heaping quantities of fruit at the base of the pyramid. 

Anyone who's tried to lose weight knows that that's not right.

How can eating those delicious little bags of sugar make you thin? 

They can't and they don't.  The advice is wrong.  What's even worse, of course,

 is the high-fructose corn syrup (HFCS) that pervades the American diet.

(But do see this "ad" from Saturday Night Live: HFCS is good for you!)


What I Eat

 

            Having spent months intensively reading this literature

(and years perusing it), what's my bottom line?

What do I actually eat?  Here's my bottom line: the foods that actually

go into my mouth. (Here: I must caution you.

What I eat is in large part determined by my own athletic lifestyle,

writing schedule, and my occasionally finicky gut. So, for example,
I will never eat a load of protein if I'm sitting down to write - the work
of digestion dulls me out (like a lion sleeping after eating a zebra).
Morning is a great time to eat veggies and salads to get my nether-parts working.
But, if I'm going for a long bike ride, I don't want that bulk in my stomach -
then, I'm just going to eat an apple.

 

If I could, I'd be eating more vegetables and salads, as advocated by
Ornish, Gupta, Fuhrman, and  Esselstyn above. But, I've found that fish is
much better at suppressing my appetite for long periods. Also, fish, meat,
and nuts increase my endurance.


Here's my food list.

 

1)  SARDINES, HERRING, SALMON

 

            Rationale:  They're tasty.  Those cans of sardines or herring are cheap.

They kill my appetite. Sardines and herring are not top predators like salmon,

so they are far less apt to contain mercury or halogenated hydrocarbons.

I do eat wild-caught salmon, but it's expensive (unless you buy the cans),

and is more apt to contain mercury. I dislike the fact that

eating salmon is not globally sustainable. I'm convinced that fish has been

part of a hominin diet for millions of years.

 

            Fatty fish are high in omega-3 fatty acids.

With all that DHA, fish is pure brain food. Or, as my mother used to say,

"fish is bene-fish-al."

 

            How about legumes like soy beans or soy burgers instead of fish?

Not for me. You may be ok with them.  But, in addition to the arguments

against soy made by the Jaminets and others, I simply cannot tolerate soy

and most other beans.  Here is a key principle of the foods I eat.

 

            Do not eat any food that causes you problems!

If a food gives you gas, bloating, diarrhea, constipation,

low energy (or whatever), dump it.  Forget whatever the literature says.

That's just theory.

 

2)  CHICKEN

 

            Rationale:  It's tasty.  I eat a fair bit of chicken
(Trader Joe's "Just Chicken.")  No cooking, easy.

It's skinless.  If you have access to free-range chicken,

so much the better. (Remember the factory farms in Earthlings.)

BTW, I'm tapering off chicken and onto more fish.

 

3)  EGG WHITES (and occasionally, yolks)

 

            Rationale:  High protein, easy to digest.
I make hard-boiled eggs every couple of weeks, and usually,
but not always, throw away the yolks. Each yoke contains about
300 mg of cholesterol: way too much. I'm familiar with the argument that
dietary cholesterol is irrelevant.  I'm not sure. I do think that
dietary cholesterol may be less harmful than dietary saturated fat,
but the two co-occur in many foods. Dietary cholesterol does
correlate poorly with blood cholesterol, but that does not justify
ignoring LDL-cholesterol, as claimed by some paleo bloggers.
Egg yolks, meat, and fish do contain choline, a trimethylamine
that is essential for brain health - choline is a precursor of the
neurotransmitter acetylcholine. But note this possible link to atherosclerosis.

 

            That's it for overtly "protein foods."

 Note: daily protein intake should be no more

than about 1 to 2 grams per kg of body weight per day.. 
Occasionally I go up to 2 mg/kg/day, like the body builders.

(BTW, Dr. Fuhrman, makes the point

that vegetables are also protein foods -

what do you think horses and elephants are made of?
I am persuaded by Loren Cordain's argument that animal protein
is more easily digested - that's certainly true for me. I also feel
stronger when eating animal protein. Nonetheless, the evidence
provided by the 7th Day Adventists and other vegetarian advocates
cannot be ignored.)

 

            What?  Where's the beef (or lamb or pork)?  I do eat
occasional free range beef, but not the others.

They are just too fatty for me. The immense literature condemning

satfats from animals makes it seem highly unlikely that they are

as safe as the paleo crowd believes.  I'd rather get my daily fats

 in the form of omega-3s from fish. BTW, I love the taste of meat

and my gut loves it. However, after eating fatty meat like lamb,

I can feel it in my palms. Look again at Loren Cordain slide showing
venison with 3% body fat versus a factory farm steer with 30% fat
- that should not be part of paleolithic eating.

 

Note:  Why is my list heavy with animal products when most of the links

I displayed in this article condemn them? Answer:  I myself cannot tolerate

the legumes and many of the plant food recommended by the laudable

vegetarian advocates I cited above. It would be dishonest of me
and not helpful to you to claim otherwise.

Furthermore,  this diet has led to my achieving my ideal weight

and improving my LDL and HDL. If you can

tolerate the diet advocated by Dean Ornish or

by Caldwell Esselstyn for Bill Clinton, then go for it, especially

if you have bad coronaries.  (I'll let you know when and if  the paleo crowd

does a study like Ornish's only showing that unlimited saturated fat
leads to regression of atherosclerosis.  They haven't, and they can't - that's my bet.

 

            Here's another quote from my mother (a rabbi's daughter and
career public health nurse, who died at age 91.)
"Pastrami killed more Jews than Hitler!"

 

4) NUTS: Almonds, Walnuts, Cashews, Macademias

 

            Rationale: tasty,  compact for hiking and biking, nongreasy (unlike animal fats),

source of PUFAs and MUFAs.  But need to be carefully rationed.  Easy to overdo and

loaded with fat.  The MUFA wiki contains a handy table of fat content in various foods.
(Go to the section called Natural Sources and click on the
link "Fat composition in different foods.")


Among the nuts, walnuts contain the most PUFAs. But, if you're not worried about

satfats, then also eat the others.  As Bill Lands pointed out in his lecture above,

peanuts are loaded with omega-6 fatty acids (the pro-inflammatory "insurgents"),

so no peanuts or peanut butter (the staple of my youth). I also recommend
restraint with macademia nuts. They are loaded with palmitoleic acid, which
elevates LDL cholesterol. BTW, roasted flaxseeds taste great on salads.

 

5) AVOCADOS and OLIVES

 

            Rationale: tasty, good source of MUFAs, staple of Meditteranean diets,

nongreasy. Need to be carefully rationed. Loaded with fat - not for everyday consumption.
BTW, if you insist on a salad dressing, the universally agreed upon choice
uses extra-virgin olive oil (high in oleic acid (MUFA) content.)

 

6)  FRUIT: APPLES and oranges, lemons, blueberries, raspberries, etc.

 

            Rationale: tasty, good source of carbs but need to be carefully rationed.

These little bags of sugar are seductive.  I almost never buy grapes, for example.
I'm like a dog - if I buy a week's worth of grapes, they're gone in 10 minutes.
Fruit needs to be carefully rationed.  Modern fruit bears no resemblance to the

wild varieties that our paleolithic ancestors ate.  Compare a giant, sweet

modern apple to a scrawny, crab apple, and you get the idea.

 

            My guess is that the medical establishment's recommendation to

eat lots of fruits and vegetables, gets translated to "eat lots of fruit."

(What do you think? Are people eating kale and broccoli or apples and oranges?)

If you're trying to lose weight, fruit is a huge mistake. As an experiment,

cut the fruit out entirely for awhile.

 

7)  SALADS: Romaine, Spinach

 

            Rationale: After listening to Joel Furman's lectures, I thought

 "yes, three big heaping plates of salad per day."

 I tried it and just could not do it.

 My gut won't tolerate it.  Note, Dr. Furman makes

the point that there is absolutely no point in putting

500 calories worth of dressing on a 5 calorie salad.

As he says, "why not just skip the salad, and

just drink the dressing straight out of the bottle."

I use marinara sauce on my salads instead of

any oil or mayonnaise-based dressings.

 

            Dr. Furman loves beans.  Sorry, I just can't do it.
Same with soy beans and tofu. The Jaminets think they're toxic. 

 

8)  VEGETABLES: Sweet Potatoes, Carrots, String Beans, Peas

 

            Rationale: Sweet potatoes are an idea from the

 traditional Okinawan diet. They are great.

I slice them thin and microwave them for about 3 minutes.

I eat them with some seasoning salt.

 

            My vegetables are typically frozen (a convenience thing).

 I pour them into bowls in the regular section of the fridge

and then defrost for 24 hours.  I then eat them raw. I also steam

bok choy and spinach.

 

            I'd love to be able to eat crucifers (broccoli, brussel sprouts,

cabbage, etc.) with all those wonderful anticarcinogens. If you can, go for

it. I just can't do it, despite having tried all the tricks.  Apparently, this is

a problem also shared by Big Bang’s uber-nerd Sheldon Cooper, as he

tries to go on an all-crucifer diet, desiring to live long enough to do a
mind upload to a post-Singularity mainframe. (BTW, several of my
friends are head freezers, but not me.) President George H. W. Bush
(Senior: the smarter one) was also famous for his hatred of broccoli.

 

9)  RICE and rice crackers and cakes

 

            Rationale:  I and most people on the planet have no digestive problems with rice.

It lacks the antigens present in the other grains like wheat and barley.

Rice is a staple in Asian diets, especially the Okinawan diet described above.

But watch it! Rice, even brown rice, is high-glycemic.

 

            I never cook rice.  I don't want to eat that much.  It's easier to titrate

as rice cakes or rice crackers.  I eat a gluten-free diet.

 

10)  WATER

 

            I drink distilled water.  Our municipal water,

which comes from Sierra snowmelt, is pretty good.

But, by the time it gets to me, it tastes like iron from the pipes.

The snowmelt I drink in the Sierras every August

tastes much more like my distilled water.  At home

 I usually add a splash of low-cal cranberry juice.   Yum.

 

            (Also see my article on supplements I take.
(My vitamin D is mainly from from walking shirtless on warm days.
But, don't overdo it! Melanoma is worse than having low vitamin D.)
Most supplements are useless or worse. Get your vitamins
from food! Here, I discuss the difficulty of determining
whether a drug or supplement actually works
.
Most of them do NOT.)

 

            A note about chewing gum.  I occasionally chew
sugarless gum to end a meal.  But there is a potential problem
with it that you need to be aware of.  It contains unabsorbable
sugars like sorbitol, maltitol, and mannitol. It exacerbates
gut problems in many people - eg, these two whom it nearly killed

 

            And a note on DAIRY FOODS. Most people on the planet have
lactose intolerance. But, even if you don't, I would still exercise great
restraint with dairy. It was NOT a part of the paleolithic diet, as Loren Cordain
emphasizes. Furthermore, it's loaded with satfat. Please recall the interview
I linked to above with renowned lipoprotein pioneer Ron Krauss who recommends
limiting satfats to 10% of calories. Furthermore, please recall the
2007 meta-analysis analyzed by Sir Richard Peto involving 900,000
patients that found a large correlation between high cholesterol and cardiac death.


CONCLUSION

 

            As I Iook at what I actually eat, it looks far more

like a Loren Cordain paleo diet than a complex carb,

ultra-low fat vegetarian diet a la Dean Ornish. Yes, indeed.

But please note - this is heavily influenced by

what happens to work best for me . 

But perhaps this is also a part of the truth that has been exposed by

the paleo advocates like Gary Taubes and Loren Cordain. 

That is part of what motivated this article (the difference between
theory and practice). Achieving an optimal diet is not simple.

It must be carefully tailored by each of us

to our own circumstances, tastes, and tolerances.

 

            To your health. Live long and prosper!

 

Bob and Ray Kurzweil at SETI

 With Ray Kurzweil at the SETI Institute. We're holding the Drake Equation.
Ray was a classmate of mine at MIT in the 1960's. Like Ray, I am enthralled
by the accelerating pace of information technology and biomedical research.
Longevity enables me to take advantage of new research innovations.
It's never been easier - the world's knowledge is at your finger tips on the web.

 

CORRESPONDENCE           


On January 15, 2012 I sent the following letter to Stephen Guyenet, PhD.
Dr. Guyenet studies lipoprotein metabolism and its relationship to neural regulation of appetite.
He runs a popular website, Whole Health Source, that deals with these issues.
This post of his focuses on the satfat issue and prompted my letter to him.

Hi Stephen,

 A few of my friends are fans of your nutrition website.   I also really appreciate your
detailed and scholarly analyses of these very important issues.

I'm  an MD, PhD, career emergency physician and former Stanford researcher,
now back on campus studying cognitive neuroscience.

I wanted to sort out the statin/ saturated fat/ LDLc  issues for myself to see
where the literature stands in 2012.     This essay is my result -  not as high-brow as your posts -
http://www.bobblum.com/ESSAYS/MEDICINE/Food.html


Here's why I'm writing.  It's  easy to find articles in the literature
that support statin efficacy - here's one among many.

Do you deny that efficacy or explain it via other mechanisms?  Did I miss
an essay of yours in which you  deal with  this and other similar articles. 
(My feeling is that you, Chris Kresser, Sally Fallon all have this  WRONG -
although many of your posts are correct (on insulin, n3/n6 etc.)

Similarly,  with LDLc,  I note that  Chris Kresser poo poos it, and possibly you do, too .
So,  how do you account for Ron Krauss's  remarks  (limit satfat < 10% of calories)
in this interview
(near the  close of the interview). Or,  this consensus paper 
(supported by the national dairy councils!!) that warns about satfats and LDLc.

Or,  this one (note: co-author  SIR Richard PETO - no slouch!)
 
Did I miss your response to these articles in your blog? 
Just trying to keep you out of trouble.

Best wishes,  Bob
 
www.bobblum.com
Cognitive Neuroscience, Artificial Intelligence, Automated Discovery,
Biotechnology, Biosphere Preservation and Global Consciousness

And here, on January 17, 2012 Dr. Guyenet responds.

Hi Dr. Blum,

   Thanks for your message.  My position is that LDL (most likely oxLDL (oxidized LDL),
but I can't be 100% confident that native LDL does not play a role) contributes to
atherosclerosis and thus the likelihood of having a heart attack.  Statins are effective
preventative agents against heart attacks in high-risk groups (particularly secondary
prevention in men), probably via a mechanism involving LDL reduction and
suppression of inflammation (statins are anti-inflammatory and have shown efficacy
against rheumatoid arthritis for example). Statins also have negative side effects
including increased risk of myopathy, cognitive problems and diabetes.

Atherosclerosis, as far as I can tell, is primarily an inflammatory disorder, and
the primary inflammatory agent is excessive oxidized lipoproteins with insufficient
reverse cholesterol transport via HDL.  But there are probably many other
inflammatory factors that can contribute to the process.

Regarding the effect of SFA (satfat) on atherosclerosis and CHD risk, I continue
to maintain that a significant role in humans has not been established. 

A recent meta-analysis by Ronald Krauss's group concluded "there is
no significant evidence for concluding that dietary saturated fat is associated
with an increased risk of CHD or CVD".  SFA increases LDL cholesterol content
(not necessarily particle number) in the short term, but apparently not oxLDL and
they also increase HDL.  Therefore, the effect of SFA on LDL cholesterol content
cannot be used in isolation to predict its effect on CHD risk.
What we need to consider are studies that examine the effect of SFA
on CHD risk directly. These have been conducted, and they largely indicate that
SFA reduction is ineffective for CHD prevention,
particularly when it is replaced by n-6 rich refined seed oils.

I have no doubt that a simple, unprocessed, high-fiber, low-fat plant-based diet would
lower CHD risk relative to what most people eat today.  Therefore I am not at all surprised
by the apparent results of Ornish, Esselstyn etc, although I think that scientifically,
they really have not rigorously established that their interventions work.  My position is that
this kind of diet would be better for overall health if it included more animal foods and focused
on starchy root vegetables to a greater extent than grains, and this would still be consistent
with excellent cardiovascular health.  But I have nothing against a low-ish fat diet that
contains only a small amount of meat/fish/dairy/eggs as long as it is well composed
(no white flour, seed oils, refined sugar, processed food, grains and legumes
prepared according to traditional methods).  And I certainly have nothing at all against
unrefined carbohydrate.

Cheers, Stephan
-----------------------------------------------
Stephan J. Guyenet, Ph.D.
Senior fellow
University of Washington
Division of Metabolism, Endocrinology and Nutrition
Laboratory of Dr. Michael W. Schwartz