spinach/berry smoothie

New, favorite, easy. Makes 2 servings

Ingredients:

1 bag frozen sweet cherries

1 bag frozen berries (blueberry, strawberry, raspberry, or mixed)

1 bag (5 oz) spinach

1 large orange or 2 small, or 4 mandarine, peel and remove seeds

2 Tbsp flax seeds

2 Tbsp sunflower/pumpkin/hemp seeds

vitamins and vitamin D

DHA supplement

1/2-1 cup water

Blend the supplements, seeds, oranges, water, and spinach until smooth. Add the berries and blend again until smooth.

blueberry/cherry "compote"

This is easy and fast and good.

Ingredients:

1/2-1 cup frozen blueberries

1/2-1 cup frozen cherries

0-1/2 oz chopped nuts (walnuts are good, so are cashews, brazil nuts)

1 tsp unsweetened coconut shavings (optional)

Combine in a bowl, heat in the microwave for a minute or two. A good winter treat.

New Year's eve

Today I had fun making healthy "treats" since it's New Year's eve.

I made peanut/banana spread. This is healthier than fresh peanut butter, and I confirmed that it tastes better! (I had some peanut butter yesterday with a banana). I like the consistency better too. Peanut butter is too gooey.

I ate it with an apple (no picture), celery,

lettuce,

and carrot:

My favorite was the lettuce and least favorite was the apple. The apple is good on its own so no need to add this--it drowns out the taste a bit. The celery and carrot and lettuce were great.

At lunchtime, I made blueberry/cherry "compote." Yummy:

I was studying for a nutritional exam, and was reminded how good spinach is for you, so for dinner I had a spinach/berry smoothie.

I also ate a pomelo, and too many brazil nuts. The pomelo is a giant fruit that is a bit sweeter than grapefruit. It was a bit dry but good.

The Body Fat Setpoint

One pound of human fat contains about 3,500 calories. That represents roughly 40 slices of toast. So if you were to eat one extra slice of toast every day, you would gain just under a pound of fat per month. Conversely, if you were to eat one fewer slice per day, you'd lose a pound a month. Right? Not quite.

How is it that most peoples' body fat mass stays relatively stable over long periods of time, when an imbalance of as little as 5% of calories should lead to rapid changes in weight? Is it because we do complicated calculations in our heads every day, factoring in basal metabolic rate and exercise, to make sure our energy intake precisely matches expenditure? Of course not. We're gifted with a sophisticated system of hormones and brain regions that do the calculations for us unconsciously*.

When it's working properly, this system precisely matches energy intake to expenditure, ensuring a stable and healthy fat mass. It does this by controlling food seeking behaviors, feelings of fullness and even energy expenditure by heat production and physical movements. If you eat a little bit more than usual at a meal, a properly functioning system will say "let's eat a little bit less next time, and also burn some of it off." This is why animals in their natural habitat are nearly always at an appropriate weight, barring starvation. The only time wild animals are overweight enough to compromise maximum physical performance is when it serves an important purpose, such as preparing for hibernation.

I recently came across a classic study that illustrates these principles nicely in humans, titled "Metabolic Response to Experimental Overfeeding in Lean and Overweight Healthy Volunteers", by Dr. Erik O. Diaz and colleagues (1). They overfed lean and modestly overweight volunteers 50% more calories than they naturally consume, under controlled conditions where the investigators could be confident of food intake. Macronutrient composition was 12-42-46 % protein-fat-carbohydrate.

After 6 weeks of massive overfeeding, both lean and overweight subjects gained an average of 10 lb (4.6 kg) of fat mass and 6.6 lb (3 kg) of lean mass. Consistent with what one would expect if the body were trying to burn off excess calories and return to baseline fat mass, the metabolic rate and body heat production of the subjects increased.

Following overfeeding, subjects were allowed to eat however much they wanted for 6 weeks. Both lean and overweight volunteers promptly lost 6.2 of the 10 lb they had gained in fat mass (61% of fat gained), and 1.5 of the 6.6 lb they had gained in lean mass (23%). Here is a graph showing changes in fat mass for each individual that completed the study:

We don't know if they would have lost the remaining fat mass in the following weeks because they were only followed for 6 weeks after overfeeding, although it did appear that they were reaching a plateau slightly above their original body weight. Thus, nearly all subjects "defended" their original body fat mass irrespective of their starting point. Underfeeding studies have shown the same phenomenon: whether lean or overweight, people tend to return to their original fat mass after underfeeding is over. Again, this supports the idea that the body has a body fat mass "set point" that it attempts to defend against changes in either direction. It's one of many systems in the body that attempt to maintain homeostasis.

OK, so why do we care?

We care because this has some very important implications for human obesity. With such a powerful system in place to keep body fat mass in a narrow range, a major departure from that range implies that the system isn't functioning correctly. In other words, obesity has to result from a defect in the system that regulates body fat, because a properly functioning system would not have allowed that degree of fat gain in the first place.

So yes, we are gaining weight because we eat too many calories relative to energy expended. But why are we eating too many calories? Because the system that should be defending a low fat mass is now defending a high fat mass. Therefore, the solution is not simply to restrict calories, or burn more calories through exercise, but to try to "reset" the system that decides what fat mass to defend. Restricting calories isn't necessarily a good solution because the body will attempt to defend its setpoint, whether high or low, by increasing hunger and decreasing its metabolic rate. That's why low-calorie diets, and most diets in general, typically fail in the long term. It's miserable to fight hunger every day.

This raises two questions:

1. What caused the system to defend a high fat mass?
2. Is it possible to reset the fat mass setpoint, and how would one go about it?
   

Given the fact that body fat mass is much higher in many affluent nations than it has ever been in human history, the increase must be due to factors that have changed in modern times. I can only speculate what these factors may be, because research has not identified them to my knowledge, at least not in humans. But I have my guesses. I'll expand on this in the next post.


* The hormone leptin and the hypothalamus are the ringleaders, although there are many other elements involved, such as numerous gut-derived peptides, insulin, and a number of other brain regions.

dec. 29 food

Today I had berries for brekky (frozen blueberries), plus too much other fruit and too many cookies.

For lunch I had delicious soup, lettuce & bell pepper, some fruit and carrots, and too many cookies.

For dinner, I had yummy butternut squash apple bake, some berries from the freezer (blueberry and cherry), and some carrots.

I ate too much. burp.

butternut squash/apple bake

This is really a version of Dr. Fuhrman's sweet potato apple bake, but I tried it with butternut squash instead of sweet potato, since we get the squash locally for much of the winter.

Ingredients:

1/2 large or 1 medium butternut squash

2 apples

2/3 cup raw cranberries, fresh or frozen

1/2 cup raisins

2/3 cup orange juice (I used mandarin oranges)

1/2-1 tsp cinnamon

Preheat the oven to 350 F. Cut the squash in half lengthwise, and dig out the seeds and stringy stuff. I found scraping it with a knife first frees up the stringy stuff, and then a spoon can remove it. Peel the squash. I recently got what I think is called a t-peeler. This worked great. Here's a picture showing the t-peeler at top left, and the chopped squash:

Next, peel and chop the apples. Combine everything in a baking dish. Cover with foil. Bake for 1 hour, 15 minutes. In the last 15 minutes, add the cinnamon and remove the foil to toast it a bit.

I forgot to take a picture of the finished project. Here's a picture of a version with sweet potatoes instead of squash:

Note on modifications: I recently tried this with beets and squash and didn't like it as much. It's better just with the squash!

Dec. 28 food

Here's a pictoral view of yesterday's meals.

Brekky:

mandarine oranges, apple, kiwi, carrot.

Lunch:

At top left is house-mate's lunch: brussels sprouts, carrots, corn, edamame, ground sunflower seeds. Mine is at right: brussels sprouts, red cabbage drenched in kale fennel soup. Now I really like that soup. It just took getting used to. dessert was one cashew cookie and banana oatmeal cookie each.

Dinner was salad with my favorite sweet pea dressing. Today's version had peas, flaxseeds, mandarine oranges and d'angou pear vinegar. Here's the dressing before blending:

Here's the salad, and the cookies for dessert.

oops, then I had some more cookies.

Review of Avatar

Here is an intriguing quote from the NYT's review of James Cameron's latest blockbuster, Avatar:

"Religion exists, in part, precisely because humans aren’t at home amid these cruel rhythms. We stand half inside the natural world and half outside it. We’re beasts with self-consciousness, predators with ethics, mortal creatures who yearn for immortality.

This is an agonized position, and if there’s no escape upward — or no God to take on flesh and come among us, as the Christmas story has it — a deeply tragic one.

Pantheism offers a different sort of solution: a downward exit, an abandonment of our tragic self-consciousness, a re-merger with the natural world our ancestors half-escaped millennia ago.

But except as dust and ashes, Nature cannot take us back."

It is interesting to hear such thoughts expressed in the NYT. Maybe I'm not as critical a thinker as I need to be, or I'm secure in my world view, but this neither bothered me, nor seduced me while I was watching it. I actually found the movie quite amazing and well-worth the watching in the theater.

I have read this critical review knocking the movie as an "anti-war politic[al] movie". But after watching the film, I walked away thinking I agreed with the movie's "agenda" as I understand it. It really was more of an anti-colonialism movie, which I can proudly say America does NOT embrace this ideology. Yes, we have a history of it, but not anymore. And as we look back and see the destruction that colonialism had on a native people, this movie portrays that well. No one group of people has the right to enslave or exile another group for the first group's own benefit - no matter how you slice it. That was the political message I got. Additionally, the "anti-war" agenda that was present was more tied to this use of the military, more than a pure "anti-war" theme. Of course, there were the stereo-typical strawmen comments/arguments in the movie. But overall, they are easily over-looked for the benefit of the rest of the movie.

As I saw it, it was a brilliant and redeeming portrayal of an ugly historical theme. World history has reflected the battle of colonialism countless times. The movie portrayed it in a future setting in another world. Aside from that, it was fascinating, creative, beautiful, and moving, as well as scientifically curious related to the "avatar" technology. I overlooked the pantheism the movie presented - it actually reminded me of a Native American culture, which was not offensive to me. I highly recommend this movie. It's great eye candy.

Fun weekend cooking!

I decided to make some Fuhrman recipes this weekend. His soups tend to be hearty and rich, which sounds perfect for the winter. I decided I want to make the 3 "High Cruciferous Soups" in the Nov. 2004 newsletter (members only, sorry!). So I started yesterday with the Kale fennel soup (recipe here, my post about it here). It was good, but as I said in my post, I think my modifications made it worse than it should have been. So I'll have to try it again sometime.

Then today, to help me resist those awful SAD (Standard American Diet--namely, sugar, refined grains, and chocolate!) treats that not only are unhealthy, but make me feel like crap when I eat them, I decided to make some Fuhrman treats. Even though I didn't think I needed to be such an extremist, well, I think I do after all! I just can't stand how I feel when I eat that stuff, not only moments afterwards with the hyperactivity, but days afterwards with the grogginess. I think I just have to be 100% in the Fuhrman universe so that I feel normal all the time. The chocolate and sugar feels like a strong drug to me now, as does alcohol and caffeine. And if I'm 98% compliant, that's pretty extremist to most people, so why not go all the way to 100%. No one will notice the difference. They'll notice much more if they see me eating SAD food. Okay, sorry to ramble so much there.

So, anyway, to help me in the psychological department where I get jealous when I see everyone eating all those treats, I decided I should probably have some treats from the Fuhrman universe of foods. So today I made cashew cookies and banana oat cookies. I actually wasn't sure I'd like either one but I ended up liking both! I think my taste buds have changed over the years, which is also why I find the SAD treats too sweet and artificial tasting. So I'm not suggesting that SAD eaters will like these, but I'm not making these for SAD eaters. However, I was surprised that house mate, who eats a lot of SAD sweets, liked both batches of cookies. In addition to the cookies, I made a bunch of smoothies for house mate (two batches of 3, or 6 total). I love making the smoothies because I nibble on the various ingredients as I make them. I don't make the smoothies for myself because I prefer the flavor of the individual fruits better, these days anyway. But I do enjoy eating the leftovers from the blender afterwards with the help of the spatula, yum. It's amazing how much you can scrape out of there.

Anyway, it was a fun weekend in the kitchen. I love preparing food. I wish I could do this all the time!

kale fennel soup

Even though I can't post this recipe here, because it's on the Fuhrman member site, I'm going to write some notes for myself for future reference. I also forgot to take pictures, sorry.

I modified the recipe a little based on recent advice from Dr. F. to blend up the cruciferous veggies before cooking to allow isothiocyanates to form (they fight cancer). So I blended up the onions, zucchini and kale before cooking. Well, it's not quite as creamy when you do this before instead of after. So next time I will also blend afterwards. In fact, I didn't need to blend the zucchini before, since it's not a cruciferous veggie. I liked the parsnips. The first time I ate parsnips, I didn't like them, but I really like them in this soup. I guess I just had to get familiar with them. Next time instead of split peas and lentils, I will use these heirloom beans that I've been enjoying so much lately. They are so creamy, I think because they are reasonably fresh. After soaking overnight, they only need a few hours to cook so are not that much different in cooking time from the split peas that do not seem to be so fresh and seem to take a few hours also (even though they should take less if they are fresh). Also these larger beans have more resistant starch which Dr. F. says is really good for you. I usually double the amount of beans in these recipes because I love beans.

So my verdict on the recipe: Following the lead of Jana, who grades the recipes, I think I would just give this a B (update the next day: I like this much more today and give it an A-. It's great by itself or on vegetables. I think I just had to get used to it. An A- for texture due to my blending the veggies ahead of time, and an A for taste).

Banana oatmeal cookies

I don't feel right sharing the recipe for these cookies since it only appears on Dr. Fuhrman's member site. But I will show some pictures and describe them. They are pretty low-fat and low-sugar so I was not expecting to like them, but I was surprised that I did like them! I find most SAD (Standard American Diet) cookies to be too sweet, so SAD eaters used to them might find these too bland. Still, house mate, who eats SAD candy all the time, liked them.

The recipe calls for oats, over-ripe bananas, baking soda, cinnamon, and a small amount of sunflower seeds and raisins. That's very low fat and low sugar!

You grind up the oats in the blender:

Puree the bananas in the blender:

Then combine everything and bake. Here's the final result:

It tasted kind of like banana bread. My bananas weren't overripe enough so I added 1 Tbsp of date sugar. Next time, I'll let the bananas over-ripen. The sunflower seeds add a nice accent. The raisins add sweetness. A nice little treat.

cashew cookies

To prevent myself from eating off-plan treats, I'm going to supply myself with healthy treats so I don't feel deprived. These don't make me feel like crap the way the sugar and chocolate and oil in regular cookies do (plus they don't give me all the diseases those other cookies do). This recipe is posted here, which is a public site, so I think it's okay to repost here for my own benefit. Also I did some variations.

The ingredients are:

1 cup raw cashew butter or 2 cups raw cashews

1 cup oats

1 tsp cinnamon

1/3 cup date sugar

1/2 cup water

1/4 cup unsweetened applesauce

1 tsp vanilla

Unsweetened strawberry jam

Well, I don't see the need to buy unsweetened apple sauce when you can just cook up an apple in some water and that will turn into apple sauce. So that's what I did:

And I thought, a pear would be good too, so I added in a pear too. I probably had quite a bit more than the 1/4 cup called for in the end (1/2 cup maybe or more, didn't seem to hurt anything). I added my 1/3 cup date sugar and 1/2 cup water to this to let the flavors blend in a bit.

Then I was at the store looking at the ingredients in unsweetened strawberry jam and it was just strawberries and apple or grape juice, and I thought, well, I can make that too. I just happened to be making a bunch of smoothies for house mate anyway, so I took some of the frozen berries---blueberries, raspberries, cherries, and strawberries, and put them in a pan. Then I juiced a pear and apple (helps to have a juicer!). Here they are cooking:

I just let them cook down until it was a mushy jam. I was busy making the smoothies while this was cooking so I was in no hurry.

Next you grind the oats to a flour. Vita-mix has a dry blender container. I think the blades are pointed differently and it works great. Here's the ground oats:

You can use this container to grind the cashews too. before grinding:

And after, in the mixing bowl. It was turning into cashew butter:

Next, mix everything together, then drop onto a cookie sheet, make a well in the middle and add the jam there. I oiled the cookie sheet with olive oil, wiped up with a paper towel so it was just a thin layer.

Here they are after baking:

I liked them! They taste kind of like peanut butter and jelly. House mate liked them too, which surprised me, because she also likes the standard cookies with lots of sugar and butter. This container is going in the freezer, and another in the fridge:

Great new blog

Jana started a new blog patterned after the Julie/Julia movie. She's going through Dr. Fuhrman's Eat for Health book, making every recipe and blogging about it! It's great! Here's the link.

holiday eating

I had an enjoyable holiday season. However, I did go off the healthy eating plan on 3 occasions over the course of 2 days, at a party and at two restaurant meals. I rationalized it as follows: I’m thin and healthy (knock on wood) and Dr. Fuhrman says 90% compliance is enough to maintain health. So I’m well within his parameters. But I have to say, I don’t think it’s worth it! The effect of unhealthy food on a healthy body is too much of a shock. I felt hungover for 3 days after this, and what fun is that? And I didn’t even eat that unhealthy, compared to normal standards. At the party I had small servings of lentil salad, chick pea salad, hummus, tempeh, chocolate pudding (made with tofu), chips & salsa, and a few vegan cookies. I have to admit I enjoyed the salt a lot. But I hardly slept that night from the sugar and chocolate. At one of the restaurant meals I had a tofu scramble burrito, fried potatoes, toast with earth balance (margarine), and a decaff soy latte. At the other restaurant meal, I had hummus & pita bread, a couple of small falafels (deep fried!), and baklava (very sweet! and, yes, good). It all tasted good, but mainly due to the salt—try eating that stuff without salt and it’s bland, I guarantee. Again, I was surprised by my attraction to the salt. But then I paid for it. My hands got uncomfortably swollen, and my nose bled a little. I suspect this is harmful to the body to go from no salt to a ton of salt in one day. And the same goes for a body not used to sugar, caffeine, and chocolate. I’m glad I didn’t try the alcohol.

One thing I noticed is that I am more fun and interesting when I’m on these drugs (sugar, refined grains, caffeine), and I have more fun at the parties. When I went back to healthy eating and went to another party, and I found it dull and I was probably dull too. When you think about it, everyone else is on drugs from the sugar, refined grains, caffeine, chocolate, and alcohol (all at the same time!). So they are all hyped up and I’m not. I come across as boring and tired, and I have to admit, it is kind of boring to stand around and watch everyone else eat and drink.

After going back on plan, I wasn’t very hungry for 2 days, and mainly ate veggies and fruit. I’ve been eating cabbage & apple (no onion or raisins) for brekky. I had my favorite simple salad a couple of times: lettuce and sweat pea dressing. When I ate that I thought it was as good as anything I had on the “splurge”. So why bother?? I was sort of back to normal on day 3. That was today, Christmas Day. I was planning to visit relatives but the weather prevented it, so a friend and I did some volunteering at a local church and Christmas dinner. That was lots of fun. Afterwards I gave my friend the option to go over to another friend’s house for a traditional dinner, or to eat the last of the veggies in my refrigerator. He chose the veggies. I made my usual veggies & beans & seeds dish (had some beans in the freezer), with broccoli, carrots, potato, corn, cabbage, and hemp/sunflower seeds. My friend loved it. That’s such an easy recipe and it’s a hit with SAD (Standard American Diet) eaters. I think the reason is due to the carrot juice in the beans. It gives it a little sweet flavor. The ground seeds are also key because they thicken the cooking water up a bit and make it into a sauce with some fat in it. I made a mango-mandarine-coconut sorbet, which was good (1 cup frozen mangos, 2 small mandarine oranges, 1 Tbsp shaved coconut).

Tomorrow I will have to go grocery shopping, though it would be fun to see how far I can go with what I have in the fridge. It’s now mostly carrots and some cabbage and oranges, and one cup of beans. Hmmm. Well, that combo would probably taste good too!

Blog update

I took a little break from blogging over the holidays. I'm hoping to start up a new hobby soon, so I think I will have to cut back on blogging to fit it in. I’ll probably cut back on the daily food logs and just post recipes or rants. I did the daily food logs to provide examples for how to eat healthy on a daily basis (when I do it right!). There are plenty of old posts if someone wants to see that still. Just click on the “food logs” label at right to see hundreds of posts.

Rabbits on a High-Saturated Fat Diet Without Added Cholesterol

I just saw another study that supports my previous post Animal Models of Atherosclerosis: LDL. The hypothesis is that in the absence of excessive added dietary cholesterol, saturated fat does not influence LDL or atherosclerosis in animal models, relative to other fats (although omega-6 polyunsaturated oils do lower LDL in some animal models). This appears to be consistent with what we see in humans.

In this study, they fed four groups of rabbits different diets:

1. Regular low-fat rabbit chow
2. Regular low-fat rabbit chow plus 0.5 g cholesterol per day
3. High-fat diet with 30% calories as coconut oil (saturated) and no added cholesterol
   
4. High-fat diet with 30% calories as sunflower oil (polyunsaturated) and no added cholesterol
   

LDL at 6 months was the same in groups 1, 3 and 4, but was increased more than 20-fold in group 2. It's not the fat, it's the fact that they're overloading herbivores with dietary cholesterol!

Total cholesterol was also the same between all groups except the cholesterol-fed group. TBARS, a measure of lipid oxidation in the blood, was elevated in the cholesterol and sunflower oil groups but not in the chow or coconut groups. Oxidation of blood lipids is one of the major factors in atherosclerosis, the vascular disease that narrows arteries and increases the risk of having a heart attack. Serum vitamin C was lower in the cholesterol-fed groups but not the others.

This supports the idea that saturated fat does not inherently increase LDL, and in fact in most animals it does not. This appears to be the case in humans as well, where long-term trials have shown no difference in LDL between people eating more saturated fat and people eating less, on timescales of one year or more (some short trials show a modest LDL-raising effect, but even this appears to be due to an increase in particle size rather than particle number). Since these trials represent the average of many people, they may hide some individual variability: it may actually increase LDL in some people and decrease it in others.

Merry Christmas!

My New House So Far - UPDATED

[UPDATED with paint and cabinets on the wall]

I bought a house this year taking advantage of the fed grant for first-time home-buyers. Here are some before/during pictures (I'm not to the "After" stage yet).

When you walk into the house you used to see into a hallway staring at the furnace closet. Now you see an entryway closet and there is just a foyer, no hallway anymore.



This is looking toward the kitchen at a door that goes to the car port and another (on the left) that goes to the laundry room. The wall on the right is where the double oven is. I tore out all the panelling, took out that full wall and moved it out another foot or so, creating a breakfast bar and expanding the kitchen to include the eating area on the left of the first picture. (I closed off the door on the right to the car part)





[Here is the same view -one before and one now with paint and cabinets]












Here is a view looking from other corner into the same room. I closed of the door going into the back yard on the far right and took out the window to make room for the wall going across the room and added the french doors.







[Here's what it looks like now with paint and cabinets and furniture]












Here's what it looked like from inside and outside the house to close off the door and window and make an opening for the French doors.



This is the living room looking at the wall to the dining room/kitchen. The door on the right goes down the hallway to the bedrooms. So to create more of a Great Room/open floor plan, I have cut 2 six-foot doorways into the dining room and taken out the door to the hallway. Right now the new cabinets are sitting in the living room waiting for the kitchen to be done.



Well, I'm getting close to finishing the new drywall in the kitchen and dining room and then will be able to paint. It will be nice to have things put in place soon. Stay tuned for the "after" pictures. And feel free to come visit!

Global Warming Takes on the Family Pet

If your God is Mother Earth it makes sense you will take on anything that assaults her honor.  It's interesting that this whole "carbon footprint" calculation could be turned on everything from how much your plasma tv is desecrating the holy Mother to the obvious abomination of the driving an SUV.  Well the Crusade has made it to the new frontier of the family pet!

Combine the land required to generate its food and a "medium" sized dog has an annual footprint of 0.84 hectares (2.07 acres) -- around twice the 0.41 hectares required by a 4x4 driving 10,000 kilometres (6,200 miles) a year, including energy to build the car....

"Owning a dog really is quite an extravagance, mainly because of the carbon footprint of meat," Barrett said.

Other animals aren't much better for the environment, the Vales say.

Cats have an eco-footprint of about 0.15 hectares, slightly less than driving a Volkswagen Golf for a year, while two hamsters equates to a plasma television and even the humble goldfish burns energy equivalent to two mobile telephones....

And pets' environmental impact is not limited to their carbon footprint, as cats and dogs devastate wildlife, spread disease and pollute waterways, the Vales say.

But there was one point I could agree with in the article:

But the best way of compensating for that paw or clawprint is to make sure your animal is dual purpose, the Vales urge. Get a hen, which offsets its impact by laying edible eggs, or a rabbit, prepared to make the ultimate environmental sacrifice by ending up on the dinner table.

"Rabbits are good, provided you eat them," said Robert Vale.

I've always said, "I like cats - they taste like chicken."

What's the Ideal Fasting Insulin Level?

Insulin is an important hormone. Its canonical function is to signal cells to absorb glucose from the bloodstream, but it has many other effects. Chronically elevated insulin is a marker of metabolic dysfunction, and typically accompanies high fat mass, poor glucose tolerance (prediabetes) and blood lipid abnormalities. Measuring insulin first thing in the morning, before eating a meal, reflects fasting insulin. High fasting insulin prevents the escape of fat from fat tissue and causes a number of other metabolic disturbances.

Elevated fasting insulin is a hallmark of the metabolic syndrome, the quintessential modern metabolic disorder that affects 24% of Americans (NHANES III). Dr. Lamarche and colleagues found that having an insulin level of 13 uIU/mL in Canada correlated with an 8-fold higher heart attack risk than a level of 9.3 uIU/mL (1; thanks to NephroPal for the reference). So right away, we can put our upper limit at 9.3 uIU/mL. The average insulin level in the U.S., according to the NHANES III survey, is 8.8 uIU/mL for men and 8.4 for women (2). Given the degree of metabolic dysfunction in this country, I think it's safe to say that the ideal level of fasting insulin is probably below 8.4 uIU/mL as well.

Let's dig deeper. What we really need is a healthy, non-industrial "negative control" group. Fortunately, Dr. Staffan Lindeberg and his team made detailed measurements of fasting insulin while they were visiting the isolated Melanesian island of Kitava (3). He compared his measurements to age-matched Swedish volunteers. In male and female Swedes, the average fasting insulin ranges from 4-11 uIU/mL, and increases with age. From age 60-74, the average insulin level is 7.3 uIU/mL.

In contrast, the range on Kitava is 3-6 uIU/mL, which does not increase with age. In the 60-74 age group, in both men and women, the average fasting insulin on Kitava is 3.5 uIU/mL. That's less than half the average level in Sweden and the U.S. Keep in mind that the Kitavans are lean and have an undetectable rate of heart attack and stroke.

Another example from the literature are the Shuar hunter-gatherers of the Amazon rainforest. Women in this group have an average fasting insulin concentration of 5.1 uIU/mL (4; no data was given for men).

I found a couple of studies from the early 1970s as well, indicating that African pygmies and San bushmen have rather high fasting insulin. Glucose tolerance was excellent in the pygmies and poor in the bushmen (5, 6, free full text). This may reflect differences in carbohydrate intake. San bushmen consume very little carbohydrate during certain seasons, and thus would likely have glucose intolerance during that period. There are three facts that make me doubt the insulin measurements in these older studies:

1. It's hard to be sure that they didn't eat anything prior to the blood draw.
2. From what I understand, insulin assays were variable and not standardized back then.
   
3. In the San study, their fasting insulin was 1/3 lower than the Caucasian control group (10 vs. 15 uIU/mL). I doubt these active Caucasian researchers really had an average fasting insulin level of 15 uIU/mL. Both sets of measurements are probably too high.
   

Now you know the conflicting evidence, so you're free to be skeptical if you'd like.

We also have data from a controlled trial in healthy urban people eating a "paleolithic"-type diet. On a paleolithic diet designed to maintain body weight (calorie intake had to be increased substantially to prevent fat loss during the diet), fasting insulin dropped from an average of 7.2 to 2.9 uIU/mL in just 10 days. The variation in insulin level between individuals decreased 9-fold, and by the end, all participants were close to the average value of 2.9 uIU/mL. This shows that high fasting insulin is correctable in people who haven't yet been permanently damaged by the industrial diet and lifestyle. The study included men and women of European, African and Asian descent (7).

One final data point. My own fasting insulin, earlier this year, was 2.3 uIU/mL. I believe it reflects a good diet, regular exercise, sufficient sleep, a relatively healthy diet growing up, and the fact that I managed to come across the right information relatively young. It does not reflect: carbohydrate restriction, fat restriction, or saturated fat restriction. Neither does the low fasting insulin of healthy non-industrial cultures.

So what's the ideal fasting insulin level? My current feeling is that we can consider anything between 2 and 6 uIU/mL within our evolutionary template, although the lower half of that range may be preferable.

Guest Commentary: Where are Nurse Practitioners in Health Care Reform?

Theresa Pluth Yeo, PhD, MPH, MSN, CRNP, AOCNP
Coordinator, Advanced Practice Oncology Nursing Program
Assistant Professor, Jefferson Schools of Nursing and Population Health
(Former President of the Nurse Practitioner Association of Maryland)

Cortese and Korsmo, in their September 23, 2009 article in the NEJM, observed that, “Americans do not consistently receive high-value health care. Collectively, our country spends more on health care than any other nation, but our people do not receive the best outcomes, safety, service, or access (to health care) in return.”

Our health care system is largely dominated by a plethora of specialists but deficient in primary care physicians. At a time when only 247 residency positions in primary care are available for graduating medical students per year (down 328 residency positions since 1999), over 6,000 nurse practitioners (NPs) are educated each year at more than 325 colleges and universities. Most of these NPs choose primary care or family practice settings for employment. (For the uninitiated, NPs are fully-trained and licensed registered nurses who complete a Master’s or doctoral degree as an advanced practice nurse and pass a certifying examination administered by a national board, which allows them to be licensed by state boards of nursing as a NP).

NP educational programs provide training in the diagnosis and treatment of acute minor illnesses, disease prevention, and management of stable chronic conditions. Nurse practitioners are part of the solution in health care reform and fill an important niche in providing access to a qualified health care provider for millions of Americans. NPs are a win-win for patients – NPs bring their education, compassion and experience as RNs to bear on patient care, yet they are paid less than physicians. An ever growing body of evidence points to comparable quality care – and often higher patient satisfaction – with NPs as primary health care providers. Currently there are 139,000 NPs practicing in the US.

So why is the AMA threatened by NPs? In October 2009 the AMA launched an offensive, targeting NP practice in a document entitled: AMA Scope of Practice Data Series – Nurse practitioners. The document states in part that: “The physician is responsible for the supervision of nurse practitioners and other advanced practice nurses in all settings and that the physician is responsible for managing the health care of patients in all practice settings.” This is blatantly untrue. Nursing has been a self-regulating and self-licensing profession for as long as medicine has. Why has the leadership of the AMA decided that physicians and only physicians have the “right” to assess, diagnose and treat ill persons and that all “non-physician providers” should be supervised by a physician?

The American Nurses’ Association recently issued a response to this AMA document, voicing its objection to the AMA’s attempts to change the public’s perception of NP practice as anything other than fully qualified professionals working within a legally established scope of practice. As America struggles to reconstruct its health care delivery “system,” it is unproductive for one profession to attempt to marginalize another. NPs stand ready to help meet the nation’s health care needs as collaborating partners, not as physician supervised providers. Health care reformers look our way!

dec. 20 food

Today I didn't feel well thanks to yesterday's escapades with the chocolate chip cookies. I hardly slept last night, and had a stomach ache today. I just ate a big bowl of veggies at dinner time: brussels sprouts, broccoli, and cauliflower, and a couple of raw carrots. Housemate reminded me that I did the same thing last year during the holidays. When will I learn? I'm amazed chocolate affects me so much. I really have to avoid that completely!

O Holy Night

This is my favorite traditional Christmas hymn. This version is by David Archuleta. He was a contestant on American Idol 7. I had heard of him before, but this version popped up on my pandora account and I really like what he does on the second verse. Enjoy

smoothie time

I like making house-mate's smoothies on Saturday morning. I make 2 batches of 3 smoothies each, and freeze them. Here were today's ingredients:

vitamins & DHA, bananas, mandarin oranges, pears (local), blueberries, pineapple chunks, raspberries, strawberries, flaxseeds and sunflower seeds. I didn't have spinach, and decided to let house-mate have a Christmas treat this week so I put the lettuce (top right) back in the fridge and these were just sweet fruit smoothies. yummy!

last few days

I had to go to out of town for a funeral this week. I brought my food with me, some servings of beans & veggies, some lettuce and fruit (mandarine oranges and apples). I wasn't that hungry because of the sadness of the event. For some people, this kind of stress makes them eat more; it makes me eat less, but as you'll see, it's the happy events that make me crack. After I got home, I have been going to parties nonstop, full of sweet treats. I finally cracked today and had several vegan chocolate chip cookies. Then I decided, let's make a day of it, so I got a couple of non-Fuhrman foods at the deli at my co-op, some red curry tofu and a quinoa salad, and a falafel. It was small servings and not too far off the plan, except for the oil and salt. As usual, I didn't think it was as good as my food and realized again that I'm not missing anything. I satisfied my urge to splurge so I think I can resume healthy eating tomorrow. I think the last time I went off plan was in September so that's not so bad (though I have over-eaten on plan several times). But I would like to kick the sugar habit completely. It just feels too much like an addiction, because it is. I never thought sugar would be harder than coffee or alcohol to give up. Pretty interesting.

Don't Waste Your Cancer - John Piper

I actually had someone reference this to me recently and checked at a local bookstore for it.  I had not heard of it, but was intrigued.  This is an article John Piper wrote in 2006 after being diagnosed with cancer himself.  Here are the main points:

   1. You will waste your cancer if you do not believe it is designed for you by God.
   2. You will waste your cancer if you believe it is a curse and not a gift.
   3. You will waste your cancer if you seek comfort from your odds rather than from God.
   4. You will waste your cancer if you refuse to think about death.
   5. You will waste your cancer if you think that “beating” cancer means staying alive rather than cherishing Christ.
   6. You will waste your cancer if you spend too much time reading about cancer and not enough time reading about God.
   7. You will waste your cancer if you let it drive you into solitude instead of deepen your relationships with manifest affection.
   8. You will waste your cancer if you grieve as those who have no hope.
   9. You will waste your cancer if you treat sin as casually as before.
  10. You will waste your cancer if you fail to use it as a means of witness to the truth and glory of Christ.

A Look at Charity

HT: Between Two Worlds

Quote of the Week

This from an article lambasting the events of the Copenhagen Summit on Global Warming:

This week has been truly historic. It has marked the beginning of the landslide that is collapsing the whole AGW imposture. The pseudo-science of global warming is a global laughing stock and Copenhagen is a farce. In the warmist camp the Main Man is a railway engineer with huge investments in the carbon industry. That says it all. The world’s boiler being heroically damped down by the Fat Controller. Al Gore, occupant of the only private house that can be seen from space, so huge is its energy consumption, wanted to charge punters $1,200 to be photographed with him at Copenhagen. There is a man who is really worried about the planet’s future.

What Causes Terrorism?

Here is a good article related to the idea that "Gitmo causes terrorism" and thus, we should close the prison.  I have always found this argument laughable and am glad to see someone take it on.  One quote from this article in National Review that sums things up:

After 17 years of attacks, we should have learned the difference between causes of terrorism and pretexts for terrorism. Terrorism is caused, and terrorist recruitment is driven, by Islamist ideology and by American weakness in the face of terror attacks. In that sense, Senator Durbin causes more terrorism than Gitmo ever will. Terrorist organizations are encouraged when they come to believe they can win — when they come to believe they can outlast America because we lack resolve.

Sarah Palin is Straight?

So it's come to this. This is the first time I've ever seen this type of description in print:

"The failed Vice Presidential nominee took time off from shilling her book to vacation with her son Trig, daughter Piper and opposite sex spouse Todd, in President Barack Obama's birth state of Hawaii on Tuesday."

I guess I just always thought that would be assumed unless otherwise noted!

Climategate Spreading

Now that people are trying to just defend the mere credibility of the AGW position, there seems to be a lot of people reviewing and verifying info that was previously taken as "solid".  In this article from the UK Telegraph we now see that the data from Russia has most likely been "fudged":

The IEA believes that Russian meteorological-station data did not substantiate the anthropogenic global-warming theory. Analysts say Russian meteorological stations cover most of the country’s territory, and that the Hadley Center had used data submitted by only 25% of such stations in its reports. Over 40% of Russian territory was not included in global-temperature calculations for some other reasons, rather than the lack of meteorological stations and observations.

The data of stations located in areas not listed in the Hadley Climate Research Unit Temperature UK (HadCRUT) survey often does not show any substantial warming in the late 20th century and the early 21st century.

The HadCRUT database includes specific stations providing incomplete data and highlighting the global-warming process, rather than stations facilitating uninterrupted observations.

On the whole, climatologists use the incomplete findings of meteorological stations far more often than those providing complete observations.

IEA analysts say climatologists use the data of stations located in large populated centers that are influenced by the urban-warming effect more frequently than the correct data of remote stations.

The scale of global warming was exaggerated due to temperature distortions for Russia accounting for 12.5% of the world’s land mass. The IEA said it was necessary to recalculate all global-temperature data in order to assess the scale of such exaggeration.

Global-temperature data will have to be modified if similar climate-date procedures have been used from other national data because the calculations used by COP15 analysts, including financial calculations, are based on HadCRUT research.

And it seems like this issue has been around for some time based on the following source:

As Steve McIntyre reports at ClimateAudit, it has long been suspected that the CRU had been playing especially fast and loose with Russian – more particularly Siberian – temperature records. Here from March 2004, is an email from Phil Jones to Michael Mann.

Recently rejected two papers (one for JGR and for GRL) from people saying CRU has it wrong over Siberia. Went to town in both reviews, hopefully successfully. If either appears I will be very surprised, but you never know with GRL.
    Cheers
    Phil

And then there's this video posted at Hot Air reviewing the computer model programming from CRU:

Dec. 15 food

Brekky: blueberries & mango. The blueberries were frozen and thawed in the microwave. The mango was a small yellow one. I also had a small delicious ripe pear. Brekky was late, about 10 am, and merged with an early lunch, finished by noon.

Lunch: beans on chopped spinach & arugula. 1/2 butternut squash. 1 banana.

Dinner: snacked on carrots and peas while making a salad with lettuce & arugula & red bell pepper and sweet pea salad dressing. Dessert was 2 small apples.

Total calories: 1651, protein 52 g (10%); carbs 362 g (81%), fat 15 g (8%). I was more in the mood for fruit and veggies than nuts and seeds today.

What was I thinking?

Warning: if you are easily tempted by sugary foods, don't look at the picture below! Just ignore the whole post!

I bought a bunch of vegan chocolate junk food for housemate from Vegan Essentials. My reasoning was as follows: A close family member recently died of cancer, and I recently listened to the audio of the China Study and was reminded again how animal protein, especially casein in dairy, is a major cause of cancer. Housemate eats mostly vegan food, except for her chocolate candy which is things like m&ms, reese's peanut butter cups, candy bars, etc. I thought, I'll get her a bunch of vegan chocolate candy and let her taste test them and there's bound to be something in this pile she will like. The rest I can donate to a young vegan college kid I know who likes to eat. Here's what I bought, arrived in the mail today:

Now for a repeat of my question: What the hell was I thinking? Here are some reasons why this was a stupid thing to do: 1) I'm concerned that house mate will get diabetes due to her love of candy. So here I am buying a ton of candy for her! 2) I forgot about the temptation this could have for me. I have no trouble saying no to non-vegan anything. But I'm as susceptible to vegan treats as any food addict. If I started eating this stuff, I wonder how much I'd eat before I'd stop. Would it be like an alcoholic on a bender?

Still, if I can survive without touching this stuff, the experiment could work. If housemate finds a treat she likes, it will probably be better than a snickers bar. Then the goal is to get her to limit them to smaller quantities than she normally eats. And regarding my temptations, right now, this stuff doesn't look appealing to me. It doesn't look like food. Last week I made apple sauce for some family members and I used sugar from the basement fridge that was 2 years old. I thought, is that really food? No, that's a chemical. Also, I don't like how chocolate affects me because it makes me hyperactive. But that knowledge doesn't always stop me.

So we'll see if this was a great or really dumb idea...

The Dirty Little Secret of the Diet-Heart Hypothesis

The diet-heart hypothesis is the idea that saturated fat, and in some versions cholesterol, raises blood cholesterol and contributes to the risk of having a heart attack. To test this hypothesis, scientists have been studying the relationship between saturated fat consumption and heart attack risk for more than half a century. To judge by the grave pronouncements of our most visible experts, you would think these studies had found an association between the two. It turns out, they haven't.

The fact is, the vast majority of high-quality observational studies have found no connection whatsoever between saturated fat consumption and heart attack risk. The scientific literature contains dozens of these studies, so let's narrow the field to prospective studies only, because they are considered the most reliable. In this study design, investigators find a group of initially healthy people, record information about them (in this case what they eat), and watch who gets sick over the years.

A Sampling of Unsupportive Studies

Here are references to ten high-impact prospective studies, spanning half a century, showing no association between saturated fat consumption and heart attack risk. Ignore the squirming about saturated-to-polyunsaturated ratios, Keys/Hegsted scores, etc. What we're concerned with is the straightforward question: do people who eat more saturated fat have more heart attacks? Many of these papers allow free access to the full text, so have a look for yourselves if you want:

A Longitudinal Study of Coronary Heart Disease. Circulation. 1963.

Diet and Heart: a Postscript. British Medical Journal. 1977. Saturated fat was unrelated to heart attack risk, but fiber was protective.

Dietary Intake and the Risk of Coronary Heart Disease in Japanese Men Living in Hawaii. American Journal of Clinical Nutrition. 1978.

Relationship of Dietary Intake to Subsequent Coronary Heart Disease Incidence: the Puerto Rico Heart Health Program. American Journal of Clinical Nutrition. 1980.

Diet, Serum Cholesterol, and Death From Coronary Heart Disease: The Western Electric Study. New England Journal of Medicine. 1981.

Diet and 20-year Mortality in Two Rural Population Groups of Middle-Aged Men in Italy. American Journal of Clinical Nutrition. 1989. Men who died of CHD ate significantly less saturated fat than men who didn't.

Diet and Incident Ischaemic Heart Disease: the Caerphilly Study. British Journal of Nutrition. 1993. They measured animal fat intake rather than saturated fat in this study.

Dietary Fat and Risk of Coronary Heart Disease in Men: Cohort Follow-up Study in the United States. British Medical Journal. 1996. This is the massive Physicians Health Study. Don't let the abstract fool you! Scroll down to table 2 and see for yourself that the association between saturated fat intake and heart attack risk disappears after adjustment for several factors including family history of heart attack, smoking and fiber intake. That's because, as in most modern studies, people who eat steak are also more likely to smoke, avoid vegetables, eat fast food, etc.

Dietary Fat Intake and the Risk of Coronary Heart Disease in Women. New England Journal of Medicine. 1997. From the massive Nurse's Health study. This one fooled me for a long time because the abstract is misleading. It claims that saturated fat was associated with heart attack risk. However, the association disappeared without a trace when they adjusted for monounsaturated and polyunsaturated fat intake. Have a look at table 3.

Dietary Fat Intake and Early Mortality Patterns-- Data from the Malmo Diet and Cancer Study. Journal of Internal Medicine. 2005.
I just listed 10 prospective studies published in top peer-reviewed journals that found no association between saturated fat and heart disease risk. This is less than half of the prospective studies that have come to the same conclusion, representing by far the majority of studies to date. If saturated fat is anywhere near as harmful as we're told, why are its effects essentially undetectable in the best studies we can muster?

Studies that Support the Diet-Heart Hypothesis

To be fair, there have been a few that have found an association between saturated fat consumption and heart attack risk. Here's a list of all four that I'm aware of, with comments:

Ten-year Incidence of Coronary Heart Disease in the Honolulu Heart Program: relationship to nutrient intake. American Journal of Epidemiology. 1984. "Men who developed coronary heart disease also had a higher mean intake of percentage of calories from protein, fat, saturated fatty acids, and polyunsaturated fatty acids than men who remained free of coronary heart disease." The difference in saturated fat intake between people who had heart attacks and those who didn't, although statistically significant, was minuscule.

Diet and 20-Year Mortality From Coronary Heart Disease: the Ireland-Boston Diet-Heart Study. New England Journal of Medicine. 1985. "Overall, these results tend to support the hypothesis that diet is related, albeit weakly, to the development of coronary heart disease."

Relationship Between Dietary Intake and Coronary Heart Disease Mortality: Lipid Research Clinics Prevalence Follow-up Study. Journal of Clinical Epidemiology. 1996. "...increasing percentages of energy intake as total fat (RR 1.04, 95% CI = 1.01 – 1.08), saturated fat (RR 1.11, CI = 1.04 – 1.18), and monounsaturated fat (RR 1.08, CI = 1.01 – 1.16) were significant risk factors for CHD mortality among 30 to 59 year olds... None of the dietary components were significantly associated with CHD mortality among those aged 60–79 years." Note that the associations were very small, also included monounsaturated fat (like in olive oil), and only applied to the age group with the lower risk of heart attack.

The Combination of High Fruit and Vegetable and Low Saturated Fat Intakes is More Protective Against Mortality in Aging Men than is Either Alone. Journal of Nutrition. 2005. Higher saturated fat intake was associated with a higher risk of heart attack; fiber was strongly protective.

The Review Papers

Over 25 high-quality studies conducted, and only 4 support the diet-heart hypothesis. If this substance is truly so fearsome, why don't people who eat more of it have more heart attacks? In case you're concerned that I'm cherry-picking studies that conform to my beliefs, here are links to review papers on the same data that have reached the same conclusion:

The Questionable Role of Saturated and Polyunsaturated Fatty Acids in Cardiovascular Disease. Journal of Clinical Epidemiology. 1998. Dr. Uffe Ravnskov systematically demolishes the diet-heart hypothesis simply by collecting all the relevant studies and summarizing their findings.

A Systematic Review of the Evidence Supporting a Causal Link Between Dietary Factors and Coronary Heart Disease. Archives of Internal Medicine. 2009. "Insufficient evidence (less than or equal to 2 criteria) of association is present for intake of supplementary vitamin E and ascorbic acid (vitamin C); saturated and polyunsaturated fatty acids; total fat; alpha-linolenic acid; meat; eggs; and milk" They analyzed prospective studies representing over 160,000 patients from 11 studies meeting their rigorous inclusion criteria, and found no association whatsoever between saturated fat consumption and heart attack risk.

Where's the Disconnect?

The first part of the diet-heart hypothesis states that dietary saturated fat raises the cholesterol/LDL concentration of the blood. This is held as established fact in the mainstream understanding of nutrition. The second part states that increased blood cholesterol/LDL increases the risk of having a heart attack. What part of this is incorrect?

There's definitely an association between blood cholesterol/LDL level and heart attack risk in certain populations, including Americans. MRFIT, among other studies, showed this definitively, although the lowest risk of all-cause mortality was at an average level of cholesterol. The association between blood cholesterol and heart attack risk does not apply to Japanese populations, as pointed out repeatedly by Dr. Harumi Okuyama. This seems to be generally true of groups that consume a lot of seafood.

So we're left with the first premise: that saturated fat increases blood cholesterol/LDL. This turns out to be largely a short-term effect. In fact, it isn't even true in animal models of heart disease if you exclude those that use large doses of dietary cholesterol. In the 1950s, the most vigorous proponent of the diet-heart hypothesis, Dr. Ancel Keys, created a formula designed to predict changes in blood cholesterol based on the consumption of dietary saturated and polyunsaturated fats. This formula does not have a very good predictive value in long-term controlled trials and its use in the modern medical literature is declining.

This is it, folks: the diet-heart hypothesis ends here. It's been kept afloat for decades by wishful thinking and selective citation of the evidence. It's time to put it out of its misery.