A Tale of Two Hormones: Leptin vs. Insulin

 

Thank you to everyone for feedback on the leptin post. I am grateful to have readers! One of the main questions I got after the post was "so, what should I eat?" In answering this question, I gave what, at this point, has worked for me and can only be considered my opinion. What I want you guys to realize is that I'm not trying to impose my opinions and habits on you, but rather gather factual information that you can use to form your own opinions and habits. Some of this information resembles flashing red arrows pointing in a particular direction, but otherwise, I think it's important that my opinions be questioned. I don't want to be another person telling you what to eat. There are far too many of those people out there already. 

Since most of us don't have a particular zest for dissecting medical journals, let's make reading about nutrition a little more fun. When I was a kid, the Sherlock Holmes series were some of my favorite stories. Instead of feeling overwhelmed and lost in trying to decide what is good for us and what is bad for us (and, ostensibly, sounding a bit like Chicken Little), let's pretend we are Sherlock Holmes starring in the greatest caper of the century. Think about it: If proper nutrition can actually prevent the majority of chronic diseases and save millions of lives, perhaps even save YOUR life, this really is the greatest mystery you'll ever solve. Sherlock has a wonderful saying to guide our quest: "It is a capital mistake to theorize before one has data.  Insensibly one begins to twist facts to suit theories, instead of theories to suit facts."

Well, dear Watson, today let's learn about what blocks leptin because it does a whole host of other things of interest as well. Due to the rising rate of diabetes, many people are now familiar with insulin, but let's review the basics anyway. Insulin is a hormone produced by the pancreas when it is processing/digesting carbohydrates.

For the sake of this discussion, let's also define a carbohydrate. A carbohydrate is a molecular compound found in nature that is composed of carbon, hydrogen, and oxygen. Remember in chemistry class where we learned words based on the periodic table? The generic formula for a carb is C_n (H₂O)_n, which we could call "hydrates (H₂O) of carbon (C)" or  "carbon hydrates."  The most fundamental type of carbohydrate is simple sugar, which comes in the form of glucose, galactose, and fructose (this group is called the "monosaccharides"). These simple sugars can combine to form more complex carbs such as sucrose, lactose, cellulose, and starch (these more complex groups are called "disacharides" and "polysaccharides"). Combining these carbs with other things (such as fiber in bread and fruit) changes the rate at which your body breaks down and absorbs sugar, but, keep in mind, your body is still processing sugar.

When you ingest carbohydrates, such as a bowl of pasta, your body uses enzymes to break down the carbohydrates into glucose which then enters the bloodstream. This is why folks with diabetes have to measure their "blood sugar." If you do not have diabetes or prediabetes, carbohydrates stimulate your pancreas, which then produces insulin at a rate consistent with the level of sugar in the bloodstream. Insulin is a hormone, just like leptin, that communicates with your brain. Insulin tells your brain to stop the use of fat as an energy source.  It also helps transport glucose out of the bloodstream and  into muscle, fat, and liver cells. Insulin tells these cells to store the glucose that's been circulating in your blood.

Unlike "starvation mode" when your body is not getting enough energy for its basic functions and is slowing your metabolism and slowly burning your fat stores, when you ingest a significant amount of carbohydrates your body goes into "storage mode."  Unlike leptin, which tells your brain that you are full, insulin tells your brain to keep eating while the body stores this treasure trove of carbs that you've just happened upon (score!). Remember, your body is looking out for you! Food has only recently been so plentiful, convenient, and inexpensive. Far before this occurred, your body developed a process to store energy, so that you don't starve when food is less plentiful (like in the winter). Insulin guides this process while leptin takes a nap. Until recently, our bodies have never been in continuous storage mode. In another post, I'll discuss the long-term effects of continuous storage mode.

Important side note to keep in mind for later: protein can also cause the pancreas to produce a bit of insulin. The stored form of glucose is called glycogen and it is required for rebuilding muscle tissue. Your body doesn't need carbohydrates to do this, however, as it can use protein, which is also a source of amino acids. However, too much protein will require your body to store glycogen elsewhere (such as fat cells). The amount of protein you need varies based on how much glycogen your muscles need.

Sources/further reading:
http://www.nhlbi.nih.gov/health/health-topics/topics/ms/
http://www.ncbi.nlm.nih.gov/pubmed/21713385
http://www.ncbi.nlm.nih.gov/pubmed/11566073
http://www.ncbi.nlm.nih.gov/pubmed/11596667
http://www.slideshare.net/ancestralhealth/ahs-slidesrobert-lustig
http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/#what

Leptin: The Golden Key to Appetite

One of the most interesting things I've read about when researching nutrition is the hormone leptin, so named from the Greek word leptos, meaning "thin." The reason why I find leptin interesting is because frequently when people think of going on a diet, they think they need to starve themselves (relatively speaking). "I just need to eat less and exercise more" is a common way to think about a new year's resolution to lose weight. The problem with this strategy is that you're hungry and the plan is unsustainable for a specific scientific reason: leptin. Control your leptin and you control your appetite. Once you control your appetite, it is MUCH easier to be selective about what food you choose to eat. So, today, let's learn about leptin because LEPTIN IS AWESOME.

Leptin is a protein that is made in your fat cells and is transported to your brain through your bloodstream. Leptin tells your hypothalamus (a specific area of the brain) that you have enough energy. Leptin is kind of like your food accountant, it tells the brain you've eaten enough food and stored enough energy to engage in activity. Just like a good accountant, leptin says, "Your cash/energy flow is positive and you've got enough to cover all your essential expenses, so feel free to go spend some money/energy on other things." Most important of all: You are not in starvation mode when leptin is talking to your hypothalamus.

What is starvation mode you ask? Let's say you're on one of those extreme "juice cleanse" diets. Leptin is not being sent to your brain and, as a result, your brain senses starvation and goes into survival mode. Your brain and body's primary goal right now is to get you fed. So the brain sends a signal to your vagus nerve (the longest cranial nerve in the body that stretches all the way to your abdomen) and that causes the feeling of hunger. Your brain also sends a signal to your thyroid that slows your metabolic rate. In starvation mode, your body is doing everything it can to extend the energy stores you have until you feed it again. So here you are, trying to drop a few pounds, and your body is working in overdrive to hold onto fat until you give it some food. Seems a bit inefficient, no?

Here's another way your body is working against you and your juice cleanse: Once leptin gets to the hypothalamus it sets off these "leptin-responsive" neurons in your brain. These neurons feed directly into the dopamine system, which controls the brain's reward and pleasure center. The lower your dopamine level, the more rewarding food becomes. The higher your dopamine level, the less rewarding food becomes. THIS IS NOT ABOUT WILLPOWER PEOPLE. You are biologically programmed to properly feed your body. So if you can't starve yourself to lose weight, what can you do? Eat the right foods. Eat the foods that keep your leptin and dopamine levels high. I promise to help us all figure out what those are. I just can't do it in the space of this post. The good news is that the ones I know about taste really, really good -- and are SO much better than endless glasses of brownish green juice!

Now, there's a wrench in this explanation that I'm sure you guys are bound to catch. Don't obese people have lots of leptin if it's generated by fat cells? Yes, an obese person does have high leptin levels, unfortunately, there is something blocking the leptin from getting to the hypothalamus. There are particular foods that make this happen. I'll get into this in more detail later as well. But here's something to get you thinking: Ever notice how certain foods never make you full? Like that time you sat down with a bag of potato chips and ate the whole thing? You were like, holy crap, where did that bag of potato chips just go?  Those potato chips were not generating any leptin, but they did give your body some carbohydrates which it is going to store until you give it what it really wants.

The key to controlling leptin is knowing which foods allow it to function normally and which foods block it from signaling your brain. It probably doesn't come as a surprise to you that many of the most well-known "bad" foods are not conducive to leptin functionality (e.g., chips, soda, cupcakes), but there are also a lot of other foods that might surprise you. What also may surprise you is the food that is conducive to leptin functionality: fat. Heart advocates, please indulge me, we have been very misled about fat. When you eat the right fat, it's not going to clog your arteries, but we'll get into the different types of fat and what your body does with them in another post.

The main thing to take away about leptin is that the right foods make you full (and happy!) and don't cause you to gain weight. Leptin does all your accounting for you (no calorie counting!) if you eat the right foods. Furthermore, if you are already full, eating a bag of potato chips is not appealing to you. If you eat the right food, you will feel satisfied and your leptin and dopamine levels will be high. If you eat the right food, you will be less hungry and more happy. Sounds like a win-win, right?

Dr. Lustig has a lot to say about leptin, you can read more about this amazing protein here, here, and here.

The Chasm Between Weight and Health

After reading my post yesterday, a friend of mine sent me a message about how she frequently felt judged for her small size (OMG, she must purge all her food, GAH, go eat a cheeseburger!) and found it comparable to how we judge people for being a larger size. She also kindly shared with me that she lost her dad to heart disease; even though he was very slender, he was certainly not healthy. I really appreciate her reaching out, and it made me realize that I needed to discuss this in further detail before moving forward with other posts.

My friend's story about her dad also reminded me of an article I read ages ago in Runner's World about an ultramarathoner who suffered a heart attack in his early 30s. Genetics? Perhaps. A diet extremely high in simple carbohydrates that he explained in great deal? In my humble opinion, this is the more likely culprit. I plan to do a post on the mounting evidence of sugar causing heart disease, but for now, I will simply state that is my opinion. Don't believe it until you read the evidence for yourself.

Too often we attribute weight to health when it's really just one of many factors and certainly, in my opinion, void of the most important factor: what do you actually eat. So I feel the need to set the record straight: size does not determine how healthy you are. I chose to start this discussion of health and nutrition based off of weight gain because I think it is something most people can relate to. My grander purpose is to get us thinking about health instead of weight. There are lots of overweight people who are not binge eaters, just like there are lots of skinny people who are not binge eaters. The morbidly obese and the emaciated actually have a lot more in common than meets the eye: their bodies are starved of the nutrients they actually need. You can be a medically defined "ideal weight" and be much less healthy than an overweight person. For example, you could have lung cancer, or any other number of diseases that have nothing to do with being overweight. This is how some parts of our medical lexicon play into nutritional misinformation. In fact, recent evidence shows a correlation between being overweight and having a longer lifespan. I would purport that, it's not the excess weight that's helping the overweight live longer, but one macronutrient in particular that is essential to the body (particularly the brain) that also helps absorb micronutrients. The overweight may be eating this macronutrient in addition to the food that causes them to be overweight. A slender person could also be eating this macronutrient without gaining any excess weight. (I will discuss this lovely macronutrient, my favorite of them all, in great detail, in another post.)

So please, pretty please with a cherry on top, stop judging other people based on their outward appearance/weight, and, more importantly, stop judging yourself based on your outward appearance and/or weight. The reason I wrote the "ultimate fat trap" post relatively early on in this discussion is because I want us to really see how little evidence our judgments are based on. And, furthermore, how little evidence our nutritional guidance is based on. It's enough to make anyone throw up their hands and say "screw it, I'll eat what I want."

Learn what foods are good for you and indulge in your favorites; may you find pleasure in food and find pleasure in health. Feed your body, feed your mind, and feed your soul with positive things. I hope my blog can help guide you a little bit in finding what things are actually good for you, as well as delicious and satisfying, and to stop the judging, depriving, binging, purging, or any other disadvantageous activity. I hope that we can do it together actually. I am learning and growing right beside you, and I think I can help us both ask the right questions. The hardest part of this equation is figuring out what foods are actually good for you, and I think we may actually be able to figure this out. Please, join me!

The Ultimate Fat Trap

The conventional wisdom that millions of people follow and thousands of food companies and treadmill designers would like you to believe is "a calorie is a calorie." Let's discuss why this ubiquitous mantra simply doesn't work.

To begin, how do those nutritional labels on food get their caloric information? The U.S. has a uniformed system implemented that assigns each gram of the macronutrients contained within the food item (e.g., fat, carbohydrates, protein, alcohol, etc.) the average caloric value. This system, officially named the "Atwater system," uses 4 calories per gram for protein, 4 calories per gram for carbohydrates, and 9 calories per gram for fat. These averages were derived from a laboratory instrument called the "bomb calorimeter." The representative macronutrient was placed in a sealed container surrounded by water. Then, the food was completely burned and the resulting rise in water temperature was measured. Remember back to science class? A calorie is a measure of the amount of heat energy ("enthalpy of combustion") needed to raise the temperature of 1 kilogram of water 1 degree Celsius.

(Side note from Dr. Attia: "If you’re wondering why fats contain more heat energy than carbohydrates or proteins, it has to do with the number of high energy bonds they contain. Fats are primarily made up of carbon-hydrogen and carbon-carbon bonds, which have the most stored energy.  Carbs and proteins have these bonds also but “dilute” their heat energy with less energy-dense bonds involving oxygen and nitrogen." I also borrowed a handy chart from him, seen below.)

Now, before I put you guys to sleep, what we really need to ask here is how does the human body process caloric energy? Does the human body process energy the same way as a calorimeter? Without knowing any advanced science, I think it's safe to say that no, the body does not process energy the same way as a calorimeter. For the smartypants out there, here's a post that addresses the First Law of Thermodynamics. I think discussing thermodynamics is too much detail for our current purposes. It distracts from the issue at hand and we can arrive at a logical conclusion without it.

The main thing we normal folks need to understand is that the body uses different molecules for different functions. Energy isn't coming in with nothing happening between when you ingest food and when you exert energy. Your body isn't a giant pot of water, there's a lot more going on inside there than this mantra would lead you to believe. You can measure a calorie in just about any organic matter, including poison, spiders, toenail clippings, propane.... but the body reacts quite differently to different molecules. Our question should really be, how does the body react to the molecules we typically ingest and how does it use the macronutrients (e.g., fat, carbohydrates (SUGAR), protein, alcohol).

 

On a non-scientific level, let's also think about this anecdotally. Whenever someone says, "a calorie is a calorie; you just have to burn more calories than you take in," I picture a young girl, about 13, who is overweight. She has a deep desire to be accepted by her peers and is in the midst of forming her adult identity. She thinks if she can finally slim down, people will see her for who she really is, because right now they only see her as the "big girl." She's resolved that this is the year she is going to lose weight. This girl skips breakfast and has a soda (~200 calories) and a yogurt with fruit (~200 calories) for lunch. At night she eats a salad with a low calorie/low fat dressing that her concerned parent prepares (700 calories). She might lose a little bit of weight, but soon she feels awful and can't suppress her hunger so she binge eats until she finally feels full. Her cycle of weight gain continues along with her cycle of depression over her lack of control. When her parents and her pediatrician tell her she needs to eat less calories, she grows resentful and further depressed. She feels like a victim, but is treated like the perpetrator. The reason why "a calorie is NOT a calorie" matters in her case is because losing weight and maintaining a healthy weight have a lot to do with what foods are making her eat more calories. Why does she not feel full? Why does she continue to eat when losing weight is really all she wants? Why is her urge to eat so strong that it overcomes all other desires? Why is her urge to eat more frequent than other people? Why is her body storing energy instead of expending energy??

Our society has got to stop this dogma. This isn't merely a political issue over healthcare or a pissing match between scientists, but an issue that disproportionately affects the innocent. When we say losing weight is a matter of willpower over what we eat and what we expend, we are telling this innocent child, and the millions like her (including obese babies), that her willpower is not strong enough to "put down the fork." It creates a destructive pattern of thinking and does nothing to actually help. This is a major reason why instances of bulimia and anorexia are rising in the obese community. It is also one of many reasons the overweight and obese are disproportionately depressed, which, I am beginning to believe is more linked to the type of food they are eating than how they are treated, although that certainly isn't helping matters.

Yes, those who eat tons of calories tend to be those who are larger, but not always. What is so much more important is WHY, why are these people eating more calories. I'll discuss this in my next post on leptin, but feel free to read up on your own. :)

For my mom

Today would have been my mom's 66th birthday. God, I really miss her. I think of her every day. The grief process has been long and difficult for me, but I can say that now when I think of her, I feel joy more often than sadness. I think of how much of her is in me and how lucky I was to have her for the time that I did. On days like today though, I do get sad. It's her birthday and I just wish that I could call her or see her. Take her out to dinner. Give her some flowers. Tell her about work and what's going on in my life. It's days like today when her absence is very palpable. It's the expectation of times we would have had together that will never be. Advice that will never be given. Milestones in the road of life where she's looking down on me instead of holding my hand. I try not to wallow, but it also doesn't do her justice to pretend like I'm fine on these days.

I think of how hard she fought cancer, how hard she fought to be here with us still. I think of waiting in this courtyard at Duke during her neurosurgery and tears just cascading silently down my face for hours praying that she'd make it through the surgery. I didn't know then that she would not only make it through the surgery, but find the strength to battle a stage IV brain tumor for two years.

During her recovery, it was hardly a week before she tried to get us to walk her down to her floor back to her office. She wasn't even cured herself and she wanted to go help cure her patients. The pills, the infusions, the radiation, the hair loss, the weight gain, the nausea... How she went through it all with such beauty and strength. She survived to a point where 99% of people with her diagnosis do not. Even before she was diagnosed she was fighting cancer. I have this outdated nutrition book of hers from the '90s called "The Cancer Prevention Diet." Part of me wants to throw it away, but the other part of me sees it as a reminder of how important nutrition was to her. Just because the medical establishment hasn't figure it out yet, doesn't mean it's not coming. People like Dr. Seyfried give me tremendous hope that her dreams for preventative medicine may come to pass in my lifetime. I love you mom, happy birthday.

Why me?

Martin Luther King, Jr. once said, "Our lives begin to end the day we become silent about things that matter." I try to remember this when I write about nutrition. The fact is, I'm not a doctor or a nutritionist and who the heck cares to listen to one more person telling them what to do? There are so many fad diets, exercises, and pills that promise to make you lose weight or be healthy (and, no, those two things aren't synonymous). Why should I add to this confusing noise when I'm not an expert?

The answers I keep coming back to are: Because a lot of the "noise" is just trying to make a buck. And maybe it takes a normal person with no ulterior motive to guide normal people who are confused by the science. Because none of us are experts and we're floating in all this information and we don't know who to believe. And a lot of the "experts" feel pressure to have a theory (and be published) and use some really dubious science and logic to "back it up." And a lot of the other experts who have done great research with mind-blowingly logical conclusions get ignored by the institutions that could do something with the information. For example, if a hospital were to run a clinical trial on nutrition, where would it get the funding?  How are most clinical trials funded? You guessed it, by pharmaceutical companies. And good for them! Sometimes they really help people! The thing is: some diseases need pills, just not all. The other thing about hospitals and research universities attached to hospitals is that they aren't in the business of healthy people. What they need are prescription medications, treatment centers, and surgery wards. They do try to prevent people from coming back, but they simply aren't in the business of preventing people from going there in the first place. So why do research on nutrition? Why allocate the funding? It's simply not rational. It would be like a hospital sponsoring research on wearing helmets on motorcycles, with a sliver of hope that they might get less head trauma cases in the ER.

I used to think every doctor had all the answers. Every single person who went through medical school was some kind of genius and joined the club of geniuses who had all the answers. They all spent so much time and money studying enormous textbooks and being mentored by other doctors that they must have gotten all the answers. I thought, "doctors, well, they are just way smarter than me." And a lot of them still are WAY smarter than me. I'm really, really thankful for all of them. They are amazing people who do an incredibly important job.

Without taking away from any of what I just said, here's the thing that's important to know about doctors: When they were in medical school they took notes on lectures and read books that had the facts, and then they were tested on those lectures and books. Same thing in residency, they were shown how to operate or perform a procedure or how to diagnosis a patient based on those same books they just finished studying. At no point did anyone at any med school, anywhere say to these students, "By the way, the facts might be wrong, so you should really check all those footnotes and sources in your books and see how they came up with this information." That's not to say that doctors don't stay up on new research, but new research isn't the same as revisiting old research. And revisiting old research is not all that common, especially when it comes to nutrition (such as research on cholesterol and red meat). So often this old research relies on association instead of causation.
 
“For the greatest enemy of truth is very often not the lie — deliberate, contrived and dishonest — but the myth — persistent, persuasive, and unrealistic. Too often we hold fast to the clichés of our forebears. We subject all facts to a prefabricated set of interpretations. We enjoy the comfort of opinion without the discomfort of thought.”
- John F. Kennedy, Yale University commencement address (June 11, 1962)

Why I care

I never wanted to be a doctor or really anything even related to the medical field. I never quite got comfortable with hospitals, even though I probably should be more comfortable with hospitals since my mom worked at one for decades. Even though I rationally understand they do so much good and happy things happen there, hospitals have always struck me as kind of sad and eerie. The truth is, I'm not into what doctors actually do and always knew it on some basic level. I also don't like the sight of blood. Or other bodily fluids. Clearly, the medical profession wasn't my calling. So why do I care so much about health?

I do like to analyze things, learn details, and step back on the big picture, which makes sense with my current interests in finance, economics, and writing. However, I think my interest in health definitely starts with my mom. She was a nurse practitioner at Duke University Medical Center and spent most of her career in vascular radiology. For those who don't know what that is, the simplest explanation is that it generally involves procedures on organs, arteries, and vessels that are less invasive than surgery. A typical patient might have a blocked artery, have a stent inserted to open the artery so that blood can now be pumped through therein reducing the risk of a heart attack. Many of my mom's patients had clogged arteries as a consequence of an unhealthy lifestyle. My mom was privately frustrated with patients that wanted pills to cure their ailments. It was clear to her that changing their lifestyles would give them a happier, longer life. But most never made that change. She also never understood the lung cancer patients who would roll their wheel chairs outside to smoke cigarettes. Again, a lifestyle change is a lot more difficult than swallowing a pill. And, boy, let me me tell you what, she practiced what she preached. I was the only kid at my school in 1991 with an all-natural peanut butter sandwich on whole wheat bread. When I wanted dessert, she would hand me an orange. Soda was banned from the household except for the occasional special pizza night. And even then, she didn't drink it.

There are other reasons I care about my health. Playing sports made me competitive and strive to be my best. When I competed, I felt the effects of everything that entered my body. When you are competing for hours on a daily basis, the effects of bad food are felt much sooner than the time it takes to gain a few pounds. I also strongly believe in personal responsibility for things that are important to you. Living a long time is important to me. Life is too short as it is. When my mom passed away, it made me realize how valuable a day was, a week, a year. If eating something different gives me another year with my loved ones, it's not such a difficult choice to eat something healthy.

That being said, I don't think constant deprivation is the answer. Many people think this way. "You're overweight? Put down the fork, dummy." I disagree. For one thing, it slows your metabolism to eat less (even if you eat the "right" foods) and when you do finally eat your body will want to store any excess energy because it's not sure when you're going to feed it again. The amazing thing about the human body is how adaptable it is: It finds ways to make sure you get fed in the long term. It prioritizes your vital organs over your extremities. It slows your metabolism when you are expending a lot of energy to make sure you don't burn through your stores too quickly. It can switch between burning carbohydrates and burning fat depending on what you are feeding it. It can safely drain toxins out of what you ingest through your liver. Amazing. I mean seriously, body of mine, thanks for looking out, I know I make some poor decisions sometimes.

I think it's really important to say this before I get into this next bit of why I care about health. I do not think a lot of overweight people chose to be overweight. I think there are far more complicated issues surrounding a healthy weight than "putting down the fork." Some of it is systemic issues with our food system and some of it is wrongheaded information. But I think it's putting the cart before the horse to explain these reasons right now, so please trust me when I say, I am not blaming anyone, we are all in this together.

The societal consequences of poor nutrition are upon us and are only getting worse (facts are courtesy of Dr. Attia, Dr. Robert Lustig, and the CDC):

• 34% of Americans are obese and two-thirds are overweight.  This represents more than a 200% increase from 1970.
• A recent study in Obesity estimates that by 2030, 50% of Americans will be obese and 79% will be overweight.
• Since 1980, overweight rates have doubled among children and tripled among adolescents – increasing the number of years they are exposed to the health risks of obesity. 
• Pediatric endocrinologists (such as Dr. Lustig) are now seeing obese six-month olds. ("Hey kid! Go run on a treadmill or something!" clearly isn't the solution here.)
• Over 8% of Americans are diabetic, and if you include those undiagnosed, an additional 26% of Americans are pre-diabetic.  This represents more than a 400% increase from 1970.
• Every 7 seconds someone in the world dies from a diabetic complication (this is not a typo).
• Diabetes is also the leading cause of stroke, blindness, kidney failure requiring transplantation, all amputations combined, and many other medical problems.
• According to McKinsey & Company, reducing the U.S. obesity rate to 15% (that of 1970) would save approximately $150 billion per year in Medicare spending alone, and close to $500 billion per year in overall U.S. healthcare spending. The U.S. spends over $2.7 trillion per year on healthcare – nearly 19% of our GDP, and more than any other country.  Even if no other aspect of our spending increases in the next 20 years, the cost of healthcare alone will bankrupt us as a country. Think about the opportunity cost of this spending, think about what changes might happen in our society if this amount of money was invested in public education.

Those are some really sobering numbers. Please take a minute to let those sink in.

I think people deserve some answers about how we got here. I think my friends, my neighbors, my family, and myself need some better information and some better food. Unfortunately, we're all busy people with pressing short-term priorities and one person can't possibly solve this. That's why it really just starts with each one of us as individuals, caring a little bit about our health and trying to prevent ourselves from becoming a statistic. I'm not going to tell anyone else what they should do, but, as for myself, I think small, manageable choices done on an individual level can help the macro environment. All for now, gotta go do some laundry. 

Reflections and Resolutions

2012 and 2013 were amazing years for me: I moved to Florida from DC, started a new career, got married, toured Europe, witnessed about a dozen friends get married or have kids, bought a house, renovated said house, and hosted the holidays in the new home for the first time. These years kept me so busy that I have had little time to pause and reflect, and even less time to write. In 2014, I'm resolving to take more time to write and pursue hobbies that nourish me. Taking care of myself translates to a happier, more deliberate citizen of this grand world and allows me the energy to give more freely of myself to others (another resolution).

Losing weight is a common new year's resolution, perhaps even a cliche new year's resolution, but it certainly was my resolution in 2012 (before the wedding). I read about preventative health and nutrition a lot, so I realize that people have strong views on nutrition, much akin to politics. With that in mind, know that I'm sharing this story for those of you who are somewhat open minded. Perhaps you are struggling with your weight or your health. You may be committing to a new routine that turns out not to work (like so many plans out there). Maybe my story will help you think about things differently. Maybe it will free you from counting calories in and calories out. (I really find that exhaustive no matter how cool the gadget is.) Maybe you will stop feeling so guilty for having the basic physical impulse called hunger. Maybe you will not feel so inadequate when the scale doesn't budge.  

A lot of the research I read on nutrition is written by doctors who take the necessary dispassionate, methodical approach to their work. How this information translates to a normal human being is rarely accurately reported on in the modern media, which is driven by ratings and website hits. I've realized how even people with the best of intentions cause a damaging web of misinformation. Millions of people are critically ill after following the conventional wisdom. Millions more have low self-esteem from measuring their self worth and will power with the "calories in, calories out" mantra. It's one thing to say that premise is false, it's another thing to understand just how liberating the truth can be to the millions of people who care about their health and have the wrong information. 

Mainly what I understand is that our journey to good health is frequently a road with no signs and no map. Or worse, the wrong signs and a backwards map.  Or someone else's map and in a foreign language! For any one study on nutrition, you can read something else that completely contradicts it. So whose map do you follow? Keeping an open, yet critical mind, I found it best to draw my own.

In 2013, I had a sort of nutritional revelation. I had a blood test earlier in the year that showed I was deficient in vitamin B12. It was affecting everything: my memory, my energy, my mood, my sleep, my metabolism, and, of course, my health. I had no idea it could do all these things. None of my previous doctors had ever bothered to test me for this deficiency before. There are a million reasons why a person can't sleep or is moody and I appeared healthy and led a healthy lifestyle. At least, I thought I ate healthy (low-fat proteins and whole grains with lots of veggies and fruit). I was eating normal portions and exercising regularly. I didn't think my diet could possibly be to blame until my blood test came back and I started learning about B vitamins and how many nutrients in all the foods I was eating are fat soluble. FAT SOLUBLE. Strange because I thought fat was bad for you. In addition, B12, which is essential to the central nervous system, is only found in animal fat. HOLY BACON BATMAN. I thought vegetarians were the healthiest people on the planet and vegans were basically masters of self control with impeccable health. Yet, here is this essential nutrient whose absence was turning me into a zombie, that is ONLY found in animal fat. Yet, still, I needed a lot of convincing that animal products, particularly fatty animal products were good for me. So I started reading more critically and my world was turned upside down. 

A lot of what I found is controversial and some of it even lacks solid proof, so I hesitate to get into it in-depth right now, but I'll share a few of my favorite resources that got me to stop freely accepting conventional wisdom without critical thought. The point is, all of these authors could still be wrong about certain things, but they are at least thinking critically about the facts. As Aristotle said, "It is the mark of an educated mind to be able to entertain a thought without accepting it." My modern translation = draw your own nutritional map. Read people who contradict your worldview on nutrition, so that you get a better understanding of the facts. If you are in decent health, experiment with food and observe how different food groups affect you. Most of all, remember that YOU are the largest shareholder in your long-term health, YOU have the most at stake, and YOU care far more than the media, the government, agra-business, and certainly more than the pharmaceutical industry. No one else but you will care for your health, so think long and hard before you give up on it. To quote Mary Oliver, "Tell me, what is it you plan to do with your one wild and precious life?" I don't think it's dying young or suffering from chronic illness... (that last bit was me.)

Dr. Peter Attia

TED Talk on obesity

Eating Academy blog

Nutrition Science Initiative

Dr. Robert Lustig

The Bitter Truth About Sugar

Gary Taubes

What Really Makes Us Fat?

Big Sugar's Sweet Little Lies

My favorite quote on this topic appears in his NYT article, What If It's All Been a Big Fat Lie?: 

Phil Handler, then-president of the National Academy of Sciences, testified in Congress in 1980: ''What right,'' Handler asked, ''has the federal government to propose that the American people conduct a vast nutritional experiment, with themselves as subjects, on the strength of so very little evidence that it will do them any good?'' [Regarding legislation pertaining to the food pyramid]

Dr. Mary Enig

Know Your Fats

Dr. Thomas Seyfried

Cancer as a Metabolic Disease (book)

Standard cancer therapy with a ketogenic diet (free article)

(Not as off topic as you would think, but I will save my thoughts on this for another post.)

Without going through all the gritty details, what I will say is what has helped me the most in my search for long-term health is thinking about the quality of food versus simply measuring calories consumed and calories burned. I also found that finding the foods that boost your long-term energy levels makes a huge difference and can be highly individualized. For me it's a diet rich in healthy fat like fish, grass-fed beef and butter, olive oil, eggs, nuts, cheese, cream, spinach, berries, and avocados. Some people are allergic to nuts and dairy, so, no, there's no one way to eat that works for everyone. But thinking about your genetics (my ancestors lived in cold places with little agriculture) and being attune to how certain foods affect you can play a huge role in helping you find a sustainable healthy lifestyle.

I hope this wasn't too preachy, my goal is to encourage and inspire those who find this interesting. It's certainly something that I find fascinating. Nourishment of the mind, body, and soul is my theme for 2014.