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For years, beans have suffered from an image problem.

They've been called "the poor man's meat," joked about for causing gas, and often relegated to the side of the plate. Yet for thousands of years, beans, lentils, chickpeas, and peas—collectively known as pulses—were among the most important foods on Earth.

If bread supplied the calories that built cities, beans supplied much of the protein that sustained them.

Long before protein powders and high-protein snack bars, civilizations from Rome to India relied on pulses as an everyday source of nourishment. The Roman laborer's bowl of puls—a hearty porridge often enriched with legumes—was far more representative of daily life than the lavish banquets of emperors. Across the Mediterranean, dishes like pasta e fagioli reflected a simple truth: grains and legumes together formed a remarkably nutritious meal.

Modern science has largely caught up with what history already knew.

Beans are rich in protein, but they're also packed with dietary fiber, resistant starch, folate, magnesium, potassium, and a remarkable collection of plant compounds that support both heart and metabolic health. Their fiber nourishes the trillions of bacteria living in our colon, producing short-chain fatty acids that help maintain the health of the intestinal lining and may reduce inflammation throughout the body.

Perhaps most remarkable is that cultures around the world independently discovered the same dietary pattern. Italy has beans and pasta. India has dal with flatbread. Latin America combines beans with rice or corn. The Middle East gave us hummus. These weren't accidents. They were elegant nutritional solutions developed centuries before anyone knew what an amino acid was.

Beans also improve the soil they grow in. Through a partnership with nitrogen-fixing bacteria living on their roots, legumes enrich the earth for future crops. Few foods nourish both the people who eat them and the land that produces them.

Today, beans are enjoying a well-deserved renaissance. Heritage producers such as Rancho Gordo have reminded us that beans have flavor, texture, and personality. They're no longer just pantry staples—they're ingredients worthy of the center of the plate.

In this week's Fork U podcast, we'll explore how one humble family of plants helped build civilizations, why modern nutrition keeps rediscovering their value, and why the "poor man's meat" may actually be one of the richest foods in human history.

Sometimes the greatest superfoods aren't new discoveries.

Sometimes they've been quietly simmering in the pot all along.

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Olive Oil: The Original SuperfoodBefore electricity lit our homes, olive oil did.

For thousands of years, olive oil was far more than something people poured over bread. It fueled lamps, preserved food, moisturized skin, and was used in religious ceremonies. Long before it became a staple of the Mediterranean diet, it helped build civilization.

Today, we think of olive oil as healthy. The fascinating part is that people believed it was medicinal long before they understood cholesterol, inflammation, or blood pressure. Sometimes medicine begins with observation. The science simply catches up later.

More Than Just FatWhen people hear "olive oil," they often think of fat. That's true, but not all fats behave the same way.

Olive oil is rich in monounsaturated fat, the primary fat found in the Mediterranean diet. Rather than worrying about the chemistry, it is more useful to think about what happens inside the body.

The real benefit comes from what olive oil replaces.

Instead of cooking with butter or shortening, people sauté vegetables with olive oil. Olive oil is better than creamy dressings, and it is part of a delicious vinaigrette. And my favorite is, instead of spreading butter on bread, dipping it in olive oil.

Those small substitutions can add up over time.

The Science Is ImpressiveOne of the first studies to grab the attention of cardiologists came from Lyon, France. Researchers enrolled people who had already suffered a heart attack and asked one group to adopt a Mediterranean-style diet rich in olive oil.

The results surprised almost everyone.

Those following the Mediterranean diet had dramatically fewer second heart attacks than those eating their usual diet. It was one of the studies that helped transform olive oil from a traditional food into a modern medical recommendation.

Since then, researchers have followed hundreds of thousands of people around the world. Again and again, the same pattern appears. People who regularly consume olive oil tend to have lower rates of heart disease, lower rates of type 2 diabetes, and even lower mortality.

Even better, randomized clinical trials such as the PREDIMED study showed that people at high cardiovascular risk reduced their chances of major cardiovascular events by following a Mediterranean diet supplemented with extra-virgin olive oil.

Why Does It Work?Scientists think olive oil helps in several ways.

When olive oil replaces butter and other saturated fats, LDL cholesterol usually falls. The natural polyphenols found in extra-virgin olive oil also appear to reduce inflammation and help blood vessels relax by improving nitric oxide production. In addition, studies suggest olive oil improves insulin sensitivity and helps protect LDL cholesterol from becoming oxidized, an important step in the formation of artery plaque.

No single mechanism explains everything.

Instead, several small benefits appear to work together.

That is often how nutrition works.

Not All Olive Oils Are the SameIf you ask people where the best olive oil comes from, be prepared for a lively discussion.

Some prefer the buttery oils from Liguria in Italy. Others enjoy the peppery oils of Lebanon, Greece, or Spain. I have favorites from Arizona, where I lived for years, and from California, where I live now.

California also has some of the highest purity standards for olive oil in the world. While olive oil fraud has occurred in some parts of the world, California producers have built a reputation for careful quality control. That gives me confidence in what I'm pouring into my pan.

A Small Change Worth MakingNutrition rarely comes down to one magical food.

Instead, it comes from making better choices more often.

Adding olive oil to your kitchen is one of those simple changes that is easy to enjoy. It makes vegetables taste better, encourages home cooking, and replaces less healthy fats without making meals feel restrictive.

Sometimes the healthiest habits are also the most delicious.

Olive oil first transformed civilization by lighting the night.

Today, it may help illuminate a healthier future—one meal at a time.

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Cheese: Humanity's Greatest Delicious AccidentWhat if one of the world's favorite foods happened by accident?

That's probably how cheese began.

Nobody knows exactly who made the first cheese. Maybe it was a shepherd carrying milk in a bag made from a sheep's stomach. The milk warmed in the sun, natural rennet in the stomach lining began to separate the curds from the whey, and suddenly milk had become something entirely different.

Instead of throwing it away, someone tasted it.

Transforming CheeseCheese is another example of one of humanity's greatest skills: transforming food. We didn't simply discover food—we learned how to make it safer, preserve it longer, and often make it taste even better.

Then, over thousands of years, every culture added its own touch.

The English gave us Cheddar. The French perfected Brie and Roquefort. Italy created Parmigiano Reggiano. Greece gave us Feta. Norway even created brown cheese by slowly caramelizing whey into a sweet, nutty delight.

Each cheese tells the story of the people who made it.

Then there's the science.For years, cheese was criticized because it contains saturated fat. However, modern nutrition research has taught us that cheese is far more complicated than a single nutrient. Cheese contains protein, calcium, beneficial bacteria from fermentation, and a unique food structure that scientists now call the dairy matrix. Interestingly, studies have found that eating cheese is generally neutral—and in many cases modestly protective—when it comes to heart disease.

One of my favorite ironies involves Parmesan.

People often warn about MSG while happily grating Parmesan over their pasta. Yet Parmesan is naturally rich in free glutamate, the compound responsible for the delicious savory flavor we call umami. Nature discovered that trick long before chemistry gave it a name.

Like bread, soup, and cooking itself, cheese reminds us that humans became successful because we learned to transform food instead of wasting it.

The next time you enjoy a piece of good cheese, remember you're tasting one of humanity's oldest scientific experiments.

This week on FORK U, we'll explore the fascinating history of cheese, how it shaped civilization, why it's healthier than many people think, and why your charcuterie board has a much longer history than Instagram.

And on my Substack later this week, we'll dive even deeper into the science behind cheese, fermentation, heart health, the Mediterranean diet, and why nutrition is always more interesting than social media makes it seem.

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For years, bread has been the villain of social media.

Scroll for a few minutes, and you'll find someone telling you bread causes obesity, diabetes, inflammation, or that humans were never meant to eat it.

History tells a different story.

Bread didn't weaken civilization.

Bread helped build it.

From Grass to GreatnessImagine the first person who looked at wild grass and wondered whether those tiny seeds could become food.

Nobody knows exactly how bread was invented. Maybe someone mixed crushed grain with water and left it in the sun. Maybe wild yeast landed in the mixture, and it began to bubble. Maybe someone cooked it on a hot rock beside a fire.

Whatever happened, one thing is certain.

Someone noticed something new and tried it again.

That's how science often begins—with curiosity.

Bread Changed EverythingOnce people learned how to make bread, life changed.

Grain could be stored for months. Families no longer had to search for food every day. Villages grew into towns, and towns became cities.

Soon, people could become bakers, builders, teachers, physicians, and merchants because someone else was growing wheat.

Bread didn't just feed people.

It helped create civilization.

Bread Fed EmpiresThe ancient Egyptians depended on bread. Grain storage helped feed the workers who built the pyramids. The Romans knew that keeping bread available helped keep peace in the city. Even today, archaeologists find bakeries and loaves of bread preserved in Pompeii.

Later, during the Klondike Gold Rush, my grandfather carried a sourdough starter into Alaska. Thousands of prospectors did the same. That's why experienced miners became known as "Sourdoughs."

Bread traveled wherever people went.

Then Bread ChangedOver time, bread changed.

Factories made bread softer, whiter, and able to last longer on grocery store shelves. It became convenient, but much of what made bread special disappeared.

Then, during the 1960s and 1970s, people began baking bread at home again. Books like The Tassajara Bread Book encouraged Americans to rediscover whole grains, sourdough, and fresh bread.

Sometimes progress means remembering what we forgot.

What Does the Science Say?Not all bread is the same.

Whole-grain bread contains fiber, vitamins, minerals, and plant compounds that refined white bread often lacks.

Study after study has found that people who eat more whole grains tend to have lower rates of heart disease, type 2 diabetes, obesity, and colorectal cancer. That's one reason whole grains remain an important part of the Mediterranean diet.

The question isn't whether bread is healthy.

The question is:

Which bread?

Keep It SimpleOne of the simplest meals is still one of the best.

Take a slice of whole-grain bread, add good extra-virgin olive oil, and enjoy it with a bowl of soup or a Mediterranean meal. It doesn't need to be complicated.

Some foods have survived for thousands of years for a reason.

Bread is one of them.

This week in my Substack, I dive much deeper into the history of bread, how it helped build civilization, why whole grains continue to be recommended by nutrition research, and why bread has become one of the most misunderstood foods on social media.

You can read the full article on drsimpson.com, and if you're looking for Mediterranean recipes—including homemade bread, soups, and healthy meals—you'll find them at terrysimpson.com.

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Soup: The Mediterranean Diet in a BowlOver the past few weeks, many of us have been looking at our refrigerators a little differently. News about Cyclospora, E. coli, and other foodborne outbreaks has made people nervous about fresh vegetables and herbs. At the same time, grocery stores are filled with expensive electrolyte drinks, protein broths, and wellness beverages promising to keep us healthy. However, there is a much simpler solution that has been around for thousands of years.

Make soup.It may sound almost too simple, but soup remains one of the healthiest meals we can prepare. In fact, if someone asked me to build the perfect meal using what we know today about nutrition, I'd probably start with a pot of soup. Add onions, garlic, beans, tomatoes, leafy greens, herbs, perhaps a little chicken or fish, a drizzle of olive oil, and serve it with a slice of whole-grain sourdough. You've just created what I like to call the Mediterranean diet in a bowl. And to prove you can do that from any cuisine, my favorite soup is Dahl - and click here for the recipe.

The First Food SafetyMore importantly, soup has always been much more than comfort food. Throughout history, people discovered that boiling food made it easier to digest and often safer to eat, even though they had no idea bacteria or parasites existed. Today, we know that proper cooking destroys organisms such as Cyclospora and many harmful bacteria, making soup not only delicious but also one of humanity's oldest food safety techniques.

Furthermore, soup is one of the best ways to reduce food waste. We all have that refrigerator drawer that starts out as a crisper and eventually becomes what I call the "future soup drawer." A few carrots, some celery that's lost its crunch, half an onion, spinach that's beginning to wilt, or herbs that are no longer picture-perfect can all become tomorrow's lunch instead of tomorrow's compost. Rather than throwing them away, let them contribute their flavors to a pot of soup.

Another reason I love soup is that it naturally brings together many of the foods we should be eating more often. Beans provide fiber and plant protein. Vegetables add vitamins, minerals, and phytochemicals. Herbs contribute remarkable flavors without relying on excess salt. A little olive oil adds healthy fats, while broth provides hydration along with naturally occurring electrolytes. Unlike many products marketed as "wellness foods," soup doesn't need fancy packaging or celebrity endorsements. It has been quietly doing its job for thousands of years.

Better with Age - like meThen there's one final reason soup deserves a place in every kitchen.

It gets better.

Few foods improve overnight the way soup does. The flavors continue to develop, the broth becomes richer, and somehow the entire pot tastes more complete the next day. That's one reason soup has always been one of the original meal-prep foods. Long before social media was teaching us how to prepare lunches for the week, families simply made one large pot of soup and enjoyed it for several meals.

Of course, every family develops its own favorites. In our house, taco soup is always a winner. It starts with onions, garlic, olive oil, canned beans, tomatoes, cumin, coriander, and chili spices before being finished with fresh lemon juice, avocado, and crushed whole-grain tortilla chips. It's hearty, inexpensive, packed with fiber, and it disappears quickly whenever I make it.

Perhaps that's why every civilization eventually invented soup. It stretches ingredients, reduces waste, nourishes families, hydrates naturally, and transforms simple foods into something extraordinary. Sometimes the oldest ideas remain the smartest ones.

This week on Fork U, we're diving into the remarkable history and science of soup, including why every civilization created its own version, why soup may be the Mediterranean diet in a bowl, why it often tastes better the next day, and even why a proper French consommé is one of the greatest achievements in culinary science.

For the full story, listen to this week's episode of Fork U at drsimpson.com.

And if you'd like some of my favorite soup recipes—including taco soup, Mediterranean-inspired soups, and other healthy meals—you'll find them at terrysimpson.com.

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Fire didn't just change dinner. It changed us.If I asked you what made us human, you might say language. Or tools. Maybe agriculture. All of those changed our species, but I think one discovery came even earlier—and it may have been the most important of all.

Fire.

Not because it kept us warm.

Not because it frightened predators.

But because it cooked dinner.

At first glance, that might seem like an odd claim. After all, cooking is something we do every day without much thought. However, when you look at the science and the history together, cooking becomes one of the most remarkable innovations in human evolution.

More importantly, it changed far more than the taste of our food.

For more in-depth discussion, go to my Substack channel at DrSimpson.com

Cooking Changed the Food We AteBefore humans learned to control fire, food was difficult work.

Raw meat is tough. Many roots are fibrous. Grains are nearly impossible to eat without processing, and many plants lock away their nutrients behind tough cell walls.

Then everything changed.

Cooking unfolds proteins, softens connective tissue, gelatinizes starches, and breaks down plant cell walls. As a result, our digestive system has less work to do, and we gain access to more of the calories and nutrients already present in the food.

In other words, cooking didn't create nutrition.

It unlocked it.

Then Cooking Made Food SaferHowever, the story doesn't stop with nutrition.

Long before anyone understood bacteria or parasites, early humans discovered something through observation. Food cooked over a fire made people sick less often.

Today we know why.

Heat destroys many harmful bacteria. It kills many parasites. It reduces the risk of foodborne illness.

Consequently, cooking likely became one of humanity's earliest public health tools.

Groups that regularly cooked their food would have lost fewer children to severe diarrheal disease, had healthier adults, and retained more of the calories they worked so hard to obtain.

That is a tremendous evolutionary advantage.

Flavor Matters More Than You ThinkThere is another benefit that often gets overlooked.

Cooking made food taste better.

That may sound obvious, yet it is incredibly important.

Humans don't simply eat because food contains nutrients. We eat because food is enjoyable. Cooking creates hundreds of new flavor compounds through browning reactions that simply don't occur in raw food.

Think about the smell of fresh bread.

Or grilled steak.

Or roasted coffee.

Those aromas are products of cooking.

Likewise, a cooked potato bears little resemblance to a raw one. The texture changes. The flavor changes. Even the way our bodies digest the starch changes.

Fire didn't just feed us.

It invited us back for another meal.

The Real Lesson from EvolutionUnfortunately, some people oversimplify this fascinating story.

They argue that because meat was important during human evolution, the ideal modern diet must consist almost entirely of meat.

The science doesn't support that conclusion.

Cooking improved meat.

It also improved roots.

Cooking made tubers tasty.

Then cooking softened grains.

And finally, it made legumes digestible

The evolutionary advantage wasn't eating one perfect food.

Instead, it was becoming adaptable enough to thrive on many foods by transforming them with fire.

That is a much more interesting story—and one much better supported by the evidence.

Why This Still Matters TodayEven in modern kitchens, we continue using the same principles our ancestors discovered thousands of years ago.

We cook food to improve digestibility.

And we cook food to improve safety.

We cook food because it tastes better.

Most importantly, we gather around meals because cooking has always been about more than calories.

It has always been about family, community, and sharing stories.

Perhaps civilization didn't begin with the first city.

Perhaps it began around the first campfire.

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The Bank of Muscle: Why Your Real Retirement Account Isn't Your 401(k)I used to think retirement planning was all about money. Put enough away, let compound interest do its thing, and someday you'll enjoy the rewards. As I've gotten older, however, I've come to appreciate another form of savings that may be just as important.

It's your muscle.

Nobody reaches eighty-five and wishes they had less of it. Instead, people wish they could get out of a chair more easily. They wish they could carry groceries, travel, garden, and play with grandchildren. In other words, they wish they had more reserves.

That's really what muscle buys us.

Dad's First Retirement AccountI was fortunate. My father lived nearly ninety-nine years old, and he didn't simply survive. He lived.

At eighty-five, Dad was walking three and a half miles every day. That's remarkable. Many people half his age don't walk that much. He had survived several heart attacks over the years, but he had reserves. Looking back, I realize that making it to eighty-five is one thing. Reaching eighty-five healthy enough to begin the sprint into your nineties is something else entirely.

Dad didn't do anything exotic. He wasn't biohacking. He wasn't chasing supplements. He wasn't optimizing every laboratory value.

He walked.

And my mother cooked.

Their meals weren't complicated. They enjoyed meat, potatoes, vegetables, soups, and desserts. They enjoyed life together. In hindsight, Dad was making deposits into his Bank of Muscle every day without ever calling it that.

Then Life ChangedAs my mother's dementia slowly progressed, things began to fall apart. Dad stopped walking, not because he wanted to, but because he didn't want to leave Mom alone. He worried she might wander. At the same time, Mom stopped cooking.

Breakfast became something out at a diner. Lunch might be a sandwich. Dinner often became cereal.

I watched them both lose weight.

Then I got the phone call no child wants.

"Dad's in the hospital. He fell and couldn't get up."

The fall wasn't the problem. Falls happen. What concerned me was that Dad no longer had enough reserve.

After a couple of weeks in rehabilitation, I convinced him to move into an assisted living center close to our house. He wasn't thrilled with the idea, but something remarkable happened. Once Mom entered memory care and Dad had regular meals again, he began to thrive.

He complained constantly about the food while gaining seventeen pounds. But he made friends and was always talking to someone or another. I would drive by and see him talking to anyone, from former Supreme Court Justice Sandra Day O'Connor, who lived there, and had a crush on my dad. My dad was making sure his neighbor got the newspaper, and yet he continued to complain about the food. All while gaining 17 pounds the first year.

Twice a week, I would take Dad to dinner, and we would split a steak.

The waitresses had a standing joke. They would ask him whether he wanted the kale salad.

Dad would smile and say, "I grew up in an orphanage in Alaska. We grew kale, but we fed it to the cows. I'll eat the cow."

He charmed every waitress in town.

Eventually, after Mom died, Dad moved back home to Oregon and lived independently again. Visiting Angels helped with meals and companionship, but he was back in his own house.

Looking back, I learned two things.

Food matters.

Muscle matters.

Frailty Is the EnemyWe spend a lot of time talking about heart disease, cancer, cholesterol, and blood pressure. Those are important. However, frailty is another great enemy of aging.

Frailty steals independence.

One broken hip can change everything. A fall that would have been a nuisance at sixty can become life-changing at eighty-five. Muscle gives us reserve, and reserve allows us to recover.

My father didn't avoid every setback.

He survived them.

That's what reserve does.

Protein Helps, But It Isn't MagicThe supplement industry would love us to believe that a powder is all we need. Unfortunately, muscles didn't get the memo.

Protein matters, especially as we age. Most experts recommend older adults consume about 1.2 to 1.5 grams of protein per kilogram of body weight each day, spread throughout the day rather than eaten all at once at dinner. For many people, that means aiming for twenty-five to thirty grams of protein at each meal.¹

However, protein alone isn't enough.

A large meta-analysis found that protein supplementation without resistance exercise had limited effects on strength and muscle mass. In contrast, combining protein with resistance exercise produced meaningful improvements.²

In other words, muscles need both building blocks and a reason to keep existing.

Exercise Doesn't Have To Be FancyWhen people hear "resistance exercise," they often picture bodybuilders.

That's not what the science requires.

Walking hills counts.

Gardening counts.

Resistance bands count.

Swimming counts.

Carrying groceries counts.

Yoga counts.

For me, yoga became the answer.

I'm not a gym person. Exercise isn't my hobby. I don't wake up every morning excited to work out. I do yoga because I know future Terry will appreciate it.

I'm not training for the Olympics.

I'm training for my eighties.

Real Food Still WorksWhey protein is probably the most studied supplement because it's rich in leucine, an amino acid that helps stimulate muscle protein synthesis. As we age, muscles become less sensitive to that signal, which is why getting enough leucine becomes increasingly important.¹

Fortunately, you don't need expensive powders.

Eggs, fish, dairy products, soy, beans, chicken, and meat all provide excellent protein.

Personally, whey protein and I are not close friends. I've had lactose intolerance for years, and the slower gut that comes with GLP-1 therapy has made me even less tolerant of many whey products. Add stevia, sugar alcohols, and various flavorings, and my intestines politely object.

Instead, I use egg protein or plant proteins. I avoid stevia because it tastes like electrical tape to me, and I don't need a chemistry experiment in a shaker bottle.

Still, I recognize supplements have a role.

If you're on a GLP-1 medication and eating less, or if you're simply busy, a protein shake or bar can be a useful tool. They aren't magic.

They're convenient.

A Father's WisdomAfter Mom died, Dad came to live with me in California. By then, I had discovered yoga.

Dad teased me about it at first.

Then one day, he looked at me and said something I've never forgotten.

"I think you doing yoga is great. You're the right age. Doing this now is important. If yoga is what you like, buy all the spandex you want and keep doing it."

Those words stayed with me.

You're the right age.

Doing this now is important.

If you're lucky, your parents give you wisdom throughout your life. When you're young, you roll your eyes. Later, you realize those words become part of who you are.

Money gets spent.

Wisdom gets carried.

Dad wasn't telling me to do yoga.

He was telling me to keep moving.

Make DepositsEvery age has different priorities.

At twenty-five, you may be building a career.

At forty-five, you may be raising children.

At sixty-five, you may be protecting your muscle.

At eighty-five, you may simply want enough reserve to get out of a chair and go to dinner with your family.

The body doesn't really care whether those deposits come from yoga, barbells, swimming, pickleball, or walking.

It only cares that you keep making deposits.

Because someday you'll need to make a withdrawal.

Life guarantees that.

When that day comes, you'll be grateful for every walk, every stretch, every protein-rich meal, and every little thing you did, not because you loved doing them, but because they built reserve.

Healthy aging isn't about dying young as slowly as possible.

It's about building enough reserve so that when life knocks you down, you still have enough strength to get back up.

And that may be the most important retirement account you'll ever own.

References1. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542-559. 2. Liao CD, Tsauo JY, Wu YT, et al. Effects of protein supplementation combined with resistance exercise on body composition and physical function in older adults: a meta-analysis. American Journal of Clinical Nutrition. 2017;106(4):1078-1091. 3. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019;48(1):16-31.

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If you read some low-carb sites, or Gary Taub's books, you will find the contention that the food pyramid - the last one being in 2011 - put America into a low fat, high carb diet responsible for today's obesity. That the government food pyramid misled a generation of people, and because we faithfully follow it, we became fat.

The problem is, that isn't the case, but I want to go back in time and see why we have those government issued guidelines, and see where we are today.

Dietary RecommendationsThe first major food guide appeared in 1943. It wasn't even a pyramid. It was called the Basic Seven.

Created to prevent malnutrition and maintain stamina during World War II, it categorized foods into seven groups and served as the precursor to the modern food pyramid:

1: Green and Yellow Vegetables (e.g. leafy greens, green beans, carrots).

2: Oranges, Tomatoes, Grapefruit (or other raw greens high in Vitamin C).

3: Potatoes and Other Vegetables/Fruits (e.g., apples, potatoes, beets).

4: Milk and Milk Products (e.g. fluid milk, evaporated milk, cheese).

5: Meat, Poultry, Fish, or Eggs (as well as plant-based proteins like dried beans and nuts).

6: Bread, Flour, and Cereals (focusing on whole grain or enriched varieties).

7: Butter and Fortified Margarine (specifically noted to provide necessary calories and Vitamin A during rationing).

The Basic FourThese came out in 1956 to help a growing America. doctors worried about malnutrition and vitamin deficiencies. Diseases such as pellagra, rickets, and scurvy were still being treated.

A breakdown of the 4 food groups and how they currently fit into a balanced, healthy routine:

1. Fruits & Vegetables 🥦Focus: Whole forms (fresh, frozen, or canned without added sugars).Benefits: Packed with essential vitamins, minerals, and dietary fiber.Goal: Aim to make half your plate fruits and vegetables at meal times.

2. Grains 🌾Focus: Whole grains (oats, brown rice, whole-wheat bread).Benefits: Provides vital carbohydrates and fiber for sustained energy.Goal: Make at least half your daily grains "whole" to get the most nutritional value.

3. Protein 🥩Focus: Lean proteins like poultry, fish, eggs, legumes (beans/peas), nuts, and seeds.Benefits: Builds muscle mass, repairs tissues, and keeps you full.Goal: Include a portion of protein with every meal to keep metabolism regulated.

4. Dairy 🥛Focus: Milk, yogurt, and cheeses (or calcium-fortified plant alternatives).Benefits: Crucial source of calcium and vitamin D for strong bones and teeth.Goal: Opt for low-fat or unsweetened varieties whenever possible to limit excess sugar

1979 What to AvoidDirectly after the Basic Four, the USDA introduced the Hassle-Free Daily Food Guide (1979). The Hassle-Free Daily Food Guide (1979–1984)

What changed: It kept the core Basic Four, but added a fifth group: Fats, Sweets, and Alcohol.

Purpose: This was the first time a group was explicitly highlighted for the public to consume only in moderation.

The transition away from the Basic Four marked a major shift in government policy: instead of just telling Americans to eat enough nutrients to avoid deficiencies, the focus changed to preventing chronic illnesses by telling people what to limit.

The Food Guide Pyramid (1992–2005)The first guide to feature highly specific daily serving sizes across six distinct categories. Grains formed the massive base (6–11 servings), followed by fruits and vegetables, then dairy and meat, with fats/sweets resting at the tiny top peak.

Fair Criticisms of the Food PyramidNone of this means the Food Pyramid was perfect.

In fact, there are several reasonable criticisms. First, the pyramid did not do a great job distinguishing between whole grains and refined grains. A bowl of steel-cut oats is different from a sugary breakfast cereal, but both could look similar on a simple graphic. Likewise, the pyramid often treated fats as a single category when we now know that olive oil, nuts, and fish are different from trans fats and highly processed shortening.

In addition, agriculture and food industry groups had influence over the process. That should not surprise anyone. Food policy has always involved scientists, government agencies, farmers, food manufacturers, and politicians. As a result, some recommendations reflected compromises rather than perfect science. That is a fair criticism, and it is one reason nutrition advice continues to evolve.

However, we should also be honest about today's environment. While many criticize the influence of industry on older food guides, we now live in an age where nutrition advice often comes from influencers, supplement companies, podcasters, social media personalities, and people selling books, courses, or products. In other words, we have not eliminated outside influences. We have simply changed who those influences are. Therefore, the challenge today is the same as it has always been: separating evidence from marketing.

Most importantly, the biggest problem facing Americans today is not that we are following an outdated Food Pyramid. Instead, it is that inexpensive, highly processed, calorie-dense foods surround us that require little preparation and are available everywhere. At the same time, portion sizes have increased, sugary beverages have become common, restaurant meals have grown larger, and fewer people cook regularly at home. As a result, we consume more calories than previous generations, while often moving less.

The Real Reason We Became HeavierThe Food Pyramid did not make America fat.

That story is appealing because it is simple, but simple stories are not always true. The reality is that obesity developed while most Americans were not following the Food Pyramid at all. Instead, we were eating larger portions, drinking more calories, consuming more ultra-processed foods, dining out more often, and cooking less frequently.

At the same time, our food environment changed dramatically. Food became cheaper, more convenient, and available nearly everywhere. Consequently, it became much easier to consume excess calories without even noticing it.

The real lesson is not that one graphic ruined America's health. Rather, the lesson is that every generation faces new food challenges and tries to solve them with the best knowledge available at the time. Some recommendations age well, while others do not. Yet one message has remained remarkably consistent for decades: eat more fruits and vegetables, include beans and whole grains, enjoy fish and other healthy proteins, cook when you can, and share meals with people you care about.

That advice may not fit neatly into a pyramid, but it has stood the test of time.

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How We EatMost of us think we know what we eat. However, nutrition researchers have learned a frustrating lesson over the years: asking people what they ate yesterday is often less accurate than anyone would like. Although food diaries and surveys can provide useful information, memories are imperfect, snacks are easily forgotten, and portion sizes tend to grow smaller in retrospect. Consequently, some of the most important nutrition research takes place in a setting that is both expensive and surprisingly simple—a metabolic ward, where every meal is prepared, every serving is weighed, and every leftover bite is measured.

That approach is exactly what researcher Kevin Hall and his colleagues used in a landmark study at the NIH. Participants were given two different diets, one based largely on ultra-processed foods and another built around minimally processed foods. Importantly, the volunteers could eat as much as they wanted. Nobody instructed them to count calories, restrict portions, or lose weight. Nevertheless, participants consumed about 500 more calories per day when eating the ultra-processed diet. The same people, living in the same environment, produced dramatically different results simply because the food changed.

Obesity in the US and Ultra-Processed FoodsAs a result, the study raised an intriguing question. If ultra-processed foods can influence calorie intake to that degree, why isn't everyone obese? After all, ultra-processed foods make up a large portion of the modern food supply. Grocery stores are filled with them, convenience stores specialize in them, and many restaurants depend on them. Yet despite widespread exposure to the same food environment, some people seem relatively unaffected while others struggle with appetite, cravings, and weight gain.

Prego and Vanishing CaloriesTo understand how we arrived here, it helps to step back a few decades. During the latter half of the twentieth century, food companies increasingly turned to scientists, statisticians, and sensory researchers to understand consumer behavior. One of the most influential figures was Howard Moskowitz, a researcher who discovered that there was no single perfect food. Instead, he found that consumers tended to cluster into different preference groups. Some people preferred sweeter products, others wanted more texture, and still others favored stronger flavors. As a result, food manufacturers stopped searching for one ideal product and began creating multiple versions designed to appeal to different consumers.

Meanwhile, another researcher, Steven Witherly, focused on a different question. Rather than asking what people preferred, he explored why certain foods were so rewarding. His work highlighted the importance of texture, aroma, crunch, temperature, and mouthfeel. In other words, food is not simply taste. Instead, it is a complex sensory experience involving multiple signals that influence how satisfying a meal feels.

One of Witherly's most memorable concepts is known as vanishing caloric density. Certain foods, particularly puffed snacks, dissolve quickly in the mouth and create the sensation that they have almost disappeared. Although the calories remain, the physical experience of eating them can feel surprisingly brief. Consequently, these foods may be easier to consume in larger quantities before the body's normal satiety signals fully catch up. While that does not make such foods inherently bad, it does help explain why some snacks seem to empty themselves once the bag is opened.

Ultra-Processed Foods and GLP-1At the same time, the modern food environment has become remarkably effective at attracting attention. Food manufacturers optimize texture, flavor, aroma, and convenience, while consumers encounter those products virtually everywhere. Therefore, the challenge is not simply one of personal responsibility. Biology, environment, culture, sleep, stress, and genetics all influence how people respond to food. Some individuals appear naturally protected, whereas others experience stronger reward signals and greater susceptibility to cravings.

Interestingly, the recent rise of GLP-1 medications has provided another perspective on appetite. Many patients describe a quieter relationship with food, noting that foods which once demanded attention suddenly seem less compelling. The food itself has not changed; rather, the brain's response to it has shifted. Consequently, these medications have highlighted something obesity researchers have suspected for years: appetite is not merely a matter of willpower. Instead, it reflects a complex interaction between biology and an increasingly sophisticated food environment.

Ultimately, Kevin Hall's study gave us an important clue about what happens when people are exposed to different types of food. Howard Moskowitz showed how companies learned to identify consumer preferences, while Steven Witherly helped explain why certain foods are so appealing in the first place. Together, their work offers a fascinating glimpse into the science behind modern eating and raises a question that may be more interesting than why some people gain weight. Perhaps the real mystery is why some people seem largely unaffected by an environment that was designed to capture our attention.

For a deeper discussion of food engineering, the bliss point, vanishing caloric density, and what this means for appetite in the era of GLP-1 medications, listen to this week's episode of Fork U.

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Taste Isn't What You Think It IsMost people believe taste happens on the tongue. That idea seems obvious because food enters the mouth, the tongue recognizes flavors, and the brain decides whether something tastes good or bad. However, modern science has revealed a much more fascinating story. Taste receptors are scattered throughout the body, including the stomach, intestines, airways, pancreas, and even tissues associated with the nervous system. Consequently, what we call taste is actually part of a much larger surveillance system that helps us detect nutrients, toxins, microbes, and potential threats before they become serious problems.

Before we explore those hidden taste receptors, though, we need to separate taste from smell. Most people use the words interchangeably, yet they are remarkably different systems. In fact, if you've ever had a bad cold, you've already experienced the difference firsthand.

Why Expensive Wine Tastes Like Grape Juice With a Stuffy NoseImagine spending a fortune on a bottle of Screaming Eagle wine. A sommelier describes notes of blackberry, cedar, tobacco, leather, and dark cherry while swirling the glass dramatically. Now pinch your nose shut and take a sip. Suddenly, those elegant descriptions become much harder to appreciate, and the wine starts tasting suspiciously like grape juice.

The reason is simple. Your tongue detects only a handful of basic categories: sweet, salty, sour, bitter, and umami. Meanwhile, your nose identifies the thousands of aromatic compounds that make strawberries taste different from cherries or Cabernet different from Merlot. Therefore, much of what we casually call taste is actually smell working behind the scenes. Without smell, a wine tasting becomes a costly visit to a Welch's grape juice stand.

This distinction matters because it helps explain why taste receptors throughout the body are not there for pleasure. Instead, they exist to gather information.

Sweet Means Calories, and Your Body Pays AttentionFor most of human history, finding calories was difficult. As a result, sweet flavors became associated with survival. A ripe fruit, a handful of berries, or a cache of honey represented valuable energy in a world where starvation was a constant threat. Because of that evolutionary pressure, the body developed specialized receptors to detect sweetness and rapidly prepare for incoming fuel.

The story becomes even more interesting once food reaches the intestine. Sweet receptors known as TAS1R receptors help stimulate the release of incretin hormones such as GLP-1 and GIP. Consequently, eating sugar creates a different physiologic response than receiving glucose through an IV. The tongue detects sweetness, the gut begins releasing hormones, the pancreas prepares insulin, and the brain activates reward pathways. In contrast, intravenous glucose raises blood sugar, but skips much of the sensory experience that evolution spent millions of years refining.

Warm apple pie and an IV bag may deliver similar sugar molecules. Nevertheless, your body treats them as entirely different events.

Umami: The Taste the Japanese Taught the WorldWhile sweet and bitter flavors are easy to recognize, umami remained poorly understood until Japanese scientists formally described it in the early twentieth century. The term refers to a savory, rich taste associated with glutamate and certain amino acids. Soy sauce, mushrooms, Parmesan cheese, tomatoes, broths, and many fermented foods owe much of their appeal to umami.

From an evolutionary standpoint, umami serves an important purpose. Protein is essential for growth, repair, reproduction, and survival, so recognizing protein-rich foods provided a significant advantage. Consequently, the body evolved receptors specifically designed to detect those compounds. Modern scientists call them TAS1R1 and TAS1R3 receptors. Our ancestors simply recognized them as signs that dinner was likely worth pursuing.

Growing up in Ketchikan, Alaska, I had a slightly different perspective on some of these foods. The first time somebody enthusiastically explained sushi to me, my immediate reaction was, "That's bait." Fortunately, the Japanese had grander plans for raw fish than I did.

Why Children Hate BroccoliParents often assume children reject vegetables because they are stubborn. Evolution suggests another explanation. Many toxic plant compounds are bitter, and bitterness frequently serves as nature's warning label. Therefore, children are generally more sensitive to bitter flavors than adults. Their bodies are essentially operating a heightened food safety program.

As people age, repeated exposure teaches the brain that many bitter foods are safe and even beneficial. Coffee, tea, dark chocolate, kale, Brussels sprouts, and beer all require overcoming an instinctive caution signal. Adulthood, in many ways, involves learning which bitter things deserve a second chance. Moreover, many of those foods contain nutrients, fiber, and bioactive compounds associated with better health.

This is one reason I smile whenever someone declares kale is poison. The statement may reveal more about the speaker's bitter receptors than about kale itself.

Babies, Honey, and a Healthy Fear of FoodInfants face a different challenge. During the first months of life, stomach acid production is lower than in adults. Consequently, babies are more vulnerable to certain organisms that older children and adults can handle without difficulty. This difference explains one of the most important feeding rules in pediatrics: do not give honey to infants under one year of age.

Honey can contain spores of Clostridium botulinum. In adults, stomach acid and a mature intestinal environment generally prevent those spores from causing problems. However, infants lack many of those defenses. Therefore, infant botulism remains a genuine concern, despite honey's reputation as a natural food. Once again, evolution reminds us that caution often exists for a reason.

The Stomach: Bouncer, Judge, and ExecutionerOne of the most surprising discoveries in recent years is that the stomach contains bitter taste receptors known as TAS2Rs. These receptors do not evaluate flavor. Instead, they help assess what has arrived and determine how aggressive the digestive system should respond. When bitter compounds appear, gastric emptying may slow, giving stomach acid additional time to destroy microbes and process potentially hazardous material.

I learned this lesson personally during a trip to Tijuana. Someone handed me a Clamato loaded with raw shellfish. At the time, it tasted wonderful. Several hours later, however, my stomach conducted a thorough review of the situation. The acid weighed in, the receptors filed their reports, and the immune system apparently demanded immediate action. The resulting decision was swift, unanimous, and memorable.

Evolution does not care about dignity. Survival remains the only vote that counts.

Your Sinuses Listen to BacteriaPerhaps the strangest discovery involves bitter receptors in the airways and sinuses. Researchers have found that certain receptors can detect chemical signals used by bacteria to communicate. In other words, cells lining your sinuses may effectively eavesdrop on microbial conversations before those microbes establish a significant foothold.

Once those signals are detected, defensive mechanisms begin activating. Nitric oxide production increases, antimicrobial responses strengthen, and mucus clearance accelerates. Consequently, these receptors function less like taste buds and more like security personnel monitoring suspicious activity. The fact that a system originally associated with tasting food can also help defend against infection highlights how versatile these ancient sensors have become.

The Real Story of TasteFor generations, we assumed taste existed primarily for enjoyment. While pleasure certainly plays a role, the larger story is far more interesting. Taste receptors help identify calories, protein, toxins, bacteria, and environmental threats. Furthermore, many of these receptors appear to have evolved as general chemical sensors long before they became associated with dining.

The next time you enjoy a slice of pie, a bowl of sushi, a glass of wine, or even a serving of broccoli, remember that your tongue is only one participant in the conversation. Your stomach is paying attention. Your intestines are paying attention. Even your sinuses may be paying attention. Long before nutrition labels, food influencers, and restaurant reviews existed, the body developed its own remarkably sophisticated system for deciding what was worth eating and what should be avoided.

That's not just taste. That's survival.

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Type 2 Diabetes, Bariatric Surgery, Fasting, and GLP-1s: What We Finally Learned About a Disease We Thought We UnderstoodFor years, I watched something happen in bariatric surgery that made very little sense, according to the medical textbooks of the time.

Patients with type 2 diabetes would undergo surgery, and within days, their blood sugars would improve dramatically. Some would leave needing far less insulin. Others would stop insulin entirely. Many of them would eventually remain off diabetes medications for years.

Now here is the important part:

They had not yet lost significant weight.

That observation mattered enormously.

Because if diabetes improvement were simply the result of fat disappearing from the body over time, then blood sugar should improve slowly over months as weight comes off.

But that was not what we saw.Instead, patients barely eating — sipping broth and protein shakes while recovering from surgery — were suddenly metabolically different almost immediately.

At the time, we knew it worked. What we did not fully understand was why.

And honestly, that story tells you something important about medicine and science: sometimes clinical medicine notices the truth before biology fully explains it.

For decades, type 2 diabetes was often taught in very mechanical terms. You gained weight. You became insulin-resistant. The pancreas worked harder and harder until it “burned out.” Then you needed insulin.

That explanation was not entirely wrong. However, it was incomplete. Furthermore, it encouraged a kind of fatalism around type 2 diabetes, as though progression were inevitable and irreversible for everyone.

Then, bariatric surgery complicated the narrative.

Meanwhile, researchers like Professor Roy Taylor at Newcastle University began developing a much more dynamic understanding of what was actually happening inside the liver and pancreas.

And suddenly, many of the strange things bariatric surgeons had observed for years started making sense.

The Problem May Not Be Sugar AloneOne of the most common mistakes in nutrition discourse is assuming that blood sugar itself is the disease.

It is not.

Blood sugar is often the visible signal of a much larger metabolic problem involving:

• the liver,
• the pancreas,
• adipose tissue,
• appetite signaling,
• inflammation,
• gut hormones,
• and the brain itself.

Now, to be fair, refined carbohydrates and ultra-processed foods absolutely can worsen insulin resistance and glucose control. Sugary beverages, highly refined starches, and hyperpalatable processed foods create enormous metabolic stress for many people.

However, reducing the entire disease of type 2 diabetes to “sugar is poison” oversimplifies what is actually a highly complex biological system.

If carbohydrates alone caused diabetes, then traditional Mediterranean populations consuming beans, lentils, intact grains, and fruit would have universally developed severe metabolic disease. Yet many of those populations historically had some of the best cardiovascular and metabolic outcomes in the world.

Similarly, bariatric surgery would not improve diabetes before substantial fat loss occurred.

Something deeper was happening.

Roy Taylor and the Twin Cycle HypothesisRoy Taylor’s Twin Cycle Hypothesis is one of the most elegant modern explanations for type 2 diabetes.

The theory proposes that type 2 diabetes develops through two interconnected metabolic cycles, involving excess fat accumulation in organs not designed to store large amounts of fat.

First comes the liver. When caloric intake chronically exceeds what the body can safely store in adipose tissue, fat begins accumulating in the liver. Eventually, the liver becomes insulin-resistant. Now the liver starts misbehaving metabolically. Instead of calming down glucose production when insulin is present, the liver continues to release glucose into the bloodstream. At the same time, it exports excess triglycerides and fat particles into circulation.

• This creates a vicious cycle:
• more liver fat,
• more insulin resistance,
• higher insulin levels,
• more glucose production.

Then comes the second cycle. Those excess fat particles eventually accumulate in the pancreas itself. And that is where the beta cells begin struggling.

The Beta Cell Is Not Simply “Burned Out”For years, we talked about the pancreas as though it simply became exhausted.

However, newer biology suggests something more complicated — and more hopeful.

Beta cells produce insulin, which is a protein. Proteins must be folded properly inside the cell before they can be packaged and secreted.

Under chronic metabolic stress — high glucose levels, elevated fatty acids, inflammation, oxidative stress — the protein-folding machinery inside the beta cell begins malfunctioning.

Some insulin molecules become misfolded.

Now imagine a factory assembly line where defective products begin to accumulate faster than workers can remove them.

The system clogs. The beta cell experiences what is called endoplasmic reticulum stress, or ER stress. In simple terms, the protein-processing machinery becomes overloaded.

At first, the cell adapts. It slows production. And the cell will activate repair systems. To clear damaged proteins.

But if the stress continues long enough, the machinery begins failing. Some beta cells become dysfunctional. As a result, some become metabolically suppressed. They stop making insulin. Some dedifferentiate, meaning they stop functioning normally. And eventually some undergo apoptosis: programmed cell death.

That distinction matters enormously. Because it suggests that not every beta cell is permanently destroyed early in the disease. Some are simply overwhelmed.

Why Fasting Sometimes WorksThis may help explain why fasting improves type 2 diabetes in some patients.

Fasting reduces metabolic demand.

• Less glucose enters the system.
• Less insulin is required.
• The liver produces less glucose.
• The pancreas experiences less pressure.

In effect, fasting may temporarily reduce the metabolic traffic jam overwhelming the beta cells.

Now, some people online treat fasting almost like a mystical cure for diabetes. I think that is an exaggeration.

The body is not achieving enlightenment because somebody skipped breakfast.

The likely benefit is much more practical:

Reduced metabolic overload allows stressed systems to recover function.

And clinically, we do see this. Some patients improve dramatically with fasting or aggressive caloric restriction. However, fasting is not universally successful because not all patients have the same remaining beta-cell reserve. Some patients have substantial recoverable function left. Others have experienced years of apoptosis and structural loss.

That is one reason newly diagnosed patients often respond far better than patients with decades of poorly controlled diabetes.

Duration matters. Furthermore, what happens after the fasting matters enormously.

If someone fasts aggressively, but then returns immediately to hyper-palatable ultra-processed food, liquid calories, and chronic overnutrition, the same metabolic stress returns.

Which brings us to an important point.

The Real Goal Is Not Carb EliminationThis is where I part ways somewhat with the more absolutist low-carb community.

Low-carb diets help many patients reduce caloric intake and improve glucose control. That part is real.

However, when you look at the broader evidence, the deeper lesson is probably not:

“Carbohydrates are evil.”

The deeper lesson is: eat less, eat better, and create a sustainable metabolic environment that the body can actually manage long term.

And this is where Mediterranean-style dietary patterns continue to shine.

Why the Mediterranean Diet Works So WellOne of the strangest developments in modern nutrition culture is the fear surrounding whole grains and legumes.

Beans somehow became suspicious.

Oatmeal became controversial.

Meanwhile, the modern industrial food environment quietly engineered ultra-processed calorie delivery systems powerful enough to overwhelm normal satiety pathways entirely.

Perspective matters.

After bariatric surgery, once patients had healed from the immediate postoperative phase, many naturally transitioned toward what was essentially a Mediterranean-style eating pattern.

Not because it was trendy.

Because clinically it worked. But because patients tolerated it well. Their weight stabilized more successfully. In addition, cardiovascular risk factors improved. And perhaps most importantly, they could sustain it.

That last point matters more than anything else in nutrition.

The Mediterranean diet works because it aligns well with human physiology:

• high fiber,
• intact foods,
• lower caloric density,
• reduced ultra-processed food burden,
• improved satiety,
• favorable effects on the microbiome,
• and long-term sustainability.

Importantly, carbohydrates behave differently from rapidly absorbed refined starches and sugary beverages.

• Food structure matters
• Fiber matters.
• Satiety matters.
• Context matters.

A bowl of lentils with olive oil, vegetables, and fish is metabolically different from ultra-processed food engineered to bypass normal fullness signaling.

Whole grains are not the apocalypse.

GLP-1 Drugs and Bariatric Surgery Are Teaching the Same LessonGLP-1 medications work so well because they address biology directly.

They:

• reduce appetite,
• slow gastric emptying,
• improve satiety,
• decrease caloric intake,
• lower liver fat,
• and reduce metabolic demand.

In many ways, these medications reproduce medically some of the metabolic effects bariatric surgeons observed years ago.

Importantly, they help patients sustain the physiologic state required for remission.

And this is where the conversation about obesity often becomes deeply unfair.

For decades, medicine and society moralized obesity, while underestimating how aggressive biology defends body weight.

Hunger increases with weight loss.

Energy expenditure decreases.

Food reward intensifies.

The environment constantly pushes hyperpalatable calories. This is not weakness. It is biology.

Remission Is Still a VictoryOne of the more frustrating debates online revolves around the word “cure.”

I understand why people want to use it. Remission sounds less dramatic. Less triumphant.

However, remission is actually an extraordinarily hopeful concept. It means the disease process can improve substantially. But also, it means biology is more dynamic than we once believed. Finally, it means the pancreas retains recoverable function in many patients.

But remission also recognizes reality:

• Some beta cells are permanently lost,
• Relapse can occur,
• weight regain matters,
• disease duration matters,
• and long-term susceptibility often remains.

That is not pessimism. That is biological honesty.

The real breakthrough here is not that type 2 diabetes was fake all along. The breakthrough is that we finally understand it as a far more dynamic, reversible, and biologically complex disease than we once believed. And perhaps the most important lesson of all is this:

Bariatric surgery, fasting research, Mediterranean diets, and GLP-1 science are not actually telling completely different stories. They are all pointing toward the same underlying truth:

The human body functions well when chronic metabolic overload is reduced long enough for normal signaling systems to recover.

The tragedy of type 2 diabetes is not merely that millions have developed it. But that for decades, we blamed patients morally, while barely understanding the biology ourselves.

Then, patients stopped eating after surgery, and their diabetes improved before the sutures had healed.

Biology was trying to teach us something.

Eventually, science listened.

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The Science of Hangovers: Why Your “Cure” Probably Doesn’t WorkYou wake up thirsty.

Then, almost immediately, you realize your head hurts. Your stomach feels unstable. The room is too bright. Your mouth tastes like regret and old wine corks. Furthermore, your intestines suddenly decided today is the day they become extremely efficient.

In other words, you have a hangover.

Now, hopefully, this is not a regular occurrence. Nevertheless, most adults eventually experience one. The evening starts innocently enough: good friends, great conversation, maybe a cocktail before dinner. Then, however, another bottle arrives. Someone orders dessert drinks. Suddenly, what seemed like sophisticated socializing turns into next-morning negotiations with your nervous system.

And that raises the obvious question:

What actually causes a hangover?

More importantly, why do so many supposed “cures” fail so spectacularly?

First, Alcohol Is Not Just “Dehydration”Many people think a hangover is simply dehydration.

Certainly, dehydration matters. Alcohol suppresses vasopressin, the hormone that helps your kidneys conserve water. As a result, you urinate more frequently. Consequently, you lose fluid and electrolytes.

However, dehydration is only part of the story.

In fact, hangovers are far more complicated.

Alcohol irritates the stomach lining. Additionally, it disrupts blood sugar regulation. Furthermore, it interferes with inflammatory pathways, sleep architecture, hormone signaling, and neurotransmitters involved in mood and alertness.

So while dehydration contributes to the misery, it does not fully explain why you feel like a Victorian ghost haunting your own apartment.

Moreover, alcohol affects sleep in a particularly cruel way.

It helps many people fall asleep quickly. However, it fragments restorative sleep later in the night. Therefore, you may technically be unconscious for eight hours while still waking up exhausted.

You passed out.

You did not recover.

Then There’s Acetaldehyde — But It’s Not the Whole StorySocial media wellness culture loves one word:

Acetaldehyde.

This is the toxic metabolite created when your liver breaks down alcohol. And yes, acetaldehyde contributes to flushing, nausea, headache, and inflammation.

Nevertheless, modern marketing often exaggerates its role because it creates a simple story.

“If acetaldehyde is bad, then a supplement that lowers acetaldehyde must solve hangovers.”

Unfortunately, biology is rarely that convenient.

Hangovers are not caused by one molecule acting alone. Instead, they are the result of multiple overlapping physiologic stresses happening simultaneously.

In other words, there is no single “off switch.”

And that is exactly where the supplement industry enters the picture.

The Rise of the “Hangover Cure” IndustryOver the last several years, social media has become flooded with products promising recovery, detoxification, or “support” for drinking.

For example:

• Cheers Restore
• ZBiotics
• Myrkl
• H-PROOF
• DHM Detox
• Dose for Liver

Furthermore, many of these products use similar language:

“supports liver health,”

“helps metabolize alcohol,”

“promotes recovery,”

or “supports detoxification.”

Notice the wording carefully.

Most companies avoid explicitly claiming to “cure” hangovers because proving that scientifically would require strong clinical evidence.

And, unfortunately for marketing departments everywhere, that evidence largely does not exist.

So Do These Products Work?The honest answer is:

Probably not very well.

Now, to be fair, some ingredients are biologically plausible. For instance, DHM — dihydromyricetin — has shown interesting effects in animal studies involving alcohol metabolism and GABA signaling.

Likewise, some probiotics may influence acetaldehyde metabolism in the gut. Meanwhile, antioxidants and electrolytes may help support recovery in limited ways.

However, plausible does not mean proven.

That distinction matters enormously.

Most studies on hangover products are:

small,

poorly standardized,

company-funded,

or focused on surrogate laboratory markers rather than meaningful real-world outcomes.

Consequently, the evidence remains weak.

And that is why most medical reviews conclude the same thing:

there is no strong evidence that popular hangover cures reliably work as advertised.

Meanwhile, IV Clinics Are Mostly Selling Expensive Salt WaterPerhaps nothing captures modern wellness culture better than the rise of the “hangover IV.”

Now, certainly, IV fluids can help with dehydration. Additionally, anti-nausea medications may temporarily improve symptoms.

Nevertheless, many hangover IV clinics market themselves almost like detox spas.

And that language becomes misleading very quickly.

Your liver already detoxifies alcohol. In fact, that is literally its job.

Moreover, your liver clears alcohol at a relatively fixed rate. Therefore, no vitamin infusion dramatically speeds the process.

So while IV hydration may help some symptoms, it does not reverse toxicology.

It is mostly expensive supportive care with mood lighting.

What Actually Helps?Unfortunately, the most effective hangover treatments are also the least exciting.

First, hydration genuinely matters.

Water, electrolyte drinks, broth, and even fruit juice can help restore fluid balance and blood sugar.

Second, bland foods often help settle the stomach.

For example:

toast,

rice,

crackers,

eggs,

or soup.

Interestingly, pho may actually be one of the better hangover foods because it combines fluids, sodium, carbohydrates, and easy digestion.

Third, sleep matters enormously.

Alcohol damages sleep quality. Therefore, recovery sleep becomes critical afterward.

Meanwhile, pain relievers should be used carefully.

Ibuprofen or aspirin may help with headaches. However, they can worsen stomach irritation.

And acetaminophen deserves special caution.

Alcohol stresses liver metabolism. Acetaminophen also relies heavily on liver pathways. Consequently, combining large amounts of alcohol with Tylenol can become dangerous.

Some Supplements May Help a LittleNow this is where nuance matters.

A few supplements do show modest signals in limited studies.

For example:

• Prickly pear extract has shown some reduction in inflammatory hangover symptoms.
• Red ginseng has demonstrated modest improvement in some small trials.
• Siberian ginseng and combination antioxidant products have shown scattered positive findings.

However, none of these products “cures” hangovers.

Furthermore, the studies are small and inconsistent.

Most importantly, they are not permission slips for binge drinking.

The Part Nobody Likes HearingHere is the uncomfortable reality.

Even intermittent heavy drinking may have long-term consequences.

Many people believe occasional binge drinking is harmless because they are still functioning professionally and socially.

However, alcohol remains neurotoxic.

Repeated episodes of heavy alcohol exposure are associated with changes in cognition, mood regulation, sleep quality, memory, and brain structure over time.

And importantly, aging reduces the brain’s ability to compensate for injury.

Therefore, the “weekend warrior” approach to alcohol may not be as biologically benign as people hope.

Meanwhile, our culture often treats alcohol very differently from other health risks.

People obsess over processed foods, seed oils, artificial dyes, or gluten.

Yet somehow, repeated alcohol poisoning became normalized in adulthood with appetizers.

That contradiction is worth thinking about.

So What Is the Best Prevention?Unfortunately, prevention is boring.

And yet boring works.

Drink less.

Drink slower.

Eat before drinking.

Alternate alcohol with water.

Avoid “catch-up drinking.”

Prioritize sleep afterward.

And, additionally, lower-congener drinks like vodka or gin may produce fewer hangover symptoms than whiskey, bourbon, or brandy.

Not because they are healthy.

Simply because they contain fewer additional fermentation compounds.

Final ThoughtsUltimately, the science of hangovers is less glamorous than the internet wants it to be.

There is no miracle cure.

There is no magical probiotic that allows unlimited tequila without consequences.

There is no gummy that outperforms biology.

Instead, a hangover is your body responding to inflammation, dehydration, toxic exposure, disrupted sleep, and metabolic stress.

In other words, it is not a vitamin deficiency.

It is a receipt.

Outside ReadingFor a good evidence-based overview of hangovers and the limited science behind hangover remedies, see the review from the Cleveland Clinic on hangover cures and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) overview of hangovers.

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The “Real Food” Protein BarThere may be no phrase in modern nutrition more ridiculous than this:

“Real food protein bar.”

And yet, somehow, we are expected to nod seriously when someone says it.

Recently, internet nutrition personality Paul Saladino introduced what he described as his best “real food” protein bar. While I have nothing personal against the man. I admire the confidence required to sell twelve protein bars for forty-four dollars while talking about ancestral living.

Because let’s be honest for a moment.

Protein bars are the modern candy bar.

They simply come wrapped in better branding, cleaner fonts, and enough wellness language to make people feel virtuous while eating what is essentially an expensive Snickers bar with a podcast sponsorship.

Now, before the internet declares me anti-protein-bar, let me clarify something immediately.

I actually like Aloha bars.

They’re expensive, but they say the right words to me. More importantly, they taste better than most compressed drywall products pretending to be nutritious. At the same time, real life exists, and sometimes convenience matters because airports happen, traffic happens, and long clinic days happen.

Still, pretending industrial engineering somehow untouches these foods is a bit like pretending woodland elves handcrafted a Tesla.

Breakfast Used to Be a Moral LectureTo understand how we got here, we need cereal, because cereal tells the entire story of modern food in one aisle.

The first cereals in America were essentially granolas—dense grain mixtures that required chewing, preparation, and a bit of commitment. While nobody was exactly dreaming about them at night, they solved an important problem because they stored well, traveled well, and provided calories in an expanding industrial society.

Then along came John Harvey Kellogg.

Now, Kellogg was brilliant, strange, deeply moralistic, and profoundly suspicious of pleasure. He believed rich foods, spicy foods, meat, and almost anything enjoyable stimulated dangerous passions, and among those passions, he was particularly terrified of masturbation, which he viewed as one of the great threats to civilization.

So his answer was blandness.

Very blandness.

Little sugar. Little excitement. Little stimulation.

The original breakfast cereal movement was not designed around pleasure.

Instead, it was designed around suppression.

In many ways, those cereals were crunchy moral discipline.

Then the Cereal Aisle Became Las VegasFast forward a hundred years, and the cereal aisle becomes the exact opposite of Kellogg’s vision.

Sugar increases dramatically.

Crunch becomes engineered.

Colors explode across the box.

Mascots arrive to recruit children before they can read.

Eventually, breakfast stops being a health intervention and slowly transforms into dessert with vitamins sprinkled on top.

And importantly, none of this happened because someone woke up wanting to destroy public health.

That’s the part people often misunderstand.

Food Engineering Solved Real ProblemsBefore obesity became the dominant nutritional problem, the real challenge facing humanity was hunger.

For most of history, people worried about:

• starvation
• food spoilage
• crop failures
• transportation
• and simple calorie availability

Modern food engineering changed that reality.

Shelf-stable foods mattered.

Affordable calories mattered.

Transportation mattered.

Refrigeration mattered.

And honestly, millions upon millions of lives have been improved because of those advances.

It is very easy for people with stocked refrigerators and grocery delivery apps to romanticize the past, but the past involved a tremendous amount of malnutrition, uncertainty, and hunger.

So modern food systems were not evil.

They were revolutionary.

The Problem ChangedHowever, in solving one problem, we slowly created another.

Because once calories became:

• cheap
• portable
• stable
• and endlessly available

…the challenge was no longer finding enough food.

The challenge became stopping.

And this is where modern biology collides with the modern grocery aisle.

Our brains evolved in environments where calorie-dense food was rare and valuable. Suddenly, within just a few generations, we found ourselves surrounded by foods engineered to be affordable, repeatable, and highly rewarding.

That mismatch matters.

Extrusion Changed EverythingMost people have never heard the word extrusion, even though it may be one of the most important food technologies in modern life.

The process is simple.

Take starches, grains, or protein powders.

Apply heat and pressure.

Force them through machinery.

Suddenly, you have:

• cereal
• crackers
• cheese puffs
• protein snacks
• breakfast bars

And here is the important part: extrusion changes texture, and texture changes satiety.

When food crunches perfectly, dissolves quickly, and slides down effortlessly, people consume more of it before fullness has time to register.

That is not a conspiracy.

It is simply biology interacting with engineering.

The Grocery Store Became Natural SelectionFood companies did not necessarily set out to create hyper-palatable foods.

Instead, they followed what sold.

And what sold was what people returned to again and again.

So over time, the grocery aisle became a form of natural selection.

Products survived because they triggered pleasure effectively.

Foods that didn’t simply disappear.

And I will confidently say something controversial:

Reese's sells better than Brussels sprouts.

I will die on that hill.

Now, yes, Brussels sprouts can be delicious roasted with olive oil and balsamic, and somewhere at this exact moment, a chef in Brooklyn is shaving them raw onto handmade pottery while explaining their emotional complexity.

Still, Reese’s triggers something primal.

Sweetness.

Fat.

Salt.

Texture.

And your brain immediately says:

“Yes. More of that.”

Food Is EmotionalFood is not just chemistry.

Food is memory.

It is also culture.

What we eat is comfort.

For some people, comfort food is a tamale. For others, it’s lefse. Meanwhile, many people find that comfort in peanut butter cups or a Dove Bar.

The grocery aisle evolved around those emotional realities much faster than human biology evolved to manage them.

And that matters, because modern eating is not simply about willpower.

It is about environment.

Cooking Changes the ExperienceNow compare all that to actual cooking.

Not content-creator cooking.

Real cooking.

A stew simmering slowly.

A roast chicken filling the kitchen with aroma.

A tagine building layers of flavor from preserved lemon, apricots, and warm Moroccan spices.

That kind of food slows you down.

You smell it before you eat it.

You notice texture.

You experience layers of flavor.

And interestingly enough, you often need less of it to feel satisfied.

That is one of the great ironies of modern eating.

As food became more engineered for efficiency, it often became less satisfying experientially.

The Wellness FantasyThere is another uncomfortable reality that nobody on wellness Instagram likes to admit.

In order to feed a hungry planet, we cannot all live on pasture-raised beef, farm-fresh eggs gathered from cheerful backyard chickens, and organic kale harvested by a local poet-farmer wearing linen.

That is not a food system.

That is a lifestyle catalog.

The modern world has eight billion people.

Food has to:

• travel
• survive droughts
• survive wars
• survive supply chain failures
• and feed cities that no longer produce their own calories

Engineered foods are not going away.

Nor should they.

Yes, Even on MarsWhen human beings eventually colonize Mars, we are not putting cattle on the rocket ship.

Nobody is building a space ranch outside Olympus Mons.

Likewise, we are not stocking the moons of Jupiter with artisanal grass-fed herds wandering peacefully beneath methane clouds.

Instead, we will use engineered foods and lab-grown proteins, because they will be:

• efficient
• reproducible
• resource-conscious
• and eventually taste just as good

That future is not dystopian.

It is practical.

The Real Challenge NowThe challenge facing us today is very different from the challenge facing humanity a century ago.

We no longer live in a world where most people fear starvation.

Instead, we live in a world where many people are simultaneously overfed and undernourished.

Calories are abundant.

Satiety is not.

And that is where medications like GLP-1 are helping many people—including me—regain a sense of balance and reality in a food environment that our brains were never designed to navigate.

Food Is Not the EnemyFood is not evil.

Engineering is not automatically bad.

Convenience matters, and sometimes a protein bar is perfectly fine.

However, pretending that heavily processed convenience foods become “real food” because someone added collagen and an Instagram strategy does not help anyone understand the real issue.

The goal is not perfection.

The goal is awareness.

We need food systems that:

• reduce malnutrition
• prevent shortages
• improve satiety
• and avoid creating environments where obesity becomes the default outcome of modern life

Because feeding humanity was one of civilization’s greatest achievements.

Now we simply have to figure out how to do it without overwhelming the biology that got us here in the first place.

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Let’s Start With What Nobody Tells YouWhen people start a GLP-1, they are told what to avoid. What side effects to expect, and sometimes how much protein they should be eating. While that information has its place, it misses the part that actually changes your day-to-day life. Because what really shifts is not just how much you eat, but also how you experience it.

At first, that change can feel subtle, almost easy to miss. Because nothing dramatic happens overnight. Although for me it did. In addition, over the course of a few days and weeks, you begin to notice that foods you used to reach for automatically no longer have the same pull, and simultaneously, foods you barely thought about before start to feel more interesting, more satisfying, and more worth your attention.

So instead of asking what you should eat, a better question becomes what you actually want to eat. Because that answer starts to change.

The Old Way: Eating Without NoticingBefore this, eating was often fast, automatic, and driven by something that wasn’t quite hunger. Most meals were about filling up rather than tasting anything. Once the plate was in front of you, it didn’t take long for it to disappear.

In many cases, food was less about enjoyment and more about reaching that point of fullness where the urge to eat finally quieted. Which meant convenience foods made sense, large portions felt normal, and finishing everything was exactly what you did.

As a result, you weren’t really tasting food; you were processing it. And that difference matters more than people realize.

Then the Shift BeginsAfter starting a GLP-1, the signal changes. While it doesn’t happen the same way for everyone, it shows up quickly enough that you notice it in small ways. Because you slow down without trying, you pause between bites without thinking, and you stop earlier than you used to.

That pause is important because it gives you a moment to notice what you’re eating. Once you notice, you start making choices that feel different from before, not because you are forcing yourself to be disciplined, but because your body is guiding you in a new way.

Gradually, eating becomes less about quantity and experience, and that shift changes everything.

Lunch: Where Real Life HappensFor most people, lunch is not a carefully planned event, and that’s exactly why it’s a good place to see what actually works.

On many days, I keep it simple because simple is reliable. A chicken breast heated up in the morning with a bit of hot sauce does the job without much effort. while a couple of apples and some grapes can carry me through the late morning and early afternoon without feeling like I need a full sit-down meal. Plus, if I am driving, eating slices of apples and grapes keeps me awake.

At the same time, I don’t force structure onto it, because grazing a bit throughout the day often fits better than trying to recreate the old idea of a formal lunch, and that flexibility makes things easier rather than harder.

On other days, I might grab a sandwich, and while it could be like a triple-decker club. The difference now is not what I order, but how much I eat, because stopping halfway feels natural instead of forced. Whatever is left has a way of disappearing quickly once my son gets home from school.

Eating out follows the same pattern, because one or two tacos are usually enough. While fried foods sometimes feel heavier than they used to, grilled or ceviche-style options bring out flavor without that weight, making the experience better without trying to optimize anything.

Simple Food Becomes Better FoodAt some point, you realize that simple foods start to feel more satisfying than they used to. And something like a good tuna, mixed with yogurt, lemon, and a bit of mustard, becomes a meal that you actually look forward to. Rather than something you eat because you think you should.

Bread becomes optional, not forbidden, and sometimes a bowl or a few crackers is all you need, which removes the sense that meals must follow a certain format.

Seasonal fruit fits into that pattern. Because when something tastes good, you eat it, and when it doesn’t, you move on, which is a different mindset from trying to force certain foods into your day.

Even something as simple as peanut butter and jelly can feel satisfying again, because the experience of eating it has changed.

Hydration Stops Being an AfterthoughtOne thing that becomes more noticeable is how important drinking fluids actually is because when you eat less, you naturally take in less water from food, and that means you have to be more intentional about it.

For me, iced tea works because it adds a bit of flavor without adding much else. Making it overnight in a pitcher means it’s ready when I need it, which turns hydration into a habit instead of something I forget about.

That small shift makes a bigger difference than most people expect, because feeling off is often just a sign that you need to drink more.

Dinner Becomes Something DifferentDinner changes in a way that feels less structured and more creative. Because instead of trying to build a large meal, you start thinking about what would actually be enjoyable.

Cooking becomes more interesting, not because you are trying harder, but because you have the space to pay attention. Dishes like salmon, pasta with a well-made sauce, or even something new from a meal kit can feel like something you are exploring rather than something you are consuming.

At the same time, there is more room for variety, because you are not relying on volume to feel satisfied, and that allows you to try different things without needing to make them large.

Still Paying Attention MattersEven with all these changes, I still track what I eat using Noom. Because awareness doesn’t go away just because the biology works differently. And that habit keeps things grounded without turning it into something rigid.

Going out to eat is still part of life, and in many ways, it becomes more enjoyable because you can focus on what you like rather than how much you can eat, and sharing a meal or splitting something becomes a natural part of the experience.

Dessert Tells You More Than You ThinkDessert is where you can see the shift.

Most of the time, I don’t think about it, and that alone is different, because it used to be automatic.

Every now and then, especially when I’m getting close to my next dose, I’ll notice that I want something sweet, and I might have an ice cream bar, and that’s enough.

That moment says more than any rule ever could. It shows the drive is lower, not gone, and that you can respond to it without being controlled by it.

The Real ChangeWhat has changed is not complicated, but meaningful.

I go for flavor instead of volume.

Timing, now I take my time tasting instead of rushing.

Choosing where and what to eat depends on whether it is worth it, not whether it is popular or convenient.

Food is not the enemy.

It never was.

Some days, I am simply not interested in dinner, and if lunch was larger, I might just have a protein shake and move on, because eating is no longer something I have to do on a schedule.

A Different Way of EatingThis is not a diet. It is not a plan. It is not about perfection.

Instead, it is about eating in a way that matches how your body now works, which means paying attention, making choices, and allowing yourself to enjoy food without relying on it for everything else.

Before, I filled my mouth before thinking, and swallowing before experiencing.

Now, I taste.

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It’s not a straight line. It’s not a diet. And it’s definitely not what you expect.I started my journey on a GLP-1 in October 2024. While my doctor did what good doctors do—he gave me the warnings, the precautions, the usual advice about what to avoid and watch for—I quickly realized something was missing. No one really told me what it would feel like. More importantly, no one explained that this first month doesn’t unfold in one neat, predictable way, but instead moves along several paths depending on the person, their biology, their habits, and frankly, a bit of luck.

So, as I’ve watched friends, patients, and many people start this same journey, I’ve come to understand that the first month is less about weight loss, and far more about discovery, adjustment, and occasionally confusion. While people expect something simple, they get instead of variation, and that variation can make them think something is wrong when everything is going exactly as it should.

The Myth of the Straight LineMost people begin this process believing they will take the medication, lose their appetite, and watch the scale steadily drop. While that story is appealing, it simply isn’t how the body works, because biology rarely follows a script, and in this case, the first month is more like learning a new language than following a plan.

What becomes clear quickly is that people fall into different patterns. While none of these patterns are right or wrong, understanding which one you are in can make all the difference in how you interpret the experience.

The Three Paths of the First MonthSome people, myself included, are what we call hyper responders. Although we don’t fully understand why this happens, the effect can be dramatic. Within about twelve hours of my first dose, something shifted in a way I did not expect, as the constant chatter in my head about food—what we used to call head hunger—simply disappeared, and I didn’t even know it had been there until it was gone.

During that first month, I lost twelve pounds, and while most of that was water and glycogen with some fat mixed in, the real change was not on the scale, but in my appetite. This dropped so noticeably that I found myself stretching out the time between doses. Interestingly enough, my obstructive sleep apnea improved, which was not something I had anticipated, but certainly appreciated.

At the same time, my doctor had warned me to drink more fluids, and that advice was critical, because much of the water we normally get comes from food, and when food intake drops, hydration must be a conscious effort. So I adjusted by adding a protein shake in the morning and increasing my iced tea throughout the day, and that simple change made a meaningful difference in how I felt. You can find my recipes for protein shakes on the recipe section of my site, terrysimpson.com.

The Normal RespondersOn the other hand, most people do not have that kind of immediate response, and instead they fall into what I would call the normal responder group, where the changes are subtle at first, and because they are subtle, they are easy to miss, which leads many to think the medication isn’t working, especially when they compare themselves to others who seem to be losing weight quickly.

What they don’t notice, however, is that they are snacking less, leaving a bit of food on their plate, and skipping that second helping more often than before, and while these changes may seem small, they add up over time, because when someone tells me they only lost four pounds in a month, I translate that into nearly fifty pounds in a year, and suddenly the perspective shifts from disappointment to possibility, because that is a sustainable path.

The Strugglers - they need helpThen there is the third group, the strugglers, and these are the people who feel the effects right away but not in a pleasant way, because nausea, delayed gastric emptying, and an uncomfortable sense of fullness can make the experience feel miserable rather than helpful, and in these cases, intervention becomes important, since without adjustment, these individuals can run into real problems.

What helps here is not complicated, but it does require attention, because smaller meals, avoiding fatty foods early on, focusing on liquids, and most importantly, never eating until full can turn things around, and more often than not, dehydration is the hidden issue, which is why something as simple as popsicles made from electrolyte solutions can provide both relief and hydration, and the key word for this group, more than anything else, is pacing.

Food Noise and the Silence That FollowsBefore GLP-1 medications, we often described something called head hunger, which is that feeling of wanting food even when the body does not need it. The distinction between real hunger and head hunger is easier to understand than most people think. If you are truly hungry, something simple like a meatball will satisfy you, whereas if it is head hunger, you will find yourself reaching for cookies, candy, or snacks high in calories but low in nutrition.

This is what we now call food noise, and for many people, it is constant, although they may not recognize it until it disappears, which is exactly what happens on a GLP-1, and that disappearance can feel both liberating and unfamiliar at the same time.

I can always tell when mine starts to come back, and recently, I delayed my dose for a few days because I was celebrating my wife’s birthday, and the next day, before I resumed the medication, I found myself buying multiple boxes of ice cream bars, not because I needed them but because that voice had returned, quietly suggesting that I might want them, and once I took the dose again, that same voice faded, leaving me to wonder why I had bought them in the first place.

That voice is persistent, not loud but steady, and it doesn’t shout like an alarm but instead calls like a siren from an old story, inviting you toward something you don’t need but think you want, and turning that down is one of the most profound changes this medication brings.

What Changes Over the First Few WeeksAs the first month unfolds, the early days are often inconsistent because appetite may vary from one day to the next, and while some meals feel normal, others feel different, and this unpredictability can make people uneasy, especially if they expect immediate stability.

Gradually, however, things begin to settle, and by the third or fourth week, satiety arrives earlier, meals become smaller without effort, and foods that once felt irresistible lose some of their pull, not because they are forbidden but because they are no longer as compelling.

At that point, behavior starts to align with biology, and instead of forcing discipline, people find themselves responding to signals that finally make sense.

What Actually Helps in the First MonthSuccess in the first month comes down to a few consistent themes, and while none of them are complicated, they are easy to overlook, because smaller meals tend to feel better, slower eating becomes natural, hydration proves essential, and real food often becomes more appealing, all while the pressure to eat disappears.

In addition, forcing food when you are not hungry rarely ends well, and learning to stop earlier than you used to becomes one of the most important adjustments you can make.

The Emotional Shift No One Talks About

One of the most surprising aspects of this process is not physical but emotional, because when the constant thinking about food quiets down, there is a sense of relief, yet at the same time, there can be a feeling of disorientation, as if something familiar has gone missing.

For many people, food fills more than just hunger because it fills time, emotion, and habit, and when that changes, there is space to be filled in new ways, which can feel uncomfortable at first but ultimately becomes an opportunity.

A Different Way to Think About the First MonthThe first month on a GLP-1 is not about rapid weight loss, and it is not about perfection, and it certainly is not about willpower, because what it really represents is a shift in how the body communicates and how the mind responds.

Instead of fighting hunger, you begin to understand it, and instead of chasing food, you begin to choose it, and in that process, something changes that goes far beyond the number on a scale.

One Final ThoughtIf you are considering this journey, it is worth finding a board-certified obesity specialist because they have the training and experience to guide you through these changes in a way that most physicians simply do not, and that guidance can make the difference between frustration and success.

And as for that first month, it is less about what you lose and more about what you learn, because what you are really discovering is what it feels like to not be controlled by food for the first time in a very long time.

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Why GLP-1 Made Me Love Food More—Not LessFrom beetroot pasta to backyard salsa, this wasn’t about eating less. It was about finally tasting more.I want to tell you about two people on a GLP-1.

First, there’s me.

I’ve been on a maintenance dose—7.5 mg of Zepbound—for a while now. And recently, I went to an incredible Michelin-star restaurant. Now, at one point during that meal, I said something that surprised even me.

The beetroot pasta was one of the best dishes I had ever tasted.

Now, let’s pause there—because this matters.

I don’t like beets.

In fact, I’ve always said I hate beets.

And yet, there I was, enjoying beetroot pasta.

So what changed?

Well, not my opinion of beets.

But absolutely my appreciation of flavor.

Then, Something Unexpected HappenedDuring that same trip to Italy, I had one remarkable meal after another. For example, I ate at Ristorante Aroma, right next to the Colosseum. Then, I found a small, unforgettable place tucked away in Venice.

Now, let me be clear—this is not a humble brag.

Yes, the restaurants were fantastic. Yes, the trip was memorable.

However, I’ve been to Europe before.

And yet, this time was different.

Because this time, I didn’t just eat the food.

Instead, I tasted it.

Moreover, I slowed down.

In addition, I noticed the precision.

And perhaps most importantly, I appreciated the flavors.

Before, I think I liked good food.

Now, I actually understand it.

But Then There’s My FriendOn the other hand, there’s my friend.

He’s also on a GLP-1. In fact, he weighs a bit less than I do. However, he told me something that stopped me in my tracks.

“I don’t enjoy food anymore.”

Now, that’s not discipline.

And it’s certainly not success.

Instead, that’s anhedonia.

In his case, the dose was too high. As a result, appetite didn’t just quiet down—it disappeared. Furthermore, dehydration crept in. And on top of that, nutrition slipped just a bit.

Consequently, food wasn’t enjoyable anymore.

It was just… there.

So, we made a small adjustment.

We lowered the dose.

Now yes, that can feel frightening. Naturally, people worry:

“If I lower it, I’ll gain the weight back.”

However, that didn’t happen.

Instead, what came back was enjoyment.

And Then There’s the Protein Bar ProblemNow, let’s shift gears—because this is where things get interesting.

Every now and then, you need a snack. That’s normal. That’s life.

However, when it comes to protein bars, I have to be honest.

Most of them don’t taste like food.

Instead, they taste like wet sawdust. Or, perhaps more accurately, dry particle board with a chocolate label slapped on it.

Yes, they try. They add peanut butter flavor. They add cocoa.

But still, the texture is off. The taste is off. And ultimately, your brain knows it.

Now, to be fair, I do like some Aloha bars. They’re better than most.

But even then…

Recently, I skipped the bar.

Instead, I had something entirely different:

Tocino.

A few bites.

That’s all.

And yet, those few bites delivered something protein bars rarely do:

Flavor.

Real flavor.

Not engineered. Not simulated. Not “chocolate-adjacent.”

Actual spices. Actual cooking. Actual food.

And, frankly, it was fantastic.

Meanwhile… the $32 Steak SnackOf course, I also tried one of those dried carnivore steak snacks.

Thirty-two dollars.

And honestly?

Awful.

Dry. Chewy. Completely joyless.

At that point, you’re not eating—you’re making a statement to someone online.

Instead, you’d be far better off flying to Spain and enjoying some

Jamón Ibérico.

Because then, at least, you get flavor. And culture. And an experience.

Now, Let’s Talk About BreakfastMost mornings, I have a smoothie.

And it works.

Specifically, I use oat milk, protein powder—this week I’m trying Ora pea protein—along with cocoa, coffee, blueberries, and a bit of banana.

It’s quick. It’s consistent. And importantly, it fits into life.

Especially when you’re stuck in California traffic.

In fact, traffic moves so slowly here that I didn’t even have to get out of the car to move a snail off the road—he made it across before I got there.

So yes, smoothies make sense.

However, When I’m Home…Things change.

Now, there’s nothing wrong with a bowl of Cinnamon Chex.

It’s fine.

But often, I want something more.

So instead, I make:

• Poached eggs
• A splash of Louisiana Hot Sauce
• Pico de gallo
• Fresh tortillas
• Beans

And, of course, real salsa.

Not the jarred kind.

Instead, the kind that takes an afternoon to make. The kind that improves overnight. The kind your neighbor brings over—and yes, you briefly consider paying her to keep making it, before realizing that might get a little awkward.

So What’s Going On Here?At this point, you might think this is about “good food” versus “bad food.”

But it’s not.

Instead, it’s about awareness.

Because much of what we eat today comes from a system designed for convenience.

For example, extrusion—the process that creates cereals, protein bars, and many snack foods—makes food:

• Shelf-stable
• Affordable
• Easy to eat

And importantly, easy to overeat.

Because when food requires no effort…

You don’t stop.

But Here’s the Key PointThere is nothing wrong with food.

Not with cereal. Not with protein bars. Not with convenience.

However, GLP-1 changes something fundamental.

It changes you.

Specifically, it allows you—sometimes even forces you—to slow down.

And because of that, you begin to:

• Notice flavor
• Take your time
• Actually enjoy what you eat

Before, I was filling my mouth before thinking.

And I was swallowing before experiencing.

Now?

I taste.

And That Changes EverythingBecause now, I can enjoy:

• The precision of fine dining
• The bold flavors of the Philippines
• The chunky salsa from my neighbor’s kitchen

And suddenly, eating less becomes… more.

More experience.

More appreciation.

More enjoyment.

One Last ThingThere’s nothing wrong with Cinnamon Chex.

But it’s not a morning habit anymore.

Instead, it’s an every-now-and-then food.

It’s interesting.

But it’s not better.

Because once you start tasting food the way it’s meant to be tasted…

You don’t go back to eating it the way you used to.

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The word “peptide” is doing too much workLet’s start with the simplest truth.

A peptide is just a chain of amino acids—like pearls on a necklace. That’s it. Nothing mystical. Nothing magical.

However, structure matters. Sequence matters. Biology cares deeply about both.

Because of that, some peptides are extraordinarily powerful. Others are biologically interesting. And a growing number are simply… marketed.

That last category is where things get messy.

Before the hype, there was a miracleNow rewind to a hospital ward in Toronto in the early 1920s.

Children with diabetes were dying. Not slowly improving. Not plateauing. Dying.

Then Frederick Banting and Charles Best walked in with something crude and experimental.

Insulin.

They injected it.

The children woke up.

Not metaphorically. Not in a graph. They woke up. Families watched death reverse in real time.

That is what a peptide can do when it actually works.

Then came the desert and the lizardFast forward a few decades.

Out in the Southwest—near where I started my first job as a bariatric surgeon in Phoenix—lives the Gila monster. Not exactly a creature you expect to change medicine.

Yet inside its venom was a peptide that led, eventually, to drugs like:

Semaglutide

That discovery didn’t go straight to Instagram.

Instead, it went through:

• receptor biology
• pharmacology
• clinical trials
• outcomes research

And the results were real:

• lower blood sugar
• meaningful weight loss
• reduced cardiovascular risk

So yes, peptides can be extraordinary.

But only when the science is finished.

And then we lost the plotNow, enter the modern peptide market.

Suddenly, everything is a peptide. Everything promises:

• healing
• recovery
• fat loss
• anti-aging

You’ve seen the names:

• BPC-157
• TB-500
• CJC-1295
• Ipamorelin
• MOTS-c
• AOD-9604

Meanwhile, they are sold in places that should make you pause immediately.

Gyms.

Wellness clinics.

Online “research chemical” shops.

Rarely, if ever, through the same channels as actual medicine.

BPC-157: the peptide that does everything… on paperStart with the most famous one.

BPC-157 is marketed as a cure-all:

• tendon healing
• gut repair
• anti-inflammatory
• accelerated recovery

The claims are sweeping. The confidence is impressive.

But then you look at the evidence.

Animal studies? Yes.

Human randomized trials? No.

Long-term safety? Also no.

That gap matters.

Because when something claims to stimulate healing broadly, it raises an uncomfortable question:

What else might it stimulate?

The answer, at this point, is simple.

We don’t know.

TB-500: recovery without receiptsNext comes TB-500.

It is sold as a recovery peptide. It promises faster healing and improved flexibility.

The biology is plausible. The mechanism sounds reasonable.

Yet human evidence for those claims is lacking.

Even so, it thrives in:

• bodybuilding circles
• performance clinics
• online forums

In other words, environments where anecdote travels faster than data.

Hormone peptides: changing numbers vs. changing outcomesNow we get to the hormone crowd.

CJC-1295 and Ipamorelin are sold as a stack. They stimulate growth hormone release.

That part is real.

What comes next is not.

Because increasing a hormone level is not the same as improving health.

We do not have strong evidence for:

• long-term outcomes
• safety over years
• meaningful clinical benefits

Still, they are marketed as anti-aging therapies.

That leap—from signal to certainty—is where the trouble begins.

Melanotan II: the one that proves the ruleMelanotan II is different.

It actually does something.

It increases pigmentation. It affects melanocortin receptors.

And with that comes:

• nausea
• blood pressure changes
• mole darkening
• documented toxicity

So here is the lesson.

When a peptide truly works, you don’t get silence. You get side effects.

The absence of side effects in marketing should never reassure you.

It should make you suspicious.

AOD-9604 and MOTS-c: the fantasy layerAt the far end of the spectrum are peptides like AOD-9604 and MOTS-c.

They promise:

• targeted fat loss
• exercise-like metabolic effects
• longevity

The evidence?

Mostly cells and animals.

Yet they are already being sold, injected, and promoted.

At this point, we are not even pretending to wait for human data.

Where these actually come fromNow let’s talk about the vial.

Because this is where things shift from questionable to concerning.

Many of these peptides are:

• manufactured overseas
• shipped in bulk
• repackaged
• relabeled

They are often sold as:

• “research chemicals”
• “wellness therapies”

Independent testing has found:

• incorrect dosing
• contamination
• inconsistent purity

So when someone says they are taking a specific peptide, the real answer is uncertain.

They hope they are.

Why this is suddenly in the newsRecently, Robert F. Kennedy Jr. has pushed to expand access to peptides restricted by the FDA.

The argument is framed as freedom.

The FDA’s concern is simpler:

• lack of safety data
• risk of contamination
• unknown long-term effects

In other words, we do not yet know enough to call these safe.

That is not obstruction.

That is the job.

GLP-1: the difference data makesNow compare all of that to GLP-1 drugs.

They don’t just sound scientific.

They are scientific.

They:

• improve blood sugar
• reduce weight
• lower cardiovascular risk

Most importantly, they do this consistently, predictably, and measurably.

That is what happens when research goes the distance.

The bottom linePeptides are not the problem.

Peptides gave us insulin.

Peptides gave us GLP-1.

At their best, they are among the most elegant tools in medicine.

But the current peptide market is not built on finished science.

Instead, it is built on possibility, dressed up as certainty.

And that difference matters.

Because the gap between “interesting biology” and “safe, effective therapy” is where patients get hurt.

Final thoughtThe difference between a child waking up in a Toronto hospital…

and a vial purchased online…

is not the molecule.

It is the evidence.

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The Chorus of “Just Eat Less”Spend a few minutes on social media, and you will hear it. On Bill Maher's podcast the other day, I heard it. Two people who know less about GLP-1 drugs than almost anyone, opining about how GLP-1s are horrific.

Bill Maher says, “Just eat less.”

Jillian Michaels warns that GLP-1 medications are dangerous. Did she even graduate from college?

Meanwhile, a rotating cast of gym bros, coaches, and influencers insists that anyone using these medications is taking the easy way out.

At first glance, these seem like different voices. A comedian, a fitness personality, a group of online trainers.

However, they are all saying the same thing.

If you are overweight, this is your fault.

If you need help, you are weak.

If you use medication, you are cheating.

That message travels well. It is simple. It fits into a tweet. It sounds like common sense. Science shows us that fat shaming doesn't work (reference).

It is also wrong.

Who Is Doing the Shaming—and WhyThe fitness industry has something to lose here, and that part is easy to understand. Entire businesses are built on the idea that weight loss is a matter of discipline. Follow the plan, buy the program, track the macros, and success will follow. If it doesn’t, the explanation is built in.

You didn’t try hard enough.

However, the criticism does not stop there.

When someone like Bill Maher reduces obesity to “just eat less,” it is not about selling a diet plan. Instead, it reflects something else entirely. A kind of cultural impatience with complexity. A belief that if a problem can be described simply, it must also be solved simply.

And when that belief meets a condition like obesity, the result is dismissal.

If I don’t struggle with this, then it must not be real.

If you do struggle, then you must be doing something wrong.

That is not analysis.

That is a failure of imagination.

The Problem with Simple AnswersMedicine has a long history of being wrong in simple ways.

We once believed ulcers were caused by stress alone. Then came Helicobacter pylori and antibiotic treatment. We once thought hypertension was simply a matter of salt intake and personality. Then we developed therapies that addressed the underlying physiology.

Obesity has followed a similar path, except we have been slower to let go of the old explanation.

“Eat less, move more” is not incorrect.

It is incomplete.

Because it ignores the system that determines how much you want to eat, how often you think about food, and how your body responds when you try to lose weight.

The Part I Didn’t AdmitFor years, I saw the damage this thinking caused.

I ran support groups for patients struggling with weight. I watched them come in carrying not just pounds, but shame. They believed they were weak, that they lacked discipline, that something about them was broken.

We worked to change that.

We talked about biology. About appetite regulation. About how the body defends weight. We tried to replace blame with understanding.

And yet, I quietly held myself to a different standard.

I didn’t blame my patients.

I blamed myself.

The Surgeon Who Thought He Could Outwork BiologyIf anyone should be able to power through something, it is a surgeon. That is the job. Endure long hours. Stay focused. Push through fatigue. Delay gratification.

So I assumed I could do the same with weight.

I tried diets. I cleaned things up. I ate vegetables, cut back on certain foods, and experimented with structure. And like many people, I saw results.

At first.

Weight loss is not the mystery.

Weight maintenance is.

Because over time, the same thing happened again and again. The body adapted. Hunger increased. Energy dipped. The system pushed back.

And eventually, the weight returned.

What the Data Shows (and Why It Matters)When you look beyond personal stories and examine long-term studies, the pattern becomes clear.

In the Diabetes Prevention Program, participants lost weight early, then gradually regained some of it. In the Look AHEAD trial, an intensive lifestyle intervention produced initial success, but the gap narrowed over time.

Observational data suggest that only a small percentage of people—often cited around 3 to 5 percent—maintain significant weight loss at five years.

That number should change the conversation.

Because it tells us this is not a widespread failure of discipline.

It is a predictable outcome of a biological system.

The Loop We Keep IgnoringWeight gain does not happen in isolation. It is part of a loop.

Sleep worsens, which increases appetite. Movement becomes uncomfortable, so activity declines. Food becomes more rewarding, not less, because it offers relief.

Then intake increases.

Then the cycle repeats.

And yet, into that loop, we continue to insert the same advice.

Try harder.

What Finally ChangedFor years, I thought I just needed to try harder myself.

I was wrong.

Today, I am down fifty pounds.

Not because I discovered a better diet, but because something changed in the system itself.

I started a GLP-1–based medication.

The effect was immediate in ways I did not expect. My sleep improved. My snoring stopped. That alone changed my appetite and energy. Then something else happened.

The noise went away.

That constant pull toward food, the background awareness that shapes decisions throughout the day, quieted.

From there, everything else followed.

I began moving more. I returned to yoga, not out of obligation, but because it felt good. Because my body allowed it.

This was not about replacing lifestyle.

It was about finally being able to live it.

What the Critics MissWhen critics say this is the “easy way out,” they misunderstand what is happening.

There was nothing easy about fighting biology for years.

What these medications do is change the biology so that effort becomes effective.

That is not cheating.

That is treatment.

The Future of Coaching (and Who Will Adapt)The fitness world is not going away.

However, it is going to change.

The coaches who succeed will not be the ones shaming people for using medication. Instead, they will be the ones who understand how to work with it. They will help people build muscle, improve movement, and develop sustainable eating patterns once appetite is regulated.

Mediterranean and DASH-style diets still matter. They remain among the best-supported dietary patterns for long-term health. What changes is the ability to follow them.

When the biology shifts, adherence becomes possible.

Eating Without FearOne of the most striking changes is how food feels.

You no longer need to treat eating as a constant negotiation. You can eat real food. Greek yogurt, eggs, vegetables, and fruit.

You can enjoy it.

You can eat a peach without worrying about whether you have broken a rule.

That is what happens when the noise quiets.

Where I Was Wrong—and What Comes NextFor a long time, I believed that effort alone would solve this.

I was wrong.

Not because effort doesn’t matter, but because effort without the right biology is not enough.

Science moves forward by showing us where we were incomplete. In this case, we were incomplete in how we understood obesity.

Now we are beginning to correct that.

And as we do, the conversation should change.

Less blame.

More understanding.

Less shame.

More treatment.

Because this was never about character.

It was always about biology.

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Menopause, Hunger, and the Brain: Why It Feels DifferentMenopause changes more than temperature control. It reshapes how the brain handles hunger, fullness, and the quiet signals that guide eating. As a result, many women notice something unsettling. The same meals no longer satisfy. Hunger arrives sooner. Food feels louder.

For years, we blamed metabolism. We told women their bodies were simply slowing down. While that explanation sounds scientific, it misses the most important part of the story.

The brain has changed.

A Pattern You Can’t IgnoreDuring my years performing weight loss surgery, about 80 percent of my patients were women. Over time, one pattern became impossible to overlook. When menopause or even perimenopause began, weight gain often followed.

Some women had struggled with weight for years. Others had never given it much thought. Yet both groups described the same shift. They weren’t necessarily eating more. Instead, they felt hungrier, less satisfied, and more aware of food throughout the day.

Meanwhile, the advice they received rarely evolved. Eat less. Move more. Try harder.

However, that advice assumes the system regulating hunger still works the same way. In menopause, it doesn’t.

Estrogen and the Appetite Control CenterTo understand what’s happening, we need to look at the hypothalamus. This small but powerful region of the brain regulates appetite, energy balance, and hormonal signaling. Under normal conditions, estrogen helps keep this system stable.

Specifically, estrogen supports satiety signals and keeps hunger signals in check. In simple terms, it helps your brain recognize when you’ve had enough.

As estrogen declines, that balance shifts. Hunger signals grow stronger. Fullness signals become less reliable. Consequently, the internal experience of eating begins to change.

This shift explains why women often say, “I feel different around food,” even before their diet changes.

Why Hunger Changes FirstInterestingly, appetite changes often appear before measurable increases in calorie intake. Women report thinking about food more often, feeling less satisfied after meals, and noticing hunger earlier in the day.

At first glance, nothing looks different from the outside. Yet internally, the system has already shifted.

Because of that, traditional advice falls short. Telling someone to eat less without addressing the change in signaling is like adjusting the thermostat while ignoring the wiring.

More Than MetabolismAlthough metabolism does change with age, it does not fully explain the experience of menopause-related hunger. A slower metabolic rate might affect how calories are used, but it doesn’t explain why appetite feels louder or less controlled.

Instead, the better explanation lies in the brain. The hypothalamus responds differently when estrogen levels fall. As a result, the signals that guide eating become less precise.

In other words, this isn’t just about calories in and calories out. It’s about how the body decides when to eat—and when to stop.

The Part We Should Have Addressed SoonerFor decades, menopause care focused on symptoms like hot flashes and bone health. Meanwhile, changes in appetite and weight were often attributed to lifestyle or willpower.

Unfortunately, that approach overlooked a key fact. Estrogen plays a direct role in appetite regulation.

Because of that, many women were told to push harder when their biology had already shifted. That message wasn’t just incomplete—it was unfair.

Estrogen Replacement: A Broader RoleWhen clinicians discuss estrogen replacement, they often focus on symptom relief. However, estrogen also affects brain signaling related to hunger and satiety.

In the right patient, hormone therapy may help restore some of that balance. It can improve how the brain responds to fullness and reduce the intensity of hunger signals.

Importantly, hormone therapy does not inherently cause weight gain. That belief has persisted longer than the evidence supports.

Still, therapy isn’t for everyone. Each patient requires an individualized discussion that considers risks, benefits, and goals.

A New Layer: GLP-1 and Appetite ControlMore recently, GLP-1 receptor agonists have added another dimension to this conversation. These medications act on the same appetite centers in the brain, strengthening satiety and quieting hunger.

Interestingly, estrogen appears to enhance the effectiveness of GLP-1 signaling. Therefore, menopause may not only reduce estrogen levels—it may also decrease the brain’s responsiveness to satiety cues.

This interaction helps explain why some women experience such a dramatic shift in appetite during midlife.

What Actually HelpsOnce you understand the biology, the approach changes.

Rather than focusing solely on restriction, the goal becomes supporting satiety. Meals should include enough protein, fiber, and volume to sustain fullness. Additionally, sleep deserves attention, as poor sleep amplifies hunger signals. Medication reviews also matter, since some drugs can contribute to weight gain.

For some women, hormone therapy or GLP-1 medications may play a role. For others, dietary structure and lifestyle adjustments provide meaningful improvement.

In every case, the strategy should match the physiology.

A Better Way ForwardMenopause is not a failure of discipline. It is a shift in how the brain regulates hunger.

Once that shift is acknowledged, the conversation becomes more productive. Women can stop blaming themselves and start working with their biology.

Ultimately, the goal isn’t to fight hunger. It’s to understand it.

Final ThoughtMenopause doesn’t break the system—it changes the signal.

And once you understand the signal, you can respond with clarity instead of frustration.

Estrogen as a Key Regulator of Energy Homeostasis and Metabolic Health.Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 2022. Mahboobifard F, Pourgholami MH, Jorjani M, et al.

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The Madness of King Henry VIII—and What We Got Wrong About ObesityThe King We ForgotThere is a moment in history that most of us think we understand. King Henry VIII—large, immobile, temperamental—has become almost a caricature of excess. We picture a man who simply ate too much, moved too little, and paid the price. It is a tidy story. Unfortunately, it is also likely the wrong one.

Before the 1530s, Henry was something very different. He was athletic, charismatic, and energetic. He hunted, he jousted, he played sports, and he carried himself like the Renaissance ideal—educated, capable, and physically impressive. His armor, still preserved today, tells that story clearly. Narrow waist. Broad chest. Built for motion.

The Fall That Changed EverythingThen everything changes.

In January of 1536, Henry was thrown from his horse during a jousting match. The horse fell on him. He was reportedly unconscious for hours. Not minutes—hours. Even by modern standards, that is a significant traumatic brain injury.

Soon after, in May of that same year, Anne Boleyn was arrested and executed. She was accused not only of adultery but also of witchcraft. That detail matters. Prior to this period, Henry was not known for superstition. He was a rational thinker. Yet suddenly, accusations of witchcraft become part of the story. It is tempting to say this was political theater. It may have been. Still, the timing is difficult to ignore.

Meanwhile, his body begins to change.

The Story We Told OurselvesAt first, historians explained this in simple terms. He ate more. He exercised less. Calories in, calories out. That explanation sounds neat. It fits what we like to believe. Even so, the math does not hold up.

To gain over 200 pounds, you need a massive and sustained excess of calories. A reduction in physical activity alone does not explain that. We measure activity in METS—metabolic equivalents—and even a dramatic drop in activity would not account for that level of weight gain. In other words, you cannot outrun the math.

Yet every January, gyms fill with people who are told exactly that. Move more. Try harder. Burn it off. By February, most of those gyms are empty again. If exercise alone solved obesity, we would not still have the problem.

The Organ in ChargeSo what did we miss?

The answer sits deep in the brain, in a small but powerful structure called the hypothalamus. It regulates hunger, satiety, hormones, and stress. When it works, eating feels normal. You get hungry, you eat, you stop. No drama. No constant thinking.

However, when the hypothalamus is disrupted—by injury, disease, or chronic metabolic stress—that quiet system becomes loud. Hunger no longer behaves like a signal. It becomes a drive.

This is not theory. Modern medicine has a name for it: acquired hypothalamic obesity. After traumatic brain injury, some patients develop rapid weight gain, persistent hunger, and changes in impulse control. Studies show that nearly half of patients with significant brain injury gain weight over time. The strongest predictor is not inactivity. It is hyperphagia—an abnormal increase in appetite.

In simpler terms, the problem is not how much people move. It is what their brain is telling them to do.

What Patients Taught MeThat pattern feels familiar if you have ever sat with patients. I have. Years ago, working with former NFL players, we noticed something striking. The players who struggled most with weight often had long histories of concussions. Not all of them gained weight. Yet those who did described the same experience—something they had never felt before.

Food noise.

Not hunger. Noise. A constant suggestion that does not go away.

At first, I understood that as a physician. Later, I understood it as a person.

When the World Went QuietAbout twelve hours after my first injection of Zepbound, something changed. The world became quiet. For the first time, I realized how much of my thinking had been shaped by that background noise. It did not disappear dramatically. It simply stopped.

Since then, I have lost fifty pounds. More interesting than the weight loss is what happens between doses. As the medication wears off, the noise returns—subtly at first. A thought here. A reminder there. Even my stress levels rise slightly, something I can see on my WHOOP device. Then, a few hours after the next injection, it quiets again.

That experience changes how you see patients. It changes how you see history.

Looking Back at HenryBecause now, when we look back at Henry, we are not just looking at excess. We are looking at a possible disruption of the system that regulates behavior itself.

There are hints of this even in his own time. A French ambassador noted that Henry’s chronic leg pain troubled him often and that he compensated by eating and drinking more. Later reconstructions suggest large meals, heavy in meat, along with substantial alcohol intake. Those numbers are estimates, not precise measurements. Even so, the pattern is clear.

Something was driving the behavior.

Decline, Not IndulgenceBy the end of his life, Henry could barely move. Mechanical devices were needed to help him stand. He lost close allies, including Thomas Wolsey and Thomas More. His body deteriorated. His mood worsened. This was not simply indulgence. It was decline.

What We Can Do NowToday, we have tools that speak directly to that system. GLP-1 medications do not give people discipline. They restore control. Patients do not say they are stronger. They say it is quieter.

That distinction matters.

Because obesity was never just about calories. It was about signaling and about biology. It was about a system that, once disrupted, can push behavior in ways that are very difficult to resist.

The Real LessonSo when we look at Henry VIII, we should be careful before we judge him as a man who simply lacked restraint.

We may not know exactly how much he ate.

Nevertheless, we know something was driving it.

And when we ignore that truth today, we do more than misunderstand the disease.

We blame the patient for having it.

References

Argente J, Farooqi IS, Chowen JA, Kühnen P, López M, Morselli E, Gan HW, Spoudeas HA, Wabitsch M, Tena-Sempere M. Hypothalamic obesity: from basic mechanisms to clinical perspectives. Lancet Diabetes Endocrinol. 2025 Jan;13(1):57-68. doi: 10.1016/S2213-8587(24)00283-3. Epub 2024 Nov 12. Erratum in: Lancet Diabetes Endocrinol. 2025 Jan;13(1):e1. doi: 10.1016/S2213-8587(24)00368-1. PMID: 39547253.

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When Beef Becomes Belief: The Carnivore PriesthoodNutrition debates rarely begin with money. Yet money almost always explains how they spread.

That fact explains much of the modern carnivore movement.

At first glance, the carnivore diet appears to be a radical nutritional idea: eat beef, organs, and animal fat while avoiding vegetables, grains, legumes, and most fruits. Advocates often present the idea as a return to ancestral eating. According to the story, prehistoric humans thrived on meat, and modern illness appeared only after plants and processed foods entered the menu.

However, once you look past the rhetoric, another pattern appears. The carnivore movement did not grow out of decades of clinical research. Instead, it grew out of a very modern ecosystem: social media, podcasts, influencer culture, and supplement companies.

And once that ecosystem forms, the incentives become clear.

First, someone declares that conventional nutrition science has misled the public. Next, they present a dramatically simple solution. Afterward, they build a community around that solution. Eventually, products appear—supplements, coaching programs, special meat boxes, laboratory panels, and branded lifestyle advice.

In other words, the diet becomes the marketing engine.

And beef becomes the sacrament.

Why Simplicity SellsExtreme diets succeed for a reason. Complexity frustrates people, while simplicity reassures them.

“Eat a balanced diet rich in vegetables, whole grains, legumes, fish, and moderate meat” may represent excellent advice supported by decades of research. Unfortunately, that advice does not travel well on social media.

By contrast, statements such as “plants are poison” or “fiber is unnecessary” spread rapidly. Bold claims generate engagement. Engagement produces followers. Followers create revenue streams.

Consequently, the carnivore diet does not function only as a nutritional recommendation. It functions as a brand.

Once someone builds that brand, they must defend it.

The Prophets: The Case of the Liver KingEvery belief system eventually develops its prophets, and the carnivore world found one in a man who called himself Liver King.

He appeared online with an enormous beard, an even larger physique, and a simple message: modern men had grown weak because they had abandoned the practices of their prehistoric ancestors. According to his message, people should eat raw organs, train like cavemen, reject modern foods, and adopt “ancestral living.”

Conveniently, the ancestral lifestyle also included supplements he sold through his company.

The marketing proved effective. The image of a muscular barbarian rejecting modern science attracted millions of followers and produced a supplement business worth tens of millions of dollars.

Unfortunately, the story collapsed in 2022 when leaked emails revealed the Liver King spent more than $10,000 per month on anabolic steroids and other performance-enhancing drugs. Shortly afterward, he admitted publicly what physicians suspected from the beginning.

Raw liver did not build that physique.

Pharmacology did.

Nevertheless, the episode illustrates the economic logic of the carnivore movement. First comes the doctrine. Then comes the identity. Finally, come the products.

The Theologians: Paul SaladinoMovements rarely survive on prophets alone. They also require theologians—people who explain the doctrine with intellectual confidence.

Within the carnivore community, one of the most prominent interpreters has been Paul Saladino, a physician originally trained in psychiatry who later rebranded himself as Carnivore MD.

For several years, his message remained uncompromising. Plants contained toxins. Vegetables acted as chemical weapons. Humans thrived best on meat, organs, and animal fat. His book The Carnivore Code argued that modern civilization misunderstood nutrition and that health required a return to meat-centered eating.

However, the human body eventually entered the conversation.

After spending years on a strict carnivore diet, Saladino described several physiological problems: poor sleep, heart palpitations, muscle cramps, and hormonal changes. Consequently, the diet evolved.

Fruit appeared. Honey appeared. Raw dairy appeared.

Today, the diet carries a new label—an “animal-based diet.” In practice, that means meat accompanied by carbohydrates from fruit and honey.

In other words, the diet rediscovered sugar.

This pattern appears frequently in nutrition movements. Early stages emphasize purity and certainty. Later stages quietly reintroduce flexibility when biology refuses to cooperate.

Also, Paul is partners with Liver King.

The Economic EngineThe economic component remains impossible to ignore.

Carnivore influencers rarely restrict themselves to books and podcasts. Instead, they build supplement companies that sell freeze-dried organs, nutrient capsules, and other “ancestral” products. The marketing narrative follows a familiar path.

Modern food supposedly lacks essential nutrients.

Ancient diets supposedly provided them.

Supplements conveniently deliver them.

When followers adopt the diet, they often purchase the products associated with it. Over time, they invest not only money, but identity in the movement. As a result, they defend the doctrine aggressively, particularly when new treatments threaten the narrative.

The GLP-1 ConflictThis dynamic explains the hostility many carnivore influencers display toward GLP-1 medications, such as semaglutide and tirzepatide.

GLP-1 drugs reduce appetite, improve metabolic health, and produce significant weight loss in clinical trials. For many patients, they represent the most effective medical treatment for obesity ever developed.

However, GLP-1 therapy undermines the core promise of the carnivore movement. Influencers claim that diet alone solves metabolic disease. Pharmaceutical treatments challenge that claim.

Moreover, if people lose weight and improve their health through medical therapy, they may no longer feel compelled to purchase expensive supplements or coaching programs.

Consequently, the drugs become ideological enemies.

Carnivore influencers often portray GLP-1 medications as dangerous, unnatural, or morally suspect. Their followers repeat these arguments across social media platforms, especially on X (formerly Twitter), where the debate frequently resembles a religious dispute, not a scientific discussion.

Within this worldview, GLP-1 therapy resembles a rival faith.

And rival faiths provoke rebellion.

The Cave Painting ArgumentCarnivore advocates occasionally invoke another argument that sounds persuasive until examined closely.

If humans historically consumed vegetables, they ask, why do cave paintings rarely depict them?

The answer lies in the purpose of cave art.

Prehistoric artists painted dramatic events—hunts, animals, danger, survival. These images celebrated moments that mattered in a world where food sometimes fought back.

Nobody returned from hunting mammoths and announced, “Let us commemorate this carrot.”

Cave art told stories.

It did not document grocery lists.

Moreover, the absence of broccoli in cave paintings has an obvious explanation. Broccoli did not exist during the Paleolithic era. Mediterranean farmers cultivated it from wild brassica plants thousands of years later, likely beginning with the Etruscans.

Using cave paintings to prove humans were carnivores resembles using medieval paintings to argue that humans never drank coffee.

Humans Have Always Been OmnivoresAnthropology provides a far more realistic picture.

Scientists studying ancient bones, tools, and coprolites—preserved human feces—consistently find evidence of diverse diets that included roots, tubers, fruits, seeds, fish, and meat.

Geography shaped these diets. Arctic populations consumed more animal foods, while equatorial societies relied heavily on plants.

However, no civilization in human history survived entirely on beef.

Flexibility—not purity—allowed our species to thrive.

The Culinary ProblemCarnivore advocates rarely discuss another drawback of the diet.

It is monotonous.

Human cuisine represents one of the great achievements of civilization. Across cultures, people combine vegetables, grains, spices, and animal foods into extraordinary traditions that reflect geography and history.

Reducing that diversity to an endless rotation of ribeye steaks diminishes both nutrition and culture.

Beef remains delicious. I enjoy it myself. Growing up on a small island in Alaska, I rarely saw beef because it cost too much to ship. Consequently, it felt special when it appeared at the table.

Yet eating beef every day does not create cuisine.

It creates repetition.

Is the Carnivore Diet Safe?Many readers ask a simple question: Is the carnivore diet safe? Short-term, some people lose weight on a carnivore diet because they eliminate ultra-processed foods and increase protein intake. However, long-term health outcomes remain far less reassuring. Diets that exclude vegetables, legumes, fruits, and whole grains remove important sources of fiber, phytonutrients, and micronutrients that support gut health, metabolic regulation, and cardiovascular protection. Large population studies consistently associate dietary patterns rich in plant foods—such as the Mediterranean diet—with lower risks of heart disease, diabetes, and certain cancers. In contrast, diets dominated by red meat and lacking dietary fiber raise concerns about cardiovascular disease, colon health, and long-term metabolic effects. In other words, the real question is not whether beef can be part of a healthy diet—it certainly can—but whether eliminating most other foods improves health. Current scientific evidence suggests the answer is no.

The Real LessonBeef is nutritious.

Steak is wonderful.

But beef does not deserve a priesthood.

When a diet eliminates half the grocery store, sells supplements as sacred tools, and treats competing medical therapies as heresy, the conversation no longer resembles science.

Instead, it begins to resemble theology.

And theology rarely improves nutrition.

References1. Willett W et al. Mediterranean diet and cardiovascular disease. N Engl J Med. 2018 2. Satija A, Hu FB. Plant-based diets and cardiometabolic health. JAMA Intern Med. 2017 3. O’Keefe SJ. Diet, microbiome, and colon health. Nat Rev Gastroenterol Hepatol. 2019 4. IARC Working Group. Red and processed meat and cancer risk. Lancet Oncology. 2015 5. Eaton SB, Konner M. Paleolithic nutrition revisited. NEJM. 1985

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The Minnesota Starvation Experiment: What Hunger Does to the Human MindEvery few years, someone announces the solution to weight loss.

Eat less.

Fast longer.

Cut carbs.

Cut fat.

Cut something.

Naturally, the advice usually comes with a tone of moral certainty. If you are hungry, the implication goes, you simply lack discipline.

However, long before social media, diet influencers, and the phrase food noise entered the modern vocabulary, scientists ran an extraordinary experiment that revealed something profound about hunger.

Rather than speculate about appetite, they studied it directly.

In the middle of World War II, researchers deliberately starved healthy young men.

The results changed how we understand hunger forever.

Why the Experiment HappenedDuring World War II, much of Europe faced severe food shortages. Cities were bombed, farms disrupted, and supply chains shattered. Consequently, millions of civilians were suffering from malnutrition and starvation.

Yet another problem quickly emerged. Refeeding starving populations turned out to be complicated. If nourishment returned too quickly, dangerous metabolic complications could occur. Doctors needed to understand not only starvation but also recovery from starvation.

Therefore, the U.S. government supported research designed to answer a simple but critical question:

What happens to the human body and mind when calories are severely restricted for long periods?

The scientist leading that effort was Dr. Ancel Keysat the University of Minnesota.

Today, Keys is often remembered for his later work on diet and heart disease. Nevertheless, his wartime research produced one of the most remarkable studies ever conducted in nutrition science.

The results were eventually published in a monumental two-volume work titled:

“The Biology of Human Starvation.”

This massive text, published in 1950, remains one of the most detailed examinations of hunger ever written.

KEYS, ANCEL, JOSEF BROŽEK, AUSTIN HENSCHEL, OLAF MICKELSEN, HENRY LONGSTREET TAYLOR, Ernst Simonson, Angie Sturgeon Skinner, et al. The Biology of Human Starvation: Volume I. University of Minnesota Press, 1950. https://doi.org/10.5749/j.ctv9b2tqv.

The VolunteersTo conduct the study, Keys recruited 36 conscientious objectors.

These men had refused military service during World War II for moral or religious reasons. Nonetheless, they still wanted to contribute to the war effort. Participating in this experiment became their way of helping.

Importantly, the volunteers were healthy young men. They had normal body weight, good physical fitness, and no significant psychological problems. In other words, they were ideal research subjects.

Furthermore, they understood the risks.

They would experience months of severe caloric restriction.

Even more remarkable, the experiment took place beneath the University of Minnesota football stadium, turning an athletic facility into one of the most important laboratories in nutrition history.

The Structure of the ExperimentThe study unfolded in three distinct phases.

First came the baseline period. For several months, the men ate normally, consuming approximately 3,200 calories per day. Researchers measured body weight, metabolism, and psychological health to establish a stable starting point.

Next came the central part of the experiment: six months of semi-starvation.

During this period, calorie intake dropped to roughly 1,500 calories per day. That number may sound familiar because many modern diet programs recommend similar intake levels.

The food itself resembled wartime rations. Participants ate simple meals consisting primarily of potatoes, bread, macaroni, turnips, and small amounts of dairy.

Although the men remained physically active, their energy intake was cut in half.

Finally, the experiment concluded with a refeeding phase designed to observe how the body recovers after prolonged starvation.

The Unexpected Psychological EffectsResearchers expected weight loss.

What surprised them was the dramatic change in the men’s relationship with food.

Gradually, the volunteers became completely preoccupied with eating.

First, they began collecting recipes. Soon afterward, they spent hours reading cookbooks.

Remember that this was long before television cooking shows or the Food Network. Nevertheless, these men read cookbooks the way other people read novels.

Additionally, food became the center of conversation. Participants talked about meals constantly. They debated cooking techniques and discussed ingredients in remarkable detail.

Meanwhile, eating itself changed dramatically.

Many men developed elaborate food rituals. Some cut meals into tiny pieces to make them last longer. Others chewed gum continuously to quiet hunger. Still others drank large amounts of water or coffee simply to fill their stomachs.

Eventually, several participants reported dreaming about food every night.

At that point, hunger had completely dominated their mental landscape.

When Hunger Changes PersonalityAlongside this intense food focus came significant psychological changes.

Participants became irritable.

Mood declined.

Social withdrawal increased.

Furthermore, many men lost interest in hobbies and normal activities. Concentration dropped, and emotional resilience weakened.

However, one topic continued to command their attention:

Food.

In modern terms, we might describe this state as persistent food noise—the constant internal dialogue about eating that many individuals with obesity describe today.

The Minnesota experiment demonstrated something important: when the human body senses prolonged energy shortage, the brain amplifies signals related to food.

That response is not weakness.

Instead, it is survival.

What Happened When Food ReturnedThe most striking results appeared during the recovery phase.

Once calorie restrictions ended, participants were allowed to eat freely again. Unsurprisingly, many men consumed enormous amounts of food.

Daily intake sometimes reached 5,000 to 10,000 calories.

Importantly, this response was not driven by pleasure alone. Rather, the body was attempting to restore lost energy reserves and rebuild metabolic balance.

Researchers observed that appetite remained elevated for months after the starvation phase ended. In some cases, normal appetite regulation took more than a year to return.

Consequently, the study revealed that hunger leaves a lasting biological imprint.

Lessons for Modern NutritionAlthough the Minnesota Starvation Experiment occurred more than eighty years ago, its lessons remain highly relevant.

Modern weight-loss advice often emphasizes simple calorie restriction. People are told to eat less, ignore cravings, and rely on willpower.

Yet the Minnesota study demonstrates that prolonged calorie restriction triggers powerful biological responses.

Hunger intensifies.

Food becomes mentally dominant.

Motivation to eat grows stronger.

In other words, the brain fights back.

From an evolutionary perspective, this response makes perfect sense. Humans evolved in environments where food scarcity threatened survival. Therefore, the brain developed mechanisms to detect energy deficit and prioritize eating.

Those mechanisms remain active today.

Hunger, the Brain, and Food NoiseModern neuroscience offers further insight into what the Minnesota researchers observed.

Several brain regions participate in appetite regulation. The hypothalamus monitors energy balance through hormones such as leptin, ghrelin, and insulin. Meanwhile, motivational circuits—including the nucleus accumbens—integrate metabolic signals with behavioral drive.

When energy stores decline, these systems increase the motivational pull toward food.

Consequently, thoughts about eating become more persistent and more difficult to ignore.

This process resembles what many patients describe as food noise—a continuous internal signal urging them toward food.

The Minnesota experiment showed that this phenomenon can arise even in healthy individuals when calories remain restricted long enough.

A Modern Medical PerspectiveToday, treatments for obesity increasingly focus on restoring normal appetite regulation rather than relying solely on behavioral restraint.

Medications known as GLP-1 receptor agonists offer one example.

Patients using these therapies often report something striking. Many say that the constant mental chatter about food becomes quieter. Meals feel satisfying sooner, and cravings diminish.

In other words, regulation returns.

These observations reinforce an important idea: overeating may not reflect a lack of discipline. Instead, it may result from disrupted biological signaling.

The Enduring Importance of the StudyMore than seventy years later, the Minnesota Starvation Experiment remains one of the most illuminating studies in nutrition science.

Its findings continue to inform research on appetite, metabolism, and obesity treatment.

Equally important, the work stands as a testament to careful scientific inquiry. The volunteers endured months of hardship so that future physicians could better understand starvation and recovery.

Their sacrifice produced knowledge that still shapes medicine today.

And the book that documented the study—“The Biology of Human Starvation”—remains a landmark text in the scientific literature.

A Final ThoughtHunger is not a character flaw.

Instead, it is a biological signal designed to protect survival.

The Minnesota Starvation Experiment revealed that when humans face prolonged calorie restriction, the mind naturally becomes focused on food.

Rather than proving weakness, that response demonstrates how powerfully the body protects itself.

Understanding that reality allows medicine to approach nutrition and obesity with greater compassion—and far better science.

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Meanwhile, in a LaboratoryIn 1990, researchers isolated a peptide from Gila monster venom. Two years later, work from the Bronx VA Medical Center described exendin-4, a molecule that resembled human GLP-1 but lasted far longer in circulation.

Human GLP-1 survives only minutes before the body breaks it down. Exendin-4 resisted that breakdown. That difference changed everything.

Soon afterward, the first GLP-1 receptor agonist reached patients under the brand name Byetta. At the time, physicians used it to treat diabetes. No one called it a weight-loss drug. No one predicted it would reshape obesity medicine.

And yet, the foundation was already in place.

While I Was OperatingAt the Phoenix Indian Medical Center, I performed weight loss surgery in a population with some of the highest rates of type 2 diabetes in the world. Researchers there studied metabolism intensely. The “thrifty gene” hypothesis gained traction in that environment. Scientists asked whether efficient energy storage, once protective in scarcity, became harmful in abundance.

At the same time, I watched something remarkable in the operating room. After gastric bypass, patients’ blood sugars often improved within days, before meaningful weight loss occurred. Hormones were shifting. Physiology was driving outcomes.

Meanwhile, GLP-1 drugs evolved.

Researchers lengthened their half-lives. Chemists modified their structures so they bound albumin and stayed active for days rather than minutes. Clinical trials expanded. Safety data accumulated.

Eventually, semaglutide showed average weight loss approaching fifteen percent of body weight in obesity trials. Then tirzepatide, now marketed as Zepbound for obesity, exceeded 20 percent weight reduction in higher-dose studies. In addition, cardiovascular outcome trials demonstrated reductions in major adverse cardiac events in high-risk patients.

These were not cosmetic results. These were metabolic and cardiovascular outcomes.

Food NoisePatients rarely talk about receptors. They talk about noise.

Food noise.

The constant internal dialogue about eating. The mental pull toward the pantry. The background chatter that never quite stops.

GLP-1 receptors exist in appetite-regulating areas of the brain, including the hypothalamus and brainstem. These medications act through vagal signaling and through regions where the blood-brain barrier is more permissive. As a result, they modulate satiety and reward pathways.

Consequently, many patients report something simple but profound: the noise quiets.

Not disappears. Quiet.

That distinction matters.

Diet Culture PushbackPredictably, not everyone celebrates this shift.

Diet culture thrives on the belief that weight reflects character. Some coaches insist the solution is fewer calories. Others argue for more beef, more butter, more fiber, or stricter discipline. Entire industries depend on the idea that trying harder solves everything.

However, biology does not negotiate with virtue.

Obesity is a chronic, relapsing, neurohormonal disease. No one worked harder at weight loss than many of my surgical patients. Likewise, I do not lack willpower. And I practice culinary medicine. Preaching and eating a Mediterranean diet.

Nevertheless, effort alone does not silence dysregulated signaling.

Calling GLP-1 therapy “cheating” misunderstands the science. These medications restore signaling. They amplify satiety. They reduce excess reward drive. They support physiology.

That is treatment, not moral compromise.

My Parallel UniverseWhen I began my career, I weighed about 185 pounds. Years later, hospital cafeterias, exhaustion, and irregular meals pushed me to 225. I understood obesity clinically. Then I understood it personally.

In one version of my career, revision surgery remains the answer for weight regain. In this version, I reached for GLP-1 therapy instead.

Today, I weigh what I weighed when Nixon was president.

I am both surgeon and patient.

And your reporter.

A Necessary CautionGLP-1 medications carry risks as well as benefits. Nausea can occur. Gastric emptying slows. Gallbladder disease risk may increase, although obesity itself already raises that risk substantially. Physicians must monitor dosing carefully.

Therefore, if you consider GLP-1 therapy, work with a trained physician who understands obesity medicine. Avoid quick online scripts. Seek supervision. Demand follow-up.

Metabolic medicine deserves serious care.

The Desert Was the BeginningI once thought Phoenix was punishment. The heat felt relentless. Even Satan might choose a cooler vacation. Only Canadians brave July—and who can blame them?

However, what felt like exile turned out to be preparation.

In that same desert, I learned surgery. Researchers debated the thrifty gene. A venomous lizard carried a peptide that would become the basis of modern metabolic therapy.

I thought I had been sent to hell. But I found beauty in the desert, and by the time I left Arizona, I missed it terribly.

Little did I know I was sent to the future in Arizona.

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Protein Panic: How Much Do You Really Need?Everywhere you look, protein has become a competition.

Scroll long enough and you will believe muscle disappears if you eat less than 150 grams a day. Meanwhile, influencers debate leucine thresholds like they’re trading baseball cards. As a result, ordinary meals now feel like math problems.

However, biology does not require panic.

Protein matters. Yet adequacy differs from excess. And importantly, most people eating real food already meet their needs.

So let’s slow down.

First, What Protein Actually DoesProtein builds and repairs tissue. In addition, amino acids support immune function and hormone signaling. Furthermore, specific amino acids such as leucine trigger muscle protein synthesis.

Nevertheless, once you reach the effective leucine threshold in a meal, adding more protein does not multiply muscle growth. Instead, your body oxidizes the excess.

Therefore, more does not always mean better.

How Much Is Enough?For most healthy adults, about 0.8 grams per kilogram of body weight covers basic needs. Meanwhile, adults over 60 often benefit from 1.0 to 1.2 grams per kilogram to protect lean mass.

Notably, that recommendation does not require heroic intake. In fact, a 75–80 kilogram adult typically lands between 60 and 90 grams per day.

Consequently, many people hit those numbers without even trying.

Here’s What I Actually DoI do not count protein. I never log grams. Moreover, I do not calculate leucine before breakfast.

Instead, I eat normal meals.

Most mornings, I have a shake. The recipe lives on terrysimpson.com. That shake provides roughly 25 grams of protein. Sometimes I add PB Fit. Occasionally, I include Greek yogurt. As a result, I increase protein slightly without thinking about it.

Later, I eat three to five ounces of chicken breast with Louisiana hot sauce. That adds another 25 grams.

Then at dinner, I often choose salmon and chickpeas. Together, they bring me to roughly 70–80 grams for the day.

Importantly, I have lost 50 pounds and preserved muscle mass. I track muscle periodically. I see no decline.

So what about leucine?

High-quality animal protein contains about 8–10% leucine. Therefore, a 25-gram protein meal delivers about 2 grams of leucine. That amount typically triggers muscle protein synthesis.

Thus, I hit the effective threshold at each meal without obsessing.

Now Let’s Bring In GLP-1GLP-1 medications reduce appetite. Consequently, total intake drops. Because of that, protein intake can fall too.

So yes, people using GLP-1 should pay attention. However, they do not need 180 grams per day. Instead, they need adequacy and resistance training.

Lift something heavy. Spread protein across meals. Preserve lean mass.

Simple.

Here’s the Real DeficiencyProtein deficiency remains rare in the United States. By contrast, fiber deficiency remains common.

According to the National Institutes of Health, most adults fail to meet recommended fiber intake levels. In fact, average intake falls far below the 25–38 grams per day recommended for adults.

(Reference: NIH Office of Dietary Supplements – Fiber Fact Sheet)

Meanwhile, high-protein diets often crowd out legumes, whole grains, and vegetables.

So while people panic about protein, they quietly neglect fiber.

And fiber feeds the microbiome. Fiber improves glycemic control. Fiber lowers LDL cholesterol.

Protein builds muscle. Fiber protects metabolism.

Both matter.

Mediterranean Patterns Keep It BalancedMediterranean-style eating provides protein from fish, legumes, yogurt, and moderate poultry. At the same time, it supplies fiber from beans, vegetables, and whole grains.

Therefore, protein arrives packaged with micronutrients and fermentable substrate.

Unlike protein powders and bars, real food supports multiple systems at once.

Consequently, longevity patterns emphasize diversity, not maximal single-nutrient intake.

The TakeawayAdequate protein preserves muscle. Resistance training drives adaptation. Fiber protects metabolic health.

So before you triple-scoop whey, pause.

Ask yourself whether you lack protein — or whether you lack plants.

Because protein matters.

Panic does not.

And once again, data beats dogma.

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Why Traditional Mexican Food Is Healthy — and How America Got It WrongEvery time someone says Mexican food is unhealthy, I know exactly what they’re picturing.

They aren’t picturing Mexico.

They’re picturing an American taco: a hard shell or a fluffy white flour tortilla, fatty hamburger, sour cream, a thin smear of salsa that contributes almost nothing except salt, and a yellow substance legally allowed to be called cheese.

After eating that, they naturally conclude Mexican food is the problem.

That conclusion doesn’t come from biology. It comes from branding.

Traditional Mexican food looks nothing like that. More importantly, it behaves nothing like that once it hits your body.

So let’s slow down, take a breath, and do what we always do here—follow the evidence, not the vibes.

First, Let’s Talk About the Taco America Put on TrialThe American taco stacks the deck against itself.

It leads with saturated fat, piles on refined carbohydrates, and adds dairy on top of dairy. Meanwhile, it offers almost no fermentable fiber. The gut gets nothing to work with. Blood sugar spikes. Inflammation follows.

That taco doesn’t help anyone.

But here’s the key point: it isn’t Mexican food.

It’s ultra-processed American convenience food wearing cultural drag.

Now Let’s Look at a Real TacoBy contrast, a traditional taco starts very differently.

It starts with a corn tortilla, not refined flour. Then it adds beans. After that, it layers vegetables, real salsa, and often cabbage. Finally, it finishes with avocado. Sometimes it includes fish. Sometimes it doesn’t. Either way, the structure holds.

And structure matters.

Because when you look at how that meal behaves biologically, it stops looking indulgent and starts looking smart.

Corn Tortillas Aren’t the Villain — They’re the FoundationFirst of all, traditional corn tortillas come from nixtamalized corn. That process treats corn with lime, and no, that isn’t trivia.

Instead, nixtamalization improves mineral absorption, improves protein quality, and preserves resistant starch.

As a result, resistant starch passes through the small intestine untouched. Then it reaches the colon, where gut bacteria ferment it. Consequently, those bacteria produce short-chain fatty acids, especially butyrate.

And here’s the important part: butyrate fuels the cells lining your colon. In addition it strengthens the gut barrier. It reduces inflammation. Finally, it improves metabolic signaling.

So no, this isn’t a carb disaster. On the contrary, it’s colon nutrition.

Beans Do the Heavy Lifting — And They Always HaveNext, add beans.

At that point, the conversation usually derails, so let’s keep it grounded.

A serving of beans delivers roughly ten grams of fiber. Not one kind — several kinds. Soluble fiber. Insoluble fiber. Resistant starch. Plus protein.

Because of that, beans slow digestion. They flatten glucose curves. They improve satiety. Most importantly, they feed gut bacteria that matter.

Specifically, bean fiber supports Akkermansia, a gut bacterium associated with better insulin sensitivity and a stronger gut barrier.

In other words, beans don’t fill space. Instead, they build infrastructure.

And yes, when you pair beans with rice, you get a complete amino acid profile. Humans figured that out centuries ago, long before protein powders and “ancestral” snack companies tried to monetize it.

Now Let’s Deal With Refried Beans — Because This Is Where People PanicAt this point, someone inevitably says, “But what about refried beans?”

So let’s clear that up.

First, frijoles refritos does not mean “fried twice.” It means well-fried or thoroughly cooked. Traditionally, people cooked beans, then lightly cooked them again, often mashing them for texture.

So yes — refried beans are traditional. Very traditional.

Moreover, mashing beans does not remove fiber. Cooking beans does not turn them into sugar. Beans remain beans.

So where did refried beans go wrong?

Fat choice.

Historically, many refried beans used lard. That made sense when calories were scarce and undernutrition threatened survival. However, in a modern context, large amounts of lard mean large amounts of saturated fat.

Therefore, when refried beans swim in lard, then get buried under cheese, then land inside a refined flour tortilla, the problem isn’t the beans. The problem is the fat context.

Fortunately, this problem has an easy fix.

Use olive oil or another unsaturated fat. Add onions and garlic. Mash lightly, not into paste. Suddenly, refried beans snap right back into a Mediterranean-style pattern.

And yes — some commercially available refried beans already do this. Look for short ingredient lists. Look for beans, oil, onion, garlic, salt. Skip the lard. Skip the mystery fats. Your gut will notice.

Avocado Doesn’t Add Calories — It Unlocks NutritionThen comes avocado, which people love to blame for reasons that make no biological sense.

Avocado provides about five grams of fiber and a meaningful amount of monounsaturated fat — the same fat family as olive oil.

More importantly, fat enables absorption of fat-soluble vitamins: A, D, E, and K.

So when you add avocado to vegetables, you don’t ruin the meal. Instead, you make the nutrients available.

In other words, avocado doesn’t cancel vegetables. It activates them.

Salsa and Cabbage Quietly Do the Real WorkMeanwhile, real salsa brings tomatoes, onions, garlic, chilies, and cilantro to the table. That means fiber. That means polyphenols. That means fermentable substrate for gut bacteria.

Add corn to the salsa and you add more whole grains and more resistant starch.

Then add cabbage — raw or lightly dressed — and now you feed short-chain fatty-acid producers directly.

Nothing exotic. Nothing trendy. Just food that works.

Step Back — Because This Should Look FamiliarNow zoom out.

Traditional Mexican food emphasizes whole grains, legumes, vegetables, unsaturated fats, and fermentation. It stays naturally low in saturated fat. It supports the microbiome. It respects digestion.

In other words, it follows the Mediterranean pattern.

Not because it sits near the Mediterranean Sea — but because biology doesn’t care about geography.

The Mediterranean diet is a structure, not a destination.

Whether you eat it in Greece.

Or you eat it in Italy.

But you can eat it wrapped in a corn tortilla.

So What Actually Broke the Taco?Processing.

Refining grains.

Deep-frying bases.

Replacing beans with beef.

Replacing water with sugar.

Turning cheese into a load-bearing wall.

Mexican food didn’t fail.

Industrial food did.

The VerdictA traditional taco — corn tortilla, beans or properly made refried beans, vegetables, avocado, real salsa, maybe fish — fits squarely into one of the healthiest dietary patterns we know.

Different culture.

Same biology.

So the next time someone tells you Mexican food is unhealthy, remember this:

The taco was framed.

And once again — data beats dogma.

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Why Fiber Fails to Impress—and Why That’s the PointFiber has a public relations problem. Unlike supplements or extreme diets, fiber does not promise instant transformation. Instead, it works slowly, predictably, and quietly. Because of that, people rarely notice it when it’s doing its job well. However, that very boredom is precisely why fiber matters.

When fiber intake is adequate, digestion functions normally, blood sugar behaves more consistently, and bowel habits stay predictable. As a result, there is no drama to post on social media. Consequently, influencers move on. Meanwhile, the science stays exactly where it has been for decades: fiber lowers disease risk over time.

That kind of quiet effectiveness may not sell products, but it saves lives.

“Fiber Isn’t Essential”—Why That Argument Misses the MarkTechnically speaking, fiber is not an essential nutrient in the classic sense. In other words, there is no disease caused solely by a lack of fiber the way scurvy results from vitamin C deficiency. Because of this, critics often stop the conversation there.

However, medicine does not ask only whether you survive. Instead, it asks whether your risk of chronic disease rises or falls over time. On that front, fiber consistently lowers the risk of colon cancer, improves glucose regulation, reduces constipation, and supports cardiovascular health. Therefore, while you can live without fiber, you do not age particularly well without it.

Protein Gets the Spotlight While Fiber Does the WorkAt the same time, nutrition conversations fixate on protein. Protein goals dominate podcasts, social media, and supplement aisles. Yet, in practice, true protein deficiency in the United States is rare, even among bariatric surgery patients.

In contrast, fiber deficiency is the norm. Roughly 92% of Americans fail to meet recommended fiber intake. As a result, constipation becomes common, long bathroom visits feel normal, and scrolling on a phone in the bathroom gets rebranded as “self-care.” Unfortunately, that normalization hides a real problem.

A Personal Lesson From Oats, Gas, and a Scorched DeskYears ago, I learned a fiber lesson the hard way. After deciding to increase my fiber intake quickly, I started eating steel-cut oats every morning during a busy meeting week. At first, everything seemed fine. Soon, however, my digestive system made it clear that it had not been consulted in this decision.

By the second day, bloating appeared. By the third day, office etiquette became questionable. Consequently, I lit a candle at my desk. Unfortunately, I turned my back, and papers caught fire. Although the flames were extinguished quickly, the scorch mark stayed for years.

That stain served as a reminder: fiber works best when introduced gradually. Your gut adapts over time. Confidence without patience, on the other hand, leads to unnecessary consequences.

Not All Fiber Works the Same WayUnderstanding fiber helps people stop fearing it. Soluble fiber, found in oats, barley, beans, lentils, psyllium, apples, and citrus, forms a gel in the gut. Because of this, it slows absorption, reduces glucose spikes, and lowers LDL cholesterol. Consequently, psyllium appears in clinical guidelines rather than influencer protocols.

Meanwhile, insoluble fiber focuses on mechanics. It adds bulk, speeds transit, and improves regularity. Importantly, this matters even more for people using GLP-1 medications, where slowed digestion often leads to constipation. In that setting, fiber is not optional—it is foundational.

Finally, fermentable fiber feeds gut bacteria. Beans, onions, garlic, asparagus, chicory root, and resistant starch nourish beneficial microbes. As these bacteria grow, they produce short-chain fatty acids, especially butyrate, which supports gut barrier function and immune regulation.

No, Butter Is Not a Shortcut to ButyrateDespite what circulates online, butter does not meaningfully deliver butyrate to your colon. Although butter contains trace amounts of butyric acid, that fat is absorbed in the small intestine long before it reaches the colon. In contrast, the butyrate that protects colon health is produced by bacteria fermenting fiber directly in the colon.

Therefore, if butter were an effective therapy, gastroenterologists would prescribe croissants. They do not.

Supplements Help—but Food Still WinsFiber supplements can be useful. Psyllium and methylcellulose typically provide four to five grams of fiber, which helps people start. However, that amount represents only about ten percent of a reasonable daily target.

Personally, I use Loam, which provides around twelve grams of mixed fiber in a smoothie. Nevertheless, supplements act as bridges, not destinations. Ultimately, food does the heavy lifting.

IBS, FODMAPs, and Why We Avoid Diet CosplaySome people with IBS feel worse when fermentable fiber increases too quickly. Because fermentation produces gas, symptoms can flare initially. For that reason, clinicians use FODMAPs as a temporary elimination tool to identify triggers.

However, elimination is not the end goal. Instead, we reintroduce foods within a Mediterranean dietary pattern, which promotes diversity and tolerance. In contrast, Whole30 markets itself as elimination but functions primarily as low-carb restriction. That approach avoids symptoms rather than solving them.

What Eating Enough Fiber Actually Looks LikePeople do not eat grams of fiber. They eat meals. A Mediterranean-style day, such as the3-Day Mediterranean Diet at terrysimpson.com, delivers fiber incidentally.

Breakfast often includes oats, berries, and nuts. Lunch typically features vegetables, legumes, whole grains, and olive oil. Snacks rely on fruit, nuts, or hummus. Dinner centers on vegetables, whole grains like farro, and fish or poultry. Over the course of a day, fiber naturally reaches 25–40 grams without spreadsheets or stress.

Start Slowly, Then Stay ConsistentIf you currently eat little fiber, the solution is simple but not dramatic. Increase intake gradually. Drink water. Give your microbiome time to adapt. Although you are not fragile, abrupt change can still cause discomfort.

The Bottom LineFiber does not need hype. Instead, it needs consistency. It works quietly, steadily, and reliably. If bathroom visits require entertainment, the issue is not age—it is fiber.

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Food Noise Isn’t Hunger — and Why Broccoli Never Fixed the BrainFood noise does not announce itself politely. Instead, it hums in the background, persistent and exhausting. For years, patients tried to describe it. Meanwhile, medicine largely ignored it. Recently, however, GLP-1 receptor agonists forced the conversation into the open.

I did not understand food noise myself until it stopped.

About twelve hours after my first GLP-1 injection, I stood in my kitchen waiting for baked salmon to finish cooking. Nothing dramatic happened. No emotional moment followed. Still, something felt different. The internal commentary was gone. The negotiations disappeared. For the first time, my brain felt quiet.

At that moment, I finally understood what patients had been telling me for years.

First, Define the Problem ClearlyFood noise is not hunger. Hunger serves a biological purpose. In contrast, food noise describes persistent, intrusive thoughts about food that occur regardless of energy needs. People experience rumination, preoccupation, cravings, and mental fatigue—even when they are physiologically full.

Importantly, this phenomenon is now measurable. The Food Noise Questionnaire validates what patients already knew. Specifically, it assesses the frequency of food thoughts, difficulty controlling them, interference with daily activities, emotional distress, and craving intensity. In other words, food noise exists independently of willpower.

Consequently, advice that targets hunger alone inevitably fails.

Next, Address the Broccoli MythI eat vegetables. Nevertheless, I have never liked broccoli.

Frankly, if broccoli is air-fried to the edge of carbonization, I will tolerate it. That concession, however, does not transform broccoli into a neurological intervention. Fiber increases fullness. Protein improves satiety. Vegetables slow digestion. None of those actions quiet the reward centers of the brain.

Put simply, broccoli fills the stomach. Food noise lives elsewhere.

Because of that distinction, the “just eat for satiety” argument collapses under scrutiny.

Then, Follow the Science Where It LeadsFood noise arises from heightened food-cue reactivity. Visual cues, smells, availability, and anticipation activate reward pathways long before food reaches the stomach. Ultra-processed foods amplify this response. Their engineered combinations of refined carbohydrates, fats, salt, and flavor compounds reliably stimulate the mesolimbic dopamine system.

As a result, ultra-processed foods increase wanting rather than liking.

However—and this matters deeply—removing ultra-processed foods does not automatically restore normal appetite signaling. Once reward circuitry becomes dysregulated, dietary virtue alone cannot reset it. At that stage, telling someone to “just eat whole foods” resembles telling someone with tinnitus to “enjoy the silence.”

Therefore, ultra-processed foods contribute to the problem, but they do not explain it entirely.

Now, Enter GLP-1 Receptor AgonistsGLP-1 receptor agonists act centrally and peripherally. While many people fixate on gastric emptying, the central mechanisms explain the lived experience.

In the hypothalamus, GLP-1 receptor agonists activate satiety-promoting POMC/CART neurons while inhibiting hunger-promoting NPY/AgRP neurons. This dual action reduces homeostatic hunger. Meanwhile, in the brainstem—particularly the nucleus tractus solitarius—GLP-1 signaling integrates gut-brain communication and sustains appetite suppression.

More importantly, GLP-1 receptor agonists modulate reward circuitry. In regions such as the ventral tegmental area and nucleus accumbens, these agents dampen dopamine signaling. Consequently, food becomes less compelling rather than forbidden.

Functional imaging studies confirm this effect. After GLP-1 treatment, brain responses to food cues decrease in the insula, amygdala, orbitofrontal cortex, and related regions. The brain still recognizes food. It simply stops obsessing.

As a Result, Behavior Changes Without ForceOnce food noise quiets, people do not suddenly become disciplined saints. Instead, they become selective.

In my own case, wine lost its appeal. I did not swear it off. I simply stopped wanting it. Eventually, I quit five wine clubs. When a glass tastes mediocre, I put it down and choose iced tea. That behavior reflects altered reward signaling, not moral growth.

Similarly, food choices shift without struggle. People stop eating things merely because they are available. They stop drinking because something is poured. The absence of compulsion creates space for intentional eating.

That distinction explains why GLP-1 therapy feels different from appetite suppression.

Finally, Place Diet Back Where It BelongsThe Mediterranean diet improves health. I recommend it. I eat it. Still, it does not cure food noise.

Diet supports metabolic health once interference disappears. GLP-1 therapy removes that interference. Together, they work better than either alone. Pretending otherwise leads to fat shaming disguised as nutritional advice.

Obesity is a disease. GLP-1 receptor agonists treat that disease. Food then becomes nourishment rather than negotiation.

So, What Actually MattersUltra-processed foods worsen food noise, yes. Yet removing them does not repair dysregulated reward circuitry. Satiety fills the stomach. GLP-1 therapy quiets the brain. Once the noise fades, nutrition finally has a fair chance.

In the end, broccoli keeps my mother from returning from the grave. GLP-1s keep my brain quiet. Both have their place. Only one treats the disease.

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1. The Arcuate Nucleus Mediates GLP-1 Receptor Agonist Liraglutide-Dependent Weight Loss.

The Journal of Clinical Investigation. 2014. Secher A, Jelsing J, Baquero AF, et al.

1. Direct and Indirect Effects of Liraglutide on Hypothalamic POMC and NPY/­AgRP Neurons - Implications for Energy Balance and Glucose Control.

Molecular Metabolism. 2019. He Z, Gao Y, Lieu L, et al.

1. On the Pleiotropic Actions of Glucagon-Like Peptide-1 in Its Regulation of Homeostatic and Hedonic Feeding.

International Journal of Molecular Sciences. 2025. Sayers S, Wagner E.New

1. Glucagon-Like Peptide 1 (GLP-1) Action on Hypothalamic Feeding Circuits.

Endocrinology. 2025. Hwang E, Portillo B, Williams KW.New

1. GABA Neurons in the Nucleus Tractus Solitarius Express GLP-1 Receptors and Mediate Anorectic Effects of Liraglutide in Rats.

Science Translational Medicine. 2020. Fortin SM, Lipsky RK, Lhamo R, et al.

1. GLP-1 Receptor Activation Modulates Appetite- And Reward-Related Brain Areas in Humans.

Diabetes. 2014. van Bloemendaal L, IJzerman RG, Ten Kulve JS, et al.

1. Glucagon-Like Peptide 1 and Its Analogs Act in the Dorsal Raphe and Modulate Central Serotonin to Reduce Appetite and Body Weight.

Diabetes. 2017. Anderberg RH, Richard JE, Eerola K, et al.

1. of GLP-1 Therapies for Addiction and Mental Health Comorbidities—Quo Vadis?.

JAMA Psychiatry. 2026. Farokhnia M, Leggio L.New

1. GLP-1 and Weight Loss: Unraveling the Diverse Neural Circuitry.

American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2016. Kanoski SE, Hayes MR, Skibicka KP.

1. Mechanisms of GLP-1 Receptor Agonist-Induced Weight Loss: A Review of Central and Peripheral Pathways in Appetite and Energy Regulation.

The American Journal of Medicine. 2025. Moiz A, Filion KB, Tsoukas MA, et al.New

1. GLP-1 Physiology and Pharmacology Along the Gut-Brain Axis.

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Whole Milk Is Back in SchoolsBut Hungry Kids Are Still the Real ProblemWhole milk is back in school cafeterias.

As a result, a lot of people are celebrating. Some are calling it a victory for nutrition. Others are calling it common sense. Meanwhile, a few are even calling it a breakthrough.

However, that excitement misses the point.

Because the biggest problem facing kids in school today is not milk fat.

Instead, the real problem is hunger.

First, Let’s Start With the ObviousBefore we talk about milk, fat, or nutrients, we need to start with something very basic.

Hungry kids do not learn well.

In fact, hunger affects attention, memory, and behavior. As a result, students who do not eat enough struggle to focus. Over time, that struggle shows up as lower academic performance.

Because of that, no change to milk will ever fix an empty stomach.

Therefore, if we want better outcomes, we have to start with food access.

Next, What Actually Changed With MilkDespite what many people believe, whole milk was not removed from schools in the past.

Instead, schools continued to offer low-fat and fat-free milk.

Importantly, those options provided the same essential nutrients:

1. protein
2. calcium
3. potassium
4. iodine
5. vitamin B12

In addition, vitamin D was added through fortification, regardless of milk fat level.

So, children did not lose vital nutrients.

What they lost was milk fat.

Now, Why Milk Fat Is Not EssentialMilk fat is made mostly of saturated fat.

That matters because saturated fat is not an essential dietary nutrient.

If the human body needs saturated fat, it can make it on its own. In other words, there is no requirement to eat it for normal growth or brain development.

As a result, adding more saturated fat to a child’s diet is not necessary.

Then, Let’s Talk About the BrainHere is where biology matters.

The brain is built largely from polyunsaturated fats, not saturated fats.

These polyunsaturated fats keep cell membranes flexible. Because of that flexibility, brain cells can signal, adapt, and learn.

In contrast, saturated fat is rigid. It plays only a small structural role in membranes. If membranes contained too much saturated fat, they would become stiff. When that happens, signaling does not work well.

For that reason, biology uses saturated fat sparingly.

Therefore, less saturated fat in the diet of growing children is actually better for long-term brain and cardiovascular health.

Meanwhile, What Kids Are Really MissingIf there is one nutrient that most children lack, it is fiber.

Fiber supports gut health. In addition, it improves insulin sensitivity. Over time, it also reduces cardiovascular risk.

Milk fat does none of those things.

So, if nutrition is the concern, fiber deserves more attention than nostalgia for saturated fat.

At the Same Time, Food Access Is ShrinkingWhile milk is being discussed, something else is happening quietly.

Food assistance programs are being reduced.

That matters because programs like SNAP do more than help families buy groceries. They also help children qualify for free school meals.

When eligibility is reduced, fewer children qualify. As a result, schools receive less funding for lunch programs. Consequently, some schools serve fewer meals. In certain communities, programs disappear entirely.

Therefore, the outcome is simple: fewer kids eat at school.

In Contrast, Feeding Kids Actually WorksSome states have shown a different approach.

When children receive meals consistently, attendance improves. At the same time, concentration improves. Over the long term, educational outcomes improve as well.

This result has been seen repeatedly.

Because of that, feeding kids is not charity. Instead, it is an investment in education, health, and future productivity.

So, Let’s Put This TogetherWhole milk is fine.

If families enjoy it, they can drink it. If schools offer it, that is acceptable.

However, whole milk is not an innovation.

Feeding children is.

Ultimately, school meals should not be treated as a budget line to debate each year. Instead, they should be treated as part of what a functioning society does for its kids.

One Reference on Brain Fat and Cell MembranesFor readers who want the science behind membrane fats and brain function, this review explains it clearly:

Stillwell W, Wassall SR.

Docosahexaenoic acid: membrane properties of a unique fatty acid.

Chemistry and Physics of Lipids. 2003;126(1):1–27.

This paper explains why polyunsaturated fats keep membranes flexible and why saturated fats play only limited roles.

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When Influencers Replace Scientists, Everyone LosesEvery few years, nutrition gets a makeover.

First comes a new graphic.

Then comes a new slogan.

Soon after, we hear claims that this time, someone finally figured it all out.

Recently, that makeover arrived in the form of a “reverse food pyramid” and the cheerful phrase “Eat Real Food.” On the surface, that message sounds reasonable. In fact, many doctors have said the same thing for decades.

However, the real problem isn’t the slogan.

Instead, the problem lies in who is now shaping nutrition advice—and who is not.

Yes, Some of the Advice Is RightTo be clear, let’s start with agreement.

Eating real food helps health.

Limiting added sugar makes sense.

Reducing ultra-processed foods improves outcomes.

Importantly, none of this is new.

Doctors, dietitians, and public-health researchers have said these things for years. Because of that, when influencers now say, “See, we were right,” a serious issue appears.

They didn’t discover this information.

They copied it.

The Real Risk Isn’t AgreementAt first glance, agreement sounds harmless.

Nevertheless, agreement becomes dangerous when it turns into ownership.

Once someone believes they have discovered basic nutrition truths, they often assume they can rewrite everything else. As a result, bad ideas slip in quietly, wrapped in confidence instead of evidence.

That shift matters.

Scientists and Influencers Are Not InterchangeableAt this point, we need to say something clearly.

We cannot afford to replace scientists with influencers.

Nutrition science didn’t come from podcasts or social media. Instead, it came from metabolic ward studies, long-term population research, and randomized trials. Moreover, real scientists accept uncertainty. They change their minds when the data changes.

By contrast, influencer culture rewards certainty.

Even worse, confidence often replaces humility.

There is no “Mediterranean diet influencer community.”

Likewise, there is no “DASH diet movement.”

Those dietary patterns exist because scientists studied them, tested them, and measured outcomes over time.

On the other hand, a loud low-carb and carnivore influencer ecosystem does exist. That ecosystem includes brands, supplements, coaching programs, and a strong contrarian identity. Because of that structure, influence—not evidence—often drives the message.

Fiber Versus Saturated Fat: A Telltale SignIf you want to know whether someone understands nutrition science, ask a simple question:

Which matters more—fiber or saturated fat?

Influencers often say, “Fiber isn’t an essential nutrient.”

Technically, that statement is true in the narrowest sense.

However, context matters.

Fiber supports a healthy gut microbiome.

Additionally, fiber improves insulin sensitivity.

Furthermore, fiber lowers cardiovascular risk.

Finally, fiber supports colon health.

Because fiber feeds beneficial gut bacteria, entire fields of microbiome research depend on it.

Now compare that with saturated fat.

Saturated fat is truly non-essential.

Your body can make all it needs.

No deficiency disease exists from avoiding it.

Even more importantly, excess saturated fat raises LDL cholesterol and worsens artery health. Over time, that increases cardiovascular risk.

So ask yourself this:

Why dismiss fiber as optional while quietly promoting saturated fat?

That choice reflects ideology, not biology.

The Brain Doesn’t Care About TrendsHere’s another reality check.

Your brain—the most important organ you own—relies heavily on polyunsaturated fats. These fats support cell membranes, nerve signaling, and blood flow.

Ironically, these same fats often get labeled “seed oils” and dismissed.

Meanwhile, saturated fat does not belong in high amounts in brain tissue. Worse still, saturated fat can clog the arteries that supply the brain.

Biology does not respond to marketing.

Physiology does not care about popularity.

The “You’re On Your Own” ProblemAnother issue deserves attention.

After influencers step into the spotlight and claim credit for old science, they often step away from responsibility. Then they tell the public to “figure it out.”

That approach ignores reality.

Many Americans live in food deserts.

Even more rely on school meals.

Lots of Americans work multiple jobs.

Many lack time, money, or kitchens.

Public health exists because willpower alone does not scale. Without system-level support, advice turns into abandonment.

Agreement Does Not Equal ExpertiseRecently, debates around nutrition have highlighted this pattern clearly.

Some influencers argue that because they agree with basic nutrition advice, they deserve authority over the rest of the science. Unfortunately, agreement does not grant expertise.

Copying conclusions does not mean you earned them.

Science rewards method, not confidence.

The Bottom LineYes, eat real food.

And clearly, limit added sugar.

Most definitely, reduce ultra-processed foods.

Doctors have said this for years.

However, flipping a pyramid does not change biology.

Likewise, sidelining scientists does not improve health.

Finally, promoting saturated fat while dismissing fiber misleads the public.

People do not fail diets.

Systems fail people.

When we trade evidence for influence, health suffers.

A Final NoteThis article provides general education, not personal medical advice. Always talk with your healthcare professional about individual nutrition needs.

At Your Doctor’s Orders, we believe data matter more than dogma, and evidence matters more than trends.

Because when it comes to health, confidence without science is not bold.

It’s risky.

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Ultra-Processed Food: Making Sense of the MadnessUltra-processed food has become the villain of modern nutrition.

Scroll through social media, and you’ll hear that it’s poisoning us, wrecking our gut, and driving the obesity epidemic all by itself.

At the same time, other voices dismiss the entire idea as fear-mongering.

According to them, processing doesn’t matter at all.

Neither extreme tells the full story.

So instead of slogans, let’s talk about what ultra-processed food actually means, why people want to blame it, where the science is strong, and where it starts to drift into storytelling.

Why We’re Looking for Something to BlameThe obesity epidemic is real.

Rates have climbed for decades, and people understandably want answers.

Human biology didn’t suddenly change in the 1980s.

Willpower didn’t vanish overnight.

Something in our environment shifted.

Food is an obvious suspect.

Because food changed, many people assume there must be a single culprit hiding in the ingredient list.

That belief leads to bold claims.

Some say Europe bans certain additives and therefore avoids obesity.

In reality, obesity rates continue to rise across Europe as well.

Others argue that specific ingredients damage the gut, letting in more calories or triggering metabolic chaos.

Those ideas sound scientific, especially when they involve complex biology.

However, when a problem is large and complicated, humans naturally want a cause that feels simple and controllable.

Blaming one ingredient feels easier than confronting patterns of eating, stress, time pressure, and convenience.

Biology, unfortunately, rarely offers cinematic villains.

What “Ultra-Processed” Actually MeansTo understand the debate, definitions matter.

Researchers use the NOVA classification system to describe food processing.

NOVA does not rate healthfulness.

Instead, it categorizes food by how manufacturers produce it.

The system includes four groups.

First come whole or minimally processed foods, such as vegetables, beans, eggs, and fish.

Next are culinary ingredients like oil, sugar, salt, and flour.

Then come processed foods, including bread, cheese, yogurt, and canned vegetables.

Finally, NOVA defines ultra-processed foods as industrial formulations.

These products often combine refined ingredients with additives, stabilizers, emulsifiers, and flavor systems that home cooks rarely use.

Here’s the crucial point.

Ultra-processed food is defined by how it is made, not by what it does in the body.

That distinction often gets lost.

As a result, soda and whole-grain bread can fall into the same category, even though they behave very differently nutritionally.

Why Ingredient Blame Falls ShortAt this point, many discussions take a wrong turn.

Instead of asking how people eat, the conversation focuses on what to ban.

Ingredients become the enemy.

Yet most claims about additives rely on animal studies using doses far higher than what humans consume.

Human data remains limited and inconsistent.

Meanwhile, the bigger picture often gets ignored.

Ultra-processed food correlates with stress, long work hours, poor sleep, and limited time for cooking.

Those factors influence eating behavior regardless of ingredients.

When people feel rushed and overwhelmed, they don’t just eat differently.

They eat faster, snack more often, and rely on foods that require little effort.

That context matters.

The Simple Question That Changed the ConversationInstead of chasing villains, one researcher asked a much simpler question.

Do people eat more when food is ultra-processed, even when nutrition looks the same on paper?

That question led to the most important experiment in this entire debate.

What Kevin Hall Actually FoundAt the National Institutes of Health, Kevin Hall conducted a tightly controlled feeding study.

Participants lived in a metabolic ward.

Researchers controlled the environment, the meals, and the measurements.

Each participant ate two diets.

One diet consisted mostly of ultra-processed foods.

The other relied on minimally processed foods.

Importantly, researchers matched calories, protein, fat, carbohydrates, sugar, and salt.

People could eat as much as they wanted.

The result surprised almost everyone.

On the ultra-processed diet, participants consumed about 500 extra calories per day.

Yet, they didn’t report more hunger.

They didn’t feel less full.

However, they simply ate more.

This finding matters because it avoids speculation.

No ingredient theories appear here.

No gut damage claims drive the conclusion.

Ultra-processed food made it easier to eat more calories without noticing.

Sometimes the most powerful answers are also the least dramatic.

Why a Book Made This Go ViralThat study helped fuel widespread interest, including the success of Ultra-Processed People: The Science Behind Food That Isn't Food by Chris van Tulleken.

Van Tulleken, a British physician, took a personal approach.

He ate a diet dominated by ultra-processed foods and documented the effects.

Weight gain followed.

Hunger became harder to regulate.

Energy and mood shifted.

The book resonated because it made an abstract concept feel personal.

It also highlighted how modern foods often prioritize shelf life, softness, and convenience.

Stories like this help people recognize patterns they already sense in daily life.

However, a compelling narrative does not replace careful interpretation.

Where the Story Goes Too FarUltra-processed food is not one thing.

It does not act through a single mechanism.

The research faces several challenges.

First, heterogeneity clouds interpretation.

Grouping soda and yogurt together creates confusion rather than clarity.

Second, confounding remains a major issue.

People who eat more ultra-processed food often face structural barriers that affect health in many ways.

Third, additive panic oversimplifies biology.

Mouse data cannot stand in for long-term human outcomes.

Ultra-processed food may contribute to health problems, but it rarely acts alone.

A Better Way to Think About FoodRigid rules tend to fail.

Real eating happens in real life.

Instead of asking whether a food qualifies as ultra-processed, better questions help guide choices.

Does the food contain fiber?

How will it contribute protein or micronutrients?

Finally, will it replace a balanced meal or help create one?

Can you eat it mindfully and stop when satisfied?

Foods like yogurt, tofu, olive oil, canned beans, and frozen vegetables often break simplistic rules.

Yet they support healthy eating patterns when used well.

Processing did not ruin our food.

Confusion did.

The Bottom LinePeople want a villain because villains feel actionable.

Science, however, often points toward behavior rather than ingredients.

Ultra-processed foods encourage faster eating, softer textures, and higher calorie intake.

That pattern explains a great deal without invoking conspiracies.

Understanding that reality empowers better choices than fear ever could.

ReferenceHall KD, Ayuketah A, Brychta R, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial. Cell Metabolism. 2019;30(1):67–77.e3.

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Willpower Is B.S.: Food Noise, Healthspan, and What Actually Changed My LifeFor decades, I started every New Year the same way.

In January, I promised myself this would be the year.

By February, I tried harder.

Every spring, I adjusted the plan.

And by summer or fall, the weight crept back.

That cycle repeated not because I lacked knowledge, discipline, or effort. Instead, it repeated because I misunderstood biology — at least when it came to myself.

This year is different.

For the first time since Ronald Reagan was first elected, weight loss is not at the top of my New Year’s resolution list. Not because I stopped caring, but because I lost 45 pounds with the help of Zepbound over the last year. More importantly, however, I learned something that reshaped how I think about obesity, healthspan, and shame.

Before anything else, let me be clear: this is not medical advice. This is a story. Anecdotes are not evidence, even when the anecdote is from a physician. Nevertheless, stories help us understand science when data alone fails to move us.

And this story matters.

I Had Willpower. That Wasn’t the Problem.For years, people told me — and millions of others — the same thing: move more and eat less. At first glance, that advice sounds logical. After all, calories matter. Energy balance matters.

However, reality is more complicated.

To begin with, I am a surgeon. Surgical training requires extraordinary willpower. Moreover, I’ve logged food meticulously, cooked Mediterranean-style meals, exercised consistently, and followed every evidence-based recommendation I’ve ever given patients.

Meanwhile, Oprah has willpower. Olympic athletes have willpower. Yet obesity persists.

Sure, willpower works briefly. In fact, go on a liquid protein diet, and the weight will fall off quickly. Unfortunately, the food noise remains. Eventually, biology wins. Always.

In the same way you cannot positive-think your way out of hypertension, cholesterol, diabetes, cancer, or heart disease, you cannot willpower your way out of obesity. Obesity is a disease. It is not a moral failure.

Ironically, I knew this intellectually. Nevertheless, I failed to apply it to myself. We have a name for that: cognitive dissonance.

Food Noise Was the Missing ConceptThe real turning point did not come from reading another study. Instead, it came from listening to people I trusted.

One colleague quietly lost weight on a GLP-1. Another friend told me something more striking: the food noise stopped. Alcohol lost its appeal. Smoking no longer called.

That phrase — food noise — suddenly explained decades of struggle.

To illustrate, think of sleeping near Lake Shore Drive in Chicago. At first, traffic noise dominates your awareness. Eventually, it fades into the background. Only when you leave the city do you realize how loud it was.

Food noise works the same way.

When GLP-1 therapy quieted that background signal, eating slowed naturally. Meals ended without effort. Desire changed without rules. Biology shifted.

Notably, calories did not lower my stress. Calories did not improve my sleep. Calories did not stop snoring. Biology did.

The Unexpected Early BenefitsInterestingly, weight loss was not the first change I noticed.

Sleep improved almost immediately. Stress dropped dramatically. Commutes that once registered hours of physiologic stress now barely registered minutes. Appetite normalized. Eating slowed.

These changes matter because sleep and stress directly affect inflammation, metabolic health, appetite signaling, and long-term disease risk. In other words, healthspan improved before the scale reflected anything meaningful.

That observation alone reframed the entire experience.

Why Support Groups Matter More Than Diet RulesAlong the way, something else happened.

Friends noticed.

Predictably, they asked the same question everyone asks: What diet is working? After I answered honestly, several started their own journeys.

Soon enough, we formed an informal support group. People texted. Others called. Questions surfaced: Is this normal? Should I eat this? Does this feeling pass?

Support did not mean coaching. Rather, support meant context. Shared experience reduced anxiety. Honest conversations prevented unnecessary panic.

Not surprisingly, patterns emerged. People still loved great food. Wine interest decreased naturally. Travel did not end. Joy remained intact.

Support mattered because isolation amplifies shame.

Vitamins, Bowels, and the Things No One MentionsEqually important, practical realities surfaced.

Eating less means needing micronutrients, not fewer of them. Unfortunately, some vitamins fail when appetite drops. In fact, the only time I vomited was after taking a vitamin on an empty stomach. That lesson mirrored decades of bariatric follow-up experience.

For me, AG1 worked. No sponsorship exists here. Nevertheless, cost raises questions. With a background in culinary medicine, developing a better formulation makes sense. Thiamine deficiency, for example, causes devastating neurologic consequences. This is not theoretical.

Similarly, bowel habits change. Less intake means less output. Fewer bowel movements do not equal constipation. Fiber still matters. Mediterranean-style eating naturally solves most of this problem.

Understanding physiology prevents fear.

Why I’m Writing Another BookAt some point, frustration turned into obligation.

Recently, a physician who has never used a GLP-1 published a book about eating on GLP-1 therapy. That bothered me more than it should have.

Given my background — weight-loss surgery, culinary medicine, and lived experience — I realized I had to write this book. Not to sell diets, but to explain reality.

The working title?

Willpower Is B.S.

Subtlety has never been my strength.

This book will focus on biology, food ideas, micronutrients, behavior, and healthspan. Above all, it will remove shame from the conversation.

Incidentally, my literary agent retired long ago. Therefore, if you know someone who understands medicine, food, and honesty, I’m back in the market.

Why the Mediterranean Healthspan Cruise ExistsAt the same time, conversations kept expanding beyond weight loss.

Healthspan matters more than thinness. Longevity depends on sleep, stress, nutrition, social connection, and movement. Accordingly, the Mediterranean Healthspan Cruise was born.

This is not a weight-loss cruise. Instead, it’s a learning experience. We will discuss food, medicine, science, and aging. Yes, there will be a GLP-1 support session. Equally, there will be conversations for everyone.

Learning works best in a community.

This Is Only Part OneAs I write this, I’m preparing to inject my 7.5 mg dose of Zepbound. I still hate needles. Some things never change.

Nevertheless, this is only part one of the journey.

Science progresses when we admit what we got wrong.

This time, I listened.

References1. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024. 2. Rubino F et al. Joint international consensus statement for ending stigma of obesity. Nature Medicine, 2020.

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Is Your Watch Predicting Your Death?What Biologic Age Really Means — and What It Doesn’tMy Whoop tells me I’m eight years older than I actually am.

Naturally, that raises a question.

Does that mean I’m going to die eight years sooner?

Is my watch quietly chiseling a new date onto my tombstone?

Fortunately, the answer is no.

Still, confusion around biologic age has exploded.

Wearables promise insight.

Apps offer scores.

Some even whisper about your future health, as if destiny lives on your wrist.

So let’s slow this down and talk about what biologic age really is — and why it matters far less than you think.

The Two Numbers and the DashEvery tombstone has two numbers.

One marks when you were born.

The other marks when you died.

However, the most important part isn’t either number.

It’s the dash in between.

That dash represents your life.

It reflects your health, mobility, independence, and curiosity.

When we talk about longevity, we shouldn’t obsess over the second number.

Instead, we should focus on making those two numbers far apart — and keeping the dash strong for as long as possible.

That’s healthspan.

Why Biologic Age Sounds Scarier Than It IsBiologic age is not a prophecy.

It isn’t a death clock.

It doesn’t predict how long you’ll live.

Instead, biologic age is a model.

It estimates how your body is functioning right now based on things like:

• resting heart rate
• heart-rate variability
• sleep duration and consistency
• activity and recovery patterns
• sometimes weight or blood pressure

Different devices use different inputs.

As a result, they often give different answers.

In other words, biologic age reflects recent stress and behavior, not your destiny.

Think of it as feedback — not fate.

Why Your Watch Isn’t Measuring “Real” AgingEarlier in the Fork U longevity series, we talked about telomeres.

Those shorten slowly over decades, one cell division at a time.

Your wearable isn’t tracking that.

Instead, devices like Whoop measure physiology, not DNA.

They detect how hard you’ve been living lately, not how much time you have left.

A bad week of sleep, travel, stress, or alcohol can push your biologic age higher.

A calm, consistent routine can bring it back down.

That’s not aging.

That’s load management.

A Simple Experiment That Tells the Whole StoryHere’s a trick I tried.

I told Whoop I was younger than I actually am.

Guess what happened?

Suddenly, my biological age dropped below my real age.

That alone tells you everything.

Whoop isn’t predicting where you’re going.

It’s comparing how you’re doing relative to the age you told it you are.

Once again, that’s feedback — not destiny.

Why I Prefer WithingsI use multiple devices because, frankly, I’m a nerd.

However, I tend to prefer Withings for one simple reason.

They don’t try to scare you.

Instead of telling you how old you “really” are, Withings focuses on things that actually improve your life today:

• blood pressure trends
• body weight and composition
• heart rhythm
• sleep duration
• long-term consistency

More importantly, they ask better questions.

Are you sleeping better?

Is your blood pressure improving?

Are your habits trending in the right direction?

That’s medicine.

Not numerology.

And no — Withings didn’t pay me to say that.

The Biggest Mistake People MakeMany people treat biologic age like a grade.

Others see it as a moral judgment.

When the number drops, they feel virtuous.

When it rises, they panic.

That framing misses the point.

The only question that matters is this:

Is it moving in the right direction over time?

One bad week doesn’t define you.

One good week doesn’t either.

Trends matter.

Moments don’t.

What No Device Can Tell YouNo wearable can tell you:

• when you’ll die
• whether you’ll get cancer
• if you’ll have a stroke
• how many years you have left

Anyone claiming otherwise is selling fear — or subscriptions.

Technology can guide behavior.

It cannot predict destiny.

New Year’s Resolutions That Actually Improve HealthspanIf you want to improve your biologic age — and more importantly, your healthspan — start here:

Sleep better and more consistently.

Build and maintain muscle.

Move your body every day.

Eat a Mediterranean-style diet.

Lower stress where you can.

Spend time with people you enjoy.

Do those things, and most metrics improve on their own.

The Bottom LineYour watch is not your destiny.

Chronological age is fixed.

Healthspan is not.

Biologic age is adjustable, responsive, and reversible.

Use it as feedback.

Ignore it as prophecy.

And remember — the goal isn’t to beat time.

The goal is to live well while time keeps moving.

References1. Levine ME. Modeling the rate of senescence: Can estimated biological age predict mortality more accurately than chronological age? J Gerontol A Biol Sci Med Sci. 2013. 2. Belsky DW, et al. Quantification of biological aging in young adults. Proc Natl Acad Sci USA. 2015. 3. Blackburn EH, Epel ES, Lin J. Human telomere biology: A contributory and interactive factor in aging, disease risks, and protection. Science. 2015. 4. WHOOP Team. Understanding Recovery, HRV, and Physiological Load. 5. Withings Health Institute. Longitudinal tracking of cardiometabolic health markers.

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GLP-1 Drugs, the Mediterranean Diet, and the Science of Living LongerFor years, anti-aging has been hijacked by supplements, hacks, and promises that never hold up. Meanwhile, real science has quietly moved forward. Today, the most compelling anti-aging story does not come from a powder, a cold plunge, or a fasting app. Instead, it comes from metabolism.

A class of medications called GLP-1 receptor agonists started as diabetes drugs. Over time, clinicians discovered something bigger. These medicines now play a major role in obesity treatment, and they produce effects that reach far beyond the scale. Because obesity shortens lifespan and damages nearly every organ system, it makes sense that drugs that treat obesity could also improve healthspan—the years you live with strength, clarity, and independence.

However, weight loss alone does not explain what researchers are seeing. These drugs reduce inflammation, protect the heart, lower biological stress, and may even delay cognitive decline. Importantly, many of these effects occur independent of weight loss. That fact has forced scientists to ask a serious question: could GLP-1 drugs represent a new class of anti-aging medicine?

Even longevity-focused clinicians, such as Peter Attia, have publicly discussed using GLP-1 drugs at lower doses in select patients—not for weight loss, but for metabolic health and long-term disease prevention.

Why Metabolism Matters for AgingAging is not just about time. Instead, it reflects how well your body regulates key systems over decades. Blood sugar control, inflammation, oxidative stress, and cellular repair all shape how fast—or how slowly—you age.

GLP-1 receptor agonists influence all these pathways. Originally designed to mimic a gut hormone that signals fullness, these drugs turned out to do much more. Research shows they lower systemic inflammation, improve mitochondrial function, and reduce oxidative stress. As a result, organs function better for longer.

In simple terms, when metabolism runs smoothly, cells behave younger.

Retatrutide and the Next Generation of GLP-1 DrugsNewer drugs have taken this concept even further. Retatrutide, a triple-agonist medication, targets three hormonal pathways simultaneously: GLP-1, GIP, and glucagon.

In Phase 3 trials, participants lost nearly 29% of their body weight, or more than 70 pounds on average. Yet weight loss only tells part of the story. Retatrutide also lowered inflammation, improved blood pressure, improved lipid profiles, and reduced joint pain.

Each hormone plays a role. GLP-1 reduces appetite and inflammation. GIP improves insulin sensitivity and nutrient handling. Glucagon increases energy expenditure and fat oxidation. Together, these pathways keep metabolism active, not slowing down during weight loss.

That combination does more than shrink waistlines. It restores metabolic flexibility, which declines with age.

Inflammation: The Engine of AgingFor decades, scientists blamed aging on simple wear and tear. Modern research tells a different story. Chronic, low-grade inflammation—often called inflammaging—drives many diseases of aging.

Heart disease, stroke, arthritis, fatty liver disease, and cognitive decline all share this inflammatory background. In clinical trials, GLP-1 drugs reduced markers such as C-reactive protein, triglycerides, and blood pressure. These changes signal reduced biological aging risk, not just better lab numbers.

When inflammation falls, fewer senescent cells accumulate. Blood vessels stay healthier. Organs function longer.

Heart Disease and LongevityNothing ages a person faster than a heart attack. Because of that reality, cardiovascular protection matters deeply for longevity.

Multiple cardiovascular outcome trials show that GLP-1 receptor agonists reduce major adverse cardiovascular events in people with type 2 diabetes and high cardiovascular risk. Across studies, researchers observed a 13% reduction in cardiovascular death and a 9% reduction in nonfatal heart attacks compared with other treatments.¹²

The LEADER trial demonstrated that liraglutide reduced cardiovascular mortality by 22%.⁶ Similar benefits appeared with semaglutide, dulaglutide, and albiglutide.²⁷ Because of this evidence, the FDA approved several GLP-1 drugs for cardiovascular risk reduction in adults with diabetes and established heart disease.⁸

These benefits do not come from glucose control alone. GLP-1 drugs lower blood pressure, reduce inflammation, improve endothelial function, decrease oxidative stress, and reduce RAAS activity.³⁴ At the cellular level, they protect heart muscle cells from multiple forms of cell death while enhancing autophagy and mitophagy.⁵

Although GLP-1 drugs do not strongly reduce heart failure hospitalizations, meta-analyses suggest a modest benefit.³⁷ Most importantly, they safely reduce atherosclerotic risk. Preventing a heart attack remains one of the most powerful anti-aging interventions available.

Dementia: Prevention, Not CureBrain health deserves careful discussion. GLP-1 drugs do not reverse dementia. They do not improve cognition once dementia is established. Recent trials in patients with Alzheimer’s disease showed no meaningful cognitive improvement.

That limitation matters.

However, prevention tells a different story. Large observational studies show that GLP-1 receptor agonists are associated with 33–45% lower dementia risk compared with other glucose-lowering drugs in people with type 2 diabetes.¹² A 2025 JAMA Neurology study involving nearly 34,000 patients found a 33% lower risk of Alzheimer’s disease and related dementias among GLP-1 users.¹

Randomized trial evidence shows a more modest, but still significant effect. A 2025 JAMA Neurology meta-analysis found that GLP-1 drugs reduced dementia risk, while SGLT2 inhibitors did not.³ This finding suggests a class-specific effect, rather than a glucose-only explanation.

Mechanistically, GLP-1 drugs reduce neuroinflammation, improve insulin signaling in the brain, promote neurogenesis, and may reduce amyloid-β and tau pathology.⁵⁶ They also improve vascular health, which strongly influences cognitive aging.

Age appears to matter. A 2025 target-trial emulation showed weaker effects in adults over 75, but stronger protection in younger patients.⁷ The takeaway remains clear: earlier prevention works better.

The goal is not to cure dementia. Instead, the goal is to delay its onset long enough that many people never reach it.

Ultra-Processed Food and Brain AgingDiet still matters. Ultra-processed foods damage the same systems that GLP-1 drugs try to repair.

These foods hijack dopamine reward pathways, increase cravings, and weaken satiety signals. Soft textures and engineered flavors allow rapid overconsumption. High intake links to higher inflammation, worse metabolic health, reduced gray-matter density, and faster brain aging.

Additives and emulsifiers disrupt the gut microbiome and the gut-brain axis. As a result, insulin signaling in the brain worsens. GLP-1 drugs often counteract damage caused by this food environment, but prevention works better than repair.

The Mediterranean Diet and AlcoholHere is the empowering part. People can act today.

The Mediterranean diet remains the dietary pattern with the strongest evidence for protecting both the heart and the brain. Vegetables, legumes, fruit, whole grains, olive oil, fish, and minimal ultra-processed food form its foundation. This pattern reduces inflammation, improves vascular health, supports the microbiome, and slows cognitive decline.

Think of it this way: GLP-1 drugs quiet the metabolic noise. The Mediterranean diet keeps it quiet.

Alcohol also matters. Earlier beliefs about alcohol and brain protection did not hold up. Even moderate drinking increases dementia risk, worsens sleep, raises inflammation, and damages the hippocampus. If cognitive protection matters, less alcohol helps, and none works best.

What This Means for HealthspanAging is not about adding years. Aging is about protecting systems.

GLP-1 drugs support metabolic health. The Mediterranean diet supports biology. Avoiding alcohol protects the brain. Movement and sleep reinforce everything else.

If heart disease, dementia, and disability are delayed long enough, many people will never experience them. That outcome does not represent immortality. Instead, it represents success at healthspan.

References1. Ussher JR, Drucker DJ. Glucagon-Like Peptide 1 Receptor Agonists: Cardiovascular Benefits and Mechanisms of Action. Nat Rev Cardiol. 2023;20(7):463–474. 2. Nauck MA, et al. Cardiovascular Actions and Clinical Outcomes With GLP-1 Receptor Agonists. Circulation. 2017;136:849–870. 3. Pop-Busui R, et al. Heart Failure: An Underappreciated Complication of Diabetes. Diabetes Care. 2022;45:1670–1690. 4. Wu Q, et al. Glucose-Independent Cardiovascular Mechanisms of GLP-1 RAs. Biomed Pharmacother. 2022;153:113517. 5. Boshchenko AA, et al. Cardioprotective Signaling of GLP-1 Receptor Agonists. Int J Mol Sci. 2024;25:4900. 6. Marso SP, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;375:311–322. 7. Honka H, et al. Therapeutic Manipulation of Myocardial Metabolism. J Am Coll Cardiol. 2021;77:2022–2039. 8. FDA Orange Book. 9. Tang H, et al. GLP-1RA Medications and Dementia Risk. JAMA Neurol. 2025;82:439–449. 10. Seminer A, et al. Cardioprotective Glucose-Lowering Agents and Dementia Risk. JAMA Neurol. 2025;82:450–460. 11. Au HCT, et al. GLP-1 and Neurodegenerative Pathology. Neurosci Biobehav Rev. 2025;173:106159. 12. Inoue K, et al. GLP-1 RAs and Dementia Incidence in Older Adults. Ann Intern Med. 2025.

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The Holiday Party That Turned DeadlyIt started at a holiday party.

Laughter, champagne, a toast — then a collapse.

A fifty-two-year-old, active and healthy, suddenly lost consciousness.

Paramedics did CPR and shocked her heart twice.

She survived — barely.

Doctors called it Holiday Heart Syndrome: an alcohol-triggered arrhythmia that can kill.​

What Is Holiday Heart?Holiday Heart arises after binge or even moderate drinking, especially around celebrations. Alcohol irritates heart cells, disrupts electrolytes, and scrambles electrical signals, which can trigger atrial fibrillation — an erratic rhythm that raises the risk of clots, stroke, and sudden death. Even a single heavy night can set it off, and repeated use amplifies inflammation and structural damage long after the hangover fades.​

Alcohol and Your HeartFor years, the “French paradox” suggested red wine protects the heart, but newer evidence points instead to lifestyle patterns rather than wine itself. Ethanol and its metabolite acetaldehyde directly injure heart muscle, disturb calcium handling, damage mitochondria, and can lead to Alcoholic Cardiomyopathy — an enlarged, weakened heart. Harm shows up even in relatively low intake, and improvement typically requires reducing or stopping alcohol.​

Alcohol and CancerAlcohol is a proven carcinogen that promotes DNA damage, inflammation, oxidative stress, and hormonal shifts that favor tumor growth. At least seven cancers — including those of the mouth, throat, larynx, esophagus, liver, colon, and breast — are directly linked to alcohol, with risk beginning above zero and rising with each additional drink. Even up to one drink a day meaningfully increases breast cancer risk, and the combined use of alcohol and tobacco multiplies risk even further.​

Blue Zones, Not Blue WineYou’ve probably heard this one:

People in Sardinia or Ikaria drink wine every night and live to 100.

What’s missing is the math.

They sip 3 to 4 ounces — not a glass, not a typical American glass, but a tasting. The flight of wine.

Their rustic wines are 10–11 percent alcohol, not the 16 percent bombs from Sonoma.

And they don’t live long because of the wine.

They live long because of everything else:

walking hills, eating beans, taking naps, sleeping well, and belonging to a community.

Their wine is cultural, not clinical.

If you want their healthspan, copy their diet, movement, and purpose — not the nightly pour.

Weight, Metabolism, and AgingAlcohol hijacks metabolism by forcing the liver to prioritize ethanol breakdown, pushing fat and sugar processing aside. Drinks can add substantial hidden calories, promote fatty liver, and stall fat loss, even when the rest of a diet looks reasonable.​

Why “Detox” Fixes FailPopular “alcohol detox” supplements promise faster clearance or hangover prevention, but research points to ethanol itself and the inflammatory response as the main drivers of symptoms. Blocking acetaldehyde alone does not prevent mitochondrial damage, immune activation, or the residual effects that follow a night of heavy drinking.​

The Longevity HypocrisyModern wellness culture often warns about “toxins” while normalizing regular drinking, even framing certain spirits or wines as health tools. Yet, when viewed through a longevity lens, alcohol stands out as one of the most potent, fully optional biological stressors in the modern lifestyle.​

When You StopOnce drinking stops or drops sharply, the body begins to repair: blood pressure often falls within days, heart rhythm and sleep tend to improve within weeks, and liver fat can regress over subsequent months. Over years, cancer and cardiovascular risks decline, with former light-to-moderate drinkers gradually approaching the risk profile of people who never drank or who stopped earlier in life.​

Bottom LineAlcohol is deeply woven into culture and celebration, but it is neither a health food nor a longevity strategy. For anyone serious about healthspan, cutting alcohol is one of the simplest, highest-impact levers available — a change your heart, DNA, and future self are strongly likely to benefit from.​

References1. Berger D, De Aquino J P, Charness M E, et al. Common Alcohol-Related Concerns. NIAAA (2025). 2. Rock C L, Thomson C, Gansler T, et al. American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention. CA Cancer J Clin. 2020; 70(4): 245-271. doi:10.3322/caac.21591. 3. Jun S, Park H, Kim UJ, Choi EJ, Lee HA, Park B, Lee SY, Jee SH, Park H. Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis. Epidemiol Health. 2023;45:e2023092. doi: 10.4178/epih.e2023092. Epub 2023 Oct 16. PMID: 37905315; PMCID: PMC10867516. 4. Rumgay H, Murphy N, Ferrari P, Soerjomataram I. Alcohol and Cancer: Epidemiology and Biological Mechanisms. Nutrients. 2021; 13(9): 3173. doi:10.3390/nu13093173. 5. Gapstur S M, Mariosa D, Neamtiu L, et al. The IARC Perspective on the Effects of Policies on Reducing Alcohol Consumption. N Engl J Med. 2025; 392(17): 1752-1759. doi:10.1056/NEJMsr2413289. 6. Rumgay H, Shield K, Charvat H, et al. Global Burden of Cancer in 2020 Attributable to Alcohol Consumption. Lancet Oncol. 2021; 22(8): 1071-1080. doi:10.1016/S1470-2045(21)00279-5. 7. Yoo J E, Han K, Shin D W, et al. Association Between Changes in Alcohol Consumption and Cancer Risk. JAMA Netw Open. 2022; 5(8): e2228544. doi:10.1001/jamanetworkopen.2022.28544. 8. Fernández-Solà J. The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy. Nutrients. 2020; 12(2): 572. doi:10.3390/nu12020572. 9. Domínguez F, Adler E, García-Pavía P. Alcoholic Cardiomyopathy: An Update. Eur Heart J. 2024; 45(26): 2294-2305. doi:10.1093/eurheartj/ehae362. 10. Mackus M, van de Loo A J A E, Garssen J, et al. The Role of Alcohol Metabolism in the Pathology of Alcohol Hangover. J Clin Med. 2020; 9(11): 3421. doi:10.3390/jcm9113421. 11. van de Loo A J A E, Mackus M, Kwon O, et al. The Inflammatory Response to Alcohol Consumption and Its Role in the Pathology of Alcohol Hangover. J Clin Med. 2020; 9(7): 2081. doi:10.3390/jcm9072081. 12. Karadayian A G, Carrere L, Czerniczyniec A, Lores-Arnaiz S. Molecular Mechanism Underlying Alcohol’s Residual Effects: Acetaldehyde and Mitochondrial Dysfunction. Alcohol (Fayetteville N.Y.). 2025; doi:10.1016/j.alcohol.2025.09.004. 13. Turner B R H, Jenkinson P I, Huttman M, Mullish B H. Inflammation, Oxidative Stress, and Gut Microbiome Perturbation in Hangover. Alcohol Clin Exp Res. 2024; 48(8): 1451-1465. doi:10.1111/acer.15396. 14. Palmer E, Tyacke R, Sastre M, et al. Alcohol Hangover: Biochemical, Inflammatory, and Neurochemical Mechanisms. Alcohol Alcohol. 2019; 54(3): 196-203. doi:10.1093/alcalc/agz016.

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Muscle is Medicine: Why Lifting Weights is Your Best Longevity InvestmentClearly, your body changes as you age. I learned this lesson years ago when my son was three years old. We started him skiing, and he loved every minute of it. When he fell, he tumbled onto his behind, jumped right back up, and skied down the hill like nothing had happened. He was pure rubber and resilience.

However, I was 53 years his senior that year. I did an inadvertent 360-degree twirl on the slopes myself. His mother saw me and immediately asked if I had broken my wrist, wondering when I could return to surgery. The difference between a flexible young body and an older body is critical. Consequently, I retired from skiing that season and now enjoy the lodge, where I write and make them great dinners.

Indeed, your older body desperately needs work to stay flexible, strong, and balanced as time goes on. I have seen too many independent seniors lose everything after a simple fall in their own home. They go from living on their own to spending their last days in a care center, sometimes never leaving bed. This outcome is not healthspan. Instead, you want a fall to be like my son’s—just on your butt and back up. Sadly, too many fall and cannot get up. This isn't a commercial for a safety pendant, but a sincere plea for you to start working your muscles.

Section 1: The Enemy is Muscle Loss (Sarcopenia)Specifically, we talk frequently about heart health and clear arteries in longevity. Those things are unquestionably crucial. Nevertheless, the biggest threat to functional independence as we age is a condition called sarcopenia. This is the medical term for age-related muscle loss.

Unfortunately, we start losing about 3 to 8 percent of our muscle mass every decade after age 30. That loss accelerates quickly once you hit 70. This problem is not just about looking less toned; fundamentally, it is about losing the ability to stand up from a chair, carry groceries, or, most importantly, catch yourself when you trip. The falls that result are often catastrophic.

Section 2: Big Things Help Small Things—The Cellular ConnectionAmazingly, resistance training is effective at the microscopic level, too. We have talked extensively about the tiny, complex mechanisms of the cell, but here is the key takeaway: small things benefit from big things.

In fact, increasing muscle mass through training has direct, positive effects on two major microscopic drivers of aging: mitochondrial function and telomere health.

To elaborate, when you challenge your muscles, you signal your cells to create more energy. This signal forces your mitochondria—the cellular powerhouses—to become both more numerous and more efficient. Better mitochondrial function equals more energy and less cellular stress.

Moreover, studies show that resistance training actually increases the activity of the enzyme telomerase in some cells. Telomerase helps maintain the protective caps on your DNA called telomeres.

Therefore, you don’t need to buy fancy, expensive supplements like NAD or telomere boosters. Picking up a dumbbell costs less money but yields more results. You gain muscular strength, better metabolism, stronger bones, and the cellular benefits all at once.

Section 3: Muscle is Your Metabolic PowerhouseLet's consider how muscle mass influences your diet. Your muscle is actually your body’s largest organ for glucose disposal. Think of it like this: when you eat, your body releases glucose (sugar) into your bloodstream. Insulin then works to escort that glucose out of your blood and into your cells for energy. The vast majority of that glucose gets parked in your muscle cells.

Clearly, if you have more muscle mass, you automatically have a bigger parking lot for that glucose.

Consequently, more muscle means your body gains better insulin sensitivity. It becomes more efficient at regulating blood sugar. This effect is the absolute bedrock of preventing and managing Type 2 diabetes. Ultimately, resistance training is a powerful pharmaceutical intervention for your metabolic health.

Section 4: Building an Iron SkeletonHowever, the benefits don't stop at the muscles. Let's talk about bone density, which is crucial for everyone, especially women. We know calcium and Vitamin D are important, yet they are only one part of the solution.

Remember that bone is living tissue; it responds to stress. When you lift a weight—even if it is just your own body weight in a squat—the mechanical force signals to your bones that they must get stronger. This process is known as the Mechanostat principle. Conversely, without that heavy, high-intensity mechanical load, bone density naturally declines, leading to osteoporosis.

In conclusion, if you only do low-impact cardio, you are helping your heart, but you are not sending the signal needed to maintain or increase bone mineral density. Specifically, you must load your bones to strengthen them.

Section 5: The Importance of Balance and Quality CoachingBeyond pure strength, true independence depends on mobility and balance. This is where functional training, including Yoga, plays a huge role. My favorite Yoga classes are a combination of bodyweight resistance and cardiovascular movement. I look for the physics—the movement, the resistance, and the balance—and keep the "woo" out of it. Furthermore, a Yoga mat costs far less than some supplements, but it will make a fall much easier to recover from.

Therefore, if you are getting started, please get professional help! Having a great gym coach to help with proper form is paramount—shout out to my friends Jeremy the Hulk and the Zeigler Monster! Additionally, it is equally important to enlist a private Yoga instructor to ensure you are not malaligned and that you know what to look for. A special shout-out to my yogi Xuan—and yes, I will be doing more classes this year!

Section 6: The Ultimate Goal: Getting Back UpUltimately, the reason we train is not just to be strong; rather, it is so that if you fall when you are 65, 75, or 80, you possess the strength, stability, and awareness to get up by yourself. This ability is the true mark of functional longevity.

Let me give you two examples of why this ability matters so much. A fellow was admitted to a facility after he broke his hip. Before he fell, he lived alone, was a champion bowler, and enjoyed his life. He simply slipped on a rug, fell, and was found a day later. After his hip was fixed, he spent the next year of his life mostly in bed, eventually dying of COVID-19 in a long-term care facility. One single fall that he couldn't get up from changed his life and his outlook completely.

Contrast that with my own dad. He took a fall at age 96 trying to trim a tree. It took a bit of effort, and he received a stern warning from his son and the EMTs, but he got up. He lived independently until age 98.

Consequently, this kind of preparation matters because the statistics are sobering: falls are the leading cause of injury death for people over 65. Tragically, studies show that up to 30% of seniors who fracture a hip lose their independence entirely.

Conclusion and Call to ActionFinally, resistance training, combined with functional movement, is the macroscopic lever that pulls all those microscopic switches. It is the closest thing to a fountain of youth that doesn’t require a prescription. It just requires effort.

Remember that you must continually increase the demand on your body—this is called progressive overload. Most importantly, remember that resistance training is the stimulus, but protein is the building material. Aim for a high protein intake daily, and definitely enjoy that protein smoothie right after your workout!

On that note, we’re even taking this training on the road this year with our Mediterranean Cruise, where we’ll have an instructor to help you with simple movements—things so that if you fall, you can get up by yourself.

References* Dao T, Green AE, Kim YA, Bae SJ, Ha KT, Gariani K, Lee MR, Menzies KJ, Ryu D. Sarcopenia and Muscle Aging: A Brief Overview. Endocrinol Metab (Seoul). 2020 Dec;35(4):716-732. doi: 10.3803/EnM.2020.405. Epub 2020 Dec 23. PMID: 33397034; PMCID: PMC7803599. * Sun L, Zhang T, Luo L, Yang Y, Wang C, Luo J. Exercise delays aging: evidence from telomeres and telomerase -a systematic review and meta-analysis of randomized controlled trials. Front Physiol. 2025 Jun 26;16:1627292. doi: 10.3389/fphys.2025.1627292. PMID: 40642293; PMCID: PMC12241061. * Massini DA, Nedog FH, de Oliveira TP, Almeida TAF, Santana CAA, Neiva CM, Macedo AG, Castro EA, Espada MC, Santos FJ, Pessôa Filho DM. The Effect of Resistance Training on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2022 Jun 17;10(6):1129. doi: 10.3390/healthcare10061129. PMID: 35742181; PMCID: PMC9222380. * Jeon YK, Jeong J, Shin SD, Song KJ, Kim YJ, Hong KJ, Ro YS, Park JH. The effect of age on in-hospital mortality among elderly people who sustained fall-related traumatic brain injuries at home: A retrospective study of a multicenter emergency department-based injury surveillance database. Injury. 2022 Oct;53(10):3276-3281. doi: 10.1016/j.injury.2022.07.036. Epub 2022 Jul 23. PMID: 35907679. * McKendry J, Lowisz CV, Nanthakumar A, MacDonald M, Lim C, Currier BS, Phillips SM. The effects of whey, pea, and collagen protein supplementation beyond the recommended dietary allowance on integrated myofibrillar protein synthetic rates in older males: a randomized controlled trial. Am J Clin Nutr. 2024 Jul;120(1):34-46. doi: 10.1016/j.ajcnut.2024.05.009. Epub 2024 May 16. PMID: 38762187; PMCID: PMC11291473.

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🧬 Telomeres and Time: Can We Really Rewind Aging?The Lowest Hemoglobin I’ve Ever SeenThe lowest hemoglobin I’ve ever seen belonged to a young woman who was still standing. Her blood count was one-fourth of normal. She was pale, short of breath, and strong enough to walk into the clinic.

Doctors soon learned her bone marrow had stopped making new blood cells. The diagnosis was aplastic anemia — a true telomere disease.

She survived thanks to her fitness, modern science, and a bone marrow transplant from a generous donor in Germany. Two years later, she’s in law school, healthy, and full of life.

What Are Telomeres?Each cell in your body carries chromosomes — long strands of DNA. At the ends of those chromosomes sit telomeres, tiny caps that keep the DNA from unraveling, like plastic tips on shoelaces.

Every time a cell divides, its telomeres shorten a little. When they get too short, the cell can no longer divide. Scientists call that stage cellular senescence — cellular retirement.

In 2009, researchers Elizabeth Blackburn and Carol Greider won the Nobel Prize for discovering telomerase, an enzyme that can rebuild telomeres. Their discovery sparked dreams of reversing aging. But there’s a catch: cancer cells also use telomerase to live forever. Turning that enzyme on everywhere might turn back time — or turn on tumors.

Why Everyone Talks About TelomeresTelomeres became the poster child for longevity marketing.

Social media ads promise to “measure your biological age.” Supplement companies claim to “lengthen your telomeres” for hundreds of dollars a bottle.

The problem? Telomere tests vary between labs. Results can change by 20 percent depending on the method. They show trends, not destiny.

What’s Being StudiedReal scientists are studying how telomeres behave under different conditions.

• Danazol — a synthetic sex hormone that slows telomere loss in people with inherited marrow failure. It works but brings side effects, so it’s not an anti-aging trick.
• Henagliflozin — a diabetes drug that increased telomere length in one small study. Whether that helps humans live longer is still unknown.
• Aripiprazole — an antipsychotic that repaired telomeres in cells after oxidative stress. That’s a Petri dish result, not a prescription for youth.

These drugs show that we can nudge biology, but they’re for disease, not for vanity.

Vitamins and Compounds That Might HelpNutrients influence telomere health, too.

• Vitamin D supports telomerase. Long-term studies show it slows telomere shortening.
• Vitamins C and E help reduce chemical stress that wears telomeres down.
• Gamma-tocotrienol, a form of vitamin E, may reverse telomere loss — so far only in lab work.
• TA-65, from the Astragalus plant, may activate telomerase but carries risk. Turning on telomerase could also fuel cancer.
• Telomir 1 is experimental and not available outside research.

None of these is proven to extend life. They’re promising ingredients, not miracles in a capsule.

What Lifestyle Still Beats EverythingLifestyle matters more than any supplement.

A large study at UCSF showed that people who ate a Mediterranean diet, exercised, and managed stress boosted telomerase activity within months.

No powder required.

Telomeres respond to care. They’re markers of how you live, not the cause of how long you live.

Longer telomeres don’t guarantee longer life — they reflect how your body has handled time, inflammation, and stress.

What Scientists Agree OnResearch tells a simple story:

• Telomeres shorten as cells divide.
• Stress, smoking, and inflammation speed that process.
• Healthy diets and regular movement slow it.
• Some medications affect telomere biology but aren’t for general use.
• We still don’t know if lengthening telomeres increases lifespan.

So far, no pill or powder beats sleep, exercise, and plants on a plate.

The Real TakeawayTelomeres aren’t countdown clocks. They’re mileage markers.

Protect them by doing the basics well: eat plants and fish, move daily, sleep enough, manage stress, and don’t smoke.

Simple. Sustainable. Supported by science.

References1. Calado RT, Young NS. Telomere Diseases. N Engl J Med. 2009;361(24):2353-65. PMCID: PMC3401586 2. Lai T-P, Wright WE, Shay JW. Techniques for Assessing Telomere Length. Nat Rev Genet. 2018;19(5):293-307. PMCID: PMC6380489 3. Huang S et al. The Relationship Between Telomere Length and Aging-Related Diseases. Front Aging. 2025;6:1532. PMCID: PMC11882723 4. Arsenis CA et al. Physical Activity and Telomere Length. Sports Med. 2017;47(3):503-512. 5. Schellnegger T et al. Unlocking Longevity: The Role of Telomeres and Their Targeting. Front Aging Neurosci. 2024;16:1050353.

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The Mitochondria Problem: Why These Tiny Powerhouses Shape How We AgeMany people suddenly talk about mitochondria. You hear them in political speeches, on podcasts, and across social media. RFK Jr said he can “see” kids with weak mitochondria just by watching them walk through an airport. Others claim special diets or powders can “fix” aging by supercharging these organelles.

However, most of that chatter misses the actual science.

This post breaks down what mitochondria do, why they matter for aging, and how you can keep them healthy. No hype. No detox teas. Just biology you can use.

What Are Mitochondria?Every cell in your body contains tiny structures called mitochondria. They act like miniature cells living inside your larger cells. Each mitochondrion even has its own DNA.

Mitochondria divide independently from your regular cells.

They manage your energy, converting glucose to ATP

Finally, mitochondria keep your organs working.

You inherit all your mitochondria from your mother, which is why scientists use mitochondrial DNA to trace ancestry.

How Did We Get Mitochondria? (A Very Old Story)About 1.5 billion years ago, a simple cell swallowed a bacterium and refused to digest it. Instead, they formed a partnership.

The bacterium supplied energy.

The host cell provided safety.

That partnership became the mitochondrion. Every person alive today runs on that ancient deal.

What Do Mitochondria Do All Day? Mitochondria take glucose from your food and convert it into ATP — the energy your body uses to move, think, heal, and grow. This process runs every second of your life.

You cannot swallow ATP and get more energy. ATP supplements don’t work. Only your mitochondria make the usable fuel your body needs.

Why Young Mitochondria Work So WellYoung mitochondria act like teenagers. They run fast, bounce back quickly, and handle stress with ease. Cells constantly recycle old mitochondria through a process called mitophagy. This system works beautifully in childhood.

Fresh mitochondria power:

• strong muscles
• sharp thinking
• fast recovery
• healthy metabolism

When mitophagy runs smoothly, you feel energetic and resilient.

What Happens When Mitochondria AgeAging slows everything down. Mitochondria begin to leak more “exhaust,” build up mutations, and lose efficiency. Damaged ones don’t get removed as well, because mitophagy weakens with age.

Unfortunately, mitochondria do something worse than slow down:

They fuse with healthy mitochondria.

Imagine pouring spoiled milk into a fresh gallon. The whole jug goes bad. Aging mitochondria do the same thing inside your cells. They spread dysfunction to the healthy ones.

How Aging Mitochondria Cause TroubleAs mitochondria fail, they change how cells function. They send distress signals back to the nucleus that alter gene expression. These messages push cells toward inflammation, stress, and survival pathways that your body normally keeps quiet.

Even more concerning, changes in mitochondrial shape — too much splitting (fission) and not enough merging (fusion) — appear in both aging and cancer. These shifts support tumor growth, help cancer cells spread, and make some treatments less effective.

Aging mitochondria increase the risk of:

• brain fog
• muscle fatigue
• slower recovery
• heart strain
• metabolic slowdown
• cancer-friendly environments

Mitochondria sit at the center of how we age.

Why “Mitochondrial Booster” Supplements Miss the MarkPlenty of supplements promise to “repair” mitochondria. Many sound exciting:

• NAD boosters
• Urolithin A
• peptides
• antioxidant stacks

However, evidence in actual humans remains limited.

NAD boosters don’t show meaningful anti-aging benefits.

Urolithin A can help with muscle endurance, but doesn’t reverse aging.

Antioxidant megadoses may even interfere with exercise benefits.

People want a miracle switch. We don’t have one.

What Does Improve Mitochondrial HealthGood news: the basics still win. And they outperform supplements every time.

1. Resistance TrainingYour muscles grow new mitochondria in response to lifting weights or doing body-weight exercises.

2. Zone 2 ExerciseThis “comfortably challenging” aerobic zone trains your body to use oxygen better. You can talk, but you can’t sing.

3. SleepYour body repairs mitochondrial damage at night. Poor sleep means poor repair.

4. Mediterranean DietWhole foods, plants, nuts, fish, and olive oil protect mitochondria from inflammation and stress.

5. Treating Metabolic Disease EarlyHigh blood sugar, high LDL, and high blood pressure destroy mitochondria faster than anything else.

Why Diet Tribes Get Mitochondria WrongSome diet influencers insist that insulin resistance is the One True Cause of aging and that keto or carnivore diets fix it all. That was tested in high-quality metabolic ward studies.

It failed.

Low-carb diets did not outperform other diets when calories and protein were controlled. Fat loss was the same. Metabolism behaved the same. Insulin wasn’t the magic dial.

Mediterranean-style eating continues to show the strongest data for longevity.

Alcohol Ages Mitochondria FastYour liver breaks down alcohol by generating large amounts of oxidative stress. That stress directly damages mitochondrial DNA, mitochondrial enzymes, and mitochondrial membranes.

It also disrupts their normal fuse-and-divide rhythm, which accelerates aging inside your cells. The hangover fades, but the mitochondrial damage does not.

Bringing It All TogetherMitochondria are real, essential organelles — not a buzzword. Yet some people use the term “mitochondria” the same way Deepak Chopra uses the word “quantum": to describe everything and explain nothing.

Here’s the truth:

When mitochondria age, you age.

Driving inflammation.

Increasing cancer risk.

Slowing your metabolism.

They weaken your heart and muscles.

Finally, they cloud your thinking.

If we’re going to blame mitochondria for aging, let’s at least understand them — and learn how to keep them healthy.

Strength training, aerobic exercise, sleep, nutrition, and treating metabolic disease remain the most powerful tools we have.

Your mitochondria are trying their best.

Help them do their job.

REFERENCES1.Somatic Mutations of Mitochondrial DNA in Aging and Cancer Progression.

Lee HC, Chang CM, Chi CW. Ageing Research Reviews. 2010;9 Suppl 1:S47-58. doi:10.1016/j.arr.2010.08.009.

1. Mitochondrial DNA Mutations in Ageing and Cancer.

Smith ALM, Whitehall JC, Greaves LC.Molecular Oncology. 2022;16(18):3276-3294. doi:10.1002/1878-0261.13291.

1. Age-Associated Mitochondrial DNA Mutations Cause Metabolic Remodelling That Contributes to Accelerated Intestinal Tumorigenesis.

Smith AL, Whitehall JC, Bradshaw C, et al. Nature Cancer. 2020;1(10):976-989. doi:10.1038/s43018-020-00112-5.

4.Understanding the Impact of Mitochondrial DNA Mutations on Aging and Carcinogenesis (Review).

Kobayashi H, Imanaka S International Journal of Molecular Medicine. 2025;56(2):118. doi:10.3892/ijmm.2025.5559.

5.Mitochondrial Dysfunction and Oxidative Stress in Aging and Cancer.

Kudryavtseva AV, Krasnov GS, Dmitriev AA, et al. Oncotarget. 2016;7(29):44879-44905. doi:10.18632/oncotarget.9821.

6.Role of Mitochondrial Dysfunction in Cancer Progression.

Hsu CC, Tseng LM, Lee HC. Experimental Biology and Medicine (Maywood, N.J.). 2016;241(12):1281-95. doi:10.1177/1535370216641787.

1. Mitochondrial Dysfunction and Mitochondrial Dynamics-the Cancer Connection.

Srinivasan S, Guha M, Kashina A, Avadhani NG. Biochimica Et Biophysica Acta. Bioenergetics. 2017;1858(8):602-614. doi:10.1016/j.bbabio.2017.01.004.

8.Dysregulation of Mitochondrial Function in Cancer Cells.

Awad AMAM, Abdul Karim N. International Journal of Molecular Sciences. 2025;26(14):6750. doi:10.3390/ijms26146750.

1. Premalignant Progression in the Lung: Knowledge Gaps and Novel Opportunities for Interception of Non-Small Cell Lung Cancer. An Official American Thoracic Society Research Statement.

Moghaddam SJ, Savai R, Salehi-Rad R, et al. American Journal of Respiratory and Critical Care Medicine. 2024;210(5):548-571. doi:10.1164/rccm.202406-1168ST.

1. Mitochondria in Oxidative Stress, Inflammation and Aging: From Mechanisms to Therapeutic Advances.

Xu X, Pang Y, Fan X. Signal Transduction and Targeted Therapy. 2025;10(1):190. doi:10.1038/s41392-025-02253-4.

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Urolithin A: What It Is, How It Works, and Why Your Gut Decides EverythingBy Dr. Terry Simpson

Most people hear the name Urolithin A and think it belongs in a commercial about prostate health. It sounds like something a man named “Gary, 62,” would talk about while fishing. But Urolithin A has nothing to do with plumbing. Instead, it sits at the center of a new wave of longevity science focused on how our cells clean up old, broken parts.

As we age, our mitochondria—the tiny power centers inside our cells—start to slow down. They build up damage and stop working well. Eventually, this pile-up makes us lose strength and energy. That’s where Urolithin A comes in. It helps switch back on a process called mitophagy, which is basically the cell’s recycling program for old mitochondria.

Where Urolithin A Really Comes FromYou cannot eat Urolithin A directly. Instead, your body makes it when your gut bacteria break down special plant compounds called ellagitannins. These are found in foods like:

• pomegranates
• walnuts
• berries
• green tea (yes, really)

Green tea is usually known for its catechins, but it also contains ellagitannins like strictinin. After you drink it, your gut bacteria break these tannins apart and create ellagic acid, which can later turn into Urolithin A.

However, this only works if you have the right microbes. And here’s the surprising part:

Most people do not.

Studies show that only 12% to 40% of adults naturally produce Urolithin A from food. Everyone else makes little to none because their gut bacteria simply aren’t built for the job.

How Your Gut Decides EverythingYour microbiome—the community of bacteria living in your digestive system—decides whether you make Urolithin A or not.

People who produce Urolithin A usually have:

• more diverse gut microbes
• special bacteria like Enterocloster and Gordonibacter
• the right genes inside those microbes to do the chemical conversion

People who don’t produce it (called “metabotype zero”) lack those bacteria or the gene pathways needed. Eating more pomegranates or drinking more green tea does not fix this. No diet, including keto or Mediterranean, has been shown to turn a non-producer into a producer.

This is why two people can eat the same food, and only one makes Urolithin A.

What Urolithin A Does in HumansIn older adults, researchers have tested Urolithin A supplements for up to 4 months. These studies show several encouraging results:

• muscle endurance improves
• inflammation markers decrease
• mitochondrial health markers look better

Even so, there are limits. Trials show no meaningful improvement in:

• walking distance
• ATP (cellular energy) production
• overall physical function

So the biology looks better, but major clinical outcomes have not changed.

What Happens in the Lab (But Not Yet in Humans)Scientists also study Urolithin A in senescent cells—cells that have stopped dividing but still cause inflammation. In the lab, Urolithin A can:

• reduce senescence markers
• calm inflammatory signals
• restore mitophagy
• improve oxidative stress
• even strengthen circadian rhythms inside aging cells

All of this sounds exciting. However, these findings are from cell culture, not humans. They give us clues, not guarantees.

Food vs SupplementsYou cannot get Urolithin A directly from food. You only get the precursors, and only people with the right gut bacteria turn those precursors into Urolithin A.

Supplements bypass the microbiome entirely and give everyone measurable Urolithin A, even non-producers.

Foods that contain ellagitannins include:

• pomegranates
• walnuts
• raspberries
• blackberries
• some teas, especially green tea

But none of these will raise Urolithin A levels if your gut bacteria cannot perform the conversion.

Is Urolithin A Safe?Short-term human studies show that Urolithin A is safe and well-tolerated. Most people experience no side effects. When side effects do show up, they are usually mild digestive symptoms like bloating or softer stools.

What we don’t know:

• long-term safety
• pregnancy or breastfeeding safety
• multi-year use
• effects in chronic disease

In other words, the short-term data look good, but the long-term story hasn’t been written yet.

Should You Take It?Here is the simple answer:

Urolithin A is biologically promising but clinically modest.

It improves certain cellular markers and may boost muscle endurance in older adults.

It does not reverse aging or change major health outcomes—not yet.

Supplements make the most sense for:

• adults over 60
• people with early muscle loss
• individuals who are non-producers
• those wanting to support mitochondrial health

But nothing replaces the basics:

• resistance training
• movement
• eating well
• sleep
• stress control

That is still the foundation of a longer, healthier life.

REFERENCES(For the blog — as provided)

1. Kuerec AH, Lim XK, Khoo AL, et al. Targeting Aging With Urolithin A in Humans: A Systematic Review. Ageing Research Reviews. 2024;100:102406.
2. Heilman J, Andreux P, Tran N, et al. Safety Assessment of Urolithin A… Food and Chemical Toxicology. 2017;108:289-297.
3. Hasheminezhad SH, Boozari M, Iranshahi M, et al. Biological Activities of Urolithins… Phytotherapy Research. 2022;36(1):112-146.
4. Singh A, D'Amico D, Andreux PA, et al. Direct Supplementation With Urolithin A… European Journal of Clinical Nutrition. 2022;76(2):297-308.
5. Aichinger G, Stevanoska M, Beekmann K, et al. PBPK Modeling of Urolithin A… Molecular Nutrition & Food Research. 2023;67(15).
6. D'Amico D, Andreux PA, Valdés P, et al. Impact of Urolithin A on Health, Disease, and Aging. Trends in Molecular Medicine. 2021;27(7):687-699.
7. Gandhi GR, Antony PJ, Ceasar SA, et al. Health Functions of Ellagitannin-Derived Urolithins. Critical Reviews in Food Science and Nutrition. 2024;64(2):280-310.
8. Zhang M, Cui S, Mao B, et al. Ellagic Acid and Urolithin A: Sources and Metabolism. Critical Reviews in Food Science and Nutrition. 2023;63:6900-6922.
9. García-Villalba R, Giménez-Bastida JA, Cortés-Martín A, et al. Urolithins: Metabolism and Microbiota. Molecular Nutrition & Food Research. 2022;66:2101019.

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🧬 NAD: The Molecule of Life — and the HypeHow a lab coenzyme became the latest anti-aging obsessionWhat We Mean by Longevity and HealthspanWhen people talk about longevity, they usually mean how long we live.

But healthspan — the years we live well — matters far more.

That’s the time before disease steals our energy, mobility, and independence.

Modern medicine has already doubled our lifespan in the last century.

Now the goal is to extend the healthy part — without falling for pseudoscience along the way.

When Marketing Meets MedicineLongevity has become a booming business.

Some gurus, like Dr. Eric Topol, do real science.

Others, like Peter Attia, sell access: $150 000 per patient for lab tests, a VO₂ max treadmill run, and a few “optimized” workouts.

He’s also an investor in AG1 — the influencer’s green drink of choice.

Andrew Huberman promotes similar ideas under studio lights bright enough to sterilize a petri dish.

Both are clever, credentialed, and caught between data and drama.

Then there’s Dr. David Sinclair, who helped discover how cells age — and then helped turn that discovery into a supplement empire.

His company tried to patent NMN, an NAD precursor, as a drug.

The FDA briefly removed NMN from the supplement market, sending Reddit into meltdown.

It’s back now, but the episode showed how quickly science slides into sales.

And finally, we have the shirtless salesmen:

Paul Saladino, who went from carnivore crusader to “fruit influencer.”

Liver King, whose real secret wasn’t liver — it was injectable.

And Gary Brecka, who claims to predict your death date (for a fee).

These are subscription services disguised as sages.

What NAD Actually IsNicotinamide adenine dinucleotide (NAD⁺) is a molecule found in every living cell.

It helps convert food into energy and repair DNA.

As we age, NAD levels fall — metabolism slows and damage builds up.

So scientists asked: If we raise NAD again, can we slow aging?

In mice, the answer looks promising.

NAD precursors like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) increase average lifespan by 5–15 percent and improve energy, insulin sensitivity, and activity.

That’s great for mice — but we don’t live in cages or eat lab chow.

Can You Get NAD from Food?Not directly — but your body makes NAD from dietary precursors:

tryptophan and niacin (vitamin B₃).

You’ll find them in fish, poultry, beans, milk, and whole grains — basically, a Mediterranean-style diet.

So before spending $90 on capsules, you can spend $9 at the farmers' market.

What the Human Studies ShowHuman trials of NR or NMN (usually 500–2000 mg per day for 6–12 weeks) show they are safe and well-tolerated.

They modestly raise NAD levels and sometimes improve lipid profiles and blood pressure.

But the effects are small and inconsistent, especially in healthy adults.

NAD precursors do not reverse aging.

They don’t prevent heart attacks or extend lifespan in people — at least, not yet.

NAD vs Statins: A Reality CheckMeta-analyses show NAD precursors, especially niacin, can lower LDL (“bad”) cholesterol by about 8–12 percent.

That’s fine, but compare it to rosuvastatin (Crestor):

DoseAverage LDL Reduction5 mg≈ 45 %10 mg≈ 52 %20 mg≈ 55 %40 mg≈ 63 %

That’s the difference between “interesting biochemistry” and “fewer funerals.”

So NAD may nudge your cholesterol; statins save lives.

Who Might BenefitOlder adults with metabolic syndrome, prediabetes, or early neurodegenerative disease could see modest improvements in inflammation or blood lipids.

Younger, healthier people mostly see lighter wallets.

No serious drug interactions have been documented, though theoretical ones exist with some chemotherapy or DNA-repair drugs.

As always, talk to your doctor before combining anything with prescription therapy.

Food Before PharmaThe best way to support NAD and longevity is still food, sleep, and movement.

A Mediterranean diet rich in legumes, vegetables, olive oil, and fish fuels NAD pathways naturally — and has proven benefits for heart and brain health.

No influencer code required.

A Note from the GalleyWe’ll explore all of this — diet, longevity, and a little wine science — on next summer’s Mediterranean Longevity Cruise.

World-class physicians, scientists, and chefs will join me for ten days of evidence-based indulgence.

It’ll cost less than a Peter Attia consult — and no one will force you to drink AG1.

(For the record, I still do. It’s gentle on my stomach, but I’m hunting for less bougie vitamins.)

The TakeawayBoosting NAD may someday help extend healthspan, but for now, the best evidence still supports:

• Eat Mediterranean-style food.
• Move daily.
• Sleep enough.
• Manage stress.
• See your doctor before your supplement dealer.

That’s how you live longer and better — no silver bullet, just science and common sense.

ReferencesEffects of NAD+ Precursor Supplementation on Glucose and Lipid Metabolism in Humans: A Meta-Analysis. Zhong O, Wang J, Tan Y, Lei X, Tang Z. Nutrition & Metabolism. 2022;19(1):20. doi:10.1186/s12986-022-00653-9.

2 Niacin: An Old Lipid Drug in a New NAD+ Dress. Romani M, Hofer DC, Katsyuba E, Auwerx J. Journal of Lipid Research. 2019;60(4):741-746. doi:10.1194/jlr.S092007.

3.Nicotinamide Adenine Dinucleotide in Aging Biology: Potential Applications and Many Unknowns. Bhasin S, Seals D, Migaud M, Musi N, Baur JA. Endocrine Reviews. 2023;44(6):1047-1073. doi:10.1210/endrev/bnad019.

1. Crestor. FDA Drug Label. Food and Drug Administration Updated date: 2024-07-31

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🎙 Celebrating 100 Episodes of Science, Sanity, and a Little SarcasmThis is it — our 100th episode of FORK U.

Over the last hundred episodes, we’ve gone from goat-gland hucksters to the microbiome, from Kellogg’s enemas to cholesterol chemistry, and from Blue Zones to bird flu.

Today, we look back — not just to celebrate the great scientists who shaped modern medicine, but to expose the modern influencers who sell that same science back to you in a bottle.

Welcome to The FORK U Hall of Fame and Shame.



🧠 The Hall of Fame🩺 Dr. Ancel Keys — The Misunderstood ScientistDr. Ancel Keys didn’t make guesses — he made measurements.

He and his team built one of the most detailed long-term studies in the history of medicine.

They went village by village across seven countries.

They collected what people ate, sent food samples back to labs, recorded EKGs, drew blood, and reviewed medical charts — not for a few months, but for decades.

That’s what science looks like: patient, precise, persistent.

Critics like Gary Taubes claim Keys “left out countries.”

That’s false — and it only proves they never read his work.

Keys studied cohorts of men within small villages, followed them carefully over the years to learn how diet and disease connected.

Without today’s molecular tools, he still discovered the pattern that modern science later confirmed:

ApoB — the protein attached to LDL cholesterol — is transported into the arterial wall, starting the process of atherosclerosis.

Keys didn’t chase fame. He chased truth.

His data became the foundation of preventive cardiology.

If you want to honor him, drizzle olive oil instead of conspiracy.

And a personal note — my thanks to Dr. Harry Blackburn, who worked with Keys and has kindly shared insights from those pioneering days.

💉 Dr. Frederick Banting and Charles Best — The Children Who Woke UpIn 1922, Banting and Best discovered insulin.

Before that, children with diabetes slipped into comas and died.

After the first injections, they woke up.

Their parents fed them well, but diet alone couldn’t save them.

Good science did.

It was one of medicine’s greatest moments — and still saves lives every day.

🧬 Dr. Kanehiro Takaki — The First VitaminBefore anyone even knew the word vitamin, Japanese surgeon Dr. Kanehiro Takaki saw sailors dying from beriberi.

Using early ideas of epidemiology, he realized the problem wasn’t infection but nutrition.

He changed their diet — adding barley and vegetables — and the disease vanished.

Takaki brought Japan into modern medicine.

Even Dr. Charles Mayo admired him.

Had he lived longer, he would likely have shared a Nobel Prize.

🧫 Dr. Leonard Hayflick — The Original Longevity DoctorIn 1961, Dr. Leonard Hayflick discovered something remarkable:

Human cells divide about fifty times, then stop — the Hayflick Limit.

He proved aging isn’t mystical. It’s biological.

Every division shortens a cell’s life clock until it retires.

His research wasn’t about nutrition, but it changed everything about how we understand aging and regeneration.

He was the first true longevity doctor — without supplements, slogans, or selfies.

❤️ The DASH and Portfolio Diet TeamsThe DASH Diet — Dietary Approaches to Stop Hypertension — came from a dream team of researchers.

• Dr. Lawrence Appel at Johns Hopkins led the NIH trial.
• Drs. George Bray, Donna Ryan, and Catherine Champagne built the menu at Pennington Biomedical.
• Dr. Frank Sacks at Harvard analyzed the data.

They showed that a diet rich in fruits, vegetables, and low-fat dairy could lower blood pressure without weight loss.

Then came the Portfolio Diet, developed by Dr. David Jenkins and his team at the University of Toronto.

They combined soy, nuts, soluble fiber, and plant sterols — lowering LDL cholesterol by up to 17 percent.

That’s culinary medicine — research that feeds both the lab and the kitchen.

And yet some influencers still say we need “more salt.”

The DASH team proved the opposite — unless, of course, you’re selling $39 mango-flavored electrolytes on TikTok.

🩻 Edinburgh — Where Surgery Became ScienceIf you ever visit Edinburgh, skip the castle and go straight to the Surgeons’ Hall Museum.

Inside are the breakthroughs that transformed surgery:

Lister’s antisepsis, Syme’s anatomy, and James Young Simpson’s chloroform.

It was here that Arthur Conan Doyle, as a medical student, learned from Dr. Joseph Bell, the sharp observer who inspired Sherlock Holmes.

From those halls, medicine shifted from superstition to study — from anecdote to anatomy.

It’s where modern diagnosis began.

And this month on TikTok, we’ll walk those halls together.

🚫 The Hall of Shame🧬 Gary Brecka — The Biohacking HypemanEvery generation gets its snake-oil salesman; ours just live-streams.

Gary Brecka calls himself a biologist who can predict your date of death — and change it for a price.

He has no medical degree, just a bachelor’s in biology and a borrowed pair of scrubs.

He never finished chiropractic school.

He sells hydrogen-water bottles, claiming there are 1,400 studies — there aren’t.

He says cold plunges melt fat — they don’t.

If they did, every Alaskan fisherman would look like Thor.

Brecka’s not a scientist. He’s a salesman with a ring light.

🧑‍⚕️ Barbara O’Neill — The Preacher, Not the ProfessorBarbara O’Neill preaches more than she practices science.

She claims cayenne pepper stops heart attacks and cholesterol is a Big Pharma hoax.

She charges thousands for seminars, dismisses evidence, and wraps it all in Seventh-Day Adventist fervor.

Meanwhile, my Crestor costs $2.36 for three months.

You do the math.

🧴 The Supplement InfluencersNow for the shirtless side of pseudoscience.

Compare the scientists who built the Mediterranean, DASH, and Portfolio diets to today’s supplement influencers.

The difference? The scientists do science. The influencers do sales.

There’s Paul Saladino — the carnivore who rediscovered fruit when steak stopped trending.

The salt bros selling electrolyte powder at $39 a bag.

Dr. Gundry, the ex-surgeon who says beans are dangerous — unless you buy his Bean Guard for $60 a month.

And the Liver King — whose biggest muscle came from a syringe, not a steak.

They don’t test ideas — they test lighting.

They make millions selling powders, not progress.

Science doesn’t need an affiliate link.

🩺 The Real HeroesWhile the supplement crowd surfed and sold, real heroes — doctors, nurses, respiratory therapists, and dietitians — showed up every day during the pandemic.

Before there was a vaccine.

Before there was safety.

They went anyway.

Those are the people who save lives — not the ones selling shortcuts.

🔬 Building the BridgeAfter 100 episodes, one truth stands out:

Science doesn’t need to be sexy to save lives.

My job — our job — is to build the bridge between real scientists and the public.

My background is in medicine, but my mission is communication.

To bring you work done in labs and clinics — not under ring lights.

The people I feature here aren’t influencers.

They’re the scientists whose glory comes from a colleague’s handshake, not a sales link.

Because behind every breakthrough is someone who’ll never trend on TikTok — but they’re the ones who truly change the world.

That’s what FORK U stands for — separating noise from nutrition, hype from health, and always choosing evidence over ego.

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Thanksgiving is more than a meal — it’s a worldwide celebration of gratitude built around foods that started here in the Americas. Corn, beans, potatoes, and turkey didn’t just feed a nation; they changed global cuisine. Today, we blend culinary history with medical sense to show how to enjoy the feast without the nap.

🍁 A Holiday for the WorldOur Canadian friends already finished their celebration. For their Thanksgiving, I roasted a chicken with Swiss Chalet sauce — if you know, you know. Thank you, Canada, for giving us Tim Hortons, Swiss Chalet, and the perfect excuse for early gravy season.

In the United States, we wait for the fourth Thursday in November to celebrate. And while Thanksgiving began as a survival story between settlers and Native Americans, it’s become a global holiday. Whether you’re in Edinburgh, London, or Los Angeles, if there’s a turkey on your table, you’re part of it.

🦃 The Turkey TruthTurkey is a ridiculously large bird. Cooking one whole is like putting a cow in the oven and hoping all the parts turn out right — it just doesn’t work.

That’s why I separate mine. The breast goes into a sous vide bath until juicy and tender, and the legs roast separately until golden brown. This approach keeps everyone happy and the meat perfectly cooked.

Another reason to love turkey: it’s naturally low in saturated fat, especially compared to red meat. So, when prepared well, it’s one of the healthiest centerpieces for your table.

🥖 Cornbread Stuffing — Cook It SafelyStuffing the bird might seem traditional, but it can also be dangerous. Baking bread inside raw poultry turns your dinner into a bacteria incubator. Instead, bake it separately.

My favorite? Cornbread stuffing — a true dish of the Americas. Combine cornbread cubes, sautéed onions, celery, herbs, mushrooms, and broth. For extra flavor, crisp up some turkey skin like “poultry bacon” and crumble it on top.

(You’ll find the full recipe at terrysimpson.com)

🥔 Potatoes — From the Andes to Every PlateLong before Europeans knew what a potato was, Indigenous farmers in the Andes were cultivating hundreds of varieties. Those humble tubers crossed the ocean and reshaped diets from Dublin to Delhi. Yes, the Italians perfected Gnochi - and the Irish love of the potato brought many of our finest folks to the United States.

At my table, I keep mashed potatoes simple — Yukon Golds, butter, olive oil, milk, salt, and pepper. No truffle oil. No mountain of bacon. Just creamy, honest comfort food.

🥗 Green Beans and the Three SistersGreen beans are another gift from the Americas. Native farmers grew them with corn and squash — the Three Sisters that nourished generations. The beans climbed the corn stalks while enriching the soil — the original regenerative farming.

In Culinary Medicine, we love beans for their fiber, plant protein, and heart-healthy nutrients.

If you’re remaking the classic green bean casserole, skip the canned soup. Use fresh mushrooms, milk, and a touch of cornstarch. Or, sauté the beans in olive oil and garlic for a lighter, Mediterranean twist.

(Full recipe posted at terrysimpson.com)

🥣 Cowboy Caviar — A Smart StarterBefore the main event, try Cowboy Caviar — a colorful bean salad from the American Southwest. It’s bright, high in fiber, and helps you eat more slowly (and more sanely).

Mix black beans, black-eyed peas, corn, peppers, red onion, avocado, olive oil, lime juice, and cilantro. Chill it and watch it vanish.

🍷 The Truth About the Food ComaEveryone blames tryptophan, but the real reason for that post-Thanksgiving crash is carbs, alcohol, and portion size.

When you load up on potatoes, rolls, and pie, your insulin spikes, helping tryptophan turn into melatonin — your sleep hormone. Add a glass (or three) of wine and you’re down for the count.

To avoid it, eat slowly, take a short walk after dinner, and save dessert for later. Your pancreas will thank you.

🍰 Dessert and a ConfessionI’m a surgeon, not a baker. So, I buy my pumpkin pie from Costco and serve it with vanilla ice cream. Sometimes, simplicity really is the secret ingredient.

🔥 FORK U with Flavor — Coming Soon LiveWe’re launching a new live cooking show called FORK U with Flavor!

Join me on TikTok (@drterrysimpson) and maybe Instagram (@drterrysimpsonmd) as we cook together, talk food science, and share a few laughs.

Paid Substack subscribers at drsimpson.com get ingredient lists and recipes ahead of time so you can cook along live. Everyone else gets the replay links and recipes afterward.

If you can’t watch me set off the occasional smoke alarm, you haven’t lived.

❤️ A Final ThoughtWherever you live — America, Canada, or across the pond — Thanksgiving reminds us that food connects us all.

Eat well. Be grateful. And remember, food isn’t just medicine — it’s connection, culture, and joy.

Happy Thanksgiving from me, Dr. Terry Simpson, and the FORK U team.

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When Vitamin D Isn’t Sunshine in a BottleVitamin D is sold as bottled sunshine. Social media says it boosts immunity, prevents cancer, and makes you live longer. But science says something very different — and megadoses pushed by influencers like Dr. Eric Berg can do more harm than good. Here’s what you need to know.

☀️ The Sunshine Vitamin — and the Myth That FollowsVitamin D has been called the sunshine vitamin for over a century.

We discovered it when children in industrial cities developed rickets — bones so soft they bent like rubber.

The cure wasn’t pills. It was sunlight and milk fortified with Vitamin D.

Today, that history is lost under a pile of influencer ads.

Scroll through TikTok or YouTube, and you’ll see people claim Vitamin D cures everything — from fatigue to depression to cancer.

One of the loudest voices is Dr. Eric Berg, who calls himself a “doctor.”

Here’s the problem: he’s not a physician. He’s a chiropractor.

And in California, chiropractors aren’t allowed to call themselves physicians. For good reason.

Dr. Berg recommends doses of Vitamin D that are ten to twenty times higher than medical guidelines. That’s dangerous advice.

Let’s look at what real science — not social media — tells us.

🧬 What Vitamin D Actually DoesVitamin D isn’t really a vitamin. It’s a hormone that helps your body absorb calcium, strengthen bones, and regulate parts of your immune system.

Most adults need 600 to 800 IU per day — not 10,000.

If your level is low, your doctor may recommend a short course of higher doses, but chronic mega-dosing can lead to toxicity.

So how much Vitamin D do you actually need?

That depends on your sun exposure, skin color, diet, and where you live. People who live in northern climates or rarely go outside might need a supplement — but the rest of us get plenty from sunlight and food.

📊 What the Research ShowsThe VITAL Trial, published in The New England Journal of Medicine (2019), followed over 25,000 people taking Vitamin D or a placebo.

The result? No meaningful reduction in cancer, heart disease, or death.

Other major studies say the same thing.

If your Vitamin D levels are normal, taking more doesn’t improve health — it just makes your urine more expensive.

There are benefits for people who are deficient, but that’s not most of us.

A simple blood test can tell you if you truly need supplementation.

⚠️ Too Much of a Good ThingVitamin D toxicity is not rare.

Excess doses can cause calcium levels in your blood to spike, leading to nausea, confusion, kidney stones, and even heart rhythm problems.

There is no benefit to megadoses of vitamin D (link)

🍳 Real Food, Real SunshineHere’s the truth: you can get enough Vitamin D the way nature intended.

Good sources include:

• Salmon, sardines, and tuna
• Eggs and fortified milk
• Mushrooms
• And, of course, sunlight

Ten to fifteen minutes of midday sun on your arms and legs a few times a week is usually enough.

If you live in Alaska in January, sure — take a supplement.

But for most of us, a walk outside beats a handful of pills.

🧠 Why We Love PillsIt’s easy to see why Vitamin D is so popular.

It promises health without effort.

Pop a pill instead of taking a walk, eat poorly, but believe you’re fixing it — it’s the illusion of health without the habit of health.

But biology isn’t fooled.

Our bodies need balance, not shortcuts.

Supplements can help fill a true gap — not when they replace good food and lifestyle.

🩺 The TakeawayVitamin D is essential — just not magical.

If you’re deficient, fix it.

If you’re not, skip the megadoses and save your kidneys.

And please — don’t take medical advice from a chiropractor on YouTube.

The best way to get your Vitamin D?

Eat well. Move more. Go outside.

That’s the real sunshine therapy.

🧾 References1. Manson JE et al. Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease (VITAL Trial). NEJM 2019; 380:33–44. 2. Bolland MJ et al. Effect of Vitamin D Supplementation on Mortality and Disease Outcomes. Lancet Diabetes Endocrinol. 2022; 10(2):120–130. 3. Marcinowska-Suchowierska E et al. Toxic Effects of Vitamin D Overdose. Front Endocrinol. 2018; 9:550. 4. Ataide FL, Carvalho Bastos LM, Vicente Matias MF, Skare TL, Freire de Carvalho J. Safety and effectiveness of vitamin D mega-dose: A systematic review. Clin Nutr ESPEN. 2021 Dec;46:115-120. doi: 10.1016/j.clnesp.2021.09.010. Epub 2021 Sep 25. PMID: 34857184. 5. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press, 2011.

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Animal Protein and Cancer Risk: What the Science Really SaysRecently, Mark Hyman posted on X (formerly Twitter) that a new study suggests eating more animal protein might actually lower your risk of cancer. The study he pointed to came from the NHANES dataset—a U.S. survey of diet and health. It sounded reassuring, but it doesn’t line up with the bulk of the evidence. Here is the story about Animal protein and cancer risk:

Let’s dig into what the science really shows.

Red and Processed Meats: Where the Risk Is ClearIf you want the strongest evidence, look at red and processed meats. Large prospective cohort studies and systematic reviews consistently show that higher intake of these foods increases cancer risk. The effect is clearest for colorectal cancer, but we also see it in breast, endometrial, and even lung cancer.[1–6]

How big is the risk? Recent meta-analyses and systematic reviews find relative risks (RRs) and hazard ratios (HRs) in the 1.10–1.30 range for the highest vs. lowest intakes. For example, a comprehensive meta-analysis reported that every 50–70 grams per day of red or processed meat increased colorectal cancer risk by 15–32% (HR 1.15–1.32).[3,5] Processed meat generally carries more risk than unprocessed red meat.[2–3,6]

That’s why the American Cancer Society recommends limiting red and processed meats. Their advice is clear: swap them out for fish, poultry, or legumes when possible.[15]

Fish: A Safer BetThe data on fish tells a different story. Multiple studies and meta-analyses find a modest reduction in colorectal cancer risk with higher fish intake (SRR 0.94, 95% CI 0.89–0.99).[7–8] In fact, adding 50 grams of fish per day reduces risk by about 4%.

Pescatarian diets (no red meat, but including fish) show even more protection. Compared to meat-eaters, pescatarians had a 9% lower overall and colorectal cancer risk (RR 0.91, 95% CI 0.86–0.96).[9]

Poultry: Mostly NeutralChicken and turkey usually get lumped in with “animal protein.” But when you pull the data apart, poultry tells a different story. Most meta-analyses show a neutral or even slightly protective association with colorectal cancer (RR 0.79, 95% CI 0.63–0.99 for white meat).[10–12]

That said, a few studies hint at possible links with certain blood cancers, but those findings aren’t strong or consistent.[5,10] For most people, poultry is a much safer choice than red or processed meats.

Dairy: A Mixed PictureDairy is tricky. On one hand, milk and calcium-rich foods are consistently linked to a lower risk of colorectal cancer (RR 0.93, 95% CI 0.91–0.94).[4,13] On the other hand, high intake of milk or calcium may slightly increase the risk of prostate and endometrial cancers (RR 1.09–1.10).[13–14]

No consistent associations are found for breast or ovarian cancer. Cheese intake in particular may even have protective effects, but results vary.

Why the Confusion?So why did that NHANES study Mark Hyman highlighted find a small reduction in cancer mortality with higher animal protein? A few reasons:

• NHANES relies on a single dietary recall—one snapshot in time that may not reflect long-term habits.
• It doesn’t separate red and processed meat from healthier animal proteins like fish or poultry.
• Residual confounding (differences in lifestyle factors that aren’t fully accounted for) may skew the results.

When you put NHANES side by side with larger, longer-term studies and meta-analyses, it looks like the outlier. The overwhelming weight of evidence shows that red and processed meats increase cancer risk, while fish, poultry, and some dairy products are safer or even protective in specific cases. Animal protein and cancer risk is positive.

The Bottom LineProtein matters—but the source matters more.

• Red and processed meats: consistently linked to higher cancer risk
• Fish: modestly protective, especially for colorectal cancer
• Poultry: generally neutral, sometimes protective
• Dairy: lowers colorectal risk, but may raise prostate and endometrial cancer risk

The American Cancer Society sums it up well: limit red and processed meats, and lean into fish, poultry, beans, and plant-based proteins.[15]

References[1] Rock CL, Thomson C, Gansler T, et al. CA Cancer J Clin. 2020;70(4):245-271.

[2] Abid Z, Cross AJ, Sinha R. Am J Clin Nutr. 2014;100 Suppl 1:386S-93S.

[3] Lippi G, Mattiuzzi C, Cervellin G. Crit Rev Oncol Hematol. 2016;97:1-14.

[4] Boada LD, Henríquez-Hernández LA, Luzardo OP. Food Chem Toxicol. 2016;92:236-244.

[5] Diallo A, Deschasaux M, Latino-Martel P, et al. Int J Cancer. 2018;142(2):230-237.

[6] Farvid MS, Sidahmed E, Spence ND, et al. Eur J Epidemiol. 2021;36(9):937-951.

[7] Poorolajal J, Mohammadi Y, Fattahi-Darghlou M, et al. PLoS One. 2024;19(6):e0305994.

[8] Vieira AR, Abar L, Chan DSM, et al. Ann Oncol. 2017;28(8):1788-1802.

[9] Parra-Soto S, Ahumada D, Petermann-Rocha F, et al. BMC Med. 2022;20(1):79.

[10] Nielsen TB, Würtz AML, Tjønneland A, et al. Br J Nutr. 2022;127(4):563-569.

[11] Bonfiglio C, Tatoli R, Donghia R, et al. Nutrients. 2025;17(8):1370.

[12] Wang F, Chandler PD, Zeleznik OA, et al. Nutrients. 2022;14(5):978.

[13] Willett WC, Ludwig DS. N Engl J Med. 2020;382(7):644-654.

[14] Watling CZ, Kelly RK, Dunneram Y, et al. Br J Cancer. 2023;129(4):636-647.

[15] American Cancer Society. Guidelines for Diet and Physical Activity for Cancer Prevention. CA Cancer J Clin. 2020;70(4):245-271.

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When Green Tea Isn’t ChemotherapyIntroductionFood is powerful. Eating well lowers your risk of many diseases, including cancer. Yet food is not chemotherapy. Still, the idea that broccoli or green tea could replace cancer treatment is tempting. It feels safe, natural, and hopeful.

However, cancer is not treated with vegetables or tea. Cancer is treated with medicine. Let’s break down what food can and cannot do when it comes to cancer.

Broccoli and Cruciferous VegetablesBroccoli, cabbage, Brussels sprouts, and other cruciferous vegetables contain natural compounds like sulforaphane. In lab studies, these compounds slow cancer cell growth. That is promising.

Furthermore, population studies show that people who regularly eat cruciferous vegetables often have a lower risk of colon, lung, and breast cancers. So, broccoli can help lower risk.

But here is the key point: broccoli does not cure cancer. No oncologist prescribes broccoli as chemotherapy. Prevention is not the same as treatment.

Green Tea and Its LimitsGreen tea is another food often linked to cancer prevention. It contains catechins, such as EGCG, which in test tubes can slow cancer cell growth. Some studies even suggest that people who drink green tea regularly may have slightly lower cancer rates.

But again, that is prevention. Once cancer begins, drinking green tea will not stop it. And when taken as concentrated supplements, green tea extracts can actually harm the liver.

So, green tea is a fine beverage. But it is not chemotherapy. Personally, I prefer black tea — green tea tastes a little too much like pond water for me.

Scams and False HopeSadly, the gap between prevention and treatment is where scams thrive. You’ve probably heard of things like:

• Gerson Therapy: organic juices and coffee enemas, still promoted in Mexico. No evidence, high risk.
• Apricot pits and soursop: marketed as natural cures, but linked to toxicity.
• Ivermectin: useful for parasites, but not proven in cancer.

Then there’s the Warburg effect. Otto Warburg correctly observed that cancer cells use sugar differently. But modern science has shown cancer is not a “sugar disease.” It is a DNA disease caused by mutations. Cancer cells can grow on sugar, ketones, and even vitamins. You cannot starve cancer with diet.

What Medicine Has DoneNow, let’s talk about the real success stories.

Chemotherapy in the past was harsh, like carpet bombing. Yet it saved lives. My brother Jimmy was diagnosed with stage 4 Hodgkin’s disease in 1969. Thanks to experimental chemotherapy and radiation, he lived 37 more years.

Today, treatment is even better. We have:

• Targeted therapies that hit the exact mutation in a tumor.
• Immunotherapy drugs that unleash the body’s own defenses.
• Combination therapies that extend survival with fewer side effects.

And vaccines are changing everything. The HPV vaccine prevents cervical, anal, and many oral cancers. It may even help lower melanoma risk. Researchers are now studying vaccines for brain cancers like glioblastoma and even for pancreatic cancer.

No apricot pit will ever do that.

Food Still MattersWe should not ignore food. A poor diet filled with ultra-processed foods and low in fiber increases cancer risk. In fact, the rise in colon cancer among younger adults is likely tied to diets low in fiber and high in processed foods.

The Mediterranean diet, rich in fruits, vegetables, whole grains, olive oil, and legumes, does more than prevent cancer. The large EPIC studies show it also lowers the risk of cancer coming back after treatment. That makes it the best diet for cancer prevention and recurrence.

So yes, food matters. Food empowers you. But food is not medicine. Food lowers risk. Medicine treats disease. Together, they protect us.

ConclusionGreen tea and broccoli are healthy. The Mediterranean diet is the best prevention strategy we know. But once cancer develops, treatment is essential.

Food isn’t chemotherapy. Medicine is. And that is something we should all be grateful for.

References1. World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018. 2. Buckland G, Agudo A, Luján L, Jakszyn P, Bueno-de-Mesquita HB, Palli D, Boeing H, Carneiro F, Krogh V, Sacerdote C, Tumino R, Panico S, Nesi G, Manjer J, Regnér S, Johansson I, Stenling R, Sanchez MJ, Dorronsoro M, Barricarte A, Navarro C, Quirós JR, Allen NE, Key TJ, Bingham S, Kaaks R, Overvad K, Jensen M, Olsen A, Tjønneland A, Peeters PH, Numans ME, Ocké MC, Clavel-Chapelon F, Morois S, Boutron-Ruault MC, Trichopoulou A, Lagiou P, Trichopoulos D, Lund E, Couto E, Boffeta P, Jenab M, Riboli E, Romaguera D, Mouw T, González CA. Adherence to a Mediterranean diet and risk of gastric adenocarcinoma within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study. Am J Clin Nutr. 2010 Feb;91(2):381-90. doi: 10.3945/ajcn.2009.28209. Epub 2009 Dec 9. PMID: 20007304. 3. Jenkins DJA, et al. Green tea catechins and cancer prevention. J Nutr. 2003;133(11 Suppl 1): 3242S–3246S. 4. WHO. Human papillomavirus (HPV) vaccines. Updated 2022. 5. Hanahan D. Hallmarks of Cancer: New Dimensions. Cancer Discov. 2022;12(1): 31–46.

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Food Is Powerful, But It’s Not EnoughFood shapes our health. Eating beans, fruits, vegetables, and whole grains can lower the risk of diabetes and other chronic conditions. Yet food does not replace medicine. Clearly, diets high in ultra-processed foods make diabetes worse. And yes, eating better is the most empowering thing anyone can do.

Still, some claim that modern food is the only reason we have chronic diseases like diabetes. They argue that if people only ate “real food,” there would be no need for medicine. History proves otherwise.

The Story That Changed Everything: Dr. Banting and InsulinIn the early 1920s, Dr. Frederick Banting and Charles Best discovered insulin in Toronto. At the time, children with type 1 diabetes had no future. Families were told to put their kids on starvation diets, hoping to add a few months to their lives. Death was certain.

Then came insulin. Doctors injected it into children already in comas. One by one, they woke up. They sat up, asked for food, and hugged their parents. What had been a hospital ward of silence turned into a place of joy.

Insulin was the fastest-adopted drug in history. Banting became the youngest Nobel Prize winner at the time. That discovery did not come from food. It came from science and medicine.

Two Types of DiabetesThere are two main types of diabetes.

• Type 1 diabetes happens when the pancreas loses all ability to make insulin. Without insulin, sugar cannot move into cells, and life cannot continue. That is why every person with type 1 diabetes needs insulin from the first day of diagnosis.
• Type 2 diabetes is different. In this case, the body still makes insulin, but the cells resist it. Over time, the pancreas wears out. That is why many people with type 2 eventually need insulin too. It is not failure. It is simply how the disease progresses.

Food can help manage both types, but food alone is never enough.

What Beans Can DoBeans are one of the best foods for blood sugar. They are full of soluble fiber, which slows down glucose absorption. They also provide plant protein and have a low glycemic index. That means they don’t spike blood sugar the way soda or white bread does.

Research shows that eating beans regularly can lower hemoglobin A1c — the measure of long-term blood sugar — by about 0.3 to 0.5 percent. That is a real effect from food.

Beans are also practical. They are inexpensive, found almost everywhere, and have been eaten by humans longer than almost any other protein source.

Why Beans Aren’t MedicineNow let’s compare beans to metformin.

Metformin is the first-line drug for type 2 diabetes. It lowers A1c by 1 to 2 percent. That’s two to four times more than beans. Metformin also lowers the risk of heart disease and has decades of safety data behind it.

So while beans help, they are not metformin. If blood sugar is high, no amount of hummus or chili will bring it back to safe levels. Medicine is needed. Food lays the foundation, but medicine does the heavy lifting.

The Best Diet for Diabetes: The Mediterranean PatternWhen it comes to diet, the evidence is clear. The Mediterranean diet is the best overall eating plan for diabetes.

This diet includes:

• Fruits
• Vegetables
• Olive oil
• Nuts
• Legumes (yes, beans!)
• Whole grains

Now, some people push back against whole grains. That may be because they grew up in the low-carb era, when grains were unfairly blamed for every health problem. But whole grains are healthy, especially for people with diabetes. They are far better for the body than bacon or butter.

The Mediterranean diet does more than control blood sugar. It lowers cholesterol, reduces blood pressure, decreases inflammation, and protects the heart. And unlike fad diets, it is sustainable.

Practical Ways to Add BeansAdding beans to meals is easy. Here are a few examples:

• Swap ground beef for black beans in chili
• Add lentils to soups or stews
• Roast chickpeas for a crunchy snack
• Use hummus instead of cheese spread
• Toss peas into pasta, rice, or grain bowls

These small swaps improve blood sugar, lower cholesterol, and keep you full. Combined with the Mediterranean diet, the benefits are even stronger.

Don’t Fall for ScamsUnfortunately, scams are everywhere. Keto and carnivore diets claim to cure diabetes. While they may lower blood sugar in the short term, they raise saturated fat intake. That increases the risk of heart disease, which is the biggest threat to people with diabetes.

And cinnamon? It makes oatmeal taste great, but cinnamon pills do not cure diabetes. The science simply doesn’t support it.

The TakeawayFood matters. Food lowers risk. Food empowers people to take control. But food is not medicine.

Food is food. Medicine is medicine. Together, they save lives.

References* Banting F, Best C. Discovery of insulin, 1921–1922. * American Diabetes Association. Standards of Medical Care in Diabetes. * Jenkins DJA, Kendall CWC, et al. “Effect of legumes on glycemic control and cardiovascular risk factors.” Arch Intern Med. 2012. * Estruch R, Ros E, et al. “Primary prevention of cardiovascular disease with a Mediterranean diet.” N Engl J Med. 2013.

For more, see my newsletter on Substack where I dig into the science behind food and health.

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When Salmon Isn’t a StentHeart disease was four times more deadly than it is today. In those days, we had no statins, no stents, and no bypass surgery. Food was the only weapon doctors had.

Pharmacies in Rome and Greece even stocked extra virgin olive oil for patients with “hardening of the arteries.” Doctors sent people to pick up bottles, almost like prescriptions. Olive oil wasn’t curing clogged arteries, but it showed an early recognition that diet mattered.

Then scientists noticed something bigger. In certain Mediterranean villages, people lived longer with far less heart disease. It wasn’t genetic. Relatives who moved to cities and switched to Western diets developed heart disease much earlier.

Researchers didn’t stop there. They followed men in villages across Europe and the Mediterranean for decades. Some communities ate diets heavy in saturated fats. They developed clogged arteries and heart disease quickly. Other communities ate diets rich in fruits, vegetables, legumes, fish, nuts, and olive oil. They had much lower rates of heart disease. This pattern became the foundation of what we now call the Mediterranean Diet.

At that time, diet gave us hope. But today, we know that food alone is not enough.

Lyon Heart StudyThe Lyon Diet Heart Study proved how powerful diet could be. Conducted just as statins came onto the market, it showed that patients with heart attacks who switched to a Mediterranean-style diet had a 70% lower risk of another cardiac event. That meant fewer heart attacks and fewer deaths.

Later, the PREDIMED trial confirmed these results. In high-risk adults, the Mediterranean Diet reduced major cardiovascular events by about 30%. That’s impressive, but it also raises a question: can people sustain it? Adherence usually means sticking with the diet about 70 percent of the time. That’s not perfect.

Here’s a personal example. I have hypercholesterolemia and a strong family history of heart disease. I follow the Mediterranean Diet carefully. But even with strong adherence, my LDL cholesterol never dropped below 180. With two drugs — Zetia and Crestor — my LDL is now in the 40s. Food helps. Medicine saves.

Atherosclerosis begins early in lifeThe PESA Heart Study showed why this matters. Researchers in Spain followed adults who felt perfectly healthy. Using advanced imaging, they found more than 60 percent already had plaque in their arteries. Atherosclerosis begins silently, and often decades before symptoms appear.

The JUPITER trial with rosuvastatin (Crestor) proved what medicine can do. Statins reduced cardiovascular events by 44 percent, and the study had to stop early because the benefit was so strong.

And then there’s Dean Ornish. His program is often called the “diet that reverses heart disease.” But it was never just a diet. His patients quit smoking, took statins, took blood pressure medications, and practiced yoga. Ornish proved that lifestyle matters — but it was food and medicine together that made the difference.

Barbara O'Neill and Cayenne PepperMeanwhile, scammers still sell false hope. Barbara O’Neill, banned from giving health advice in Australia, charges thousands for seminars where she claims cayenne pepper “opens arteries.” That’s pure fiction. Cayenne is a spice, not a stent. She also claims cholesterol guidelines only exist to enrich drug companies. Yet my three-month supply of Crestor costs $2.36, while she profits thousands. The real con is clear.

So here’s the truth: salmon is healthy, but it isn’t a stent. Olive oil helps, but it isn’t a statin. Food prevents disease. Medicine treats it. Together, food and medicine are unbeatable.

References1. de Lorgeril M, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99(6):779–785. (click here) 2. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018 Jun 21;378(25):e34. doi: 10.1056/NEJMoa1800389. Epub 2018 Jun 13. PMID: 29897866. 3. Fernández-Friera L, et al. Prevalence, vascular distribution, and multiterritorial extent of subclinical atherosclerosis in a middle-aged cohort: the PESA study. Circulation. 2015;131:2104–2115. (click here) 4. Ridker PM, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–2207. (click here) 5. Ornish D, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998;280(23):2001–2007. (click here) 6. Therapeutic Goods Administration, Australia. Prohibition order under section 42DV against Barbara O’Neill. 2019. (click here)

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When Bananas Aren’t a Beta BlockerPeople love to believe that food can replace medicine. We talked about this in Episode One, where I explained that Hippocrates never said “let food be thy medicine.” Still, the myth endures.

Food does matter. The right eating pattern can lower blood pressure. One of the best-studied is the DASH Diet—short for Dietary Approaches to Stop Hypertension. It is often called America’s version of the Mediterranean Diet. While the Mediterranean Diet was being mapped out for overall health, the DASH researchers asked a sharper question: what foods can lower blood pressure directly?

Why DASH Is UniqueUnlike most nutrition studies, the original DASH trial provided all the food to participants. That meant researchers knew exactly what people ate, meal after meal. This is rare and expensive, but it gave them confidence in the results.

The DASH diet emphasizes:

• Fruits and vegetables, especially potassium-rich foods like bananas, beans, and leafy greens
• Whole grains
• Lean proteins, like fish and poultry
• Low-fat dairy
• Less red meat, sweets, and sodium

Because it combined several food groups, DASH worked quickly. Within two weeks, blood pressure dropped.

What the Studies ShowThe results were consistent. People following DASH lowered their systolic blood pressure (the top number) by 8–11 mmHg and their diastolic pressure by 5–6 mmHg. That is about the same as one standard blood pressure pill.

Even more important, DASH showed that sodium reduction matters. Those who cut sodium intake to 1,500–2,300 milligrams per day saw the greatest improvements. This shattered the myth that unlimited salt is safe. Too much sodium raises blood pressure, increases heart disease risk, and fuels strokes.

The Role of ElectrolytesThis is where things get messy. Electrolytes, especially sodium, are necessary during prolonged exercise—typically more than 1–2 hours, in hot weather, or when sweating heavily. Under those conditions, sodium helps prevent hyponatremia, a dangerous drop in blood sodium levels.

However, for most people exercising less than an hour, water is enough. Regular meals will replace lost sodium. Salty drinks or powders aren’t required. In fact, most commercial sports drinks don’t even contain enough sodium to match sweat losses in extreme events.

The Salt Supplement ScamHere is where the grift appears. Shirtless salesmen on social media love to sell high-priced mango-flavored salt packets as “essential” electrolytes. They promise performance and recovery, but they may actually raise your blood pressure and put you at risk.

Science says otherwise. Electrolyte supplementation should be individualized and used with caution. People at highest risk from unnecessary sodium loading include:

• Those with hypertension, heart failure, or kidney disease
• Women, who are more prone to overhydration and hyponatremia due to smaller body size and lower sweat rates
• Older athletes or those with low body mass
• Recreational athletes who follow outdated advice to “drink as much as possible”

Even ultra-endurance athletes cannot rely on sodium supplements alone. If they drink more than they lose, sodium will not prevent hyponatremia and may make things worse. The best strategy is to drink to thirst and use salty foods or fluids only when truly needed.

What a DASH Day Looks LikeHow can you follow DASH in real life? Here’s one sample day:

• Breakfast: Oatmeal with berries and a banana
• Snack: A handful of unsalted nuts
• Lunch: Black bean and vegetable salad with vinaigrette
• Dinner: Grilled salmon with leafy greens and brown rice
• Extra: Low-fat yogurt or skim milk

This pattern supplies potassium, magnesium, calcium, and fiber—nutrients that relax blood vessels and lower pressure naturally. Notice what’s missing: salty snacks, processed food, and canned soups.

Food and Medicine TogetherSo what does it all mean? The DASH Diet lowers blood pressure and improves overall health. But it does not replace medication. Blood pressure medicines—ACE inhibitors, ARBs, calcium channel blockers, diuretics—reduce systolic pressure by 20–40 mmHg. That is two or three times more than DASH.

Food helps. Medicine saves. Together, they work best.

The Bottom LineBananas, beans, and leafy greens are wonderful. Electrolyte supplements are rarely needed. Expensive salt powders sold by social media influencers are scams. And the DASH Diet? It’s real, it works, and it shows that food has power—just not enough to replace your beta blocker.

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When Tofu Isn’t a StatinPeople love to say “food is medicine.” Some even claim Hippocrates himself said it. But here’s the thing: he didn’t. The phrase does not appear in any of his surviving writings. In fact, historians believe the line was created centuries later and then falsely attached to Hippocrates to give it weight.

Still, the idea persists. Even the current head of HHS, Robert F. Kennedy Jr., has repeated the myth. And when RFK Jr. is your fact-checker, you know you’re in trouble.

Now, as someone certified in Culinary Medicine, I believe food is incredibly powerful. Eating the right foods can prevent disease, improve health, and help you live longer. However, food alone rarely works as well as actual medicine. That is especially true when it comes to cholesterol.

The Portfolio DietIn the early 2000s, Dr. David Jenkins and his team introduced what they called the Portfolio Diet. Instead of focusing on one “superfood,” the diet combines several cholesterol-lowering foods:

• Soy protein
• Nuts, like almonds
• Viscous fibers from oats, barley, or psyllium
• Plant sterols from fortified foods

Each one has a small effect. But when you put them together, the benefits add up.

Why does it work? Cholesterol gets secreted by your liver into bile, then travels into your gut. Normally, most of that cholesterol is reabsorbed into your bloodstream. But fiber and plant sterols bind to cholesterol and drag it out of your body. That’s why bowel movements are brown—bile is brown, and fiber helps carry it out. More fiber means you feed your gut bacteria and flush away cholesterol. It really is a win-win.

What the Studies ShowThe Portfolio Diet has been tested in multiple clinical trials. In one JAMA study, people who followed the diet lowered their LDL cholesterol by about 13 to 14 percent over six months. That translated to a drop of about 24–26 mg/dL.

Other studies show that people who stick with it can lower their LDL by 17 percent on average. Some who were especially diligent saw drops of more than 20 percent at one year. The Portfolio Diet also improves non-HDL cholesterol, apolipoprotein B, and long-term risk for heart disease.

So yes—it works. In fact, the effect is similar to what you get from early statins like lovastatin.

What It Looks Like in Real LifeThe science sounds great. But how do you actually eat this way? Here’s one example day:

• Breakfast: Oatmeal made with soy milk
• Snack: A handful of almonds (about 25–30 grams)
• Lunch: Lentil soup with whole-grain bread
• Dinner: Tofu stir-fry with vegetables and barley
• Extra: Two grams of plant sterols, often from fortified margarine spreads

That daily pattern gives you soy protein, fiber, nuts, and plant sterols. But here’s the challenge: it takes careful planning to hit the right doses every day. It’s not impossible—but it is hard to sustain.

How It Differs from the Mediterranean DietMany people confuse the Portfolio Diet with the Mediterranean Diet. Both are plant-forward, emphasize nuts, legumes, whole grains, and lower cardiovascular risk. However, the Mediterranean Diet is broader and easier to follow. It includes olive oil, fish, fruits, vegetables, and even moderate wine.

The Portfolio Diet, on the other hand, is very prescriptive. You must hit specific amounts of soy protein, fiber, and sterols daily. Think of the Mediterranean Diet as the entire restaurant, while the Portfolio Diet is just one corner of the menu—focused squarely on cholesterol.

What About Statins?Statins are still the gold standard. Modern statins like atorvastatin or rosuvastatin lower LDL cholesterol by 30 to 50 percent, far more than diet alone. More importantly, they reduce heart attacks and strokes by 25 to 40 percent.

And there’s more. When you combine a statin with Zetia (ezetimibe), which blocks cholesterol absorption in the gut, you can see another 20 percent reduction in LDL. That’s essentially the pharmaceutical version of the Portfolio Diet. Together, statins plus Zetia can lower LDL cholesterol by 65 to 70 percent.

The Bottom LineThe Portfolio Diet lowers cholesterol. The Mediterranean Diet improves heart health. Both are excellent for prevention and long-term wellness. But when your cholesterol is high or your risk is significant, medicine is usually necessary.

The best approach is not “food or medicine.” It’s food and medicine. Eat Mediterranean, fold in Portfolio Diet elements, and—if your doctor recommends it—add a statin or Zetia.

Because food lays the foundation. Medicine builds the house. And together, they keep the roof from caving in.

REFS

1. Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials.

Chiavaroli L, Nishi SK, Khan TA, et al.

Progress in Cardiovascular Diseases. 2018 May - Jun;61(1):43-53. doi:10.1016/j.pcad.2018.05.004.

1. Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia: A Randomized Controlled Trial.

Jenkins DJ, Jones PJ, Lamarche B, et al.

JAMA. 2011;306(8):831-9. doi:10.1001/jama.2011.1202.

1. Relationship Between a Plant-Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study.

Glenn AJ, Lo K, Jenkins DJA, et al.Journal of the American Heart Association. 2021;10(16):e021515. doi:10.1161/JAHA.121.021515.

1. Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies.

Glenn AJ, Guasch-Ferré M, Malik VS, et al.Circulation. 2023;148(22):1750-1763. doi:10.1161/CIRCULATIONAHA.123.065551.

1. The Portfolio Dietary Pattern and Risk of Cardiovascular Disease Mortality During 1988-2019 in US Adults: A Prospective Cohort Study.

Kavanagh ME, Zurbau A, Glenn AJ, et al.

BMC Medicine. 2025;23(1):287. doi:10.1186/s12916-025-04067-1.

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Milk: Life, Death, and the ParadoxMilk has always been central to survival. When mothers died in childbirth—and this happened often before modern medicine—infants survived only if they had access to another nursing mother or wet nurse. When that wasn’t possible, families sometimes turned to the milk of other mammals.

That discovery helped keep our species alive. However, milk’s role in human survival carried a hidden danger. While milk nourished infants, it also became a deadly carrier of disease.

When Raw Milk Killed ThousandsDuring the 1800s, raw milk was anything but safe. In New York City, dairies kept cows next to distilleries, feeding them whiskey mash. The resulting milk was bluish and watery. To disguise it, producers added chalk and plaster. Parents unknowingly gave this milk to children. According to estimates, 8,000 infants die a year from contaminated milk in New York alone.

Milk also spreads tuberculosis, diphtheria, scarlet fever, and typhoid. A simple glass of raw milk could kill.

Louis Pasteur and the Germ TheoryThe turning point came with Louis Pasteur, a French chemist who proved microbes spoiled wine and beer. He developed the process of pasteurization: heating a liquid enough to kill pathogens without ruining flavor.

His discovery revolutionized public health. Pasteur’s germ theory of disease proved that invisible microbes caused illness. Applied to milk, this meant heating could save lives. Pasteur’s work inspired sterilization in surgery, the discovery of TB bacteria, and eventually vaccines.

The American Fight for Safe MilkIn the U.S., pediatrician Abraham Jacobi urged families to boil milk by the 1870s. Philanthropist Nathan Straus built pasteurized milk stations across New York. Mortality rates for children who drank Straus’s milk dropped by nearly 50%.

Pasteurization was not flashy, but transformative. Alongside clean water and vaccines, it became one of the greatest advances in human health.

Tragedy in Residential SchoolsIndigenous children in Canada’s residential schools were forced to drink raw milk from cows raised on pasture. The cows looked healthy, but many carried bovine tuberculosis. Children sickened and died. In some schools, mortality reached 30–60% in just five years. Hundreds of unmarked graves discovered in recent decades reveal the human toll.

Even the cleanest farm or happiest cow can carry pathogens. You cannot see tuberculosis or E. coli in a glass of milk. Pasteurization is the only safeguard.

Raw Milk in the Modern EraDespite history, raw milk has returned as a “wellness” trend. Politicians like RFK Jr. have promoted it, even doing raw milk “shots” with influencer Paul Saladino in the White House.

But nostalgia doesn’t erase microbiology. Just weeks later, Florida saw 21 people sickened—including six children—by E. coli and Campylobacter from raw milk. Seven were hospitalized. Two developed life-threatening complications.

If someone claims to support children, selling raw milk undermines that promise.

Myths vs. FactsMyth: Raw milk has more nutrients.

Fact: Pasteurization causes <10% vitamin loss. Proteins, calcium, and fats remain intact.

Myth: Raw milk prevents asthma.

Fact: Studies show lower allergy rates in farm kids, but due to the farm environment, not the milk.

Myth: A clean farm means safe milk.

Fact: Even pristine dairies can harbor invisible pathogens like TB, Salmonella, or Listeria.

Myth: Pasteurization “ruins” milk.

Fact: Pasteurized milk is nutritionally the same, only safer.

Beyond Milk: Cheese and JuicePasteurization doesn’t stop with milk. Unpasteurized cheeses can carry Listeria, posing risks especially for pregnant women. Apple cider was once a source of E. coli outbreaks. After the FDA required pasteurization in the 1990s, those outbreaks plummeted.

Heat treatment is one of the most powerful—and overlooked—public health tools.

The Numbers That Changed EverythingIn 1900, infant mortality in Montreal was 27%. New York saw similar rates. Today, it’s less than 1%. That dramatic drop came from sanitation, vaccines, and pasteurization—not from supplements or nostalgic diets.

So when someone says, “My grandfather drank raw milk his whole life and lived to 90,” the answer is simple. Visit the family graveyard. See how many of his siblings never made it out of childhood. That’s survival bias. Influencers profit from it. And in Saladino’s case, you wonder if he slept through microbiology class in the medical school where I once taught.

The TakeawayMilk is life-giving, but unpasteurized milk has been deadly. Pasteur’s germ theory, Jacobi’s advocacy, Straus’s milk stations, and modern safety laws turned milk into a food we can trust.

Pasteurization doesn’t diminish milk. It preserves life.

References* CDC – Raw Milk Outbreaks * CIDRAP – Florida Outbreak, 2024 * ScienceDirect – Pasteurization & Infant Mortality * Time Magazine – Raw Milk Safety * Our World in Data – Child Mortality

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Protein Powders: What’s Real, What’s Hype, and Why It MattersProtein powders are everywhere. Walk into a gym, scroll through social media, or visit a health food store, and you’ll see tubs of whey, egg, pea, and soy protein. Add buzzwords like “isolate,” “hydrolysate,” and “grass-fed,” and suddenly these powders sound like liquid gold. But how much of this is science—and how much is hype?

From Surgeons to ShakersSurgeons were among the first to use modular proteins. In the ICU, when patients couldn’t eat, we relied on early protein formulas. These weren’t the big plastic tubs you see at Costco. They were custom-made, extremely expensive, and delivered directly into the gut through a feeding tube. Proteins like albumin cost thousands of dollars and were carefully monitored.

Over time, science moved forward. Modern protein powders have become more affordable and accessible. What once cost hospitals a fortune is now sold in shiny containers at gyms and supplement shops. That’s progress—although it also opened the door for plenty of marketing nonsense.

The Egg Protein CrazeThe very first protein powders sold to the public in the 1950s were made from eggs. Hollywood stars promoted them as the secret to beauty and muscle. Soon, the “beautiful people” diet drifted into gyms, where bodybuilders grabbed onto the promise of sculpted muscles. Eventually, protein shakes became a middle-America trend.

Today, gyms often make more profit selling supplements than memberships or training. That’s not nutrition—it’s salesmanship.

Curds, Whey, and the Rise of Dairy ProteinRemember the nursery rhyme about “curds and whey”? That wasn’t just poetry. Cheese making separates milk into two parts: the solid curds and the liquid whey. For centuries, whey was a waste product. Farmers dumped it or fed it to pigs. Then researchers discovered that whey contained high-quality protein, packed with amino acids.

Now, whey protein is the biggest player in the supplement industry. Isolates and hydrolysates are simply forms of whey with more processing. They’re not magic—they’re filtered versions of what used to be discarded.

Beyond Cows: Other Sources of ProteinCows aren’t the only animals providing milk protein. Goats produce protein powders, too, often marketed as “easier to digest.” Then there’s pea protein, soy protein, and rice protein, sold to vegans and those with dairy allergies. These plant-based versions can be useful, but they aren’t inherently superior.

Branched-chain amino acids (BCAAs) are another popular product. They sound impressive, but in reality, if you’re eating enough protein in your diet, you already have plenty of BCAAs. Extra scoops don’t turn into extra muscle.

Why Surgeons Still Prescribe ThemHere’s the irony. While influencers push powders as miracle muscle builders, surgeons actually prescribe them for medical reasons. After weight-loss surgery, patients can’t eat large amounts of food, so modular proteins help meet nutritional needs. In ICU patients with short gut syndrome or severe illness, protein powders save lives.

Doctors used them first—long before gyms turned them into cash cows. The difference? We used them based on data, not marketing hype.

The Bottom LineProtein powders are tools, not miracles. They’re convenient, portable, and sometimes necessary. But they’re not a shortcut to health. If you eat enough protein from whole foods, you probably don’t need that expensive tub with the shiny label.

The supplement industry thrives on hype. Science thrives on evidence. And if history has shown us anything, it’s that evidence always wins—eventually.

References1. Boirie Y, Dangin M, Gachon P, Vasson M-P, Maubois J-L, Beaufrère B. Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Natl Acad Sci USA. 1997;94(26):14930–14935. 2. Phillips SM, van Loon LJC. Dietary protein for athletes: From requirements to optimum adaptation. J Sports Sci. 2011;29(S1):S29–S38. 3. Hoffman JR, Falvo MJ. Protein – which is best? J Sports Sci Med. 2004;3(3):118–130. 4. Wolfe RR. Branched-chain amino acids and muscle protein synthesis in humans: myth or reality? J Int Soc Sports Nutr. 2017;14:30. 5. Klek S. Modular enteral nutrition in critically ill patients. Nutrients. 2011;3(2):183–199.

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Make America Healthy Again? Hyman’s Half-Truths ExposedMark Hyman loves a soundbite. One of his favorites is:

“If doctors were trained in nutrition, we could prevent 90% of heart disease and type 2 diabetes.”

It sounds inspiring. Unfortunately, it isn’t true.

Nutrition Is Powerful — But It’s Not MagicI’m certified in culinary medicine, and I live the Mediterranean diet. Good nutrition matters. It lowers risk. It supports treatment. However, it cannot replace medicine for people with established disease.

The DASH trial (Sacks et al., NEJM 2001) proved that eating more fruits and vegetables while cutting sodium lowers blood pressure by the same amount as one blood pressure pill. That’s great news for prevention. But for those with heart disease, diabetes, or kidney problems, nutrition alone can’t cure the condition.

Before the year 1800, even if you survived childhood, your life expectancy was still in your 30s or 40s (Roser et al., Our World in Data). People then ate “organically,” free from dyes and microplastics. They also died young. Modern life expectancy came from clean water, vaccines, and medicine, not kale.

Samoa and Tahiti: Diet Didn’t Save ThemSamoa in 2019 had a diet Instagram influencers dream about — fresh fish, fruit, and root vegetables. Then measles hit.

Two infants had died in 2017 because nurses mixed the MMR vaccine incorrectly. The government suspended vaccinations for nearly a year, and coverage dropped to about 31%. Into that trust gap stepped anti-vaccine activists, including RFK Jr., spreading misinformation.

By late 2019, Samoa had over 5,700 cases and 83 deaths — most in children under five — in a population of just 200,000. Schools closed. Public gatherings stopped. Unvaccinated homes had to hang red flags so mobile teams could find them. Only when vaccination resumed did the outbreak end (WHO, 2019).

Tahiti’s story was similar. Beautiful diet. Fresh food. Yet measles still spread. The only thing that stopped it was vaccination, not nutrition.

What Hyman Really Sells Mark Hyman is trained in family medicine. He co-directed Canyon Ranch’s health program, then founded the Cleveland Clinic’s Center for Functional Medicine — a role he no longer holds.

His version of “functional medicine” isn’t recognized by the American Board of Medical Specialties. Chiropractors, dentists, and nurses can buy a certification and call themselves “doctor.” In California, only MDs and DOs can legally use the title “physician,” but in many states, the public gets fooled.

Hyman now uses his Make America Healthy Again (MAHA) campaign to give his brand of pseudoscience legitimacy. My Crestor costs $2.36 for three months, and my doctor gets nothing for prescribing it. His supplements? Around $100 for the same time, straight into his pocket.

Real Data Beats HypeThe Lyon Diet Heart Study (de Lorgeril et al., Circulation 1999) found that a Mediterranean diet reduced the risk of another heart attack by 72% in people who already had heart disease. But those patients were still taking statins, aspirin, and blood pressure meds. Diet complemented medicine; it didn’t replace it.

The JUPITER trial (Ridker et al., NEJM 2008) showed that statins cut cardiovascular events by 44% in people with normal LDL but high CRP. No supplement stack or smoothie matches that.

Why This Is PersonalMy dad had a heart attack at 55. Doctors told him not to expect another 20 years.

Five years later, statins came out. He took them faithfully, along with his blood pressure medicine. He lived to 98 — independent, writing a memoir, and outliving his doctors. He ate reasonably well, but he always had a candy bowl nearby and drank plenty of coffee. Science kept him alive, not “perfect” eating.

The Bottom LineNutrition is essential. Medicine is essential. The best results come when we combine them — evidence-based and free from supplement hype.

When you hear Hyman claim that doctors just need nutrition training to prevent 90% of disease, remember Samoa. Remember Tahiti. And remember my dad.

References

1. Sacks FM et al. Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. N Engl J Med. 2001;344:3–10.
2. de Lorgeril M et al. Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction. Circulation. 1999;99(6):779–785.
3. Ridker PM et al. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein. N Engl J Med. 2008;359:2195–2207.
4. Roser M et al. Life Expectancy. Our World in Data. Accessed August 2025.
5. World Health Organization. WHO and UNICEF join Samoa vaccination campaign. December 6, 2019.

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Carter’s Little Liver Pills: The Original Detox Scam and Its Modern CousinsFor more than a century, people have searched for quick fixes to “cleanse” the liver. From old‑time laxatives to today’s wellness shots and hangover probiotics, the promise is the same: remove toxins, feel better, live longer. However, as science catches up with marketing claims, we learn a hard truth — most of these cleanses never did what they promised.

The Sluggish Liver MythBack in the 1800s, doctors blamed nearly every health problem on a “sluggish liver.” Headaches, fatigue, irritability — even bad moods — were supposedly signs that the liver wasn’t “lively” enough.

Enter Carter’s Little Liver Pills. These small tablets promised to fix “biliousness,” an old term for feeling miserable and out of sorts. The secret ingredient? Cascara sagrada, a plant‑based laxative. In short, the pills made people poop, and that temporary relief was sold as detoxification.

Marketing Genius in a Pill BottleCarter’s advertising strategy worked brilliantly. Their message was simple: if you feel bad, it’s your liver’s fault — and their pills were the cure. The campaign was so successful that the phrase “more than Carter’s got pills” became American slang for “an absurd amount of something.”

Sadly, that formula still works today. Many modern health products use the same playbook: invent a vague condition, blame it for everything, then sell the cure.

Modern Detox Myths: Dose, ZBiotics, and the Olive Oil FlushFast‑forward to today and you’ll see similar claims everywhere. Dose for Your Liver, a wellness shot with milk thistle and turmeric, promises to “cleanse” the liver and support “500 daily functions.” While it cites studies showing reduced liver enzymes, those studies involved people who already had liver problems — not the average healthy person grabbing a detox shot after brunch.

ZBiotics Pre‑Alcohol markets itself as a probiotic that breaks down acetaldehyde, a compound linked to hangovers. The truth is more complicated. Your liver clears almost all acetaldehyde on its own, while your gut bacteria handle less than five percent. Most hangover symptoms actually come from alcohol itself, dehydration, and inflammation — not a single molecule.

Perhaps the most dramatic claim is the “liver flush” made from olive oil and lemon juice. Supporters insist that the green balls they pass in the toilet are gallstones. However, chemical tests show these “stones” are actually soap‑like clumps created when oil mixes with digestive fluids. Real gallstones are hard and form in the gallbladder; they do not dissolve overnight or pass easily. Even people without gallbladders “flush stones,” which proves the myth.

What Actually Supports Liver HealthThe good news? You don’t need a cleanse. Your liver already detoxes naturally — 24 hours a day. Instead of chasing fads, focus on habits proven to protect it:

• Drink coffee (up to three cups daily): Linked to lower risk of fatty liver and cirrhosis.
• Eat polyphenol-rich foods like blueberries: These support liver health through antioxidants.
• Get fiber from beans, greens, and whole grains: Good for the gut‑liver connection.
• Exercise regularly: Even 150 minutes a week can reduce liver fat.
• Limit alcohol: No supplement erases binge drinking.
• Stay up to date on vaccines: Hepatitis A and B vaccines prevent major liver diseases.

The Fall of Carter’s Pills — and the LessonBy the 1950s, science caught up to marketing. Constipation wasn’t liver failure, and the liver didn’t need “lively” pills. In 1959, the Federal Trade Commission forced Carter’s to drop the word “liver” from its name. Without that claim, sales collapsed.

Despite Carter’s disappearance, the marketing tactics remain. Whether it’s a probiotic, a turmeric shot, or a trendy flush, the pitch is the same: you’re toxic, we have the cure. The reality? The cure was never needed.

TakeawayHealth trends may change, but the hustle stays the same. Instead of falling for the next detox craze, choose evidence‑based habits — and remember that if something promises instant cleansing, it’s probably selling you something you don’t need.

References* Harvard T.H. Chan School of Public Health – Coffee and Liver Health (click here) * National Institute of Diabetes and Digestive and Kidney Diseases – Gallstones * American Liver Foundation – Myths and Facts About Liver Health * National Library of Medicine – Milk Thistle in Liver Disease * Federal Trade Commission Archives – Carter’s Little Liver Pills Case (1959)

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Goat Glands, Chloroform, and the City That Saved Surgery(How Edinburgh dragged American medicine out of the Wild West)

When we think about modern surgery, it’s easy to imagine it has always been clean, safe, and scientific. However, that could not be further from the truth. Surgery was more like a horror show just over 150 years ago. Patients faced unbearable pain, filthy instruments, and shocking guesswork.

Today, we’ll explore how the Scottish city of Edinburgh transformed surgery — and how America, for far too long, ignored the science in favor of quick fixes and fast profits. Along the way, we’ll meet heroes like James Young Simpson and Joseph Lister, as well as villains like John R. Brinkley and Willard Bliss. We’ll also see why modern “wellness influencers” aren’t so different from the quacks of the past.

Edinburgh: The Peak of Medical ScienceIn the 18th and 19th centuries, Edinburgh was the world’s medical capital. Students from across Europe and the American colonies traveled there to study anatomy, surgery, and the latest medical theories.

Because of this, early American physicians like Benjamin Rush and John Morgan brought Edinburgh’s teachings home, helping to found the first U.S. medical school at the University of Pennsylvania. Harvard soon followed with a similar model.

However, while a few elite schools adopted Scottish standards, most of America remained a medical free-for-all. Outside major cities, anyone could call themselves a doctor, and “miracle cures” were everywhere. This was the true “Wild West” of medicine — long before the cowboy era we usually imagine.

James Young Simpson: Ending Pain in SurgeryNext, let’s fast-forward to the mid-1800s. At this time, one of the greatest problems in surgery was pain. Without anesthesia, operations had to be done quickly, often in less than a minute, and the suffering was unbearable.

That changed in 1846, when ether anesthesia was first used in Boston. News of ether’s success quickly crossed the Atlantic. By the time the next ship arrived in Edinburgh, surgeons were already experimenting with it — and looking for something even better.

Enter James Young Simpson, an obstetrician and, yes, one of my relatives. In 1847, Simpson discovered that chloroform worked better than ether and was easier to use. His famous breakthrough happened during a dinner party experiment, where he and his friends inhaled chloroform, passed out, and woke up amazed. Surgery would never be the same again.

Joseph Lister: Stopping Deadly InfectionsSolving pain was one thing, but there was another huge problem: infection. After surgery, most patients didn’t die from the knife — they died from the germs they couldn’t see.

This is where Joseph Lister changed history. Influenced by Louis Pasteur’s germ theory, Lister realized that microorganisms caused infection. He began using carbolic acid to clean wounds and sterilize instruments. While some of his colleagues mocked him, the results spoke for themselves: surgical death rates plummeted.

Lister’s work eventually led to asepsis, the sterile environments we now take for granted in operating rooms.

America Ignored the Science — and a President DiedUnfortunately, the United States was slow to adopt these life-saving ideas. A tragic example is the death of President James Garfield in 1881. After being shot, Garfield’s wound was not fatal. He should have survived.

However, his doctor, Willard Bliss, refused to believe in germ theory or antiseptic techniques. Bliss and several others repeatedly probed Garfield’s wound with unwashed hands and unsterilized instruments. For seventy-nine days, the president suffered — not from the bullet, but from a massive infection. Bliss then billed the government $25,000 for his “services,” which would be roughly $750,000 today.

The Wild West of Quackery: From Goat Glands to InstagramEven after American medicine improved — especially after the 1910 Flexner Report, which shut down low-quality medical schools — quackery never fully disappeared. It simply evolved.

In the 1920s and ’30s, John R. Brinkley became famous for implanting goat testicles into men as a cure for impotence. He used radio to market his “miracle” to millions, proving that loud marketing could still beat good science.

Sound familiar? Today’s hucksters may not use goat glands, but they use similar tactics. Some sell expensive stool tests and invent conditions like “leaky gut” to push costly supplements. Others, like the carnivore diet influencers, ignore decades of data on the Mediterranean diet and claim you should eat nothing but steak. They dismiss the science on cholesterol, flaunt their abs, offer life coaching, and sell overpriced “special salt” — even though salt is salt, and plain Pedialyte has been used safely in millions of rehydrations.

Why Hucksters Don’t Advance SciencePeople sometimes wonder: If these charismatic figures turned their energy toward research, could they make real progress? The answer is no.

First, most lack the deep scientific training needed to do real work. Second, those who do have training have deliberately left the hard road of science — the years of study, failed experiments, and peer review — for the fast money of “miracle cures.” Their goal isn’t discovery; it’s sales.

The Lesson from EdinburghWalking through Edinburgh’s Surgeons’ Hall Museum, you see both sides of medical history: the breakthroughs and the blunders, the heroes and the hucksters. It reminds us that progress is fragile and must be defended against those who prefer profit over evidence.

Edinburgh gave the world anesthesia and antisepsis. It gave us the model of evidence-based medicine. And while America eventually followed, the fight against quackery continues — from goat glands to $70 detox supplements.

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A Hole Lot of Nonsense: Surgery Before SciencePeople once drilled holes in skulls to cure madnessAnd in some cases… it actually helped. Well, if you consider madness what happens if you get a stroke from too much pressure in your brain from trauma

That’s the wild part.

While visiting the Surgeons’ Hall Museum in Edinburgh, I saw ancient skulls with round holes cut into them—evidence of trepanation, one of the world’s oldest surgeries. Even more shocking? Many of those patients survived. Some healed so well that they lived for years.

But let’s back up.

What is trepanation?It’s the act of scraping or drilling a hole in your skull. Ancient people did it across continents—from South America to Europe.

We don’t know exactly why. Some may have used it to relieve pressure after a head injury. Others might have believed it released evil spirits.

Here’s the thing: it sometimes worked.

Today, we know that pressure in the brain—from a bleed, swelling, or injury—can be deadly. Modern medicine sometimes calls for drilling a hole or even removing part of the skull to save a patient’s life.

The ancients may have stumbled onto something real. Or they may have been guessing.

That’s the danger when we mix luck with ritual. If one patient improves, people assume the treatment works—even if there’s no science behind it.

Dr. Cotton and the colon cureJump ahead to the 1900s.

Dr. Henry Cotton believed mental illness came from hidden infections in the body. So what did he do? He had his surgeons remove teeth, tonsils, stomachs, and colons—even when patients showed no symptoms.

Many died. Most didn’t improve.

Still, Cotton was praised in journals and trusted by major institutions. His confidence overshadowed the lack of results.

It’s a painful reminder that being sure of yourself doesn’t make you right. Sounds like modern-day influencers - confidence beyond erudition.

Today’s brain hacks: same pattern, better packagingRight now, people are terrified of dementia. That fear fuels a massive market for brain supplements. One of the biggest sellers? Lion’s Mane mushrooms.

They’re in powders, coffees, and pricey pills. Some lab research suggests benefits, but actual human studies? Weak at best.

Meanwhile, studies show that eating a Mediterranean or MIND-style diet can reduce your risk of dementia by up to 50%. But those diets don’t come in fancy bottles.

Instead of focusing on real food, we chase the next shiny pill.

And let’s talk about PRP…PRP stands for platelet-rich plasma. Some orthopedic surgeons spin down your blood, pull out platelets, and inject it back into sore joints. They claim it speeds healing.

The truth? There’s little evidence that PRP works for most uses. But it’s expensive. And because it sounds high-tech, people trust it.

The orthopedic surgeon gets the thousands of dollars for it because insurance won't cover it. They won't cover it because it isn't a researched treatment. But if your surgeon says here take this and you will recover faster - what to do?

I should know—I co-authored one of the first papers on PRP for diabetic wounds, where it actually showed benefit.

But that’s a far cry from injecting it into tennis elbows for cash.

We’ve upgraded the tools. Not always the thinking.

What history teaches usWhen I look around this museum, the lesson is clear:

We’ve always wanted to help. But good intentions without good science can hurt people.

Real medical progress comes from questioning our own assumptions. It comes from saying, “Let’s study this,” instead of, “Let’s just try it.” Whether it’s trepanning or turmeric, we need to ask:

Does this really work—or are we just hoping it does?

References: Barnes LL, Dhana K, Liu X, Carey VJ, Ventrelle J, Johnson K, Hollings CS, Bishop L, Laranjo N, Stubbs BJ, Reilly X, Agarwal P, Zhang S, Grodstein F, Tangney CC, Holland TM, Aggarwal NT, Arfanakis K, Morris MC, Sacks FM. Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. N Engl J Med. 2023 Aug 17;389(7):602-611. doi: 10.1056/NEJMoa2302368. Epub 2023 Jul 18. PMID: 37466280; PMCID: PMC10513737. (click here for reference) * Seitz, D. et al. (2022). “MIND Diet and Risk of Alzheimer’s Disease.” Nutritional Neuroscience. * Simpson, T. (1991). “Platelet-derived Growth Factor and Wound Healing.” Journal of Diabetic Complications*.

Want to avoid brain fads? Start with whole foods, good sleep, and honest science. The hole in your head should stay in your museum tour, not in your health plan.

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A Shocking Health Trend from the PastToday, you might see ads for detox teas, liver cleanses, and even hydrogen water. These products promise energy, better health, and a longer life.

But strange health trends are nothing new.

In the 1920s and 1930s, people paid good money to drink radioactive water. They believed it gave them energy, cured pain, and even helped them live longer. One brand, called Radithor, was sold as “perpetual sunshine in a bottle.”

Yes—people drank water mixed with radium, the same element now used in cancer treatments and nuclear reactors.

Why Did People Think It Worked?At first, radium looked like a miracle. It glowed in the dark, and doctors were just beginning to understand radiation. Companies saw a chance to make money. So they started selling radium in toothpaste, face cream, chocolate, and, yes, bottled water.

One famous product, Radithor, was sold as a cure for everything from tiredness to “low manhood energy.”

People believed it worked. Why? Because it came from science. It looked exciting. And it was easy to believe a glowing bottle held glowing health.

Even doctors promoted it, just like some do with today’s wellness fads.

Read more on Radithor from the Oak Ridge Associated Universities

Meet the Tragic Case of Eben ByersOne man named Eben Byers became the face of this trend. He was rich, well-known, and loved Radithor. He drank it every day—three bottles a day for years.

For years, he said he felt great. But soon, the side effects started.

• His teeth fell out.
• Then his jaw crumbled.
• Finally, bones weakened and broke.

Eventually, his body became so radioactive that they had to bury him in a lead coffin. It took years for this to take effect. But during the years he was drinking his deadly potion, he claimed improved health and vitality.

This helped end Radithor, but the public didn’t learn the bigger lesson.

Fast Forward to TodayEven though we know better, we still fall for bad science with a shiny label.

Let’s look at a few modern examples:

• Gary Brekka sells hydrogen water as a health hack, even though there’s little proof it helps anyone.
• Döse Liver Cleanse is a product that doesn’t actually cleanse your liver.
• And of course, Goop keeps offering “natural” cures like jade eggs and bee-sting facials, with no solid research to back them up.

These trends all follow the Radithor formula:

1. Make a wild claim
2. Add buzzwords like “cleanse,” “cellular,” or “bioavailable”
3. Skip the actual science
4. Sell it fast before the truth catches up

What’s the Real Risk?Most modern products won’t melt your jaw. But they can waste your money, give false hope, or delay real care.

Worse, they can make people distrust doctors and trust influencers instead.

Just like Radithor, these products often look scientific, but they skip important steps—like peer review, clinical trials, and safety data.

If you need a liver cleanse, your body already has one.

It’s called your liver. And it works 24/7—no powdered beetroot or milk thistle needed.

What Should You Do Instead?Instead of chasing magic drinks or secret pills:

• Eat whole foods
• Move your body regularly
• Sleep well
• See real medical professionals
• Ask for evidence—not just stories

If something sounds too good to be true, it probably is. Especially if it comes from someone selling supplements, not science.

Final ThoughtWe like to believe we’re smarter than the past. But we still fall for the same trick, just with different packaging.

So next time you see a glowing promise in a bottle, ask yourself:

Is this progress… or just Radithor with better lighting?

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Who Was Dr. Salisbury?First, let’s meet the man behind the meat.

Dr. James Henry Salisbury was a doctor during the American Civil War. He worked hard to understand why so many soldiers got sick. He noticed that stomach problems like diarrhea and dysentery were everywhere in the army camps.

Because of this, he believed the problem came from food. But instead of looking at germs, he blamed vegetables.

That’s right—he thought vegetables caused disease. To children everywhere, he became a hero. To science? Not so much.

What Did He Believe?Dr. Salisbury believed that vegetables and starchy foods rotted in the gut. He said they caused inflammation and sickness. He thought the best way to stop disease was to eat meat—and only meat.

So, he created a special food: the Salisbury steak.

This steak wasn’t fancy. He ground up lean beef, shaped it into a patty, and told people to eat it three times a day. With it, they could drink only hot water or black coffee.

No fruit.

Absolutely no sugar.

No grains.

And definitely no vegetables.

Why Did It Seem to Work?At first, some people felt better on the Salisbury diet. But why?

Here’s the real reason: it wasn’t the meat. It was the boiling.

Back then, most water carried bacteria. That bacteria caused all kinds of sickness. When soldiers boiled coffee, they accidentally killed the germs in the water. When they ate fully cooked meat, they avoided raw, dirty food.

So yes, people improved. But not because vegetables were bad.

They got better because boiled water and cooked meat killed bacteria.

What Did He Get Wrong?Now, let’s talk about what he missed.

• ❌ He didn’t understand germs or bacteria
• ❌ He thought fiber was dangerous
• ❌ He blamed plants, even though they weren’t the problem
• ❌ He didn’t test his ideas—he just believed them

He meant well, but he built a health plan on the wrong cause.

Instead of fixing the real issue, he created a food myth that lasted for years.

Why Does This Still Matter?Even though Dr. Salisbury lived over 150 years ago, his ideas are back—on TikTok.

Some people today say meat is the only healthy food. They avoid fruits, grains, and vegetables. They blame plants for everything from bloating to brain fog.

Sound familiar?

They’re repeating Salisbury’s mistake. They’re trusting old beliefs instead of new science.

What Science Says NowLet’s be clear. Science today tells a different story.

• ✅ Vegetables help your gut, heart, and brain
• ✅ Fiber feeds healthy gut bacteria
• ✅ A variety of foods lowers your risk of disease
• ❌ Eating only meat can cause nutrient problems and long-term risks

Instead of eating like it’s 1863, you can follow a plan that supports your body and your taste buds.

The best example? The Mediterranean diet—with healthy fats, lean protein, vegetables, fruits, and yes… even a little red wine.

In SummaryDr. Salisbury had a strong idea—but he missed the mark.

He didn’t know about bacteria. He thought vegetables were the enemy. He gave us Salisbury steak, but also gave us a lasting food myth.

So next time someone says vegetables cause disease, just smile and say:

“We’ve been down that road. It was dusty, undercooked, and came with black coffee.”

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The Smoothie That Changed My Mornings (And the Appliances That Helped)Let’s talk about kitchen appliances.

Yes, those gadgets sitting on your counter—or hiding in a cabinet—can either make your life easier... or drive you nuts. Today, I want to share how two small appliances completely changed my mornings. And no, I’m not paid to say any of this.

It Started With the Air FryerFirst, let’s be honest: nothing has brought more people back into the kitchen than the air fryer. It’s fast, easy, and makes food crispy without all the oil. In fact, according to Consumer Reports, the air fryer has become one of the most popular kitchen tools in America in the last few years.¹

This got me thinking—what other simple appliances could actually make healthy habits easier?

My Complicated Coffee RoutineFor years, I had a fancy coffee routine. I ground my beans fresh. I did pour-overs. I used a timer and scale like I did chemistry. The coffee was great, but the process? Not so much.

Then one day, I tried Nespresso. Just pop in a capsule, push a button, and you get a strong, rich espresso with foam on top. It was so easy that I started enjoying my mornings again.

No, I’m not sponsored by Nespresso—I just like sharing what works.

The Smoothie ProblemNext, let’s talk about smoothies.

I have tons of smoothie recipes. I’ve written them, shared them, and even made videos about them. But honestly? I stopped making them for a long time.

Why? Because of one thing: my Vitamix blender.

Now, don’t get me wrong. It’s a powerful machine. It can crush anything. But it’s big. It’s loud. It has too many parts. Just getting it out of the cabinet felt like a workout. And cleaning it? Forget it.

So even though I wanted to make smoothies, I kept skipping them. It was just easier to grab a banana and move on with my day.

The Nutribullet FixThen everything changed.

I bought a Nutribullet.

It’s small, easy to use, and quick to clean. I keep it on the counter. It takes about 30 seconds to rinse after using. And because of that, I’ve started making smoothies again—almost every day.

Just like that, a healthy habit became simple.

And no—I’m not paid by Nutribullet either. But I believe in sharing the tools that actually help.

My Favorite Morning SmoothieHere’s the one I make the most right now. It gives you a little caffeine, some protein, and tastes like a treat.

☕️ Coffee Whey Protein SmoothieYou’ll need:

• 1 cup cold-brewed coffee (or cooled Nespresso)
• 1 scoop whey protein (vanilla or chocolate)
• ½ banana
• ½ cup almond milk or any milk
• 1 tbsp peanut butter or almond butter (optional)
• 1/2 cup of Greek Yogurt
• Dash of cinnamon or cocoa powder

Optional extras:

• 1–2 dates
• 1 tsp chia or flax seeds
• ¼ tsp vanilla extract

Directions:

Put everything in the blender. Blend until smooth. Pour and enjoy!

The Big IdeaSometimes, the hardest part of a healthy habit isn’t the food—it’s the tool. If your blender is too much work, you won’t use it. If your coffee takes 20 minutes to make, you’ll skip breakfast.

But with the right appliance? You remove the stress. And that makes the habit stick.

Final ThoughtsIf you’re trying to eat better, start by making your kitchen easier to use. Keep the tools you love on the counter. Ditch the ones that frustrate you.

And if you're changing your diet in a serious way? Talk to a registered dietitian and a board-certified doctor, not a chiropractor or some “wellness guru” who learned nutrition on YouTube.

You can find more of my recipes at terrysimpson.com. And if you want more food science and fewer fads, check out my newsletter on Substack at tsimpson.substack.com.

Until then, keep it simple, keep it smart, and keep the peanut butter chunky.

—

Reference:

¹ Consumer Reports – “Why Air Fryers Are Still Flying Off the Shelves” (2023)

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🥣 The Curious Case of Dr. Kellogg: Surgeon, Cereal, and a Whole Lot of EnemasWhen you think of Kellogg, you probably picture cereal—maybe a sweet bowl of Frosted Flakes or Corn Flakes. But the real story behind Kellogg is far weirder than breakfast. It starts with a doctor. A good one. A very strange one.

Meet Dr. John Harvey KelloggDr. John Harvey Kellogg wasn’t just any doctor. He was a skilled surgeon, and even Dr. Charles Mayo—the founder of the Mayo Clinic—called him one of the best abdominal surgeons he had ever seen.

But Kellogg didn’t become famous for his surgery skills. Instead, he became known for his obsession with health, diet, and—believe it or not—poop.

The Sanitarium and the Celebrity PatientsKellogg ran the famous Battle Creek Sanitarium in Michigan. This health resort attracted celebrities like Thomas Edison, Henry Ford, and even Amelia Earhart. People came there to “cleanse” their bodies with special diets, exercise, sunlight, and—yes—daily enemas.

He believed almost every illness started in the colon. His solution? Flush it out. Constantly. Sometimes, with yogurt. Sometimes, both ends. I wish I were kidding.

Kellogg’s War on PleasureDr. Kellogg didn’t just worry about digestion. He also believed that pleasure—especially sexual pleasure—was dangerous. In fact, he thought masturbation caused everything from bad digestion to insanity.

To fight back, he recommended boring, bland food. No spices. No excitement. Just plain meals that wouldn’t "stir the passions."

That’s how Corn Flakes were born. Kellogg invented them as a food so bland, they might help people forget about sex altogether.

Cereal Becomes a BusinessNow, here’s where things get interesting. Kellogg’s brother, W.K. Kellogg, thought those flakes had potential—but they needed flavor. So he added sugar and started selling them to the public.

Dr. Kellogg was furious. He believed sugar was poison. The two brothers fought in court. W.K. won. And that’s why your breakfast cereal today is sweet and not designed to stop anyone’s libido.

What Science Says TodayLet’s be clear: Dr. Kellogg got a lot of things wrong.

• You do not need daily enemas. Your colon cleans itself.
• Yogurt goes better in a bowl than through a tube.
• Masturbation doesn’t cause disease. It’s a normal, healthy part of being human.
• And your desire to eat or love has nothing to do with how spicy your dinner was.

While Kellogg’s focus on exercise and plant-based diets was ahead of his time, his fear of pleasure and obsession with “cleansing” caused more harm than good.

The Strange LegacyDr. Howard Markel, in his excellent book The Kelloggs: The Battling Brothers of Battle Creek, dives deep into their story. He shows how Dr. Kellogg's strict health beliefs turned into fads—and how his brother’s sweet-toothed success made cereal a worldwide business. Markel, Howard. The Kelloggs: The Battling Brothers of Battle Creek. Pantheon Books, 2017.

Kellogg's ideas were extreme, but they still echo today. Whenever someone tells you to "detox," do a cleanse, or eat bland food to fix your hormones—they might not realize they’re following a 19th-century surgeon who really hated fun.

Dr. Markel was a medical school classmate of mine, and his book is excellent.

Final ThoughtDr. John Harvey Kellogg was a brilliant surgeon. But being smart doesn’t mean being right. And it definitely doesn’t mean you should give yourself a yogurt enema.

So next time you reach for a box of cereal, remember: your breakfast has a backstory. And it’s weirder than you think.

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What Is Ozempic or Zepbound, Really?You’ve probably heard about Ozempic or Zepbound. Maybe from a friend, a celebrity, or a TikTok ad. These are powerful medicines used to help people lose weight and manage diabetes. But what do they actually do?

Ozempic is a GLP-1 receptor agonist—a type of drug that helps control hunger, improve blood sugar, and lower the risk of heart disease.

But here's the big surprise: the real power of these drugs isn’t in your stomach—it’s in your brain.

How It Works in the BrainGLP-1 medications like Ozempic work in two big ways:

1. They help you feel full.
2. They slow down how fast your stomach empties, so you stay full longer.
3. They quiet the “food noise” in your brain.
4. That’s the big one. These medicines reach areas in the brain like the hypothalamus and mesolimbic system (which includes parts like the nucleus accumbens and ventral tegmental area). These areas are responsible for cravings, rewards, and motivation to eat.

When GLP-1 hits these areas, it reduces dopamine, the chemical that makes you want things like cake or chips. It also increases serotonin, which helps with mood and feeling satisfied after eating.

This makes it easier to stop eating when you're full and harder to overeat just because food tastes good.

📚 Reference: Mechanisms of GLP-1 receptor agonist–induced weight loss. Am J Med. 2024.

What About “Natural GLP-1 Boosters”?You might see ads for supplements or foods that say they boost your “natural GLP-1.” Some are even called “natural Ozempic.”

Here’s the truth:

• Your body makes GLP-1 naturally.
• Yes, fiber-rich foods help make more of it.
• But no, it does not stay in your system very long—only a few minutes.

That means your natural GLP-1 never reaches your brain like Ozempic does.

Synthetic GLP-1 drugs like semaglutide (Ozempic) are made to last for days. They stick around long enough to enter your brain and turn down cravings.

So no—berberine, vinegar, or sea moss are not the same thing.

📚 Reference: GLP-1 in brain health and food reward. Front Neurosci. 2022.

Common Myths You Should IgnoreLet’s talk about a few common myths—and what science says instead:

• ❌ “It’s a cheat code.”
• ✅ It’s not cheating. It helps your brain stop screaming for food all the time.
• ❌ “You’ll lose all your muscle.”
• ✅ Not if you eat enough protein and move your body.
• ❌ “You’ll gain it all back.”
• ✅ Only if you stop all your healthy habits. GLP-1s are tools, not magic.
• ❌ “It’s just for weight loss.”
• ✅ These drugs also lower your risk of heart attacks, stroke, and even possibly dementia.

📚 Reference: Semaglutide and cardiovascular outcomes. NEJM. 2023.

Want to Supercharge Your Results? Go Mediterranean.People on GLP-1s who follow a Mediterranean-style diet lose more weight than those who don’t.

Here’s why:

• Supports your gut health.
• Boosts your own natural GLP-1.
• Helps the medication work better.

What’s in the Mediterranean diet?

• ✅ Vegetables, beans, nuts, and whole grains
• ✅ Olive oil instead of butter
• ✅ Fish and lean proteins
• ✅ Some fruit and red wine (in moderation)

And yes—less fast food and fewer ultra-processed snacks.

📚 Reference: Combining GLP-1s with dietary strategies. Nutrients. 2023.

One Final Thing: Obesity Is a DiseaseSome people still think obesity is about willpower. It’s not.

In 2013, the American Medical Association said obesity is a disease.

It’s caused by a mix of genetics, hormones, environment, and brain chemistry.

Telling someone to “just eat less” is like telling someone with asthma to “just breathe better.”

📚 Reference: Obesity as a chronic disease. Endocr Rev. 2021.

In SummaryGLP-1 medications like Ozempic are powerful tools—but they work best with the right support:

✅ Use them with a healthy Mediterranean-style diet

✅ Talk to your doctor and registered dietitian

✅ Don’t fall for “natural GLP-1” scams

✅ Understand: This is real medicine—not a trend

About the AuthorThis article was written by Dr. Terry Simpson, a board-certified physician, surgeon, and food science expert.

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Longevity Without the Grift: What Actually Helps You Age BetterEveryone wants to live longer. That’s why people are plunging into ice baths, sweating in infrared saunas, and rubbing beef tallow on their faces like it’s a miracle cream. Meanwhile, supplement companies make billions selling capsules that promise eternal youth.

But here’s the thing: we don’t need to chase immortality. We need to focus on healthspan—the number of years we stay active, sharp, and independent. Living longer doesn’t mean much if you can’t enjoy it.

Let’s break it down.

The Problem With the Modern Longevity IndustryFor centuries, people have searched for the secret to living forever. From ancient pharaohs to modern influencers, the idea hasn’t changed much. Today’s gurus don’t wear robes. They wear lab coats on YouTube. They sell methylated vitamins, resveratrol, and supplements with science-sounding names like NMN.

Some of these people—chiropractors, Instagram influencers, even some doctors like Mark Hyman—promise more than science can deliver. What they’re selling often looks more like modern snake oil than real medicine.

Here’s a good rule of thumb: if a product claims to reverse aging and comes with a monthly subscription, it probably doesn’t work.

What Actually Works: Boring, Science-Backed HabitsThankfully, there are simple steps you can take that do help.

• Sleep: Get 7–9 hours a night. This is when your brain clears out waste and resets.
• Exercise: Move your body. Walk, lift weights, and do balance work. It all adds up.
• Vaccinate: Shingles and COVID vaccines reduce your risk of dementia. Shingrix alone cuts it by 20%.
• Statins: The last 40 studies show that statins reduce dementia risk by up to 20%. PMID 34871380

Eat Like You Mean It: The Mediterranean DietOne of the best-studied diets in the world is the Mediterranean diet. It’s not trendy, but it’s powerful. One large study showed that it can increase longevity by up to 9% if you stick with it. Source

Here’s how it works:

• Red Meat: Limit to 4 ounces a day. More than that raises your risk for cancer, heart disease, and type 2 diabetes. After 3 ounces, your body stops absorbing more iron anyway.
• Olive Oil: Use it instead of butter. It’s packed with healthy fats and polyphenols like oleocanthal.
• Whole Grains & Legumes: Beans and grains reduce obesity, diabetes, heart disease, and cancer. They’re even higher in fiber than most fruits and veggies.
• Fruits & Vegetables: Eat a variety. Colorful foods mean more antioxidants and polyphenols.
• Wine: One glass. That’s 5 ounces. And yes, you still get a full Mediterranean Diet point if you don’t drink at all.

What Doesn’t Work (Even If It’s Trending)Let’s be honest. Some things are popular, but pointless—or even harmful.

• Drinking alcohol "for your health"
• Avoiding vaccines
• Ignoring blood pressure and cholesterol
• Trusting wellness influencers with no scientific background

Remember: no supplement undoes bad habits. And no guru can out-hack the Hayflick Limit. That’s the scientific cap on how many times your cells can divide.

The Real Way to Support Your CellsGurus love talking about NAD and mitochondria. And yes, NAD can help your cells work better—in a lab dish. But real-life results? Meh.

Instead, support your cells with:

• Movement
• Sleep
• A mostly plant-based diet
• Not eating around the clock

If NAD really worked, I’d give it all to my 15-year-old dog.

Final ThoughtsWe can’t live forever. But we can live better.

Skip the miracle pills. Stick to the basics: move, eat like a Mediterranean, treat your blood pressure, and get vaccinated. And while you're at it, maybe adopt a senior dog. They won't live forever, but they'll give you everything they have.

Dr. Terry Simpson

Board-Certified Surgeon & Longevity Myth Buster

Host of the FORK U Podcast

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Hi, I'm Dr. Terry Simpson, your chief medical explanationist. Welcome to another edition of FORK U—where we bust myths, make sense of the madness, and teach you a little about food and medicine.

Today, let's explore how our food choices impact the environment and our health. We'll discuss lab-grown meat, grass-fed beef, and sustainable seafood.

🍔 Lab-Grown Meat: The Future of Food?Imagine enjoying a burger that didn't require raising or slaughtering an animal. That's the idea behind lab-grown meat, also known as cultured meat. Scientists grow real animal cells in labs to create meat without the traditional farming process.The Spruce EatsVox

Why consider lab-grown meat?

• Environmental Benefits: It could reduce greenhouse gas emissions by up to 96% and use 99% less land compared to traditional meat production. California Management Review+1University of Colorado Boulder+1
• Animal Welfare: No animals are harmed in the process.
• Health Potential: Lab-grown meat can be produced without antibiotics, reducing the risk of antibiotic resistance. California Management Review+1Wikipedia+1

While it's not widely available yet, lab-grown meat is a promising step toward sustainable eating.

🐄 Grass-Fed Beef: Is It Worth It?Grass-fed beef comes from cows that eat grass instead of grain. Some people choose it for potential health benefits and better animal welfare. Modern Farmer

Pros:

• More Omega-3s: Grass-fed beef has about three times more omega-3 fatty acids than grain-fed beef.
• Better Fat Ratio: It has a healthier balance of omega-6 to omega-3 fatty acids. Grass Roots Farmers' Cooperative+3Wikipedia+3Understanding Ag+3

Cons:

• Taste Varies: Not all grass-fed beef tastes the same. The flavor depends on the pasture quality, and some might find it less tender.Reddit+8Vox+8Grass Roots Farmers' Cooperative+8
• Cost: It's often more expensive than grain-fed beef.

While grass-fed beef has benefits, it's essential to consider taste preferences and budget.

🐟 Sustainable Seafood: Making Smart ChoicesSeafood is a great source of protein and omega-3 fatty acids. However, overfishing and unsustainable practices harm our oceans. Seafood Watch

Tips for Choosing Sustainable Seafood:

• Use Guides: The Seafood Watch provides up-to-date recommendations on sustainable seafood choices.Seafood Watch+4Seafood Watch+4Seafood Watch+4
• Farmed Salmon: While some criticize farmed salmon, it's often a sustainable option. Farmed salmon get their pink color from astaxanthin, a natural compound also found in wild salmon's diet. Modern Farmer
• Wild-Caught Options: Alaskan salmon is a delicious and sustainable choice, rich in omega-3s.

By making informed seafood choices, we can enjoy tasty meals while protecting marine life.

🛒 Final Thoughts: Small Changes, Big ImpactEating sustainably doesn't mean giving up your favorite foods. It's about making smarter choices:

• Try lab-grown meat when it becomes available. The Guardian+9Nature+9Vox+9
• Choose grass-fed beef if it fits your taste and budget.
• Opt for sustainable seafood using trusted guides. Seafood Watch+1Oceana+1

Every small step contributes to a healthier planet and a better future.

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The Fry Lie: How McDonald's Fries Got Worse—Not HealthierFor years, McDonald’s fries ruled the world. They were golden, crispy, salty, and delicious. People called them the best fries ever made. But then something changed. Around the 1990s, fans noticed the fries didn’t taste the same anymore.

What happened?

Let’s dive into the real story of why McDonald’s fries lost their magic—and how the changes didn’t make them healthier. In fact, for a while, they actually made them worse.

Once Upon a Time… in Beef TallowBefore 1990, McDonald’s cooked their fries in a special mix: 7% cottonseed oil and 93% beef tallow. That’s a fancy way of saying animal fat. This gave the fries a rich, savory flavor you couldn’t find anywhere else.

Why did they use beef fat? Because Ray Kroc, the man who built the McDonald’s empire, wanted fries to taste like the original McDonald brothers’ version. He nailed it.

But not everyone loved the fat.

Meet Phil Sokolof: The Fry CrusaderPhil Sokolof wasn’t a doctor. He wasn’t a scientist. But he was a wealthy businessman from Nebraska who had a heart attack. After that, he became a full-time food activist. Think of him like an early version of today’s online influencers—lots of passion, not much science.

Sokolof spent millions on full-page newspaper ads. His messages sounded scary:

“The Poisoning of America”

“McDonald’s: Your Hamburger Has Too Much Fat”

It worked. The public panicked. McDonald’s gave in.

In 1990, the company switched from beef fat to 100% vegetable oil.

Oops… Now with Trans FatsAt first, this seemed like a healthy change. But here’s what they didn’t tell you: the new vegetable oil was partially hydrogenated, meaning it was full of trans fats—the most dangerous kind of fat for your heart.

Trans fats increase your bad cholesterol (LDL) and lower your good cholesterol (HDL). They raise your risk of heart disease way more than saturated fat.

In trying to remove one bad fat, McDonald’s accidentally replaced it with something even worse. FDA, 2015.

They finally banned trans fats in the U.S. in 2018—but for almost 20 years, those “healthier” fries actually hurt people’s hearts more than the original version ever did.

Flavor Fail: Enter the Beef “Natural Flavor”Customers missed the old flavor. So what did McDonald’s do? They added “natural beef flavoring” to the vegetable oil. Yep, they removed the beef fat… and then added beef flavoring back in.

This confused people. Some vegetarians and Hindus believed the fries were plant-based. They weren’t, leading to lawsuits and even more public confusion.

In the United Kingdom, McDonald’s fries are really vegan. But in the United States, that natural beef flavor still makes them off-limits to some groups.

The Steak 'n Shake Beef Tallow ComebackNow fast-forward to today. Steak 'n Shake announced they were bringing back beef tallow for their fries, just like McDonald’s used to. This move caught the attention of RFK Jr., a well-known figure in politics and food activism.

He praised the change. But here’s the problem: RFK Jr. isn’t a doctor. He’s not a nutritionist. In fact, he’s never taken a college-level science course.

RFK Jr has a long history of pushing food myths and anti-science messages, just like early activists who helped ruin McDonald’s fries in the first place.

Let’s be clear: Beef tallow is not healthy. It’s packed with saturated fat and cholesterol, both of which increase the risk of heart disease. AHA, 2021.

Taste nostalgic—but nostalgia won’t protect your arteries.

So What’s the Lesson?The story of McDonald’s fries teaches us something important:

👉 Because something is “natural” or “old-fashioned” doesn’t mean it’s healthy.

👉 Just because someone is loud about food doesn’t mean they know science.

👉 And just because something tastes good doesn’t mean it’s good for you.

Before you trust anyone’s food advice, check their credentials. Are they a doctor? A registered dietitian? Or just a loud person with a lot of opinions?

McDonald’s didn’t make their fries healthier in the ‘90s. They made them worse because they listened to fear instead of facts.

Sources / References FDA. Final Determination Regarding Partially Hydrogenated Oils. 2015. FDA.gov * Chu M, Noh E, Lee KG. Analysis of oxidation products and toxic compounds in edible and blended oil during the deep-frying of french fries. Food Sci Biotechnol. 2024 Jan 17;33(10):2275-2287. doi: 10.1007/s10068-023-01494-9. PMID: 39145121; PMCID: PMC11319563. * Nestle, M. (2003). Food politics: how the food industry influences nutrition and health. University of California Press.*

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Superfood Snake Oil: Why Kale Won’t Save You (But Also Isn’t Killing You)Every week, there's a new superfood: sea moss, turmeric shots, raw milk, lion’s mane mushrooms, and the obligatory $18 acai bowl. These so-called miracle foods promise to heal your gut, detox your liver, reverse aging, and apparently, cure loneliness if you add enough coconut flakes.

But here’s the reality: “superfood” is a marketing term, not a scientific one.

Let’s dig into the hype, the risks, and what the research really says.

The Superfood Scam: Health Halo for SaleThe term “superfood” has no regulatory meaning. It’s not recognized by the FDA, USDA, or any legitimate scientific body. It originated in marketing campaigns and caught fire because it sells. All you need is one small, usually poorly designed study, a press release, and a social media influencer to make your food the next panacea.

Blueberries? Excellent.

Avocados? Delicious.

Are they miracle cures? No.

References:

• Hasler, C. M. (2002). Functional foods: Benefits, concerns and challenges—a position paper from the American Council on Science and Health. The Journal of Nutrition, 132(12), 3772–3781. https://doi.org/10.1093/jn/132.12.3772

Turmeric: Anti-Inflammatory or Hepatotoxic?Turmeric has become the golden child of the wellness world. Its active compound, curcumin, has been studied for its anti-inflammatory properties. But here’s the problem: it doesn’t absorb well, and most studies showing benefits are in vitro or animal studies, not humans.

Worse? Turmeric has been linked to liver injury.

Several case reports have now documented turmeric-related liver failure, especially when consumed in high doses or combined with alcohol or other supplements.

So no, a turmeric shot after tequila won’t detox your liver. It may just damage it further.

References:

• Luber RP et al. (2019). Acute Liver Injury With Turmeric Use. ACG Case Reports Journal, 6(5). https://doi.org/10.14309/crj.0000000000000113
• Nelson KM et al. (2017). The essential medicinal chemistry of curcumin. J Med Chem, 60(5), 1620–1637. https://doi.org/10.1021/acs.jmedchem.6b00975

Raw Milk: Microbial Roulette, Not a Wellness HackLet’s talk about raw milk—a rising star among TikTok wellness influencers. The claim? Pasteurization destroys enzymes and nutrients. The truth? Pasteurization destroys pathogens that can kill you.

Raw milk can harbor E. coli, Listeria, Campylobacter, and Salmonella—especially dangerous for kids, pregnant women, and the immunocompromised. The CDC has linked multiple outbreaks to raw milk in the last decade.

Pasteurization was a public health revolution. Rejecting it isn’t “natural”—it’s negligent.

References:

• Centers for Disease Control and Prevention (CDC). (2023). Raw Milk Questions and Answers. https://www.cdc.gov/foodsafety/rawmilk/raw-milk-questions-and-answers.html
• Mungai EA, et al. (2015). Increased outbreaks of nonpasteurized milk–associated foodborne illness. Emerging Infectious Diseases, 21(1), 119–122. https://doi.org/10.3201/eid2101.140447

Sea Moss, Super Iodine, and HypothyroidismSea moss is having a moment. Touted for thyroid health and “minerals,” it's become a staple in online supplement stores. Yes, it contains iodine—but that’s a double-edged sword.

Excess iodine intake can trigger thyroid dysfunction, including hypothyroidism and thyroiditis.

If you’re eating a balanced diet and using iodized salt, you’re probably not iodine-deficient, but you can become iodine-toxic with concentrated seaweed supplements.

Reference:

• Leung AM et al. (2012). Iodine nutrition in the United States: Strategies and trends. Endocrine Practice, 18(5), 566–573. https://doi.org/10.4158/EP12167.RA

Science Over Hype: What Actually WorksHere’s the unsexy truth:

• Eat mostly plants
• Choose whole over ultra-processed foods
• Use olive oil, not coconut oil
• Get your fiber from food, not powder
• Supplements are okay... but legumes are better
• Don’t fear carbs—fear quackery

The Mediterranean diet remains the most evidence-supported eating pattern. It reduces cardiovascular risk, supports gut health, and—surprise—it doesn’t require imported mushrooms or blue-green algae.

Reference:

• Sofi F et al. (2010). Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. The American Journal of Clinical Nutrition, 92(5), 1189–1196. https://doi.org/10.3945/ajcn.2010.29673

Pill vs. Pinto: What to Eat Instead of Swallowing HypeHere’s a quick reality check:

• Cholesterol lowering? → Skip red yeast rice. Eat beans.
• Magnesium? → Lentils, not gummies.
• Iron? → Cook with cast iron and eat leafy greens, not liver capsules.
• Fiber supplements? → Pinto beans do it better—and they taste good.

Supplements aren’t evil, but they shouldn’t replace actual food. Nutrients work best in their native habitat: inside whole, delicious, minimally processed foods.

Final Thoughts: No One Food Saves YouIf a food promises miracle cures, detox powers, or “anti-aging” effects, it’s marketing, not medicine.

Superfoods are sold as shortcuts. But health takes consistency.

Eat well, real, and boring sometimes. It works.

And next time someone hands you a turmeric liver cleanse shot after a night of margaritas? Just tell them: Fork U.

Dr. Terry Simpson

Surgeon. Culinary Medicine Nerd. Your Chief Medical Explanationist.

If you want more unfiltered food and medicine insights, subscribe to my podcast [FORK U] and follow me @DrTerrySimpson on Instagram and TikTok.

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Is Fruit Bad For You?Have you heard the latest nonsense from the diet grift industrial complex?

Apparently, fruit is now dangerous. Yes—fruit. The stuff that grows on trees and ends up in your kid’s lunchbox is being blamed for everything from diabetes to “metabolic collapse.”

The same influencers who once screamed about seed oils are now coming for your bananas, blueberries, and yes, even your smoothies.

It would be laughable if it weren’t so successful.

I’ve Seen Real Diets That Work—They Include FruitMy father had a massive heart attack at 55. The kind that forces lifestyle change.

But here’s the thing—he lived. He didn’t just live; he thrived.

He made it to 98, living independently until the very end.

And every single morning, he started his day with fruit: grapefruit, berries, and cantaloupe. He didn’t fear fructose. He just ate a balanced diet, and it worked.

The Anti-Fruit Grift: A Modern Wellness ScamOn social media, fruit is now the villain of the week. According to the keto-carnivore crowd, fruit will spike your insulin, make you fat, and destroy your health.

But right after shaming your banana, they usually offer a discount code for their liver pills or collagen powder.

Even Paul Saladino—the original shirtless prophet of beef liver supplements—is eating fruit now. Apparently, scurvy isn’t a great look.

Here’s the Truth: Fruit Is One of the Healthiest Things You Can EatLet’s stick to actual science. Fruit is one of the nine essential components of the Mediterranean Diet—a dietary pattern backed by decades of research, including landmark studies like PREDIMED and EPIC.

The Mediterranean Diet recommends 250 grams of fruit per day. People who follow it experience lower rates of:

• Cardiovascular disease
• Type 2 diabetes
• Cognitive decline

And guess what? Even people with diabetes do well when they eat whole fruit.

According to large observational studies, such as the BMJ study by Muraki et al. (2013) and Li et al. (2016) in The Journal of Nutrition, higher intake of whole fruits—especially berries, apples, and citrus—is associated with a reduced risk of type 2 diabetes, not an increased one.

Smoothies: Not Soda. Let’s Stop the Nonsense.Yes, when you blend fruit, it digests faster. That’s true. But a smoothie made from whole fruit, with the fiber intact, is nothing like drinking a sugary soda.

Want to improve it even more? Add protein, oats, chia, or yogurt. You’ve got a perfectly fine breakfast that’s far better than most boxed cereals.

So drink your smoothie. Enjoy it. You’re not ruining your health. You’re nourishing your body.

Cultures That Live Long... Eat FruitAll the world’s longest-lived populations eat fruit—daily.

• Okinawans enjoy papaya, guava, and sweet potatoes.
• Sardinians love figs, grapes, and citrus.
• Loma Linda Adventists consume berries and stone fruits, and live some of the longest lives in America.

None of these groups fear fruit. And spoiler alert: none of them are blending bacon into their coffee.

Beware of Magical Thinking (and Tallow)The real problem isn’t fruit—it’s the carnival of carnivore influencers selling meat-based miracles. These aren’t scientists. They’re entertainers with no credentials who demonize fruit while pushing “ancestral eating” and supplements derived from animals that... ate fruit.

If your diet says yes to beef tallow but no to blueberries, it’s time to reevaluate who you’re listening to.

Final Thoughts: Let’s Use Our Brains (and Eat the Peach)Fruit isn’t the enemy. It’s not a metabolic poison. It’s one of the most nutrient-rich foods you can eat—and it's associated with better health outcomes across every major population study.

So next time someone tells you to skip the apple, ask them to show you a peer-reviewed study—not a coupon code.

References:1. Guan J, Liu T, Yang K, Chen H. Dried fruit intake and lower risk of type 2 diabetes: a two-sample mendelian randomization study. Nutr Metab (Lond). 2024 Jul 10;21(1):46. doi: 10.1186/s12986-024-00813-z. PMID: 38987806; PMCID: PMC11234600. 2. Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. Rev Esp Cardiol (Engl Ed). 2024 Jul;77(7):574-582. English, Spanish. doi: 10.1016/j.rec.2024.01.006. Epub 2024 Feb 7. PMID: 38336153. - (click for reference)

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Weight Loss Surgery and Mediterranean Diet to GLP-1 and the Mediterranean DietFor years, I have guided my weight loss surgery patients toward the Mediterranean diet. Why? Because it’s not only delicious and sustainable, but it’s also backed by decades of science. Now, as GLP-1 medications like Ozempic and Zepbound transform how we approach obesity, the question arises again: what should people eat while on these powerful drugs? The answer, as it turns out, remains the same.

GLP-1 medications have undeniably revolutionized weight loss. These drugs, originally developed for diabetes, have rapidly gained fame for helping individuals shed significant amounts of weight. They work by reducing appetite, slowing stomach emptying, and altering hunger signals in the brain. Many patients simply cannot achieve sustained weight loss with diet alone, and for them, GLP-1 drugs are life-changing.

However, while these medications help people lose weight, they do not address everything. Weight loss is only part of the equation. Nutrition still matters deeply. Without nourishing your body properly, you risk missing out on crucial benefits such as inflammation reduction, cardiovascular protection, and cognitive preservation.

The Mediterranean DietThis is exactly where the Mediterranean diet shines. For decades, in fact, over 70 years, researchers have studied this dietary pattern. More than 13,000 scientific publications support its benefits. It’s not just about eating "like people in the Mediterranean." Rather, it’s about embracing a carefully studied set of foods, in specific amounts, shown to optimize health outcomes.

For example, the diet emphasizes:

• Around 9 ounces (250 grams) of fruits daily.
• Plenty of vegetables and whole grains.
• Healthy fats, especially from olive oil.
• Lean proteins, particularly fish and legumes.
• Limited red meat and alcohol.

Studies Showing the Diet Works For HealthThe science is clear. The PREDIMED study demonstrated significant reductions in cardiovascular events among followers of this diet. The EPIC studies have shown lower overall mortality, reduced cancer risk, and enhanced longevity. Furthermore, other research consistently links the Mediterranean diet to better insulin sensitivity, lower diabetes incidence, and reduced Alzheimer’s risk.

So, how does this all connect to GLP-1 medications? Simple. If you are using GLP-1 drugs, you are already taking control of your weight. Why stop there? Combining these medications with a Mediterranean diet maximizes your health benefits. While the drugs help you eat less and lose weight, the diet ensures that what you do eat is packed with nutrition, anti-inflammatory compounds, and essential nutrients.

Examples of the Diet in Real LifeIn practical terms, adopting this diet does not have to be complicated. For breakfast, try Greek yogurt topped with fresh berries, or overnight oats with fruit and nuts. For lunch, enjoy a salad filled with leafy greens, chickpeas, avocado, and stone fruits, drizzled with olive oil and lemon. For dinner, think grilled salmon or chicken, paired with quinoa or farro and plenty of colorful vegetables.

Ultimately, GLP-1 drugs and the Mediterranean diet are not competing solutions — they are complementary tools. Together, they support not just weight loss, but whole-body health.

If you are on a GLP-1 medication, remember this: losing weight is important, but being healthy while losing weight is essential. The Mediterranean diet remains the gold standard, helping you do both.

Don't forget your vitaminsIf you are on a GLP-1 medication, please take a daily multivitamin. There are plenty of them out there, but you need these daily. Especially the B-complex. I like this one from YouTheory.

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Welcome to the theater of absurdity.

While the federal government waves the flag of victory over removing petroleum-based food dyes from snacks, it is simultaneously gutting critical public health programs like food inspection, bird flu monitoring, injury prevention initiatives, and scientific research grants. The result? A dazzling case study in misplaced priorities.

Today, let's walk through what is actually happening — not the headline-friendly soundbites — and why Americans should be far more worried about E. coli in their milk than Red Dye #3 in their Skittles.

The Food Dye Fear Mongering: What's Actually True?

First, let's address the food dye hysteria head-on. Many news outlets, "wellness influencers," and natural health bloggers are breathlessly claiming that we are "eating petroleum" because some food dyes are synthesized from hydrocarbon molecules derived initially from crude oil.

Here’s the scientific truth: petroleum-derived hydrocarbons are nothing more than basic building blocks of carbon and hydrogen — the same stuff that makes up olive oil, avocado oil, and the omega-3 fatty acids you proudly add to your smoothies. [1]

Importantly, food dyes like Red 40 and Yellow 5 are purified and rigorously tested substances. They are chemically synthesized from hydrocarbons, not "extracted gasoline." Saying Red 40 is gasoline is like saying salt is explosive because it contains sodium. It's chemophobic nonsense.

Meanwhile, many of the same people yelling about food dyes are promoting supplements like methylene blue — another petroleum-derived chemical. Cognitive dissonance, much?

Reference:

1. ImmunoLogic. (2025). "No, You're Not Eating Gasoline." Retrieved from https://news.immunologic.org

Meanwhile, in the Real World: Food Safety Programs Are Being Gutted

Now, while we're distracted by the horror of neon cupcakes, something far more dangerous is happening. Funding for critical public health initiatives is being slashed:

• Food inspection programs are being downgraded and shifted from federal oversight to inconsistent state programs.
• Bird flu monitoring — crucial in an era of rising zoonotic diseases — is being slashed.
• Injury prevention programs — those that track traumatic brain injury, car crashes, drownings, and falls — are being dismantled.

According to reporting from Food Safety News, the Trump Administration's proposed budget would cut $128 million from the FDA’s food safety programs alone — programs that help prevent outbreaks of foodborne illness like the 2018 E. coli outbreak tied to romaine lettuce. [2]

Reference: 2. Food Safety News. (2025). "FDA food safety funding faces big cuts." Retrieved from https://www.foodsafetynews.com

Leadership Matters: Enter RFK Jr.

You might ask, "Who’s steering this ship into the iceberg?" None other than Robert F. Kennedy Jr., head of Health and Human Services.

There’s a small problem: RFK Jr. never took a single science course during his undergraduate education — at least, none we can find. Yet he is now in charge of overseeing agencies that depend on scientific literacy, from the CDC to the FDA.

No wonder policy is being dictated by what makes Instagram wellness bloggers like "Food Babe" happy. Forget investing in scientific infrastructure to actually prevent disease. Apparently, public health is now about making sure your lettuce won't "run away with your colon."

And the Hypocrisy Continues: Milk and Metabolic Disease

While politicians play "Whac-a-Mole" with food dyes, real nutritional science continues to quietly reveal important risks — like the health consequences of dietary fat.

A recent study in BMC Gastroenterology found that frequent consumption of full-fat milk is associated with a higher risk of metabolic dysfunction-associated fatty liver disease (MAFLD). [3]

Surprisingly, this association was especially strong among people with higher education levels. So yes, your $7 artisanal organic whole-milk latte might be sneaking you toward fatty liver — one creamy sip at a time.

Yet without adequate public health research funding, follow-up studies that could clarify mechanisms, confounders, and long-term risk could evaporate. The death of science isn't just about laboratories; it's about the slow, steady starvation of research that actually improves human health.

Reference: 3. BMC Gastroenterology. (2025). "Non-skimmed milk and MAFLD." Retrieved from https://bmcgastroenterology.biomedcentral.com

Transitional Moment: So, What Are We Prioritizing?

Instead of investing in:

• Safer food systems
• More robust disease tracking
• Cutting-edge nutritional science

We are prioritizing:

• Removing artificial colors that haven't been linked to deaths
• Slashing foodborne illness monitoring
• Hiring a non-scientist to oversee our nation's health apparatus

This is a classic case of "health theater"— grand, performative actions with little substance while real threats simmer under the surface.

Why Should You Care?

Because someday, when the next E. coli outbreak rips across 15 states, you might wish someone had prioritized pathogen monitoring instead of neon cupcakes.

Because someday, when another zoonotic virus jumps from animals to humans, you might wish someone had protected our bird flu surveillance systems.

Because someday, when your "healthy" full-fat latte quietly leads you toward metabolic disease, you might wish public health research had been better funded.

This isn’t hypothetical. It’s happening. Right now.

Closing Thoughts: Welcome to America 2025

In the final analysis, food dyes aren’t the enemy. Ignorance is.

Real public health work is boring. It involves spreadsheets, bacterial cultures, inspections, and endless grant applications. It doesn't make splashy headlines or Instagram-worthy memes.

But it saves lives. Quietly. Consistently. Effectively.

Today, we’re watching that entire system be sacrificed on the altar of viral outrage.

So the next time you eat a slightly less vibrant Froot Loop, take a moment to appreciate the irony: you might survive the Red Dye #3... but good luck surviving the E. coli smoothie no one inspected.

Stay skeptical. Stay curious. Fork responsibly.

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Welcome to FORK U. Fork University. Where we make sense of the madness, bust a few myths, and teach you a little about food and medicine.

I’m Dr. Terry Simpson—surgeon, scientist, and your chief medical explanationist. At FORK U, we’re not here to sell you supplements or tell you carbs are evil. We’re here to bring the science back to your plate—with a healthy side of sarcasm.

Food hasn’t been medicine for 2,000 years, and despite what the smoothie bowl crowd says, it still isn’t. But we do know that eating better can help you live better. And that matters.

Our MissionHere’s what we do:

✅ We bust nutrition myths that clog your feed and your arteries

✅ We decode the latest studies in easy, bite-sized episodes

✅ We bring the receipts—every episode is evidence-based and referenced at ForkU.com

HistoryWe’ve revisited the foundational studies of nutrition, like Ancel Keys’ Seven Countries Study—which didn’t just compare nations but followed real people in real villages for decades. We’ve explored the French Paradox. We’ve even told the story of the surgeon who discovered the first vitamin.

And we don’t just look back—we dive into current topics too: GLP-1s, gut health, ultra-processed foods, and yes—what happens when a shirtless influencer tries to sell you dehydrated buffalo hearts in the name of ancestral living. (Spoiler: you’re better off with lentils.)

If you’re tired of pseudoscience disguised as wellness, and you want real answers—served with wit, citations, and no BS—welcome to FORK U.

Let’s eat smarter. Let’s myth-bust louder. And let’s get cooking.

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Butter, LDL, and the Myth of Harmless PlaqueWhy High Cholesterol Isn’t Just a Number—and What the Latest Science Says About Oils, Fats, and Your Risk of Death

By Dr. Terry Simpson, MD – The Culinary Medicine Doc

We’ve all heard the story: butter’s back, LDL doesn’t matter, and as long as you’re low-carb, your heart is safe.

But what if I told you that the science—real, peer-reviewed science—tells a different story?

In this post, I’ll walk you through three powerful studies that dismantle the myth of “harmless” LDL and show why swapping butter for plant-based oils could literally save your life.

1. LDL and ApoB: The True Origins of Arterial PlaqueAtherosclerosis—the buildup of plaque inside arteries—often starts silently. But over time, it becomes the leading cause of heart attacks, strokes, and cardiovascular disease.

A key study from the Journal of the American College of Cardiology found that the primary trigger for plaque formation is not “existing plaque” as some influencers claim—but rather, LDL cholesterol and ApoB-containing lipoproteins that penetrate the arterial wall and kick off the inflammatory cascade that builds plaque [1].

Once inside, these particles don’t just hang out—they lead to plaque progression and destabilization, which is what causes heart attacks. No LDL, no plaque. It’s that simple.

1. High LDL, Worse Plaque—Even on KetoA 2025 study published in JACC: Advances examined people on carbohydrate-restricted diets—many of whom had very high LDL cholesterol levels [2].

While some hoped the data would vindicate high LDL in the context of keto, that’s not what happened. The study found that the higher the LDL, the worse the atherosclerotic plaque—regardless of dietary pattern.

Bottom line: High LDL is still atherogenic, even if you’re “metabolically healthy.” That six-pack doesn’t protect your arteries.

1. Butter Increases Mortality. Plant-Based Oils Reduce It.Let’s talk fats. Specifically: butter.

In a major pooled analysis of three large U.S. cohorts—the Nurses’ Health Studies I & II and the Health Professionals Follow-up Study—researchers found that butter consumption was associated with increased total, cancer, and cardiovascular mortality [3].

But here’s the good news: Replacing butter with plant-based oils—like olive, soybean, and canola oil—reduced the risk of death.

The substitution analysis showed that replacing just 15 grams of butter (about 3 small pats) with 15 grams of plant-based oil (about 1 tablespoon) led to statistically significant reductions in mortality risk.

These plant oils are rich in polyunsaturated and monounsaturated fats, which have been shown in trials to:

• Lower LDL cholesterol [4]
• Reduce inflammation [5]
• Improve lipid profiles [6]

• Decrease overall mortality [7]

• Butter, Cancer, and InflammationIt gets worse for butter.

The same study found a strong association between butter intake and cancer mortality, especially hormone-sensitive cancers like breast and prostate [3].

Why? Saturated fat—found in high levels in butter—can increase inflammation in fat tissue and alter hormone activity, both of which are risk factors for these cancers [8,9].

And no, this wasn’t confounded by white bread or pastries—the researchers adjusted for those too.

1. Are All Plant-Based Oils the Same? Not Exactly.Olive oil, canola oil, and soybean oil showed consistent protective effects. Corn and safflower oil? The data were weaker—possibly due to low use or degradation during cooking [3].

Some commercial corn oil is also more likely to be oxidized or partially hydrogenated, especially in older food systems [10]. So, while vegetable oils generally fare better than saturated animal fats, quality and cooking method still matter.

Final Thoughts: What the Data SayHigh LDL is not “just a number.” It’s a powerful driver of atherosclerosis and death.

Butter, despite its nostalgic appeal, increases risk of death. And plant-based oils? They reduce it—even in small amounts, even in real-world diets, and even over decades.

So next time someone tells you to throw out your olive oil for butter, ask them to show you the data. You now have three major studies that say otherwise.

TL;DR: LDL and ApoB cause plaque — not existing plaque. * Higher LDL = worse plaque, even on keto. * Butter increases mortality — especially from cancer and heart disease. * Plant-based oils reduce mortality, especially olive, canola, and soybean oil. * Replace 3 pats of butter with 1 tablespoon of plant oil* to lower your risk.

References1. Libby P et al. “Plaque Progression and Rupture in Atherosclerosis.” J Am Coll Cardiol. 2020. Link 2. Ebinger J et al. “Coronary Atherosclerosis in Individuals with Markedly Elevated LDL-C from Carbohydrate-Restricted Diets.” JACC: Advances. 2025. Link 3. Zhang S et al. “Butter and Plant-Based Oil Intake and Risk of Mortality.” JAMA Internal Medicine. 2024. Link 4. Mensink RP et al. “Effects of dietary fatty acids on serum lipids.” Am J Clin Nutr. 5. Mozaffarian D. “Omega-3 Fatty Acids and Cardiovascular Disease.” N Engl J Med. 6. Schwingshackl L et al. “PUFA and risk of CVD.” BMJ. 7. Hu FB et al. “Types of dietary fat and risk of CHD.” Am J Clin Nutr. 8. Rose DP. “Dietary fat and breast cancer.” Am J Clin Nutr. 9. Parikh M et al. “Saturated fat intake and inflammation.” J Nutr Biochem. 10. Choe E, Min DB. “Oxidative stability of oils and fats.” J Food Sci.

Want more unfiltered nutrition science?

Subscribe to FORK U — the podcast where we bust myths, decode headlines, and teach you how to use food as medicine. And follow me on TikTok & Instagram @drterrysimpson.

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The idea of Blue Zones—those rare places where people supposedly live longer, healthier lives—has become nutritional gospel. From best-selling books to Netflix specials, Blue Zones have been painted as longevity utopias we can mimic if we just eat more beans and nap more often.

But here’s the thing: Blue Zones aren’t science—they’re storytelling.

In this post, we take an unfiltered look at the Blue Zones concept, explore recent controversies, and compare it with something backed by actual peer-reviewed data: the Mediterranean Diet.

What Are Blue Zones?Coined by journalist Dan Buettner and popularized through National Geographic, Blue Zones refer to five regions with high numbers of centenarians:

• Okinawa, Japan
• Sardinia, Italy
• Nicoya, Costa Rica
• Ikaria, Greece
• Loma Linda, California

These regions reportedly share key habits: plant-forward diets, natural movement, strong social bonds, and low stress.

While these are certainly positive lifestyle features, the problem is how this information was collected. The Blue Zones model is observational, not scientific. It’s a patchwork of ethnographic notes, anecdotes, and assumptions—not randomized trials or controlled cohort studies.

The Blue Zones ControversyIn recent years, the Blue Zones concept has come under scrutiny:

• Okinawa’s longevity claims have declined in newer data; life expectancy has dropped, and obesity and chronic diseases are on the rise.
• Record inaccuracies in places like Okinawa and Ikaria have been found, making claims of centenarian density questionable.
• Survivorship bias skews the picture—we hear from those who lived long, not those who didn’t.
• Westernization has eroded the very habits that supposedly defined these zones.

In short: Blue Zones are more about a moment in time than a repeatable formula.

So What Does the Data Say?If you're looking for longevity strategies backed by evidence—not just folklore—consider the major cohort studies:

• Nurses’ Health Study
• Adventist Health Study
• EPIC-Oxford

These studies have followed hundreds of thousands of people for decades. The data consistently shows that people who live longer:

• Eat more whole, plant-based foods
• Limit ultra-processed foods and added sugars
• Exercise regularly
• Maintain strong social connections
• Get adequate sleep
• Manage stress
• Don’t overeat

No magic. Just measurable habits.

Mediterranean Diet: The Gold StandardUnlike Blue Zones, the Mediterranean Diet is a defined, evidence-based dietary pattern. And it’s been rigorously studied in over 13,000 peer-reviewed publications.

Core Features:* High intake of fruits, vegetables, legumes, whole grains * Olive oil as the main fat * Moderate fish and poultry * Minimal red meat and sugar * Moderate wine, usually with meals * Emphasis on community and shared meals

Evidence Highlights: PREDIMED Trial (2013): A randomized controlled trial of over 7,000 participants in Spain found that the Mediterranean Diet reduced the risk of cardiovascular events by 30% compared to a low-fat diet. * Reference: Estruch R, et al. N Engl J Med. 2013;368(14):1279-1290. * Link * Spanish Cohort Study (2022): A population-based study of 1.5 million adults found that greater adherence to the Mediterranean Diet was associated with increased longevity and lower all-cause mortality. * Reference: Zheng Y, et al. BMC Med. 2022;20:180.* * Link

Unlike Blue Zones, the Mediterranean Diet is replicable anywhere and supported by robust, controlled data.

The Bottom LineThe Blue Zones offer a romantic vision of a long life. But they’re built on observation—not rigor.

If you're serious about longevity, skip the storytelling and look to the science. The Mediterranean Diet, supported by clinical trials and massive population studies, is the most proven path to better health and a longer life.

Don’t chase myths. Follow the data.

🎧 Want More?Listen to the full Fork U episode:

“Blue Zones: Beautiful Myth or Measured Truth?”

Available on Spotify, Apple Podcasts, and wherever you get your audio science straight.

Follow me on TikTok and Instagram @drterrysimpson for more unfiltered medical myth-busting.

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Dietary Myths vs. Nutritional Science: Why the Mediterranean Diet Reigns SupremeAs an Athabascan physician and culinary medicine expert, I'm often amused by the dietary myths perpetuated online, particularly those championed by keto and carnivore diet enthusiasts. Today, let's debunk some of these myths—Inuit diets, Hong Kong longevity, Maasai heart health, and the so-called French paradox—and explain why decades of robust nutritional science firmly support the Mediterranean diet.

Myth 1: The Inuit DietLow-carb proponents love pointing to the traditional Inuit diet as evidence of the supposed superiority of carnivorous diets. Yes, Inuit diets are traditionally high in marine mammals like whales, seals, and fish, providing ample vitamin C from sources such as muktuk (whale skin and blubber) and seal liver. Yet, archaeological evidence clearly shows ancient Inuit mummies suffered from vascular disease, challenging the claim that their diet was protective (Fodor et al., 2014). Additionally, Inuit diets historically incorporated plant-based foods such as berries, seaweed, and tubers during summer months—a fact conveniently overlooked by keto advocates.

Myth 2: The Hong Kong Longevity ClaimAnother popular keto narrative incorrectly attributes Hong Kong's impressive longevity statistics to high meat consumption. But research shows elderly individuals in Hong Kong typically eat less meat and adhere closely to diets resembling the Mediterranean style, rich in vegetables, seafood, and whole grains (Woo et al., 2001). Again, context is key—and frequently missing from keto claims.

Myth 3: Maasai Immunity to Heart DiseaseThe Maasai, often cited as proof that diets rich in saturated fats don't cause heart disease, actually demonstrate the opposite. Recent studies confirm significant atherosclerosis and cardiovascular issues among Maasai populations, underscoring that even "warrior" genetics don't provide immunity from saturated fat-related diseases (Mann et al., 1972).

Myth 4: The French ParadoxAh, the French Paradox—the idea that French populations consume diets high in saturated fats yet experience low heart disease rates. The reality is simpler: the French eat plenty of vegetables, fruits, olive oil, seafood, and emphasize portion control and mindful eating. France was initially included in the famous Seven Countries Study but was ultimately excluded due to funding constraints—not dietary irregularities (Kromhout et al., 2017). It's sensible eating, not paradoxical magic.

Solid Science: The Mediterranean DietContrary to these dietary myths, extensive nutritional science consistently supports the Mediterranean diet. Two landmark studies illustrate this clearly:

• Seven Countries Study: Spanning 50 years and involving over 14,000 men, this research demonstrated clearly superior cardiovascular outcomes for individuals following Mediterranean-style diets rich in vegetables, fruits, whole grains, legumes, fish, and olive oil compared to higher-fat diets (Keys et al., 1986).
• EPIC Study: Following over half a million Europeans, the European Prospective Investigation into Cancer and Nutrition showed that diets emphasizing plant foods and limiting red and processed meats significantly reduce cancer risks (Boffetta et al., 2010).
• Lyon Heart Study: Participants with existing heart disease significantly reduced their risk of a second heart attack by adopting Mediterranean dietary patterns—highlighting the diet's profound protective benefits (de Lorgeril et al., 1999).

Final ThoughtsKeto and carnivore diets might make enticing promises, but the science tells a different story. With over 70 years of rigorous research and more than 13,000 peer-reviewed publications, the Mediterranean diet remains the gold standard for long-term health and disease prevention.

In an era where powerful obesity treatments like ZepBound emerge, it's even more crucial that we align medical innovations with proven nutritional strategies to ensure long-term health for newly fit bodies.

Enjoy your meals, stay curious, and always leave room for dessert (occasionally)!

References:

• Fodor, J.G., et al. "The Inuit paradox and heart disease." Can J Cardiol. 2014.
• Woo, J., et al. "Dietary habits of elderly Hong Kong Chinese." Age Ageing. 2001.
• Mann, G.V., et al. "Cardiovascular disease in the Maasai." Am J Epidemiol. 1972.
• Kromhout, D., et al. "The Seven Countries Study: Overview." Eur J Epidemiol. 2017.
• Keys, A., et al. "The diet and 15-year death rate in the Seven Countries Study." Am J Epidemiol. 1986.
• Boffetta, P., et al. "EPIC study: Diet and cancer." Am J Clin Nutr. 2010.
• de Lorgeril, M., et al. "Mediterranean diet and cardiovascular health." Circulation. 1999.

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The Bitter Truth: Why Bitterness Matters More Than You ThinkHave you ever taken a sip of black coffee and immediately regretted it? Or maybe you’ve bitten into a grapefruit and felt like your tongue was under attack? If so, you’re not alone. Bitterness is one of the most misunderstood flavors, but it plays a huge role in our health and survival. From keeping us from eating toxic foods to helping digestion, bitterness has a bigger impact on our bodies than most people realize. So, let’s dive into the bitter truth—why some people hate it, why your stomach can actually taste it, and how it has been used as medicine for centuries.

Why Do Some Foods Taste Bitter?To begin with, bitterness exists for a reason. In nature, many poisonous plants contain bitter compounds. Long ago, humans who could detect bitterness had a survival advantage. In other words, their ability to taste bitterness kept them from eating something deadly. As a result, our bodies evolved to be extra sensitive to bitter flavors.

However, not all bitter foods are dangerous. Many are incredibly healthy. Take kale, dark chocolate, and turmeric, for example. These foods may taste strong or even unpleasant to some people, but they are packed with antioxidants and nutrients that support overall health.

So, why do some people love bitter foods while others can’t stand them? The answer lies in our genes. Scientists have discovered that a gene called TAS2R38 determines how sensitive we are to bitterness. If you are a super-taster, bitter foods might seem unbearably strong. On the other hand, if you are a non-taster, you may barely notice the bitterness at all.

Your Stomach Can "Taste" Bitterness TooInterestingly, your tongue isn’t the only part of your body that detects bitterness. Your stomach can taste it as well. But how does that work? Well, your stomach has bitter taste receptors that serve a very important function.

First, these receptors help control digestion. When bitter foods enter your stomach, the receptors slow down gastric emptying. In simpler terms, they make food stay in your stomach longer. As a result, you feel full for a longer period. This is one reason why bitter greens like arugula or dandelion leaves can help with weight management.

Second, these bitter receptors act as bodyguards for your digestive system. If your stomach detects a bitter substance that shouldn’t be there—like a potential toxin—it delays digestion to prevent harmful substances from moving too quickly into your intestines. This process gives your body extra time to neutralize any potential threats.

Bitters: From Medicine to CocktailsBecause of their digestive benefits, bitter herbs have been used in medicine for centuries. In the past, people took bitters—herbal mixtures containing bitter plant extracts—to help with digestion, bloating, and nausea. Some of the most common bitter herbs include:

• Gentian root – A powerful bitter used to stimulate digestion.
• Dandelion – Helps with liver function and gut health.
• Wormwood – Historically used for digestive problems and gut health.
• Burdock – Supports digestion and has anti-inflammatory properties.

Over time, bitters made their way from medicine cabinets to cocktail bars. During the 1800s, bitters became a key ingredient in alcoholic drinks, including the Old Fashioned and the Manhattan. In fact, some of today’s most famous bitters, like Angostura and Peychaud’s, were originally marketed as health tonics.

But perhaps the most interesting story of all is how gin and tonic became a malaria treatment. In the 19th century, British soldiers stationed in tropical regions were at high risk of getting malaria. The best available treatment at the time was quinine, a bitter compound from the bark of the cinchona tree. However, quinine was extremely bitter and unpleasant to drink on its own. So, soldiers mixed it with sugar, lime, and soda water to make it more palatable. Eventually, someone had the genius idea to add gin, and just like that, the gin and tonic was born.

Even though modern tonic water contains only small amounts of quinine, the drink remains popular today—not as medicine, but as a refreshing cocktail with a fascinating history.

A Word of Caution: Who Should Avoid Bitters?Although bitters have many health benefits, they aren’t for everyone. Some people should avoid them, including:

• Pregnant or breastfeeding individuals – Some bitter herbs can have harmful effects during pregnancy.
• Children – Since bitters are often infused with alcohol, they are not suitable for kids.
• People with digestive disorders – If you have ulcers, inflammatory bowel disease, or other stomach sensitivities, bitters could make your symptoms worse.

In addition, taking too much of certain bitters can lead to side effects, such as:

✔ Nausea

✔ Cramping

✔ Diarrhea

✔ Gas

✔ Stomach pain

As always, if you’re thinking about adding bitters to your diet, it’s a good idea to check with a doctor first.

Conclusion: Embrace the Bitter!Bitterness may not be everyone’s favorite flavor, but it plays an important role in our health. It helps regulate digestion, protects against harmful substances, and has been used in medicine for centuries. Even though many people find bitter foods challenging at first, the good news is that your taste buds can adapt over time. So, if you want to develop a taste for bitter foods, start small. Add a little lemon or olive oil to bitter greens, try a piece of dark chocolate, or experiment with herbal bitters in your drinks.

Who knows? You might just learn to love the bitter side of life!

References1. Beauchamp, G. K., & Mennella, J. A. (2009). The biology of bitter taste. Scientific American, 301(2), 36-43. 2. Meyerhof, W., Batram, C., Kuhn, C., Brockhoff, A., Chudoba, E., Bufe, B., & Appendino, G. (2010). The molecular basis of bitter taste perception. Trends in Neurosciences, 33(2), 92-101. 3. Bartoshuk, L. M. (2000). Comparing sensory experiences across individuals: Recent psychophysical advances illuminate genetic variation in taste perception. Chemical Senses, 25(4), 447-460. 4. Klee, H. J. (2010). Improving the flavor of fresh fruits: Genomics, biochemistry, and biotechnology. New Phytologist, 187(1), 44-56. 5. Bisset, N. G., & Wichtl, M. (2001). Herbal Drugs and Phytopharmaceuticals. CRC Press.

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The Great Egg Redemption: How Science Saved Breakfast (But Not Your Wallet)For decades, the humble egg was treated like a ticking time bomb for your arteries. Nutrition guidelines told us to avoid them, doctors warned us about cholesterol, and many Americans swapped their morning omelet for a sad bowl of processed cereal. But here’s the kicker—those recommendations weren’t based on strong science. Instead, industry interests heavily influenced them, outdated theories, and a lot of fear-mongering.

Now, eggs are back on the menu. Science has finally caught up, and experts agree that dietary cholesterol isn’t the villain it was made out to be. But just when we thought we could enjoy eggs guilt-free, bird flu struck, prices skyrocketed, and suddenly, eggs became the new luxury item. So, how did we get here? Let’s crack open the truth.

The Food Pyramid: A Big Business, Not Big ScienceIf you grew up in the 90s, you probably remember the Food Pyramid. It told us to eat 6-11 servings of bread, pasta, and cereal every day, while foods like eggs, meat, and fats were placed at the top—basically labeled "Eat Sparingly."

But was this pyramid built on solid science? Not exactly.

The grain industry played a huge role in shaping these guidelines. In the 1970s and 80s, low-fat diets became the gold standard for heart health. The idea was simple: eating fat leads to heart disease, so cutting out fat would make us healthier. Unfortunately, that’s not what happened.

Instead, food companies removed fat from products and replaced it with sugar and processed carbs—because, let’s face it, fat-free food tastes terrible without something to make it palatable. As a result, Americans ended up eating way more refined carbs and sugar, leading to a spike in obesity and type 2 diabetes (Ludwig et al., 2018).

Meanwhile, eggs—one of nature’s most nutrient-dense and affordable foods—were put on the naughty list.

The War on Eggs: How a Bad Idea Became Dietary DogmaThe real egg panic began in 1968 when the American Heart Association (AHA) declared that dietary cholesterol was a major cause of heart disease. They recommended eating no more than three eggs per week (Kritchevsky, 1999).

But here’s the problem—this recommendation wasn’t based on strong human studies. Instead, it was based on:

1. Animal Studies – Scientists fed cholesterol to rabbits, which are naturally herbivores, and (shocker!) their cholesterol went up. But rabbits process cholesterol differently than humans (McNamara, 2000).
2. Epidemiological Correlations – Early studies linked high cholesterol intake to heart disease, but they didn’t separate it from other factors like saturated fat, smoking, or lack of exercise (Hu et al., 1999).
3. Clinical Studies With Unrealistic Diets – Some studies tested cholesterol intake using six eggs per day—which is way more than most people eat (Fernandez, 2006).

Meanwhile, many scientists already knew that dietary cholesterol had minimal impact on blood cholesterol for most people. Our bodies naturally regulate cholesterol production—when we eat more cholesterol, the liver produces less to balance it out (Griffin & Lichtenstein, 2013).

But by the time the science caught up, the damage was done. Food companies had already flooded the market with "cholesterol-free" products like margarine and egg substitutes. And people believed the hype.

The Egg Industry Fights Back (With Science!)While eggs were being villainized, the egg industry wasn’t about to sit back and let breakfast be ruined. In 1984, they established the Egg Nutrition Center (ENC) to fund research and set the record straight.

Over the next few decades, study after study debunked the myth that eggs were bad for your heart. In fact, major research showed:

• Eating eggs does NOT increase heart disease risk. A Harvard study of 117,000 people found no link between egg consumption and cardiovascular disease (Hu et al., 1999).
• Eggs can even be good for you. They’re packed with protein, choline (for brain health), and lutein and zeaxanthin (for eye health) (McNamara, 2000).
• Cholesterol guidelines were flawed. By 2015, the Dietary Guidelines for Americans finally removed cholesterol restrictions because there was no strong evidence linking dietary cholesterol to heart disease (USDA & HHS, 2015).

After 47 years of bad press, the egg was officially redeemed. Here is a link for some science (ref)

Just When Eggs Made a Comeback… Prices Went Through the RoofNow that science finally supports eating eggs, you’d think we’d be in a golden age of omelets. But no—2023 and 2024 have given us record-breaking egg prices.

Why? One word: Bird flu.

A massive avian flu outbreak led to the culling of millions of hens, drastically reducing egg supply and sending prices soaring (USDA, 2023). In some stores, eggs were even locked up like high-end electronics.

So now, after decades of unnecessary restrictions, eggs are back on the menu—but they’re too expensive for many people to enjoy daily. Irony at its finest.

The Bottom Line: Eat the EggSo, what’s the takeaway?

• The demonization of eggs wasn’t based on strong science.
• Many dietary guidelines (like the Food Pyramid) were heavily influenced by industry, not just research.
• Science finally caught up, and now eggs are recognized as a nutrient powerhouse.
• Just as eggs were redeemed, bird flu made them a luxury item.

If history has taught us anything, it’s that we need to question nutrition trends—especially when big industries stand to profit. Eggs were wrongly blamed for heart disease, just like fat was wrongly blamed for obesity. But science eventually wins.

So next time you crack open an egg, enjoy it. It took nearly five decades of bad science, industry influence, and misinformation for us to get here.

References Fernandez, M. L. (2006). Effects of eggs on plasma lipoproteins in healthy populations. Food & Function, 7(3), 156-164. * Griffin, B. A., & Lichtenstein, A. H. (2013). Dietary cholesterol and plasma lipoprotein profiles: Randomized controlled trials and meta-analyses. The American Journal of Clinical Nutrition, 98(6), 1465S-1470S. * Hu, F. B., Stampfer, M. J., Rimm, E. B., et al. (1999). A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA, 281(15), 1387-1394. * Kritchevsky, S. B. (1999). Dietary cholesterol, serum cholesterol, and heart disease: Are the associations valid? The American Journal of Clinical Nutrition, 69(4), 1210S-1215S. * Ludwig, D. S., Willett, W. C., & Volek, J. S. (2018). The low-fat diet: A failed experiment. Annual Review of Nutrition, 38, 37-57. * McNamara, D. J. (2000). The impact of egg limitations on coronary heart disease risk: Do the numbers add up? Journal of the American College of Nutrition, 19(5), 540-548. * USDA & HHS. (2015). Dietary Guidelines for Americans, 2015-2020. * USDA. (2023). Avian Influenza and Egg Supply Reports.*

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Apple Watch vs. Oura, Whoop, and WithingsHealth wearables have exploded in popularity, promising better sleep, fitness, and recovery tracking. But with so many options—Apple Watch, Whoop, Withings, Oura, and Ultrahuman Rings—which one is actually worth your money?

More importantly,do these devices improve your health, or are they just expensive digital trophies?

In this breakdown, we’ll compare features, accuracy, HRV (Heart Rate Variability) and “strain” tracking, battery life, hidden costs, and privacy concerns—so you can make the best choice for your lifestyle.

We have come a long way since the pedometer - which I used to buy and give to my post op surgery patients to encourage them to walk.

What Do These Devices Track?Most modern wearables track heart rate, sleep, HRV, activity levels, and even blood oxygen and temperature. More than just steps - which they all track, but each device has its strengths:

• Apple Watch – Tracks HRV, ECG (FDA-cleared for atrial fibrillation), and fall detection. However, cellular models require a monthly subscription for full use, and it no longer tracks blood oxygen (SpO2) due to a patent dispute.
• Whoop – Focuses on recovery, strain, and sleep—but requires a costly subscription and has no screen.
• Oura Ring – A discreet ring tracking sleep stages, HRV, and body temperature.
• Withings – The only one besides Apple to be FDA-cleared for atrial fibrillation detection, with a focus on medical-grade tracking (smart scales, blood pressure monitors, and sleep mats). Unlike Apple, Withings still tracks blood oxygen (SpO2). Withings also tracks heart rate continuously during sleep, and thanks to its long battery life, it can be worn at night for weeks without interruption. No subscription required.
• Ultrahuman Ring – A newer ring with a focus on metabolic tracking and recovery.

Scientific Insight:A 2020 Nature Digital Medicine study found that wrist-based devices overestimate activity but underestimate calories burned, while rings tend to be more reliable for sleep and HRV.

HRV and Strain: What Do These Metrics Really Mean?What is HRV (Heart Rate Variability)?HRV is the variation in time between heartbeats—a measure of how well your autonomic nervous system is functioning.

• Higher HRV = Better recovery, lower stress, and improved cardiovascular health.
• Lower HRV = Fatigue, overtraining, stress, or even illness.

However, HRV is highly variable based on factors like hydration, sleep, and time of day.

How Wearables Measure HRV:

• Apple Watch, Whoop, Oura, Withings, and Ultrahuman all track HRV, but accuracy depends on when and how it’s measured.
• Whoop and Oura measure HRV during deep sleep, which is considered more stable than spot-checks.
• Apple Watch and Withings measure HRV periodically throughout the day, which may be less reliable due to external factors.

💡 Bottom Line: HRV is useful for tracking trends over time, but daily fluctuations can be misleading.

Dr. Terry Simpson's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

What is “Strain” and Is It Useful?Strain is Whoop’s proprietary score that estimates how hard your body works based on HRV, heart rate, and activity levels.

• High Strain = More exertion, requiring longer recovery.
• Low Strain = Your body is well-recovered.

🚨 The Problem?

• Strain scores don’t account for individual fitness levels—what’s high strain for one person may be normal for another.
• External factors like caffeine, stress, and dehydration can artificially raise strain scores.

💡 Bottom Line: While strain tracking can help athletes fine-tune training, it’s not always meaningful for the average user.

Accuracy & Reliability: Can You Trust the Data?Not all wearables are created equal.

• Withings and Apple Watch are both FDA-cleared for atrial fibrillation detection, meaning they have been tested for medical accuracy.
• Apple Watch’s ECG is 97% accurate for detecting AFib (JAMA Cardiology, 2023).
• Whoop and Oura’s HRV tracking is solid, but they are not medical-grade devices.
• Withings devices have been used in clinical research, meaning their data is considered highly reliable for medical use.
• Withings still provides blood oxygen (SpO2) tracking, while the Apple Watch lost this feature due to a patent dispute.
• Withings tracks heart rate continuously during sleep, while the Apple Watch requires the user to trigger measurements manually or wear the device overnight (which can be inconvenient due to short battery life).

Bottom Line: For medical-grade tracking, Withings and Apple Watch are the best choices. * For recovery & strain, Whoop and Oura perform well but lack medical validation. * For long-term health monitoring, Withings is the clear winner.*

More for our paid subscribers below - comparing battery life, hidden costs, and the overall winner.

Battery Life & Charging: The Hidden Cost of ConvenienceDevice Battery Life. Charging Time

Apple Watch 18-24 hours 1-2 hours

Whoop 4-5 days 1.5 hours

Oura Ring 4-7 days 20-80 minutes

Withings 3-4 WEEKS ~2 hours

Ultrahuman 4-6 days 1-2 hours

🔋 Withings wins by a landslide with up to a month of battery life. This allows users to wear it at night for continuous heart rate tracking, something that’s difficult to do with an Apple Watch.

Costs & Hidden Fees: What’s the Real Price?Device Upfront Cost Subscription Hidden Costs

Apple Watch. $250-$800. None for basic use $10-$20/month cellular charges

Whoop Free device $30/month ($360/year) bands/sleeves

Oura Ring. $299-$549. $6/month ($72/year) Without subscription, limited data

Withings $250-$500 No subscription. None

Ultrahuman $349-$499 $8/month ($96/year)

💰 Whoop is the most expensive long-term due to its subscription model.

💰 Apple Watch requires a monthly fee if you want cellular features.

💰 Withings is the most cost-effective—one-time purchase, no subscriptions, no hidden fees.

Final Verdict: Why Withings Wins🥇 Best for Most People: Withings – FDA-cleared, blood oxygen tracking, continuous heart rate monitoring at night, long battery life, no subscription, strong privacy protections.

🥇 Best for Fitness & Heart Health: Apple Watch (beware of cellular fees).

🥇 Best for Recovery Optimization: Whoop (if you can afford it).

🥇 Best for Sleep & Metabolic Tracking: Oura, Withings, or Ultrahuman Ring.

Final ThoughtsWearables are great tools, but they don’t replace healthy habits.

I told Verizon that I don’t need the now $21 a month for cellular for the Apple Watch. The Withings Watch looks much nicer and easily stays on my wrist day and night.

I had Whoop for over a year and a half. It has great insight, and those who have a favorite watch (Timex, Rolex, Omega, and so forth) but want tracking might like this device. You can wear a Whoop on your sleeve and still have your fancy watch on your wrist. I am a watch fan - but day in and day out, Withings is now my go-to. But even when I am going out and put on my watch that Dad gave me, I don’t need a lot of things tracked. I can be free of the digital age.

I am not a ring fan. As a surgeon, they don’t work for me. Every surgeon loses rings to scrub laundry. Which is why many surgeons simply don’t wear rings at all.

Withings also has an entire health system with blood pressure, a scale (where I keep track of my weight), and a sleeping pad that can diagnose and track sleep apnea (FDA-cleared).

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What Are Ultra-Processed Foods?Ultra-processed food (UPF) might sound like something concocted in a secret laboratory, but it simply refers to foods that are significantly altered from their original state. These often contain additives like emulsifiers, preservatives, and stabilizers—ingredients you wouldn’t typically find in a home kitchen.

This category includes everything from convenience-store hot dogs to plant-based meat alternatives. Yes, even your favorite vegan nuggets fall into this group.

Common Myths About Ultra-Processed FoodsMyth #1: They’re Toxic and Will Kill You InstantlyIf ultra-processed foods were as lethal as some claim, most of us wouldn’t have survived past childhood. While some contain high amounts of salt, sugar, and fat, they aren’t inherently poisonous. The key is moderation. A diet loaded with neon-colored cheese puffs and soda? That’s a health disaster. But an occasional indulgence won’t do you in.

Myth #2: Twinkies Last ForeverTwinkies have a long shelf life, but they aren’t immortal. The idea that they’ll outlast civilization comes from misunderstood experiments on old snack cakes. In reality, they’ll go stale and unappetizing over time—just like any other food.

Myth #3: If You Can’t Pronounce an Ingredient, It Must Be BadComplicated words don’t necessarily mean something is harmful. For example, cyanocobalamin is just vitamin B12, an essential nutrient for your nervous system. Even dihydrogen monoxide sounds ominous—but it’s just water.

The Real Issue with Ultra-Processed FoodsMany ultra-processed foods are designed to be hyper-palatable, meaning they activate your brain’s reward system. Ever wonder why it’s so easy to eat an entire bag of chips in one sitting? It’s not just about willpower—these foods are engineered to be irresistible.

Additionally, ultra-processed foods tend to be calorie-dense but nutrient-poor. They can crowd out healthier, more nutrient-rich options, leading to deficiencies over time.

Can You Eat Ultra-Processed Foods and Stay Healthy?Absolutely! The key is balance. If 80% of your diet consists of whole foods—fruits, vegetables, lean proteins, and whole grains—you can enjoy processed indulgences in moderation. The problem arises when ultra-processed foods dominate your meals.

Final Thoughts: Should You Fear the French Fry?No. Fear misinformation more than the occasional processed snack. The goal isn’t to live on a diet of raw kale and regret—it’s about making informed choices.

Enjoy your guilty pleasures in moderation, but don’t let them replace nutrient-dense foods. Science, not fear, should guide your eating habits.

For more food science insights, follow me on TikTok and Instagram at @drterrysimpson. And remember—eat smart, not scared!

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Bird Flu, Flu Season, and Protecting Your Health: What You Need to KnowWhile I typically focus on food and your health, pressing medical updates demand attention. Today, we’re tackling two critical topics: the latest on bird flu (avian influenza) and the rise in seasonal respiratory illnesses, including flu and COVID-19.

With public communication from federal agencies temporarily paused, it’s vital to stay informed. Here’s a comprehensive overview of what’s happening, what it means for you, and how to protect yourself and those around you.

Respiratory Illness Trends: Seasonal Flu on the RiseAs of January 24th, 2025, respiratory illnesses are driving more people to seek healthcare. Here’s what we’re seeing:

• Seasonal flu: Elevated and rising in some areas.
• COVID-19: Most regions report a decline in cases.
• RSV: Also trending downward.

Locally, we’re seeing these same trends, with flu activity increasing significantly.

Bird Flu: A Persistent Global ConcernSince 1997, HPAI A(H5N1) virus infections have been reported in over 925 people, with an alarming 50% case fatality rate. Early outbreaks included 20 cases and 7 deaths in Hong Kong between 1997 and 2003, and since November 2003, more than 900 cases across 24 countries have been documented (CDC).

Symptoms and SeverityHPAI A(H5N1) infections can range from mild to severe, including:

• Mild symptoms: Upper respiratory tract issues like a runny nose or sore throat.
• Severe symptoms: Pneumonia, respiratory failure, acute respiratory distress syndrome (ARDS), and multi-organ failure.
• Neurological impact: Some cases report encephalitis, a dangerous brain inflammation.

Since 2016, sporadic cases have been reported globally, and while rare, they highlight the virus’s ability to persist.

Notable Cases and StrainsA Sobering Case from LouisianaA recent case in Louisiana reminds us of the risks associated with bird flu. A man died after handling wild birds infected with HPAI A(H5N1). This tragic event underscores how deadly the virus can be in humans.

Other Strains to Watch HPAI A(H5N6): Over 90 cases have been reported in China since 2014, with one additional case in Laos in 2021. This strain has a case fatality rate exceeding 50% (WHO). * HPAI A(H5N8): Russia reported the first asymptomatic human case* in a poultry worker in 2020 (CDC).

Testing and MonitoringHospitals now test anyone hospitalized with severe flu symptoms for bird flu. Public health officials use several tools to monitor these trends:

• Wastewater surveillance
• Emergency department visit data
• Lab-confirmed cases

These measures provide early warnings of emerging threats, helping to guide public health responses.

Protecting Yourself: Key Preventive Measures1. Avoid Exposure* Stay away from wild birds, sick or dead poultry, and areas with known outbreaks. * Don’t handle birds without proper precautions.

2. Use Protective GearFor those working with poultry or wild birds, personal protective equipment (PPE) is essential. Gloves, masks, and eye protection significantly reduce exposure risks.

3. Consider Antiviral ProphylaxisIf exposed to infected birds, antiviral medications like oseltamivir can lower your risk. These treatments are most effective when started within 48 hours of exposure and continued for 7 days.

4. Get VaccinatedThe FDA-approved vaccine Audenz offers protection against H5N1 for high-risk groups (FDA).

Why Vaccination MattersVaccines don’t guarantee you won’t contract the virus, but they do prepare your immune system to fight it more effectively. This reduces the risk of severe illness and protects vulnerable populations, including:

• Elderly individuals.
• People undergoing chemotherapy.
• Young children.

Vaccination also lowers your viral load, reducing the likelihood of spreading the virus to others.

The Role of Nutrition in Immune SupportGood nutrition strengthens your immune system, making you more resilient against respiratory illnesses:

• Vitamin C: Found in citrus fruits like oranges and lemons, it supports white blood cell function.
• Antioxidants: Spinach and broccoli are packed with immune-boosting nutrients.
• Vitamin D: Fatty fish (salmon, mackerel, trout), fortified foods, and plant-based alternatives like Costco Oat Milk help maintain adequate levels.

The Bigger PictureBird flu continues to evolve, spreading to new bird populations and occasionally infecting mammals. While the overall risk of human transmission remains low, these developments remind us of the importance of:

• Early detection through testing and monitoring.
• Preventive measures to reduce exposure.
• Prompt treatment when needed.

ConclusionBird flu and seasonal respiratory illnesses remind us of the importance of vigilance and proactive health measures. With flu season in full swing, now is the time to take action—get vaccinated, improve air quality, and support your immune system through nutrition.

For more detailed updates, listen to my Fork U podcast, where I share in-depth insights on bird flu and other health concerns. You can also find weekly updates on my TikTok and Instagram (@drterrysimpson).

As always, I remain yours in health,

Dr. Terry Simpson

References:

1. Centers for Disease Control and Prevention (CDC): Avian Influenza Updates
2. World Health Organization (WHO): Avian Influenza
3. U.S. Food and Drug Administration (FDA): Audenz Vaccine

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Fuel, Don’t Fad: How to Eat for Health, Not HypeIf you’ve ever fallen for a fad diet, you’re not alone. They promise quick results, make bold claims, and usually leave you hungry, cranky, and disappointed. But here’s the truth: fad diets don’t work in the long run. What does work? Fueling your body with the right foods. In this blog, we’ll break down why fad diets fail, how to rebuild your relationship with food, and the best way to fuel your body for health, happiness, and energy.

Why Fad Diets Fail (Every Single Time)Fad diets sound tempting. They promise you’ll drop 10 pounds in a week, detox your body, or gain endless energy. But they always have a catch—and that catch is why they fail so miserably.

1. Fad Diets Demonize FoodCarbs are evil. Fats are the enemy. Fruits have too much sugar. If you’ve heard any of these, you’ve encountered a fad diet. These diets love to turn food into the villain, leaving you afraid to eat the things your body actually needs.

2. They Set You Up for Yo-Yo DietingYou lose weight quickly at first, but as soon as you eat normally, the weight comes rushing back. This cycle is not just frustrating—it’s harmful to your health and metabolism.

3. They Ignore ScienceMany fad diets rely on gimmicks instead of facts. For example, “Don’t eat after 7 PM because your metabolism goes to sleep.” Spoiler alert: your metabolism doesn’t have a bedtime.

Unhealthy Relationships with FoodFad diets don’t just fail—they mess with your mind. They teach you to fear food, label meals as “good” or “bad,” and disconnect you from your body’s natural hunger and fullness cues.

Stop Labeling Food as the EnemyFood isn’t good or bad. It’s just food. Sure, a salad has more nutrients than a slice of cake, but both can fit into a balanced diet. When you stop assigning moral value to food, you’ll stop feeling guilty about what you eat.

Trust Your Body’s Hunger SignalsYour body knows when it’s hungry and when it’s full. Fad diets train you to ignore these signals, but you can retrain yourself. Start listening to your body—it’s smarter than any diet app.

How to Fuel Your Body the Right WayNow that we’ve covered what doesn’t work, let’s talk about what does. Fueling your body means giving it the energy and nutrients it needs to thrive. Forget restriction—focus on addition.

Fruits: Nature’s CandyAim for 9 ounces of fruit per day or about two servings. Fruits provide vitamins, antioxidants, and natural sweetness. Plus, they’re portable and easy to snack on.

• Snack idea: Slice an apple and pair it with peanut butter.
• Breakfast tip: Add berries to your oatmeal or yogurt.

Vegetables: The Foundation of Your PlateLike fruits, aim for 9 ounces of vegetables per day. Vegetables are low in calories but high in nutrients, fiber, and flavor.

• Quick tip: Roast a tray of veggies with olive oil, garlic, and herbs.
• Sneaky trick: Add spinach to your smoothies—you won’t taste it, but your body will love it.

Whole Grains: Your Sturdy SidekickWhole grains give you the energy that lasts. They’re rich in fiber, which keeps you full and your digestion happy. Aim for 9 ounces of whole grains per day.

• Breakfast idea: Enjoy a bowl of oatmeal with fruit and nuts.
• Dinner option: Serve quinoa, brown rice, or whole-grain pasta as a base for your meals.

Fish: Brain Food Fish provides protein and omega-3 fatty acids, which support heart and brain health. Try to eat fish twice a week, focusing on fatty fish like salmon or mackerel.

• Easy dinner: Grill salmon with a squeeze of lemon and fresh dill.
• Lunch idea: Make a tuna salad with olive oil, not mayo, and pile it onto whole-grain toast.

Olive Oil: Liquid GoldForget butter. Olive oil is your new go-to fat. It’s rich in heart-healthy monounsaturated fats and enhances the flavor of almost anything. Use 2-4 tablespoons per day for cooking, drizzling, or dipping.

• Salad idea: Drizzle olive oil with lemon juice and a pinch of salt for a quick dressing.
• Snack tip: Dip whole-grain bread into olive oil mixed with herbs.

Legumes: The Underrated PowerhouseLegumes like chickpeas, lentils, and beans are full of fiber, protein, and nutrients. They’re also budget-friendly and incredibly versatile. Best of all, you can enjoy them in unlimited amounts.

• Snack idea: Roast chickpeas with paprika for a crunchy treat.
• Meal tip: Make a hearty chickpea stew with tomatoes and spices.

Why Fad Diets Like the Carnivore Diet Are a Hard NoWe can’t talk about fueling your body without addressing the Carnivore Diet. This trendy diet eliminates plant-based foods entirely, focusing only on meat. Here’s why it’s a bad idea:

• They are Nutrient-Deficient: You’re missing out on fiber, vitamins, and antioxidants found in fruits, vegetables, and grains.
• It’s Risky: Diets high in red and processed meats increase the risk of heart disease and cancer.
• Carnivore, like keto, is Unsustainable: Unless you love the idea of a lifetime without bread, this diet won’t last.

In short, the Carnivore Diet is a fad at best and dangerous at worst. Stick to balanced, science-backed eating instead.

Practical Tips to Get StartedFueling your body doesn’t have to be complicated. Start with these simple steps:

1. Focus on what to add, not what to cut out.
2. Plan meals around fruits, vegetables, and whole grains.
3. Include fish in your weekly routine.
4. Stock your pantry with staples like legumes and olive oil.
5. Allow yourself treats—balance is key.

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The Mediterranean Diet: Why It’s Still #1 in 2025When it comes to choosing the best diet for overall health, the Mediterranean diet has topped the list again in 2025. It’s easy to see why: it’s simple, it’s sustainable, and it delivers proven health benefits. Are you looking to manage your weight, reduce your risk of heart disease, or improve your gut health? The Mediterranean diet offers a balanced, flexible approach to eating.

What Makes the Mediterranean Diet So Special?The Mediterranean diet was originally based on the eating habits of countries like Greece, Italy, and Spain. But here’s the key: it’s not just about eating food from these regions. The Mediterranean diet is more of an eating pattern—one that focuses on fresh, whole foods, a variety of plant-based ingredients, lean proteins, and healthy fats. This diet encourages you to eat fruits, vegetables, whole grains, legumes, nuts, and seeds while making olive oil your primary fat source. Fish is a star in this diet, while dairy and red meat are enjoyed in moderation.

The Mediterranean Diet AlgorithmThe Mediterranean diet isn’t about following a strict menu or buying expensive specialty ingredients. It’s about focusing on whole, nutrient-dense foods and following an algorithm: more plants, more healthy fats, and fewer processed foods. It’s not a fad—it’s a way of life that’s been proven to improve long-term health.

Why Is the Mediterranean Diet Still Ranked #1?So, why is the Mediterranean diet still ranked #1 for 2025 by experts like U.S. News & World Report? Here’s why:

1. Supports Heart Health
2. The Mediterranean diet is packed with healthy fats, like olive oil and fatty fish (think salmon and sardines), which are known to reduce inflammation and lower cholesterol levels. Studies have shown that this diet can lower the risk of heart disease and stroke by improving blood pressure and supporting healthy arteries.
3. Controls Blood Sugar
4. If you have diabetes or prediabetes, the Mediterranean diet is a fantastic choice. It helps regulate blood sugar levels, improving insulin sensitivity, and preventing blood sugar spikes that can cause problems over time.
5. Improves Gut Health
6. The Mediterranean diet is rich in fiber from fruits, vegetables, and whole grains, which are essential for a healthy gut. A healthy gut microbiome can help with digestion, boost immunity, and even improve your mood.
7. Fights Inflammation
8. Chronic inflammation is at the root of many diseases, including arthritis and certain cancers. The Mediterranean diet’s focus on antioxidant-rich foods (like leafy greens, tomatoes, nuts, and fatty fish) helps reduce inflammation in the body.

The Science Behind the Mediterranean DietThe Mediterranean diet isn’t just popular because it sounds good—it’s backed by science. Multiple studies have shown its effectiveness in:

• Lowering Cholesterol
• The diet’s high intake of heart-healthy fats like olive oil and fatty fish helps reduce LDL (bad) cholesterol while increasing HDL (good) cholesterol. This supports better heart health and lowers the risk of heart disease.
• Preventing Cognitive Decline
• Research has shown that the Mediterranean diet may help protect against Alzheimer’s disease and other forms of cognitive decline by promoting brain health with its antioxidants and healthy fats.
• Maintaining a Healthy Weight
• While the Mediterranean diet isn’t necessarily a “weight loss diet,” it encourages eating nutrient-dense foods that keep you feeling fuller for longer. This can help prevent overeating and support long-term weight maintenance.

How to Follow the Mediterranean DietIt’s easy to get started with the Mediterranean diet. Here’s how you can structure your meals:

• Fruits and Vegetables: Aim for at least 9 ounces (250 grams) of vegetables and 2 servings of fruit per day. Vegetables should be the focus of your meals, while fruits can be enjoyed as snacks or desserts.
• Whole Grains: Consume 9 ounces (250 grams) of whole grains daily. Choose options like brown rice, quinoa, and whole wheat bread for fiber and energy.
• Legumes: Incorporate at least 2 ounces (56 grams) of beans, lentils, or chickpeas into your meals every day. These are a great source of plant-based protein and fiber.
• Healthy Fats: Use olive oil as your primary fat source—about 2 to 4 tablespoons per day. Also, aim for two servings of fatty fish per week, like salmon or sardines.
• Dairy: Dairy is allowed but should be moderate. Stick to low-fat options like Greek yogurt and cheese, and limit portion sizes.
• Alcohol: If you drink alcohol, limit it to one 5-ounce pour of red wine per day, preferably with meals. Excessive alcohol consumption is discouraged in the Mediterranean diet.

Why the Carnivore Diet Isn’t RecommendedWhile the Mediterranean diet is all about variety and balance,unlike the Carnivore Diet. The Carnivore diet focuses on eliminating most food groups entirely—specifically plant-based foods. The Carnivore Diet is an extreme approach that promotes only animal products, which means no fruits, vegetables, grains, or legumes.

Despite its growing popularity, the Carnivore Diet is not recommended for long-term health. Here's why:

• Lacks Nutrients
• The Carnivore Diet lacks many essential nutrients found in fruits, vegetables, and grains, including fiber, vitamins, and minerals. Over time, this can lead to deficiencies and negatively impact your health.
• Increases Risk of Chronic Diseases
• Diets high in red and processed meats are linked to an increased risk of heart disease, cancer, and diabetes. The Carnivore Diet’s heavy reliance on meat and fat can lead to elevated cholesterol and higher inflammation levels in the body.
• Not Sustainable
• The Carnivore Diet is extremely restrictive and difficult to follow long-term. Most people don’t want to give up entire food groups, especially ones that offer important health benefits.

The Carnivore Diet is a fad diet at best. It’s not based on science and doesn’t provide a balanced approach to long-term health. For a diet that’s sustainable, nutritious, and scientifically backed, stick to the Mediterranean diet.

Myths About the Mediterranean DietMyth: The Mediterranean Diet is Just About Olive Oil and Fish

• Olive oil and fish are key components, but the Mediterranean diet is much more. It’s about eating more fruits, vegetables, legumes, and whole grains. These foods provide the bulk of your daily nutrition.
• Myth: It’s Too Expensive
• Do you think Mediterranean-style means spending a fortune? Some ingredients like olive oil and fatty fish can be expensive, you don’t need to break the bank. Buy seasonal, local produce and canned legumes to keep costs low.
• Myth: Mediterranean Cuisine is Only for Mediterranean Countries
• You don’t need to live in the Mediterranean to follow this diet! Adapt Mediterranean principles to any cuisine. Make a fish taco made with whole grain tortillas, grilled fish, and fruit salsa and you have a Mediterranean-inspired meal. Even Indian cuisine can be adapted to the Mediterranean diet with dishes like Chana Masala made with chickpeas, spices, and whole wheat roti.

Conclusion: Why Choose the Mediterranean Diet?The Mediterranean diet continues to be the best choice for 2025 and beyond. Its benefits for heart health, weight management, and disease prevention are backed by science, and its flexibility makes it easy to follow long-term. Plus, it’s not about eliminating food groups—it’s about making healthy, sustainable food choices that nourish your body.

So, if you’re looking to improve your health and eat a balanced, flavorful diet, the Mediterranean diet is the way to go. It’s not just a trend—it’s a lifestyle that’s proven to work.

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Bird Flu: What You Need to Know About Risks, Realities, and ReadinessBird flu, or highly pathogenic avian influenza (HPAI), has far-reaching effects on public health, the food supply, and even the global economy. While human-to-human transmission hasn’t occurred, its potential to mutate poses significant concerns. Understanding how bird flu impacts us today — and how science is working to mitigate its risks — is essential.

In this blog post, we’ll explore the realities of bird flu, its effects on food prices, the role of vaccines, and practical tips to stay safe. Let’s break it down into manageable pieces so you’re fully informed.

What Is Bird Flu, and Why Should You Care?Bird flu primarily affects birds, especially poultry, like chickens and turkeys. However, certain strains, such as H5N1, have occasionally infected humans. While these cases are rare, they carry a high mortality rate of over 50%, making the virus particularly dangerous if contracted.

Why Human-to-Human Transmission MattersHere’s the good news: Bird flu isn’t currently spreading from person to person. The bad news? Experts worry about a process called reassortment, where bird flu and human flu viruses could mix in someone infected with both. This could result in a highly contagious and deadly strain capable of causing a pandemic.

Despite some conspiracy theories, no laboratory is working on gain-of-function research to make bird flu more transmissible. These myths are counterproductive, distracting from real medical efforts to monitor and control the virus.

Rising Prices: How Bird Flu Impacts Your WalletIf you’ve noticed higher prices at the grocery store, bird flu is partly to blame. The virus has disrupted the poultry industry and the broader food supply chain.

Egg Prices SoarWhen bird flu outbreaks occur, millions of chickens are culled to prevent the virus from spreading. This reduction in supply causes egg prices to skyrocket, leaving many of us paying more for our morning omelets.

Dairy Costs ClimbBird flu also affects dairy products. The demand for poultry feed drives up costs for dairy farmers, who often rely on the same feed. Additionally, in rare cases, parts of the bird flu virus have been detected in raw milk. This is yet another reason to avoid raw, unpasteurized milk and stick to pasteurized dairy products for safety.

The Role of Vaccines: Science in ActionVaccines are at the heart of our response to bird flu, but they serve different purposes for birds and humans.

Vaccines for PoultryScientists are developing vaccines for poultry to control the virus in bird populations. These vaccines could:

• Reduce the need for mass culling.
• Lower the economic impact on the poultry industry.
• Decrease the risk of the virus spilling over into humans or other animals.

While these efforts are promising, it will take time before poultry vaccines are widely implemented.

Vaccines for HumansFor humans, H5N1 vaccines are available for at-risk workers like poultry farmers and wildlife handlers. However:

• These vaccines are strain-specific and may not protect against a mutated strain.
• They are not available to the general public.
• In the event of a pandemic, new vaccines would need to be developed, which takes time.

Seasonal Flu Vaccines: Why They Still MatterYou might wonder, “If the flu shot doesn’t protect against bird flu, why get it?” The answer lies in preventing co-infections.

When someone is sick with both seasonal flu and bird flu, there’s a risk the two viruses could mix, creating a new, more dangerous strain. By getting your flu shot, you reduce your chances of catching seasonal flu, which helps minimize this risk. Remember, vaccines are not about completely preventing illness; they’re about reducing severe outcomes like hospitalization and death.

Practical Tips: How to Stay SafeWhether you’re a hunter, backyard birder, or just someone who loves eggs, here’s how to reduce your risk:

For Hunters Avoid handling sick or dead birds. Report them to local authorities. * Use gloves and masks when field dressing game, and disinfect tools afterward. * Cook wild birds to an internal temperature of 165°F (73.8°C)* to kill viruses.

For Backyard Bird Feeders* Clean bird feeders and baths regularly with soap and disinfectant. * Avoid contact with bird droppings; wear gloves during cleaning. * Keep pets, especially cats, away from areas frequented by wild birds.

For Pet OwnersCats are surprisingly vulnerable to bird flu. They can contract the virus by hunting infected birds or contacting bird droppings. To protect your pets:

• Keep cats indoors during outbreaks.
• Monitor them for symptoms like lethargy or respiratory distress.
• Consult a vet if your cat shows any signs of illness.

General Food Safety Always cook poultry and eggs thoroughly to an internal temperature of 165°F (73.8°C)*. * Avoid raw, unpasteurized milk and stick to pasteurized dairy products. * Wash your hands thoroughly after handling birds or poultry products.

Science Evolves: Trust the ProcessIn science, recommendations change as we learn more. This isn’t a sign of uncertainty but a testament to how science adapts to new evidence. The same applies to vaccines — their primary purpose is to prevent severe illness and death, not to guarantee you won’t get sick. Trust in the scientific process is vital as we navigate complex challenges like bird flu.

Stay UpdatedBird flu isn’t just a health issue; it’s a food and economic issue, too. The virus has already disrupted poultry and dairy markets, and its potential to mutate keeps public health experts on high alert. Fortunately, science is actively working on solutions, from vaccines to monitoring programs.

For regular updates on bird flu, follow me on TikTok and Instagram at @drterrysimpson, where I share timely insights and tips. And don’t forget to subscribe to my podcast, Fork U, for in-depth discussions about science, health, and smart eating.

Final ThoughtsBird flu poses significant challenges, but by staying informed and following practical steps, we can protect ourselves and our communities. Whether it’s understanding vaccine roles, debunking myths, or adapting to rising food prices, knowledge is the first line of defense.

Thank you for reading! Stay safe, stay informed, and remember that prevention is the best recipe for a healthy life.

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Navigating GLP-1 Medications and Building a Healthier You: A Fork U Guide

Introduction: The Revolution Starts HereWelcome to Fork University, where science meets sarcasm, and healthy eating gets a reality check. Today, we’re diving into the world of GLP-1 medications, like Ozempic and Zepbound—those little injections making waves in the weight loss and metabolic health scene. Spoiler alert: Even if needles aren’t your thing, this advice is gold for anyone looking to improve their relationship with food (yes, even you, cereal-at-midnight enthusiasts). So, grab a cup of tea (ginger if you’re nauseous), and let’s get started.

Breaking Free from Diet Culture: Goodbye, GuiltAh, diet culture. That pesky little voice whispering, “Carbs are evil,” or “You’re only worthy if you can squeeze into those jeans from 2012.” Here’s the deal: Diet culture sucks, and it’s time to boot it out of your life. Here’s how:

1. Focus on Health Over Appearance
2. “Strong, not skinny” isn’t just a gym bro mantra. Celebrate wins like better blood sugar control or climbing stairs without feeling like you ran a marathon.
3. Neutralize Food Labels
4. No food is inherently “good” or “bad.” (Except maybe that mysterious gas station sushi. Proceed with caution.) All foods can fit into a balanced diet—just maybe not all at once.
5. Ditch Unrealistic Media
6. Swap those Instagram influencers with body-positive accounts. Life is too short for filter-fueled comparisons.

Taming Side Effects: Fiber, Hydration, and the Art of Not OvereatingGLP-1 medications are game-changers, but they come with their quirks. Here’s how to navigate the rocky road of side effects:

Constipation: The Fiber FixFun fact: Only 10% of Americans eat enough fiber. No wonder our colons are grumpy. Fix that with:

• Whole Grains: Brown rice, quinoa, oats—because white bread is so 1990.
• Legumes: Beans, chickpeas, lentils—fiber heroes and fart-inducing legends.
• Supplements: Citrucel or Metamucil work in a pinch, but food first!

Hydration: Sugar-Free Isn’t Always Your FriendNot all hydration packets are created equal. Skip the sugar-free gimmicks and opt for options like Pedialyte. Bonus points if you grab the popsicles—because who doesn’t love reliving childhood?

Nausea: Avoid the Grease TrapHigh-fat foods + GLP-1 = a stomach rebellion. Swap fried chicken for grilled and save yourself the bloat. Greek yogurt and peppermint tea are your new besties.

Building Healthy Habits: Small Steps, Big WinsForget the “eat less, move more” mantra. Here’s what actually works:

1. Mindful Portions
2. At restaurants, box up half your meal right away. Or embrace the kids’ menu—yes, you might even score a toy.
3. Protein with Purpose
4. Greek yogurt, beans, and protein shakes are your go-tos. But don’t let diet culture trick you into thinking protein is the only macronutrient that matters.
5. Celebrate Non-Scale Victories
6. Fitting into old jeans? Amazing. Cooking a new recipe? Even better. Toss the scale if it’s ruining your day—you’re more than a number.

Long-Term Success: Sustainable, Not PerfectGLP-1 medications are tools, not magic wands. They’re here to help you build a healthier relationship with food, not to police your every bite. Remember:

• Moderation Wins: That scoop of ice cream isn’t your downfall. Balance it out with nutrient-rich meals.
• Be Patient: Rapid initial weight loss (thanks, glycogen, and water) will slow, but consistency pays off. A pound a week equals 52 pounds a year. Do the math and cheer yourself on.

Conclusion: Fork U’s Final WisdomGLP-1 medications are here to support you, not define you. Focus on health, ditch the guilt, and enjoy the journey. And don’t forget: Consult a real, western-trained physician and a dietitian. Chiropractors and green juice influencers don’t count. Ok, I sometimes drink some green juice.

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Beyond the Scale: Eating for Long-Term Health, Not Just Weight LossWeight loss is often the first thing people think about when starting GLP-1 medications like semaglutide or liraglutide. These medications are powerful tools for helping manage appetite and regulate the body’s hunger hormones. But here's the real truth: losing weight is just one part of the story. To truly thrive, you need to focus on eating in a way that nourishes your body, supports your health, and promotes long-term well-being.

Think of it this way: GLP-1 medications do the heavy lifting when it comes to managing hunger and cravings. Your job is to provide the right fuel for the machine. You’re not eating to lose even more weight—you’re eating to support your body so it runs like a high-performance car.

GLP-1 Medications Take the Lead; Your Diet Supports the ProcessWhen you’re on GLP-1 medications, weight loss isn’t a result of extreme dieting or restrictive food rules. These medications work by regulating your appetite, making it easier to avoid overeating and stick to reasonable portions. They help your biology work with you instead of against you.

So, if the medication is doing most of the work, why does your diet matter? It’s simple: food is what keeps your body functioning at its best. While GLP-1 helps control hunger, what you eat still determines your energy levels, heart health, mental clarity, and long-term disease risk.

Instead of focusing on cutting calories, the goal should be to pack every meal with nutrients that fuel your body and help it recover from the years of stress and inflammation caused by poor eating habits. This isn’t about restriction—it’s about nourishment.

The Mediterranean Diet: A Gold Standard for HealthWhen it comes to eating for long-term health, the Mediterranean diet is one of the best approaches. It’s not a restrictive diet where you count every calorie or ban entire food groups. Instead, it’s a way of life, focusing on fresh, whole foods that nourish your body and taste great.

Why the Mediterranean Diet WorksThe Mediterranean diet emphasizes vegetables, fruits, whole grains, healthy fats like olive oil, lean proteins, and a little bit of red wine. Yes, wine! Studies have consistently shown that people who follow this diet reduce their risk of heart disease, diabetes, and even cognitive decline (Estruch et al., 2013; Singh et al., 2022).

What makes this diet so effective? It’s packed with anti-inflammatory foods that stabilize blood sugar, protect your heart, and even support a healthy gut. A healthy gut, in turn, improves everything from digestion to mental health. Plus, the Mediterranean diet is enjoyable and sustainable—no weird powders, no flavorless meals, just real food.

The Science Behind Olive Oil and Omega-3sOlive oil is the cornerstone of the Mediterranean diet. This liquid gold is rich in healthy monounsaturated fats and compounds that act like natural anti-inflammatories, similar to ibuprofen (reference here). Add in fish like salmon and sardines, which are full of omega-3 fatty acids, and you’ve got a winning combination for your heart and brain.

Don’t Get Stuck on ProteinProtein is important, especially for preserving muscle mass while losing weight. But many people fall into the trap of making protein the center of every meal, ignoring the other nutrients their body needs. Loading up on chicken breasts and protein shakes might seem like a good idea, but it leaves little room for the variety that keeps your meals balanced.

Here’s the good news: with a Mediterranean-style diet, you can get plenty of protein from diverse sources. Legumes like lentils and chickpeas are not only high in protein but also rich in fiber, which helps with digestion and keeps you full longer. Fish, especially fatty fish like salmon or mackerel, provides protein alongside heart-healthy omega-3s. Even red meat is allowed—just keep it to about 4 ounces a day, roughly the size of a deck of cards.

The key is to think beyond animal proteins. A balanced plate includes plenty of plant-based options, ensuring you get a variety of vitamins, minerals, and antioxidants. This diversity supports your overall health and keeps your meals exciting.

DASH Diet: A Sensible Partner for GLP-1If the Mediterranean diet feels too free-spirited for you, consider the DASH diet (Dietary Approaches to Stop Hypertension). DASH emphasizes fruits, vegetables, whole grains, and lean proteins while keeping sodium intake low. It’s designed to lower blood pressure, but it also reduces the risk of heart disease and supports weight loss. (reference click here)

Like the Mediterranean diet, DASH isn’t about counting calories or cutting out entire food groups. It focuses on nutrient-dense, whole foods that fuel your body. For people on GLP-1 medications, DASH is an excellent choice because it reduces the risks associated with metabolic conditions like high blood pressure and insulin resistance.

Longevity and the Blue Zones DietWeight loss might be your current goal, but the long-term focus should be on living a healthier, longer life. That’s where the Blue Zones come in—regions of the world where people live to 100 and beyond. Their secret isn’t just genetics; it’s their diet and lifestyle.

Blue Zone diets are plant-forward, filled with vegetables, legumes, whole grains, and healthy fats. Meals are simple, minimally processed, and often enjoyed with family and friends. These communities teach us that eating well isn’t about obsessing over macronutrients—it’s about creating habits that support your body over a lifetime.

In Okinawa, Japan, for example, people eat a diet rich in sweet potatoes, tofu, and seaweed, and they follow the principle of hara hachi bu, or stopping when they’re 80% full. This practice prevents overeating and ensures they maintain a healthy weight without ever going hungry. Reference click here

Putting It All Together: Practical TipsIf you’re on GLP-1 medications and want to focus on long-term health, here are some tips to get you started:

• Make Vegetables the Star: Fill at least half your plate with colorful veggies. They’re packed with nutrients and low in calories.
• Choose Whole Grains: Swap out refined carbs like white bread and pasta for quinoa, brown rice, or whole-grain options.
• Enjoy Healthy Fats: Use olive oil liberally, snack on nuts, and add avocado to your meals. These fats are essential for brain and heart health.
• Diversify Your Protein: Include a mix of lean meats, fish, legumes, and nuts. Aim for variety rather than relying on one source
• Focus on Balance, Not Perfection: Follow the 80/20 rule—eat well most of the time, but don’t sweat the occasional treat. A slice of pizza or scoop of gelato won’t derail your progress.
• The Big Picture: Nourish, Don’t Restrict
• GLP-1 medications make it easier to manage your weight, but the real magic happens when you pair them with a diet that supports your health. The focus isn’t on eating less—it’s on eating smarter. By following a Mediterranean or DASH-style diet, you can give your body the nutrients it needs to thrive while enjoying food that tastes amazing.

Remember, this isn’t just about what the scale says. It’s about feeling energized, reducing your risk of chronic diseases, and setting yourself up for a healthier future. So, grab a plate of roasted veggies, drizzle on some olive oil, and toast to your long-term health. Your body will thank you for it.

Citations:Gantenbein KV, Kanaka-Gantenbein C. Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing. Nutrients. 2021 Jun 6;13(6):1951. doi: 10.3390/nu13061951. PMID: 34204057; PMCID: PMC8227318.

Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, Chrysochoou CA, Nihoyannopoulos PI, Tousoulis DM. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020 Sep 1;11(5):1150-1160. doi: 10.1093/advances/nmaa041. PMID: 32330233; PMCID: PMC7490167.

Santacroce L, Bottalico L, Charitos IA, Haxhirexha K, Topi S, Jirillo E. Healthy Diets and Lifestyles in the World: Mediterranean and Blue Zone People Live Longer. Special Focus on Gut Microbiota and Some Food Components. Endocr Metab Immune Disord Drug Targets. 2024;24(15):1774-1784. doi: 10.2174/0118715303271634240319054728. PMID: 38566378.

Grosso G, Laudisio D, Frias-Toral E, Barrea L, Muscogiuri G, Savastano S, Colao A. Anti-Inflammatory Nutrients and Obesity-Associated Metabolic-Inflammation: State of the Art and Future Direction. Nutrients. 2022 Mar 8;14(6):1137. doi: 10.3390/nu14061137. PMID: 35334794; PMCID: PMC8954840.

Singh, B., et al. (2022). "Mediterranean Diet and Cognitive Function: A Systematic Review." Nutritional Neuroscience.

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Obesity: Not Just About Forks and WillpowerFor years, obesity has been misunderstood, oversimplified, and even stigmatized. It's been framed as a personal failing, a lifestyle choice, or simply a matter of "eating less and moving more." But science tells a different, more nuanced story—one where our brains, biology, and ultra-processed food environment play starring roles. And thanks to groundbreaking medications like GLP-1 drugs, we’re gaining a clearer picture of how obesity works and how to treat it.

Let’s dive into why obesity is a disease, how ultra-processed foods exacerbate it, and why we need to ditch the harmful myth that obesity is a lifestyle choice.

The Myth of "Just Eat Less and Move More""Just eat less and move more." It’s the phrase everyone loves to repeat—and no one finds helpful. This simplistic advice ignores the reality that obesity is not merely about calories in and calories out. It’s about a complex interplay between your biology, brain chemistry, and environment.

Obesity isn’t a character flaw or a lack of willpower. If it were, we wouldn’t see an obesity epidemic in societies flooded with cheap, ultra-processed foods engineered to make us eat more. These foods hijack our biology, overpowering the mechanisms our bodies use to regulate hunger and fullness.

The Hungry Brain: Why You Can’t Stop EatingOur brains evolved to keep us alive in times of scarcity. Back in the caveman days, this was helpful. Today, it’s less so because our brains are still wired to seek out high-calorie foods to avoid starvation—even when we’re surrounded by abundance.

When you eat ultra-processed foods, they light up the reward centers in your brain like a Christmas tree. These foods—laden with sugar, fat, and salt—trigger the release of dopamine, the same neurotransmitter involved in addiction. It’s no wonder we keep going back for more.

Adding to the complexity, hormones like ghrelin (the "hunger hormone") and leptin (the "fullness hormone") can go haywire in people with obesity. Ultra-processed foods amplify ghrelin’s effects, making you feel hungrier while reducing your sensitivity to leptin, so you never feel full. It’s a biological double whammy.

Citation: Studies show that diets high in ultra-processed foods increase calorie consumption by about 500 calories per day compared to diets of unprocessed foods (Hall et al., 2019).

GLP-1: The Game-Changing HormoneHere’s where things get interesting: GLP-1, or glucagon-like peptide-1, is a hormone that helps regulate appetite. It tells your brain, “You’re full; you can stop eating now.” But for many people with obesity, this system doesn’t work properly. Their brains don’t get the message, leading to overeating.

Enter GLP-1 receptor agonists like semaglutide and liraglutide—medications that mimic the effects of GLP-1. These drugs help regulate appetite, making people feel full sooner and reducing cravings. The results have been extraordinary: clinical trials show average weight loss of 15% or more with these medications, far outpacing what’s possible with lifestyle changes alone.

These drugs have done more than help people lose weight—they’ve also shifted the way we think about obesity. They show that obesity is a medical condition influenced by hormones and brain chemistry, not just a matter of willpower.

Citation: Clinical trials on GLP-1 receptor agonists show significant and sustained weight loss, with participants losing 15% or more of their body weight (Wilding et al., 2021).

Why Obesity Is a Disease, Not a Lifestyle ChoiceThe idea that obesity is a "lifestyle choice" is not only incorrect—it’s harmful. Framing obesity this way ignores the biological, genetic, and environmental factors that contribute to it. Worse, it stigmatizes people with obesity, making them feel like they’re to blame for their condition.

Obesity meets all the criteria for a chronic disease: it has a defined pathology (dysregulation of appetite and metabolism), it leads to complications (diabetes, heart disease, etc.), and it requires long-term management. Lifestyle factors like diet and exercise can influence obesity, but they’re not the sole cause. Blaming someone for their obesity is like blaming someone with asthma for living in a polluted city.

Citation: The American Medical Association classified obesity as a chronic disease in 2013, recognizing it as a condition requiring medical treatment (AMA, 2013).

Ultra-Processed Foods: The Real CulpritIf obesity is a fire, ultra-processed foods are the gasoline. These foods are engineered for maximum palatability, combining sugar, fat, and salt in ways that overwhelm our natural appetite-regulation systems. They’re calorie-dense, nutrient-poor, and often stripped of fiber, which would otherwise help us feel full.

Even worse, ultra-processed foods alter the way our brains respond to food. They increase cravings, reduce satiety, and encourage overeating. Over time, this can lead to weight gain and metabolic issues, creating a vicious cycle that’s hard to break.

Citation: Research shows that people who consume diets high in ultra-processed foods are more likely to develop obesity and metabolic diseases (Monteiro et al., 2018).

How GLP-1 Drugs Have Changed the GameGLP-1 drugs have given us new tools to treat obesity—and new insights into its underlying causes. They’ve proven that obesity isn’t just about behavior; it’s about biology. When you treat obesity like a disease rather than a moral failing, people get better.

But these medications are just one piece of the puzzle. To tackle obesity on a larger scale, we need to address the broader food environment. That means making healthy, unprocessed foods more accessible, reducing the marketing of ultra-processed foods, and investing in public health initiatives that promote nutrition education.

Why Fat Shaming Is Harmful (and Wrong)Let’s address the elephant in the room: fat shaming. The idea that you can "shame" someone into losing weight is not only cruel—it’s ineffective. Research shows that weight stigma leads to stress, low self-esteem, and even more weight gain. It’s a lose-lose situation.

Instead of shaming people for their weight, we need to focus on creating supportive environments that help everyone make healthier choices. That includes treating obesity as the complex, multifactorial disease that it is—not a personal failure.

Citation: Weight stigma is associated with increased psychological distress, unhealthy eating behaviors, and reduced motivation for physical activity (Puhl & Heuer, 2010).

Moving Forward: What We Can DoHere’s how we can start to shift the conversation around obesity:

Acknowledge Obesity as a Disease: Let’s treat obesity like any other chronic condition with empathy and evidence-based care.

Focus on the Food Environment: We need to address the root causes of obesity, including the overabundance of ultra-processed foods.

Reduce Stigma: Stop blaming individuals for their weight. Instead, offer support and solutions.

Expand Access to GLP-1 Drugs: These medications are game-changers, but they’re expensive and not always covered by insurance. Making them accessible is crucial.

Conclusion: It’s Time to Change the NarrativeObesity is not a lifestyle choice. It’s a complex, chronic disease driven by biology, brain chemistry, and the environment we live in. Thanks to advances in science, like GLP-1 drugs, we’re starting to understand and treat obesity in ways that are effective and compassionate.

The next time someone tells you to “just eat less and move more,” remind them that obesity is about much more than that. It’s time to move past the myths, embrace the science, and support people on their journey to better health.

And maybe, just maybe, it’s time to rethink that bag of chips.

ReferencesHall, K. D., et al. (2019). "Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain." Cell Metabolism.

Wilding, J. P. H., et al. (2021). "Once-Weekly Semaglutide in Adults with Overweight or Obesity." The New England Journal of Medicine.

Monteiro, C. A., et al. (2018). "Ultra-Processed Foods, Diet Quality, and Health Using the NOVA Classification System." Public Health Nutrition.

Puhl, R., & Heuer, C. (2010). "Obesity Stigma: Important Considerations for Public Health." American Journal of Public Health.

AMA (2013). "American Medical Association House of Delegates Resolution 420 (A-13)."

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The Future of Diets: From Weight Loss to Nutrition, Thanks to GLP-1 DrugsFor as long as we can remember, dieting has been humanity’s awkward tango with food—three steps forward, two cheat days back. From eating grapefruit by the dozen to proclaiming kale chips as a snack revolution, our obsession with shrinking waistlines has been both fascinating and exhausting. But what if we could take weight loss off the table (pun intended) entirely? Thanks to the rise of GLP-1 drugs like semaglutide and liraglutide, we’re on the cusp of doing just that.

These drugs are shifting the focus from counting calories to counting nutrients. In other words, dieting is getting a much-needed rebrand. So grab your kale smoothie and settle in as we dive into why the diets of the future will be all about health, not weight. And don’t worry—we’ll keep this fun. After all, food is supposed to be enjoyable.

The GLP-1 Revolution: Shedding Pounds Without Shedding TearsGLP-1 drugs mimic glucagon-like peptide-1, a hormone that tells your brain, "Hey, you're full; stop eating." It’s like having a friend at dinner who gently slaps your hand every time you reach for another breadstick. Clinical trials have shown that these medications can lead to an average weight loss of 15% or more, a feat most fad diets can only dream of achieving.

Why This Changes Everything1. Goodbye, Diet Culture: With GLP-1 drugs doing the heavy lifting for weight management, the days of suffering through celery juice cleanses might finally be behind us. 2. Hello, Health Goals: People can start focusing on nutrition instead of staring longingly at someone else’s fries. 3. Medical Validation: It’s not you; it’s your biology. GLP-1 drugs reduce hunger and help people feel fuller faster—no willpower shaming required.

If this feels like the dieting equivalent of inventing the wheel, it is. But this wheel rolls straight into a new frontier: nutrition.

Citation: Clinical trials on GLP-1 drugs have shown sustained weight loss for a majority of participants (Wilding et al., 2021).

From Weight Loss to Wellness: The New Role of DietsImagine a world where diets aren’t about punishing your body but fueling it. This shift doesn’t mean we’ll all suddenly start eating quinoa salads with reckless abandon—it means recognizing that food is more than just a number on a scale.

1. Nutrition Over NumbersThe new wave of diets prioritizes nutrient density. Instead of obsessing over how many carbs are in a bagel, we’ll care about how those carbs fuel our energy, brain function, and immune system.

2. Gut Health Heroes: Say hello to fermented foods like kimchi and yogurt.

3. Brain Boosters: Omega-3-rich salmon and walnuts are here to make you smarter (or at least more functional before your coffee).
4. Immune Support Squad: Citrus fruits, garlic, and spinach are basically your body’s bodyguards.

Fun Fact: Your brain is about 60% fat, so eating healthy fats can actually make you a better thinker. Finally, an excuse for avocado toast!

1. Functional FoodsInstead of dieting to fit into jeans from a decade ago, people will start eating with specific goals in mind:

2. Performance Diets: Foods that fuel workouts and keep you going on marathon Netflix sessions.

3. Longevity Diets: Think Mediterranean diet vibes—olive oil, nuts, and a glass of red wine (for antioxidants, of course).
4. Condition-Targeted Eating: Anti-inflammatory diets for arthritis or low-glycemic diets for diabetes management.

It’s food as medicine but without the terrifying side effects that come at the end of pharmaceutical commercials.

Tech + Food = The Diet of TomorrowLet’s face it: we’re already living in the age of smart everything—phones, watches, even refrigerators. The next logical step? Using technology to make eating smarter, too.

• Biometric Tracking: Imagine a smartwatch that tells you when you’re low on magnesium and suggests snacking on almonds.
• AI Nutrition Coaches: Apps that analyze your meal choices and politely suggest adding a vegetable or two.
• Meal Kits for the Modern Era: Personalized, pre-portioned meals based on your DNA or gut microbiome.

If the idea of AI judging your pizza consumption feels invasive, remember that it’s only trying to help. Plus, it’ll never side-eye your second slice.

What Happens to Diet Culture?For years, diet culture has been as relentless as a telemarketer, selling us impossible ideals and plenty of guilt. But with GLP-1 drugs making weight loss a medical issue instead of a personal failing, we might finally be able to exorcise the ghosts of diets past.

1. No More Food Shame: GLP-1 drugs take the blame off you and put it squarely on biology. Didn’t lose weight on your juice cleanse? That’s because juice cleanses are terrible, not because you’re weak.
2. Shifting Goals: The focus moves to health outcomes like better energy, clearer skin, and reduced risk of chronic disease.
3. Diverse Definitions of Health: Turns out your value isn’t tied to your ability to fit into skinny jeans. Who knew?

But let’s not get too smug—diet culture is like a cockroach. Just because you think you’ve squashed it doesn’t mean it won’t find a new way to thrive. Be wary of buzzwords like "clean eating" or "biohacking;" they’re often just rebranded food guilt.

Challenges to ConsiderBefore we declare victory over bad diets, there are a few hurdles to clear:

• Access to GLP-1 Drugs: These medications are expensive and often not covered by insurance. If they’re going to revolutionize health, they need to be affordable for everyone.
• Nutritional Education: We’ll need to teach people how to nourish their bodies without falling into new fads.
• Avoiding Over-Medicalization: Weight loss drugs are a tool, not a replacement for a balanced lifestyle. Don’t toss your running shoes just yet.

Citation: "Cost and insurance coverage are significant barriers to GLP-1 access for many patients" (Drucker, 2022).

How to Embrace the New Era of Diets TodayReady to ditch the old diet mentality and embrace the future? Here’s how you can get started:

• Add More Colors to Your Plate: No, not M&Ms—fruits and veggies. The more variety, the better.
• Think About Food as Fuel: Skip the crash diets and focus on eating foods that energize you.
• Experiment with Recipes: The future of eating should be fun, not a chore. Try new cuisines, flavors, and textures.
• Celebrate Small Wins: Did you swap your afternoon candy bar for an apple today? That’s a win worth celebrating.

Conclusion: Diets Are Dead (Long Live Diets!)Thanks to GLP-1 drugs, we’re witnessing the dawn of a new era. The diets of tomorrow aren’t about deprivation—they’re about abundance. They’ll prioritize what food can do for us, from boosting our mood to supporting long-term health.

This isn’t just a trend; it’s a revolution. And with the right tools, education, and maybe a little humor, we can finally stop fighting food and start embracing it. So let’s raise a glass (of antioxidant-rich red wine) to the end of diets as we know them. Cheers to a healthier, happier future!

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From Starving to Stuffed: The Evolution of Obesity in AmericaThe rise of ultra-processed foods in the United States closely parallels the surge in obesity rates and increased caloric intake observed from the 1980s onward. Starting in the 1970s, shifts in food production and consumer habits paved the way for these foods to become dietary staples, ultimately contributing to the obesity epidemic we see today. Let’s explore how these changes unfolded and their direct link to America’s rising weight problem.

1970s: Setting the Stage for Ultra-Processed FoodsIn the 1970s, the food industry underwent dramatic changes that laid the groundwork for the proliferation of ultra-processed foods.

1. Economic Shifts and Agricultural Policies
2. In 1973, new agricultural policies began to encourage farmers to produce more crops like corn, soy, and wheat. These policies made ingredients, particularly high-fructose corn syrup (HFCS) from corn, much cheaper for food manufacturers to obtain (Nestle, 2002). As a result, companies could produce food more cost-effectively and in larger quantities, leading to affordable, calorie-dense, ultra-processed foods.
3. Rise of Convenient Snack Foods and Fast Food
4. At the same time, the popularity of fast-food chains and processed snacks grew. Brands like McDonald's, Coca-Cola, and Frito-Lay expanded their offerings and marketed these convenient, hyper-palatable foods to the masses. They loaded these products with refined sugars, fats, and additives to enhance flavor and shelf life, making them hard to resist and easily accessible.
5. The “Diet” Food Craze
6. The 1970s also saw a surge in demand for high-protein diet products due to growing concerns about carbohydrates. Low-carb became the flavor, and at any given time, 10% of the country was on low-carbohydrate diets. Ironically, these “diet” foods often contained as many or more calories as regular options.

1980s: Ultra-Processed Foods Take Center Stage, and Obesity Rates Start to ClimbBy the 1980s, ultra-processed foods had fully embedded themselves in American diets, creating a foundation for the obesity epidemic.

1. Processed Food Production Surges
2. Food companies expanded their product lines in the 1980s, launching a wide range of snack foods, frozen meals, and sugary drinks. These foods were not only inexpensive but also tasty, thanks to the addition of refined sugars and fats, as well as preservatives to prolong shelf life (Monteiro et al., 2013). Marketing highlighted their convenience, appealing to busy families and individuals.
3. Caloric Intake Climbs
4. Alongside the rise in ultra-processed foods, average daily caloric intake also increased. Between the late 1970s and early 2000s, Americans consumed over 200 more calories per day. This rise came largely from high-calorie processed snacks and sugary drinks that were easy to consume between meals (Wright et al., 2004).
5. Obesity Rates Begin Their Upward Trajectory
6. During the 1980s, obesity rates started climbing. From 1980 to 2000, the obesity rate in U.S. adults jumped from 15% to 30% (Flegal et al., 2012). Children and teenagers weren’t spared either; childhood obesity rates nearly tripled, aligning with the increased availability of ultra-processed foods.

1990s: Fast Food and Convenience Foods Dominate the American DietThe 1990s brought even more ultra-processed foods, solidifying their role in the American diet.

1. Fast Food Reigns Supreme
2. Fast-food outlets exploded across the country in the 1990s, offering cheap, calorie-dense meals that were easily accessible. These chains embraced supersizing, encouraging customers to choose larger portions for just a small price increase. As a result, Americans began consuming more calories per meal, often in ultra-processed fast food.
3. Sugary Beverages Become a Staple
4. Consumption of sugar-sweetened beverages (SSBs) like sodas and sweetened teas, also skyrocketed during this decade. Many of these drinks relied on HFCS, delivering a heavy dose of empty calories without satisfying hunger. Studies show that sugary drinks don’t curb appetite the same way solid foods do, leading people to consume extra calories without feeling full (Malik et al., 2010).
5. Caloric Intake Peaks
6. By the end of the 1990s, Americans’ average daily caloric intake had reached new heights, with ultra-processed foods making up a significant portion of the diet. Research indicates that nearly 60% of Americans’ daily calories came from ultra-processed foods by the late 1990s (Monteiro et al., 2013). The rise in these calorie-dense, low-nutrient foods is directly correlated with increasing body weight and obesity rates.

2000s to Present: Ultra-Processed Foods and the Obesity EpidemicAs we moved into the 2000s, ultra-processed foods remained a dominant force in the American diet, pushing obesity rates even higher.

1. Obesity Reaches Public Health Crisis Levels
2. By 2020, nearly 42% of American adults and 20% of children were considered obese (Hales et al., 2020). Studies have consistently linked this trend with ultra-processed foods, which are designed to be “hyper-palatable” and, thus, difficult to resist. Their addictive taste profile has fueled a snacking culture, where more people consume larger portions and eat more frequently throughout the day.
3. Calories from Ultra-Processed Foods Remain High
4. Research shows that 60-70% of the average American’s daily calories now come from ultra-processed foods (Juul & Hemmingsson, 2015). These foods are often low in fiber, protein, and essential nutrients, which leaves people unsatisfied and more likely to overeat. Additionally, foods high in refined carbs and sugars cause blood sugar spikes and crashes, leading to frequent hunger pangs and cravings.
5. The Health Toll Beyond Obesity
6. Ultra-processed foods haven’t just contributed to obesity; they’ve also been linked to type 2 diabetes, cardiovascular disease, and certain cancers. Their high-calorie density, poor nutritional profile, and use of additives have been shown to negatively impact health, making them a major public health concern.
7. Efforts to Combat Ultra-Processed Food Consumption
8. Despite public health campaigns promoting whole foods, ultra-processed options remain attractive for many Americans due to their affordability and convenience. In many low-income areas, they’re also more readily available than fresh, whole foods, perpetuating health disparities.

Conclusion: Ultra-Processed Foods and America’s Obesity EpidemicSince the 1970s, the rise of ultra-processed foods in the United States has closely tracked with an increase in calorie consumption and obesity rates. As companies produced more of these convenient, highly palatable foods, Americans’ eating habits changed, leading to greater calorie intake through frequent snacking, sugary drinks, and supersized portions. The dominance of ultra-processed foods in the diet has not only contributed to rising obesity rates but also to an increase in related health issues like diabetes and heart disease.

Although efforts to reduce ultra-processed food consumption continue, their deep-rooted presence in American culture and food systems makes reversing the trend challenging. For a healthier future, we need a multifaceted approach that includes improved access to nutritious foods, public health policies, and greater awareness about the risks associated with ultra-processed foods.

References:

• Malik, V. S., et al. (2010). Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care, 33(11), 2477-2483.
• Monteiro, C. A., et al. (2013). Ultra-processed products are becoming dominant in the global food system. Obesity Reviews, 14(S2), 21-28.
• Nestle, M. (2002). Food Politics: How the Food Industry Influences Nutrition and Health. University of California Press.
• Hales, C. M., et al. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief, (360), 1-8.

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In recent years, GLP-1 agonists have gained significant attention as effective treatments for obesity and type 2 diabetes. However, emerging research suggests these medications may also influence brain function and behaviors related to reward and addiction. In this article, we’ll explore how GLP-1 agonists work, where they act in the brain, and how they can help reduce “food noise” — the constant chatter about food that often distracts us from healthier choices.

Understanding GLP-1 AgonistsGLP-1, or glucagon-like peptide-1, is a hormone released from the intestines after eating. It plays a crucial role in regulating appetite and glucose metabolism. GLP-1 agonists mimic this hormone, enhancing insulin secretion and reducing glucagon levels, which leads to lower blood sugar and reduced appetite. Popular medications in this class include semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda).

How GLP-1 Agonists Affect the BrainRecent studies have illuminated the complex ways in which GLP-1 agonists impact brain function, particularly in areas involved in reward processing. Researchers have found GLP-1 receptors in key brain regions such as:

Hypothalamus: This area regulates appetite and energy balance.

Nucleus Accumbens: Part of the brain's reward system, it processes pleasure and reward.

Prefrontal Cortex: This region is crucial for decision-making and impulse control.

By acting on these regions, GLP-1 agonists can dampen the brain's reward response to food, which may help reduce cravings for high-calorie, palatable foods (Müller et al., 2022).

GLP-1 Agonists and Food Noise“Food noise” refers to the mental chatter and constant preoccupation with food choices, cravings, and dietary restrictions that many people experience. This noise can lead to unhealthy eating patterns and distract individuals from making mindful food choices.

GLP-1 agonists appear to quiet this food noise. By enhancing satiety signals and reducing cravings, these medications help individuals feel fuller longer and decrease the frequency of thoughts about food. Studies indicate that people using GLP-1 agonists often report less preoccupation with eating and cravings, allowing them to focus on other aspects of their lives (Chaudhary et al., 2023).

Implications for Other AddictionsInterestingly, the effects of GLP-1 agonists extend beyond appetite regulation. Some studies suggest these medications may also influence other forms of addiction. For example, animal research indicates that GLP-1 agonists can reduce alcohol consumption, highlighting their potential for treating alcohol use disorder (Gonzalez et al., 2021).

This intersection raises important questions about the ethical use of GLP-1 agonists. While they can serve as valuable tools in addiction treatment, we must consider the implications of modifying behaviors that involve complex neurological pathways.

It even appears to change one's reaction to stress.

ConclusionGLP-1 agonists offer more than just a path to weight loss; they may help reshape our relationship with food and reduce the noise that often accompanies dietary decisions. As we continue to explore the benefits of these medications, understanding their multifaceted role in brain function is essential.

Further research will clarify how we can harness the potential of GLP-1 agonists in treating not only obesity but also other forms of addiction.

ReferencesChaudhary, N., et al. (2023). The effects of GLP-1 agonists on cognitive function and eating behaviors: A review. Journal of Obesity, 12(4), 234-245.

Gonzalez, R., et al. (2021). GLP-1 receptor signaling and alcohol consumption: Implications for addiction treatment. Neuroscience Letters, 748, 135709.

Müller, T.D., et al. (2022). GLP-1 receptor agonists: An update on their role in obesity treatment. Obesity Reviews, 23(2), e13356.

By addressing both obesity and potentially other forms of addiction, GLP-1 agonists represent a promising avenue in our quest for better health. Stay informed and explore how these medications can fit into your overall wellness journey!

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Apolipoprotein B (apoB) is the causative agent in atherosclerosis. If your apoB is low, you will not develop atherosclerosis. However, if your apoB is high, you could die young.

We know this because of genetic studies of people with different levels of apoB and their health outcomes.

What is Atherosclerosis of the heart?Atherosclerosis is a progressive laying down of "plaque" in the wall of the coronary arteries. Since the coronary arteries feed the heart, this can lead to three outcomes:

1. The plaque impinges on the artery. Thus, the plaque will decrease blood flow to the heart. This can lead to angina or a poorly working cardiac muscle.
2. The plaque can rupture (burst) into the artery. Next the body repairs this by clotting the blood. Thus, the blood flows to that portion of the heart is stopped. Without blood flow, the heart muscle starves, and if the flow isn't restored, that part of the heart will die. This is a heart attack or myocardial infarction.
3. The plaque can have no result. Meaning, it isn't stopping blood flow to lead to angina, and it doesn't occlude the artery.

What is in the plaque?In the above artery, you can see the yellow cholesterol in the wall. This is a "soft" plaque, like porridge.

The plaque is not inside the vessel. The artery is lined by a layer called the intima. So how does cholesterol get from the inside of the blood vessel to behind the layer?

The Process of Atherosclerotic Plaque FormationLipoprotein Entry into the Arterial Wall: The process begins when ApoB-containing lipoproteins pass through the endothelial layer of arteries. Normally, this layer acts as a barrier, but factors like high blood pressure or inflammation can make it more permeable, allowing these particles to accumulate beneath the endothelial cells.

Retention and Modification: Once inside the arterial wall, ApoB lipoproteins are trapped by proteoglycans (components of the extracellular matrix). These retained lipoproteins undergo modifications, such as oxidation, which makes them more likely to trigger inflammatory responses.

Inflammatory Response: The modified lipoproteins activate endothelial cells and attract immune cells like monocytes. These monocytes enter the arterial wall and transform into macrophages. Macrophages engulf the modified lipoproteins, turning into foam cells, which are a hallmark of early atherosclerotic plaque.

Plaque Development: Over time, foam cells accumulate, leading to the formation of fatty streaks in the arterial wall. Smooth muscle cells migrate into the intimal layer of the artery, contributing to the formation of a fibrous cap that covers the plaque. This cap consists of connective tissue, calcium, and cholesterol deposits.

Progression and Complications: As the plaque grows, it narrows the artery and restricts blood flow. If the fibrous cap ruptures, it can lead to the formation of a blood clot (thrombus), which may block the artery entirely, causing a heart attack or stroke.

Preventing Plaque FormationUnderstanding how ApoB-containing lipoproteins contribute to atherosclerosis underscores the importance of managing blood cholesterol levels. Lifestyle changes such as diet, exercise, and medications like statins can reduce LDL levels, lowering the risk of plaque formation and subsequent cardiovascular events.

Atherosclerosis is a gradual process that starts with the seemingly harmless entry of ApoB lipoproteins into arterial walls. By addressing the risk factors that promote lipoprotein retention and inflammation, the progression of atherosclerosis can be slowed or prevented.

LDL particle sizeLDL particles can vary in size, and it was previously believed smaller, denser LDL particles were more atherogenic than larger, buoyant ones. However, research has shown that the number of LDL particles, regardless of size, is a more significant determinant of cardiovascular risk. Studies indicate that the concentration of LDL particles is more closely associated with atherosclerosis than the size of the particles themselves.

The ApoB Factor: Why It's a Big DealApoB is a protein found on the surface of atherogenic lipoproteins, including LDL, VLDL, and IDL. Each of these particles contains one ApoB molecule, making ApoB a direct measure of the number of atherogenic particles in the blood. This measurement is crucial because it provides a clearer picture of the atherogenic burden in the bloodstream than LDL-C alone.

Why ApoB is the Star Player

Direct Measure of Risk: ApoB directly measures the number of atherogenic particles, providing a more accurate assessment of cardiovascular risk.

Independent of Particle Size: Unlike LDL size, which can vary and complicate risk assessment, ApoB consistently reflects the number of risk-contributing particles.

Predictive Power: Numerous studies have shown that ApoB is a better predictor of cardiovascular events than LDL-C or other traditional lipid measures.

ApoB: Direct Measurement of Atherogenic Particles

Apolipoprotein B (ApoB) is the main protein component of several lipoproteins, including low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and lipoprotein(a). Each atherogenic particle contains one molecule of ApoB, making ApoB a direct measure of the number of atherogenic particles circulating in the bloodstream.

Key Points:Direct Indicator of Particle Number: Since each atherogenic lipoprotein particle has one ApoB molecule, measuring ApoB provides an accurate count of these particles. This is crucial because the more atherogenic particles present, the higher the risk of these particles penetrating the arterial walls and contributing to plaque formation.

Independent of Cholesterol Content:The cholesterol content does not influence ApoB measurement within these particles. Therefore, it provides a clearer picture of cardiovascular risk, especially in cases where LDL cholesterol (LDL-C) levels might be normal, but the number of LDL particles (and thus ApoB) is high.

HDL-TG Ratio: A Marker of Lipid MetabolismThe HDL-TG ratio, which is the ratio of high-density lipoprotein cholesterol (HDL-C) to triglycerides (TG), is used as a marker to assess lipid metabolism and insulin resistance. A high HDL-TG ratio generally indicates a favorable lipid profile and a lower risk of cardiovascular disease. However, this ratio has limitations:

Indirect vs direct measure:Indirect Measurement: The HDL-TG ratio provides an indirect measure of cardiovascular risk. It does not directly quantify the number of atherogenic particles but rather gives a sense of lipid metabolism status. While a low HDL-C and high TG level can indicate higher cardiovascular risk, it doesn't directly account for the number of atherogenic particles present.

Variability and Confounding Factors:Several factors can influence the ratio, including lifestyle, diet, and metabolic disorders, which can confound its predictive value for cardiovascular risk. Additionally, HDL-C levels alone have not consistently been shown to correlate with reduced cardiovascular risk, as HDL particles can vary in functionality.

Why ApoB is More ImportantPredictive Power: Numerous studies have shown that ApoB is a stronger predictor of cardiovascular events than the HDL-TG ratio. For instance, the INTERHEART study highlighted that ApoB levels were more predictive of myocardial infarction than other lipid markers, including the HDL-TG ratio.

Comprehensive Risk Assessment: ApoB accounts for all atherogenic particles, providing a more comprehensive assessment of cardiovascular risk compared to measures that only consider cholesterol content or ratios of different lipid components.

Focusing on the Right MetricIn summary, the focus has shifted from LDL particle size to the number of atherogenic particles, as measured by ApoB. This shift is grounded in the understanding that cardiovascular disease risk is more closely linked to the number of these particles rather than their size or cholesterol content alone. Therefore, ApoB provides a more accurate and reliable measure for assessing cardiovascular risk.

ConclusionWhile both ApoB and the HDL-TG ratio can provide valuable information about lipid metabolism and cardiovascular risk, ApoB is considered more important due to its direct measurement of atherogenic particles. This makes it a more reliable and comprehensive marker for assessing the risk of atherosclerosis and related cardiovascular events.

Citations:Sniderman, A. D., & Tsimikas, S. (2014). Apolipoprotein B. Circulation, 129(11), 1112-1120.

Packard, C. J., & Shepherd, J. (1999). Lipoprotein heterogeneity and apolipoprotein B metabolism. Atherosclerosis, 141(1), 27-42.

McQueen, M. J., Hawken, S., Wang, X., Ounpuu, S., Sniderman, A., Probstfield, J., ... & Yusuf, S. (2008). Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. The Lancet, 372(9634), 224-233.

Cromwell, W. C., & Otvos, J. D. (2004). Low-density lipoprotein particle number and risk for cardiovascular disease. Current Atherosclerosis Reports, 6(5), 381-387.

Mora, S., Otvos, J. D., Rifai, N., Rosenson, R. S., Buring, J. E., & Ridker, P. M. (2009). Lipoprotein particle profiles by nuclear magnetic resonance compared with standard lipids and apolipoproteins in predicting incident cardiovascular disease in women. Circulation, 119(17), 931-939.

Packard, C. J., & Shepherd, J. (1999). Lipoprotein heterogeneity and apolipoprotein B metabolism. Atherosclerosis, 141(1), 27-42.

Sniderman, A. D., & Furberg, C. D. (2008). Age as a modifiable risk factor for cardiovascular disease. The Lancet, 371(9623), 1547-1548.

Cromwell, W. C., & Otvos, J. D. (2004). Low-density lipoprotein particle number and risk for cardiovascular disease. Current Atherosclerosis Reports, 6(5), 381-387.

Sniderman, A. D., & Tsimikas, S. (2014). Apolipoprotein B. Circulation, 129(11), 1112-1120.

Harchaoui, K. E., Visser, M. E., Kastelein, J. J., Stroes, E. S., & Dallinga-Thie, G. M. (2009). Triglycerides and cardiovascular risk. Current Cardiology Reviews, 5(3), 216-222.

McQueen, M. J., Hawken, S., Wang, X., Ounpuu, S., Sniderman, A., Probstfield, J., ... & Yusuf, S. (2008). Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. The Lancet, 372(9634), 224-233.

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The Cyclical Nature of Autoimmune Diseases: A Huckster's PlaygroundAutoimmune diseases are notoriously difficult to manage because they don’t follow a linear progression. Patients often experience periods of remission, where symptoms lessen or disappear, followed by flare-ups, where symptoms return, sometimes worse than before. This cyclical nature gives the illusion that certain "treatments" or lifestyle changes are working when, in reality, the disease is simply following its natural course.

Hucksters exploit this ebb and flow, offering unproven solutions and claiming credit for any improvements that coincide with the natural remission phase. When symptoms return during a flare-up, they may shift the blame to the patient, suggesting they didn’t follow the regimen properly or need to try an even more restrictive approach.

In many cases, these alternative therapies center around the idea that gut issues cause autoimmune diseases, particularly leaky gut syndrome. The pitch is simple: repair the gut, and the immune system will stop attacking the body. Unfortunately, the science doesn’t back this up.

Why the Gut Isn’t the Root Cause of Autoimmune DiseaseIt's true that there is a connection between the gut and the immune system. In fact, about 70% of the immune system resides in the gut, and gut bacteria (the microbiome) play a role in regulating immune responses. However, autoimmune diseases are far more complex than just a gut issue.

Genetic predispositions primarily drive Autoimmune diseases, environmental triggers, and immune system dysregulation. While diet and gut health can influence immune responses, there’s no evidence that simply "healing" the gut will reverse the course of autoimmune diseases. The immune system in these conditions has gone awry in ways that are not fully understood, and current medical treatments focus on suppressing overactive immune responses and managing symptoms—not on gut health alone.

Myasthenia Gravis (MG) is an autoimmune disease where medical treatment significantly outperforms dietary interventions.MG is characterized by autoantibodies targeting the neuromuscular junction, leading to fluctuating muscle weakness and fatigability. The primary treatment modalities for MG involve immunosuppressive therapies and precision medicine approaches.

Current treatment guidelines, as discussed by Cavalcante et al., highlight the use of immunosuppressive therapies such as corticosteroids, azathioprine, and mycophenolate mofetil to control symptoms and improve muscle strength. (reference here)

Additionally, novel biological drugs targeting B cell activation, antibody recycling, and complement system-mediated neuromuscular junction damage have shown efficacy and safety in clinical trials. These precision medicine approaches are tailored to the patient's specific immunopathogenic mechanisms, offering a more targeted and effective treatment strategy.

In contrast, dietary interventions have not demonstrated significant efficacy in managing MG. While general nutritional support is important for overall health, there is no specific diet that can modulate the autoimmune mechanisms underlying MG to the same extent as pharmacological treatments.

In summary, medicine does better than diet in managing Myasthenia Gravis, with immunosuppressive therapies and precision medicine approaches being the cornerstone of treatment.[1]

Here’s why relying on gut health as the sole solution is like using a garden hose to fight a forest fire:A. The Complexity of Autoimmune DysregulationAutoimmune diseases involve dysregulation at multiple levels of the immune system. In diseases like lupus or multiple sclerosis, immune cells are mistaking the body's own tissues for foreign invaders. This misidentification isn’t simply the result of a leaky gut; it’s a deeper issue with how the body’s T-cells, B-cells, and other immune components are functioning.

Medical treatments for autoimmune conditions, such as biologics and immunosuppressants, target these complex pathways to reduce inflammation and prevent further tissue damage. These therapies are carefully designed to modulate specific immune processes—something that diet and gut health alone can’t achieve.

B. Gut Health Cannot Reverse Severe Immune AttacksImagine trying to put out a raging forest fire with a garden hose—that’s what focusing solely on gut health is like when trying to manage autoimmune flare-ups. Autoimmune diseases can cause severe damage to the organs, such as the joints, kidneys, or central nervous system, depending on the condition. These diseases are often life-altering and, in severe cases, life-threatening.

Even if the gut plays some role in immune regulation, "fixing" the gut doesn’t address the immune attacks happening in vital organs throughout the body. Managing an autoimmune condition requires powerful treatments that target these immune responses at the source, not superficial changes to the digestive system.

C. Gut-Focused Diets Can Be Restrictive and HarmfulAnother major issue with the gut-healing approach is that it often involves restrictive diets that cut out whole food groups in the name of reducing inflammation or healing the gut lining. These diets, such as the autoimmune protocol (AIP) or extreme versions of the paleo diet, are promoted as cures but lack strong scientific backing.

For many patients, these diets can lead to nutrient deficiencies, unnecessary food anxiety, and added stress—none of which is helpful when managing a chronic condition. Worse, some people may forego or delay important medical treatments, opting instead for these restrictive, gut-healing diets in hopes of a cure. This can lead to uncontrolled disease progression and irreversible damage to organs.

What We Do Know: The Gut’s Role in Autoimmune Disease ManagementThis isn’t to say the gut has no role in autoimmune disease—far from it. Gut health can influence overall health, including the immune system, and managing autoimmune diseases often includes dietary adjustments to improve symptom management. But diet should be seen as one tool in a larger toolbox, not the magic bullet.

For example:Probiotics and prebiotics may support gut health and help modulate immune responses in some cases, though the evidence is still emerging.

However, if these patients are not appropriately followed, they can develop kidney involvement leading to loss of function or severe joint destruction for RA type, or even severe vasculitis, and none of these conditions are treated by or recognized by chiropractors

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Should I eat bread?The low carbohydrate movement has demonized bread. But is bread fattening? Does it cause inflammation? And if so, why do we call bread the Staff of Life?

The Staff of LifeImagine calling white bread the staff of life. And yet bread is more responsible for humans ending a nomadic existence. The cultivation of wheat and barley, both in the Nile and in the Euphrates/Tigris rivers, led to civilization.

Calendars, Art, Religion

Not having to forage meant there was time to build a more permanent shelter. It also meant a steady supply of food.

This also meant a calendar was needed because when is the optimal time to plant?

The calendar helped predict when the rivers would swell and recede. The bottom land, with its rich topsoil, is ideal for growing crops.

When you don't need to spend time looking for food, you have time to develop other things:

• Make a religion around grains - the god of the weather, of the earth of the river
• Grain can become the first currency, facilitating trade
• Art because you spend less time seeking food
• Storage systems to overcome times of famine.
• Mathematics, weights, and measures are needed to buy and sell grain
• Writing to make contracts and facilitate trade of the grain
• A government is needed to settle disputes

Storage SystemsHarvested grain can be stored. Storing grain in Egypt was easier because of the dry climate. Joseph, of the Hebrew Bible, prophesied to the Pharoh of an upcoming famine. As a result, the Pharoh built silos and stored a portion of each harvest. Seven years later, the harvest failed. But

The silo system was complex. Filling from the top and arranged in a way that winds would keep the grains cool. Where did Egyptians get the idea for such an invention? From bees. You can see the bees' natural ventilation system here:

Bees were the symbol of royalty in ancient Egypt. Their honey was tears from the sun god. Bee architecture was copied for the ventilation system for the silos storing grain. Thus, the storage of grain allowed society to thrive during the time of famine.

Bronze Age to Iron AgeBread was portable. Served as currency. Allowed armies to march. Facilitated trade between city states. The grain rich regions of the Nile produced grain traded with Mycennians for olive oil and wine.

The Roman emperors gave bread to the poor as welfare. Part of the bread and circus program to keep Romans happy. Bread was imported to Rome, and ultimately, Roman citizens were given "their daily bread."

Rome fell, but bread continued to be important.

Bread until 1920Grains, including bread, were the major source of calories for most of Europe. From the fall of Rome through the Middle Ages, bread was the main source of calories, along with other grain products.

Bread in the Industrial AgeWhite bread was considered pure, hygienic, the whiter the better. Brown bread could be contaminated. The ability of mills to separate wheat from chaff, and to make bread without a human hand touching it was irresistible. Industrial bread slicing resulted in "best thing since sliced bread."

White bread became the preferred style of bread from the 1920s until 2009.

Fortification of bread with vitamins in the 1940s made bread a health food. Pellagra (vitamin B 3 deficiency) and beriberi (thiamine deficiency) had sadly become common in the US and were eliminated by fortification. So it was indeed revolutionary, but calling it a health food? Even the Federal Trade Commission had issues with this "12 ways campaign" and sued Wonder Bread. The Feds lost.

Age of Aquarius Beats BreadIn spite of the world loving white bread, with baby boomers and Gen X growing up on it, there was rebellion. Health guru Adele Davis, who sold millions of health books, decried bread for its lack of fiber and urged people to make whole wheat bread at home.

But then came the hippies and the summer of love. Hundreds of kids were flocking to San Francisco without jobs, without money, and hungry. Feeding these young adults became a group priority.

In 1967, Walt Reynolds came, brought 400 pounds of flour, and baked bread twice a week to feed these kids. They didn't have enough bread trays, so they used coffee cans.

Walt insisted on using whole wheat bread, something rare in those days. But this became part of the counter-culture. Make your own bread. Make it healthy. It became their own bread, their own symbol.

We don't know what happened to Walt Reynolds after this - he lives, changed the way a generation looked at bread, and then disappeared.

Atkins and BreadThe low carb movement of the 1970's meant bread sales went declined. They recovered a bit, but in the second Atkins revolution, bread sales were down in some bakeries by 40%. Today Atkins Corporation sells bread.

But How to Make ItWhile there were lots of recipes to make bread from Digger Bread, as seen above, home cooks wondered. Then came along another baker who made the bread everyone dreamed of. From the baker of the Zen Retreat - we have this book.

In 2009 whole wheat bread surpassed white bread as the major bread sold over time. With fiber at the core all whole wheat products have increased.

And we can say for certain—yes, you can buy bread—but buy or make your own. Today, I can walk to a local baker who makes whole-grain sourdough bread.

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Seed Oils: Toxic or Not?Today, the low-carb/carnivore community has a new enemy. It is seed oils. Here is their argument:

• There were no seed oils in ancient lands
• Seed oils are highly inflammatory
• Seed oils are extracted with hexane, a cancer-causing agent
• The rise of seed oils correlates with the rise of obesity
• Seed oils are high in omega-6 fatty acids, which are inflammatory

That is the summary of their logic. Now, let's get to the science.

What are Seed Oils?See those beautiful seeds, in them are bits of oil. This is the rapeseed plant, which we have covered before. From rapeseed came canola oil. And this has been used as a source of oil starting about 4000 years ago. A much misunderstood oil, please see our previous podcast.

Seed OilsEvery seed has oil. Nuts are a type of seed, and their caloric density comes from oil. Oddly, low carb/keto types tend to eat nuts, the carnivore crowd avoids them.

Seed oils are another name for vegetable oils, and they are used often in cooking because they have a neutral taste and high smoke point. The more common ones include corn, peanuts, sunflowers, grapes, and others.

Seed Oils and Ancient Humans Besides the logical fallacy about what ancient humans ate, seed oils have been cultivated and used for the whole of written humanity. Ancient Egyptians used oils for cooking and perfume. Even the Bible talks about the use of oils, including the gifts sent to the birth of Jesus. To summarize, humans have recorded the use of oils from seeds through all recorded history.

Components of Seed OilsThere is no one "oil" that can chemically be called a "seed oil." Rather, every seed contains different compositions of oils, and it is how the body uses those particular oils that makes us interested in them. Thus, seed oils as a term is silly. I wonder why the carnivore/keto crowd decided to use "seed oils" instead of vegetable oils? After all, they don't call beef tallow "meat oil."

Oleic Acid: Olives to ButterOleic acid is the main fatty acid in olive oil (55-85% of the oil). This is a mono-unsaturated fatty acid, which everyone seems to agree is heart healthy. Hence, the more oleic acid in something, the better.

• Peanut oil 48%
• Canola oil 65%
• Palm oil 39%
• Soybean oil 23%
• Coconut oil 7%
• Beef Tallow 47%
• Butter 24%

But are Vegetable Oils Inflammatory?The short answer is no. To be inflammatory, they would have to elicit an inflammatory response. This means that inflammatory markers in the blood would be elevated for those who use vegetable oils over meat oils. In contrast, there is no increase in inflammatory markers of those who use vegetable oils.

Want to see the data? Take a look at this paper where they look at foods, like vegetable oils, with high ratios of omega-6 fatty acids. What didn't they find? Higher levels of inflammatory markers. Thus, seed oils are not inflammatory.

Atherosclerosis and Seed Oils

Do vegetable oils increase your risk of atherosclerosis, or do they decrease it? If the carnivore crowd is correct, they have not been yet, then their view of the vegetable oils is that it would increase your risk of atherosclerosis

REFERENCES:Courville AB, Majchrzak-Hong S, Yang S, Turner S, Wilhite B, Ness Shipley K, Horneffer Y, Domenichiello AF, Schwandt M, Cutler RG, Chen KY, Hibbeln JR, Ramsden CE. Dietary linoleic acid lowering alone does not lower arachidonic acid or endocannabinoids among women with overweight and obesity: A randomized, controlled trial. Lipids. 2023 Nov;58(6):271-284. doi: 10.1002/lipd.12382. PMID: 38100748; PMCID: PMC10767670.

Innes JK, Calder PC. Omega-6 fatty acids and inflammation. Prostaglandins Leukot Essent Fatty Acids. 2018 May;132:41-48. doi: 10.1016/j.plefa.2018.03.004. Epub 2018 Mar 22. PMID: 29610056.

Fava M, De Dominicis N, Forte G, Bari M, Leuti A, Maccarrone M. Cellular and Molecular Effects of Microgravity on the Immune System: A Focus on Bioactive Lipids. Biomolecules. 2024 Apr 5;14(4):446. doi: 10.3390/biom14040446. PMID: 38672462; PMCID: PMC11048039.

Ooi EM, Watts GF, Ng TW, Barrett PH. Effect of dietary Fatty acids on human lipoprotein metabolism: a comprehensive update. Nutrients. 2015 Jun 2;7(6):4416-25. doi: 10.3390/nu7064416. PMID: 26043038; PMCID: PMC4488792.

Prater MC, Scheurell AR, Paton CM, Cooper JA. Blood Lipid Responses to Diets Enriched with Cottonseed Oil Compared With Olive Oil in Adults with High Cholesterol in a Randomized Trial. J Nutr. 2022 Sep 6;152(9):2060-2071. doi: 10.1093/jn/nxac099. PMID: 35511204; PMCID: PMC9449680.

Isaakidis A, Maghariki JE, Carvalho-Barros S, Gomes AM, Correia M. Is There More to Olive Oil than Healthy Lipids? Nutrients. 2023 Aug 18;15(16):3625. doi: 10.3390/nu15163625. PMID: 37630815; PMCID: PMC10459315.

Schwingshackl L, Bogensberger B, Benčič A, Knüppel S, Boeing H, Hoffmann G. Effects of oils and solid fats on blood lipids: a systematic review and network meta-analysis. J Lipid Res. 2018 Sep;59(9):1771-1782. doi: 10.1194/jlr.P085522. Epub 2018 Jul 13. PMID: 30006369; PMCID: PMC6121943.

Neuenschwander M, Stadelmaier J, Eble J, Grummich K, Szczerba E, Kiesswetter E, Schlesinger S, Schwingshackl L. Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies. BMC Med. 2023 Nov 16;21(1):404. doi: 10.1186/s12916-023-03093-1. PMID: 37968628; PMCID: PMC10652524.

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Ancestral Diets and Logical FallaciesThere is an appeal to ancient history: the idea that ancient beings were either "designed"—as from a creator—or "evolved" to eat in a certain way. Both are logical fallacies, but both are meant to be the "ex-cathedra" in a debate.

You read these logical fallacies in communities that claim they understand this. Here are some comments you will get:

• Our ancestors ate xyz (fill in the blank) and never had the modern chronic diseases
• Our teeth have (canines/molars), so we were designed to eat only (meat/plants)
• You won't see broccoli on the walls of caves
• If we ate like our ancestors, we would be in great health.

Appealing arguments, but they are as flawed as they are simply incorrect.

What Do We Know About Early Humans?Of the early human records, they are based on precious little data. Consider in the fossil record we have about our ancestors? And by the way, where do we start?

If we begin with homo sapiens, we have been around as a species somewhere between 70,000 to 250,000 years.

Often the "low-carb" community will conflate distant cousins of homo sapiens as direct ancestors. Most of them were not but were a branch on the tree of evolution that are only related to us.

Homo ErectusPerhaps the best adapted was the homo erectus, which was around for two million years. It is doubtful that homo sapiens will make it that long, but we can hope.

Most fossil finds come from Australia and Asia - where they not only foraged but also established some organized hunting.

Fossil RecordsThere are about 6000 fossils of early man. That's it. Just 6,000. When we look for fossils of our particular, such as early homo sapiens, we have enough fossils that we might fill up a school bus.

How long did they live? It turns out we know. Many died around the age of 35 years. So why do we want to eat like they did?

At this point, someone in the audience will be bound to say - "They lived longer if you take into account infant mortality."

When we date a fossil and see when it died, we don't average the infant mortality of the time.

Recent DiscoveriesBones and teeth from seen people, and isolated teeth, were reported recently. These came from a cave in Morocco. As these teeth are from about 15,000 years ago. Hence, the diet was before the advent of agriculture.

Evidence points to plants being a major part of these hunter-gatherer's menu. As plants can be stored by hunter-gatherers all year round to protect against seasonal prey shortages. Thus, there is a regular food supply.

Hunter-GatherersThe famous caveman diet- life wasn't so simple.

When people of the carnivore tribe try to convince you about their diet, they invoke the mighty hunter.

A better term was that our ancestors survived by being fishers, gatherers, and scavengers.

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Rice and Fruit or CarnivoreThe rice diet successfully treated malignant hypertension. Today, we have medications that treat malignant hypertension. Before the 1940s, there were no drugs available to treat this disease, resulting in death from untreated malignant hypertension within six months. Despite the best medical care available, President Franklin Delano Roosevelt died from this disease.

History of the Rice DietWalter Kempner developed the rice diet to treat malignant hypertension. For example, failing kidneys would be given a reprieve with a diet low in sodium and protein. Then removal of saturated fat would allow some recovery of the heart.

In a disease that had 100 percent death in six months, Kempner's results were amazing. For example, in Kempner’s original cohort of 192 people, only 25 patients died. In addition, 107 patients showed significant improvement (from 200/112 mm Hg to 149/96 mm Hg) with the diet. Equally important, heart size decreased in 66 of 72 patients. Moreover, cholesterol was reduced in 73 of 82 patients. Finally, retinopathy improved or disappeared completely in 21 of 33 patients.

"Therapeutic results are little short of miraculous," noted an editorial in the New England Journal of Medicine.

The Rice DietPatients were first hospitalized. The diet consisted of white rice, sugar, fruit, fruit juices, vitamins and iron. Total calories were 2,000 with 20 grams of protein and 150 mg of sodium.

Kempner kept careful records of his patients. Reporting success and failure is a key to academic transparency. Finally, the ability to reproduce the data in other centers provided the final key to Kempner's work.

Contrast the Carnivore DietThe carnivore diet is popular among young, buff men whose living is made by promoting and coaching this diet. They sell the diet based on classic marketing techniques used for overweight patients.

• Lose weight without trying
• No need to log your food
• Eat as much as you want
• Hunger isn't an issue

Marketing phrases used by hucksters for years to trap people unhappy about their weight.

No Science in the Carnivore DietThe carnivore diet relies on anecdotes, not evidence. Testimonials rule Facebook and YouTube sites. There are no publications about the diet. Finally, many in the carnivore community push against medicine. Conspiratorial thinking is strong, with phrases like this:

• Doctors want you to be sick
• The Medical Community wants to push pills
• Vegetables have anti-nutrients

Try to raise a concern about how this diet would increase the risk of heart disease, and they double down with misinformation. They will deny the evidence showing that high cholesterol leads to heart attacks and strokes. Or make the claim that if you are "metabolically healthy," you don't need to worry about cholesterol.

No Academic ResearchersThere are no academic research scientists following people trying the carnivore diet.

That means there is no transparency about the results. In addition, there is no accountability for any bad results.

Those who promote the diet include Paul Saladino, a physician who doesn't see patients and makes his income selling supplements.

The Liver King, who doesn't follow the diet, was caught using performance-enhancing drugs.

Shawn Baker is an orthopedic-trained surgeon who lost his medical license and makes his money promoting the carnivore diet. The New Mexico Medical Board ordered the "voluntary and permanent surrender" of Baker's medical license in 2017. "This action was based on failure to report adverse action taken by a healthcare entity and incompetence to practice as a licensee." He had his license reinstated but is not seeing patients for anything more than coaching for $150 for half an hour.

Ken Berry also lost his medical license for inadequate infection prevention in his offices. He has regained his license.

Concerning CommentsSome comments left on a recent YouTube video by Shawn Baker include:

• A patient developed painful neuropathy from vitamin B6 toxic levels. He quit the carnivore diet and vows never to return
• Another patient developed high oxylate levels. More kidney stones come from eating red meat than spinach - sorry, Paul Saladino.
• One noted fasting glucose increased to 126, which we call diabetes. Saturated fat is not a friend of the pancreas and increases insulin resistance.
• Another noted worsening kidney function with his filtration rate decreasing by 23 percent.
• Multiple complaints about LDL, including one that went from 148 to 353
• Psoriasis is often touted as being healed with this diet, but one noted their psoriasis spreading and getting worse. Red meat is highly inflammatory and not the optimal diet for people with psoriasis. Although psoriasis will come and go spontaneously, a carnivore diet is the worst diet for these patients.
• Gynecomastia was noted by one male, and if you look at many carnivore shirtless salesmen of scams, you will see they also suffer from gynecomastia - those aren't pectoral muscles, those are breasts. Red meat can increase estrogen levels greatly.

Not once did Shawn Baker instruct these people to see their regular doctor for appropriate treatment and follow-up. Hopefully, this will change.

University StudiesDo a research study with human subjects in a university, and there will be an independent board looking over the results. If there are any adverse results, those are reported to the research board, and sometimes studies are stopped because of too many adverse events. When results are published, both the good and the bad - like Kempner's work - are reported.

Don't Do The Rice DietThe rice diet is for historical purposes only. The Mediterranean Diet is a far superior and more balanced diet. With over 13,000 peer reviewed publications, the Mediterranean Diet is the current pattern of eating that we recommend.

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The Benefits of Whole Grains in Your DietI want to take you back in time. While we talk about the Mediterranean diet not being a diet of culture but a pattern of eating – it still had its origins in the Mediterranean.

The original Mediterranean diet was described as far back as 500 BC in the Ilead. The ancient Greeks ate whole grains, fruits, vegetables, pulses, and a bit of fish. Red meat was rare.

While red meat may not have been a dietary staple for the Ancient Greeks, it was consumed during feasts, festivals, and special occasions.

Cows were considered sacred gods, like Zeus, and their slaughter was for religious ceremonies and consumed during feasts

The majority of the population received protein from fish, poultry, legumes, and whole grains.

The First OlympicsThis was the diet of the first Olympians, as well as the Romans. Ancient Greeks worshiped the body, as you can see from the statues, as well as our language.

We get the word gym from the Greek word “gymnasion," which translates to a place to exercise naked. But those gyms not only had a place to train but also schools, where literature, philosophy, math, and music were taught, as well as a social gathering place.

We also get Diet from the Greeks, which originates from “diaita,” meaning the “way of life” or a manner of living. The Greeks had a balanced approach to health and well-being, emphasizing diet, exercise, and the mind.

Gym bros and bro science were yet to be invented.

Ancient GrainsCould those Olympians of old who ate diets filled with whole-grain cereals have been wrong? Or could it be that those grains of the past were different from today’s grains?

If you’ve ever been on a “low carb” diet, one of the first food groups you eliminate are grains.

As you dutifully got rid of the last bit of joy in your life, you feel it was the cost to have your weight drop.

You might have thought – "Grains are evil."

Low Carb Life Without GrainsEating burgers without the bun, breakfast without toast, no pastries, no bread, no pasta, no rice, and you were losing weight. Lots of confirmation bias.

Oh those heady early days of a low carb diet, losing weight, feeling better, maybe even noticing cholesterol improved. Hard to sustain though, and did you ever get tired of steak?

Finding Joy in the Mediterranean DietNow you come here and find the best diet is the Mediterranean diet. Lots of peer reviewed literature to support it.

Then you wondered what in grains was evil. The first easy thought was that it all breaks down to glucose, and glucose is evil.

Unless you know biochemistry and realize no, that’s not it. Your body runs on glucose.

It's the GlutenAnd maybe you read about celiac disease and gluten as its trigger. Maybe some blogger convinced you that wheat in America is filled with gluten, and this is the problem.

Unable to sustain a low-carb diet, you return to the joy of the morning pastry or dessert, all the while thinking grains are what caused the weight to return.

Now you come to the Mediterranean Diet, and whole grains, not refined grains, are on the menu.

Still, you are suspicious, and you think – maybe it was the gluten.

Celiac DiseaseOr what happens if you come to the Mediterranean diet and have Celiac disease and gluten causes horrific issues?

But should we all avoid gluten? And can we have a Mediterranean diet if we must be gluten-free?

Should the ancient Greeks become Carnivores instead of those grizzly men who are on a diet now associated with the healthiest people on planet Earth?

Clearly not. Eating too much red meat is associated with increasing heart disease and cancer, while the Mediterranean diet is associated with less heart disease and cancer.

Carnivore's TakeCarnivores like pointing to the ancient wrestler Milo of Croton, who ate twenty pounds of meat a day. They fail to mention that he also ate twenty pounds of bread and drank 18 pints of wine while training. Funny, they all talk about the meat. –There are always outliers, and Milo was one.

When Milo trained, he carried a calf, and as the creature grew, he kept carrying it. He won about six Olympic medals (560 BC).

While we don’t know details, it is odd he ate meat, since his mentor Pythagoras – of the theorem – thought eating meat was unhealthy and made people wage war.

Grains are Evil - "They" SayAnd despite what the low-carb and carnivore community tells you, Whole grains have been associated with decreased risk of diabetes, less obesity, and lower rates of cancer and heart disease.

Whole grains have a lot of fiber. In fact, whole grains are one of the fiber rich portions of the foods you eat.

Gluten is a protein found in many grains, like wheat, but not all grains. Do you know how to stretch dough? Like pizza, the reason you can do it is gluten.

For most of us, gluten isn’t an issue. But for about one percent of the population, gluten can exacerbate an auto-immune response against your small bowel.

If you have celiac disease...If you have celiac disease and have gluten in your diet, your bowel will be harmed. Thus, you will not effectively absorb nutrients. Many with celiac disease have anemia from an inability to absorb iron.

Most patients with celiac disease will feel bloated with gas, sometimes diarrhea, or even constipation. They might have chronic fatigue or weakness due to a lack of nutrients. In children, it often leads to weight loss. In adults, it can manifest in weight gain.

The symptoms are vague and not specific, but they are part of a history that we see with our patients.

Gluten-free for EveryoneSince the symptoms are so general, many people advocate a gluten-free diet. Some have written books about how gluten causes issues in everyone, and we should avoid it. This is incorrect, but it does sell a lot of books.

Incorporating Gluten-Free Whole Grains

Here are some easy ways to add gluten-free whole grains to your Mediterranean-inspired meals:

1. Quinoa: Swap traditional grains like couscous with quinoa in salads, pilafs, or stuffed vegetables. Quinoa is a complete protein and offers a nutty flavor that complements Mediterranean ingredients well.
2. Brown Rice: Use brown rice instead of traditional pasta in dishes like risotto, stir-fries, or alongside grilled fish or chicken. Brown rice provides a hearty texture and adds a dose of fiber to your meal.
3. Millet: Experiment with millet in place of bulgur wheat in tabbouleh salads or use it as a base for grain bowls topped with roasted vegetables and a drizzle of olive oil.
4. Buckwheat: Incorporate buckwheat flour into your baking for gluten-free bread, pancakes, or crepes. You can also use cooked buckwheat groats as a nutritious alternative to traditional grains in salads or as a side dish.
5. Amaranth: Add amaranth to soups, stews, or porridge for a nutrient-packed boost. Its slightly nutty flavor pairs well with Mediterranean spices and herbs.

My favorite is oatmeal. But make sure you get oats that were ground away from wheat. Bob’s Red Mill has a gluten free oat that you can use. Since oats are a staple of my morning breakfast you might find these a great choice.

Finally, corn is a whole grain. Good to add to salads, and my favorite cowboy caviar dish.

By incorporating gluten-free whole grains into your Mediterranean diet, you can enjoy a diverse range of flavors and textures while reaping the nutritional benefits of these wholesome ingredients. Whether you're looking to support digestive health, manage blood sugar levels, or simply explore new culinary horizons, there's a gluten-free whole grain waiting to elevate your next meal.

Whole grains are a powerhouse of nutrition, offering a range of health benefits that make them an essential part of a balanced diet.

Why Gluten-Free Whole Grains?But what if you have celiac disease and cannot tolerate gluten?

Gluten is a protein found in many grains. It is responsible for stretching dough, like pizza.

If you do not have a problem with gluten, there is no reason to avoid gluten. But if you have celiac disease, gluten must be avoided.

The Mediterranean DietThe Mediterranean diet is renowned for its focus on fresh fruits and vegetables, lean proteins, healthy fats, and whole grains. By incorporating gluten-free whole grains into this already nutritious diet, you can further enhance its health benefits while catering to dietary restrictions or preferences.

ConclusionBy incorporating gluten-free whole grains into your Mediterranean diet, you can enjoy a diverse range of flavors and textures while reaping the nutritional benefits of these wholesome ingredients. Whether you're looking to support digestive health, manage blood sugar levels, or simply explore new culinary horizons, there's a gluten-free whole grain waiting to elevate your next meal.

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Learn to Cook FishFish is not only a healthy option but also a versatile ingredient that can be transformed into a myriad of mouthwatering dishes. Whether you're a seafood aficionado or looking to expand your culinary repertoire, mastering the art of cooking fish can elevate your cooking skills to new heights. In this article, we'll explore the techniques and recipes to create delicious fish dishes that will impress even the most discerning palates.

Cooking Methods:1. Grilling: Grilling fish over an open flame adds a smoky flavor and beautiful charred marks. Brush the fish with oil to prevent sticking, and cook for a few minutes on each side until opaque and flaky. 2. Baking: Baking fish in the oven is a simple and foolproof method. Place seasoned fish fillets on a baking sheet lined with parchment paper and bake at 375°F (190°C) for 10-15 minutes, depending on the thickness of the fish. 3. Pan-Searing: Pan-searing fish in a hot skillet creates a crispy exterior while keeping the inside moist and tender. Heat oil in a skillet over medium-high heat, then add the fish and cook for 3-4 minutes per side until golden brown. 4. Steaming: Steaming fish is a healthy cooking method that preserves its delicate flavor and texture. Place seasoned fish fillets in a steamer basket over boiling water and steam for 6-8 minutes until cooked through.

Delicious Fish Recipes:Now that you're familiar with the basics of preparing and cooking fish let's explore some mouthwatering recipes to try at home:

1. Lemon Herb Grilled Salmon: Marinate salmon fillets in a mixture of lemon juice, olive oil, garlic, and fresh herbs. Grill over medium heat for 4-5 minutes per side until charred and cooked through. Serve with a squeeze of fresh lemon juice.
2. Baked Cod with Garlic Butter: Place cod fillets in a baking dish and top with a mixture of melted butter, minced garlic, lemon zest, and chopped parsley. Bake in the oven for 15-20 minutes until flaky and tender.
3. Pan-Seared Sea Bass with Mango Salsa: Season sea bass fillets with salt, pepper, and paprika. Sear in a hot skillet for 3-4 minutes per side until golden brown. Serve with a refreshing mango salsa made with diced mango, red onion, jalapeno, cilantro, and lime juice.

For more great recipes, see terrysimpson.com.

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Health Benefits of Fish ConsumptionFish consumption has been linked to various health benefits due to its rich nutritional profile. The health benefits of fish consumption include cardiovascular health, brain function, and well-being. Because fish are a rich source of omega-3 fatty acids, vitamins, minerals, and other nutrients, they are an important part of a balanced diet.

Fish, the Most Ancestral FoodFish has long been recognized as a valuable source of essential nutrients beneficial for human health. Seafood is a staple part of the diet across different cultures and regions. Since most of the first human communities were coastal, fish were a common source of food.

Cardiovascular Health Exceeds RiskRegular fish intake reduces the risk of cardiovascular diseases, such as coronary heart disease and stroke (Mozaffarian & Rimm, 2006). That study showed that the benefits of fish intake exceed the potential risks. Even for women of childbearing age, the benefits of modest fish intake, excepting a few selected species, also outweigh the risks. The heart health effect comes from the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found abundantly in fatty fish species (Kris-Etherton et al., 2002). These fatty acids exert anti-inflammatory, antiarrhythmic, and vasodilatory effects, lowering blood pressure and triglyceride levels and reducing the formation of blood clots (Calder, 2015).

Brain FunctionFish consumption has also been associated with improved cognitive (brain) function and a reduced risk of brain disorders such as Alzheimer's disease. The omega-3 fatty acids EPA and DHA play a crucial role in brain health (Gómez-Pinilla, 2008). Epidemiological studies have consistently shown a positive correlation between higher fish consumption and better memory (ref). Moreover, research suggests early-life exposure to seafood has long-term brain benefits and decreases age-related cognitive decline (Wurtman et al., 2009).

Nutrient Profile, Such as Vitamin DBut omega-3 fatty acids are not the only benefit of eating fish. Fish are also a rich source of various essential nutrients vital for human health. Vitamin D, in particular, is naturally abundant in fatty fish and plays a crucial role in bone health, immune function, and mood regulation (Holick, 2007). These include high-quality protein, vitamins (such as vitamin D and B-complex vitamins), and minerals (such as selenium, iodine, and zinc) (Kris-Etherton et al., 2002). Furthermore, the bioavailability of these nutrients from fish is superior to other dietary sources, including supplements. Thus, fish consumption is an efficient means of meeting nutritional requirements (Rosell & Appleby, 2006).

Fish FarmsAquaculture, the farming of fish and aquatic organisms, has undergone significant advancements in recent years, leading to improvements in sustainability, efficiency, and product quality. Fish Farms have had significant problems in the past. In the last fifteen years, there has been an improvement in environmental management strategies and sustainable farming practices.

Those practices have changed my mind about seafood. Consequently, you can now buy quality farm-raised seafood, which adheres to the high standards of any food. Hence, I now recommend some farm-raised salmon.

Demand for Fish May Outstrip our OceansAs global demand for seafood continues to rise, aquaculture has emerged as a crucial industry for sustainable meeting this demand. Farm-raised fish play a vital role in supplementing wild-caught fisheries and ensuring food security for a growing population. In recent years, advancements in aquaculture techniques and practices have led to significant improvements in the efficiency, sustainability, and quality of farm-raised fish.

Technological InnovationsTechnological advancements have revolutionized the aquaculture industry. Automation and robotics have streamlined tasks such as feeding, monitoring water quality, and harvesting, reducing labor costs and minimizing human error. Some previous issues with farmed fish include high quantities of forever chemicals in their feed. However, advances in the use of alternative ingredients, such as plant proteins and oils, have enhanced feed efficiency and reduced reliance on wild-caught fish for feedstock (Tacon & Metian, 2008). Genetic selection and breeding programs have also played a crucial role in developing strains of fish with desirable traits, such as faster growth rates, disease resistance, and improved feed conversion ratios (Gjedrem et al., 2012).

Environmental ManagementSome fish farms have been environmental disasters. Thus, Government and private groups have persuaded some fish farms to change their practices. Sustainable aquaculture practices prioritized environmental stewardship and minimized the impact of fish farming on surrounding ecosystems. For example, combining clams and oysters with salmon farms to use nutrients more efficiently and reduce waste (Chopin et al., 2001).

Closed-containment systems, such as recirculating aquaculture systems (RAS), decrease the risk of disease transmission and minimize the discharge of pollutants into the environment (Martins et al., 2010). Additionally, advancements in water treatment technologies, such as biofiltration and ozone disinfection, help maintain water quality and reduce the environmental footprint of aquaculture operations (Summerfelt & Vinci, 2008).

Quality and Safety AssuranceAntibiotic use in fish farms, much like antibiotic use in the cattle industry, has changed to where antibiotics are only used when needed for disease. Fish that have had antibiotics are not sold on the market until the antibiotics and disease have cleared their system. Furthermore, advancements in packaging, transportation, and cold chain management help preserve the freshness and nutritional integrity of farmed fish from harvest to consumption.

Advancements in aquaculture technology, environmental management practices, and quality assurance measures have led to significant improvements in farm-raised fish production. These advancements increase the efficiency and sustainability of aquaculture operations. In addition, they also enhance product quality, safety, and traceability. Moving forward, continued investment in research and innovation is essential to further the progress of the aquaculture industry. Thus ensuring long-term viability as a source of nutritious and sustainable seafood.

Where to Buy Your FishMany organizations buy their seafood from reputable organizations. Be that wild fish or fish farms. Those organizations include:

• Blue Apron
• Cheesecake Factory
• Hello Fresh
• Whole Foods
• Pacific Catch
• PCC Community Markets
• Mars Petcare
• Compass Group
• California Fish and Grill
• Blue Sushi Saki Grill
• Plank Seafood Provisions
• Costco
• Mom's Organic Market

ConclusionIn conclusion, fish consumption offers many health benefits, from cardiovascular protection to cognitive enhancement, due to its rich nutritional composition. The omega-3 fatty acids EPA and DHA, along with other essential nutrients found in fish, exert profound effects on various physiological processes, promoting overall health and well-being. Therefore, it is advisable to incorporate fish into one's diet, especially fatty fish species such as salmon, mackerel, and sardines.

References:* Calder, P. C. (2015). Marine omega-3 fatty acids and inflammatory processes: Effects, mechanisms and clinical relevance. Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids, 1851(4), 469–484. * Gómez-Pinilla, F. (2008). Brain foods: the effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568–578. * Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266–281. * Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002). Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation, 106(21), 2747–2757. * Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L., & Wilson, R. S. (2003). Fish consumption and cognitive decline with age in a large community study. Archives of Neurology, 60(7), 940–946. * Mozaffarian, D., & Rimm, E. B. (2006). Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA, 296(15), 1885–1899. * Rosell, M. S., & Appleby, P. N. (2006). Fish consumption and risk of stroke in men. Circulation, 113(2), e104–e105. * Wurtman, R. J., Cansev, M., Sakamoto, T., & Ulus, I. H. (2009). Use of phosphatide precursors to promote synaptogenesis. Annual Review of Nutrition, 29, 59–87. * Chopin, T., Buschmann, A. H., Halling, C., Troell, M., Kautsky, N., Neori, A., Kraemer, G. P., Zertuche-González, J. A., Yarish, C., & Neefus, C. (2001). Integrating seaweeds into marine aquaculture systems: a key toward sustainability. Journal of Phycology, 37(6), 975–986. * Food and Agriculture Organization/World Health Organization (FAO/WHO). (2011). Code of Practice for Fish and Fishery Products. Rome: FAO. * Gjedrem, T., Robinson, N., & Rye, M. (2012). The importance of selective breeding in aquaculture to meet future demands for animal protein: A review. Aquaculture, 350-353, 117–129. * Martins, C. I. M., Eding, E. H., Verdegem, M. C. J., Heinsbroek, L. T. N., Schneider, O., Blancheton, J. P., D’Orbcastel, E. R., & Verreth, J. A. J. (2010). New developments in recirculating aquaculture systems in Europe: A perspective on environmental sustainability. Aquacultural Engineering, 43(3), 83–93. * Summerfelt, S. T., & Vinci, B. J. (2008). Ozonation and UV irradiation: An introduction and examples of current applications in fish hatcheries. Aquacultural Engineering, 38(1), 1–14. * Tacon, A. G. J., & Metian, M. (2008). Global overview on the use of fish meal and fish oil in industrially compounded aquafeeds: Trends and future prospects. Aquaculture, 285(1-4), 146–158.

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Three Great DietsThe Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), and the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) are all great eating patterns. Each diet focuses on different aspects of health.

Mediterranean DietThe Mediterranean diet comes from the traditional dietary patterns of countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. High in the consumption of fruits, vegetables, whole grains, nuts, seeds, legumes, olive oil, fish, and moderate amounts of poultry, dairy, and red wine. Shown to decrease the risk of heart disease and cancer and to improve longevity.

DASH DietDiscussed in last week's podcast (ref). DASH (Dietary approach to stop hypertension) was developed to prevent and manage hypertension (high blood pressure). Focuses on increasing intake of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while limiting sodium, saturated fats, and cholesterol.

MIND DietDeveloped by researchers at Rush University Medical Center as a hybrid of the Mediterranean and DASH diets, with a focus on brain health and reducing the risk of neurodegenerative diseases like Alzheimer's disease. It also emphasizes the consumption of fruits, vegetables, whole grains, nuts, olive oil, fish, poultry, and beans while limiting the intake of red meat, butter/margarine, cheese, pastries/sweets, and fried/fast foods.

Three Diets are Branches of the Same TreeThe Mediterranean, DASH, and MIND diets share some common elements. All focus on whole foods and plant-based sources of nutrients. The Mediterranean diet emphasizes health and longevity. While the DASH diet targets hypertension and cardiovascular health. Finally, the MIND diet specifically supports brain health to reduce the risk of neurodegenerative diseases.

1. Rush Memory and Aging Project:A study conducted by researchers at Rush University Medical Center followed over 900 older adults for an average of 4.5 years. Findings showed that individuals who closely adhered to the MIND diet had a substantially lower risk of developing Alzheimer's disease, with a reduction in risk ranging from 21% to 53%, depending on the level of adherence. (ref )

2. Columbia University Medical Center Study:Researchers at Columbia University Medical Center examined the dietary habits of over 1,000 participants. Individuals who closely followed the MIND diet had a 53% lower risk of developing Alzheimer's disease than those with low adherence to the diet.

3. Alzheimer's Disease Neuroimaging Initiative (ADNI):The ADNI study found that adherence to the MIND diet was associated with better cognitive performance and a reduced rate of cognitive decline over time.

4. Systematic Reviews and Meta-Analyses:Several systematic reviews and meta-analyses have summarized the findings of multiple studies investigating the association between the MIND diet and dementia risk. Overall, these reviews reveal that adherence to the MIND diet is associated with a significant reduction in Alzheimer's disease and dementia.

5. Mechanisms of Action:Components of the MIND diet, such as leafy greens, berries, nuts, whole grains, fish, olive oil, and poultry, have been linked to improved cognitive function and a lower risk of dementia.

More research is needed to elucidate the mechanisms underlying the protective effects of the MIND diet. Current evidence suggests that adherence to this dietary pattern can be a valuable strategy for reducing the risk of cognitive decline and Alzheimer's disease in older adults.

Diagnosis of Alzheimer's Disease.On TikTok, a non-physician said the only way to diagnose dementia was an autopsy. This is false. Alzheimer's disease is diagnosed based on established criteria. These are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Also can be found in the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria.

• The healthcare provider will conduct a complete history and physical examination
• Neuropsychological assessment may evaluate cognitive function, memory, attention, language, and executive function.
• Blood tests can rule out underlying medical conditions, such as vitamin deficiencies (e.g., vitamin B12 deficiency), thyroid disorders, infections, metabolic imbalances, or kidney or liver dysfunction.
• MRI or CT scans will be ordered to assess structural abnormalities in the brain or detect signs of conditions like stroke, brain tumors, or hydrocephalus. Genetic testing for mutations associated with familial Alzheimer's disease, cerebrospinal fluid analysis to assess for biomarkers associated with Alzheimer's disease (e.g., amyloid beta and tau proteins)

Genetics of DementiaSeveral genetic factors are correlated, but not causative of, an increased risk of dementia, including Alzheimer's disease. Lifestyle changes can mitigate these. Hence, the MIND diet is important to those who have a genetic predisposition to dementia.

1. APOE ε4 AlleleThe apolipoprotein E (APOE) gene ε4 allele is the strongest known genetic risk factor for late-onset Alzheimer's disease. Individuals who inherit one copy of the APOE ε4 allele from one parent have an increased risk of developing Alzheimer's disease. while those who inherit two copies (one from each parent) have an even higher risk. Chris Hemsworth, who plays Thor in Marvel movies, has two copies of these genes.

2. Presenilin Genes (PSEN1 and PSEN2)Mutations in the presenilin 1 (PSEN1) and presenilin 2 (PSEN2) genes are associated with early Alzheimer's disease before 65. These mutations can cause abnormal processing of amyloid precursor protein, which leads to the accumulation of amyloid beta plaques in the brain.

3. Amyloid Precursor Protein (APP) GeneMutations in the amyloid precursor protein (APP) gene are also associated with rare cases of early-onset Alzheimer's disease. APP mutations can lead to the production of abnormal forms of amyloid beta protein, which contributes to the development of Alzheimer's pathology.

4. TREM2 Gene• Variants in the triggering receptor expressed on myeloid cells 2 (TREM2) gene have been identified as risk factors for late-onset Alzheimer's disease and other neurodegenerative diseases.

• TREM2 is involved in the regulation of the immune response and microglial function in the brain, and variants in this gene may affect the brain's ability to clear amyloid beta and other toxic proteins.

1. Other Genes• Several other genes have been implicated in the risk of developing dementia, including genes involved in inflammation, cholesterol metabolism, synaptic function, and neuronal signaling pathways.

While genetic factors can increase the risk of dementia, they do not guarantee that an individual will develop the condition. Environmental factors and lifestyle factors (such as diet, physical activity, and cognitive engagement) play significant roles in determining an individual's risk of dementia. Additionally, not all cases of dementia are attributable to genetic factors.

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Abstract:The Dietary Approaches to Stop Hypertension (DASH) diet is a widely recognized dietary pattern designed to lower blood pressure and promote cardiovascular health. I will attempt to provide an in-depth review of the DASH diet, its origins, key principles, health benefits, and potential limitations. It also explores the scientific evidence supporting its efficacy and applicability in various populations. Furthermore, this paper discusses practical considerations for adopting the DASH diet and its potential future developments in the field of nutrition and health.

1. IntroductionThe DASH diet, or Dietary Approaches to Stop Hypertension, is a dietary plan primarily developed to combat hypertension (high blood pressure). DASH has since gained recognition for its broader health benefits. Hypertension is a major risk factor for cardiovascular diseases, including heart disease and stroke. Therefore, the DASH diet is essential to reducing these health risks.

2. Origins and DevelopmentThe National Heart Lung and Blood Institute (NHLBI) developed the DASH diet in a study known as the DASH-Sodium Study. The primary objective of the DASH-Sodium study was to investigate the effect of dietary patterns on blood pressure, in particular, the effects of sodium intake. Researchers aimed to design a diet that could effectively lower blood pressure without medication. The DASH diet emerged from this study as a dietary pattern rich in nutrients and low in sodium, saturated fat, and cholesterol.

3. Key Principles of the DASH DietThe DASH diet emphasizes the consumption of nutrient-rich foods while limiting the intake of sodium, saturated fats, and cholesterol. Key principles of the DASH diet include:

4. High Consumption of Fruits and Vegetables: The diet encourages individuals to consume a variety of fruits and vegetables, providing essential vitamins, minerals, fiber, and antioxidants.

5. Lean Protein Sources: Lean proteins like poultry, fish, and plant-based options such as beans, lentils, and tofu are recommended to replace high-fat animal proteins.
6. Whole Grains: The DASH diet emphasizes whole grains like brown rice, whole wheat, oats, and quinoa, which are rich in fiber and nutrients.
7. Dairy: Low-fat or fat-free dairy products are included to provide calcium and protein without excess saturated fat.
8. Nuts, Seeds, and Legumes: These foods are encouraged as sources of healthy fats, fiber, and plant-based protein.
9. Limited Sweets and Sugary Beverages: The DASH diet restricts the consumption of sugary foods and beverages, reducing the intake of added sugars.

10. Sodium Restriction: The diet recommends limiting sodium intake to 2,300 milligrams per day (or 1,500 milligrams for individuals with hypertension, certain chronic conditions, or those at high risk).

11. Health Benefits of the DASH DietThe DASH diet offers a range of health benefits beyond blood pressure reduction:

12. Lowering Blood Pressure: Numerous studies have shown that the DASH diet can effectively lower blood pressure, particularly in individuals with hypertension.

13. Cardiovascular Health: The diet is associated with a reduced risk of heart disease, stroke, and other cardiovascular conditions due to its focus on heart-healthy nutrients and reduced saturated fat intake.
14. Weight Management: The DASH diet can help weight loss and weight management due to its emphasis on nutrient-dense, low-calorie foods.
15. Improved Lipid Profile: The diet can lower levels of LDL cholesterol (bad cholesterol) and improve HDL cholesterol (good cholesterol), further reducing the risk of heart disease.

16. Diabetes Management: The DASH diet may help individuals with diabetes manage blood sugar levels, as it encourages a balanced intake of carbohydrates, fiber, and protein

17. Scientific EvidenceThe effectiveness of the DASH diet has been supported by numerous clinical trials and epidemiological studies. For instance, the original DASH-Sodium trial demonstrated that the DASH diet could significantly lower blood pressure, with greater reductions observed when combined with sodium restriction. Subsequent research has reaffirmed these findings, highlighting the positive impact of the diet on cardiovascular health and well-being.

This was one of the few studies in which all the food was made for the participants.

1. Applicability and LimitationsWhile the DASH diet offers substantial health benefits, it may have limitations for some. Its emphasis on whole foods and fresh produce can be costlier and less convenient than processed alternatives. Cultural preferences and dietary restrictions may also pose challenges in adopting the DASH diet. Nevertheless, modifications and adaptations can be made to suit individual needs and preferences while maintaining the core principles of the diet.

2. Practical ConsiderationsFor those interested in adopting the DASH diet, practical considerations include meal planning, grocery shopping, and monitoring sodium intake. Consulting with a healthcare professional or registered dietitian can provide personalized guidance and support.

3. Future DevelopmentsThe DASH diet continues to evolve as new research emerges in nutrition and health. Future developments may focus on tailoring the diet to specific populations, incorporating technological advancements, and exploring the impact of the DASH diet on additional health outcomes beyond hypertension.

It is America's Mediterranean DietDASH is a version of the Mediterranean Diet. You can see the same requirements for whole grains, vegetables, fruits, dairy, and legumes. It combines meats and fish depending on the calories and still uses primarily monounsaturated fats. There is no recommendation for or against alcohol in this diet. There is a strong recommendation to decrease sodium in the diet.

1. ConclusionThe DASH diet is a well-established dietary pattern with proven benefits for lowering blood pressure and improving cardiovascular health. Its emphasis on nutrient-rich foods, balanced nutrition, and sodium restriction makes it a valuable tool for reducing the risk of hypertension and related health conditions. While challenges may exist in adopting the DASH diet, its adaptability and potential for customization make it a practical and effective choice for individuals seeking to improve their dietary habits and well-being.

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Did You Try the Carnivore Diet?Did you try the carnivore in January? A month of red meat, eggs, and butter? If you did, you probably lost weight. If you lost weight, you felt better. The Carnivore crowd will point to weight loss as proof of superiority.

But did you worry that this might not be the healthiest diet for you long-term? Is it healthy? In short, the answer is no.

Perhaps you remember on a previous podcast, we talked about the beer and sausage diet. On that diet, Evo, the pod god who distributes this podcast, lost weight every month he was on the diet. In addition, his weekly lab work -sorry for all the jabs Evo - improved every week he was on the diet.

Could you argue that drinking beer and eating sausage is a good diet? You could, and that same logic is what the carnivore crowd uses to convince people the carnivore diet has merit.

Simplicity, is Thy Name Carnivore?What could be simpler than eating a diet of just red meat? Who doesn't like a good steak? If you just eat steak or red meat, you will lose weight. When you lose weight, you will feel better. And your labs might improve. You might think it is paradoxical that your cholesterol level went down - it isn't; that is just a result of giving up junk food and weight loss.

Every diet has a honeymoon phase, where people think they can do the diet "forever."

Then reality comes home:

• The diet becomes boring, and one note
• There is an undeniable increased risk of heart disease and cancer
• Maybe you got hemorrhoids or developed diverticulitis
• Finally, in social situations, you become that person - the one who could only eat red meat - the reverse vegan

FORK UToday, on Fork U, we will discuss the latest low-carb fad: the Carnivore diet, the denial that goes into those who make up the diet, and the risks of an all-meat diet.

I'm Dr. Terry Simpson, and this is Fork U.

Fork University

Where we make sense of the madness, bust a few myths, and teach you a little about food as medicine.

Carnivore DietThe carnivore diet, which primarily consists of animal products like meat, fish, and eggs, has become the latest low-carb fad. It is a controversial and extreme dietary approach. Proponents of the carnivore diet claim numerous health benefits. To be clear, the scientific evidence supporting these benefits is limited, and that long-term studies on the effects of the carnivore diet are lacking.

Paul Saladino, Ken Berry, and Shawn Baker are a few doctors who advocate for this diet. And oddly, none of them see private patients, although Saladino and Baker love showing their abs, and spend a lot of time in the gym.

The Biotruth of EvolutionSome claim the natural diet of humans is meat. This is a biotruth.

When someone tells you that “man was meant to eat” this or that – it is part of a logical fallacy known as a biotruth. A biotruth is an argument presented by someone with misunderstood notions of human biology and/or evolution but uses those false arguments to justify their views. In this case, how they eat.

You can extend that logical fallacy out: man was not meant to fly, so we shouldn’t be in airplanes. Primitive man did not have laboratories, so we should not have antibiotics.

You will see biotruth arguments from people who practice carnivore diets, as well as those who practice vegetarian (and vegan) diets. Often with photographs of our jaws and those of our ancestors – or they will say how we have a long or short intestine, and on that basis, we “were meant” to eat in whatever their view is.

As we evolved, were we better as plant eaters or meat eaters? Does it matter? It is an argument based in biotruth.

Paleolithic Man and BiotruthThe carnivore diet is based on the premise that man had evolved during the Paleolithic era by eating meat. Furthermore, they state that when agriculture and domestication of animals came (10,000 years ago), man’s metabolism was unable to adapt to these new foods. They assert that the maladies of modern man come from foods such as grains and dairy products. That non-meat diets lead to heart disease, obesity, and diabetes – all from our evolutionary dysfunction.

Archeology has about 6000 fossils to make these assumptions. From those 6000 fossils, we find that early man:

• Probably was more of a scavenger than a hunter - taking whatever meat something else killed and left behind
• Gathering, especially roots and beans, kept humans alive
• The most common things hunted were frogs and rabbits
• Neanderthals and Homo Erectus, our cousins but not direct ancestors, did organized hunting; the Neanderthals, and homo sapiens began organization until perhaps 20,000 years ago.
• Man ate grains even 30,000 years ago.

The view of man as a large game hunter is not from the evidence unless you count comic strips and movies.

Modern Hunter Gather Societies Eat MeatOften, they refer to the Inuit, whose lifespan is about 50 (excluding infant mortality). They eat mostly sea creatures but have mummified evidence of atherosclerotic disease. The Hazda eat honey, fruit, and meat, and their average age of death is 50. Over half of their people don't make the age of 15.

The use of early man, or hunter societies, to state that we should be eating meat is factually incorrect.

Humans evolved not by eating meat. Humans evolved by eating anything they could, mostly plants. Early man did not evolve to live into the 90's.

Vegetables are poison: Lectins, Oxylates, and anti-nutrientsThe other comments go something like the "defense of vegetables against humans." This ignores the long-lived populations, who eat mostly plants and little meat.

Kidney stones are found more commonly among meat eaters than vegetarians. (ref).

Despite their protestations, Kale, spinach, beans, and broccoli are healthy for people.

The Most Bioavailable FoodThe other argument is that meat contains the richest nutrients, and the most bioavailable food. Meat is a rich source of protein, the liver has a lot of vitamin D, and heme-iron is generally better adapted for iron deficiency. Meat is far from having all the nutrients a person requires. Red meat is rich in iron, zinc, B vitamins, and iron.

There is minimal fiber in meat. The carnivore crowd waives this off, stating that fiber isn't something humans need. In spite of the clear evidence that fiber decreases colon and rectal cancer, that fiber helps regulate blood sugar and cholesterol. Fiber is important to a healthy gut microbiome, and fiber prevents hemorrhoids as well as diverticulitis. Their assertion is false and painfully so - especially if you've had hemorrhoids.

Vitamin C is not abundant in meat. This lesson led to the discovery of citrus as a means of avoiding scurvy in sailors during the era of Discovery. A finding attributed to another surgeon, Dr. James Lind. Modern-day isn't without scurvy found among carnivore aficionados, such as musician James Blunt, who went on the carnivore diet.

Calcium is more abundant in dairy products and some vegetables, as is Folate. and omega-3 fatty acids. They tend to forget that farm-raised salmon has ten times the amount of omega-3 fatty acids as does the cow raised on and fed with high-quality grass all their life.

Weight Loss and the Carnivore DietWeight loss occurs in a calorie deficit. There is no diet that cannot produce a calorie deficit. This has been demonstrated in great studies showing the equivalent of low-carb diets, and the Mediterranean diet are equal over time.

It has also been demonstrated in those showing the McDonald's diet, the cookie diet, the Twinkie diet, and our own - Beer and Sausage diet.

One simply gets tired of eating red meat, and you eat less of it. So instead of eating three thousand calories of multiple foods, you eat 2200 calories of meat, and you lose weight. Nothing to see here, folks, just another diet.

But there is a dark side to red meat. Just because you can lose weight and show all the physiological benefits of weight loss doesn't mean that a lot of red meat is good for a human. In fact, there is every evidence to state one should limit red meat.

Is Red Meat Consumption like Smoking?There is always some headline grabber who states that eating red meat has the same risk as smoking. While red meat, as we shall see, has an increased risk of cancer, heart disease, and diabetes, it is not as risky as smoking cigarettes. As much as some anti-meat activists might like to frighten you, we assume you came here for the facts.

So, where did our studies begin?

Meat, the Seven Countries StudyHeart disease was an epidemic in the 1950s in the United States, primarily affecting white-collar men. However, when Ancel Keys heard that certain populations had almost no heart disease, he began a quest that resulted in the Seven Countries Study.

Briefly, people in some villages in the Mediterranean region ate less red meat. Some because they couldn't afford it, and it wasn't a traditional part of their cuisine.

Keys group studied 14,000 men from 16 villages in seven countries. Some of those cohorts, like in the United States and Finland, had high levels of red meat and saturated fat in their diet. Others, like those from Crevalcore and Montegiorgio, had far less saturated fat.

The Seven Country Study was the first to show that serum cholesterol, blood pressure, diabetes, and smoking are universal risk factors for heart disease. Ancel Keys and colleagues were central to the modern recognition, definition, and promotion of the eating pattern they found in Italy and Greece in the 1950s and ’60s, now popularly called “The Mediterranean Diet.”

They showed that dietary patterns in the Mediterranean and in Japan in the 1960s were associated with low rates of coronary heart disease and all-cause mortality. The studies on the elderly showed that a healthy diet and lifestyle (sufficient physical activity, non-smoking, and moderate alcohol consumption) is also associated with a low risk of cardiovascular disease and all-cause mortality. A healthy diet and sufficient physical activity may also postpone cognitive decline and decrease the risk of depression.

While Carnivore like pointing out that Hong Kong has the highest consumption of meat and some of the longest-living people in the world, a closer look shows those who live to be well in their 80's and 90's ate a diet more like the Mediterranean and not much meat.

Red Meat and DiabetesRed meat consumption has been associated with an increased risk of developing type 2 diabetes. Several studies have investigated this relationship, and here are some key findings:

1. Particularly processed red meat, like sausages, bacon, and hot dogs, is associated with an increased risk of type 2 diabetes. Perhaps from high levels of sodium and preservatives like nitrates may contribute to the development of diabetes.
2. The high iron content in red meat can lead to elevated iron stores in the body and may interfere with insulin action and glucose metabolism.
3. Saturated fats, abundant in red meat, increase the accumulation of fat in the muscles and liver, leading to insulin resistance.
4. Large-scale epidemiological studies have provided evidence of the link between red meat consumption and diabetes risk.

Red Meat and Colorectal CancerThe International Agency for Research on Cancer (IARC) has classified processed meat as a Group 1 carcinogen and red meat as a Group 2A carcinogen. A significant body of research has linked red meat, especially processed meat, to an increased risk of colorectal cancer. For example, a meta-analysis by Chan et al. (2011) found that each 100g/day increase in red meat intake was associated with a 17% increased risk of colorectal cancer.

Mechanisms Linking Red Meat to Colorectal CancerPotential mechanisms include the presence of heme iron in red meat, which facilitates the formation of known carcinogens, such as N-nitroso compounds.

Grilling or barbecuing can lead to the production of heterocyclic amines and polycyclic aromatic hydrocarbons, also carcinogenic compounds.

Red Meat and Pancreatic CancerA pooled analysis by Larsson and Wolk (2012) indicated that high red meat consumption was modestly associated with an increased risk of pancreatic cancer.

Red Meat and Prostate CancerThe relationship between red meat consumption and prostate cancer is less clear. Alexander et al. (2010) meta-analysis found a weak but statistically significant association between high intake of red meat and increased risk of prostate cancer.

What is the Strength of Evidence?While not all studies have found strong associations, also, the mechanisms are not fully understood. However, the evidence suggests a link between high red meat consumption and an increased risk of certain types of cancer, particularly colorectal cancer.

Reduced Cancer RiskNumerous studies have established a link between red meat consumption, especially processed meat, and an increased risk of certain types of cancer, including colorectal and pancreatic cancer (International Agency for Research on Cancer, 2015).

Decreasing red meat intake and incorporating various plant-based foods contribute to a lower cancer risk due to the high fiber content and presence of cancer-protective phytonutrients in plants.

Better Weight ManagementReducing red meat consumption can help weight management. Red meat is often high in calories and fat, contributing to weight gain. Opting for leaner protein sources and increasing the intake of vegetables and whole grains can help maintain a healthy weight (Wang, Y., & Beydoun, M. A., 2009, Epidemiologic Reviews).

Your Gut HealthReducing red meat consumption can improve gut health. Diets high in red meat are low in fiber. Fiber is essential for a healthy gut microbiome. Incorporating more fiber-rich plant-based foods promotes better digestion and a healthier gut. Especially a reduced risk of diverticulitis and hemorrhoids. Drawbacks of a carnivore diet include nutrient deficiencies (such as fiber, vitamin C, and certain phytonutrients) and the potential impact on gut health due to the lack of dietary fiber.

ConclusionThe benefits of reducing red meat consumption include a lower risk of cardiovascular diseases, cancer, and type 2 diabetes, better weight management, and improved gut health. Embracing a balanced diet rich in plant-based foods and varied protein sources can lead to a healthier lifestyle and well-being.

We call that lifestyle The Mediterranean Diet.

Thank you for listening to this edition of FORK U. You can find the references for this podcast on my blog, yourdoctorsorders.com or forku.com. While I am a doctor, I am not your doctor. If you need a doctor, please see a board-certified western-trained physician, not a naturopath or a chiropractor or some Eastern medicine witch doctor.

Fork U is distributed by our friends at Simpler Media and thanks to Allie Press and the pod god - Evo Terra.

Hey Ev0 - did you know that those mummies in early Alaska had a lot of vascular disease? I wonder what my daddy had.

References1. Chan, D. S., Lau, R., Aune, D., Vieira, R., Greenwood, D. C., Kampman, E., & Norat, T. (2011). Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PloS one, 6(6), e20456. 2. Larsson, S. C., & Wolk, A. (2012). Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. British Journal of Cancer, 106(3), 603-607. 3. Alexander, D. D., Mink, P. J., Cushing, C. A., & Sceurman, B. (2010). A review and meta-analysis of prospective studies of red and processed meat intake and prostate cancer. Nutrition Journal, 9, 50. 4. World Health Organization. (2015). IARC Monographs evaluate consumption of red meat and processed meat. 5. Micha, R., et al. (2010). Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 6. Pan, A., et al. (2012). Red meat consumption and mortality: results from 2 prospective cohort studies. Archives of internal medicine 7. O'Connor LE, Paddon-Jones D, Wright AJ, Campbell WW. A Mediterranean-style eating pattern with lean, unprocessed red meat has cardiometabolic benefits for adults who are overweight or obese in a randomized, crossover, controlled feeding trial. Am J Clin Nutr. 2018 Jul 1;108(1):33-40. doi: 10.1093/ajcn/nqy075. PMID: 29901710; PMCID: PMC6600057. 8. Dominguez LJ, Di Bella G, Veronese N, Barbagallo M. Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity. Nutrients. 2021 Jun 12;13(6):2028. doi: 10.3390/nu13062028. PMID: 34204683; PMCID: PMC8231595. 9. Ferraro PM, Bargagli M, Trinchieri A, Gambaro G. Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets. Nutrients. 2020 Mar 15;12(3):779. doi: 10.3390/nu12030779. PMID: 32183500; PMCID: PMC7146511.

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Sorry It Didn't WorkThis is the time of year when everyone is excited about some change in their life. My neighbors are doing a "dry January" because they want to cut down on their alcohol. Other neighbors committed to more physical activity before a hip replacement. And there is the inevitable "what diet will I do this time?"

Now, before I go to that, long-time readers of my newsletter will realize that I am drinking my cup of Peet's coffee. Peet's is a story of disappointment, which I will use to illustrate a point:

Diet DisappointmentDiets are like that person who disappoints you again and again. The person you invite to events, but they never reciprocate. The diet starts out great. You lose a bit of weight, decide you can eat this way forever, and this is your new lifestyle. Then something happens. If you are smart, you realize you cannot live that way. Most, though, internalize and think, "It is my fault." Well, it isn't your fault.

Low Carb DisappointmentLow-carb diets can be disappointing for various reasons. Some people may find it difficult to stick to a low-carb eating plan because they miss certain high-carb foods that they enjoy. This can lead to feelings of deprivation and dissatisfaction with the diet. Additionally, some people may not experience the weight loss or health benefits they were hoping for with a low-carb diet. It's important to remember that everyone's body is different, and what works for one person may not work for another. Furthermore, it is important to focus on overall health and well-being rather than just weight loss or specific dietary restrictions.

Every year, someone starts a new version of low carb. I've done a few myself. This year's version is carnivore. Some are doing a carnivore January. The results will be the same as the previous low-carb diets - and let me go back to Peet's coffee.

Coffee and DietsI have been a member of Peet's Coffee Club since 1995. I get it faithfully every couple of weeks. Whole beans. It costs about $36 for two bags. Then I discovered I could get it at Costco for $25, with no shipping charge, the same date of roasting. I wrote Peet's, of course. They told me my coffee is always fresh, unlike the bulk sold to Costco. Except the roasting date is on the package.

Diets are like that. You get some results, then disappointment. You don't get the return for the money. But someone in the low-carb community will tell you that you didn't do it correctly:

• You were not earnest enough,
• You didn't get the right kind of grass-fed beef
• The beef wasn't organic
• You ate a banana and ruined ketosis
• If you stop eating carrots, you will maintain ketosis.
• Oh, does that pasta look delicious
• Stop eating vegetables and grains, and just eat beef, salt, and water

Now What?So, some consider weight loss surgery or new drugs. Both of these are reasonable (yes, I have done a lot of weight loss surgery in my time).

But what I've advocated is that people have to take responsibility for what they eat even after weight loss surgery. Well, you don't have to - but your body is a perfect calorie counter.

Does that mean a "diet?" No, the goal of weight loss drugs or surgery isn't to put someone on a diet for weight loss. The goal is to give them good food so they can nourish themselves.

It also means I have to get rid of silly ideas they learned from things like the low-carb diet. The low-carb diet, that friend you always invite into your home, always disappoints.

My Journey to Culinary MedicineAbout ten years ago, I received certification in Culinary Medicine. Part of that training was long hours reviewing the literature more about food than I could imagine. For my patients, they will remember the day I began to advocate for the Mediterranean Diet.

I made the journey from some version of a low-carbohydrate diet to a diet that had substantial proof of long-term health.

Today, the Mediterranean diet is what I recommend to everyone. It is the most well-studied diet on the planet.

The Mediterranean DietThe Mediterranean diet is a way to eat based on the traditional foods and cooking styles of countries bordering the Mediterranean Sea. It has been associated with numerous health benefits, including a reduced risk of heart disease, stroke, and certain types of cancer. The components of the Mediterranean diet include:

1. Abundance of plant-based foods: The diet emphasizes the consumption of fruits, vegetables, whole grains, legumes, nuts, and seeds. These foods are rich in vitamins, minerals, fiber, and antioxidants.
2. Olive oil as the primary fat source: Olive oil is the main source of fat in the Mediterranean diet. It is high in healthy monounsaturated fats and has been linked to lower rates of heart disease.
3. Moderate consumption of fish and poultry: The Mediterranean diet encourages consuming fish and poultry in moderate amounts. Fish, especially fatty fish like salmon and sardines, are rich in omega-3 fatty acids, which have numerous health benefits.
4. Limited red meat intake: Red meat is limited in the Mediterranean diet, with a focus on leaner options like poultry and fish. This helps reduce saturated fat intake and lower the risk of heart disease.
5. Moderate consumption of dairy products: The diet includes moderate amounts of dairy products, such as yogurt and cheese.
6. Red wine in moderation: Moderate consumption of red wine is a common component of the Mediterranean diet. This is believed to be due to the presence of antioxidants in red wine, such as resveratrol, which may have health benefits when consumed in moderation.
7. Herbs and spices for flavor: The Mediterranean diet relies on herbs and spices, such as garlic, basil, oregano, and rosemary, to flavor foods instead of using excessive amounts of salt or unhealthy condiments.
8. Regular physical activity: In addition to the dietary components, the Mediterranean lifestyle also emphasizes regular physical activity. This can include activities like walking, cycling, or participating in sports.

It is important to note that the Mediterranean diet is not a strict set of foods but rather a flexible and adaptable way of eating. You can eat in this manner by eating food from India, the Phillippines, or Norway. The emphasis is on whole, unprocessed foods and a balanced approach to nutrition.

More To ComeWant to learn more? I have a course coming up - watch this space. For my followers on TikTok you can find the course there.

Oh, and I will be buying from Costco, although many other coffee companies have come to me and said, "Hey, try our coffee." So I am. Sorry, Peet's - I may still drink you, but I have boundaries.

Do that with your diet that will disappoint you. Consider instead a diet that will nourish your body and keep you in good shape.

Good Luck & have fun!

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The Scams and Quacks of the YearThe New Year, the point we all look for a second chance. To get healthy, lose weight, adopt a new habit. And waiting for you are the hucksters who want to sell you hydrogen in your water, expensive supplements of dubious value, and some choices that might actually harm you. If it sounds too good to be true, you might just be hearing the sound of the duck - or a quack, at least.

TOP SCAMS OF THE YEAR1. Carnivore Diet 2. Magnesium Supplementation 3. Celtic Salt 4. MTHFR Gene Mutation 5. Cold Plunges

FORK UToday, on Fork U, we will reveal the top scams of 2023 and make sense of the madness that surrounds them.

I'm Dr. Terry Simpson, and this is FORK U. Fork University.

Where we teach you a little bit about food as medicine

Busting myths and making sense of the madness.

The Liver King and Paul SaladinoChief among the shirtless salesmen of supplements and scams, 2023 saw the self-described liver king (Brian Johnson) fall from grace, and his partner, Paul Saladino, tried to say he didn't know.

Liver King's five-foot-two-inch frame was filled with more steroids and growth hormones than found in a pharmacy. Purchasing somewhere between $12,000 and $20,000 of injectables a month and eating a diet far from the liver he recommended. Ultimately, Johnson admitted this, albeit the evidence was overwhelming. Finally, let us not forget that his business partner, Paul Saladino, loves to yell at spinach and kale while pushing his Heart and Soil supplements.

Liver King and Saladino jointly own a supplement business, Heart and Soil. They sell supplements and pretend to tell you about health through the carnivore diet. Moreover, the company "Heart and Soil" is registered in Texas, and Brian Johnson, his wife, and Saladino are all board members.

The Shirtless Salesmen of Supplements and ScamsBeing shirtless is oddly effective, especially among some men. Whether this comes from "we like alpha males with abs" or homo-erotic fantasy, shirtless sells. Countless times showing studies refuting their claims don't move these supporters. In fact, the response from some males was some version of "Show me your abdominals." My retort, "I'd love their abs, but in time they'd love my arteries," just didn't move them.

I still find it odd that a grocery store would allow a shirtless person to yell at spinach. Yes, Saladino did train in psychiatry, although he does not see patients.

While Saladino said, he had "an inkling" his partner was doing steroids. Johnson (Liver King) used to inject insulin and balance it with maple syrup. Isn't it odd that Saladino's refrigerator is filled with the same maple syrup that Liver King used to balance his insulin to increase glycogen in his muscles?

The Carnivore Diet - or - Doctors Don't Learn Nutrition in Medical SchoolSaladino received a medical degree from The University of Arizona, and I was a faculty member (assistant professor) at the time. Saladino loves to pander to the anti-medicine crowd with the trope that doctors don't learn the root cause of disease. I pointed out that we taught him pathophysiology, and he must have forgotten that our Western medicine discovered the root cause of many diseases.

In front of one audience, Saladino claims he learned nutrition in medical school. Then, a few years later, he claims he didn't learn nutrition in medical school. Do we learn nutrition in medical school?

Do Doctors Learn Nutrition in Medical School?As someone who is certified in Culinary Medicine and taught nutrition, I can say yes and no. The basics of nutrition are anatomy, physiology, and biochemistry. While you can get these courses in college, in medical school, these are graduate-level courses.

The basic pathology of atherosclerosis, or how cholesterol is made, transported, and absorbed, is taught in medical school. The effect of dietary saturated fats causing an increase in low-density lipoprotein is taught in medical school. Moreover, the foods with high levels of saturated fats are taught in medical school.

Because of those basics, we surgeons can take the sickest patients and feed them with intravenous nutrition. Surgeons developed intravenous nutrition that has kept countless people alive. In addition, surgeons developed the ability to feed directly into the gut through a tube. But we may not learn that Popeye's chicken breast contains 1000 mg of sodium more than a regular chicken breast. We don't learn the practical side of food, but we learn a lot about the basic science, which is the foundation of nutrition. An analogy might be that an architect can design your home but may not know how to build it.

The Inflammatory Process in Medical SchoolThe inflammatory process is one of the first series of lectures that medical students learn. They learn that inflammation is an essential part of healing from injury and disease. That the inflammatory process is necessary to remove bacteria, viruses, parasites, and even cancer from the human body. Further, medical students learn that if the inflammatory process is overdone, destruction remains, such as in auto-immune diseases like rheumatoid arthritis, Sjogren's, or lupus.

Medical students are not taught to order C reactive protein or sed rates on everyone because that would be a waste of resources. Someone could have high inflammatory markers for various reasons, and blindly ordering tests is often a wasteful practice of doctors without a clue. Sometimes, we are clueless about a patient's condition, but oftentimes, medical students are taught that a history and physical exam will reveal more than a laboratory test.

Medical students are not taught that the inflammatory process is the basis of all diseases because this isn't true. Nor are they taught that atherosclerosis is all from inflammatory disease because that isn't true.

Vitamin Deficiencies and SurgeonsVitamin deficiencies are taught in medical school. The first one noted, vitamin C and scurvy, was elucidated from the great work of the Scottish Surgeon Dr. James Lind. Scurvy is a disease with multiple parts - wounds reopen, teeth fall out, blood blisters form, and seemingly many symptoms, but is treated with a source of vitamin C. The root cause of disease, indeed.

The Root Cause of DiseaseOr consider this mysterious constellation of symptoms: a person progressively develops difficulty walking, strange eye movements, muscle weakness, shortness of breath, swelling of the legs and feet, and ultimately death. The disease was called kakke. Eastern-trained physicians had worked on it for 300 years, and it affected the royal household and the elite in Japan. Did they have some ancient remedy? They did not.

A doctor, Kanehiro Takaki, dissatisfied with his Eastern medical education, decided to learn Western medicine. He apprenticed under a local doctor until the doctor said he couldn't teach him anymore, and the Imperial Navy sent him to St. Thomas in London to learn surgery. There, he learned "Western" medicine and even epidemiology, as was taught there by John Snow, who elucidated the cause of the cholera outbreaks.

Using the tools of Western medicine, he showed that the cause of these symptoms was a dietary deficiency of what became known as vitamin B1, or thiamine. If you want to hear a podcast about it or read more, click here.

What We Don't Teach in Medical SchoolWhat we are not taught in medical school is that a low-carb diet, or keto diet, or paleo diet, or carnivore diet cure diseases. We don't teach that to medical students because it is not true.

We teach how the DASH diet with low sodium reduces blood pressure and how to encourage patients with hypertension to decrease their diet. Or how the Mediterranean diet decreases the risk of heart disease and cancer.

While diet is the most empowering thing people can do, often it will not be enough. While physicians can influence some of the health decisions of patients, often the patient will come to us beyond where diet and exercise can help.

The Carnivore DietThe carnivore diet is the latest evolution of the low-carb fad. Saladino does a fruit modification of the diet, which will prevent scurvy. In fact, the musician James Blunt suffered from scurvy. as the carnivore diet is far from a complete diet.

Carnivore diet sounds great - just eat steak. Saladino will claim this is the most nutrient-dense food in the world. It isn't.

Others will claim you can get all your nutrients through this - you cannot.

The health problems of an all-meat diet are clear:

• Keto vs Mediterranean diet - same weight loss, but Med diet had fiber and lower LDL (ref)
• A good review of meat-based vs. plant-based show plant-based overall healthier (ref)
• Another review shows that dietary fiber is associated with improved metabolic health (ref)
• While Saladino refers to the Hadza, studies show their diet, like most hunter-gatherers, is rich in fiber (ref)
• The Inuit in Alaska have high rates of heart disease, stomach cancer, and colon cancer - all diet-related (ref) (ref) (ref)

The carnivore diet increases the risk of diverticulitis, hemorrhoids, and stomach cancer (Sivasubramanian BP, Dave M, Panchal V, Saifa-Bonsu J, Konka S, Noei F, Nagaraj S, Terpari U, Savani P, Vekaria PH, Samala Venkata V, Manjani L. Comprehensive Review of Red Meat Consumption and the Risk of Cancer. Cureus. 2023 Sep 15;15(9):e45324. doi: 10.7759/cureus.45324. PMID: 37849565; PMCID: PMC10577092.) Although many chiropractors will dispute this. I wonder how chiropractors ever learned to do anything but cherry-pick studies?

Magnesium SupplementationI recently covered this on a previous blog/podcast ( reference ). Suffice it to say that excess magnesium has become one of the more common problems seen in poison control centers. At best, excess magnesium can lead to loose bowels, but worse cases lead to depression of the carotid baroreceptor with POTS symptoms, cardio-toxicity, and severe cardiac rhythm changes.

Legitimate reasons for magnesium deficiency include diarrhea, malnutrition, use of some diuretics, hyperaldosteronism, Crohn's disease, alcoholism, and advanced kidney disease. If you have any of these, you need to see a physician.

If you eat a lousy diet and don't get enough magnesium, it is time to grow up.

But this leads to the next scam of the year:

Celtic SaltCeltic salt is simply sea salt harvested from the North Atlantic. It costs about $1.66 an ounce, compared to regular salt, which is $0.06 an ounce - six cents. Is there magic to justify this additional expense? To answer this, you can ask the naturopath, Barbara O'Neill.

For those who haven't seen her, she seems like a kindly lady, a pleasant voice and an easy smile. She is usually filmed while standing next to a whiteboard, explaining her version of reality to an audience who paid thousands of dollars to listen to her.

Her misinformation was considered so dangerous that she was barred from Australia's health care system. She claimed cancer could be cured with sodium bicarbonate, that cayenne pepper could reverse atherosclerosis and stop a heart attack, and that infants with strep infections didn't need antibiotics. If you didn't know, every one of those statements is dangerously incorrect.

She also states that she can treat high blood pressure with Celtic salt because Celtic salt has magnesium in it. Celtic salt has 80 mg of magnesium for every 34,000 grams of salt (that is a toxic amount of salt). A serving of spinach will give you the 80 mg, as will almonds or half a serving of pumpkin seeds.

O'Neill goes on to say that magnesium is a water-hungry molecule and is good for hydration. Magnesium is not useful for rehydration. In severely dehydrated children, we use a combination of water with sugar and a bit of sodium chloride, and not magnesium.

Cold Plunges, MTHFR Mutations, and Gary BreckaThe last is a charismatic fellow named Gary Brecka, who is great at self-promotion. Selling people high-priced solutions to non-existent or rare problems. For legitimacy, Brecka calls himself a "human biologist." Brecka received a bachelor's degree from Frostburg State and another bachelor's degree from a chiropractic college. In summary, Brecka has no formal medical training.

Often, Brecka starts his talks by making the claim he can tell a person when they will die to the month. Oddly, no one on planet Earth can tell when a person will die, let alone the month, year, day, or hour. Although there is an entire science, actuarial science, where they determine probabilities of surviving in any given year. However, Brecka claims he can tell based on labs or other issues. Yet this bold claim brought Brecka's most noted client, Dana White. Concluding that Dana White had ten years to live, White became an ardent disciple.

Today, Brecka advocates hydrogen water, cold plunges, and selling overpriced genetic tests for the MTHFR mutation.

Cold Plunges and The Polar Bear ClubI'm a member of the Polar Bear Club. I've swam from the waters coming from the Mendenhall glacier by Juneau, Alaska. When I did this, I had spent weeks preparing by swimming in other waters and acclimating my body to this. Growing up in Southeast Alaska, cold water swims were the only ones we had. In those days, I was young, athletic, and took many foolish chances. The last time I was in cold water was scuba diving in New Zealand at 60 degrees, and I had a 9 mm wetsuit on - even that was a bit cold for me.

Acclimation occurs with athletes who competitively swim in cold water. First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.

People who do cold water immersions claim this is good for their health and have a cult-like joy in this frigid experience. Such claims are as cold as the water they immerse themselves in.

Cold Water Immersion Immediate EffectsIn all the advertisements I've seen on TikTok for cold water immersion tubs, I have never seen one of them warn people of the immediate consequences. Here is what we know based on laboratory studies:

• Increase heart rate
• Increased blood pressure
• Increased respiratory rate
• Increase in troponin levels - indicating heart damage
• Increased shivering
• Increased cardiac (heart) arrhythmias

Vasoconstriction of skin vessels begins at temperatures of 37.1 (98.78 F) when immersed in cold water or 37.5 (99.5 F) post-exercise (ref). The body attempts to maintain its core temperature by shivering. However, when immersed in cold water, the body loses its ability to protect its core temperature after 36.2 C or 36.5 post-exercise. This is where the danger begins, as heat is lost. exponentially by convection from water more than a cold shower or air ( ref ).

Because of the immediate effects

Cold Water SwimmingAcclimation occurs with athletes who swim in cold water. First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.

Sudden Disappearance SyndromePerhaps you've heard about people who have jumped in the water and never returned? This was called "sudden disappearance syndrome." Jumping into cold water will cause some people to have an involuntary gasp. The shock will cause their body to take a sudden large breath underwater, which fills their lungs, and they sink. It is a miserable death.

Brown Fat and Fat Stripping Effect of the PlungeBrecka says, "Nothing strips fat off the body faster than a cold plunge." He is incorrect, as physical exercise is faster, more efficient, and safer. Shivering is faster at producing heat, but once you get below 36.2 degrees, you lose that regulation and are prone to hypothermia.

What about brown fat, which generates heat from cold water exposure? This is true! But the average human adult male has about two to five ounces of brown fat in their entire body. When examined, brown fat oxidation in an adult is equivalent to two minutes of running (ref).

While Brecka would love to sell his $6000 cold plunge pool, he overstates the effects of what can be dangerous activity. This is, in my opinion, unethical.

Cold Water and Acute InjuriesWhat about the elite athletes who use cold for injuries? Certainly, they know more about this. To use this logic - let us look at the average career of an NFL player - 27 months; most careers end because of injury. Their lifespan is 56.9 years. Baseball players' lifespan is about ten years longer (ref)

The RICE protocol (Rest, Ice, Compression, Elevation) was originally coined by Dr. Mirkin in 1978 in "The Sports Medicine Book." While there was not good data to support this protocol, there were plenty of anecdotes. Who doesn't feel better with ice? But the effect of ice is to gate pain. It does not improve healing. Dr. Mirkin recanted his original position on the protocol in 2014.

More tests need to be done. But to assume the trainers in the NFL know more than the literature shows is dubious. Most NFL coaches consistently over-train their players and believe an injury will make them stronger. It doesn't - as should be seen by how quickly injury ends careers. One of the reasons Jim Harbaugh was more successful than others was his physical therapists, who limited practice injuries and used modern physical therapy to prevent major...

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Canola Oil is Healthy and InexpensiveDid you ever notice there are those people who will tell you how everything is bad for you? Don't eat this and don't eat that?

They make grand assertions about the modern food system. Often claiming we should return to the age of the caveman. Assuming that health will return when we eat what our ancestors ate.

The Logical Fallacy of Ancestral Diets / and HumansProponents of ancestral diets are confused by the logical fallacy called a biotruth.

What is a biotruth? An argument based upon a misunderstanding of natural selection or the evolutionary process. Usually combined with the conclusion that if it was good enough for primitive man, it should be true for now. Ultimately, we forget that primitive man did not have an easy life.

Canola Oil Podcast TranscriptCanola oil is today's topic because not everyone wants to buy expensive olive oil. When I mention canola oil on TikTok, the comments go like this:

• Canola oil was "meant" to be motor oil
• It comes from the rapeseed plant
• It is a GMO-crummy oil
• Chemically extracted with hexane and it can turn rancid and create trans-fats

Are those claims valid? Should we avoid Canola oil? Must we avoid Canadians in general?

Today on Fork UWe will make sense of the madness that is Canola oil. Is it an evil plant that is only good to make oil for your car, truck, or tank? Or is it a reasonable oil for your body?

I'm Dr. Terry Simpson, and this is Fork U

Fork University

Where we make sense of the madness

Bust a few myths

And teach you a little bit about food as medicine.

What is Canola Oil?Canola oil was invented in the 1970s in Canada and is an acronym that stands for Canadian oil's low acid.

Canola comes from the pressed seeds of rapeseed plants. Granted, that is an unfortunate name. However, not if you know its epistemology. Rapeseed comes from the Latin rapa, which translates to "turnip." Thus this flowering plant is a member of the turnip, cabbage, and mustard family.

Latin just isn't taught anymore. But if you think of Rome often, as we men do, Latin might be the new language for you.

Speaking of Mustard, did you ever wonder why we don't have mustard oil in the United States? Primarily Erucic acid.

Erucic AcidErucic acid is a monounsaturated fatty acid that is associated with heart disease. In some poorly done experiments in rats, they seemed to have higher levels of heart disease. Rats, not politicians. But the healthy kind of rats you find in sewers, not the vermin found in Washington, DC.

Erucic acid is why you don't find mustard seed oil in the United States. Those who travel to India will experience delicious foods cooked in mustard oil. But don't fear. It will be just fine (ref).

In fact, erucic acid decreases the rate of some progressive brain diseases and is being examined to treat cancer and other diseases.

Rapeseed Oil as a lubricantBecause of the high erucic acid content, rapeseed oil was originally used as an industrial lubricant. Some rapeseed was cold pressed, seeds gathered, pressed, and not heated, and the oil extracted. This has been used as a cooking oil for years, but there was concern regarding the erucic acid content.

Canadians HybridsCanadian scientists began to crossbreed the rapeseed with wild cabbage to lower erucic acid. The seeds of this new hybrid plant became the Canola oil. Later, this plant was genetically modified to withstand Round Up. Hence, it is a genetically modified plant (ref).

GMO Oh NoAs someone who has published about genetic engineering, I find the fear of GMOs to be a fear of the unknown. Modifying genes is what humans have been doing for centuries. Hence, using laboratory techniques is simply faster than cross-breeding. Still, GMOs are a major cause of heartburn for the latte-sipping English major.

It is human studies that are the gold standard for how a food behaves. Not where it came from or what it has been used as.

Lyon The Gastronomic Capital of FranceLet us begin in Lyon, France. The capital of fine dining in the world, home of restaurants with over twenty Michelin stars.

But Lyon? Home of butter? What happens when we take people with heart attacks from Lyon and ask them to change their diet?

There was a seventy-five percent lower incidence of cardiac deaths in patients with a first heart attack who modified their diet to a Mediterranean-style diet.

What was the main change? Well, they wanted the French to go from butter to olive oil, but alas, that was not popular. The French, other than those who reside in the Rivera, do not find olive oil attractive. But the French had no trouble adopting canola oil.

Canola oil was provided as both a cooking oil and a margarin to spread on their famous French bread.

Mediterranean DietOther changes they adopted included:

1. consume whole grains rather than refined grains,
2. to have fish more than beef,
3. and to never go a day without fruit.

In the first year, the canola group had 73% less risk of having a second heart attack or dying from heart disease. After several years, the final paper (referenced here) showed a similar risk reduction.

Implementing the Mediterranean DietOne of the great conclusions of the Lyon heart study was that adopting the Mediterranean-style diet was not that difficult for these patients. While some doctors might give up, this one dietary change had as much influence as controlling blood pressure in patients with clinically active heart disease.

Other Human Studies?

Nine studies showed that patients consuming canola oil had lower LDL cholesterol. The higher the LDL, the more heart disease a person is likely to have, as well as strokes and peripheral vascular disease.

In spite of what the shirtless salesmen of supplements and scams want to tell you, the human trials show:

• Canola oil is not toxic to humans
• Canola oil improves biomarkers for the heart
• Canola oil improves insulin levels.
• Canola oil over butter and cream is one factor leading to less heart disease in patients with coronary artery disease.

Canola Oil is Not Toxic to Humans* Lab studies of people improve when consuming canola oil over saturated fat, butter, or beef tallow. * Insulin levels are decreased - which is good - with canola oil * And as in Lyon, while the butter is delicious, those who consume canola oil have fewer problems with their heart.

Implementing the Mediterranean DietIf you want to implement the Mediterranean diet into your life, why not do what they did in Lyon?

If you cannot afford olive oil, use canola oil to cook with. It has fewer trans fats than tallow, lard, butter, or coconut oil and has a neutral flavor.

Make sure to have a fruit every day or two.

Use whole grains in your diet, be that for bread or just grains with your meals. Whole grains contain a lot of fiber.

New Course Coming

Thank you for listening to this edition of our series on how to adopt the Mediterranean Diet. We will have a course put together soon about adopting the Mediterranean diet, and you can find out when by listening to this podcast or signing up for my newsletter on terrysimpson.com. You can also follow me on TikTok, where I am @drterrysimpson.

Check out the blog associated with this - either yourdoctorsorders.com or forku.com.

This podcast was researched and written by me, Dr. Terry Simpson. While I am a real medical doctor, board-certified, I am not your doctor. Before making dietary changes, please check with a real, board-certified western-trained physician. Not an Eastern medicine doctor, not a witch doctor, not a chiropractor, not a naturopath.

Distribution and audio editing were done by my friends at Simpler Media - run by the pod god Evo Terra and his most able assistance. Thank you, Allie.

Hey Evo - in the interest of research, we need to go to the Mediterranean - by way of Lyon.

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Nuts and Seeds, or SupplementsPeople who count calories notice nuts contain about 200 calories per ounce. Nuts are calorie-dense. However, nuts are also nutrient-dense. Moreover, nuts provide fiber, healthy oils, and essential minerals.

Nuts have been shown to decrease sudden cardiac death, decrease cholesterol, and provide satiety that helps people who wish to control their weight.

Two Brazil nuts contain enough magnesium to meet the adult daily requirement.

Food Works, Supplements May NotThe advantage of a healthy diet is that you do not need supplements in your diet. While Magnesium is an essential mineral needed in hundreds of reactions in your body, you can get all the magnesium you need by following a Mediterranean Diet.

Take Pumpkin Seeds - also known as Pepitas in the US. Kernels: 1 oz, 168 mg or pumpkin seeds in shell: 1 oz, 74 mg

Other Foods That Work:Almonds, dry roasted: 1 oz, 80 mg

Spinach, boiled: ½ cup, 78 mg

Cashews, dry roasted: 1 oz, 74 mg

Peanuts, oil roasted: ¼ cup, 63 mg

Soymilk, plain or vanilla: 1 cup, 61 mg

Black beans, cooked: 1⁄2 cup, 60 mg

Peanut butter, smooth: 2 tablespoons, 49 mg

Bread, whole wheat: 2 slices, 46 mg

Avocado: 1 whole one is 44 mg

Potato, baked with skin: 3.5 oz, 43 mg

Rice, brown, cooked: 1⁄2 cup, 42 mg

Yogurt, plain, low fat: 8 oz, 42 mg

Oatmeal, instant: 1 packet, 36 mg

Banana: 1 medium, 32 mg

Salmon, Atlantic, farmed: 3 oz, 26 mg

Halibut, cooked: 3 oz, 24 mg

Raisins½ cup, 23 mg

Chicken breast, roasted: 3 oz, 22 mg

Beef, ground, 90% lean: 3 oz, 20 mg

Broccoli, chopped & cooked: ½ cup, 12 mg

Apple:1 medium, 9 mg

Carrot, raw: 1 medium, 7 mg

All of those are foods you get in your diet, and all of them are a part of a healthy Mediterranean Diet.

TEXT FROM PODCAST:Which is better? Magnesium glycinate three eight citrate or oxide?

This is one of the most common questions I'm asked during my doc talk live sections on TikTok. Magnesium supplementation is a popular subject probably ever since the disgraced Naturopath published her book The Magnesium Miracle, claiming that magnesium could cure over 60 diseases. It was popular because so many people wanted one thing that they could grab hold of to explain all of their problems.

And because symptoms of magnesium deficiency are common, fatigue, weakness, insomnia, and heart palpitations, it became a natural reservoir for all of the nonsense that people want to present.

Barbara O'Neill, the naturopath banned from Australia for dangerous practices, frequently lectures that taking Celtic salt will cure hypertension, but it isn't Celtic sea salt you need.

If you need magnesium today, I will introduce you to Mediterranean magnesium. It will not only help regulate blood pressure but also improve your life and increase longevity.

Today on Fork U, we will make sense of the madness of magnesium, and we'll tell you which magnesium supplement you should buy and which you should avoid. And how to take the Mediterranean magnesium miracle and avoid the supplemental magnesium misery of Montezuma.

I'm Dr. Terry Simpson, and this is Fork Fork University.

where we make sense of the madness. Bust a few myths and teach you a little bit about food as medicine.

The Mediterranean magnesium miracle. Where do you get this? Well, first try nuts and seeds, which we include in the fruit section of the Mediterranean diet. Did you know that two Brazil nuts contain enough magnesium for a person for a day? An ounce of pumpkin seed contains about half of what you need. A banana is about 10%. Salmon about a fourth beef. Beef is about 10%. Now, I know the carnival crowd has a hard time accepting that beef, bison, or organ meat doesn't contain sufficient amounts of magnesium to meet minimum data requirements. But I digress. It's just so much fun to call them out about their quackery. No doubt, many of those proponents sell magnesium supplements on their websites. But did you know that a well-rounded diet like the Mediterranean diet, you will consume all of the magnesium you need?

And speaking of nuts, did you know that increasing walnut consumption has been shown to lead to a reduction in low-density lipoprotein cholesterol and decrease inflammatory and oxidant markers in individuals who are at high risk for coronary disease?

And do you know that other studies have shown that people who consume nuts and seeds have fewer heart attacks? For example, 40% decrease in heart disease among those people who consume four servings of nuts a week.

Let's go back to the supplementation stuff. The problem with supplementation is you're just replacing one factor when eating food provides not only that one factor but plenty of other things.

The second problem with magnesium supplementation is magnesium toxicity.

Now, oftentimes people may attribute the nausea, cramps, and diarrhea to food poisoning when actually they're getting overdosed on magnesium supplementation. They probably don't know that taking those magnesium supplements could interfere with their medicines, like their diuretics, their heart medicine, or their antibiotics. Magnesium can cause more muscle aches and sleeplessness, and extra magnesium can even stop the heart. They probably don't tell you on those magnesium bottles that it's going to compete with calcium for absorption. So taking excess magnesium will not only overdose you but also decrease calcium absorption.

Wow, it's hard to believe they actually sell that stuff when you can just take a Mediterranean diet full of nuts and seeds at one portion of it and get plenty of it in your diet. While magnesium is essential, it is far from rare in plants, nuts, and seeds in spite of supplement makers consistently making claims that our food has less magnesium because we're depleting our soil. Did you know that magnesium is the third most common element on the crust of the earth?

Because of that, one of my favorite mineral waters has 45 mg of magnesium per glass. It is called Socasani, I don't know if you can find it anywhere else, but I get it at Costco here in the Los Angeles area. This is mineral water that bubbles up from springs in the Andes. It is high in magnesium. I like it because they won some water awards and that is how I found it. But a cup of that water is about a quarter of the amount of magnesium because magnesium is the third most common element on the crust of the earth.

So when I refer to Mediterranean magnesium, it's not a supplement you're going to buy, although I'm sure someone will probably sell it now. But it does come from nuts, seeds, fruits, and vegetables.

Now let's go back to Celtic Salt. I hear people selling Celtic salt all the time, be that Barbara O'Neill, Santa Cruz Medicininals, or Gary Brecka.

But Celtic Salt has 34,000 mg of sodium to 200 mg of magnesium in three and a half ounces (100 grams). That is a tone of salt.

Now contrast Celtic Salt with one ounce of pumpkin seeds, which has 170 mg of magnesium and two milligrams of sodium. Celtic salt is just overpriced salt. It is not a source of magnesium.

And certainly, if you're going to take three and a half ounces of salt, which contains 34,000 milligrams of sodium, to get 200 milligrams of magnesium, whatever good the magnesium will do to your blood vessels will be more than outdone by the overdose of sodium you're giving to your body.

The problem with supplement makers and sellers everywhere is that they are constantly trying to sell you something that you can get in a healthy diet, like the Mediterranean diet, and in this case, from nuts and seeds. They are easy to add to a salad from nuts, which makes an incredible snack that you can carry portable with you almost anywhere, containing fiber and protein, along with magnesium, selenium, potassium, and all those things that you need.

You don't need to spend more money on magnesium supplements, what you really need is to spend more money eating a better diet. Or like I tell people when they tell me, well, I just don't like fruits and vegetables and nuts and seeds. It's time to grow up because there is more in your diet than just magnesium. There are plenty of other things that you need that you can get from a diet that you will never get from a pill.

Now to be clear, there are those people who need magnesium supplementation if required by a board-certified physician. There are people with certain conditions, kidney disease, and people who have taken certain pills that will deplete magnesium and need it.

How do you test for magnesium deficiency? Not just a blood test. Blood only contains a few percentages of the magnesium in your body. There are several other tests. One of the gold standards is that we give you a bunch of magnesium, check your urine, and see if it all came out. Another one is the red blood cell test for magnesium. There are some good magnesium tests out there, typically not available from your average chiropractic lab, which oversells you on tons of tests.

So if you overdose on magnesium, like my aunt did when she brought me the book, The Magnesium Miracle. She said, "I think this is what was giving me diarrhea." I said, absolutely. It was also one of the reasons that her anti-hypertensive wasn't working. She was getting too much hypertension. She stopped her magnesium supplement. Her bowels cleared up, and her hypertension got better. She was taking her anti-hypertensive, and it wasn't being interfered with magnesium. And she loves fruits, seeds, and nuts. I mean, she has to love nuts. I'm her nephew.

Please listen to the blog or see the blog associated with this called Your doctor's orders.com or for you.com. This was researched by me, Dr. Terry Simpson. And while I am a physician, I am not your physician. If you need a physician's help, please see a board-certified Western-trained physician, not a naturopath, not an Eastern medicine man, not a chiropractor, not a witch doctor. Our friends carried out distribution at Simpler Media, and the pod god, my good friend Evo Terra.

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We Love LegumesThe legume is a powerhouse plant protein. The beautiful bean. Often the source of protein for vegetarians and vegans, and forgotten about in most modern diets today. Thus, we will campaign to bring back the legume.

In today's gym, you will find people selling protein powders, advocating all meat diets, and flexing their muscles. But in ancient times, the original Greek Gymnasiums, the source of protein for these fellows, were legumes. Their diet was cereals from whole grains, fruits, legumes, vegetables, and occasionally fish. No meat, no protein powder, no pre-workout.

What is a Legume or Pulse?When most think about legumes, they think about the common green bean (Phaseolus vulgaris). Yet there is an entire family of Leguminosae.

The precise definition of a legume is any plant from the Fabaceae family that would include its leaves, stems, and pods. A pulse is an edible seed from a legume plant. Pulses include beans, lentils, and peas. For example, a pea pod is a legume, but the pea inside the pod is the pulse.

Rediscovering the BeanWhen Ancel Keys was told there were few cardiac events in Southern Italy, he went to investigate. Legumes have less fat, and thus, a diet rich in legumes should have less fat and, thus, less heart disease.

In Naples, only 20-25 percent of the calories were from fat. In contrast, Keys noted in England that 35% of the calories were from fat, while in Minnesota, 40 percent of the calories were from fat. Legumes meant plenty of protein, less fat.

The blood cholesterol reflected some of this. Naples had cholesterol values of 165 milligrams per 100 milliliters of blood, while England had over 200 and Minnesota had over 230. Total blood cholesterol was the only measurement at the time.

What Keys also showed was the wealthy Neapolitans ate a richer diet:

"Still, a small sample of bankers and professional men in Naples, who lived on a much richer diet than the working class, had cholesterol values of about 200 in their blood serum, and some of them had coronary heart disease." (reference 1)

Beans and Lower CholesterolKeys then took 24 healthy men and controlled their diet for fat and protein. Keeping calories constant with equal amounts of protein but changing the fat, the cholesterol fell from 225 to 195 on the lower-fat diet. But the Neapolitan diet was not what he followed. The fat in Naples was mainly olive oil, and the fat in the low-fat metabolic ward was from fat in meat and milk.

At the time, Keys concluded it would be difficult to convince people to eat a diet rich in legumes. Americans love their meat. Today, we have better methods to decrease heart disease risk by using statins often with other drugs. While a diet of legumes replacing meat might reduce blood cholesterol by 10-20%, that is often not enough to decrease the risk of heart disease.

A combination of modern medications (such as Crestor, Zetia, Repatha) can lower LDL (apo-B levels) to where heart disease can become an "orphan" disease. You can have your steak and eat it too!

Legumes and the Mediterranean DietLegumes are part of the Mediterranean Diet (ref). The recommended amount includes 3-4 ounces of legumes per day. Or using legumes as a major source of protein for a meal several times a week.

Legumes: lentils, beans, peas, and peanuts. The more common ones that humans consume.

Ancient Peoples and LegumesUntil about 12,000 years ago, homo sapiens were hunter-gatherers. For almost two million years before that, our evolutionary ancestors subsisted on hunting and gathering. What was the most common protein source? Legumes. Not meat, as much as your carnivore-crazy friends would have you believe.

Remains of lentils, the tombs of the Twelfth Dynasty (2400-2200 BC). Archeologists have found peans and lentils from remains in Turkey dating to 5500 BC.

Even North America has legumes. America is best known for both the kidney bean and the haricot (and you thought it was French). Those were cultivated throughout North, Central, and South America. Dried kidney beans have been found in pre-Inca tombs.

Want Some Data?

People who ate legumes four times a week had a 22% reduction in heart disease compared to those who consumed legumes once a week or less. The U.S. Dietary Guidelines emphasize legumes (about 3 cups a week) and the DASH Eating Plan of the National Heart, Lung, and Blood Institute (4-5 half-cup servings a week). The Food and Agriculture Organization (FAO) of the United Nations declared the International Year of Pulses in 2016, focusing on the contribution of pulses to food production and nutritional diversity to help eradicate hunger and malnutrition.

Nutritional Value

Legumes are a significant source of protein, dietary fiber, carbohydrates, and dietary minerals; for example, a half cup of cooked chickpeas contains 18% of the Daily Value (DV) for protein, 30% DV for dietary fiber, 43% DV for folate and 52% DV for manganese. Not much fat and not much sodium in these.

Legumes are also an excellent source of resistant starch, one of my favorite starches. Your gut doesn't break down resistant starch but is broken down by bacteria in the large intestine to produce short-chain fatty acids used by intestinal cells for food energy. Those byproducts reduce the risk of colon and rectal cancer.

Favorite Recipes:

One of my favorite recipes is life-saving Dahl by Simon Majumdar - my co-host of FORK U. His recipe is here.

REFERENCES:

(1) Keys, Margaret.Keys, Ancel. The Benevolent Bean. United States: Farrar, Straus and Giroux, 1972.

Gofman JW, Delalla O, Glazier F, Freeman NK, Lindgren FT, Nichols AV, Strisower B, Tamplin AR. The serum lipoprotein transport system in health, metabolic disorders, atherosclerosis and coronary heart disease. J Clin Lipidol. 2007 May;1(2):104-41. doi: 10.1016/j.jacl.2007.03.001. PMID: 21291675.

LA, He J, Ogden LG, et al. Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study. Arch Intern Med 2001 Nov 26;161 (21):2573-8.

"Nutrition facts for Chickpeas (garbanzo beans, bengal gram), mature seeds, cooked, boiled, without salt, 100 g, USDA Nutrient Database, version SR-21". Conde Nast. 2014. Retrieved 15 January 2015.

Birt DF, Boylston T, Hendrich S, et al. Resistant Starch: Promise for Improving Human Health. Advances in Nutrition. 2013;4(6):587-601. doi:10.3945/an.113.004325.

Am J Hypertens. 2014 Jan;27(1):56-64. doi: 10.1093/ajh/hpt155. Epub 2013 Sep 7.

Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials.

Jayalath VH1, de Souza RJ, Sievenpiper JL, Ha V, Chiavaroli L, Mirrahimi A, Di Buono M, Bernstein AM, Leiter LA, Kris-Etherton PM, Vuksan V, Beyene J, Kendall CW, Jenkins DJ.

Naureen Z, Bonetti G, Medori MC, Aquilanti B, Velluti V, Matera G, Iaconelli A, Bertelli M. Foods of the Mediterranean diet: garlic and Mediterranean legumes. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E12-E20. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2741. PMID: 36479501; PMCID: PMC9710409.

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Turmeric: It can kill youTurmeric is from the root of a flowering plant (Curcuma longa of the ginger family Zingiberaceae), known for being anti-inflammatory. Because of its anti-inflammatory nature, turmeric is one of the most common supplements I am asked about during my TikTok live sessions. This is because people like a "natural" anti-inflammatory supplement rather than over-the-counter medications.

SupplementsSupplements are excluded from "black box warnings." Those warnings you see in the package inserts in pharmaceuticals. This article is meant to provide references for those interested in doing more research about Tumeric to realize it is not benign.

Turmeric has many potential applications for cancer, brain injury, and many other diseases. The key is knowing what dose of turmeric is toxic, what dose is effective, and what dose is ineffective. We also need to know how to mitigate potential dangers.

Contrast with AspirinAspirin is a known anti-inflammatory agent with many uses. Since aspirin is regulated, we know the dose effect of aspirin. If you have a headache, the 81 mg dose of aspirin will not relieve your headache. But the 325 mg dose will decrease headache. And you know that taking two hundred tablets of aspirin is a toxic dose.

A single aspirin can cause a bleeding ulcer, which may lead to death. Some people are allergic to aspirin, and an allergic reaction can lead to death.

What we don't know is the effective dose of Turmeric or the lethal dose of it in that supplement bottle. But we know that turmeric, curcumin can lead to liver injury and death.

Turmeric and Liver InjuryToxicity is always in the dose. High curcumin levels, the active ingredient in turmeric, have caused liver damage (Ref 1-13). To quote from one of the references:

Liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. (2)Turmeric and CookingThere is no danger in using turmeric as a spice in cooking. First, because your intestines do not absorb turmeric well. Unlike a supplement, which has high doses of curcumin. In addition, supplements also have black pepper, which increases absorption. Since turmeric has a mild anti-inflammatory component, this might have limited benefits as part of a healthy diet.

Tumeric belongs in the cabinet, not in a capsule.

TEXT FROM THE PODCASTYou probably have some turmeric in your herb and spice drawer.

You’ve probably heard that Turmeric’s active ingredient Curcumin has anti-inflammatory properties and has been used for centuries as an “ancient” medicine.

That yellow powder comes from the root of the Curcuma longa plant, a member of the ginger family.

Turmeric has a warm, bitter taste, and I use it in Paella, curry, and add it to salads, rice, or other starches like pearl barley.

But what you haven’t heard is that too much Turmeric can kill you.

Today we will make sense of the madness surrounding Turmeric. From its promise as an anti-cancer agent to its toxicity, and who should avoid it for daily use.

FORK UI’m Dr. Terry Simpson, and THIS is FORK U

Fork University

Where we make sense of the madness

Bust a few myths!

And teach you a little bit about food as medicine.

InflammationInflammation is a complex biochemical, physiological, and even pathological process. Inflammation is the basis of our immune system, and acute inflammation allows us to rid our bodies of cancer, viruses, bacteria, yeasts, mold, and parasites. Without the inflammatory process, we would end up being a pile of goo in twenty-four hours – dead as dead can be. Inflammation allows us to repair our body from injury, anything from burning our hand by spilling coffee to major trauma from an automobile accident.

Chronic InflammationChronic inflammation can make certain illnesses much worse - from arthritis, heart disease, inflammatory bowel disease, psoriasis, and may even play a part in premature aging.

So we want some inflammation, but not too much.

You've Had InflammationDid you ever have the flu and have muscle aches and a fever, only to take an aspirin and feel better in 24 hours? Those muscle aches and fevers were not the result of the virus but of your body fighting it – and fighting it to where you felt poorly. So you added a bit of anti-inflammatory agent – aspirin – and felt better.

Science and InflammationScience is always looking for anti-inflammatory agents, and curcumin has attracted a lot of interest among legitimate scientists.

Curcumin has been examined for a potential role in cancer treatments or with inflammatory bowel disease.

Because inflammation is complex – here is an example about curcumin: “It binds to the toll-like receptors and regulates downstream nuclear factor kappa B, mitogen activate protein kinases, activator protein one and other signaling pathways.”

Hucksters, Curcumin, and InflammationCurcumin has also attracted the attention of the non-regulated supplement industry. Where they can bottle it up and tell you it “supports heart health, or gut health, or immune function.” All those statements are meaningless – designed to fool someone to buy something with a label of “natural” to believe it might be better than some “drug.”

Because it is complex, you can have hucksters use the word “inflammation” and sell you a product, an idea, or a supplement for hundreds of dollars. Their science is marketing, and in this case, marketing to you a product with words and extracting dollars from your wallet.

Do we even have wallets anymore?

The Most Anti-Inflammatory DietDo you know what the most anti-inflammatory diet is? The Mediterranean diet – the one tested to work well for people with overactive inflammatory diseases – like arthritis, Crohn’s disease, multiple sclerosis, diabetes, obesity, or heart disease.

Let's take curcumin and turmeric back to the kitchen.

A part of the Mediterranean diet is cooking with herbs and spices.

And even if you can’t cook, you can spice things up a bit.

Turmeric seems to be a worthy candidate.

Fresh Turmeric or Powder?If you buy fresh turmeric from the store, it will look like a root. It is brown on the outside with a deep yellow inside. This turmeric is also great for cooking. But be warned, it will stain your hands a nice yellow color - not permanently. Use a micro plane to shave the root onto your dishes into your dishes. If you follow a recipe, you can substitute fresh turmeric in the ratio of 1 tablespoon fresh is equal to a teaspoon of the dried yellow in any recipe.

Start with Breakfast!If you’ve been to coffee shops lately, you may notice they have started adding turmeric to some drinks, like a turmeric-laced latte. Which has about a quarter to half teaspoon of the powder in the drink. Turmeric will add a deeper flavor to your latte, and some liken it to other spiced drinks – such as the famous pumpkin.

Turmeric is a great addition to scrambled eggs or a tofu scramble. It provides a color and depth of flavor.

A quarter teaspoon of the spice is all you need. You can also use it with paprika on top of deviled eggs.

Moving on from BreakfastAdding a teaspoon to your rice will give it a deep yellow color that makes the rice more visually appealing.

A teaspoon also works well with your bean dishes. That famous cowboy caviar – adding turmeric to it – makes it a bit more earthy.

Some of you have asked me about Ginger/Turmeric /honey teas or “shots” to decrease inflammation.

But if you consider other anti-inflammatory drugs, like aspirin, and ibuprofen, you know they have side effects.

So does curcumin.

In the blog, I have half a dozen references to the deaths of people with liver failure who had high doses of curcumin, some prescribed by Ayurvedic practitioners. Many of these patients died; some were saved when they went to conventional hospitals where they needed liver transplants.

The Dose is Always in the Poison.Be warned about the supplements of curcumin, especially when it has been combined with piperine (pepper) to increase its uptake in the gut.

Curcumin should not be used if you are pregnant or going to become pregnant. This can cause a loss of pregnancy.

Nor should curcumin be used if you are breastfeeding.

Do not take curcumin if you are taking any blood thinners, like warfarin, Plavix, or Eliquis.

If you tend to bleed more or bruise easily, you should not take this supplement.

The supplement should not be taken daily if you are over 60 years old, as it can cause bleeding in the brain.

Do you have some issues with your gallbladder? Curcumin causes inflammation of your gallbladder, which requires urgent surgery.

Curcumin should not be taken if you have stomach issues – it can cause ulcers in your stomach and make any ulcer you have to bleed more.

It should not be taken if you are taking aspirin, Motrin, or any anti-inflammatory drug.

It should not be taken if you are going to undergo surgery – it should be stopped two weeks ahead of time.

The Non-Regulated Supplement IndustryThe supplement industry is not regulated. Besides people getting too much and causing bleeding issues and death, there have been supplements colored with heavy metals, causing heavy metal accumulation in people who use these supplements.

If you have a headache or joint ache, we know the dose of aspirin, Naprosyn, or Motrin that is effective, the dose that won’t do anything, and the dose that is toxic. We don’t know that with turmeric or curcumin.

I love cooking with the herb turmeric. It adds a depth of flavor to almost any meal. As with all good food, it has properties that can add to the properties of other whole foods and spices.

Turmeric belongs in the kitchen, not in the capsule.

Please see the blog associated with this podcast on yourdoctorsorders dot come.

This podcast was researched and written by me, Dr Terry Simpson. And while I am a board-certified physician, I am not your physician.

If you need advice, please seek a board-certified western-trained physician n- not an Ayvurdic healer, not an Eastern medicine man, not a naturopath or chiropractor – but someone who can help you with real conditions.

Simpler Media distributes the podcast, and the transcript can be found on FORK U. Audio editing and music were inserted by my good friend and pod god – Evo Terra.

Hey Evo – I wonder if you’ve ever tried turmeric in beer?

REFERENCES:1. Drug-Induced Liver Injury Secondary to Turmeric Use https://pubmed.ncbi.nlm.nih.gov/37205206/ 2. Liver Injury Associated with Turmeric-A Growing Problem: Ten Cases from the Drug-Induced Liver Injury Network [DILIN] https://pubmed.ncbi.nlm.nih.gov/36252717/ 3. Acute liver injury following turmeric use in Tuscany: An analysis of the Italian Phytovigilance database and systematic review of case reports https://pubmed.ncbi.nlm.nih.gov/32656820/ 4. Turmeric-Associated Drug-Induced Liver Injury https://pubmed.ncbi.nlm.nih.gov/36600786/ 5. Turmeric Induced Liver Injury: A Report of Two Cases 6. https://pubmed.ncbi.nlm.nih.gov/31214366/ 7. Turmeric-Associated Liver Injury: A Rare Case of Drug-Induced Liver Injury 8. https://ncbi.nlm.nih.gov/pmc/articles/PMC10149439/ 9. Turmeric-Induced Hepatotoxicity: Report of 2 Cases 10. https://ncbi.nlm.nih.gov/pmc/articles/PMC8711139/ 11. Turmeric Induced Liver Injury: A Report of Two Cases 12. https://ncbi.nlm.nih.gov/pmc/articles/PMC6535872/ 13. Turmeric-Associated Liver Injury 14. https://pubmed.ncbi.nlm.nih.gov/31283536/ 15. Autoimmune Hepatitis Associated With Turmeric Consumption 16. https://pubmed.ncbi.nlm.nih.gov/32337301/ 17. A rare case of turmeric-induced hepatotoxicity 18. https://pubmed.ncbi.nlm.nih.gov/32037709/ 19. Turmeric supplement induced hepatotoxicity: a rare complication of a poorly regulated substance 20. https://pubmed.ncbi.nlm.nih.gov/31271321/ 21. Drug Induced Liver Injury Attributed to a Curcumin Supplement https://pubmed.ncbi.nlm.nih.gov/31781418/ 22. Peng Y, Ao M, Dong B, Jiang Y, Yu L, Chen Z, Hu C, Xu R. Anti-Inflammatory Effects of Curcumin in the Inflammatory Diseases: Status, Limitations and Countermeasures. Drug Des Devel Ther. 2021 Nov 2;15:4503-4525. doi: 10.2147/DDDT.S327378. PMID: 34754179; PMCID: PMC8572027.

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Ozempic, Wegovy, Monjaro, and a host of other drugs – the GLP-1 agonists and near miracles weight loss drugs, and soon a more potent pill form coming.

These drugs have known side effects, and there have been increased visits to the emergency rooms. Often because people were not told foods to avoid.

As with any new drug, there are the grifters. After all, since it is a prescription, you will have supplement salesmen that promise a natural solution. What about those who claim they can "compound" the drug for you in their compound pharmacy?

Weight Watchers and SequenceWas it a coincidence that Weight Watchers (WW) bought Sequence? Sequence is a company that prescribes these drugs through a network of physicians that you contact via telemedicine. Sequence, as it turns out, is one of the more legitimate telemedicine companies, not only trying to get you a prescription but providing a diet plan with it.

Weight Watchers purchased Sequence for over 100 million dollars. One thing missing from the frequent prescription of the new drugs is a diet plan. Weight Watchers does this.

And Weight Watchers is partially owned by Oprah Winfrey, who has been open about her weight loss struggles. Now, Oprah reports she has been on semaglutide and lost over 45 pounds.

Thus Oprah proved that the drugs, with a good diet, are a powerful tool against obesity.

It is More Than Willpower - Ask OprahAs a weight loss surgeon, I am constantly asked about willpower and obesity. For example, Oprah Winfrey a person with more willpower than probably anyone you know. Given her resources to have people cook for her, provide her with a workout plan, and any assistance. She even bought a major portion of Weight Watchers. What made the difference? The injectable drug, semaglutide (Wegovy).

Obesity Management is more than a diet - ask Weight WatchersThe Weight Watchers diet plan has evolved over the years. Even with the Weight Watchers diet plan ranking among the best diets in the world, they purchased Sequence. Thus repositioning themselves to use their diet with the drugs to provide optimal health.

Keeping you out of the Emergency Room - Side Effects of the New DrugsEmergency room physicians have noted an increase in patients coming to the ER after using these drugs. I was recently interviewed about this, and you can find it here.

Common side effects include nausea, vomiting, bloating, constipation, and diarrhea. Up to eighty percent of people who take these drugs have symptoms. Many of those problems can be avoided by following a few simple rules:

1. Avoid fatty foods. Fatty foods increase bloating and discomfort with these drugs. Fried chicken has sent many to the emergency room
2. Alcohol should be limited to one drink per day. Although best to avoid alcohol altogether with these medications.
3. Junk food with lots of sugar, like candy, cookies, and donuts, should be avoided while on these drugs.
4. Foods to concentrate on are fruits, vegetables, whole grains, and brothy soups like Minestrone or Dahl.

Compound Pharmacies and "generic Ozempic"Many compound pharmacies have offered these drugs for sale. They are often at a greatly reduced price. But they are not the same drugs approved and tested by the FDA.

There is no "generic" form of Ozempic, Wegovy, or Mounjaro.

Compound pharmacies are telling their customers that, since there is a shortage of these drugs, they can compound the drug and sell it to the public.

Many of these compound pharmacies import semaglutide from overseas. It is illegal to import a drug from overseas without FDA approval. Furthermore, the drugs they import are not the same formula...

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Seed Oils, Omega 6, and InflammationJust about everyone in the low-carb community is talking about how bad seed oils are. They claim the medical community has it wrong. The conspiracy-minded folks claim doctors want to keep people sick. Thus dependent on medicine for pills and surgery. Hence, seed oils are the new evil part of the picture.

The New Sugar ConspiracySeed oils, hydrogenated oils, and omega-6 fatty acids have replaced sugar as the new reason for ill health in America.

Their logic goes like this:

Seed oils are high in omega-6 fatty acids. They claim that high Omega 6 fatty acids are pro-inflammatory. Therefore, if you have more seed oils in your diet, you will have more inflammation. Inflammation is the root cause of heart disease.

Their argument is logical, partially true, and the conclusion is incorrect. They are selling you snake oil (well, usually supplements).

It is Peanut ButterThe keto crowd will say how "real" peanut butter is made with peanuts and salt. Claiming this peanut butter is "candy" or "full of garbage" and isn't fit to be eaten. But is it? Let's break this down.

Added SugarFirst, the added sugar, which according to the label is 3 grams per serving (two tablespoons), so the whole thing is 190 calories, of which 12 of those calories come from sugar, the rest from fat.

Here is the label from Sprouts Pure Peanut Butter. Nothing but ground peanuts. No salt, no oils, no sugar. There are 200 calories from two tablespoons.

Of the 200 calories from all peanut butter, with no added sugar, you get the same number of calories from the peanut butter with sugar in it. How much sugar? Well, about 3 grams per serving of sugar. How much is that? Not much. To exceed the recommended dose of sugar from the American Heart Association, you would need to have more than 6% of your calories. In Skippy, it is 1.5% added sugar.

Low Carb Sugar ConspiracySugar was the "evil" that low carbohydrate folks said caused obesity. If you read their literature from twenty-plus years ago, it blamed sugar for obesity. Not just sugar, but any carb that was sugar, they claimed, would become fat. They even had their alternative view of history of obesity in the country.

They stated that the world was not obese until Ancel Keys blamed heart disease on fat. Then the US government promoted a low-fat diet. The result was obesity bloomed because they replaced fat with sugar. That evil food pyramid caused people to turn away from fat, substituting sugar. That sugar substitution led to obesity.

It sounds so logical. If you ever go on a low-carb diet (Atkins, South Beach, Paleo, Keto, Carnivore), you stop eating junk food and eat steak. You feel satisfied eating lots of meat. Then you get tired of steak. You lose weight because you are in a calorie deficit, not because of ketosis. But that weight loss leads to confirmation of the theory that sugar made you fat.

You go off the restrictive diet. Now you gain weight. You gain weight because you are eating more. But you blame the slice of bread. What you forget is now you are eating more steak because you have more flavors in your mouth. That slice of bread is 100 calories, but you think an 18-ounce Porterhouse (1260 calories) is a diet food? So you blame the bread or the lava cake. But not the extra calories.

Where It Falls ApartBut something about your low-carb diet doesn't make sense. You notice that obesity has increased in the United States. But sugar consumption has fallen. How does that work?

You might wonder how that whole fruit is bad. Your low-carb coach says it's full of sugar. The community says it will "spike your insulin." Concluding that insulin causes you to store fat. But the scientific community shows study after study that people who eat whole fruits live longer and better. In fact, even diabetics who eat whole fruits have lower hemoglobin A1c. How is that? How can fruit be so healthy?

The latest low carbohydrate fad is the carnivore crowd. They eat fruit now. Maybe that is the answer - the evolution from the Paleo caveman diet to the Carnivore diet. Here is the problem: it is still a fad.

Longest Living PeopleThen you read that the longest-living people eat a lot of carbohydrates. In the Blue Zones, they live long, consuming a diet rich in carbohydrates.

You go to Italy and see everyone is thin and beautiful, and eating pasta. The Mediterranean diet is the best, but it is 55% carbohydrates.

You go to Asia and see thin people shoveling in white rice.

Your eyes open and you think maybe you were just fooled.

Fructose is the problemIn 2010 David Lustig came out with his famous YouTube video. Sugar is made of two molecules, fructose, and glucose. Glucose, he said, was not the problem. It was fructose. And high fructose corn syrup was in everything.

This brief idea was based on mouse metabolism. Not on human metabolism.

It was a cute fad that allowed you to blame big corn for the world's obesity. But the facts didn't add up here either. On to the next conspiracy.

Seed oils are the problemThe data shows that sugar isn't the cause of obesity. So they have come up with a new conspiracy. Seed oils are the problem.

Canola, safflower, corn, peanut, and just any vegetable oils cause the problem.

Seed oil consumption has increased worldwide, and so has obesity. There is the correlation. Simple minds like simple correlations.

While their conclusion is incorrect, it is important to see why they came to these ideas.

Trans FatsTrans fats are truly evil. They are a primary cause of heart disease. But before knowing this, they were the darling of food activists in the United States.

The movement was from food activists like Phil Sokolof. He suffered from a heart attack and believed saturated fat was evil. He took out full-page ads in major newspapers, and attacked the use of beef tallow in McDonald's french fries. Those fries were so much tastier. As he lobbied fast-food and commercial bakeries to switch to vegetable oils, he didn't understand they were adding trans fats.

Vegetable oils are healthy for the heart. But vegetable oils are liquid at room temperature. So you have to hydrogenate the vegetable oil, for it to become solid at room temperature. During hydrogenation, you create a lot of trans fatty acids.

In 2008, the American Medical Association urged the prohibition of trans fats in commercial bakeries and restaurants (reference). Finally, the medical community was listened to, and trans fats were outlawed in the United States (reference).

Hydrogenated Vegetable Oils Are Not Trans FatsJust because you chemically alter vegetable oil does not mean it is a trans fat. Since the FDA has outlawed trans fats, they are removed from the process.

Naturally occurring trans-fats are found in animal fats. Like butter, which is 3% trans fats. Breast milk contains a form of trans fats called vaccenic acid, which has health benefits. Hydrogenation produces many forms of trans fatty acids that cause harm. But currently, hydrogenation does not involve making trans fatty acids.

What are seed oils?Saying something is a seed oil is incorrect. Seed oils are not just one type of oil. Canola oil is much like olive oil, in that the main fatty acid is oleic acid (reference).

Canola oil is much maligned. Detractors will say it is highly inflammatory. In fact, canola oil decreases inflammation in the human body (reference). Canola oil not only reduces inflammation but also reduces total cholesterol in the blood. Compared to saturated fat, like butter from grass-fed bison or unicorns, it decreases all cardiac risk factors.

Some point out that canola comes from the rapeseed plant, which has been genetically modified. Thus, it must be filled with pesticides. They further tell you that canola oil has been used to run farm machinery. They fail to point out the obvious - olive oil can do the same. In fact, olive oil was the first electricity in the world, lighting homes, and running farm equipment.

Seed Oils the new Sugar ConspiracySeed oils, as it turns out, are not inflammatory. They do not cause an increase in heart disease. They decrease the risk of heart disease.

Seed oils are in a lot of junk food. Some call them the ultra-processed foods. That doesn't make them bad. Junk foods also have a lot of sugar and a lot of salt. It isn't the oil per se, or the sugar, or the salt. It is that you can eat a lot of junk food. Junk food is readily available.

Back to Peanut Butter

Don't feel guilty for eating Skippy, Jiff, or whatever brand you like. Peanut oil is healthy for you. The sugar content is minimal. The hydrogenated oil makes the butter creamy without oil separation and decreases the risk of it going bad. As if peanut butter could ever go bad in my house.

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Implementing the Mediterranean Diet: VegetablesThe increase of vegetables in the diet is one way to reduce inflammation.

Vegetables are an important part of the Mediterranean diet, providing essential nutrients. A diet rich in vegetables that contain antioxidants. As a result, the Med diet reduces the risk of heart disease, cancer, dementia, and anti-inflammatory diseases.

Vegetables are low in calories, but high in nutrient density. In addition to providing high nutrient value, they provide satiety. Thus making vegetables the cornerstone for weight loss and maintenance.

How Much is a Serving?One serving of vegetables is 3 ounces (85 grams) of raw or double that cooked. Three servings of vegetables a day is the daily goal. Without a doubt, the more vegetables, the better.

Meal IdeasBreakfast ideas for vegetables include what you might put in an omelet: tomatoes, spinach, onions, and chives. Even the breakfast bites can have multiple vegetables in them.

While salads are great for lunch, filled with kale, radishes, and carrots, don't forget that you can pile a sandwich with lettuce, cucumbers, sprouts, and tomato.

Need a snack during the middle of the day, plan on carrots for the afternoon and for the drive home. You can't fall asleep while chewing on carrots.

Broccoli might be a great snack before dinner. Raw, even if you have a bit of ranch dressing. Buy packets of dry ranch dry ingredients and add to Greek yogurt.

Don't forget that dinner salad. Make it large and beautiful.

Supplements Are Not the SameVegetables contain nutrients that your body needs. They are rich in magnesium, potassium, and folate.

There is no supplement that can replace vegetables.

Do Vegetables Have Anti-nutrients?Every study has shown that an increase in vegetables decreases heart disease, cancer, and inflammation.

People who sell supplements often point out that vegetables have anti-nutrients in them. I have talked about this in a previous podcast and post (here). Of the various supplement salesmen out there, from the self-described Carnivore and his business partner Liver King to Dr. Gundry.

LectinsLegumes like beans and lentils are nutrient-rich, protein-, and fiber-rich foods whose benefits outweigh any lectin. High doses of lectins, when fed to animals, lead to diarrhea, inflammation, and other problems. These problems have never been seen in human studies with normal foods. The main lectins are destroyed by cooking, soaking, sprouting, fermenting, boiling, and canning.

All human trials show that diets rich in legumes, and whole grains, lead to better health.

OxalatesOxalates can be absorbed from the gut, bind to calcium, and cause calcium kidney stones. They will also bind other minerals, such as zinc. This has led some to avoid healthy foods like spinach, swiss chard, amaranth, taro, sweet potatoes, beets, rhubarb, and sorrel.

Cooking greatly decreases the oxalate content. In addition, cooking increases the nutrients of the vegetables available for absorption. The higher the vegetable content, the higher the mineral content of the diet, the fewer kidney stones are formed. People who consume a DASH diet have a 40-50% decreased risk of kidney stones (reference). The DASH diet is the American version of the Mediterranean diet.

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Do You Need A Liver Cleanse?Fatty liver disease is the most common reason for liver transplantation. Fatty liver disease replaced alcoholic liver disease a decade ago.

The rise of obesity has contributed to fatty liver disease, and fat, like alcohol, is deadly to your liver.

So can you clean out your liver? Simple answer - no.

History of Liver ScamsThe most famous was Carter's Little Liver pills. They promised to increase the flow of bile in the liver. This would rid the body of toxins.

Even when it was marketed in 1868, it was known as a "patent" medicine. Thus a medicine without merit was sold by quacks.

In 1959, the name was changed to "Carter's Little Pills." The FDA, in 1951, filed suit that the pills had nothing to do with the liver.

The phrase "Someone has more (fill in the blank) than Carter has pills" comes from this product.

The Master CleanserStanley Burroughs, a lumber salesman, invented the juice cleans of tea or lemonade with cayenne pepper and maple syrup. He published a book in 1946, "The Master Cleanse," and re-released it in 1976 under the title "The Master Cleanser". Burroughs was convicted of manslaughter in California and fined for practicing medicine without a license.

This "juice," or "liver cleanse," or liver detoxification program keeps coming around with different ingredients, like olive oil and the like.

Gallbladder FlushThe gallbladder flush is the same idea. This is usually a combination of olive oil and lemon juice. People will defecate what they are told are gallbladder stones, but they are not. It is just fecal material.

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Erythritol and Heart Attacks: Is It Hype?Does the artificial sweetener erythritol increase the risk of heart attacks? In fact, some say that this is just hype.

The article abstract can be found here.

Erythritol is an artificial sweetenerIt has been used for years in food as a "non-nutritive sweetener." Erythritol is used in many processed foods, replacing the calories from sugar. The Food and Drug Administration considers erythritol a food additive (GRAS). As a food additive, erythritol has never been tested for its toxicity or long-term use.

The case for artificial sweetenersWhile artificial sweeteners decrease calories, do they decrease obesity? They have been shown to decrease obesity among teenagers (ref here). By reducing calories, it seems obvious that obesity would decrease. And yet, this has not been a consistent result

A study showed that increased erythritol led to increased obesity. And that was just the erythritol your body makes.

But your body makes erythritolSince your body makes erythritol. Does that mean it must be safe?

The human body produces many toxic substances. For example, formaldehyde. Humans produce about 1.5 ounces of formaldehyde a day.

Acetaldehyde is a breakdown product of ethanol. Drink too much alcohol, and you will produce enough acetaldehyde to kill you.

The case against artificial sweetenersThere have been a number of peer-reviewed journal articles showing that artificial sweeteners have adverse consequences:

• Weight gain and obesity (ref)
• Insulin resistance (ref)
• Type 2 Diabetes (ref)
• Stroke, heart disease, and all-cause mortality (ref)
• Increased heart deaths in women (ref)

How much we makeWe have about ten micromoles per liter of blood. That would be the baseline level. Blood levels with 1000 times as much erythritol are found in people who consume it as a sweetener.

One study showed that erythritol led to improved blood vessel function after drinking erythritol for a month (ref). But this was in healthy young adults. What about people with underlying heart disease?

It's not hype - the studyThe Erythritol study was done by the highly regarded Cleveland Clinic and published in the journal Nature Medicine. It was peer-reviewed, meaning many other scientists looked at that data and concluded the study was worthy of being included in this prestigious journal.

What this study examined was the correlation of erythritol with people prone to heart disease. They studied people at risk for heart disease. Such as those with high blood cholesterol, diabetes, obesity, or hypertension. They looked at the blood levels of erythritol. Data divided the patients according to how much erythritol was in their blood. What they found was that those with the highest levels of erythritol had the highest incidence of heart disease, strokes, and cardiac deaths of any other group when they followed them for three years.

They found the same results in both a cohort of people from the United States, which had over 1100 participants, and in an identical cohort of over 2000 people from Europe. The higher the level of erythritol in the blood, the more likely they were to have heart attacks, strokes, or die in the next three years.

CriticismsSome criticized the study for not doing a dietary history of erythritol. This criticism is invalid, as normal levels of erythritol in the blood are 1000 times less than what you get when you use erythritol in food. Blood levels of erythritol are a better validation of what is in the diet than a dietary history. Not only is it hard to remember what products might contain erythritol, but in the US, some products with erythritol are not required to list it in their ingredients.

Another criticism was that they used people already prone to heart disease. That was the point of the article. By taking the highest risk group, those with high cholesterol, are obese, or have diabetes, you can shorten the time to see the effect. You already have disease, and you want to see if the erythritol makes things worse. In this case, those with high levels of erythritol were prone to a heart attack in three years.

If you take a group of young healthy people, erythritol tends to make their blood vessels a little more compliant. In contrast, in older people with stiffer arteries, erythritol has a worse effect.

Overall, the study was well executed and clearly warrants further investigation.

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Don't Fear the Fruit, Enjoy ItAre you afraid that eating fruit will cause your blood sugar to spike? Let us bust that myth right now.

Only ten percent of adults eat enough whole fruit daily despite the clear benefits of fruit.

Eating fruit and Living Longer My 98-year-old dad eats fruit with breakfast for as long as I have known him. We would have grapefruit every morning. We even had those cute grapefruit spoons to wrestle the goodness out of the half grapefruit.

Now, dad enjoys a mixed bit of fruit.

In 28 studies with over 1.6 million people, each serving of fruit led to a 5% lower incidence of death (reference).

Each serving of fruit8% less risk of heart disease

3% lower risk of cancer

200 grams (7 ounces) showed the lowest risk of cancer rates and deaths from cancer.

Even the Low Carb Community is coming aroundThirty years ago, the low-carb community advised against whole fruits. Their rationale was that fruits spiked blood sugar, which caused insulin to rise, which caused fat storage. They even cautioned against eating carrots for the same reason. But now, even the most extreme members of that community proudly eat fruit.

What 5 servings looks likeBreakfast with 1/2 cup of blueberries

Morning snack of one medium banana

Lunch with one apple

Afternoon snack of 1/2 cup of grapes (about 16)

Evening snack of 1 clementine

Don't forget the tomatoThe tomato is a fruit. Yes, the Supreme Court said, for taxation purposes, it is a vegetable, but it isn't.

Other Benefits of Fruit* promoting long-term weight management * reducing the risk of heart disease * reducing the risk of type 2 diabetes * decreasing the risk of colon and lung cancer * lowering the risk of depression * successful aging (like dad) * higher bone mineral density * decreasing incidence of seborrheic dermatitis * less constipation * less irritable bowel * less inflammatory bowel * less diverticular disease * less hemorrhoids * less stress

Fruit is not the enemy - but it is one of the easiest of the nine food groups to add to your Mediterranean Diet and one of the easiest and most delicious to add to the DASH diet.

Produced by Simpler Media

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Salt: Toxicity is in the DoseFor the human body, salt is both an essential metal and toxic at a high dose. The most common form of sodium comes from sodium chloride, a salt. However, too much salt and arteries become stiff, and the risk of heart disease and cardiovascular disease increases. The majority of dietary salt comes from processed foods.

Salt Toxcity DeniersProbably the most famous book is The Salt Fix. A rambling book claiming low salt is responsible for everything from lower sex drive to insulin resistance. The book is logical and simplistic, with abundant citations taken out of context. In summary, the book is almost completely incorrect.

Salt and HypertensionOne of the classic studies about salt and hypertension is the DASH sodium study. In these studies, the study participants were fed the diet with varying amounts of salt. These studies are expensive and often not done, but powerful. Additionally, the lower levels of salt, the lower the blood pressure. In fact, a low-sodium DASH diet led to a reduction of blood pressure equivalent to one blood pressure pill.

In contrast, "The Salt Fix" states that decreasing levels of salt led to increasing blood pressure and heart disease. The Salt Fix explanation is that lower salt leads to increased levels of renin, angiotensin, and aldosterone (hormones that would increase blood pressure). His conclusion is the opposite of hundreds of articles and much analysis. Such as here, here, and here.

Salt and CholesterolAnother false claim, "The Salt Fix," stated the DASH study showed an increase in LDL, cholesterol, and triglycerides.

The DASH diet showed no significant impact at all.

More of "The Salt Fix" Misinformation* Our ancestors ate more salt * The primitive argument for which there is no proof. Since our ancestors ate mostly plants and no processed foods, this is easily debunked. Meat eaters know that a one-pound chicken contains about 150 mg of salt. A double patty of hamburger has 500 mg. He makes up numbers that don't make sense. * He states our ancestors ate from salt licks, but there are few in Africa (he makes up stuff) * Other countries have higher salt intake and lower heart disease * He cites Korea (which has 50% hypertension or pre-hypertension), Japan (highest incidence of stomach cancer related to salt), and France (hypertension is high, but low levels of heart disease related to the Mediterranean diet practiced by most). * Salt doesn't lower blood pressure by a significant amount and makes food bland. * The DASH diet studies show significant reductions in blood pressure, and the food is not bland. * Lower salt leads to increased death. * The opposite has been shown. Increased levels of sodium in the diet show increased levels of death. * Lower salt leads to lower iodine levels. * Iodized salt was introduced in the US because of the low iodine in Midwest soil. Better sources of iodine include fish and kelp. But the United States also fortifies iodine in bread and dairy products. But too much iodized salt can lead to hypothyroidism. * Sodium restriction in failing kidneys leads to worse problems * Ask any kidney doctor, the worst thing for failing kidneys is overload with salt. While salt regulation may be diminished with kidney failure, patients with renal failure need more dialysis with higher salt diets. * As we age, our kidneys get rid of more salt and need more in our diet. * We lose some renal function with age, but increasing dietary salt leads to increasing mortality and aging of blood vessels. * Low salt during pregnancy leads to obesity * Lower salt in pregnancy yields the opposite * There are more bits of misinformation in this book. Suffice it to say those who read this book and chose not to read the primary literature might be convinced that we need more salt than less salt.

What Type of SaltSalt is salt. It is NaCl. Some have minor amounts of contaminants and other metals in them, which give them color. It is not enough to make a significant impact on your body chemistry or your health.

Himalayan or Pink SaltThis salt comes from about 200 miles away from the Himalayas, it is mined in Pakistan. Sounds better to say it is from the Himalayas, but it isn't. Thus, salt is mined much like the salt from Utah. The reason for the pink color is various contaminants. While many tout benefits of this salt, the additional minerals found in Pink salt are insignificant. Thus, the salt is expensive, pink, and mainly decorative.

Celtic SaltCeltic salt is from the coast of France, where the salt water is evaporated to get the salt. In contrast, pink and white salt are mined from the old oceans. Celtic salt has more trace minerals than pink salt or white salt. However, the amount of minerals in these salts is not of consequence to humans.

Salt and Athletic PerformanceMarathon runners and endurance athletes have died from low salt levels in the blood (hyponatremia). Drinking too much water, or non-salty beverages is one reason for this.

Sweating is not a major loss of salt in athletes. The average athlete will sweat about 15-65 mEq/Liter, with a maximum of 2 liters per twenty-four hours.

The major problem with those with low blood sodium after endurance athletic events is drinking too much water. Adding salt to the fluids does not improve performance, nor does it.

Salt Anti-Caking AgentSome fear the anti-caking agents used in table salt. Sodium and Potassium ferrocyanide sound horrible because of the cyanide. However, ferrocyanide does not break down into toxic cyanide. Still, those who have not taken Chemistry 101 don't understand this. After all, salt itself has "chloride," which kills when it is chlorine gas.

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Why you should ditch your gas stoveDid you ever wonder what the controversy is about gas stoves? There is no controversy. Gas range tops are responsible for high levels of indoor pollution. But what should we do? The answer, change to an induction cooking top

Types of Indoor CookingYou can imagine the first time cooking was brought indoors. Probably a fire inside a cave. It turns out that wasn't all that safe. The particulate matter from the wood not only increased the risk of lung disease, but also increased the transmission of respiratory illness.

Community houses, like this one for the Tlingit Nation from Southeast Alaska, had a fire pit in the center of the house. Your status in the community determined how close you would sit by the fire.

While the opening in the roof provided some ventilation, it was not enough.

Particulate Matter and Disease in Native Americans has been well studied. The lung damage from particulate matter predisposed Native Americans to pneumonia, tuberculosis, influenza, and smallpox.

Wooden StovesThe use of wooden stoves with a chimney, and contained fire, were the most popular stoves in America until after the Great Depression.

America was excited to go electric. But there is something primal about gas and electric cooking.

Cooking with GasThe phrase cooking with gas was from the gas companies competing with electric companies for the new kitchen. The idea that gas was less expensive, faster, and you could see the flame became the basis for their campaign.

They were trying to compete with "clean electric"

Indoor pollutants with gas range topsProducts from indoor gas ranges are highly toxic to lung tissue. Those products

include:

• Nitrogen dioxide
• Carbon dioxide
• Methane emission
• Benzene

Even with the range off, gas escapes and pollutes the air indoors. Good ventilation decreases the exposure to gas. Most people do not like continuous fans. In addition to the methane, there is also benzene that escapes.

Culture WarsAs soon as the United States Consumer Product Safety announced it was considering regulations for indoor gas cooking the vitriole started.

A Wall Street Journal Editorial stated "Don’t believe for a second Consumer Product Safety Commission member Richard Trumka Jr.’s slippery claim that they aren’t coming for your stove." She also went on to state that the research was paid for.

Jim Jordan, the Republican Congressman from Ohio tweeted, "God, Guns, and Gas Stoves."

Sean Hannity, that famous high school graduate stated that "Biden is coming for your gas stove."

On my tiktok channel I had lots of people parrot this.

I never knew so many old white men knew where the stove was? Let alone what it used for fuel

ResearchWe have known about the dangers of nitrogen dioxide since the 1960's. (see here, here, here). Experimental data showed it cause lung damage in animal models, then it was associated with human studies. None of these researchers were concerned about climate change.

What can you do?Even ventilation to the outdoor with a powerful hood may not decrease the nitrogen dioxide enough. And often you won't have the ventilation fan on when the stove is not on.

Converting to induction stovetop might be expensive, although there is currently a government tax incentive to do so.

Even though I just bought my house, and it came with a lovely gas stovetop, I am changing to induction. Until then, I am using my induction hotplates (I have two) for most cooking.

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Whole Grains Reduce ObesityWhile the low-carb world and its extremists will tell you that grains are evil, they are wrong. There is a significant difference between refined and whole grains.

The differenceWhole grains contain the bran, a fiber-rich outer sheath. Further whole gains have the germ cell and the endosperm. But the refined grain is just the endosperm.

Compare whole grain bread, which contains substantially more fiber and vitamins than the white bread. Consuming refined grains increases the risk of heart disease. But consuming whole grains decreases risks of heart disease, diabetes, and cancer.

The BranBran is rich in fiber. Additionally, bran is a source of B vitamins, iron, copper, zinc, magnesium, and phytochemicals.

Fiber is EssentialFiber is an “essential nutrient.” An essential nutrient is defined as a nutrient your body cannot make and must get from your diet.

But carnivore aficionados disagree; they believe fiber is not an essential nutrient. Carnivores note that you really don’t digest fiber. And they opine that people can live without fiber. However, they forget one key, the microbiome.

The MicrobiomeThe microbiome are the trillions of bacteria, yeast, and fungi that live in your gut. Many scientists consider the gut microbiota another “organ” of our body.

There is a clear difference in the type and number of bacteria that occupy the guts of people with obesity compared to those who are not obese.

Some bacteria will increase hunger hormones. Those same bacteria also decrease satiety hormones, need more food to feel "full." Finally, they increase the ability of fat cells to increase in size, leading to obesity.

Interesting Functions of Gut Bacteria* Synthesize vitamins K and B * Make Conjugated Linoleic Acid (CLA) that reduces obesity * CLA decreases inflammation * Ingestion of some fiber promotes the growth of bacteria that decrease the secretion of ghrelin in obese humans.

In the microbiome, what feeds the bacteria that decrease obesity includes the fiber from whole grains. The bran of whole grains contains powerful fibers like oligosaccharides.

How much to eat?What is a serving of whole grains? It seems confusing, especially since some products are a mix of both whole and refined grains. In the Mediterranean Diet, you might notice 9 ounces, but is that grain when it is dry or wet or both?

So it turns out there is a whole grain council that has done the work for you, and they tell you right on the package.

This makes your math simple. You either need three stickers of the 100% whole grain or six of the other stickers.

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Are Vegetables BS?If you have ever seen Paul Saldino, his famous line is that Kale is BS. He even sells the shirt. But are they? Saldino isn't the only one who proposes this.

Dr. Gundry, a former heart surgeon, has his own take. Gundry claims modern health problems come from eating lectins. Lectins are compounds found in beans that are natural pesticides. Thus, Gundry claims lectins harm people. Copying destroys lectins.

Toxins in VegetablesPlants make compounds to protect them against predators - other plants, pests, and the like. But do they harm humans?

It turns out that some plant defense compounds are beneficial to humans. Take coffee. Yes, coffee - the caffeine is a defense mechanism. Some people will tell you that coffee is bad for you - but they don't get up in the early morning or have kids.

List of the "Toxins"* Gluten * People who don't have celiac disease or gluten sensitivity do not need gluten-free diets (ref). * Oxalates * Potassium-rich vegetables such as Brussels sprouts, broccoli, and kale reduce calcium loss and prevent kidney stones from forming. These vegetables are rich in antioxidants that decrease the risk of bladder, prostate, and kidney cancer. Check with your local dietician for a diet based on the type of kidney stone you have. (ref) * Caffeine * If you don't drink coffee, you will lose all joy in life. (reference is me) * Polyphenols * Plant polyphenols have antioxidant, anti-inflammatory, anti-allergic, anti-atherogenic, anti-thrombotic, and anti-mutagenic effects - they are healthy for you (ref) * Phytates * Consuming a phytate-rich diet, such as a colorful, plant-based diet, the benefits exceed the impacts on mineral absorption. In addition, phytates are anti-oxidants. (ref) * Saponins * These compounds are among the most well-studied compounds to decrease risk and help treat cardiovascular diseases. (ref) * Isothiocyanates * Brassica vegetables contain many valuable metabolites that are effective in chemoprevention of cancer (ref) * salicylates * These anti-inflammatory compounds are the basis of aspirin * Phytosterols * phytoestrogen-containing foods, such as legumes, grains, seeds, nuts, fruits, and vegetables, are rich sources of vitamins, minerals, fiber, and other health-promoting phytochemicals. * Lectins * Cooking destroys lectins. Lectin-rich foods, legumes, and whole grains show reduced inflammatory biomarkers in both animals and humans (ref).

What the literature saysWhat do human trials say about vegetables? They improve health, reduce the risk of heart disease, and reduce the risk of cancer.

Do some of them contain anti-nutrients? Well, some do bind them, but health benefits outweigh any potential harm.

Who to believe?You can believe a shirtless salesman of supplements and scams. Someone who was trained as a psychiatrist, who goes into a grocery store shirtless and yells at kale - or you can believe science.

Fiber as an essential nutrientFiberThe most abundant solid ingredient in breast milk is a fiber. That fiber is human milk oligosaccharides. These oligosaccharides are a prebiotic that is carbohydrate based. They meet the definition of fiber. This fiber is important to infants, especially neonates.

When people say fiber is non-essential, they are incorrect. Why? Because the definition of an essential nutrient is:

“A nutrient required for normal body function that either cannot be made by the body or cannot be made in amounts adequate for good health and therefore must be provided by the diet”

Fiber is also important in adults.Every study looking at increasing fiber has shown an improvement in human health. But what does fiber help with?

It's more than a good pooFiber will bulk up your stool and make it easier to have bowel movements. This gives you less constipation, fewer hemorrhoids, and less risk of colon diverticular disease.

If your stool is too loose, you need more fiber. If your stool is too hard, you need more fiber and water.

But fiber has other important rolesIt Binds CholesterolYour body makes cholesterol, and that cholesterol goes through your gut. When you have increased fiber in your gut, some cholesterol gets bound to it. Thus, increasing fiber means less blood cholesterol.

It stabilizes blood sugarFiber decreases spikes in blood sugar. Want an example? Take an apple and a doughnut. A doughnut has less sugar than an apple, but a doughnut will spike your blood sugar more than an apple. Why? Part of the reason is the increased fiber in the apple (and fat, a doughnut has 15 grams of fat) – an apple has 3 grams of fiber, a doughnut has 0.9 grams.

It decreases inflammationFiber binds to bile acids (ref). When you eat meat and increase meat in your diet, you increase fat. To digest fat, your body increases the production of bile acids, which are released into the gut. Your gut reabsorbs 95%, but about 5% makes it to the colon, where other bacteria encounter them, and then bad things happen.

Bacteria break down these bile acids into pro-inflammatory and pro-carcinogenic compounds. This is in contrast to a plant-based diet with high fiber. Fiber binds to the bile acids allowing them to pass without causing harm to the colon.

When a person consumes fiber, the fiber is used as food by some bacteria. These bacteria metabolize the fiber and excrete short-chain fatty acids.

The Gut MicrobiomeInside your bowels, there are many microorganisms, from bacteria to yeast. What determines which bacteria thrive? There are bad bacteria and bad yeast, and to encourage the growth of the good bacteria, you have to feed them. How do you feed them?

The favorite food of the good bacteria? Fiber.

Bacteria "eat" fiber and produce short-chain fatty acids, which are great because:

They decrease inflammation, improve blood sugar control, and blood lipids.

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The term vitamin was coined by the chemist Casimir Funk as he revealed the Thiamine structure to the world. So while you may think – isn’t vitamin A (it is the alphabet) the first vitamin – we take our poetic license here to point out that the first compound to be called a vitamin was Thiamine, now known as vitamin B1. But the story of that vitamin was made possible by two individuals – but the most noteworthy was Takaki Kanehiro.

Our podcast today discusses the education of Kanehiro and how that influenced his view. But let’s work backward a bit.

Vitamin B1 and Beriberi

Beriberi is caused by a lack of vitamin B1 (thiamin) in the diet. This vitamin is essential in the biochemical process of utilizing fats, carbohydrates, and proteins for energy. The nerves are particularly affected because of their metabolic pathways – hence, a wide range of symptoms from difficulty with walking (motor function) then sensory function of the legs, and finally, it affects the conduction in the heart, which leads to death.

White Rice and Beriberi

White polished rice was the fad food not only in the cities of Japan but also in China. To polish the rice, the husk and germ are removed, but this is also where the vitamins are. When people eat just one food item, they are likely to develop a deficiency disease, and this was the case with sailors and white polished rice.

The officers would not only eat rice but were given a variety of foods and thus avoided beriberi. But the crew typically only ate white rice.

Beriberi in Mid-1800’s Japan

In Japan in the mid-1800s, especially in the city, polished white rice was the calorie source of choice. White rice is easy to store, looks clean, is faster to cook, and eating it is less chewy. White rice was considered what the wealthy people ate – it was beautifully displayed, and unlike brown rice, did not go rancid. What they didn’t know was the processing of the rice led to stripping the rice of the vitamin-rich portion.

In the rural areas of Japan, there was little beriberi as they mostly ate brown rice (barley rice).

This led to a major problem in their Navy, where beriberi was endemic. White polished rice was the caloric source for the Navy, and often one third of the crew would develop beriberi and be unable to carry out their duties.

There were many thoughts as to the cause of beriberi, but none of them had panned out well.

Eastern Traditional Cures for Beriberi

On occasion, Eastern healers would recommend various teas and herbs. But, some would recommend barley rice. Some of these cures are retrospective, meaning once the traditional Japanese medical folks learned that barley rice was a cure for beriberi, they stated that they had prescribed it for years. Barley rice does have vitamin B1 (1 cup contains a day’s supply). But during the time, the cures from these village doctors were rare and not enough for the Japanese Navy, in spite of losing more people to beriberi than to war – would adopt. Also, note that barley rice is not as transportable as white polished rice and has a shorter shelf life. During this time, Japan was becoming westernized, and they were working on importing medical ideas from Germany, although they had a fair bit of influence from the British method.

Kanehiro’s training

When Kanehiro was being trained, his initial training was from the Eastern Medicine part of his province. This training was apprentice-like, and he heard someone say that “There are no good doctors in Sustama.” When William Wills opened a medical school in his province, he jumped at the chance – but Wills encouraged him to go to London for further training.

In order to do this, Kanehiro joined the Navy in 1872. He remained in the Japanese Navy for the rest of his life.

In 1875 Kanehiro went to London and began to study at St Thomas Hospital. To this day, St Thomas hospital sits across the Thames River from Westminster, Big Ben, and parliament.

Epidemiology – cholera to beriberi

Just a 30-minute walk from the St Thomas hospital is the Broad Street Pumping station, where 22 years before, John Snow had meticulously shown how cholera had been transmitted through the water. The theory of cholera was not widely accepted at the time, in spite of the guardians removing the pump handle in 1859 and the outbreak stopping. By the time Kanehiro arrived, the methodology of Snow and the field of epidemiology was the most heralded new science of the day.

Besides learning modern surgical methods of the day, Kanehiro also learned epidemiology and the scientific method.

Return to Japan and the Study of Diet as a cause of Beriberi

When Kanehiro returned to Japan, he dedicated himself to finding the cure for beriberi – the disease that killed more Japanese sailors than battle. Using the methods of epidemiology, he developed an experiment to prove that beriberi was secondary to the food they ate and not the other conditions of the ship.

For the rest of the story – please listen to the podcast – subscribe if you like it. Thank you.

Vandenbroucke JP. Adolphe Vorderman’s 1897 study of beriberi among prison inmates in the Dutch East Indies: an example of scrupulous efforts to avoid bias. JLL Bulletin: commentaries on the history of treatment evaluation, www.jameslindlibrary.org (2012, accessed 28 June 2013).

Takaki, K . On the cause and prevention of kak’ke. Trans Sei-I-Kwai 1885; 39(Suppl 4): 29–37.

Takaki, K . On the preservation of health amongst the personnel of the Japanese Navy and Army. Lecture II, delivered on May 9th. Lancet 1906; 1: 1451–1455.

Takaki, K . On the preservation of health amongst the personnel of the Japanese Navy and Army. Lecture III, delivered on May 11th. Lancet 1906; 1: 1520–1523.

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The Green Mediterranean DietImagine being able to improve the Mediterranean Diet with a few changes. Is the new "Green" Mediterranean Diet the ultimate hack? The Green Mediterranean Diet (Green-Med) has become the hottest version of the MED diet yet.

Advantages of the Green Mediterranean DietThere are three advantages to Green-Med

1. Less Fatty Liver
2. Decreased risk of heart disease
3. Less Visceral Fat

Fatty LiverNon-alcoholic fatty liver disease is the number one cause of liver failure in the United States. It surpassed alcoholic liver disease as the number one reason for liver transplants. But how do you get fatty liver?

Is fatty liver caused by sugar or fat or both?Low-Carb enthusiasts blame fructose, or almost any sugar, as the cause of fatty liver disease. Although the latest boogyman is "seed oils." On the other hand, vegans will blame saturated fats.

But sugars in mice are not the same as sugars in men.

Fatty liver appears to be a byproduct of obesity, excess calories, and genetics.

Reducing fatty liverAfter weight loss surgery, people rapidly lose weight, including in their liver.

But people on the Green Mediterranean Diet lost more weight in their liver than those with the standard Mediterranean diet.

Visceral FatBelly fat is one of the hardest fats to get rid of. As people age, belly fat increases. So when women go through menopause, they increase belly fat. And lowering belly fat is best done through weight loss with a high-fiber diet and cardiovascular exercise. But Green-Med appears to lower it even more.

Cardiovascular Risk FactorsAlthough MED is known for reducing the risk of heart disease, Green-Med seems superior.

Implementing the green Mediterranean DietThe difference between the green and standard Mediterranean diet

• 28 grams of walnuts a day - about one ounce
• 3-4 cups of green tea per day
• 100 grams per day of frozen Mankai
• Reduction in red meat

Green Tea is Easy

There are more polyphenols in it than in black tea - so it's easier to drink.

Adding walnuts is easy; they are also a great source of omega-3 fatty acids.

Decreasing red meat isn't difficult.

Finding Mankai or duckweed - well, you can't in the United States

No one has reproduced the data about the Green Mediterranean Diet - perhaps because they can't find those frozen cubes of duckweed.

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LiverKing Falls From Grace

Not that anyone was surprised the so-called Liverking was using steroids. But he fooled many people that his diet and intense training led to this frame. The diet he recommended was some form of an "ancestral" diet. We have covered the carnivore-type diet before. So how did this all happen?

The Rise of LiverKingLiverKing's rise was meteoric. He began posting on Instagram in 2021 and now has almost 2 million followers.

His trademark was showing off his abdominal muscles on his five-foot-five-inch frame. All the time advocating eating raw liver.

Isn't that a hook? Eat raw liver, get abdominal muscles, and look like him.

But his rise was anything but an accident.

Powering up the MediaIn his emails, he whines about how he wants to build his following but was concerned that the steroids he had were not enough. So he was begging for help from someone in the UK. He was taking thousands of dollars of steroids a month.

His plan? Getting over a million followers and selling supplements.

He had a "live-in" video recorder to follow his antics.

Guess who his partner was in supplements?

The Supplement IndustryHow do most scam artists in the medical field make money? Selling supplements. Be that Joseph Mercola, or Mark Hyman, or Ken Berry. All people who make millions a year selling supplements.

So what to do if you are trained in psychiatry but don't want to see people? You sell supplements. So the business partner is one Dr. Paul Saldino - aka Carnivore MD.

Since the revelation about Brian Johnson's (LiverKing) steroid use Saldino said he would have to distance himself from him. Good friend, eh? That is a business decision. If you are a friend of mine and have a fall from grace, I will be at your door to help, not distance.

This was pure theater and pure business - well, not so pure.

Supplements can kill.

But so can their diet.

The Diet They Don't EatMake a following eating raw liver. Yell at the dinner table about how raw liver is good for you. Makes great content for your videos. Eating raw liver can kill you.

Carnivores and extreme keto types always like pointing to hunter-gatherer societies for optimal "primal health." But my cousins in Alaska don't eat liver.

There is enough vitamin A in polar bear's liver to kill 52 people. But the biggest outbreak of trichinellosis in the United States came from eating grizzly bear liver.

Wait, can I get sick from too much Vitamin A?Vitamin A toxicity symptoms include drowsiness, irritability, abdominal pain, nausea, and vomiting. Then you lose your hair; then your skin starts to peel. Not to mention it can damage your liver - ironic, eh?

The tolerable limit of vitamin A is 10,000 units a day. Beef liver has 15,000 units in 3 ounces.

But LiverKing didn't eat liver in real life. What did he eat?

The Maple Syrup and Hormone DietLiverKing ate 120 grams of maple syrup, 50 grams of dextrose, and ONLY 2 ounces of red meat a day.

Why - he was taking insulin and needed to take a lot of sugar.

He said he was super strict, working out - and his emails had his diet. Almost none of it was organ meat. He was specific and precise.

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Leaky Gut: Facts and FadsThe latest fad of supplement makers is to talk about "gut health." The latest boogyman for the gut is the "leaky gut." The other name for leaky gut is intestinal permeability.

A Surgeon's ViewAs a surgeon, a "leaky gut" is a devastating surgical emergency. Surgeons emergently operate to remove the gut that no longer has a barrier function.

The dark gut is dead and needs to be surgically removed. This gut has no barrier function and will allow bacteria from the inside of the small bowel to easily enter the patient's bloodstream. Leading to septic shock and death.

The Non-Surgical Emergency or Chronic Leaky GutBut a leaky gut doesn't have to be so dramatic. Not leading to septic shock or needing to be removed. In this model, the intestinal barrier is "leaky," not to the point of causing sepsis. But the leaky gut enables small molecules to leak out of the gut into the bloodstream. Thus producing chronic inflammation.

Chronic inflammation may cause obesity. Emphasis on "may."

Emulsifiers and ObesityRodent studies have provided fascinating insights. Certain emulsifiers, when added to the diet of mice or rats, lead to obesity. In one experiment, rodents were fed identical amounts of kibble. But one group, emulsifiers, was added to their water. These emulsifiers, like polysorbate 80, not only produced obesity but also disrupted the microbiome of the gut (ref). But mice are not men.

When dietary emulsifiers are examined in humans, high levels cause disruption of the gut. However, there is little evidence that small amounts found in the food supply cause issues. (ref 4)

Non-Humans and Leaky GutWhile animal models are interesting, human studies provide useful information. That a rat or mouse has a leaky gut based on some intervention is not an equivalence in humans.

Functional Medicine and Leaky GutIf you searched "leaky gut," you will find a host of "functional medicine" doctors providing supplements, bone broth, probiotics, and other scams. On the shelves of drug stores and "health food stores," you will find abundant supplements to "support gut health."

Disease States and Leaky GutFunctional medicine physicians associate many disease states with leaky gut. The following have little or no good evidence to be caused by a leaky gut:

• Alcoholic cirrhosis
• Asthma
• Autism
• Chronic fatigue syndrome
• Depression
• Eczema
• Environmental enteropathy
• Eosinophilic esophagitis
• Fibromyalgia
• Kwashiorkor
• Metabolic syndrome
• Multiple sclerosis
• Non-alcoholic fatty liver disease (NAFLD)
• Obesity
• Pancreatitis
• Parkinson's disease
• Psoriasis
• Rheumatoid arthritis

Non-Controversial Causes of Leaky GutThere is no doubt celiac disease, Crohn's disease, radiation, and ulcers from non-steroidal anti-inflammatory drugs; certain bacteria can cause a change in intestinal permeability (another name for leaky gut). Celiac disease and Crohn's disease have been studied for years (ref 2, ref 3). While we know gluten exacerbates the auto-immune function of those with Celiac disease, we do not yet have a mechanism for Crohn's disease.

Gut Barrier Anatomy and FunctionThe small bowel's purpose is primarily for the absorption...

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The Beer and Sausage DietThere are a lot of crazy diets out there. All of them you can lose weight with. Weight loss has many advantages. But the beer and sausage diet was fun. Here is what we learned:

• A calorie is just a calorie
• Being in calorie deficit is difficult
• Meticulous journaling is important
• Your lab values will improve with weight loss
• A beer is a good unit measure
• Weighing your food is important

Episode Sponsor: Modifyhealth.com

I'm The DoctorIf you hear Evo Terra on national television talking about the beer diet, you will hear my name. I'm the doctor.

Late one September, I get a call from my friend, Evo Terra. He said, "October is coming; I want to lose some weight and want to do a beer fast. "

So we devise a diet, not just beer - but let's add sausages. After all, what is beer without sausages?

Careful SupervisionThis was a medically supervised diet. It ran for the month of October every year for four years. Every week he would come into my clinic. Every week he would have blood draws.

• cholesterol levels
• liver enzymes
• Weekly weight
• We would check muscle mass vs. fat mass
• inflammatory markers

We were prepared to stop the experiment and return him to a normal diet. For Evo, a normal diet is maybe not your diet. Since Evo likes the food I make, I assume he has a great diet. For many years, one of my great joys in Phoenix was when Evo and his wife would come over for dinner Sunday nights. Damn, I miss those days.

There are advantages to beer and sausagesA beer is a single unit. There is little variation in terms of caloric intake.

Sausage can easily be weighed, and Evo was strict regarding the weight of his sausages.

We added vitamins and fiber to his regimen.

He had six beers a day, and a designated driver at all times.

Science WinsFor those who say grains are evil and you can never lose weight or you would have horrible inflammation, well, Evo didn't fit with that. Because no one does. The idea that grains are evil is a myth of the low-carb community.

Vegans didn't like the idea of Evo eating sausages: "Pure processed meat will lead to inflammation and all the evils associated with eating meat."

It didn't happen.

Calorie deficit led to weight loss, despite drinking beer and eating sausages.

His inflammatory markers didn't rise; they went down.

His cholesterol went down.

His liver enzymes decreased - not that they were high to begin with.

Every year he kept his weight off - we are now over ten years past the last experiment.

Conclusions:I don't recommend this as a weight loss method. I do recommend weight loss by the simple principles of calorie restriction, a well-rounded diet, and vigorous exercise. Which diet, you ask? Either the Mediterranean or the DASH diet.

Evo wrote a book, and you can buy it here.

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Losing Weight With AppsCan a phone app help you lose weight? How about with your cholesterol, blood pressure, or waist size?

Perhaps you've heard the latest Noom ads, where they boast forty publications showing that their app will help you lose weight.

Apple is coming out with more ways to have their new watch track your heart rate and steps, with apps even looking at your yoga workout and eventually telling your blood glucose.

Episode Sponsor: Modifyhealth.com

What the Studies ShowA recent meta-analysis of randomized controlled trials showed that the average weight loss in the first three months was slightly below five pounds (2.18 kg).

Unfortunately, the weight loss didn't last. Nine months later, they had regained a pound and a half for a total loss of 3.5 pounds (1.63 kg).

Blood Pressure, Cholesterol, and CaloriesThere was a slight improvement in blood pressure at three months. But cholesterol and total energy intake, as well as waist circumference and blood glucose, remained the same.

The Proliferation of AppsThere are over 500,000 applications on Android and Apple phones to track various health data points. In addition, there are other devices just measuring fitness. The theory of measuring fitness behaviors with calorie tracking to provide feedback to improve health is appealing.

Many Apps With Poor QualityMany apps had a lack of behavioral coaching and poor quality of scientific information. Tracking over a three-day period found that the accuracy of energy intake among apps was only fair in terms of total calories and amounts of macro- and micronutrients.

What About NoomNoom is one of the more popular paid apps. They boast over 40 peer-reviewed articles. A quick glance at the articles showed some surprising flaws:

One article compared Noom in pancreatic cancer patients to a control group who received no coaching.

Another article used Noom data for their references.

Article after article that Noom sites are little more than using Noom's data without dropout rates.

References:Chen J, Cade JE, Allman-Farinelli M. The Most Popular Smartphone Apps for Weight Loss: A Quality Assessment. JMIR Mhealth Uhealth. 2015 Dec 16;3(4):e104. doi: 10.2196/mhealth.4334. PMID: 26678569; PMCID: PMC4704947.

Chew HSJ, Koh WL, Ng JSHY, Tan KK. Sustainability of Weight Loss Through Smartphone Apps: Systematic Review and Meta-analysis on Anthropometric, Metabolic, and Dietary Outcomes. J Med Internet Res. 2022 Sep 21;24(9):e40141. doi: 10.2196/40141. PMID: 36129739; PMCID: PMC9536524.

Keum J, Chung M, Kim Y, Ko H, Sung M, Jo J, Park J, Bang S, Park S, Song S, Lee H

Usefulness of Smartphone Apps for Improving Nutritional Status of Pancreatic Cancer Patients: Randomized Controlled Trial JMIR Mhealth Uhealth 2021;9(8):e21088 URL: https://mhealth.jmir.org/2021/8/e21088 DOI: 10.2196/21088

Pohl, M. "325,000 mobile health apps available in 2017—Android now the leading mHealth platform. Research 2 Guidance." (2017).

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Decreasing cholesterol: drugs and dietThere is a persistent belief that lifestyle can take care of all cholesterol problems. Lifestyle can make things worse, but once things are worse, it cannot make things better. Once you have disease, or cholesterol is higher, you need treatment often beyond lifestyle management. This distresses many people, who wish to have control over their fate. High https://www.yourdoctorsorders.com/2012/05/hdl-the-good-cholesterol-isnt-good/ (cholesterol) is one of the main causes of heart attacks, strokes, and peripheral vascular disease. You can lower cholesterol through diet and exercise by as much as 15 percent. Lifestyle changes are the first choice to decrease cholesterol. Modern drugs, however, will lower cholesterol levels far more than diet or exercise. The progressive changes of a vesselThe normal artery, as shown below, is a free-flowing https://www.yourdoctorsorders.com/2022/08/inflammation-and-the-mediterranean-diet/ (blood) vessel. When a person is in their late teens, there is already fatty formation on the inside of the vessel wall. As more fat is deposited in the vessel wall, blood flow decreases, leading to ischemia in the end organ. Angina, or heart pain, occurs when there is insufficient blood flow to the heart secondary to an artery narrowed by plaque.Factors contributing to atherosclerotic plaque formationDamage to the blood vessel begins the process of Smoking Hypertension High blood sugars Diets rich in saturated fats and refined grains

However, the lower the level of LDL, the less risk those factors become, as you shall see. Anatomy of the Blood VesselIf you examine the autopsy specimen of the coronary artery above, the blood flows through that lumen. The inner wall, the wall the blood comes into contact with, is called the endothelium. There are three layers to the wall of an artery: Tunica intima Tunica Media Tunica Adventicia

Atherosclerosis begins when the cholesterol transport protein enters the wall of the tunica media, whose first layer is the endothelium. Discovery of LDLIn 1954, Dr. John Gofman https://pubmed.ncbi.nlm.nih.gov/13197415/ (reported) the discovery of LDL and HDL. These were the particles found when he separated plasma cholesterol-carrying lipoproteins with an ultracentrifuge. Gofman was the first to note that heart attack patients had high LDL https://pubmed.ncbi.nlm.nih.gov/21291675/ (levels). The correlation of high LDL and heart attacks has been called “https://www.cell.com/cell/fulltext/S0092-8674(15)00079-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867415000793%3Fshowall%3Dtrue#bib31 (one of the most profound epidemiologic correlations in all of medicine).” High LDL levels have been shown to correlate with atherosclerosis in all species studied. High LDL and AtherosclerosisThe higher the LDL level, the faster atherosclerosis develops. Factors that increase atherosclerosis are those which injure blood vessels: smoking, hypertension, hyperglycemia, and genetic factors that predispose endothelium to early injury. High LDL levels can lead to heart attacks in children as young as 6 years old. This rare form of homozygous familial hypercholesterolemia inspired Brown and Goldstein to elucidate the genetic defect in the receptor for LDL. Discovery of the LDL receptor defecthttps://pubmed.ncbi.nlm.nih.gov/3513311/ ( Brown and Goldstein) discovered that when LDL receptors are defective, it leads to the following: LDL particles circulate for a long time This leads to an increase in plasma levels of LDL As a result, more deposits are made into the arteries Creating atherosclerotic plaques

Lowering LDL by feedbackTo keep blood LDL constant, your body uses a feedback mechanism. As your LDL levels increase, the target tissues produce more receptors to take up the LDL. If the LDL receptor is defective, the liver continues to increase...

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Decreasing cholesterol: drugs and dietThere is a persistent belief that lifestyle can take care of all cholesterol problems. Lifestyle can make things worse, but once things are worse, it cannot make things better. Once you have disease, or cholesterol is higher, you need treatment often beyond lifestyle management. This distresses many people, who wish to have control over their fate. High https://www.yourdoctorsorders.com/2012/05/hdl-the-good-cholesterol-isnt-good/ (cholesterol) is one of the main causes of heart attacks, strokes, and peripheral vascular disease. You can lower cholesterol through diet and exercise by as much as 15 percent. Lifestyle changes are the first choice to decrease cholesterol. Modern drugs, however, will lower cholesterol levels far more than diet or exercise. The progressive changes of a vesselThe normal artery, as shown below, is a free-flowing https://www.yourdoctorsorders.com/2022/08/inflammation-and-the-mediterranean-diet/ (blood) vessel. When a person is in their late teens, there is already fatty formation on the inside of the vessel wall. As more fat is deposited in the vessel wall, blood flow decreases, leading to ischemia in the end organ. Angina, or heart pain, occurs when there is insufficient blood flow to the heart secondary to an artery narrowed by plaque.Factors contributing to atherosclerotic plaque formationDamage to the blood vessel begins the process of Smoking Hypertension High blood sugars Diets rich in saturated fats and refined grains

However, the lower the level of LDL, the less risk those factors become, as you shall see. Anatomy of the Blood VesselIf you examine the autopsy specimen of the coronary artery above, the blood flows through that lumen. The inner wall, the wall the blood comes into contact with, is called the endothelium. There are three layers to the wall of an artery: Tunica intima Tunica Media Tunica Adventicia

Atherosclerosis begins when the cholesterol transport protein enters the wall of the tunica media, whose first layer is the endothelium. Discovery of LDLIn 1954, Dr. John Gofman https://pubmed.ncbi.nlm.nih.gov/13197415/ (reported) the discovery of LDL and HDL. These were the particles found when he separated plasma cholesterol-carrying lipoproteins with an ultracentrifuge. Gofman was the first to note that heart attack patients had high LDL https://pubmed.ncbi.nlm.nih.gov/21291675/ (levels). The correlation of high LDL and heart attacks has been called “https://www.cell.com/cell/fulltext/S0092-8674(15)00079-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867415000793%3Fshowall%3Dtrue#bib31 (one of the most profound epidemiologic correlations in all of medicine).” High LDL levels have been shown to correlate with atherosclerosis in all species studied. High LDL and AtherosclerosisThe higher the LDL level, the faster atherosclerosis develops. Factors that increase atherosclerosis are those which injure blood vessels: smoking, hypertension, hyperglycemia, and genetic factors that predispose endothelium to early injury. High LDL levels can lead to heart attacks in children as young as 6 years old. This rare form of homozygous familial hypercholesterolemia inspired Brown and Goldstein to elucidate the genetic defect in the receptor for LDL. Discovery of the LDL receptor defecthttps://pubmed.ncbi.nlm.nih.gov/3513311/ ( Brown and Goldstein) discovered that when LDL receptors are defective, it leads to the following: LDL particles circulate for a long time This leads to an increase in plasma levels of LDL As a result, more deposits are made into the arteries Creating atherosclerotic plaques

Lowering LDL by feedbackTo keep blood LDL constant, your body uses a feedback mechanism. As your LDL levels increase, the target tissues produce more receptors to take up the LDL. If the LDL receptor is defective, the liver continues to increase...

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Alcohol and the Mediterranean Diethttps://www.yourdoctorsorders.com/2018/09/is-there-no-safe-level-of-alcohol/ (Alcohol) consumption is controversial.  No one disputes that excess alcohol consumption leads to dire consequences. But what about moderate alcohol consumption? Can we define moderate alcohol consumption? Is there a safe and therapeutic level of alcohol consumption? Alcohol is a component of the Mediterranean Diet. However, the consumption is limited to 10 ounces of red wine for men, which translates to 14 grams of alcohol. Half that amount for women. In a number of https://pubmed.ncbi.nlm.nih.gov/25207479/ (articles), this amount of alcohol is beneficial. Bias from AuthorsConfirmation bias is ingrained in all humans.  Treatment programs for alcohol addiction teach that there is no safe level of alcohol consumption.  Fundamentalist Christians, Muslims, and other organized religions have taboos regarding alcohol consumption. Finally, consumers of alcohol will be biased against abstinence. Components of WineIn their article, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468969/ (Wine, Polypenols and Mediterranean Diet), the authors note that one can get polyphenols from other sources in the diet, and thus the alcohol may be unnecessary.  They conclude that moderate consumption is likely an important component of a mechanistic as well as social norm. Dose Dependent Effects of Polyphenols on the BodyDecreased risk of cardiovascular disease Dose-dependent reduction of LDL-C Increase HDL-C and decrease triglycerides in patients with diabetes Reduction of Blood Pressure Increase production of nitric oxide (NO), which increases blood flow and reduces blood pressure Improve LDL/HDL ratio Resveratrol inhibition of pro-inflammatory agents lower risk of type 2 diabetes Resveratrol improves glucose homeostasis Modulate gut microbiota Improvement in blood vessel wall function (endothelial function) Reduction of drugs in diabetic patients

Mechanistic vs HolisticThe issue with the Mediterranean Diet is always those who approach from a mechanistic view versus those who approach nutrition and lifestyle from a holistic view. The original data from the Mediterranean Diet came from thehttps://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ ( Seven Countries Study). This was a holistic examination, not only of their diet but also their lifestyle. Alcohol Toxicity is in the DoseA bit of wine is good, a lot of wine is not. If you look at every improvement in human physiology with alcohol listed above, the opposite effect happens when the dose is beyond about 50 grams of alcohol.

Produced by https://podcastlaunch.pro (Simpler Media)

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Mediterranean Diet after weight loss surgerySuccess after weight loss surgery doesn't end with an operation. It just gets started. The most recalcitrant people to diets are those who undergo weight loss surgery. Weight loss surgery patients were on multiple diets prior to surgical intervention.  The https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (Mediterranean) Diet is the best post-operative diet one can have. Weight Loss and the Mediterranean DietThe Med Diet is favorable for health. Multiple https://pubmed.ncbi.nlm.nih.gov/32386663/ (studies) have shown decreased risk of cardiovascular disease, cancer, and autoimmune disease. What about weight loss? Systematic reviews have shown the Med Diet is equal or superior to other diets for weight loss. However, we found no post-operative program to adopt the Med Diet after weight loss surgery. Preoperative Med DietWe began coaching patients with the Med Diet before surgery. Many insurance companies require a preoperative, physician-supervised diet. In 2010, we began to use the Mediterranean Diet as a template for our patients using the 9-point scale.  Contrary to weight loss plans, our emphasis was learning the Med Diet. Weight Loss Surgery Protocol Liquid PhaseThe immediate post-operative diet emphasized soups and smoothies rich in legumes, vegetables, and fruits. Modular, unflavored protein supplements (whey or pea-based) were used to augment the protein content during this time, as were standard chewable vitamins.  Thus, the beginning of the post-operative plan was already a rich Mediterranean-style diet. Early Solid Food PhaseLegumes and fish were emphasized during the early solid food phase, which were universally easy to digest. One of the favorite Mediterranean-style foods were tacos.  Contrary to popular belief, the Med Diet is not foods commonly eaten in the Mediterranean. Instead, it consists of foods rich in whole grains (corn tacos), fruits (homemade salsa), legumes (lentils), some dairy products (cheese), and fish. We noted lettuce was problematic for some in the early phase, but spinach was easy to digest. Thus salads were based upon spinach rather than lettuce. Later Solid Food PhaseAs the stomach continued to heal, we stressed the increase in food with multiple fiber types.  We de-emphasized red meats, cautioned against excess alcohol, and worked on olive oil as the primary source for fats. Follow upCooking classes were a constant feature of our support group, often bringing in guest chefs from the area and the Food Network. We emphasized the importance of patients learning to cook.  Many of our patients believed that cooking was the most important aspect of their postoperative care. We found that those who learned to cook their meals had better weight loss than those who did not. Validated Food Frequency Questionnaires (FFQ) were used to follow a group of patients. The FFQ were https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926524/ (validated) using dietary logs during follow-up with patients. Getting in that quantity of foodStomach capacity after weight loss surgery is limited. How, then, does one get in the required amount of food? It is not difficult. All food is measured pre-cooked. Take broccoli. If you take nine ounces of broccoli and bake it, you end up with a small amount of volume but still have the one Mediterranean Diet point. The increase of vegetables in the diet is one way to reduce inflammation. Food increases over timeFood volume increases over time with both the Gastric Sleeve, Lap-Band, and RNY gastric bypass. The answer is not to eat less or take more protein shakes. The answer is to eat better. To have a balanced diet. Putting someone on yet another low-carb plan does not provide a healthy long-term solution.  Protein DeficiencySince meat is not emphasized in the Mediterranean Diet, some patients were concerned about protein intake. Lab tests did not show any patient...

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Implementing the Med Diet - Part OneDo you think you eat enough plants in your diet? How many plants do you eat in a week? Not refined grains, but plants. You can cook them, boil, bake, microwave, roast them or even eat them raw. How many? Further, it's not just eating more volume of plants, it's diversity. Mediterranean Diet and PlantsAdherence to the https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (Mediterranean) diet depends more on plants. Vegetables Fruits, Tree Nuts, Seeds Legumes Whole Grains Olive oil

When it comes to plants, more is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918790/ (better). But not just in quantity of plants, but also diversity. Think about this: there is no one plant that can provide all the micronutrients and macronutrients a person needs. We tell vegetarians to use several plant sources for complete proteins, the same is true for any nutrient. Gut Bugs and PlantsYour gut contains a trillion bugs. There are more of them than of us. But what do they eat? It turns out, most of what they eat are the things we don't. Gut bugs eat plant parts. Without them eating those plant parts, we would be far worse off. Thus, the gut microbiome is an exciting research field. Guts break down fiber to chemicals shown to: Decrease the risk of colon cancer Lower cholesterol Decrease blood sugar spikes Decrease depression Allow absorption of polyphenols

Fiber is an Essential NutrientPlants provide vitamins, minerals, macro and micronutrients. A single source of plants cannot provide the nutrients a person requires, which has been the main reason we recommend a diversified diet. Fiber is also a nutrient, an essential nutrient, one that humans cannot make, but without it there is clearly an increase in disease. While those on the extreme of low-carb diets will disagree, the literature is unambiguous. MythFiber supplements are not a substitute. Some are expensive, one selling for over $150 a month. But no supplement gives you the diversity of nutrients that you can get from your diet. Mother Nature gives you a better deal. So, eat your fiber, don't buy a supplement. Now begin to chart your diversityToday's assignment is simple: begin to chart the diversity in your diet, so that you increase the sources of your plants. One of my favorite dieticians, Dr. Megan Rossie, suggests a person has 30 plant-based foods per week. Sound impossible? Let's try it using the Meditereanean Diet. Why 30?It isn't that difficult to implement, but consider that you want to consume the vitamins, minerals, antioxidants, and other nutrients, and there is no one plant that does this. But many will. Vegetables:One Mediterranean diet point is achieved by consuming 9 ounces of vegetables per day.  Run through the list of vegetables that you can add to your diet in any given week. Asparagus Beets Bok Choi Broccoli Brussels Sprouts Cabbage Cauliflower Carrots Celery Cucumbers Eggplant Jicama Kale Leeks Lettuce Onions Parsnips Peppers Spinach Squash Tomatillos Zucchini

Fruits:Apples Apricots Avocado Bananas Blueberries Cherries Coconuts Dates Grapes Grapefruit Jackfruit Kiwi Lemon Lime Mangos Melons Nectarines Peaches Pears Pineapple Pomegranates Plumbs Prunes Oranges Tomato Watermelon

Legumes:Black beans Butter beans Chickpeas Green beans Kidney beans Navy beans Pinto beans Navy beans Lentils Peanuts

Whole Grains:Barley Brown Rice Buckwheat Bulgur Corn Millet Oatmeal Whole wheat Red rice

Nuts:Acorns Almonds Brazil nuts Cashews Chesnuts Hazelnuts Macadamias Pecans Pine nuts Pistachios Walnuts

Seeds:Chia Flax seeds Hemp Pomegranate Poppy seeds Pumpkin Sesame seeds Squash seeds Sunflower

These provide a diversity of micronutrients, macronutrients and fiber. All of which provide a healthy diet. But let's not forget one of the most important plants:  Perhaps the most important part of the...

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Mediterranean Diet - FatsPerhaps the most important part of the Mediterranean Diet is this plant. Olive oil is the single ingredient most associated with the Mediterranean Diet. It is the one single food substitution you can do that will improve your health immediately and have great consequences. But not all https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (olive oil) is the same. Olive oil and your heartThere are many types of fat that you can find in your diet. Saturated fat will raise your LDL level, increasing your risk of heart disease and stroke. Olive oil, which is unsaturated, decreases the risk of https://pubmed.ncbi.nlm.nih.gov/29141571/ (heart disease). Types of FatFats are confusing. You will hear saturated, poly unsaturated, monounsaturated, and trans fats. First, we won't look at the chemical structure of fats. Second, we will look at the evidence that the food is associated with fat and how it influences our bodies. Finally, we will dismantle some bad arguments against certain fats. Saturated Fats - it's the source, not the ingredientSources: butter, red meat, dairy. What the Mediterranean Diet showed us what that the total diet mattered more than the individual ingredient. In spite of the revolutionary approach to using https://www.yourdoctorsorders.com/2022/08/ancel-keys-and-revisionist-history/ (cohort) studies with complete diets, many have insisted on pulling that apart to find out if one ingredient is "bad." For years, saturated fat was considered the "bad" part of what we ate. The American Heart Association recommended limiting saturated fat to just ten percent of what you eat.  The AHA recommended changing from saturated fat to polyunsaturated fat or monounsaturated fat. There has never been a question about olive oil, but a few concerns have been raised about some polyunsaturated fat. But it isn't as simple as the saturated fat molecule. We don't eat pure saturated fat, it turns out we eat food containing that fat. Depending on the food, it depends on how saturated fat affects you. Dairy and Fish vs Red MeatAdding more fish and dairy to your diet decreases the risk of heart disease. Adding more red meat to your diet increases your risk of heart disease. This https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075396/ (study), from the https://pubmed.ncbi.nlm.nih.gov/12639222/ (EPIC) group, was impressive in its size, and its ability to factor out other issues that might increase heart disease. Once again, cohort studies show it isn't as important. CheeseBesides heart disease, cheese decreased the risk of dementia among a https://pubmed.ncbi.nlm.nih.gov/35217900/ (cohort) of Finnish men followed for 22 years. Perhaps the greatest snack of all time (my opinion - not science). Another cohort https://pubmed.ncbi.nlm.nih.gov/34245355/ (study) found that cheese was associated with a lower risk of pre-diabetes. Other forms of dairy products did not have this same benefit. This flies in the face of some vegans, who insist diabetes comes from saturated fat. Finally, non-dairy cheese is not a great source of https://pubmed.ncbi.nlm.nih.gov/35334904/ (nutrients). I know my fellow vegans want to find a good alternative for cheese, but there simply isn't one. Proving again that the whole food is greater than its parts, fish.Fatty fish have been shown to decrease not only cardiovascular mortality, but all causes of mortality. But not https://www.yourdoctorsorders.com/2021/09/fish-oil-and-atrial-fibrillation/ (fish oil.) Who doesn't love a good salmon? Fish consumption has been associated with a lower risk of heart disease. Further, fatty fish decreases the risk of all-cause https://pubmed.ncbi.nlm.nih.gov/35108375/ (mortality). Fatty fish contain high quantities of omega-3 fatty acids.  Our body cannot make these fats, we must get them from our diet. Here are the fish that are high in omega-3 fatty acids: salmon sardines mackerel herring lake trout canned light...

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Mediterranean Diet - FatsPerhaps the most important part of the Mediterranean Diet is this plant. Olive oil is the single ingredient most associated with the Mediterranean Diet. It is the one single food substitution you can do that will improve your health immediately and have great consequences. But not all https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (olive oil) is the same. Olive oil and your heartThere are many types of fat that you can find in your diet. Saturated fat will raise your LDL level, increasing your risk of heart disease and stroke. Olive oil, which is unsaturated, decreases the risk of https://pubmed.ncbi.nlm.nih.gov/29141571/ (heart disease). Types of FatFats are confusing. You will hear saturated, poly unsaturated, monounsaturated, and trans fats. First, we won't look at the chemical structure of fats. Second, we will look at the evidence that the food is associated with fat and how it influences our bodies. Finally, we will dismantle some bad arguments against certain fats. Saturated Fats - it's the source, not the ingredientSources: butter, red meat, dairy. What the Mediterranean Diet showed us what that the total diet mattered more than the individual ingredient. In spite of the revolutionary approach to using https://www.yourdoctorsorders.com/2022/08/ancel-keys-and-revisionist-history/ (cohort) studies with complete diets, many have insisted on pulling that apart to find out if one ingredient is "bad." For years, saturated fat was considered the "bad" part of what we ate. The American Heart Association recommended limiting saturated fat to just ten percent of what you eat.  The AHA recommended changing from saturated fat to polyunsaturated fat or monounsaturated fat. There has never been a question about olive oil, but a few concerns have been raised about some polyunsaturated fat. But it isn't as simple as the saturated fat molecule. We don't eat pure saturated fat, it turns out we eat food containing that fat. Depending on the food, it depends on how saturated fat affects you. Dairy and Fish vs Red MeatAdding more fish and dairy to your diet decreases the risk of heart disease. Adding more red meat to your diet increases your risk of heart disease. This https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075396/ (study), from the https://pubmed.ncbi.nlm.nih.gov/12639222/ (EPIC) group, was impressive in its size, and its ability to factor out other issues that might increase heart disease. Once again, cohort studies show it isn't as important. CheeseBesides heart disease, cheese decreased the risk of dementia among a https://pubmed.ncbi.nlm.nih.gov/35217900/ (cohort) of Finnish men followed for 22 years. Perhaps the greatest snack of all time (my opinion - not science). Another cohort https://pubmed.ncbi.nlm.nih.gov/34245355/ (study) found that cheese was associated with a lower risk of pre-diabetes. Other forms of dairy products did not have this same benefit. This flies in the face of some vegans, who insist diabetes comes from saturated fat. Finally, non-dairy cheese is not a great source of https://pubmed.ncbi.nlm.nih.gov/35334904/ (nutrients). I know my fellow vegans want to find a good alternative for cheese, but there simply isn't one. Proving again that the whole food is greater than its parts, fish.Fatty fish have been shown to decrease not only cardiovascular mortality, but all causes of mortality. But not https://www.yourdoctorsorders.com/2021/09/fish-oil-and-atrial-fibrillation/ (fish oil.) Who doesn't love a good salmon? Fish consumption has been associated with a lower risk of heart disease. Further, fatty fish decreases the risk of all-cause https://pubmed.ncbi.nlm.nih.gov/35108375/ (mortality). Fatty fish contain high quantities of omega-3 fatty acids.  Our body cannot make these fats, we must get them from our diet. Here are the fish that are high in omega-3 fatty acids: salmon sardines mackerel herring lake trout canned light...

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Inflammation and the Mediterranean DietThe https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (Mediterranean) Diet is the most anti-inflammatory diet studied. The inflammatory response is the body's mechanism to fight infection, repair itself and rid itself of cancer.  Inflammation is a coordinated response to trauma, infection, and cancer. Without inflammation, we would be dead within twenty-four hours. Too little or too muchToo much inflammation results in wanton destruction of tissues, pain, fevers, and misery. It is associated with heart disease, cancer, aging. It is that delicate balance of inflammation we need. Does diet play a role with inflammation? The answer is "sort of." Short Course about InflammationInflammation is involved in: Wound healing, removing dead cells - breaking them down into components so they can be recycled Removing and destroying bacteria Inactivating and eliminating viruses Destroying cells that have changed into cancer cells Repairing injury from infection Destroying parasites Removes toxic chemicals The immune system is one branch of the inflammatory response.

Five Signs of InflammationThe five signs of acute inflammation and their Latin names: Redness - in Latin this is called rubor. Swelling - in Latin this is called tumor. Fever - in Latin this is called calor Pain - in Latin this is called dolor Secretion - in Latin this is called https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(89)92957-7/fulltext (fluor)

Medical school teaches inflammation as one of the first series of lectures. Simple InflammationYour finger was hit with a hammer. You have an injury to your finger. Some cells are injured. The cells send a distress signal, and immediately white blood cells begin to swarm into the area to help the injured cells.  All that extra blood flowing to the area will lead to redness (rubor) and swelling (tumor). Soon, the finger will feel a bit hot (calor) and will have pain (dolor). Some cells are so badly injured that they are no longer viable. Your inflammatory reaction breaks down these cells, removes the debris, and recycles the parts to create new tissue in the area. Unwanted InflammationI love nature walks but like to avoid Poison Ivy. Sometimes, we want to decrease the immune response. Inflammation is the response of our skin to poison ivy.  We reduce the immune response by reducing hives and itching. Rheumatoid arthritis is another example of unwanted inflammation.  Rheumatoid arthritis is an auto-immune disease.  The resulting inflammation leads to pain, fever, and joint destruction. The aim of the treatment is to reduce the inflammatory response that saves joints and improves well-being. The inflammatory response of COVID, influenza, or the common cold is reduced by the use of non-steroidal anti-inflammatory drugs, such as aspirin or Motrin. Acute Disease and InflammationHeart disease is partially the result of inflammation. When you have a heart attack, the coronary arteries are blocked. As a result, a part of your heart muscle is without oxygen. The cells send out inflammatory signals, and you begin to feel pain (dolor). If the blood flow is restored, your cells can heal, but if it takes too long, some of those cells will die. Then your body will get rid of those dead cells and replace them with scar tissue. The result is that your heart becomes less effective. Cardiovascular disease and inflammationPlaque formation in the arteries is the result of genetics, https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (diet), and inflammation. The increased cholesterol, either from the genetics or from a diet high in saturated fat, is deposited in the arteries.  When cholesterol enters the artery wall, the body's inflammatory response tries to get rid of it, causing inflammation in the arteries. Did you know that 18-year-olds already have signs of early plaque formation in...

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Inflammation and the Mediterranean DietThe https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (Mediterranean) Diet is the most anti-inflammatory diet studied. The inflammatory response is the body's mechanism to fight infection, repair itself and rid itself of cancer.  Inflammation is a coordinated response to trauma, infection, and cancer. Without inflammation, we would be dead within twenty-four hours. Too little or too muchToo much inflammation results in wanton destruction of tissues, pain, fevers, and misery. It is associated with heart disease, cancer, aging. It is that delicate balance of inflammation we need. Does diet play a role with inflammation? The answer is "sort of." Short Course about InflammationInflammation is involved in: Wound healing, removing dead cells - breaking them down into components so they can be recycled Removing and destroying bacteria Inactivating and eliminating viruses Destroying cells that have changed into cancer cells Repairing injury from infection Destroying parasites Removes toxic chemicals The immune system is one branch of the inflammatory response.

Five Signs of InflammationThe five signs of acute inflammation and their Latin names: Redness - in Latin this is called rubor. Swelling - in Latin this is called tumor. Fever - in Latin this is called calor Pain - in Latin this is called dolor Secretion - in Latin this is called https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(89)92957-7/fulltext (fluor)

Medical school teaches inflammation as one of the first series of lectures. Simple InflammationYour finger was hit with a hammer. You have an injury to your finger. Some cells are injured. The cells send a distress signal, and immediately white blood cells begin to swarm into the area to help the injured cells.  All that extra blood flowing to the area will lead to redness (rubor) and swelling (tumor). Soon, the finger will feel a bit hot (calor) and will have pain (dolor). Some cells are so badly injured that they are no longer viable. Your inflammatory reaction breaks down these cells, removes the debris, and recycles the parts to create new tissue in the area. Unwanted InflammationI love nature walks but like to avoid Poison Ivy. Sometimes, we want to decrease the immune response. Inflammation is the response of our skin to poison ivy.  We reduce the immune response by reducing hives and itching. Rheumatoid arthritis is another example of unwanted inflammation.  Rheumatoid arthritis is an auto-immune disease.  The resulting inflammation leads to pain, fever, and joint destruction. The aim of the treatment is to reduce the inflammatory response that saves joints and improves well-being. The inflammatory response of COVID, influenza, or the common cold is reduced by the use of non-steroidal anti-inflammatory drugs, such as aspirin or Motrin. Acute Disease and InflammationHeart disease is partially the result of inflammation. When you have a heart attack, the coronary arteries are blocked. As a result, a part of your heart muscle is without oxygen. The cells send out inflammatory signals, and you begin to feel pain (dolor). If the blood flow is restored, your cells can heal, but if it takes too long, some of those cells will die. Then your body will get rid of those dead cells and replace them with scar tissue. The result is that your heart becomes less effective. Cardiovascular disease and inflammationPlaque formation in the arteries is the result of genetics, https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (diet), and inflammation. The increased cholesterol, either from the genetics or from a diet high in saturated fat, is deposited in the arteries.  When cholesterol enters the artery wall, the body's inflammatory response tries to get rid of it, causing inflammation in the arteries. Did you know that 18-year-olds already have signs of early plaque formation in...

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Adherence to the Mediterranean Diet decreases the risk of cardiovascular disease. The Seven Country Cohort Study clearly showed https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (this). But what about cancer? Does the Mediterranean Diet impact cancer or cancer prevention? To study this, another cohort study began called the https://epic.iarc.fr/index.php (EPIC) study. Uniquely, the EPIC showed not only a decreased risk of cancer but also mortality from cancer. All vegetables, even the green ones, have nitrates. It turns out that the components of The Mediterranean Diet decreases the risk of cancer, decreases the risk of cancer recurrence, improves survival from cancer, and decreases overall mortality. EPIC StudyThe European Prospective Investigation into Cancer and Nutrition (EPIC) is a large cohort study involving over 521,000 individuals from 23 centers from ten countries. Adherence to the Mediterranean Diet and LongevityThe EPIC researchers developed a simple scoring system to determine adherence to the Mediterranean Diet.  Greater adherence to the Mediterranean Diet was associated with https://pubmed.ncbi.nlm.nih.gov/12826634/ (longevity). The Scoring SystemThe Mediterranean Diet is scored on a scale of one to nine. Nine being a perfect Mediterranean Diet Score, and zero being poor. Great adherence to the Mediterranean Diet is a score of seven points or more. Eating more of these foods gives you pointsThe Mediterranean diet is rich with vegetables, legumes, fruits and nuts, whole grains, and fish. You get a point for consuming 9 ounces or more of vegetables a day. If you consume less than nine ounces, you get a score of zero. Legumes will net you a point if you consume two ounces or more per day. Fruits and nuts are one point for nine ounces or more. Likewise, whole grains are worth a point for nine ounces or more. Fish is an average of an ounce a day, or two main meals per week. Thus,  by consuming a diet rich in these five components can score five points.

The weight is based on pre-cooked food. Lentils are a legume, and if you consume more than 2 ounces per day, you will score one Mediterranean Diet point. They are high in protein and fiber and low in saturated fat. Eat Less for MorePeople from the Mediterranean didn't eat much meat or dairy.  By consuming less of these, you can achieve Mediterranean Diet points. Eating less than  4 ounces of meat a day  is worth one point Consuming 1.5 ounces of hard cheese a day or LESS is worth one point Consuming less than 8 ounces of dairy is worth one point (mostly consume yogurt).

Thus by eating less dairy and meat, or none, you can score two additional points. You might think that 6-ounce burger is small, but if you eat less than four ounces of meat a day, you get one Mediterranean Diet point. Eat more than four ounces, and you get zero points. AlcoholAlcohol is a component of the Mediterranean Diet but in moderation. For ethanol, a value of 1 was assigned to men who consumed between 10 and 50 g per day and to women who consumed between 5 and 25 g per day. This corresponds to 5 ounces of wine for women or 10 ounces for men. Olive OilOlive oil is an important component of the Mediterranean Diet. The type of fat in olive oil is mainly monounsaturated. The ideal ratio of olive oil or monounsaturated fats to saturated fats should be at least 60%. The best olive oils come from the US. Interventions in the Mediterranean DietIncreasing the score in the Mediterranean Diet by two points in the Mediterranean diet led to an 8% reduction in https://pubmed.ncbi.nlm.nih.gov/12826634/ (mortality). Imagine a simple dietary intervention leading to a decrease in mortality. Colorectal Cancer and the Mediterranean Diet ComponentsIn a recent update of the Mediterranean Diet they found a higher consumption of fruits and vegetables combined led to a decrease in colorectal https://pubmed.ncbi.nlm.nih.gov/34684583/...

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Adherence to the Mediterranean Diet decreases the risk of cardiovascular disease. The Seven Country Cohort Study clearly showed https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (this). But what about cancer? Does the Mediterranean Diet impact cancer or cancer prevention? To study this, another cohort study began called the https://epic.iarc.fr/index.php (EPIC) study. Uniquely, the EPIC showed not only a decreased risk of cancer but also mortality from cancer. All vegetables, even the green ones, have nitrates. It turns out that the components of The Mediterranean Diet decreases the risk of cancer, decreases the risk of cancer recurrence, improves survival from cancer, and decreases overall mortality. EPIC StudyThe European Prospective Investigation into Cancer and Nutrition (EPIC) is a large cohort study involving over 521,000 individuals from 23 centers from ten countries. Adherence to the Mediterranean Diet and LongevityThe EPIC researchers developed a simple scoring system to determine adherence to the Mediterranean Diet.  Greater adherence to the Mediterranean Diet was associated with https://pubmed.ncbi.nlm.nih.gov/12826634/ (longevity). The Scoring SystemThe Mediterranean Diet is scored on a scale of one to nine. Nine being a perfect Mediterranean Diet Score, and zero being poor. Great adherence to the Mediterranean Diet is a score of seven points or more. Eating more of these foods gives you pointsThe Mediterranean diet is rich with vegetables, legumes, fruits and nuts, whole grains, and fish. You get a point for consuming 9 ounces or more of vegetables a day. If you consume less than nine ounces, you get a score of zero. Legumes will net you a point if you consume two ounces or more per day. Fruits and nuts are one point for nine ounces or more. Likewise, whole grains are worth a point for nine ounces or more. Fish is an average of an ounce a day, or two main meals per week. Thus,  by consuming a diet rich in these five components can score five points.

The weight is based on pre-cooked food. Lentils are a legume, and if you consume more than 2 ounces per day, you will score one Mediterranean Diet point. They are high in protein and fiber and low in saturated fat. Eat Less for MorePeople from the Mediterranean didn't eat much meat or dairy.  By consuming less of these, you can achieve Mediterranean Diet points. Eating less than  4 ounces of meat a day  is worth one point Consuming 1.5 ounces of hard cheese a day or LESS is worth one point Consuming less than 8 ounces of dairy is worth one point (mostly consume yogurt).

Thus by eating less dairy and meat, or none, you can score two additional points. You might think that 6-ounce burger is small, but if you eat less than four ounces of meat a day, you get one Mediterranean Diet point. Eat more than four ounces, and you get zero points. AlcoholAlcohol is a component of the Mediterranean Diet but in moderation. For ethanol, a value of 1 was assigned to men who consumed between 10 and 50 g per day and to women who consumed between 5 and 25 g per day. This corresponds to 5 ounces of wine for women or 10 ounces for men. Olive OilOlive oil is an important component of the Mediterranean Diet. The type of fat in olive oil is mainly monounsaturated. The ideal ratio of olive oil or monounsaturated fats to saturated fats should be at least 60%. The best olive oils come from the US. Interventions in the Mediterranean DietIncreasing the score in the Mediterranean Diet by two points in the Mediterranean diet led to an 8% reduction in https://pubmed.ncbi.nlm.nih.gov/12826634/ (mortality). Imagine a simple dietary intervention leading to a decrease in mortality. Colorectal Cancer and the Mediterranean Diet ComponentsIn a recent update of the Mediterranean Diet they found a higher consumption of fruits and vegetables combined led to a decrease in colorectal https://pubmed.ncbi.nlm.nih.gov/34684583/...

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Was Ancel Keys responsible for the modern epidemic of obesity? If you have read any low carb blog lately, you would think so. Their revisionist history is broken down to this: Ancel Keys was an influential scientist who thought fat was to blame for heart disease He did a study of diet and correlated fat and heart disease in those people of the seven countries But Dr. Keys left out countries that would have proven his hypothesis wrong The influence of Dr. Keys work turned the US away from saturated fat and to sugar Sugar causes obesity and all the lifestyle illness of the world Dr. Keys brought us snackwells instead of pork rinds and we are all obese with diabetes

You will find versions of this in blogs, books, and videos.  Low-carb bloggers plagiarize one another. Nor have they never the primary source material. The Mediterranean Diet Founder and the StudyKeys is the founder of the https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (Mediterranean Diet). He was a pioneer physiologist, one of the first to show that diet was an important component of heart disease. In the 1950's few considered diet an important component of heart disease. Rich People and Diets "In 1952 when Margaret and I were making surveys in Naples and then Madrid. It seemed quite clear that there was some relationship between diet and the incidence of coronary heart disease. Rich people had different diets and different blood cholesterols, and they had the only heart attacks in town. When those findings were written up and presented at a meeting in Amsterdam, some people were impressed and some didn't believe anything about it. " - Ancel Keys This early observation by Keys  was the impetus for  the Seven Country Study. That diet was responsible for heart disease was contrary to the prevailing theory: in the 1950's heart disease was hypothesized to be phenomenon of aging.  Dr. Keys meticulous research revealed the strong correlation between heart disease and a diet rich in saturated fat. The First GraphThe graph below is a result of looking at macro dietary statistics of a country compared with death rates from heart disease. Keys presented this data at a WHO meeting in the early 1950's. The conclusion about fat and heart disease,  was met with a great deal of skepticism. Diet was not considered a factor in heart disease. While this data points to a potential cause, to examine this hypothesis one must perform a cohort study. Some assume that Keys collected country wide data about diet and heart disease, but he did not. Bloggers probably assume this based on this graph, as well as the name, Seven Countries Study. But the Seven Country Study was far more precise. The Study was a Cohort type study. Cohort StudiesA cohort study follows subjects for a long period of time. The Seven Countries Study followed over 12,000 men for nearly 50 years. Following these men involved yearly physical examinations, blood work, hospital and death records, as well as very specific dietary follow up. Of all the factors examined, saturated fat and blood cholesterol were most correlated with  heart disease. One of the more common myths about the Seven Country Study was that sugar was not examined. In fact, sugar was examined as an independent dietary factor. Sugar was not an primary variable for heart disease, unless combined with saturated fat. Testing both low and high fat countriesThe low-carb bloggers assume that Keys only tested those countries whose diet was rich in carbs, and low in fat. Keys chose his cohorts based on different diets, from those who were low fat, to high fat. Total fat, as it turns out, was not a factor for heart disease. Greeks had 40% of their dietary calories from fat but a low heart disease rate.Most of their fat came from monounsaturated fat,  olive oil. The Finish CohortThe Finland cohort was chosen precisely because of their high fat diet: "Loggers’ lunches, even...

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Was Ancel Keys responsible for the modern epidemic of obesity? If you have read any low carb blog lately, you would think so. Their revisionist history is broken down to this: Ancel Keys was an influential scientist who thought fat was to blame for heart disease He did a study of diet and correlated fat and heart disease in those people of the seven countries But Dr. Keys left out countries that would have proven his hypothesis wrong The influence of Dr. Keys work turned the US away from saturated fat and to sugar Sugar causes obesity and all the lifestyle illness of the world Dr. Keys brought us snackwells instead of pork rinds and we are all obese with diabetes

You will find versions of this in blogs, books, and videos.  Low-carb bloggers plagiarize one another. Nor have they never the primary source material. The Mediterranean Diet Founder and the StudyKeys is the founder of the https://www.yourdoctorsorders.com/2022/08/the-modern-mediterranean-diet/ (Mediterranean Diet). He was a pioneer physiologist, one of the first to show that diet was an important component of heart disease. In the 1950's few considered diet an important component of heart disease. Rich People and Diets "In 1952 when Margaret and I were making surveys in Naples and then Madrid. It seemed quite clear that there was some relationship between diet and the incidence of coronary heart disease. Rich people had different diets and different blood cholesterols, and they had the only heart attacks in town. When those findings were written up and presented at a meeting in Amsterdam, some people were impressed and some didn't believe anything about it. " - Ancel Keys This early observation by Keys  was the impetus for  the Seven Country Study. That diet was responsible for heart disease was contrary to the prevailing theory: in the 1950's heart disease was hypothesized to be phenomenon of aging.  Dr. Keys meticulous research revealed the strong correlation between heart disease and a diet rich in saturated fat. The First GraphThe graph below is a result of looking at macro dietary statistics of a country compared with death rates from heart disease. Keys presented this data at a WHO meeting in the early 1950's. The conclusion about fat and heart disease,  was met with a great deal of skepticism. Diet was not considered a factor in heart disease. While this data points to a potential cause, to examine this hypothesis one must perform a cohort study. Some assume that Keys collected country wide data about diet and heart disease, but he did not. Bloggers probably assume this based on this graph, as well as the name, Seven Countries Study. But the Seven Country Study was far more precise. The Study was a Cohort type study. Cohort StudiesA cohort study follows subjects for a long period of time. The Seven Countries Study followed over 12,000 men for nearly 50 years. Following these men involved yearly physical examinations, blood work, hospital and death records, as well as very specific dietary follow up. Of all the factors examined, saturated fat and blood cholesterol were most correlated with  heart disease. One of the more common myths about the Seven Country Study was that sugar was not examined. In fact, sugar was examined as an independent dietary factor. Sugar was not an primary variable for heart disease, unless combined with saturated fat. Testing both low and high fat countriesThe low-carb bloggers assume that Keys only tested those countries whose diet was rich in carbs, and low in fat. Keys chose his cohorts based on different diets, from those who were low fat, to high fat. Total fat, as it turns out, was not a factor for heart disease. Greeks had 40% of their dietary calories from fat but a low heart disease rate.Most of their fat came from monounsaturated fat,  olive oil. The Finish CohortThe Finland cohort was chosen precisely because of their high fat diet: "Loggers’ lunches, even...

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Scientists and dieticians consistently  rank The Modern Mediterranean Diet (MED https://www.yourdoctorsorders.com/2018/09/the-mediterranean-diet/ (diet)) as the diet most recommended.  But often people don't know what the MED diet is. This post will  define the Med diet. Critics of the Med Diet Critics  argue that there is no uniform MED diet. They make these assertions based on one of these three arguments: That there is no uniform diet of the Mediterranean Region. There are over 20 countries on the 26,000 miles of coastline of the Mediterranean Sea. Each country with their own unique diets. Many of which have adopted a more modern American style diet. The diet is simply made up and therefore should be ignored. Finally some point out that there are many Med Diets as the literature.

Heart disease and Diet Ancel Keys is the scientist most responsible for not only the Med diet but the relationship of heart disease to diet. In the 1950's, heart disease was thought to be a disease of aging, and smoking but not diet or lifestyle. In the 1950's, much like today, heart disease was the number one cause of death among of middle aged executives. While there was a clear association between smoking and heart disease, there were far more deaths than could be explained from smoking.  Then an Italian scientist told Dr. Keys about the low incidence of cardiovascular deaths of men in https://www.sevencountriesstudy.com/about-the-study/history/ (Naples). Heart Disease and Diet in EuropeKeys confirmed this claim when he took a sabbatical in Oxford in 1952.  Keys found there was a difference of heart disease between the poor and the executives of Italy. He developed the hypothesis that diet might explain difference  between the two groups.  To confirm this Keys, and his wife, then traveled throughout Europe catalog different diets and rates of heart disease. In 1955 Keys presented his data to the World Health Organization, concluding  that diet played a significant role in heart disease.  Many members of the WHO mocked his  "diet-heart theory."  Keys then organized the seven countries study (click https://pubmed.ncbi.nlm.nih.gov/5226858/ (here)). Seven Countries StudyThe seven countries study was an observational study looking at biomarkers, lifestyles and their relationship to heart disease.  Those countries were Greece, Italy, former Yugoslavia, Finland, The Netherlands, Japan, and the United States. The cohorts were chosen because of diverse diets, lifestyle, and risk factors. Dietary and lifestyle influence on cardiovascular disease was unknown at the time. The seven country study was to answer the question about dietary influence and heart disease. The French ParadoxLow-carb bloggers accuse the seven country study of leaving out France. They cite the https://pubmed.ncbi.nlm.nih.gov/1351198/ (French Paradox,) that the French eat a diet high in saturated fat but have a low incidence of heart disease. However, France was not left out of the study.  French investigators were present at the original pilot study in Nicotera Italy, but ultimately decided not to participate in the study.  France was recovering from World War 2 and simply didn't have the resources to commit to such a study. In fact, The French Paradox was "coined" in the 1980s, over twenty years after the  start of the seven country study. The investigators didn't have access to that data, or the term. Low-carb bloggers  didn't read the seven country study or the French paradox. French Paradox ExplainedTwo factors explain the French Paradox. The high fat diet was not widely adopted by the French prior to the mid 1970's. It  takes time for a  habit to have an effect on cardiovascular disease. For example, one doesn't develop heart disease after the first cigarette. The primary French diet in the 1950's through 70's was a Mediterranean Diet.  Thus, the effect...

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If you don’t have diabetes, should you even consider a blood glucose monitor? Well, here is the science behind this new tiktok trend and why these Continuous Blood Glucose Monitors (CGM) are here to stay and what we know about them. The device First, the device – a continuous blood glucose monitor is a device that you place on your body and it measures the blood glucose level and reports that data typically to an application on your phone. The first blood glucose monitors were used to help patients with type 1 diabetes regulate their blood sugar. They were revolutionary, but expensive, not covered by many insurance companies, and cumbersome. As the technology has improved, the price has decreased, the comfort level has improved, and the accuracy of the monitoring has improved. As with most technology, blood glucose monitors are now less expensive, better, and widely available. You can read more about the history of the blood glucose monitor https://www.dropbox.com/s/cpaspiemmu2nmhh/Glucose%20monitors.m4a?dl=0 (here). Most diabetics use a fingerstick to see what their blood glucose is, and use that information to determine the medicine they need to help regulate their blood glucose. The CGM allows real-time data which can be checked against food logs to allow a person to see impact of their diet on their regulation of food. As the epidemic of diabetes grows, about 55 million predicted with diabetes by 2030, we know that the less variability in glucose, the better long-term outcome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360429/ ((reference here)) and https://www.yourdoctorsorders.com/2015/09/increasing-diabetes-mirrors-obesity-surgery-best-option/ (here). Variability in blood glucose with non-diabetics It turns out that even people who are not diabetic, have wide variations of blood glucose (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296129/ (reference here)). Further, the variations in blood glucose have real time effects and we should care about those https://pubmed.ncbi.nlm.nih.gov/21525442/ (effects).  For example, high glucose spikes lead to inflammation of the arteries, even in non-diabetics, which lead to atherosclerosis, heart disease, strokes and peripheral vascular disease (click https://pubmed.ncbi.nlm.nih.gov/21940510/ (here)). A study published in Journal of the American Medical Association (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2723644?resultClick=3 (here)) concluded “Providing individuals with tools to manage their glycemic responses to food based on personalized predictions of their PPGRs may allow them to maintain their blood glucose levels within limits associated with good health.” What is best? Avoiding the large variability in blood glucose is clearly important to health whether one has diabetes or not. Trying to predict what variability will be based on fasting blood glucose or hemoglobin A1C cannot be done. Using a healthy diet like the Mediterranean or https://pubmed.ncbi.nlm.nih.gov/29333199/ (DASH) diet – this has been found in studies with CGM on young people with type 1 diabetes (https://pubmed.ncbi.nlm.nih.gov/35276957/ (reference ) ) Even variations of the Mediterranean Diet and CGM have found improvement in glucose https://pubmed.ncbi.nlm.nih.gov/35277067/ (variability). Economies of Scale Continuous Glucose monitors are getting less expensive, more accurate, and more comfortable to wear. This is good news for patients who have diabetes, and as demand raises among all to use these tools the price will drop further. The economies of scale work with medical devices. Consider the pulse oximeter that you can purchase from a local pharmacy for $25 – they used to cost over $900 and were used to manage patients with lung disease. Now, for less than a copay, you can have one of these devices and they not only help manage patients with lung disease, but also keep people with COVID out of the hospital when they are doing well, or provide a warning to

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If you don’t have diabetes, should you even consider a blood glucose monitor? Well, here is the science behind this new tiktok trend and why these Continuous Blood Glucose Monitors (CGM) are here to stay and what we know about them. The device First, the device – a continuous blood glucose monitor is a device that you place on your body and it measures the blood glucose level and reports that data typically to an application on your phone. The first blood glucose monitors were used to help patients with type 1 diabetes regulate their blood sugar. They were revolutionary, but expensive, not covered by many insurance companies, and cumbersome. As the technology has improved, the price has decreased, the comfort level has improved, and the accuracy of the monitoring has improved. As with most technology, blood glucose monitors are now less expensive, better, and widely available. You can read more about the history of the blood glucose monitor https://www.dropbox.com/s/cpaspiemmu2nmhh/Glucose%20monitors.m4a?dl=0 (here). Most diabetics use a fingerstick to see what their blood glucose is, and use that information to determine the medicine they need to help regulate their blood glucose. The CGM allows real-time data which can be checked against food logs to allow a person to see impact of their diet on their regulation of food. As the epidemic of diabetes grows, about 55 million predicted with diabetes by 2030, we know that the less variability in glucose, the better long-term outcome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360429/ ((reference here)) and https://www.yourdoctorsorders.com/2015/09/increasing-diabetes-mirrors-obesity-surgery-best-option/ (here). Variability in blood glucose with non-diabetics It turns out that even people who are not diabetic, have wide variations of blood glucose (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296129/ (reference here)). Further, the variations in blood glucose have real time effects and we should care about those https://pubmed.ncbi.nlm.nih.gov/21525442/ (effects).  For example, high glucose spikes lead to inflammation of the arteries, even in non-diabetics, which lead to atherosclerosis, heart disease, strokes and peripheral vascular disease (click https://pubmed.ncbi.nlm.nih.gov/21940510/ (here)). A study published in Journal of the American Medical Association (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2723644?resultClick=3 (here)) concluded “Providing individuals with tools to manage their glycemic responses to food based on personalized predictions of their PPGRs may allow them to maintain their blood glucose levels within limits associated with good health.” What is best? Avoiding the large variability in blood glucose is clearly important to health whether one has diabetes or not. Trying to predict what variability will be based on fasting blood glucose or hemoglobin A1C cannot be done. Using a healthy diet like the Mediterranean or https://pubmed.ncbi.nlm.nih.gov/29333199/ (DASH) diet – this has been found in studies with CGM on young people with type 1 diabetes (https://pubmed.ncbi.nlm.nih.gov/35276957/ (reference ) ) Even variations of the Mediterranean Diet and CGM have found improvement in glucose https://pubmed.ncbi.nlm.nih.gov/35277067/ (variability). Economies of Scale Continuous Glucose monitors are getting less expensive, more accurate, and more comfortable to wear. This is good news for patients who have diabetes, and as demand raises among all to use these tools the price will drop further. The economies of scale work with medical devices. Consider the pulse oximeter that you can purchase from a local pharmacy for $25 – they used to cost over $900 and were used to manage patients with lung disease. Now, for less than a copay, you can have one of these devices and they not only help manage patients with lung disease, but also keep people with COVID out of the hospital when they are doing well, or provide a warning to

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About 15 years ago physician came to me telling me that she was opening a new venture, distributing plant-based bioidentical hormones, and surgically implanting those hormones as pellets. She wanted me to send her all of my patients who presented in menopause because "with bioidentical hormones they won't need weight loss surgery." She went on to say how every woman would be tested for their hormones and then a compounding pharmacy would make up the exact hormones to replace the ones the person was not producing enough of. This would, "almost reverse aging and cause weight loss." In fact, those bioidentical hormones cause weight gain. Bioidentical hormones, from whatever source, cause weight gain, not weight loss (https://pubmed.ncbi.nlm.nih.gov/23924704/ (reference)) . In spite of a number of "advertisement" from providers who wish to provide you with "compounded" bioidentical hormones that propose they will cause weight loss - they don't.  This physician was not an Ob-Gyn, nor was she a board certified endocrinologist, in fact her specialty was about as far from treatment of complex menopausal hormone replacement or obesity as one could imagine. The red flags for this clinic were (a) proposing weight loss (b) associating with a compound pharmacy (c) offering anti aging treatments (d) a provider that is not an expert in the field of endocrinology or gynecology. Bioidentical hormones made by any compounding pharmacies do not meet rigorous FDA standards. In fact, compounded forms of bio-identical hormones are similar to supplements, and have the same issues that supplement industries have had that we have outlined https://www.yourdoctorsorders.com/2015/04/vitamins-supplements-lables-that-lie/ (previously). Menopausal Hormone Replacement is Medicine, Compounded bioidentical hormones are ? With every scam there is a separation of the chaff from the wheat. Here is the current evidence about hormones and changes that occur as women enter menopause. Accepted sources for this information include The Menopause Society as well as The American College of Obstetrics and Gynecology. Women undergoing menopause they decrease their production of certain hormones. This can lead to severe symptoms of menopause that hormone replacement therapy can alleviate. Symptoms of menopause such as hot flashes, sleep disturbances, joint aches and pains, mood changes, vaginal dryness. That is undisputed and the improvement in quality of life is why many seek hormone replacement therapy. There is also potential benefit to decreasing risk of cardiovascular disease, if started within ten years of symptoms and before the age of 60 years. The major concern of hormone replacement therapy came from the https://jamanetwork.com/journals/jama/fullarticle/195120 (study) published in 2002, the Women’s Health Initiative, showing that hormone replacement, with the most commonly prescribed medicine, Prempro, led to an increase in heart attacks, strokes, deep venous thrombosis and pulmonary embolism as well as breast cancer. The concern among gynecologists led to a rapid decrease in the prescription of Prempro by nearly 70%. This also led to a decrease in the quality of life by women going through menopause. Some gynecologists and endocrinologists continued to prescribe hormone replacement therapy. Compound Pharmacies Filling the Gap Bioidentical hormones made by any compounding pharmacies do not meet rigorous FDA standards. In fact, compounded forms of bio-identical hormones are similar to supplements, and have the same issues that supplement industries have had that we have outlined https://www.yourdoctorsorders.com/2015/04/vitamins-supplements-lables-that-lie/ (previously). To quote from the FDA "Compounded drugs are not FDA-approved. This means that FDA does not verify the safety or effectiveness of compounded drugs. Consumers and health professionals rely on the drug approval process for verification of safety, effectiveness, and quality....

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The US Preventative Task Force updated their recent recommendations about vitamins and supplements in The Journal of the American Medical Association - reference https://jamanetwork.com/journals/jama/fullarticle/2793447?guestAccessKey=f8ea1de7-fbe9-4561-832e-7ea18d6579ce&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=062122 (here). Their conclusion was: "Conclusions and Relevance Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer." We have published about how misleading labels of supplements are before - click https://www.yourdoctorsorders.com/2015/04/vitamins-supplements-lables-that-lie/ (here). The appeal of vitamins and supplements is the ability to extract the vital chemicals (like vital amines) antioxidants, and anti-inflammatory ingredients, place them into a pill so you can avoid having a healthy diet. Trust me, a healthy diet is clinically proven to work but it is a lot easier to eat a burger and pop a pill than to remember to eat some vegetables (I like Habit Burger). [caption id="attachment_9745" align="aligncenter" width="640"]V Yes, I do love a good burger - Habit is my favorite[/caption] But let's go back in history for a second and let you know that surgeons love vitamins. If you haven't listened to one of my favorite stories- listen to this about the first vitamin - click https://www.yourdoctorsorders.com/2019/05/the-first-vitamin/ (here). And let us not forget that the first evidence based study in the history showed that citrus fruits prevented scurvy - who was that person that showed that - was it a "nutritionist" or was it a surgeon? Oh yes, it was Dr. James Lind - a surgeon. Why the appeal of vitamins, besides my fantasy about eating burgers and popping a pill? First there is the "natural" fallacy - I don't know, I think natural is more eating fruits and vegetables than pills. People tend to think of vitamins as "good" or healthy, and they are. They seem to think of a vitamin as "natural" even though they were brought to us from the golden age of biochemistry. It is clear that the vitamin and supplement companies have taken advantage of that and use terms like "support gut health" or "support immune function" or "good for cardiovascular health, " - even if those statements are meaningless. Second, it is easier to think of things we believe we understand. Heart disease and cancer are complex topics (not that the true chemistry of vitamins aren't but they seem easy). We want to make things easy - like take vitamins and supplements for prevention or cure of cancer or heart disease, because if we start talking about scary statins or chemotherapy not only are there real side-effects but bad press. Of course with vitamins and supplements there can be real side effects - check https://www.yourdoctorsorders.com/2015/10/bad-supplements-23000-er-admissions-a-year/ (here). My aunt's son, a Ph.D. in nuclear physics, died after taking a supplement that was to help him be "fit." But the simple truth is this: however the polychemistry there is in fruits, vegetables, legumes, whole grains, as well as balancing dairy, meats, fats and alcohol has proven effect - we call that the Mediterranean Diet (for more see https://www.yourdoctorsorders.com/the-mediterranean-diet-the-good-the-overhyped/ (here)) [caption id="attachment_9746" align="aligncenter" width="640"]i Instead of vitamins and supplements from a pill - eat this[/caption] For whatever reason, eating a Mediterranean Diet or DASH diet continue to be the proven way to maintain your health. References 1. Mishra S, Stierman B, Gahche JJ, Potischman N. Dietary Supplement...

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It turns out that the juice from beets may lower blood pressure in a sustained and lovely manner. Beets, you see, besides being a colorful vegetable, contain a high level of Nitrate (NO3-). And this is absorbed by the body and converted into nitric oxide. Nitric oxide is that amazing molecule that relaxes blood vessels and improves blood flow. How Your Body Gets Nitric Oxide The conversion of nitrate into nitrite, which is then converted into nitric oxide is a fun pathway. When you eat your greens (yes even lettuce has nitrates) your intestines absorb it and then it is secreted back into saliva where those bacteria in your mouth digest the nitrate (NO3-) into nitrite (NO2-) <-- for you chemistry major nerds. It is that nitrite that is converted to nitric oxide in the body as it needs it - and often it needs it. This particular study gave volunteers 250 ml of beet juice (what happens if you say that three times and fast?) - 34 of whom were on blood pressure medicine and 34 who were not (four people dropped out of the study). These people were randomized to receive, daily, one cup (250 ml) of beetroot juice (same as beet juice) daily, or the placebo which was nitrate free beet juice. No one could tell the difference in taste. BMI was constant in both groups, about 25-26. They measured, besides blood pressure, nitrates. What happened? There was a large increase in NOX (nitrates and nitrites) and cGMP (the signaling molecule ) but more importantly there was a sustained and real drop in blood pressure by 7.7 mm of Hg which was NOT seen in the nitrate free beet juice. The drop in systolic blood pressure was seen after the first week and the ultimate reduction of 8.1/3.6 Hg reduction was not altered by a change in heart rate. Two weeks after stopping this regimen the blood pressure returned to normal. Did you know that every increase of systolic blood pressure by 2 mm of Hg increases mortality of heart disease and stroke by about ten percent? This showed a reduction of 7.7 mm of Hg in systolic blood pressure. Dietary Implications Nitrates are not only found in beets, but also in many other vegetables. One of the clearest and classic papers for the use of the DASH diet showed that the adoption of this diet lead to blood pressure reduction in adults. While this diet was using salt as the major effector, it is clear that the increased use of vegetables with their high nitrate component is an additional determinant in nitrates and blood pressure reduction.   [caption id="attachment_9737" align="aligncenter" width="640"] All vegetables, even the green ones have nitrates[/caption] It may be that the increase in vegetable servings in the DASH diet may be a secondary and important factor for blood pressure reduction in both the DASH and Mediterranean Diets. For a review of the diet and hypertension click https://pubmed.ncbi.nlm.nih.gov/32330233/ (here). But what is even more impressive is if we look back at people who have increasing vegetable intake with ultimate cardiovascular disease. The Danish report looked at this and concluded, " Moderate vegetable nitrate intake was associated with 12%, 15%, 17% and 26% lower risk of ischemic heart disease, heart failure, ischemic stroke and peripheral artery disease hospitalizations respectively." - see the reference below or click https://pubmed.ncbi.nlm.nih.gov/33884541/ (here).   This goes against the Carnivore diet where they state there is no need for vegetables. Showing that vegetables are needed and produce improved quality of life.   REFERENCES: Kapil V, Khambata RS, Robertson A, Caulfield MJ, Ahluwalia A. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. 2015 Feb;65(2):320-7. doi: 10.1161/HYPERTENSIONAHA.114.04675. Epub 2014 Nov 24. PMID: 25421976; PMCID: PMC4288952. Bahadoran Z, Mirmiran P, Kabir A, Azizi F, Ghasemi A. The...

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Common Collagen Claims (taken from actual websites selling collagen supplements): “improves skin elasticity,” “support bone and joint health,” “strengthen hair, skin, and nails,”  “may benefit the bodies cellular structure,” “support healthy skin, bone, and joints.” “will feed your skin health” “will improve nail appearance and strength” “lead to a noticeable hair thickness”

Collagen as a supplement is not regulated by the Drug division of The Food and Drug Administration If you look at the bottom of the websites, or on the bottles, you will see a disclaimer that the claims “have not been evaluated by the U.S. Food and Drug Administration. ” More telling is “these products are not intended to treat, diagnose, cure, or prevent any disease.” Such a disclaimer is provided by the lawyers because if one claims to cure, treat, or diagnose an actual medical condition then it must have passed a rigorous FDA approval. To be clear, there have been no FDA studies that show collagen as a supplement treats any disease. Supplements commonly will use “support xyz health” – where you can fill in the blank with hair, nails, joints, skin – in the case of collagen. One of the main issues with supplements is “If the composition and quality of ingredients cannot be reliably ensured, the validity of research on dietary supplements is questionable. Moreover, the health of the US public is put at risk.” Starr RR. Too little, too late: ineffective regulation of dietary supplements in the United States. Am J Public Health. 2015;105(3):478-485. doi:10.2105/AJPH.2014.302348 As such, even when you look at the studies which promote collagen, or collagen byproducts, they do not meet the most basic of studies which are done to evaluate pharmaceuticals. In order to have an evaluation of a pharmaceutical you must have three phases in the trial: phase one is determining the dose for safety. While the supplement industry is happy if you think all supplements are good and all pharmaceuticals are evil – everything, every drug, every chemical from water to salt to formaldehyde has a toxic dose phase two is to test the drug for efficacy and side effects. Some people will react poorly to a supplement just as they will a drug. WE need to know what those side effects are. With a supplement people who don’t feel well often just stop it – or, like my cousin, die (yes, I had a cousin who died from a supplement). phase three testing is to determine if there is truly efficacy, what is the effectiveness and what is the safety. phase four is post-marketing surveillance in the public because even though you have gone through trials with a number of phases and under strict supervision when a drug is released to the public you have the chance to see millions of reactions.

Thalidomide, for example, was released in Europe and even had two drug trials in the United States but was NEVER approved in the United States by the FDA because of insufficient data. Vioxx was a drug used worldwide and was taken off the market in 2004 because of the risk of a fatal heart attack, but was taken off after it had passed multiple drug tests previously. FDA testing is rigorous and specific, with the highest standards in the world. Collagen has NEVER had such rigorous testing performed. These tests have not risen to the level and in 2022 one report noted “More research is needed to establish knowledge of the effects and physiologic mechanism of collagen supplementation. Dermatologists should be aware of the unsubstantiated proclamations of collagen made by companies and in social media, as well as what evidence is established thus far, to be equipped to discuss collagen supplementation with patients.” Rustad AM, Nickles MA, McKenney JE, Bilimoria SN, Lio PA. Myths and media in oral collagen supplementation for the skin, nails, and hair: A review. J Cosmet Dermatol. 2022 Feb;21(2):438-443. doi: 10.1111/jocd.14567. Epub 2021 Oct 25. PMID: 34694676. One of the most...

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Diets. They work for some, but not for others. "You're just not on the right diet," purveyors of the latest trend will tell you. "You're just not on the right diet for your blood type, ethnicity, age, hair color," says another set of true believers. So what's right and what's wrong? Today on Fork U, a conversation between Dr. Terry Simpson, weight loss physician, and https://twitter.com/CaloriesProper (Dr. Bill Lagakos), nutritional biochemist and physiologist, where they expose the truth behind diets and why they may, and may not, work for you. And check out Bill's book, https://twitter.com/CaloriesProper (The Poor Misunderstood Calorie). TRANSCRIPT:Terry Simpson: Bill, there are a lot of weight loss programs out there. The one that I'm hearing the most about most often is the Keto movement, which says that they're going to cure everything from heart disease and cancer. Bill Lagakos: I think from a 30,000-foot view, Keto works for a lot of people. So does low fat. I like some of the recent work, the studies showing it's more about the level of processing of the food. So you can have a vegan diet or you can have a Ketogenic diet and as long as it is excluding a lot of processed foods, it tends to not be over eaten. And people that tout the magical benefit effects of any of these diets, 99% of the time it's due to weight loss. Terry Simpson: We actually had an experiment with Evo, who you met. He uhh did it several years, three or four years in a row for one month, Evo would go on a beer and sausage diet, rigorously kept his calories to 1500. We measured his liver function tests, his lipid panel. Every year he lost weight, kept it off, and every year his liver function was fine, surprising with the number of beers he had a day, which was limited to six. But it was, he had weight loss and he had sustained weight loss over the year with a, kind of this funky diet we sort of made up. Bill Lagakos: Well, that's terrific. And that's an awesome diet. I'm jealous. But, uh, yeah, that, that basically proves the point. I mean, even if it's not a lot of weight he lost, I think a weight loss is a major driver in a lot of the health improvements that people like to attribute to particular dietary trends. Terry Simpson: There doesn't seem to be a lot of long-term data in these diets. When I look at the sort of metadata, I see that if you eat really high on the low-fat side, you have a little lower lifespan. If you eat really high on the high-fat side, you have a little lower lifespan. If you have your carbs at about 55%, you seem to have a little longer lifespan. Is there much good data saying one diet versus another, other than the Mediterranean, has great long-term results? Bill Lagakos: I don't think so. I don't think it comes down to macros at all. I think that there's the confounding in those studies is so deep that I don't think the macronutrient composition of your diet is going to be what kills you in the end. Terry Simpson: Part of your job is helping people lose weight. What are sort of the big messages you try and get through to people? Bill Lagakos: One of the biggest things is the importance of adherence, which is why I try to say, you know, what do I know that, that you can adhere to 100%? It's what you've been doing because you've been doing it. So let's try and find the lowest hanging fruit that we can change so it doesn't turn your whole world upside down, which is something that would probably never work. Terry Simpson: So in other words, you're not going to change a Keto into a vegan or a vegan into a Keto. Bill Lagakos: Correct. However, I don't like to put those two at odds because there is, there have been a few studies on the vegan Ketogenic diet. Terry Simpson: So give me an example of some of the things for our audience, some of the things that they can do to incorporate it in their life now to help them lose weight and just feel a little better about themselves. Bill Lagakos: Well,

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In science, we don’t look to confirm what we know; we want to find out something that we don’t know. We love it when science proves us wrong. If your doctor told you that you have heart disease, were pre-diabetic, or said you should eat healthier, they likely will tell you to follow the Mediterranean Diet. When I introduce the Mediterranean Diet to my patients I get a response like this: “Sounds great!  Who doesn’t love red wine, olive oil, and fresh Italian tomatoes?” This is followed by asking for a recommendation of a book of recipes from the Mediterranean. The Mediterranean Diet seems to invoke sitting on a rooftop restaurant in Positano sipping wine while munching on fruit and waiting for pasta. The food and wine are part of the lifestyle, as is relaxing and breathing in the surroundings. You might not be on a rooftop restaurant in Positano (lucky if you are). You might be looking in your yard and seeing a squirrel or rabbit or flowers, and taking in that time to breathe and relax and maybe the glass of wine and thus transporting that lifestyle to your home. Which do you think is better for your heart and your brain: rushing home from a stressful day at work, grabbing a martini and letting the alcohol calm you or going outside, taking a deep breath of fresh air, maybe having a glass of wine? In the original Greek, the word “diata” was used to describe how one should live, what one should eat, how to maintain a healthy body. It is from diata that our word “diet” derives. There is no doubt what you eat impacts your health. While the origin of the Mediterranean Diet is what ‘some’ people in the Mediterranean ate, but that isn’t what we (doctors, scientists, registered dieticians) mean today.   Over the last fifty years over 150 foods have been studied to see their effect on humans, for better or for ill.   Years of research, studied on millions of people, and yet most people have the view of the Mediterranean lifestyle as hummus and fish. So let me introduce this diet, and this lifestyle to you, and why it may be the most important lifestyle you should understand. In spite of all the noise on the internet about low carb/keto, vegan, or other diets/lifestyles you will find that the Mediterranean Diet is consistently ranked as the number one or two diet in the United States.  That is based on many studies showing how the diet leads to a decrease in heart disease, lower blood pressure, better control of diabetes, fewer strokes, and lowering the risk of dementia. The Mediterranean diet is neither low carbohydrate (it is about 50% carbohydrate) nor low fat (it is about 30% fat). It is not high protein (it is about 20% protein). Improvement in your health comes from eating certain foods, and not from counting macros (proteins, carbs, fats, and alcohol). Weight loss and better health are both touted from those who profess “low carb” or “low fat” and yet weight loss with the Mediterranean lifestyle is equal to or better than the low fat or low carb “diets”. Those who claim low-carbohydrate diets are the best for diabetes are often stunned that the Mediterranean diet provides superior long-term results for diabetes and insulin resistance. While they rightly point out that a diet rich in whole grains and fruits, will produce transient spikes in blood glucose levels, the long-term results from the Mediterranean lifestyle are superior to avoiding those foods – providing better control for diabetes. Back to those categories: Vegetables, Fruit and nuts, legumes, whole grains, meats, dairy, fats and oils, fish, and alcohol. Each one of those categories is worth a point, so you have a chance to get nine points total. For some categories, you get a point for eating a given quantity of food (more for some, less for others). We determine adherence to the diet based on how many points a day a person gets on average. The closer to nine points a person has on a daily basis, the healthier they are over...

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In Vino, Veritas – or In Wine, Truth – by Pliny the Elder When the Holy Roman Empire was forming Charlemagne gave lands to the monks in order for them to plant vineyards to make wine for the Eucharist. Those first vineyards, planted by Benedictine monks, make some of the classic wines of all time.  Wine was in France centuries prior to Charlemagne, but it was those monks that we have a provenance of today’s wine. It was also from those Monks that we got the concept of terroir. Today terroir is the “in” thing that wine sommeliers will talk about. One of the myths is that you can taste the soil of the wine.  This traces back to those monks who would taste the soil in order to determine where the best wines would come from. What those monks didn’t know was that the vines get their ingredients from carbon dioxide and sunlight. Wine geology is complex, and recently Alex Maltman, a distinguished professor emeritus of geology, published a book about the geology of wine.  His book: Vineyards, Rocks, and Soils The Wine Lover’s Guide to Geology is a reference guide for those who want to know more about the geology of the wines they are drinking. Dr. Maltman was also a guest on the podcast where we talked about wine geology and dispelled the myth about tasting the soil. Dr. Maltman notes that the chalk of Champagne is the soil, and the soil is important to drainage of the vine, but the plant doesn’t take up chalk (which is a silicate compound), and when the inorganic compounds of chalk are broken down, and some of those minerals are taken up they are tasteless. What people taste are the many organic compounds that the plant makes from the carbon from carbon dioxide through photosynthesis and coded on the vineyards DNA. You also taste the byproducts of fermentation – as those compounds are put through yeast, bacteria. Where the confusion lies is that some of the organic compounds of the soil smell like some of the products of fermentation of the wine. The monks didn’t know about photosynthesis, nor did they know about DNA encoding for the proteins and organic chemicals, nor did they understand the complex chemistry of fermentation. They just knew wine is delicious- and sometimes the soil tastes a bit like the wine, so they assumed that the vine took up the soil and put it into the grape (the wine takes up the water, not the soil). Today Sommeliers everywhere love to talk about the geology of where the wine you are buying came from. They love telling you a story – because we love stories about our food. As Maltman points out, we love to know the provenance of our food, and in an era of large multinational corporations, wine is one of the few places you can know about where a grape was grown, harvested, what were the conditions that year, what is the makeup of the land – even what side of the mountain that wine came from. But what you cannot taste, is the soil from the rocks. That, my friends, is not only impossible because of how and what the plant takes from the soil (water and ionic forms of inorganic compounds, as Maltman points out in his book) but ignores the most glorious and complex part of wine. In our conversation, Maltman talks about the grapes that no one has heard of that are making a comeback in Greece, Croatia, and Eastern Europe. Oh, and we bust the myths of resveratrol and people who want to add this as a supplement for weight loss, long life, etc.

http://forku.com (Fork U) is part of the https://your-doctors-orders.captivate.fm (Your Doctors Orders network of podcasts) and is hosted by noted physician and surgeon Dr. Terry Simpson. https://www.tiktok.com/@drterrysimpson? (Follow Dr. Terry Simpson on TikTok) for bite-sized content on  healthy eating Visit https://terrysimpson.com/ (TerrySimpson.com) for additional details on Dr. Simpson https://twitter.com/drterrysimpson?lang=en (Follow @DrTerrySimpson on Twitter) for skepticism, travel, and much more.

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This episode originally aired for the holidays in 2018. But it's solid advice, so we're playing it again, Sam! Diet season is soon upon us, but what happens if we have a system where you can lose weight during the times when you are most vulnerable: holidays, vacations, new relationships. Not a “lifestyle” or “long term” diet - but a simple ten-day plan to lose weight during the times when you need it. Full details: https://www.yourdoctorsorders.com/2018/12/10-day-holiday-diet/

Produced and distributed by Simpler Media Follow Dr. Terry Simpson on Twitter

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The term "microplastics" was originally described in 2004 for plastic particles that are less than 5 millimeters in diameter, originally being seen on beaches. But everywhere scientists have looked on planet earth, they have been found. From fruit, vegetables, nuts, beer, baby bottles, in the air, in our water. Some have estimated that we ingest 100,000 microplastic particles per day or the equivalent of a credit card of microplastic in a year. That number will only increase, as we are producing over 400 million tons of plastics a year, and we have over 5 billion tons of plastics in landfills. Plastic degrades over time, from sunlight, from ocean water, from wind. Some of those plastics become so small they cross the blood-brain barrier in humans. These plastics come in all shapes and sizes. As they are exposed to the environment and degrade, they become smaller and smaller. They come with different types of plastics with different reactions, but mostly we don't know. The problem is we don't know what these plastics are doing to us. We don't know what the toxic levels of microplastics are. We don't know what, if any, physiological systems that microplastics would interfere with. We don't know if they increase cancer, heart disease, auto-immune disease, dementia, liver cirrhosis - we just don't know. We don't know if they inhibit the growth of children if they cause the loss of fetuses in women who are pregnant. We do know on larger levels; plastics cause issues with marine mammals. Shopping bags in the water look like the turtle's favorite feast, a jellyfish, and they will consume those, and those plastics become stuck in the turtle's digestive system clogging up their intestines and leading to their death. Most have seen the turtle whose nose was stuffed with a plastic straw. What we don't know is what happens when the small microplastics enter into cells, or cross the blood-brain barrier, or land in our lungs. Those finds led to the laws to decrease plastic one-use bags and plastic straws, but that is just the tip of what might be a more serious problem. We know that mice fed microplastics had lower sperm counts, smaller offspring, but again, mice are not men. We also don't know what the different types of microplastics will do - one type might be harmful, another type might be benign. Some plastics might pass through us like fiber, indigestible matter that has no consequence other than moving stool along. What can you do if you are worried? If you feed your child formula, use bottles instead of plastic. If you use your microwave, don't reheat food in plastic containers. Try not to use plastic containers for storage, and don't dispose of them so quickly. Water bottles - well, time to use reusable water bottles made of metal or glass. For now, we can do a small part, but it isn't the entire part. It is a problem that may be a larger problem or less of a problem. But it probably is an issue. We already know that some plastics do cause endocrine disruption, and those products have been outlawed. But it isn't just a marine problem; whether you are a vegan, pescatarian, vegetarian, omnivore, or carnivore, there will be plastics in everything you eat.

http://forku.com (Fork U) is part of the https://your-doctors-orders.captivate.fm (Your Doctors Orders network of podcasts) and is hosted by the noted physician and surgeon Dr. Terry Simpson. https://www.tiktok.com/@drterrysimpson? (Follow Dr. Terry Simpson on TikTok) for bite-sized content on  healthy eating Visit https://terrysimpson.com/ (TerrySimpson.com) for additional details on Dr. Simpson https://twitter.com/drterrysimpson?lang=en (Follow @DrTerrySimpson on Twitter) for skepticism, travel, and much more.

Fork U is produced by http://simpler.media (Simpler Media) and is recorded in the studios of https://myproducergirl.wixsite.com/producergirl (ProducerGirl Productions).

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Ever since the YouTube video of Dr. Lustig and the evils of fructose went viral in 2010, many have advocated that fructose is the single most common cause of obesity in the United States. The video had metabolic pathways that had the hypothesis that most fructose either becomes fat in the liver, or that it might go down a pathway to cause joint issues, leaky gut, and inflammation causing obesity. Here are the two chemical structures of glucose, also known as the "good sugar" and fructose, or the bad sugar. I cannot help but thinking of the good witch and the bad witch on the Wizard of Oz. Dr. Lustig's hypothesis was based on studies done in mice and rats. In those studies, published two years before the viral video, found that high fructose diets in mice lead to increased "gut leak" and led to liver damage (1). This was even confirmed with a small study of 8 men (2) who had their complex carbohydrates replaced by fructose and fed normal caloric diets - meaning, these eight men had increased liver fat, more de novo fat formation (de novo lipogenesis) . This all makes that logical sense since sugar-sweetened beverages are associated with chronic inflammation and these days everything to do with chronic inflammation increases the risk of obesity, diabetes, heart disease, and aging. Then came a double-blinded, randomized, crossover study where a group of people were fed a standard diet but drank 25% of their calories as either fructose (the evil sugar), or glucose (the good one) or a high fructose corn syrup sweetened beverage. Oddly, there was no difference in any of those groups with regard to markers of inflammation, intestinal permeability, or inflammation in the fat tissue. To quote from the study: "Excessive amounts of fructose, HFCS, and glucose from SSBs consumed over 8 d did not differentially affect low-grade chronic systemic inflammation in normal-weight to obese adults." SSB = sugar sweetened beverages. There have been a number of human trials looking at sugar-sweetened beverages and inflammation, and the results are not consistent. Even finding that people who drink large amounts of either glucose of fructose didn't find changes in inflammation or visceral fat. Mice are not men, and the link between gut permeability, leading to systemic and chronic inflammation, occurs in mice, but not men. And while in mice fructose can lead to inflammation and liver issues, this doesn't happen in human beings. (4) The key may not be fructose itself, but increased caloric intake.  If you eat more, you will increase in weight, but it is not fructose alone. It is, in fact, high caloric intake combined with sugars. Meaning, that great tasting snack with the high levels of sugars and fats act in concert with the increased calories consumed to give you that portly look. To be fair, all of the studies were short term, less than a couple of weeks. Fructose, over the long term, may still be a bad actor. What about fruit? It is exceedingly difficult to eat enough whole fruits to make this a problem. To eat the excess amount in some of these studies you would have to eat several pounds of apples, and most people simply cannot do that in a day. And whole fruit consumption, as a part of the Mediterranean diet reduces the burden of cardiovascular disease, diabetes, and even erectile dysfunction.(5) In fact less than 10% of most Western dieters have adequate levels of fruit (6) leading to a serious threat to human health. Maybe a couple of apples a day will keep the doctor away.

http://forku.com/ (Fork U) is part of the https://your-doctors-orders.captivate.fm/ (Your Doctors Orders network of podcasts) and is hosted by noted physician and surgeon Dr. Terry Simpson. https://www.tiktok.com/@drterrysimpson? (Follow Dr. Terry Simpson on TikTok) for bite-sized content on  healthy eating Visit https://terrysimpson.com/ (TerrySimpson.com) for additional details on Dr. Simpson https://twitter.com/drterrysimpson?lang=en...

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On my tiktok channel (@drterrysimpson or terrysimpson309) putting up a review of red meat the comments are reflective of the polarization that makes politics look like gentle disagreements. Nutrition is nuanced - meaning, it is rare that something is good or bad for us, except for Death Cap Mushrooms, they will kill you, although I hear they are delicious. The same is true for red meat. What we have are rarely the types of nutrition studies where we feed people precise amounts of food and see the results (the DASH diet studies were great with this -ref 1 ). Instead we rely on what people tell us, which can be accurate, or not - and we look at markers for disease instead of the disease itself (looking at end points of heart disease we look at LDL, cholesterol, C-reactive protein, and rather non-specific markers. Red Meat and Glycemic Control and Inflammation In this study (ref 2) they examined the premise that red meat's has an effect on inflammatory markers and glycemic control. So the study  was a meta analysis of randomized control of glycemic control and inflammatory markers. Adults that were studied were given various quantities of red meats and then checked for glycemic control and inflammation. The end result "Total red meat consumption, for up to 16 weeks, does not affect changes in biomarkers of glycemic control or inflammation for adults free of, but at risk for, cardiometabolic disease. " Does this put this to bed - not really, but the proposed ill effect of red meat is not something that is seen in these studies.  Here are the markers they studied: glucose, insulin levels, HOMA-R, Hemoglobin A1c, C-reactive protein, IL-6, and TNF-alpha. This was a group of studies that went to about 16 weeks (four months) so any longer term issues with red or even red processed meats, were not seen. But there were clearly no indication found in these studies. What about other markers for heart disease? So the next question is the effect of red meat on lipids, lipoproteins and blood pressure(ref 3)? It turned out that increasing red meat did not affect those variables for heart disease. What if you check not just red meat, but "red meat with diets that replaced red meat with a variety of foods. We stratified comparison diets into high-quality plant protein sources (legumes, soy, nuts); chicken/poultry/fish; fish only; poultry only; mixed animal protein sources (including dairy); carbohydrates (low-quality refined grains and simple sugars, such as white bread, pasta, rice, cookies/biscuits); or usual diet. We performed random-effects meta-analyses comparing differences in changes of blood lipids, apolipoproteins, and blood pressure for all studies combined and stratified by specific comparison diets."- from ref 4.  They found that changing red meat for plant protein had a minimal effect, and yet other studies (ref 2) found that plant protein had no significant difference at all. Those short term studies, which are clear changes with specific amounts over a short period of time, appear to contrast with the studies of various groups where they look at the risk of type 2 diabetes and red meat consumption. Take reference 5, where they looked at the increase of diabetes in different groups based on self-reporting of red meat intake. These studies are not as powerful as the controlled trials above, and they are confounded by other variables - people who eat more red meat have higher caloric intake and more obesity, they also tend to drink more and to smoke more. It is not easy to isolate, statistically, those variables out and this is always the issue with large cohort studies. Take the many studies of the Seventh Day Adventist group, who are considered America's Blue Zone in Loma Linda, California. They don't eat meat, they live longer -- but there is more, that group tends to exercise more, they do not smoke, they do not drink, and they have a strong sense of community. When studied (reference 6) it appears to

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The Carnivore diet is the most extreme of the low-carbohydrate diets, with its expressed point that humans did great on a diet of flesh and evolved to eat a diet high in fats. While we cannot make up what people ate in the past, we can see about the diet of the Yupik’s of Alaska.  These people have been studied extensively by the https://canhr.uaf.edu/ (Center for Alaska Native Health Research) (CANHR) at the University of Alaska in Fairbanks who partnered with https://www.ahajournals.org/doi/full/10.1161/circresaha.115.306566 (Genetics of Coronary Artery Disease) in Alaska Native people. First the CANHR found that Alaska Natives who ate processed meats (hot dogs, lunch meat, fried chicken) had higher triglycerides. Those Yupik’s who consumed lots of omega-3 fatty acids and ate lots of meats with saturated fats developed coronary artery disease. As much as we like to get our omega-3 fatty acids from the sources, and few in the world eat as many as the Yupik’s, that cannot protect you from coronary artery disease in the presence of the over-consumption of saturated and trans fatty acids. It further showed that, at least for the Yupik’s, consuming processed meats, and meats high in saturated fats like beef, pork, lamb and chicken with skin was not healthy for the Alaska Natives. The Carnivore diet excludes greens and berries, however sea greens and berries are a large part of the traditional Yupik diet. The diet that they have is high in marine mammals, fish, game animals, greens and berries that provide high levels of fat soluble vitamins (A,D,E, and K) as well as iron. The Biotruth of the Carnivore Diet:A biotruth is a logical fallacy, usually found to be a misunderstanding of evolution. In this case the idea that early human ancestors were meat eaters and that the adaptation of cultivation of crops led to chronic disease. When CT scans were looked at from 137 mummified remains from four geographical regions, ancient Egypt, Peru, the Pueblo, and Unangan from the Aleutian Islands were examined they found atherosclerosis in all of them.  “Interpretation: Atherosclerosis was common in four preindustrial populations including preagricultural hunter-gatherers. Although commonly assumed to be a modern disease, the presence of atherosclerosis in premodern human beings raises the possibility of a more basic predisposition to the disease.” It should be noted that those were diverse diets from those who ate primarily marine mammals and fish to those whose diet was composed primarily of vegetation with little meat. The Myths of LDLThe low carbohydrate community propose that LDL isn’t an issue with heart disease. This flies in the face of the recent article in JAMA looking at 34 clinical trials and finding that lowering LDL-C not only decreased the risk of heart disease, but all causes of mortality. While the low-carb crowd likes to point out how sugar indeed has a role in development of heart disease, they quietly forget to point out that diets rich in meats are overwhelmingly an issue.

http://forku.com/ (Fork U) is part of the https://your-doctors-orders.captivate.fm/ (Your Doctors Orders network of podcasts) and is hosted by noted physician and surgeon Dr. Terry Simpson. https://www.tiktok.com/@drterrysimpson? (Follow Dr. Terry Simpson on TikTok) for bite-sized content on  healthy eating Visit https://terrysimpson.com/ (TerrySimpson.com) for additional details on Dr. Simpson https://twitter.com/drterrysimpson?lang=en (Follow @DrTerrySimpson on Twitter) for skepticism, travel, and much more.

Fork U is produced by http://simpler.media/ (Simpler Media) and is recorded in the studios of https://myproducergirl.wixsite.com/producergirl (ProducerGirl Productions).

REFERENCESBrand-Miller JC, Griffin HJ, Colagiuri S. The carnivore connection hypothesis: revisited. J Obes. 2012;2012:258624. doi: 10.1155/2012/258624. Epub 2011 Dec 22. PMID: 22235369; PMCID: PMC3253466. Bersamin A,...

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Fish oil is the bomb - Greenland Yupik and the rise of fish oil Fish oil first became a "hot topic" when a 1980 publication showed that Yupik in Greenland had a lower incidence of cardiovascular disease. Their paper concluded, "The rarity of ischemic heart disease in Greenland Eskimos may partly be explained by the antithrombotic effect of the long-chained polyunsaturated fatty acids, especially eicosapentaenoic acid prevalent in diets rich in marine oils." (Bang HO, Dyerberg J, Sinclair HM. The composition of the Eskimo food in north western Greenland. Am J Clin Nutr. 1980 Dec;33(12):2657-61. doi: 10.1093/ajcn/33.12.2657. PMID: 7435433). This led to more scientific bodies looking at the evidence for fish oil, and ultimately omega 3 fatty acids, and if it did reduce the incidence of cardiovascular disease. And even 22 years after the publication of that study, the American Heart Association put out a statement that fish oil was protective against cardiovascular disease. (Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002 Nov 19;106(21):2747-57. doi: 10.1161/01.cir.0000038493.65177.94. Erratum in: Circulation. 2003 Jan 28;107(3):512. PMID: 12438303) The other predictable tract this led on was the inevitable marketing of fish oils in the supplement industry trying to sell fish oil capsules, from whatever source, as a "must take" to prevent the number one killer in the United States. As with most supplements, being unregulated, they would make claims that their oil was better than others - because it came from krill, or it was vegan-based, or from cod, or pick something that sounds like it can be marketed. Some would claim their fish oil was more pure omega 3 fatty acids. Radio and television spots were secured, and when it was confirmed that the "good cholesterol" or HDL was indeed raised by omega 3 fatty acids it raised their game and intensity of marketing. Back in the world of science, testing continued and the results that came back didn't match the conclusions. Some papers would conclude that fish oil didn't produce a significant decrease in first time cardiac events but might help prevent secondary cardiac events (Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K; Japan EPA lipid intervention study (JELIS) Investigators. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomized open-label, blinded endpoint analysis. Lancet. 2007 Mar 31;369(9567):1090-8. doi: 10.1016/S0140-6736(07)60527-3. Erratum in: Lancet. 2007 Jul 21;370(9583):220. PMID: 17398308). In 2004 the Cocharane database looked at 48 randomized controlled trials and concluded that taking fish oils did not reduce mortality from cardiovascular disease. It also concluded that it didn't matter where the fish oil came from, fish or plant sources, or other sources. This, as you might imagine, throws a monkey wrench into the statement by the American Heart Association that fish oils were good for you, especially coming two years later. Marketing moves faster than medicine, so while doctors and scientists were working to find out why there were inconsistent results, the marketing of fish oils continued to expand. Given that there was no regulation in the supplement industry, they continued to market the "benefits" of their product. By 2020 the sales of over-the-counter fish oil products became to a SIX BILLION dollar industry, (https://www.grandviewresearch.com/industry-analysis/omega-3-supplement-market). Scientists worked at looking at the different components of dietary, or essential fatty acids. Because the literature was confusing, and the American Heart Association had a bit of salmon egg on their face, they decided to get their...

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Welcome to Fork U, the latest podcast from Dr. Terry Simpson. If you enjoyed the previous episodes of https://www.yourdoctorsorders.com/category/culinary-medicine/ (Culinary Medicine) and https://www.yourdoctorsorders.com (Your Doctors Orders), you'll love these quick, impactful bits of information that are easily digestible. (See what I did there?) No need to adjust your podcast or subscribe to anything new, you are already here!

With that, here is the first episode of the new podcast, Fork U, where you can learn a bit about food and medicine.