Health Journal Online

Category: Nutrition

  • Celebrating Veterans Day with Bill Muir

    Celebrating Veterans Day with Bill Muir

    We had the pleasure of talking with Bill Muir about his work in the military and as a Registered Nurse, food access, his book, and Veterans Day. We hope you enjoy this interview.

     

    Thank you for your service. We are grateful for the opportunity to interview you. Please tell us about yourself and your background. Why did you decide to join the military, and when did you enlist?

    Thank you very much! Hi, everyone. I’m Bill Muir, aka SGT VEGAN. I’m a combat veteran, RN, and 32-year vegan. I joined the U.S. Army after 9/11 to serve my country in its time of need. I had been living in Japan for about eight years at the time the attack happened, and, as an expat, it affected me very deeply. I joined the military because I thought I would be able to make a difference and help save lives, both American and Afghan, if I joined during war.

    What branch of the military were you in? What was your job? Where did you serve?

    I was a U.S. Army Paratrooper and served with the 173rd Airborne Brigade as a combat medic. I did a tour in Afghanistan from 2005 to 2006.

    What was your experience like eating a plant-based diet while serving? Did you experience particular challenges with food access? If so, how did you overcome them?

    Being vegan in the military really depends on where you are and what you are doing. Basic training was completely awful––not because training was hard, but because I was starving all the time. After bootcamp, things got better and I put the weight back on. Being stationed in Italy with the 173rd was amazing! I actually got kind of fat despite all the running I was doing, because I was eating vegan pasta, vegan pizza, and vegan gelato every day. When I deployed, I was very worried I would go back to starvation mode, but, luckily, I found a website called anysoldier.com that sends deployed service people what they need. I’ve heard conditions for people on plant-based diets have gotten better, but until there are designated vegan MRES (field rations) and plant-based options in all military cafeterias, it will be difficult to be plant-based in the military.

    Why was it important to you to remain plant-based during your military career?

    To me, being vegan meant living my ethics. I think remaining true to something I believe in while in the military, especially while in a warzone, was also about my attempt to hold on to my identity.

    How did your time in the military shape who you are today? Is there anything in particular about your service that you would like to share?

    No matter who you are, being in the military will change you almost down to a cellular level. I know that’s a popular trope in every movie and TV show featuring the military, but somehow I wasn’t expecting that would include me as well.

    After your military service, you earned a certificate in Vegan Culinary Arts from Atlantic Union College. In your opinion, how can education about preparing whole plant foods be a path forward for people to achieve better health?

    It can be huge, but people have to want to change. A vast majority of my patients have checked out and given up on trying to be healthy. I’m just trying to do the best I can to keep them from falling or dying on my shift. There is still a lot of anti-vegan propaganda in the United States, and, unfortunately, a lot of veterans still believe that somehow eating dead animals makes you more masculine.

    After you transitioned out of the military, you became a Registered Nurse. What has your experience been like working in the medical field and what area of nursing is your specialty?

    Working for Veterans Affairs (VA) as an RN has been both a blessing and a curse. On one hand, I feel lucky to be able to help my fellow veterans in their time of need, in much the same way as I joined the military in a time of war. On the other hand, working with sick and dying people takes its toll on you both physically and mentally. All in all, I feel lucky to have a job doing something that matters, but sometimes I wish I had chosen an easier profession.

    Do you still work for a VA hospital? Have you seen conditions that could be preventable with healthy lifestyle interventions, like whole food, plant-based eating?

    I work on a VA Medical/Surgical floor that has heart monitors. The vast majority of cardiac issues are lifestyle-related, meaning the patients’ hearts aren’t working the way they should because of unhealthy diets, smoking, drinking, or drugs. While we can’t live forever, we can live better, longer, if we just make simple lifestyle adjustments. The top three? Go vegan, exercise daily, and don’t smoke.

    Please tell us about your book Vegan Strong. What inspired you to write it?

    After I went to culinary school, I planned to open a restaurant. Unfortunately, my timing wasn’t great. It was 2008 and the economy was on the rocks, so I shelved that dream and made the practical choice to become a Registered Nurse. I didn’t know what I was going to do with all of my knowledge of plant-based health and plant-based living until, one day, I had an idea. I would write a book about how to be healthy and vegan, but style it like an Army Field Manual. 

    Lastly, what does Veterans Day mean to you? Is there anything you would like to share with your fellow veterans?

    Veterans Day is our day, so as a veteran, if you want it to be about getting some free meals, go for it. If you want it to be about meaningful reflection, that’s cool, too. We are around 6 percent of the population, and if you served during wartime, that number is even smaller. Eat right, take care of yourself, and if you need help, the VA is always there for you. GO VEGAN AND STAY VEGAN STRONG!

    For more information about my work and latest updates, visit my website and follow me on social media at IG @sgt_vegan, and Facebook.



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  • Drinking Water, Losing Weight 

    Drinking Water, Losing Weight 

    A few times a day, drink two cups of cold water on an empty stomach for weight loss.

    After drinking two cups (half a liter) of water, you can get a surge of the adrenal hormone noradrenaline in your bloodstream, as if you had just smoked a few cigarettes or had a few cups of coffee, boosting your metabolic rate up to 30 percent within an hour, as shown below and at 0:22 in my video Optimizing Water Intake to Lose Weight. When put to the test in randomized controlled trials, that appeared to accelerate weight loss by 44 percent, making drinking water the safest, simplest, and cheapest way to boost your metabolism. 

    Now, this entire strategy may fail if you’re on a beta-blocker drug. (Beta blockers are typically prescribed for heart conditions or high blood pressure and tend to end with the letters lol, such as atenolol, nadolol, or propranolol, sold as Tenormin, Corgard, or Inderal, respectively.) So, for example, as you can see below and at 0:59 in my video, if you give people the beta-blocker drug metoprolol (sold as Lopressor) before they drink their two cups (480 mL) of water, the metabolic boost is effectively prevented. This makes sense since the “beta” being blocked by beta blockers are the beta receptors triggered by noradrenaline. Otherwise, drinking water should work. But what’s the best dose, type, temperature, and timing?

    Just a single cup (240 mL) of water may be sufficient to rev up the noradrenaline nerves, but additional benefit is seen with drinking two or more cups (480 mL). A note of caution: One should never drink more than about three cups (710 mL) in an hour, since that starts to exceed the amount of fluid your kidneys can handle. If you have heart or kidney failure, your physician may not want you to drink extra water at all, but even with healthy kidneys, any more than three cups of water an hour can start to critically dilute the electrolytes in your brain with potentially critical consequences. (In How Not to Diet, I talk about a devastating, harrowing experience I had in the hospital as an intern. A patient drank himself to death—with water. He suffered from a neurological condition that causes pathological thirst. I knew enough to order his liquids to be restricted and have his sink shut off, but I didn’t think to turn off his toilet.)

    Getting back to it. What kind of water are we talking about? Does it have to be plain, regular water? It shouldn’t matter, right? Isn’t water just water whether it’s flavored or sweetened in a diet drink? Actually, it does matter. When trying to prevent fainting before blood donation, drinking something like juice doesn’t work as well as plain water. When trying to keep people from getting dizzy when they stand up, water works, but the same amount of water with salt added doesn’t, as seen below and at 2:40 in my video. What’s going on? 

    We used to think the trigger was stomach distention. When we eat, our body shifts blood flow to our digestive tract, in part by releasing noradrenaline to pull in blood from our limbs. This has been called the gastrovascular reflex. So, drinking water was thought to be a zero-calorie way of stretching our stomachs. But, instead, if we drink two cups (480 mL) of saline (basically salt water), the metabolic boost vanishes, so stomach expansion can’t explain the water effect.

    We now realize our body appears to detect osmolarity, the concentration of stuff within a liquid. When liquids of different concentrations were covertly slipped into people’s stomachs via feeding tubes, detection of plain water versus another liquid was demonstrated by monitoring sweat production, which is a proxy for noradrenaline release. It may be a spinal reflex, as it’s preserved in people who are quadriplegic, or picked up by the liver, as we see less noradrenaline release in liver transplant patients (who’ve had their liver nerves severed). Whichever the pathway, our body can tell. Thought we only had five senses? The current count is upwards of 33.

    In my Daily Dozen recommendation, I rank certain teas as among the healthiest beverages. After all, they have all the water of water with an antioxidant bonus. But, from a weight-loss perspective, plain water may have an edge. That may explain the studies that found that overweight and obese individuals randomized to replace diet beverages with water lost significantly more weight. This was chalked up to getting rid of all those artificial sweeteners, but, instead, it may be that the diet drinks were too concentrated to offer the same water-induced metabolic boost. As you can see below and at 4:29 in my video, diet soda, like tea, has about ten times the concentration of dissolved substances compared to tap water. So, plain water on an empty stomach may be the best. 

    Does the temperature of the water matter? In a journal published by the American Society of Mechanical Engineers, an engineering professor proposed that the “secret” of a raw food diet for weight loss was the temperature at which the food was served. “Raw food, by its very nature, is consumed at room temperature or lower.” To bring two cups (480 mL) of room-temperature water up to body temperature, he calculated the body would have to dip into its fat stores and use up 6,000 calories. Just do the math, he says: A calorie is defined as the amount of energy required to raise one gram of water one degree Celsius. So, since two cups of water are about 500 grams and the difference between room temp and body temp is about a dozen degrees Celsius, it’s about 500 x 12 = 6,000 calories needed. 

    Do you see the mistake? In nutrition, a “calorie” is actually a kilocalorie, a thousand times bigger than the same word used in the rest of the sciences. Confusing, right? Still, I’m shocked that the paper was even published.

    So, drinking two cups of room-temperature water actually takes only 6 calories to warm up, not 6,000. Now, if you were a hummingbird drinking four times your body weight in chilly nectar, you could burn up to 2 percent of your energy reserves warming it up, but it doesn’t make as much of a difference for us.

    What about really cold water, though? A letter called “The Ice Diet” published in the Annals of Internal Medicine estimated that eating about a quart (1 L) of ice—like a gigantic snow cone without any syrup—could rob our body of more than 150 calories, which is the “same amount of energy as the calorie expenditure in running 1 mile.” It’s not like you directly burn fat to warm up the water, though. Your body just corrals more of the waste heat you normally give off by constricting blood flow to your skin. How does it do that? Noradrenaline.

    If you compare drinking body-temperature water, room-temperature water, and cold water, there’s only a significant constriction in blood flow to the skin after the room-temperature water and the cold water, as seen below and at 6:39 in my video. 

    What’s more, as you can see here and at 6:45 in the video, neither the warm nor tepid water could boost metabolic rate as much as cold (fridge temperature) water. Our body does end up burning off more calories when we drink our water cold (at least indirectly). 

    So, two cups of cold water on an empty stomach a few times a day. Does it matter when? Yes, watch my Evidence-Based Weight Loss lecture to see how you can add the benefit of negative-calorie preloading by drinking that water right before your meals.

    Too good to be true? No. Check out my other three videos on water and weight loss in the related posts below.



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  • Boosting Your Metabolism Safely 

    Boosting Your Metabolism Safely 

    If you drink two cups of water, the adrenal hormone noradrenaline can surge in your bloodstream, similar to the response of smoking a few cigarettes or having a few cups of coffee.

    Given the 60 percent surge in noradrenaline within minutes of drinking just two cups of water, as shown in the graph below and at 0:13 in my video What Is the Safest Metabolism Booster?, might one be able to get the weight-loss benefits of noradrenaline-releasing drugs like ephedra—without the risks? You don’t know until you put it to the test. Published in the Journal of the Endocrine Society, the results were described as “uniquely spectacular.” Researchers found that drinking two cups of water increased the metabolic rate of men and women by 30 percent. The increase started within ten minutes and reached a maximum within an hour. In the 90 minutes after drinking one tall glass of water, the study participants burned about an extra 25 calories (100 kJ). Do that four times throughout the day, and you could eliminate 100 additional calories (400 kJ). That’s more than if you had taken ephedra! You’d trim off more calories drinking water than taking weight-loss doses of the banned substance ephedrine (the active component of ephedra) three times a day. And we’re just talking about plain, cheap, safe, and legal tap water.

    Using the Ten-Calorie Rule I’ve explained previously, drinking that much water could make us lose ten pounds over time unless we somehow compensated by eating more or moving less. Concluded one research team, “In essence, water drinking provides negative calories.

    A similar effect was found in overweight and obese children. Drinking about two cups of water led to a 25 percent increase in metabolic rate within 24 minutes, and it lasted at least 66 minutes, until the experiment ended. So, just getting the recommended daily “adequate intake” of water—about 7 cups (1.7 L) a day for children aged 4 through 8, and for ages 9 through 13, 8 cups (2.1 L) for girls and 10 cups (2.4 L) for boys, as shown below and at 1:45 in my video—may offer more than just hydration benefits. 

    Not all research teams were able to replicate these findings, though. For example, one found an increase of only about 10 to 20 percent, while another found only a 5 percent increase, and yet another team found effectively none at all. What we care about, though, is weight loss. The proof is in the pudding. Let’s test the waters, shall we?

    Some researchers suggest that the “increase in metabolic rate with water drinking could be systematically applied in the prevention of weight gain….” Talk about a safe, simple, side-effect-free solution. It’s free in every sense. Drug companies may spend billions of dollars getting a new drug to market. Surely a little could be spared to test something that, at the very least, couldn’t hurt. That’s the problem, though. Drinking water is a “cost-free intervention.”

    There are observational studies suggesting that those who drink four or more cups (1 L) of water a day, for example, appear to lose more weight, independent of confounding factors, such as drinking less soda or exercising more. What happens when you put it to the test?

    In 2013, “Effect of ‘Water Induced Thermogenesis’ on Body Weight, Body Mass Index and Body Composition of Overweight Subjects” was published. Fifty “overweight girls”—who were actually women, aged 18 to 23—“were instructed to drink 500 ml [2 cups] of water, three times a day, half an hour before breakfast, lunch, and dinner, which was over and above their daily water intake” and without otherwise changing their diets or physical activity. The result? They lost an average of three pounds (1.4 kg) in eight weeks. What happened to those in the control group? There was no control group, a fatal flaw for any weight-loss study due to the “Hawthorne effect,” where just knowing you’re being watched and weighed may subtly affect your behavior. Of course, we’re just talking about drinking water. With no downsides, why not give it a try? I’d feel more confident if there were some randomized, controlled trials to really put it to the test. Thankfully, there are!

    I hate it when the title ruins the suspense. “Water Consumption Increases Weight Loss During a Hypocaloric Diet Intervention in Middle-Aged and Older Adults.” Overweight and obese men and women randomized to two cups of water before each meal lost nearly five pounds more body fat in 12 weeks than those in the control group, as shown below and at 4:08 in my video. Both groups were put on the same calorie-restricted diet, but the one with the added water lost weight 44 percent faster.

    A similar randomized controlled trial found that about 1 in 4 in the water group lost more than 5 percent of their body weight compared to only 1 in 20 in the control group. The average weight-loss difference was only about three pounds (1.3 kg), but those who claimed to have actually complied with the three-times-a-day instructions lost about eight more pounds (4.3 kg) compared to those who only drank the extra water once a day or less. This is comparable to commercial weight-loss programs, like Weight Watchers, and all the participants did was drink some extra water. 

    The video I mentioned is The New Calories per Pound of Weight Loss Rule.

    If you missed my previous video, see The Effect of Drinking Water on Adrenal Hormones.

    For all the specifics, check out Optimizing Water Intake to Lose Weight, coming up next. 



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  • Does Drinking Water Affect Our Adrenal Hormones? 

    Does Drinking Water Affect Our Adrenal Hormones? 

    Drinking water can be a safe, simple, and effective way to prevent yourself from fainting.

    Within three minutes of drinking a few cups of water (12 mL/kg of body weight), the level of the adrenal gland hormone noradrenaline in our bloodstream can shoot up by 60 percent, as you can see in the graph below and at 0:19 in my video The Effect of Drinking Water on Adrenal Hormones. 

    When researchers had people drink two cups (500 mL) of water with electrodes on their legs, about a 40 percent increase in bursts of fight-or-flight nerve activity within 20 minutes was documented, as shown in the graph below and at 0:25 in my video. 

    If you drink two or three cups (11 mL/kg of body weight) of water, blood flow squeezes down in your arms and calves, clamping down nearly in half, as the arteries to your limbs and skin constrict to divert blood to your core, as you can see in the graph below and at 0:42 in my video. That’s why drinking water can be such a safe, simple, and effective way to prevent yourself from fainting, which is known medically as syncope. 

    Fainting is “the sudden brief loss of consciousness caused by diminished cerebral blood flow,” that is, to the brain. About one in five people experience this at least once, and about one in ten may have repeated episodes. It’s the cause of millions of emergency room visits and hospitalizations every year. Though fainting can be caused by heart problems, it is most often triggered by prolonged standing (because blood pools in our legs) or strong emotions, which can cause our blood pressure to bottom out. 

    About 1 in 25 people has what’s called blood-injury-injection phobia, where getting a needle stick, for example, can cause you to faint. More than 150,000 people experience fainting or near-fainting spells each year when they donate blood. To help prevent yourself from getting woozy, try drinking two cups of water (500 mL) five minutes before getting stuck with the needle. The secret isn’t in bolstering your overall blood volume. If you drink two cups of water or even a whole quart (500 to 1,000 mL), your blood volume doesn’t change by more than 1 or 2 percent. Rather, it’s due to the shift in the distribution of blood toward your center, caused by the noradrenaline-induced peripheral artery constriction, as you can see in the graph below and at 1:56 in my video. 

    Drinking water stimulates as much noradrenaline release as drinking a couple cups of coffee or smoking a couple unfiltered cigarettes. If the simple act of drinking water causes such a profound fight-or-flight reaction, why doesn’t it cause our heart to pound and shoot our blood pressure through the roof? It’s like the diving reflex I talked about in my previous video. When we drink water, our body simultaneously sends signals to our heart to slow it down, to “still your beating heart.” You can try it at home: Measure your heart rate before and after drinking two cups (500 mL) of water. Within ten minutes, your heart rate should slow by about four beats per minute. By 15 minutes, you should be down by six or seven beats, as you can see in the graph below and at 2:42 in my video. 

    One of the ways scientists figured this out was by studying heart transplant patients. When you move a heart from one person to another, you have to sever all the attached nerves. Amazingly, some of the nerves grow back. But still, if you give healed heart transplant patients two glasses of water, their blood pressure goes up as much as 29 points. The body is unable to sufficiently quell the effect of that burst of noradrenaline. Some people have a condition known as autonomic failure, in which blood pressure regulation nerves don’t work properly and their pressures can skyrocket dangerously by more than 100 points after drinking about two cups (480 mL) of water. That’s how powerful an effect the simple act of drinking water can be. The only reason that doesn’t happen to all of us is that we have an even more powerful counter-response to keep our hearts in check. (This reminds me of the woman who had a stroke after taking the ice bucket challenge due to an insufficient diving reflex to tamp down all that extra noradrenaline release.)

    This remarkable water effect can be useful for people suffering from milder forms of autonomic failure, such as orthostatic hypotension, which is when people get dizzy after standing up suddenly. Drinking some water before getting out of bed in the morning can be a big help. What about that metabolic boost, though? With so much noradrenaline being released and your adrenal gland hormones in overdrive, might drinking a few glasses of water cause you to burn more body fat? Could tap water be a safe form of ephedra, giving us all the weight loss but with a nice slowing of our heart rate instead? Researchers decided to put it to the test, which we’ll explore next.

    If you missed the previous video, check out How to Get the Weight Loss Benefits of Ephedra Without the Risks.

    Stay tuned for What Is the Safest Metabolism Booster? and Friday Favorites: Optimizing Water Intake to Lose Weight.

    What kind of water is better? Find out in Is it Best to Drink Tap, Filtered, or Bottled Water?.



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  • Protein & GI issues in cancer

    Protein & GI issues in cancer

    Earlier this year, Certified Specialist in Oncology Nutrition, Valaree Williams presented “Managing gastrointestinal disturbances in cancer patients: Strategies for optimizing patient care.” Valaree is back to talk about the importance of protein for those going through cancer treatment and to continue answering YOUR questions from the webinar. Tune in to learn ways to make protein foods appealing when taste and appetite have been impacted by cancer treatment, how to address swallowing issues, and nuanced recommendations for diarrhea and constipation– there may be a case for marshmallows…​​

    Hosted by Kristin Houts

    Biography

    Valaree Williams, MS, RDN, CSO, LDN, CNSC, FAND, became a registered dietitian nutritionist in 2006 and has focused many years of her work on the provision of nutrition care to patients with cancer. She is currently employed as a clinical dietitian at Memorial Sloan Kettering Cancer Center in Middletown, New Jersey. Valaree serves in volunteer roles for the Academy of Nutrition and Dietetics, Commission on Dietetic Registration, and ASPEN, where she currently serves as the chair for CDR. Additionally, she has contributed to several oncology nutrition publications. 

    In this episode, we discuss:

    • Protein recommendations for cancer patients​

    • Modifications to meals and snacks for those with swallowing difficulty​

    • Fiber’s role in the management of treatment-induced diarrhea and constipation​

    • The collaborative nature of cancer care and integral role of the dietitian on a medical team

    Additional resources

    In case you missed it, you can watch Valaree’s presentation “Managing gastrointestinal disturbances in cancer patients: Strategies for optimizing patient care” here.​

    Supported by 

    The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.

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  • Ephedra-Like Weight Loss Minus the Risks 

    Ephedra-Like Weight Loss Minus the Risks 

    The diving reflex shows that it’s possible to have selective adrenal hormone effects.

    Thermogenic drugs like DNP can cause people to overheat to death; they can increase resting metabolic rates by 300 percent or more. A more physiological spread would range about ten times less, from a 30 percent slower metabolism in people with an underactive thyroid to a 30 percent higher metabolism when the part of our nervous system that controls our fight-or-flight response is activated. In response to a fright or acute stress, special nerves release a chemical called noradrenaline to ready us for confrontation. We experience this by our skin getting paler, cold, and clammy, as blood is diverted to our more vital organs. Our mouth can get dry as our digestive system is put on hold, and our heart starts to beat faster. What we don’t feel is the extra fat being burned to liberate energy for the fight.

    That’s why people started taking ephedra for weight loss—“to stimulate the release of noradrenaline from nerve endings.”

    Ephedra is an evergreen shrub. It’s been used in China for thousands of years to treat asthma because it causes that same release of noradrenaline that offers relief to people with asthma by dilating their airways. In the United States, it was appropriated for use as a metabolic stimulant, shown to result in about 2 pounds (0.9 kg) of weight loss a month in 19 placebo-controlled trials. By the late 1990s, millions of Americans were taking it. The problem is that it also had all the other noradrenaline effects, like increasing heart rate and blood pressure. So, chronic use resulted in “stroke, cardiac arrhythmia, and death.” The U.S. Food and Drug Administration warned of its risks in 1994, but ephedra wasn’t banned until a decade later after a 23-year-old Major League Baseball pitcher dropped dead. His “autopsy report revealed evidence of ephedra, which the medical examiner said contributed to his death.”

    In the current Wild West of dietary supplement regulation, not only can a supplement be “marketed without any safety data” at all, but the manufacturer is under no obligation to disclose adverse effects that may arise. No surprise, then, that online vendors assured absolute safety: “No negative side effects to date.” “No adverse side-effects, no nervous jitters or underlying anxiety, no moodiness…” “100% safe for long-term use.” “It will not interact with medications and has no harmful side effects.” The president of Metabolife International, a leading seller of ephedra, assured the FDA that the company had never received a single “notice from a consumer that any serious adverse health event has occurred…” In reality, it had received about 13,000 health complaints, including reports of serious injuries, hospitalizations, and even deaths. 

    If only there were a way to get the good without the bad. As I discuss in my video How to Get the Weight Loss Benefits of Ephedra Without the Risks, there is. But to understand it, you first have to grasp a remarkable biological phenomenon known as the diving reflex.

    Imagine walking across a frozen lake and suddenly falling through the ice, plunging into the freezing depths. It’s hard to think of a greater, instantaneous fight-or-flight shock than that. Indeed, noradrenaline would be released, causing the blood vessels in your arms and legs to constrict to bring blood back to your core. You can imagine how fast your heart might start racing, but that would be counterproductive because you’d use up your oxygen faster. Remarkably, what happens instead is your heart rate slows down. That’s the diving reflex, first described in the 1700s. Air-breathing animals are born with this automatic safety feature to help keep us from drowning.

    In medicine, we can exploit this physiological quirk with what’s called a “cold face test.” To determine if a comatose patient has intact neural pathways, you can apply cold compresses to their face to see if their heart immediately starts slowing down. Or, more dramatically, it can be used to treat people who flip into an abnormally rapid heartbeat. Remember that episode of ER where Carter dunked a patient’s face into a tray of ice water? (That show aired on TV when I was in medical school, and a group of us would gather around and count how many times they violated “universal precautions.”)

    What does this have to do with weight loss? The problem with noradrenaline-releasing drugs like ephedra is the accompanying rise in heart rate and blood pressure. What the diving reflex shows is that it’s possible to experience selective noradrenaline effects, raising the possibility that there may be a way to get the metabolic boost without the risk of stroking out. Unbelievably, this intricate physiological feat may be accomplished by the simplest of acts: Instead of drowning in water, simply drink it. Really? Yes, you can boost your metabolism by drinking water. Buckle your safety belts because you are in for a wild ride—one that continues next.

    This is the first in a four-part video series. Stay tuned for:

    You may also be interested in Friday Favorites: The Best Diet for Weight Loss and Disease Prevention.



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  • Epigenetics and Obesity 

    Epigenetics and Obesity 

    Identical twins don’t just share DNA; they also share a uterus. Might that help account for some of their metabolic similarities? “Fetal overnutrition, evidenced by large infant birth weight for gestational age, is a strong predictor of obesity in childhood and later life.” Could it be that you are what your mom ate?

    A dramatic illustration from the animal world is the crossbreeding of Shetland ponies with massive draft horses. Either way, the offspring are half pony/half horse, but when carried in the pony uterus, they come out much smaller, as you can see below and at 0:47 in my video The Role of Epigenetics in the Obesity Epidemic. (Thank heavens for the pony mother!) This is presumably the same reason why the mule (horse mom and donkey dad) is larger than the hinny (donkey mom and horse dad). The way you test this in people is to study the size of babies from surrogates after in vitro fertilization. 

    Who do you think most determines the birth weight of a test-tube baby? Is it the donor mom who provided all the DNA or the surrogate who provided the intrauterine environment? When it was put to the test, the womb won. Incredibly, a baby who had a thin biological mother but was born to a surrogate with obesity may harbor a greater risk of becoming obese than a baby with a heavier biological mother but born to a slim surrogate. The researchers “concluded that the environment provided by the human mother is more important than her genetic contribution to birth weight.”

    The most compelling data come from comparing obesity rates in siblings born to the same mother, before and after her bariatric surgery. Compared to their brothers and sisters born before the surgery, those born when mom weighed about 100 pounds less had lower rates of inflammation, metabolic derangements, and, most critically, three times less risk of developing severe obesity—35 percent of those born before the weight loss were affected, compared to 11 percent born after. The researchers concluded that “these data emphasize how critical it is to prevent obesity and treat it effectively to prevent further transmission to future generations.”

    Hold on. Mom had the same DNA before and after surgery. She passed down the same genes. How could her weight during pregnancy affect the weight destiny of her children any differently? Darwin himself admitted, “In my opinion, the greatest error which I have committed, has been not allowing sufficient weight to the direct action of the environment, i.e. food…independently of natural selection.” We finally figured out the mechanism by which this can happen—epigenetics.

    Epigenetics, which means “above genetics,” layers an extra level of information on top of the DNA sequence that can be affected by our surroundings, as well as potentially passed on to our children. This is thought to explain the “developmental programming” that can occur in the womb, depending on the weight of the mother—or even the grandmother. Since all the eggs in your infant daughter’s ovaries are already preformed before birth, a mother’s weight status during pregnancy could potentially affect the obesity risk of her grandchildren, too. Either way, you can imagine how this could result in an intergenerational vicious cycle where obesity begets obesity.

    Is there anything we can do about it? Well, breastfed infants may be at lower risk for later obesity, though the benefits may be confined to those who are exclusively breastfed, as the effect may be due to growth factors triggered by exposure to the excess protein in baby formula, as you can see below and at 3:51 in my video. The breastfeeding data are controversial, though, with charges leveled of a “white hat bias.” That’s the concern that public health researchers might disproportionally shelve research results that don’t fit some goal for the greater good. (In this case, preferably publishing breastfeeding studies showing more positive results.) But, of course, that criticism came from someone who works for an infant formula company. Breast is best, regardless. However, its role in the childhood obesity epidemic remains arguably uncertain.

    Prevention may be the key. Given the epigenetic influence of maternal weight during pregnancy, a symposium of experts on pediatric nutrition concluded that “planning of pregnancy, including prior optimization of maternal weight and metabolic condition, offers a safe means to initiate the prevention rather than treatment of pediatric obesity.” Easier said than done, but overweight moms-to-be may take comfort in the fact that after the weight loss in the surgery study, even the moms who gave birth to kids with three times lower risk were still, on average, obese themselves, suggesting weight loss before pregnancy is not an all-or-nothing proposition.

    What triggered the whole obesity epidemic to begin with? There are a multitude of factors, and I covered many of them in my 11-video series on the epidemic in the related posts below.

    We are what our moms ate in other ways, too. Check out: 



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  • High performance sports nutrition | Dietitian Connection


    Have you ever wondered what it’s like to be the Head of Nutrition for a professional cycling team? In this episode, we chat with James Moran, an experienced sports dietitian from the UK and Head of Nutrition for Uno-X Mobility Cycling Team. James shares his incredible journey from clinical dietetics to elite sports nutrition, revealing what it takes to fuel world-class endurance athletes. He dives into his role in supporting elite endurance athletes and how he navigates the unique challenges of high-performance nutrition at events like the Tour de France.

    Hosted by Brooke Delfino

    Biography

    James Moran MSc, PG Dip, is a Registered Dietitian (HCPC) and Performance Nutritionist (SENr) from Manchester, UK. James is currently Head of Nutrition with Uno-X Pro Cycling Team and a Visiting Fellow at Leeds Beckett University. Originally completing a BSc Sport and Exercise Science at Sheffield Hallam University in 2004, James went onto do further training with the University of Chester to become a state Registered Dietitian. After working clinically for over 10 years in a range of areas including type 1 diabetes, gastroenterology, surgery and intensive care, James completed an MSc Sport Nutrition at Liverpool John Moores University under Prof James Morton and Prof Graeme Close. James has worked with a variety of professional teams and individual athletes mostly specialising in endurance sports. Recently this has included providing nutrition support to Kevin Sinfield OBE on the Extra Mile and Ultra7 Challenges, Ineos Grenadiers Cycling Team, Science in Sport, British Cycling, Team GB and the English Institute of Sport at the Tour de France and Tokyo 2020 Olympics. James also provides nutritional consultancy to a range of individual athletes and clinical clients, professional sports teams, national governing bodies, university and industry clients.

     

    In this episode, we discuss:​

    • How James transitioned from clinical dietetics to elite sports nutrition
    • The key nutritional challenges in endurance athletes
    • James’ most memorable moments at the Tour de France
    • How to personalise nutrition strategies for athletes
    • Emerging trends and the role of technology in sports nutrition
      ​​

    Additional resources

    Are you craving a quick, impactful way to stay ahead in the nutrition world? Click here to learn more about Dietitian Connection’s NEW 30-minute Lunch & Learn sessions!


    The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.


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  • Treat Type 1 Diabetes with a Plant-Based Diet? 

    Treat Type 1 Diabetes with a Plant-Based Diet? 

    Is it possible to reverse type 1 diabetes if caught early enough?

    The International Journal of Disease Reversal and Prevention has already had its share of miraculous disease reversals with a plant-based diet. For instance, one patient began following a whole food, plant-based diet after having two heart attacks in two months. Within months, he experienced no more chest pain, controlled his cholesterol, blood pressure, and blood sugars, and also lost 50 pounds as a nice bonus. Yet, the numbers “do not capture the patient’s transformation from feeling like a ‘dead man walking’ to being in command of his health with a new future and life.” 

    I’ve previously discussed cases of reversing the autoimmune inflammatory disease psoriasis and also talked about lupus nephritis (kidney inflammation). What about type 1 diabetes, an autoimmune disease we didn’t think we could do anything about? In contrast to type 2 diabetes, which is a lifestyle disease that can be prevented and reversed with a healthy enough diet and lifestyle, type 1 diabetes is an autoimmune disease in which our body attacks our pancreas, killing off our insulin-producing cells and condemning us to a life of insulin injections—unless, perhaps, it’s caught early enough. If a healthy enough diet is started early enough, might we be able to reverse the course of type 1 diabetes by blunting that autoimmune inflammation?

    As I discuss in my video Type 1 Diabetes Treatment: A Plant-Based Diet, we know that patients with type 1 diabetes “may be able to reduce insulin requirements and achieve better glycemic [blood sugar] control” with healthier diets. For example, children and teens were randomized to a nutritional intervention in which they increased the whole plant food density of their diet—meaning they ate more whole grains, whole fruits, vegetables, legumes (beans, split peas, chickpeas, and lentils), nuts, and seeds. Researchers found that the more whole plant foods, the better the blood sugar control.

    The fact that more whole fruits were associated “with better glycemic [blood sugar] control has important clinical implications for nutrition education” in those with type 1 diabetes. We should be “educating them on the benefits of fruit intake, and allaying erroneous concerns that fruit may adversely affect blood sugar.”

    The case series in the IJDRP, however, went beyond proposing better control of just their high blood sugars, the symptom of diabetes, but better control of the disease itself, suggesting the anti-inflammatory effects of whole healthy plant foods “may slow or prevent further destruction of the beta cells”—the insulin-producing cells of the pancreas—“if dietary intervention is initiated early enough.” Where did this concept come from?

    A young patient. Immediately following diagnosis of type 1 diabetes at age three, a patient began a vegetable-rich diet and, three years later, “has not yet required insulin therapy…and has experienced a steady decline in autoantibody levels,” which are markers of insulin cell destruction. Another child, who also started eating a healthier diet, but not until several months after diagnosis, maintains a low dose of insulin with good control. And, even if their insulin-producing cells have been utterly destroyed, individuals with type 1 diabetes can still enjoy “dramatically reduced insulin requirements,” reduced inflammation, and reduced cardiovascular risk, which is their number one cause of death over the age of 30. People with type 1 diabetes have 11 to 14 times the risk of death from cardiovascular disease compared to the general population, and it’s already the top killer among the public, so it’s closer to 11 to 14 times more important for those with type 1 diabetes to be on the only diet and lifestyle program ever proven to reverse heart disease in the majority of patients—one centered around whole plant foods. The fact it may also help control the disease itself is just sugar-free icing on the cake.

    All this exciting new research was presented in the first issue of The International Journal of Disease Reversal and Prevention. As a bonus, there’s a companion publication called the Disease Reversal and Prevention Digest. These are for the lay public and are developed with the belief I wholeheartedly share that “everyone has a right to understand the science that could impact their health.” You can go behind the scenes and hear directly from the author of the lupus series, read interviews from luminaries like Dean Ornish, see practical tips from dietitians on making the transition towards a healthier diet, and enjoy recipes. 

    The second issue includes more practical tips, such as how to eat plant-based on a budget, and gives updates on what Dr. Klaper is doing to educate medical students, what Audrey Sanchez from Balanced is doing to help change school lunches, and how Dr. Ostfeld got healthy foods served in a hospital. (What a concept!) And what magazine would be complete without an article to improve your sex life? 

    The journal is free, downloadable at IJDRP.org, and its companion digest, available at diseasereversaldigest.com, carries a subscription fee. I am a proud subscriber.

    Want to learn more about preventing type 1 diabetes in the first place? See the related posts below.



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  • The Largest Study on Fasting in the World 

    The Largest Study on Fasting in the World 

    The Buchinger-modified fasting program is put to the test.

    A century ago, fasting—“starvation, as a therapeutic measure”—was described as “the ideal measure for the human hog…” (Fat shaming is not a new invention in the medical literature.) I’ve covered fasting for weight loss extensively in a nine-video series, but what about all the other purported benefits? I also have a video series on fasting for hypertension, but what about psoriasis, eczema, type 2 diabetes, lupus, metabolic disorder, rheumatoid arthritis, other autoimmune disorders, depression, and anxiety? Why hasn’t it been tested more?

    One difficulty with fasting research is: What do you mean by fasting? When I think of fasting, I think of water-only fasting, but, in Europe, they tend to practice “modified therapeutic fasting,” also known as Buchinger fasting, which is more like a very low-calorie juice fasting with some vegetable broth. Some forms of fasting may not even cut calories at all. As you can see below and at 1:09 in my video The World’s Largest Fasting Study, Ramadan fasting, for example, is when devout Muslims abstain from food and drink from sunrise to sunset, yet, interestingly, they end up eating the same amount—or even more food—overall.

    The largest study on fasting to date was published in 2019. More than a thousand individuals were put through a modified fast, cutting daily intake down to about ten cups of water, a cup of fruit juice, and a cup of vegetable soup. They reported very few side effects. In contrast, the latest water-only fasting data from a study that involved half as many people reported nearly 6,000 adverse effects. Now, the modified fasting study did seem to try to undercount adverse effects by only counting reported symptoms if they were repeated three times. However, adverse effects like nausea, feeling faint, upset stomach, vomiting, or palpitations were “observed only in single cases,” whereas the water-only fasting study reported about 100 to 200 of each, as you can see below and at 2:05 in my video. What about the benefits though?

    In the modified fasting study, participants self-reported improvements in physical and emotional well-being, along with a surprising lack of hunger. What’s more, the vast majority of those who came in with a pre-existing health complaint reported feeling better, with less than 10 percent stating that their condition worsened, as you can see in the graph below and at 2:24 in my video. 

    However, the study participants didn’t just fast; they also engaged in a lifestyle program, which included being on a plant-based diet before and after the modified fast. If only the researchers had had some study participants follow the healthier, plant-based diet without the fast to tease out fasting’s effects. Oh, but they did! About a thousand individuals fasted for a week on the same juice and vegetable soup regimen and others followed a normocaloric (normal calorie) vegetarian diet.

    As you can see below and at 2:54 in my video, both groups experienced significant increases in both physical and mental quality of life, and, interestingly, there was no significant difference between the groups.

    In terms of their major health complaints—including rheumatoid arthritis; chronic pain syndromes, like osteoarthritis, fibromyalgia, and back pain; inflammatory and irritable bowel disease; chronic pulmonary diseases; and migraine and chronic tension-type headaches—the fasting group appeared to have an edge, but both groups did well, with about 80 percent reporting improvements in their condition and only about 4 percent reporting feeling worse, as you can see below and at 3:25 in my video. 

    Now, this was not a randomized study; people chose which treatment they wanted to follow. So, maybe, for example, those choosing fasting were sicker or something. Also, the improvements in quality of life and disease status were all subjective self-reporting, which is ripe for placebo effects. There was no do-nothing control group, and the response rates to the follow-up quality of life surveys were only about 60 to 70 percent, which also could have biased the results. But extended benefits are certainly possible, given they all tended to improve their diets, as you can see below and at 4:00 in my video.

    They ate more fruits and vegetables, and less meats and sweets, and therein may lie the secret. “Principally, the experience of fasting may support motivation for lifestyle change. Most fasters experience clarity of mind and feel a ‘letting go’ of past actions and experiences and thus may develop a more positive attitude toward the future.”

    As a consensus panel of fasting experts concluded, “Nutritional therapy (theory and practice) is a vital and integral component of fasting. After the fasting therapy and refeeding period, nutrition should follow the recommendations/concepts of a…plant-based whole-food diet…”

    If you missed the previous video, check out The Benefits of Fasting for Healing.



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