Alon Blumgart, Author at Baobab Health

Less focus on diagnoses and more focus on lifestyle changes

Less focus on diagnoses and more focus on lifestyle changes

In today’s medical model, we are so focused around diagnosing/labelling people with health issues, so we can prescribe a drug or give a “treatment.”

While some life threatening cases and acute cases require a quick diagnoses and treatment, most of the time, the issues that people are suffering from these days are chronic health issues that if they progress far enough, can result in the need for life saving treatments.

Therefore, rather than placing all of our emphasis on signs and symptoms to diagnose and label someone with a disease or health issue, more importantly, we should be focussing on examining the inconsistencies around peoples diet and lifestyle habits first.

This is because we know that most chronic health issues are caused by an interplay of genetics with diet and lifestyle habits. They are also exacerbated by poor diet and lifestyle habits. This means that sometimes, the diagnosis is irrelevant. If a person presented with a chronic health issue and the individuals diet and lifestyle habits were examined through questioning, there would likely be some inconsistencies around their diet habits, sleep habits, exersize habits, stress levels, smoking and alcohol intake. This means that regardless of the diagnosis, these lifestyle habits need to be addressed first in order to treat the underlying causes of the heath issue at hand. Prescribing medications will simply patch up symptoms, which is not a long term solution as the real drivers of the health issue are still manifesting. This leads to decreased effectiveness of medications, side effects as well as increased medication doses over time for symptoms that progressively get worse due to unresolved underlying drivers (i.e. diet and lifestyle habits).

Medications may need to be used to get rid of uncomfortable or life threatening symptoms, as well as decrease disease risk factors, however they should always be prescribed in conjunction with sustainable diet and lifestyle coaching. Once these underlying factors are improved and symptoms start to reduce, we can then look to wean people off the medications. At best, we can reduce the doses/amounts. This is so people do not stay on these medications at high doses for long periods of time due to their damaging effects and sometimes harsh side effects.

Addressing diet and lifestyle factors first and seeing what symptoms resolve from these changes, would in turn save peoples time, money and stress from bouncing around to different doctors and specialists to get a diagnosis. Once the person is relatively consistent around their diet and lifestyle, if some symptoms are still persisting, it may then be prudent to get more specific around treatment and testing.

For example, if a person is overweight and presents with a whole host if peculiar symptoms that don’t fit into a neat category of a specific “diagnosis.” Rather than sending them for testing and trialling certain pharmaceutical treatments in order to put a label on their symptoms, it is more important to first address the diet and lifestyle factors that are driving the weight gain. Research has shown time and time again that weight loss, via good diet and lifestyle habits significantly improves health markers and parameters. Therefore, it is likely that losing weight will improve their peculiar symptoms. This saves peoples time and money to try and find a “diagnosis.”

Why do doctors not treat with diet and lifestyle medicine?

Doctors diagnose and treat health issues with medications and/or surgery. They are not trained in changing people’s diet and lifestyle, as well as understanding how their diet and lifestyle could be causing/exacerbating a person’s health issues. They also work in a time restricted medical model, so even if they wanted to help change a person’s diet and lifestyle, most doctors’ consults are 15-30 minutes, therefore they don’t have time to coach people even if they wanted to. They may say something in passing to patients, but this is not going to stick as the person needs to be told how to change their diet and lifestyle. They need to be guided.

Also, due to the “pill for ever ill” nature of the medical industry, many people walk into doctors’ offices and have expectations of receiving a “treatment”  – as they may not recognise the connection between their lifestyle and health, as well as the fact that it is much harder to change diet and lifestyle habits. The doctor is seen as the “healer” rather than a “coach” that can help facilitate behaviour change around peoples diet and lifestyle. This is not only at doctors’ offices, a lot of the time it occurs in offices of manual therapists (e.g. physiotherapist). People want to be treated with massage, needless, stretching etc., rather than changing their diet and lifestyle habits that are likely contributing  musculo-skeletal issues. This may also be due to a lack of knowledge on both the client and practitioners part of how diet and lifestyle habits can effect joint, bone and muscle health.

In conclusion, our medical model needs to start treating the inconsistencies in peoples diet and lifestyle habits before we become fixated on diagnosing them with a health issue or disease that will ultimately result in a prescription, without addressing the underlying causes. Treating underlying causes will ultimately lead to better results and decrease the need for using individual drugs for every different presenting symptom. Treating underlying causes of health issues via lifestyle change leads to the resolve of symptoms on their own.

8 Evidence based foods and supplements that are good for your cardiovascular health

8 Evidence based foods and supplements that are good for your cardiovascular health

Cardiovascular disease is one of the most common causes of death in the western world. It used to be thought that dietary saturated fat, and cholesterol were the main drivers behind this growing epidemic, however recent evidence has shown otherwise.

I wrote a 3 part series about cardiovascular disease and explained why saturated fat and cholesterol are not the main drivers behind heart disease. I also outlined how our conventional treatment of the disease using cholesterol-lowering drugs (i.e. statins) is inadequate and we need to rethink how we approach this disease from a diet and lifestyle perspective.

If you are at risk of heart disease or already have heart disease, I believe it is important to seek a qualified health professional who is aware of the current research and is willing to help you make diet and lifestyle changes that will reduce your risk of any cardiovascular events. These changes should first start off with addressing the 4 pillars of health, diet, sleep, exerszie and stress management.

Furthermore, incorporating some heart healthy, cardio-protective foods and supplements would also be of great benefit. This post will outline these foods and supplements, which I believe are of particular importance for anyone at risk or suffering from heart disease.

So here it is, my top 8 foods and supplements that you should incorporate if you are at risk or suffering from heart disease:  

CoQ10 – 150-300mg per day:

Is a coenzyme that plays many important physiological functions in the body. It is naturally synthesized by the body but production decreases as we get older and in certain diseases. It plays a key role in energy production and is a potent anti-oxidant.

Because of its anti-oxidant capacities, it can protect LDL particles in the blood from being oxidized and causing plaque build up.

In simplistic terms, LDL or the so-called “bad cholesterol” is actually a molecule that carries cholesterol and other nutrients like CoQ10 around the body. LDL particles become an issue when they “crash” into the walls of our arteries, as this starts a cascade leading to cholesterol deposits in the blood vessels that cause blockades. So basically, CoQ10 prevents LDL particles from “crashing” into our artery walls and causing plaque build up.

CoQ10 has also been shown to assist with reducing blood pressure, which is a risk factor for cardio vascular disease.

Lastly, anyone taking a statin should always be taking CoQ10 supplements. This is because statins decrease the production on CoQ10 in the body, and this coenzyme is crucial for protecting us from heart disease. Many of the side effects associated with statin use (i.e. fatigue, muscle pain/fatigue and diabetes) are due to the depletion of CoQ10.

It is a very safe and effective supplement.

Garlic: 600 – 1,200mg/day of a garlic extract supplement or 2-3 cloves per day:

Garlic decreases blood clotting, inflammation, blood pressure and improves our cholesterol levels. It has been shown to decrease LDL and triglycerides, while increasing HDL. Incorporating garlic into the diet as well as taking a garlic extract supplement, is a great idea for anyone who is at risk of heart disease or has heart disease.

It is a very safe and effective supplement.

Cucumin: 80-500mg/day of supplemental curcumin:

Curcumin is the yellow pigment associated with the curry spice, Turmeric. It is a small molecule that exerts potent anti-inflammatory effects, which is therefore protective against heart disease as heart disease has inflammation at the core of its pathogenesis.

It is also heart healthy by supporting the hearts electrical functions, decreasing blood pressure and reducing lipid and plaque levels in arteries, and both reducing the risk of diabetes and being a good treatment for the side-effects associated with diabetes.

It has a poor oral bioavailability (a low percentage of what you consume is absorbed into the blood) and thus should be taken in supplemental form that has other compounds in it that enhance its absorption.

It is a very safe and effective supplement.

Oleic acid:

Oleic acid is a monounsaturated fatty acid that is primarily found in olives, olive oil, avocado and nuts. It is a cardio-protective fat that has been shown to decrease LDL oxidation as well as improving our lipid markers. Therefore if you have or are at risk of heart disease make sure you add oleic acid containing foods into your diet.

Magnesium: 400 – 800mg/day:

Magnesium deficiency is a very common nutrient deficiency and is one of those nutrients that most people should be supplementing with. It is an important nutrient for people at risk of heart disease because magnesium deficiency can result in high blood pressure and insulin resistance, which in turn increases blood glucose levels. Increased blood glucose levels are the hallmark feature of diabetes, which is a large risk factor for heart disease. Magnesium is found in nuts, cacao and seeds.

It is a very safe and effective supplement.

Leafy greens and beetroot:

These foods are high in chemicals called nitrites, which is a precursor to a molecule called nitric oxide. Nitric oxide helps dilate our blood vessels in order to decrease blood pressure. It also acts as an anti-oxidant and anti-clotting agent in our blood vessels, which in turn decreases the chances of LDL particles crashing and blood clots forming.

Oleurepin:

Is a plant phenolic found in olive oil and olives. It has been shown to decrease blood pressure and be extremely good at preventing LDL particles from crashing into our arteries. So if you have or are at risk of heart disease, up your intake of olives and olive oil!

L-Carnitine: 500 – 2,000mg per day:

L-Carnitine is naturally produced by the body and is an important molecule in energy production. It helps to decrease blood pressure as well as decreasing blood glucose levels.

It is a very safe and effective supplement.

Wrap up:

While these supplements can be therapeutic for anyone who is suffering from or is at risk of heart disease, there is no replacement for a healthy diet and lifestyle.

Statins: Not the miracle drug they were once thought to be

Statins: Not the miracle drug they were once thought to be

Before reading this post, I suggest you take a look at my 3 part series, explaining the real underlying causes of heart disease.

What are statins?

Statins are the most popular drugs in history. Drug companies made $26 billion selling statins alone in 2008. Millions of Australians are taking statins every year and the numbers are growing. You think their could be some invested interest here??????

Statins are a class of drugs widely used to lower cholesterol levels in the blood. They inhibit certain pathways that lead to cholesterol synthesis in the body. One way they work is by blocking the actions of an enzyme called HMG-CoA reductase that is needed for the production of cholesterol in the liver. In Australia they include:

  • atorvastatin
  • fluvastatin
  • pravastatin
  • simvastatin
  • rosuvastatin.

These are the generic (chemical) names. They are marketed under a variety of trade names such as, Crestor, Lipex, Lipitor and Pravachol.

They are indeed among the most commonly prescribed drugs in the world. However they are not the wonder drug that they are made out to be.

It is the inefficient metabolism (uptake) of LDL particles carrying cholesterol that cause cholesterol levels in the blood to be high, not an overproduction. Therefore, drugs that suppress cholesterol production (i.e statins) are not addressing the underlying cause of the problem and are treating the symptoms, which are just a manifestation of the underlying problem.

Decreasing the production of cholesterol, which is so important to the body, can be very dangerous. This is why these drugs have some serious side effects.

Furthermore, if you have still have high triglycerides and your LDL uptake is still compromised, decreasing cholesterol production will unlikely decrease the amount of LDL particles floating in your blood. It will certainly decrease the cholesterol passengers in these lipoproteins, however it will not decrease the amount of lipoproteins (cars) in the blood as these lipoproteins carry other things apart from cholesterol.

Small, dense LDL particles (cars) which are more likely to oxidize, will be unaffected by statins and cholesterol reduction. Therefore, they will not dramatically decrease your risk of heart disease because as we have discussed, elevated LDL particles and the oxidation (crashing) of these particles are the driving factors behind heart disease, not cholesterol production. By taking these drugs they will for sure show a decrease in cholesterol (passengers) on a blood lipid test, which is why they are such a popular drug for doctors, because it is believed that high cholesterol is the cause of heart disease.

Statins are not a miracle drug!

Due to the reasons discussed above, it is understandable why statins have not significantly been shown to prevent heart attacks and deaths from heart disease in those without pre-existing heart disease.

This is shown in an analysis by Dr. David Newman in 2010, which drew on large meta-analyses of statins. He found that statins do reduce the risk of heart disease among those with pre-existing heart disease that took statins for 5 years. However the results were very modest:

  • 96% saw no benefit at all
  • 1.2% (1 in 83) had their lifespan extended (were saved from a fatal heart attack)
  • 2.6% (1 in 39) were helped by preventing a repeat heart attack
  • 0.8% (1 in 125) were helped by preventing a stroke
  • 0.6% (1 in 167) were harmed by developing diabetes
  • 10% (1 in 10) were harmed by muscle damage.

There’s little doubt that statins are effective in reducing heart attacks and deaths from heart disease in people who already have heart disease. However, this is not due to their cholesterol lowering effects, rather, statins help dilate blood vessels, reduce blood clotting and they prevent plaques from dislodging and causing blockages in the brain, lungs and heart. They also have anti-inflammatory/antioxidant properties (which we know chronic inflammation drives heart disease), which is why they help people with existing heart disease. Although statins may lower cholesterol levels, they will not have any significant impact of particle numbers or density of particles (i.e. number of cars).

Dr. David Newman also found that that statins do reduce the risk of cardiovascular events in people without pre-existing heart disease. However, this effect is very, very, very modest modest.

  • 98% saw no benefit at all
  • 1.6% (1 in 60) were helped by preventing a heart attack
  • 0.4% (1 in 268) were helped by preventing a stroke
  • 1.5% (1 in 67) were harmed by developing diabetes
  • 10% (1 in 10) were harmed by muscle damage

Also, statins have been shown to be extremely ineffective in preventing heart disease in women with particular risk factors.

The only demographic that they seem to help is men over 65 with pre-existing heart disease. However, this is the issue with research sometimes, we generalize results of a certain sub group of the population, to the whole population.

Lastly, although statins may decrease the risk of heart disease in some people, it does not have an effect of their overall mortality. So while your risk of heart disease may be slightly lower, you may be at risk from dying from another condition.

The adverse side effects of statins

Not only do statins interfere with the production of cholesterol, but they also interfere with the body’s production of Co enzyme Q10. This enzyme is firstly one of the anti-oxidants that the liver packages LDL particles with, which helps protect us from heart disease. It is also very important for energy production in the body and especially the functioning of your muscles. Therefore, many people on statins experience muscle aches and pains, which is due to the blocking of Co enzyme Q10. Furthermore, your heart is the most important muscle in your body, therefore it too can suffer from inadequate amounts of CoQ10, and people on statins have experienced heart failure.

A lot of the time people don’t realize how important cholesterol is to our body. We would die without it. I discussed in previous posts that those with high cholesterol levels usually have a decreased uptake of cholesterol into cells (decreased parking) as it is, therefore, when these individuals are given a statin to block cholesterol production, MANY vital functions in the body are severely compromised due to a cholesterol deficiency!

Lets take a look at some of the functions of cholesterol, in order to see how detrimental it can be to block the production of this important molecule.

  • Cholesterol is needed for the production of bile salts, which helps you absorb fats, vitamins (A,D,E,K) and caretenoids from your diet. Some of these vitamins and caretenoids are anti-oxidants which help to protect us from things like heart disease and help protect our LDL  from oxidation.
  • Cholesterol is needed for the synthesis of vitamin D. The absolute importance of vitamin D to health cannot be explained in one dot point, but just know it is super important and most people are deficient. Deficiencies in vitamin D have been linked to a whole range of diseases. Decrease calcium, increase OP. Increase risk T2DM.
  • Cholesterol is needed for serotonin uptake in the brain. Serotonin is our “feel good” hormone and it helps regulate our mood. People on statins have experienced depression because of the reduced amount of cholesterol.
  • Cholesterol is found in the cell membrane of every cell in our body, giving the cell wall rigidity and stability.
  • Cholesterol is an integral part of myelin sheaths, which insulate nerves in our body to help make nerve impulses smooth and efficient. Therefore with a lack of myelin around nerves people can experience severe cognitive impairment, mental disorders and brain fog. It also helps form new connections between neurons, allowing us to form memories and learn new things.
  • Cholesterol is a major part of brain tissue and needed for optimum brain function. This is why people on statins have often experienced brain issues like memory loss, brain fog and Alzheimer’s.
  • Cholesterol has shown to actually be an anti oxidant, which is why we produce more of it as we age.
  • Cholesterol is needed to synthesise all of the hormones produced by our adrenal glands such as aldosterone, cortisol, cortisone and androgens. These hormones help us deal with stress.
  • Cholesterol is also needed to make all our sex hormones like testosterone and estrogen. Therefore people on statins have had side effects of impotence, infertility, low sperm production, low libido, irregular menstrual cycles in women and decreased bone density in women.

Because cholesterol has such a diverse number of functions in the body, the amount of cholesterol that is produced on a day to day basis fluctuates greatly. Therefore depending on the day you took your cholesterol test may be the difference between you being put on a statin or not.

For example if you are stressed, your cholesterol levels may be high because you need cholesterol to synthesise cortisol, which is a stress hormone. Therefore the body produces more of it. The range may be higher compared to your last lipid test which could prompt your doctor to put you on a statin.

Another example can be seen in women during menopause. Because their estrogen levels drop, more cholesterol levels are produced to try and compensate. Therefore, it is no surprise that many women are put on a statin around menopause.

Also, what most people don’t know it that on any given day, your total cholesterol levels can fluctuate up or down by 0.9mmol/L. Your LDL levels can fluctuate up or down by 0.7. Also, your triglycerides can fluctuate up or down by 1. Research shows that if you get a blood lipid test one day and then a few months later get another, if your total cholesterol has gone up or down by more than 0.9 mmol/l, only then you can be 95% sure that cholesterol production in your body has actually increased or decreased rather than just a normal fluctuation that occurs on a day to day basis. The scary thing is that when doctors notice these large fluctuations, only after two blood tests, which can be perfectly normal, they might put a person on a statin. This is because these fluctuation are large enough for a doctor to warrant the prescription of a statin.

Although lipid tests are a good marker for heart disease, they are just a marker at the end of the day, not a disease. To determine a person’s risk of heart disease, it is necessary to look at the whole person. For example, a person with high cholesterol levels who eats well, lives a low stress lifestyle, sleeps 8 hours a night, exercises regularly, doesn’t smoke, drink or have high blood pressure would be at a much lower risk of heart disease then a person who is highly stressed, eats poorly, is sleep deprived, hardly exercises, sits all day, has high blood pressure, smokes and drinks. We must analyze risk factors in the context of the persons life.

Wrapping it up

I hope this series of posts has given you a new perspective on the whole cholesterol saga. If you could be at risk of heart disease or already have heart disease, I urge you to find a health practitioner that is aware of the new research about cholesterol and heart disease that I have outlined in these posts. And one that is wiling to take a holistic approach to your treatment and address underlying diet and lifestyle factors before turning to medications.

Thanks for reading and I hope you enjoyed!

Anxiety and Depression: Why a more holistic approach is needed for treatment

Anxiety and Depression: Why a more holistic approach is needed for treatment

Anxiety and depression are two of the most common mental health disorders that affect people, from all walks of life, worldwide. In fact, depression is one of the most common causes of disability worldwide.

For decades we have tried to treat these mental health issues with medications that target one or two neurotransmitters (brain chemicals) as some research has suggested that low amounts of certain neurotransmitters may be responsible for causing anxiety and depression. While this is true, it is only a snippet of the broader picture.

These treatments have failed as depression and anxiety rates are still on the rise.  Furthermore, anti-depressants have been shown to be no more effective than placebo.

Why is this you may ask?

It is because we have been trying to treat a complex, multifaceted disease, that involves a complex interaction between genes, diet, lifestyle and environmental factors, with one drug and only targeting one pathway in the brain. Mental health issues are far too complex for such simplistic treatment and they require multifaceted treatments to address the underlying causes.

If you suffer from anxiety or depression, consider booking in an experienced holistic health practitioner (e.g. naturopath), who will help you identify the underlying physiological drivers of depression and anxiety, as well as the social/environmental factors. Find someone who will take a holistic approach to your treatment (using referrals if need be). Treatment should always involve diet and lifestyle interventions (with potential for herbal and nutritional supplementation), as well as psychological interventions that will help address these underlying causes. This may require the help of two or more practitioners.

How to extend your life by 13 years: The future of medicine in this post

How to extend your life by 13 years: The future of medicine in this post

A recent study published in the Journal Circulation found that adopting the following six healthy lifestyle habits can extend lifespan by about 13 years and quality of life, on average:

1) Not smoking
2) Getting adequate, restful sleep (7 – 8 hours)
3) Maintaining a healthy BMI
4) Not drinking excessively
5) Doing at least 30 minutes a day of moderate to vigorous physical activity
6) Eating a healthy diet (loosely defined – assumed as a minimally processed diet consisting of both plant and animal foods)

That’s no small effect! 13 years is a long time. Nothing fancy here and no magic bullet sold by a superficial instagram model. Doing healthy habits consistently is what increases longevity and health.

I would even add to this list and put in:

– stress management techniques
– having meaningful social connections with family and friends
– having fun and spending time in the sun and nature

Despite this information, very few Australians are engaging in this list of the top six health behaviours. We know this because when these behaviours are not followed, chronic disease ensues and chronic disease is our major health concern at the moment.

Chronic diseases like dementia, heart disease, cancer and lung diseases caused by smoking are the main causes of death in the developed world. Not shark attacks, not car crashes and not pianos falling on people’s heads. The main thing that is killing us prematurely are chronic diseases that are largely in our control to prevent. They can be significantly reduced and also TREATED by doing healthy diet and lifestyle habits consistently. And while it is true that despite the chronic disease rates, the average lifespan has increased due to medical advancements that keep us alive, however our quality of life into our old age is reduced by fragile bodies and minds.

But why do people struggle to follow these simple habits?

Most people KNOW they should be engaging in these behaviours. It has been repeated to us over and over again through various sources.

I can guarantee you that anyone who smokes these days know that it increases their risk of disease and death significantly. They just need to look at the packaging.

So why is it so uncommon that these behaviours are followed?

The problem is not the INFORMATION, it’s BEHAVIOUR. And the mistake we’ve made—and continue to make—is assuming that just providing more information is enough to change people’s behavior. However, that is not it, we need health practitioners and health programs (in schools and workplaces) that are willing to engage with people in treatment plans that help the CHANGE their behaviours, which are hard to do, despite people knowing the information. The choices we make around our health are not always logically driven, which is why people engage in unhealthy behaviours. Therefore, providing “logical” information is not the answer, we need to help people change their behaviour cycles.

 

Simply telling people in a consult room (under time pressure) that their behaviours are unhealthy and they need to change them is not going to elicit the desired result. It is not like they haven’t heard it before.

What people really need is to be coached on HOW to change their behaviours in measurable and sustainable manner. This is the future of medicine. No magic pills and no shmick products sold by profit driven companies

This also takes time, more than a quick 15 minute consult, which most doctors have for consults. So even if they wanted to help people change behaviors, they are pressured for time, especially in bulk billing services where they must hit a certain number of patients per day for government funding.

Changing your diet and lifestyle ain’t fancy and it can’t be “sold” as a product, but it will work. Better yet, it will save lives, increase longevity and health into our old age. The combination of modern medicine with healthy diet and lifestyle behaviours is a recipe for a long life! consistency and time

I often wonder what is the point of life. I will never know the answer, however one thing is for sure, seeking out the things that make me happy sure does feel good and I would love to live as long as possible to enjoy all the goodness with an abled body and mind. Because really, at the end of the day, through all the materialism and crap of our modern world, if you don’t have your health, what do you have? Without your health, you can’t live your best life, even if you had all the money in the world. This is why I love helping people change their behaviours to increase their lifespan, longevity and quality of life.

It is not too late to change these behaviours, extended your lifespan and decrease the risk of disease. Start now by finding someone who can help you change your habits.

 

Clearing up the misunderstanding around cholesterol, saturated fat and heart disease: Part 3

Clearing up the misunderstanding around cholesterol, saturated fat and heart disease: Part 3

Assessing your risk of heart disease and why cholesterol lowering drugs will have a negligible effect on decreasing your risk

There are ways to look at your standard lab cholesterol tests and determine the types of LDL particles in your blood. However it must also be noted that lipid results should always be examined in the context of a persons diet and lifestyle. At the end of the day those lipid results are just markers and we are treating the person, not their cholesterol levels.

We know that 90% of heart disease is driven by diet and lifestyle factors. Therefore, “bad” lipid markers in the context of an unhealthy diet and lifestyle will increase the risk of heart disease.

If a person smokes, drinks a lot, doesn’t exercise much, has a poor diet, stresses a lot, doesn’t get adequate amounts of sleep and has a family history of HD, they are at a greater risk of a cardiovascular event compared to someone that may or may not have a family history but lives healthy diet and lifestyle.

Furthermore, we know that these poor diet and lifestyle habits increase the amount of small LDL (cars), decrease large LDL 9busses) and decreases LDL receptor function (parking spaces), hence increasing the risk of HD. Where as good diet and lifestyle habits increase the amount of busses and increases parking spaces (even if passenger numbers increase or stay the same).

When a doctor looks at your bloods tests they mainly look at your total cholesterol, LDL and triglycerides.

NOTE: Think of triglycerides as luggage in the cars or busses. The more luggage there is, the more vehicles there will have to be. Triglycerides increase due to being overweight, having poor insulin sensitivity and high consumption of processed foods.

Doctors will prescribe cholesterol-lowering drugs if your LDL and total cholesterol levels are high, with little investigation into your diet and lifestyle, despite good HDL levels and whether or not these LDL are big or small.

Therefore, a person may have high cholesterol and LDL but all the cholesterol is in busses and their diet and lifestyle is good, therefore the HD risk will be low. Hence a statin should not be prescribed, as these drugs are not harmless.

Even if someone has high cholesterol and LDL levels, which may be in the form of small particles, it is unlikely that statins will protect them from a cardiovascular event anyway.

Statin prescriptions are on the rise due to the HD epidemic, however this hasn’t changed heart disease rates. One would think that if stains are effective, increased prescriptions based on high cholesterol levels, would lower heart disease rates, but this is not the case. Increased statin prescriptions has not prevented HD rates. This is because as mentioned above, HD is mainly a diet and lifestyle disease, and while genetic factors play a small role, they will only manifest themselves in the backdrop of a poor diet and lifestyle. Statin use is not going to change someones unhealthy habits.

Therefore the prescription of a statin, without diet and lifestyle interventions, is basically pointless. Stains will decrease the amount of passengers (decreases cholesterol from the liver) on the road, but it will have a negligible effect on the amount of cars on the road and no effect on parking space. This means that statins don’t change the amount of LDL floating in the blood, it may just reduce passengers.

Diet and lifestyle factors are much stronger risk factors for HD than cholesterol levels, which is why lipid results must always be interpreted in the context of a persons diet and lifestyle. There is an association between increased LDL and HD. However, this is usually if the LDL represents mostly cars and not busses, which is determined by your diet and lifestyle anyway.

Lastly, as mentioned above, while there is little evidence to say that statins prevent HD based on high cholesterol levels, there is some evidence to say that if a person has already suffered a cardiovascular event, statins may decrease the risk of reoccurrence. This is mainly shown in men over the age of 60.

How to interpret your blood test to assess your heart disease risk

So lets talk a little bit more about interpreting blood tests to determine if you have cars or busses in your blood.

Recent research has shown that if you divide your LDL by your HDL, your total cholesterol by your HDL and your triglycerides by your HDL, this will give values that are more indicative of heart disease risk as they give insight into the size of your LDL particles. Ultimately you want all these values to sit below 3.8. And as you can see, within all these equations HDL is the denominator. So if HDL (commonly known as the “good cholesterol”) is high, it will keep the ratio low. Even if total cholesterol, LDL and triglycerides are high. So we can think of HDL as also being busses that help to transport passengers back to their home, after they have gone to their destination. As mentioned above, HDL take cholesterol back to the liver and clears the blood of cholesterol. Good diet and lifestyle habits increase HDL. Increases in HDL with increases in HDL cancel each other out.

In the conventional medical realm, there is emphasis put on HDL levels, however doctors will normally prescribe statins based on LDL, triglycerides and total cholesterol. This is despite your levels of HDL and the ratios.

Yes the paradigm is slowly shifting, but it is still taking time and most doctors will want your LDL and total as low as possible and they will do this with medication. While having a lack of regard for the importance of cholesterol’s functions in the body.

Which brings me to my next point, that lowering cholesterol to very low levels can increase the risk of many other health issues, which is why stains carry so many side effects.

Because of the high amounts of cholesterol in the brain, low levels and chronic statin use can lead to (and exacerbate) depression, anxiety and other mood issues, as well as dementia. It can decrease vitamin D levels, therefore increasing the risk of many health issues associated with vitamin D deficiency such as osteoporosis, diabetes and HD! Cholesterols role in sex hormone production can lead to a vast array of issues associated with low sex hormones.

Lastly, statins also increase the risk of diabetes, which is one of the strongest risk factors for developing HD.

Wrapping it up

Hopefully in the near future enough studies will be published to convince the medical model to change the way we address HD because as you can see, it is a diet and lifestyle disease, therefore the treatment requires diet and lifestyle interventions.

While most people know they need to change their diet and lifestyle, they often don’t know HOW, which is why health practitioners need to start helping patients at risk of HD to facilitate behavior change.

After reading this three part series, I highly recommended you find a practitioner who is willing to work alongside you to change aspects of your diet and lifestyle that you may lack consistency around, such as your diet, sleep, stress levels, exercise, smoking and alcohol consumption.

Clearing up the misunderstanding around cholesterol, saturated fat and heart disease: Part 2

Clearing up the misunderstanding around cholesterol, saturated fat and heart disease: Part 2

In the last post, we spoke about the lipid hypothesis and how it came to be. In this post we will be looking at why saturated fat and cholesterol having being wrongly accused of the main drivers behind heart disease (HD).

Poor diet and lifestyle, the real causes of heart disease

If you have been told by your doctor that your cholesterol is high from a blood test, I’m sure you have all seen on your test the number values relating to your LDL and HDL cholesterol levels.

Cholesterol is just a molecule and HDL and LDL are not different types of cholesterol. Rather, they are carriers of cholesterol. Think of them as vehicles that transport cholesterol in your blood stream. Cholesterol is a fatty molecule and in order to travel through the blood, which is mostly water, it needs a carrier.

So if you imagine your blood vessels as a highway, with LDL and HDL being the cars and cholesterol being the passengers in the cars. LDL’s main function is to carry cholesterol from the liver to all the different tissues in the body where it is needed to perform its metabolic functions. HDL on the other hand is responsible for taking unused cholesterol away from the tissues and back to the liver to be excreted.

This is why HDL is considered protective against heart disease as it helps remove excess cholesterol from the blood. Where is LDL carries cholesterol into the blood. This is also why HDL is called “good” cholesterol and LDL as “bad” cholesterol. HDL and LDL are neither good or bad, they are just part of physiological functions in the body. However, in saying that, high LDL cholesterol levels on a blood tests are associated with heart disease, which is why it is called “bad,” but this association will be explained below.

Moving back to the car, highway and passenger analogy. On the road we can have either busses or cars. Obviously busses carry more people, therefore you may have a lot of people travelling on the road, however they may all be in busses. This will in turn decrease traffic. Where is if all these people were put into individual cars, this would increase traffic on the highway.

If there is more traffic on the road, there is more likely to be a crash and once this happens, there is more likely to be a build up of traffic. Similarly, if there is more LDL in your blood, the more likely that these particles will crash and causes blockages in your blood vessels, leading to decreased blood flow. There are different types of LDL in your blood. Large ones and small ones. The large ones would represent the busses and the small ones would represent the cars. Obviously, we would want more busses than cars, larger LDL than small.

When these LDL particles (busses or cars) crash into your blood vessels, the cholesterol passengers will obviously be found at the crash scene, however this does not mean that cholesterol (passengers) was the cause of the crash. It may have been the driver or something else on the road. The presence of cholesterol in blood vessel walls of people who have had a heart attacks or strokes, has led to further blame of cholesterol being the driver of HD.

Ultimately, the liver will rarely overproduce cholesterol, it just depends what type of vehicle this amount of cholesterol (passengers) is travelling in, busses (large LDL) or cars (small LDL).

What can often happen is that the LDL particles floating in the blood don’t gwt taken up by there target tissue to drop off what they are carrying. This leads to LDL lingering in the blood for longer than it should, increasing the risk of it crashing and causing a plaque in the arteries. Going back to our analogy, this can be interpreted as a lack of parking on the road, which ends up increasing traffic on the as the cars and busses can’t park and drop off their passengers. Over time this will increase passengers and vehicles on the road, increasing the risk of crashes and traffic.

Based on this information, it is not about how much cholesterol is in your blood, it is about how many LDL particles are in your blood and whether they are large (busses) or small (cars). The factors that cause a lack of parking spaces and increased amount of cars rather than busses, will be discussed below.

Saturated fat increases busses not cars, therefore it is not associated with HD

Just looking at your LDL levels on a blood test will not tell you whether or not your cholesterol is in cars or busses. Sometimes it may be high, but if it is all in busses than this is more protective against HD, as it means there is less traffic.

This is where ratios come in. Ratios help to determine particles sizes of LDL in the blood and are a more sensitive marker of HD risk on your blood tests. This will be discussed below.

in uncontrolled/poorly done feeding studies, saturated fat consumption may be associated with heart disease and increased cholesterol levels because often these studies have people eating cholesterol rich foods without other anti-oxidants like fruit and vegetables, as well as with unhealthy foods like vegetable oils and processed carbs (e.g. burgers).

However, in consistently controlled studies, it is no doubt that eating a diet high in cholesterol and saturated fat will also increase cholesterol (passengers) levels in the blood such as LDL and even HDL. However, despite this, it does not increase the actual risk of having a heart attack, a stroke or some kind of cardiovascular event.

Why is this you may ask?

Well, maybe it has something to do with the fact that saturated fat may increase passengers, but it also increases busses carrying these passenger and not cars. Saturated fat may also be less prone to causing LDL particles to crash. You could think of saturated fat maybe increasing good drivers. Lastly, saturated fat may help busses (LDL) to find parking spaces (tissue receptors).

Where is in controlled feeding studies, if you replace saturated fat for vegetable oils, there is a dramatic increase in the risk of actual cardiovascular events. This may be because that vegetable oils increase the number of cars on the road and decrease parking spaces, leading to more LDL particles floating in the blood.

(Note: Vegetable oils are easily oxidized and create inflammation the body. They are used as cooking oils in restaurant/takeaway foods and found in all packaged foods, sauces and salad dressings. They not only increase heart disease risk but the risk of other diseases as well).

The fact that saturated fat increases blood cholesterol and LDL levels, but not HD risk, it shows that simply looking at these values on a blood test is not a good marker of HD risk. This is because these values tell us nothing about the size of LDL particles.

In the last article of this series we will discuss how to analyse a standard blood test to asses your HD risk.

Clearing up the misunderstanding around cholesterol, saturated fat and heart disease

Clearing up the misunderstanding around cholesterol, saturated fat and heart disease

Heart disease is one of the biggest threats to our health and longevity. It is in the top four most common causes of death in our modern world.

In the coming three post series, I will be discussing cholesterol and saturated fats relationship (or lack thereof) to heart disease (HD).

Within this two part series, I hope to clear up some myths and misunderstanding that are very common around this topic. I think that the misunderstanding is largely driven by the media and also health professionals alike. Health professionals are not correctly educated on this topic, which is not ideal, because of how prevalent heart disease is.

Now before we dive in, I just want to give you some background information and explain to you how it came to be that there is an association between saturated fat and cholesterol intake in the diet and HD. I will also explain how this wrongful association changed our dietary patterns that ended up increasing our risk of HD, rather than decreasing it.

The lipid hypothesis myth

It all started with a researcher by the name of Ancel Keys. He is the father of what we call the lipid hypothesis, which is basically the idea that dietary cholesterol and saturated fat is one of the main causes of heart disease.

The lipid hypothesis came about as a result of a now infamous study that was run by Ancel Keys. Basically, he wanted to investigate if there was a connection between HD and dietary cholesterol and saturated fat.

So he looked at HD rates in 22 countries and then examined the amount of dietary cholesterol and saturated fat intake within these countries. His initial results were pretty unremarkable and showed no association.

However, he knew he couldn’t make a big splash in the scientific community with results like these, so he decided to eliminate countries from the study and only included 7 of them. Once he did this, the results showed a strong association.

Now not only did he falsify his research, but these studies were purely correlational. Meaning they were only drawing associations between two variables, which was HD and dietary fat intake.

As some of you may know, correlation does not mean causation. For example, in Florida, when ice cream sales go up, so do shark attacks. Does this mean ice cream sales causes shark attacks? Unlikely. However, in summer, more people are likely to buy ice creams and are more likely to be in the water, therefore increasing the risk of shark attacks.

As you can see, correlational research can’t take into account any confounding variables that may be contributing to the association made between two variables. Based on this, it should have cast even more doubt on Ancel Keys results as there may have been other reasons as to why there was a correlation with the 7 countries.

However, it didn’t. His research took off like wildfire, he was put on the cover of TIME magazine and as a result, government health agencies in the U.S, which then made it’s way to other developed nations, started to change dietary policies, ushering health professionals to tell people to replace our once traditional fats from things like dairy, meat and eggs, with vegetable oils from grains (soy oil, canola oil, sunflower and safflower oil – used in cooking and packaged food) that are low in saturated fat, as well as replacing fats with carbohydrates from things like grains (breads, pasta, rice, wholegrain cereals for breakfast).

This was supposed to decrease HD, but instead it lead to an increase in not only HD but other chronic diseases as well. Ancel even tried to justify his research with animal studies using rabbits where he fed them diets high in fat and they developed HD. However, rabbits diet is not naturally high in fat, so of course this was going to cause issues. Plus, human physiology is very different to humans.

Over the last few decades, recent research has practically debunked the connection between dietary saturated fat and cholesterol with HD. And in this three part blog series, I will explain to you what the real drivers of heart disease are.

But first, lets talk about cholesterol as a molecule.

 What is cholesterol? As a molecule

I think people don’t really know how important this molecule is to our overall health. Its importance is a reason as to why statin/cholesterol lowering drugs can be so harmful, however I will talk more about this in the next post.

Cholesterol is mainly produced in the liver. If we eat a diet high in cholesterol and saturated fat, our liver produces less cholesterol. If our diet is low in cholesterol and saturated fat, our liver produces more cholesterol. So basically, our liver tightly regulates the production of cholesterol, which means that an “overproduction” of cholesterol in the blood by the liver is not a cause of HD.

As mentioned above, cholesterol and saturated fat are found in high amounts within eggs, meat and dairy products like milk and butter.

Cholesterol within the body plays some very important roles:

  • It is involved in the production of vitamin D
  • It is needed to produce sex hormones like Testosterone, estrogen and progesterone
  • It is needed to produce bile salts in the liver, which helps us digest and absorb our fats
  • It is also needed for brain and nervous system function as cholesterol is a major part of brain and nervous tissue.

As you can see, cholesterols function in producing sex hormones, vitamin D and bile salts are actually protective against HD. Vitamin D is needed to protect us from diabetes and HD, as well as testosterone, estrogen and progesterone. As well, without bile salts, we can’t absorb healthy fat-soluble nutrients from our foods (e.g. vitamin A, D, E and K) that may protect us from HD.

The vital roles of cholesterol shows you how cholesterol is not the enemy and decreasing its levels too low via drugs may actually be harmful and cause side effects.

Now that you have a basic understanding of how the lipid hypothesis came to be and what cholesterol actually is as a molecule, in the next post, I will be writing about dietary cholesterol and saturated fats lack of connection with HD.

Genes are not set in stone

Genes are not set in stone

Our genetic code is the basic template that we come into this world with. Some genes you can’t change, however you can maximise your genetic potential by exposing yourself to environmental stimuli that force adaptations. Other genes you can manipulate depending on your diet and lifestyle.

Yes, there are certain genetic mutations in genes that can either guarantee that something is going to happen to us, such as genetic diseases/defects (which is quite rare) or make it more likely that we’re going to have a problem in a certain area of physiology or function.

However, within the last few decades, our understanding of how our genes effect our health have developed significantly.

Cue….

Epigenetics!

Epigenetics is the study of changes in gene expression that don’t involve changes to the underlying genes themselves but can be passed on to one or more generations. What we know now is that epigenetics is probably much more of a determinant of our health than genes themselves because genetics account for 10% or less of disease, and the remaining 90% is controlled by our gene expression and how our genes interact with environmental factors (i.e. diet, lifestyle, environment).

That brings us to the exposome. The exposome is the sum total of all of our non-genetic exposures that we experience from the moment of conception to the end our life. This could be our mother and father’s health at the time of our conception (i.e. the quality/DNA of the sperm and the egg, which is influenced by our parent’s diet, lifestyle and environmental exposures) and our mother’s health during pregnancy/breast feeding. This is why preconception and pregnancy nutrition for males and females are so important for fertility and the health of babies.

It also includes things like our diet, lifestyle, mindset, external environment and socio-economic class. Then our internal environment (which is affected by our external exposures), includes our microbiome, nutrient status (excess or deficiency), detoxification mechanisms, hormone balance, infection exposure, immune deregulation (e.g. chronic inflammation/oxidative stress).

The whole interplay between our genes and epigenetics and the exposome is what really drives health and disease. It is worth mentioning that some genetic predispositions are more profound and stronger in some people compared to others. Which means that in some people, it may take less accumulation of environmental triggers (e.g. diet and lifestyle habits) that put you at risk for a particular disease, in order for these genes to be expressed.

There are certain environmental exposures that are more closely linked to certain types of diseases/health issues based on how they effect the body and what systems (e.g. smoking and lung cancer). There are also certain groups (based on age, gender and ethnicity) of people more at risk of developing disease, especially in conjunction with certain types and amounts of environmental exposures. However, everyone is different, meaning two people can have the same type and amount of environmental exposures, but result in two different diseases/health issues OR, one gets a disease and the other doesn’t. This is due genetic predispositions manifesting uniquely from person to person in response to environmental triggers.

Furthermore, the degree (i.e. severity of symptoms and damage to body tissues) in which disease causing environmental exposures affect our health and if they will affect our health, largely depends on our genetic predispositions and the type/amount of exposures that accumulate over time (i.e. certain environmental exposures are more dangerous to the body than others and having high exposure over extended periods of time increases disease risk).

It also depends on something called metabolic reserve. Our metabolic reserve is largely dependent on our diet and lifestyle. If we have a good diet and lifestyle, for an extended period of time, our cells function better and are more resilient to stressors because having a good diet and lifestyle means that the bodies cells have been provided with nutrients to function properly, as well as decreased the inflammatory load on cells. Poor diet and lifestyle factors can cause inflammation in the body and years of inflammation damages cellular function and depletes the body of resources. This can increase the risk of disease as inflammation can “activate” genetic predispositions towards certain diseases. Poor diet and lifestyle habits are environmental exposures that increase disease risk. The worse the diet and lifestyle, the increased disease risk.

However, having a low metabolic reserve from poor diet and lifestyle factors can also mean that any stressors placed on the body such as infections and psychological stress, can wreak a lot more havoc with a persons health compared to someone who has a lot of metabolic reserve. A person with a high amount of metabolic reserve would be less effected in terms of symptom severity when exposed to stressors on the body like infections and stress. Also, having more metabolic reserve decreases the risk of acquiring infections in the first place due to cells being in a stronger position to fight off infections. Increased age also decreases metabolic reserve due to accumulation of stressors on cells over time, which is why older people are more susceptible to health issues in the backdrop of stressors. This doesn’t mean that having a good diet and lifestyle throughout ones life and in old age can still increase the bodies robustness.

Metabolic reserve also increases effectiveness of treatments for health issues. For example, giving anti-biotics to a person with high metabollic reserve will increase its efficacy, as well as decrease the side effects of the medication on the body.

Lastly, disease is multi – faceted and no one environmental trigger usually causes disease. It is usually an accumulation of various environmental exposures and risk factors. One example could be smoking. It is a large risk factor for many diseases, especially lung cancer (oxidative stress on the lungs), however we also know smokers tend to engage in other unhealthy habits, which increase their disease risk. We also know that not everyone gets lung cancer if they smoke and some people don’t even develop a chronic disease. Again, this comes down to genetic predispositions and it also may come down to a persons metabolic reserve and diet and lifestyle. There may even be a possibility of a “heathy” smoker who has a really good diet (lots of whole foods) and lifestyle (e.g. low stress, sleeps well, has a healthy mindset and does a lot of physical activity), which in turn  increases their metabolic reserve in order to deal with the effects of the smoking.

Due to the complexity of multi-factorial diseases, it is always hard to quantify the magnitude of one variable on disease risk, as it is hard to control all the other factors in a real world setting, to get a cause and effect relationship between two variables. Also, for some people disease may occur early in life, while others later in life (certain diseases have higher prevalence in older or younger people, as well as gender and ethnicity) – it all depends on our genes and activation of disease-causing genes depending on accumulation of certain types of environmental exposures. Therefore, due to the multi-factorial nature of disease, we must treat it by addressing all the multi-faceted contributing/exacerbating factors. This is why pharmaceuticals for symptoms are not an effective treatment in our current medical model and will simply suppress symptoms as the underlying causes are still manifesting.

What does this mean for you?

So what does the all mean for you? Well, the way in which our diet, lifestyle and environmental exposures (i.e. exposome) will manifest is dependent on our genetic predispositions.

This means that diet, lifestyle and environmental factors are the biggest determents of your health and longevity. One can say that while our genes may load the gun, our environment ultimately pulls the trigger. As you can see, depending on how strong our genetic predispositions are towards a certain health issue, will determine the amount of environmental exposures needed to activate disease causing genes. Sometimes the amount is a lot smaller for one person compared to another.

In saying that, if an individual has a generally good diet and lifestyle and enough environmental exposures occur to activate a particular disease (e.g. toxins, infections, poor diet and lifestyle habits form time to time), the symptoms of the disease/health issue is likely to be less severe. This also increases the effectiveness of treatment required. The body is better equipped to deal with the stressor.

If you would like to improve your diet and lifestyle in order to increase your metabolic reserve, improve your health and wellbeing, as well decrease disease risk and progression, make sure you start with addressing the 4 pillars of health – diet, sleep, exersize and stress management. Consistency around these 4 areas of your diet and lifestyle is the foundation of good health.

13 more health and nutrition myths that you likely been told are true

13 more health and nutrition myths that you likely been told are true

Following on from my last post on this topic, I thought I would do a follow up post with 10 other health and nutrition myths that you have likely been told are fact.

1. Dietary cholesterol and saturated fat cause heart disease. 

If there’s one thing the media is good at, it’s scaring you away from perfectly innocent foods.

Eggs, red meat, butter and other foods have been demonised because despite being full of amazing, health promoting nutrients (especially egg yolks), they also contain high amounts of cholesterol and saturated fat. Eating food high in cholesterol and saturated fat doesn’t translate to increased cholesterol in your blood. And even if they did, research is starting to show that blood cholesterol levels alone are a relatively poor marker of heart disease risk.

The myth that saturated fat and cholesterol causes cardiovascular disease is not true. Food quality is what matters – there’s a big difference between eating a grass-fed steak and a fast food hamburger.

2. Eating fat makes you fat.

No, too many calories makes you fat.

For many decades, the traditional way to lose weight has been to subject oneself to a low-fat diet. But as studies pile on, old wisdom sometimes must give way. Today, we know that, just like eating cholesterol isn’t likely to increase your cholesterol levels, eating fat isn’t what makes you fat.

Far from being healthy, shunning all fat from your diet can be dangerous, since your body needs to consume at least some omega-3 and omega-6 fatty acids. As for saturated fat being the main driver of cardiovascular disease, as you have seen above, it is just another myth.

At the end of the day, trans fat is the only kind of fat that has been shown to be categorically detrimental to health — a little won’t kill you, but avoid it when you can.

3. Salt in the diet causes high blood pressure.

Most myths grow from a grain of truth. Studies have associated excess salt with hypertension (high blood pressure) kidney damage, and an increased risk of cognitive decline.

But salt (sodium) is an essential mineral; its consumption is critical to your health. The problem is when you consume too much of it.

Another issue is the source of all that salt. The average Australian eats an incredible amount of salty processed foods — which means that people who consume a lot of salt tend to consume a lot of foods that are generally unhealthy. That makes it hard to tease apart sodium’s effects from overall dietary effects. Except for individuals with salt-sensitive hypertension, who have rises in blood pressure from salt consumption. The evidence in support of low sodium intakes is much weaker than most people would imagine. As it stands, both very high and very low intakes are associated with cardiovascular disease.

Salt reduction is important for people with salt-sensitive hypertension, and excess salt intake is associated with harm. But drastically lowering salt intake has not shown much benefit in clinical trials. Most people will benefit more from a diet of mostly unprocessed foods than they would from micromanaging their salt intake.

4. Eating frequently increases your metabolic rate and is better for weight loss.

Digesting a meal does raise your metabolism by a little bit, but the only way to sustain this elevated rate is to eat more food, which in turn increases your caloric intake. The increased metabolic rate through digestion is negligible when compared against the actual caloric content of the food consumed.

Basically if you were to eat 3,000 calories spaced out over a few meals or 3,000 calories in one big meal, it makes no difference to your metabolism and makes no difference to your overall caloric intake. Therefore, the number of meals makes no difference in fat loss.

In fact, some studies suggest having smaller meals more often makes it harder to feel full, potentially leading to increased food intake.

Your metabolism can fluctuate based on the size of the meal, so fewer but larger meals means a larger spike in metabolism. Over the course of a day or week, given an equal amount of calories, the number of meals doesn’t seem to matter — it all evens out.

5. Protein causes bone, liver and kidney damage.

Some studies done on protein detected that protein consumption (especially from animal sources) was linked to increased urinary calcium, which was thought to lead to reduced bone mass over time. Later studies determined that urinary calcium was a poor measure for bone mass, and that protein actually had a protective effect or no effect on bone. Also, these studies did not take into account the increased calcium absorption that occurs via the gut when we ingest animal protein.

Early studies showed that high protein diets increased glomerular filtration rate (GFR), a marker for waste filtration in the kidneys. Some leapt to the conclusion that increased GFR was a sign that increased protein put too much stress on the kidneys.

Later research however, has shown that kidney damage does not occur as a result of a diet high in protein. While it may exacerbate already existing kidney issues, it does not CAUSE kidney damage. This is similar in regards to the liver. While high protein diets may exacerbate existing liver dysfunction leading to ammonia build up, it does not cause liver damage. A healthy liver can handle protein just fine.

6. Alkaline diets promote health and acidic diets promote disease.

There is this idea going around that the food we eat can effect the pH of our blood and extracellular fluid. An acidic state in the body leads to disease and a more alkaline state prevents disease. However, what we eat impacts the pH our urine, not the fluids in our body (i.e. blood).

Acidic foods are things such as animal products, dairy and grains. Alkalising foods are things like fruits and vegetables. What makes a food acidic or alkaline is determined by the chemical structure of nutrients in a particular food group and how it is metabolised in the body.

It has been thought that you could test the pH of the body through testing the urine. Depending on what you eat does have an effect on your urine pH, so if you have meat your urine is more likely to be acidic compared to having a green smoothie.

However, the pH of your urine has nothing to do with pH of your blood and body. The pH of blood and extracellular fluid is tightly regulated by the kidneys through various mechanisms. The pH of the blood will only change to an acidic pH in serious disease such as end stage kidney failure. The pH of our blood is tightly regulated between a neutral 7.35-7.45. Any variations in pH above or below these numbers can lead to coma and death. Therefore, what you eat has little effect on the pH of your blood as it is so tightly regulated. If your blood pH was to be affected by what you ate, you would not survive very long.

Despite all of this, certain foods we eat leave an acidic or alkaline “ash” after they are metabolized and this can be seen in the urine, which is why the pH of our urine changes depending on what we eat. So if you have a green smoothie for breakfast it is likely your urine would be an alkaline pH, as opposed to if you ate a steak, it is likely your urine pH would be acidic.

Don’t get caught up in hype driven headlines and sometimes the truth will go against your world view. At the end of the day, fear mongering, extremism, pseudo science and sensationalism is what sells, not science.

7. Whole wheat bread is better than white bread.

White bread (made from wheat flour) and whole-wheat bread both contain gluten and related proteins. They provide a similar number of calories, but whole-wheat bread has lower glycemic and insulin indices, and so its consumption results in a lower insulin release. For that reason, and because of its higher fiber and micronutrient content, whole-wheat bread is claimed to be healthier than white bread.

What the media frequently fails to mention is that the actual differences between white bread and whole-wheat bread are relatively small. Yes, whole-wheat bread has a higher fiber content — but this content pales compared to that of many fruits and vegetables. You most definitely don’t have to eat whole-wheat products to get enough fiber in your diet! And yes, white bread does lose more micronutrients during processing — but those micronutrients are often reintroduced later (the bread is then called “enriched”).

If anything, what makes whole-wheat bread markedly different is its higher phytic-acid content. Phytic acid binds to dietary minerals, such as iron and zinc, and can thus slightly reduce their absorption in the body. On the plus side, phytic acid has a protective and anti-inflammatory effect on the colon. So there’s a little bit of bad and a little bit of good.

Though whole-wheat bread is claimed to be far healthier than white bread, they aren’t that different, and neither contains high levels of fiber or micronutrients.

8. To lose fat, don’t eat before bed.

Some studies show a fat-loss advantage in early eaters, others in late eaters. Overall, early eaters seem to have a slight advantage — nothing impressive.

In real life, there are two main reasons why eating at night might hinder fat loss, and both are linked to an increase in our daily caloric intake. The first reason is the simplest: If, instead of going directly to bed, we first indulge in a snack, then the calories from that snack are calories we might have done without. The second reason is that, when we get tired, we tend to eat to keep going — with a predilection for snack foods or sugary treats. So if we stay awake at night, especially to work or study but even just to watch TV, we’re more likely to eat, not out of hunger, but to help fight sleepiness.

Eating late won’t make you fat, unless it drives you to eat more. It can also be harder to resist tasty, high-calorie snacks after a long day.

9. Cardio in a fasted state leads to greater weight loss

Let’s get one thing out of the way. If you exercise near maximal capacity (sprints, HIIT, heavy lifting …), eat first, or you’re more likely to underperform.

Most people who choose to work out in a fasted state, however, opt for some form of “cardio” (aerobic exercise), such as jogging. During cardio, performance and energy expenditure while fasted are about the same as in a fed state. In a fasted state, you’ll burn more body fat, but that won’t make it easier for you to use body fat as fuel during the rest of the day (when you’re fed).

You’ll also burn a tiny bit more muscle, but you’ll grow it back faster afterward, too, so that it seems to balance out (as long as you get enough protein). Finally, cardio suppresses appetite less on a fasted state than on a fed state, but that doesn’t translate into a significant difference in daily caloric intake.

There’s very little difference between cardio on a fed or fasted state with regard to fat loss, muscle preservation, daily caloric intake, or metabolic rate. What really matters, then, is you. Some people feel lighter and energized when they do cardio on an empty stomach, while others feel light-headed and sluggish. Fed or fasted state: pick whichever makes you feel better.

10. Breakfast is the most important meal of the day

“Breakfast is the most important meal of the day” is something we have all heard before from parents, health bloggers, doctors, and ad campaigns. But the health advantage of consuming a regular breakfast has been overhyped.

People who are #TeamBreakfast have pointed to observational studies showing a higher BMI in breakfast skippers. However, clinical trials have pointed to personal preference being a critical factor. Some people will subconsciously compensate for all the calories they skipped at breakfast, while others won’t feel cravings of the same magnitude. In one trial, women who didn’t habitually eat breakfast were made to consume it; they gained nearly 2 pounds over a 4-week period.

Individual responses do vary, so don’t try to force yourself into an eating pattern that doesn’t sit well with you or that you can’t sustain — it may end up backfiring.

Another popular claim is that skipping breakfast can crash your metabolism. But studies in both lean and overweight individuals have shown that skipping breakfast does not inherently slow your resting metabolic rate (RMR).

One area where the “don’t skip breakfast” mantra may hold true is in people with impaired glucose regulation. These individuals may want to play it safe and avoid skipping breakfast in order to achieve better day-to-day glucose management.

You don’t need to eat breakfast to be healthy or lose weight. You should base your breakfast consumption on your preferences and personal goals. Feel free to experiment to see if you want to make skipping breakfast a habit.

11. You must eat protein immediately after your workout.

When you exercise, you damage your muscles, which your body then needs to repair, often making them more resilient (bigger) in the process. The raw material for this repair is the protein you ingest, yet the existence of a post-workout “anabolic window” for this ingestion remains a contentious topic in the literature.

“You need protein right after your workout” may not be a myth so much as an exaggeration. Consuming 20-40g of protein within the two hours following your workout may be ideal, but it isn’t necessary. What matters most is your daily protein intake. To maximize muscle repairs, aim for 1.4–2.2 g of protein per kilogram of bodyweight per day (0.64–1.00 g/lb/day).You don’t need protein immediately after your workout, but you might benefit from 20–40 g within within the next couple of hours (and before bed). What matters most, however, is how much protein you get over the course of the day.

12. Clean Eating is a misconception.

People seldom agree on what “clean” actually means. For some, it means avoiding everything that isn’t natural. For others, it means eating all your food raw (raw and cooked food have their pros and cons in various instances – no absolutes) or avoiding all “risky foods” even at the cost of living on meal replacements and other supplements. One common point of clean diets is their negativity: They tell you what clean eating is by telling you what not to eat.

Veganism can be considered the prototypal clean diet, as it shuns all meat products both for ethical reasons and for better health. But although vegans and vegetarians do live longer, this may be influenced by reasons unrelated to food. For instance, people who stick to a vegetarian diet are more likely to also stick to an exercise regimen, practice relaxation exercises (meditation, yoga …), and neither drink in excess nor smoke.

In fact, compared to people eating a varied omnivorous diet, vegans (and, to a lesser extent, vegetarians) are more likely to get less than the optimal amount of some nutrients, such as vitamin B12. However, those nutrients can easily be supplemented — nowadays, there are even plant-based options for EPA, DHA, and vitamin D3.

In saying all of this, these days you can’t simply “eat your veggies” — you need to make sure they’re organic. This is presented as self-evident, on the principle that “natural” is good whereas “synthetic” is bad; yet research has so far failed to link organic foods, plants or animal, to better health. It doesn’t mean a link cannot exist, but the organic-versus-conventional debate is complex, and can change both with the foods under scrutiny and with the individuals eating them.

One misconception is that no synthetic substance can be used to grow organic crops, whereas the National List of Allowed and Prohibited Substances makes some exceptions. Another misconception is that no pesticide can be used to grow organic crops, whereas natural pesticides exist, are used to grow organic crops, and are not always better for the consumer or the environment.

Pesticide residues in food are a valid concern, though it should be noted that the vast majority of the food on the market contains residues below the tolerable limits set by government agencies. In addition, rinsing, peeling when possible, and cooking can reduce the amount of pesticide left on your food.

And if that is not enough, some “clean eating” gurus recommend that you only eat your food raw, so as not to “denature” its nutrients. As an absolute, this rule is bunk. Raw food, like cooked food, can have pros and cons, depending on the food and context.

It’s easy to see how one can push the “clean eating” obsession too far, even all the way into orthorexia. It doesn’t mean that all foods are equal, and you certainly should favour whole foods over processed foods — most of which are nutrient-poor, calorie-dense, and easy to overeat — but you shouldn’t fear that eating anything but raw organic veggies is going to drastically shorten your lifespan.

“Clean eating” is the new fad, but gurus don’t even agree on which foods are clean and which are not. Stick to the basics. Favour whole foods (but don’t feel like any amount of processed foods will kill you), eat organic if you want and can afford it, peal or wash your vegetables and fruits (especially those with higher levels of pesticide residue, such as strawberries), and avoid stressing too much about what you eat, since stress can shorten your lifespan.

13. Foods are better than supplements.

It’s been repeated so often that the word “natural” has a positive connotation whereas “synthetic” or “chemical” has a negative one.

The truth, of course, isn’t so clear-cut. Some compounds that are found in various food sources (plants and animal products) may be isolated and synthetically made into supplemental form for specific therapeutic uses, which have been studied in clinical trials. In doing so, they may be more effective in supplemental form because in food, they may be poorly absorbed or exist in small amounts, meaning a person would have to eat large amounts of a particular food to get the therapeutic dose.

One example is the curcumin in turmeric, which is a potent anti-inflammatory but very poorly absorbed. Therefore, it is often supplemented with piperine (a black pepper extract) or taken in liposomal form to increase its otherwise low dietary bioavailability.

The same goes for some vitamins. For instance, phylloquinone (K1) is tightly bound to membranes in plants and so is more bioavailable in supplemental form. Likewise, folic acid (supplemental B9) is more bioavailable than folate (B9 naturally present in foods), though that may not always be a good thing.

Many supplemental vitamins have natural and synthetic forms. This makes them accessible to more people. For example, if B12 could not be synthesized, it would be prohibitively expensive as well as unsuitable to vegans.

On the flip side however, some supplements are unnecessary due to a lack of good evidence for their efficacy in humans, an adequate amount of the supplemental nutrient is found in food and/or better absorbed via food, they may cause harm when isolated into a supplement due to a lack of food synergy, they may interact negatively with drug or they may have a low safety threshold.

Wrap up:

You’ve likely heard all 13 of these myths repeated at one time or another — by a friend, on a blog, or somewhere in the media. Misinformation is rampant, difficult to identify, and unfortunately spreads much faster than facts.

And really, this is just the tip of the iceberg. You’ll see often see sensationalist headlines based on a study with unsurprising results.

This article and my last article hopefully removed unwarranted fear and misunderstanding around certain health and nutrition topics. When you are trying to be healthy, I know all the fear mongering and misinformation can be stressful and debilitating. It can also be expensive!

Just remember, good health requires consistent dedication to simple, healthy diet and lifestyle habits. Eat as much whole, minimally processed foods as you can (animal products and plants), pick a diet that works for you, drink water, get enough sleep, stress less, get enough exercise, spend time outdoors in the sun, spend less time on social mediaform strong/functioning interpersonal relationships, work to have a positive mindset, indulge in moderate amounts of sugar once in a while, don’t smoke and consume modest amounts of alcohol.