Link Dump

It's been a while since I last barfed up a bunch of links for you to check out and chew on. So here goes:

• Denmark just became the first country to impose a "fat tax" on foods high in saturated fat. Thanks, Ancel Keys.

• The Washington Post published a piece about the "benefits" of processed food, arguing that "[i]t’s not so easy to categorize processed foods as good or bad." Really? 'Cause I think it's pretty simple.

• Did you miss Robb Wolf on Morgan Spurlock's "I, Caveman" reality show tonight? Don't fret -- the Discovery Channel's re-airing it on October 9. Set your DVRs, people.

• Septuagenarian singer Tom Jones has lost a bunch of weight on the "caveman diet." He ought to be spry enough to evade those fusillades of panties now.

• The Army Times profiled Mark Twight of Gym Jones and Mark Divine of SEALFIT as "ex-CrossFit devotees" who have taken their gyms "to the next level."

• Can you live on $30 a week? Sheila Steffen, a producer for CNN took on a "food stamp challenge," spending only her allotment of $30 in food stamps to feed herself for a week. She wrote that the $30 didn't get her very far; she bought only beans, rice, farina, chicken, pasta, broccoli, bell peppers and tomatoes. Oh, and stuff to make peanut butter and jelly sandwiches. As many commenters noted, Steffen didn't spend wisely, passing up nutritionally dense foods in favor of empty ones (like bread and rice).

With $30, I think I would've purchased the following: two dozen eggs ($4), five pounds of chicken thighs ($10), three pounds of ground beef ($6), and five packages of frozen broccoli ($10). Not the most varied diet in the world, but I'd be fueled up just fine.

How would you spend your $30?

This Map Makes Me Sad

Check out this time-lapse video of the Centers for Disease Control's maps showing rising obesity rates in the U.S.:



And yet we're eating fewer calories and less dietary fat. Hmm.

[Source]

[Previously: The American "Paradox"]

The American "Paradox"

More evidence that the low-fat hypothesis is crap.

(Click the image for the full graphic)

In 1977, Senator George McGovern's Select Committee on Nutrition and Human Needs issued its "Dietary Goals for the United States" -- the country's first set of government-issued nutritional guidelines. The report recommended that Americans drastically cut their intake of fat -- and especially saturated fat. And guess what? We complied.

As this infographic shows, Americans' consumption of red meat -- beef, specifically -- has gone way, way down since the mid-1970s. In its place, we've increasingly turned to the "healthy" white meat of chickens. Also? Tons and tons of "heart-healthy" low-fat, low-calorie food products.

In a 1997 report entitled "Divergent Trends in Obesity and Fat Intake Patterns: The American Paradox," researchers noted that "[i]t appears that efforts to promote the low-calorie and low-fat food products have been highly successful," but this decrease in dietary fat consumption did "not appear to have prevented the progression of obesity in the population."

As Gary Taubes wrote in "Good Calories, Bad Calories":

For the past decade, public-health authorities have tried to explain the obesity epidemic in the United States and elsewhere. In 1960, government researchers began surveying Americans about their health and nutrition status... According to these surveys, through the 1960s and early 1970s, 12-14 percent of Americans were obese. This figure rose by 8 percent in the 1980s and early 1990s, and another 10 percent by the turn of this century.

Despite cutting back on red meat (and its saturated fat), and despite turning increasingly to low-fat foods, we're still getting fatter and fatter. And now, over 34 percent of Americans -- more than a third of us -- are obese.

Given that all signs point to the low-fat hypothesis being bunk, can we please stop calling the diverging trends in obesity and fat consumption a "paradox"?

Because.

Okay: I've got some explaining to do. Below, I listed (again) the dietary tweaks I intend to implement, along with my reasons. I may mangle some of this stuff up, as I'm just regurgitating what we heard yesterday at the Whole9 Foundations of Nutrition workshop.

THE TWEAK:

Get more sleep -- especially the night before a 5 a.m. class at CrossFit Palo Alto. (Whole9's rule: Didn't get at least 6 hours of sleep? THEN NO EXERCISE FOR YOU. Use that time instead to get more Z's or prep some food.)

THE REASON:

This goes without saying, right? We all know by now that we ought to be getting at least nine -- yes, nine -- hours of sleep per night, or else risk all sorts of health issues, including obesity and diabetes. These and other disorders are all linked to chronic, systemic inflammation; your body's immune system is constantly pushed to work harder than it should to repair and maintain your body in response to the added stress you're placing on it.

Another point that hit home with me at yesterday's presentation: Sleep should take priority over training. Your body doesn't get fitter while you're training. Your body gets fitter when it's recovering and re-building itself. (Some -- including Robb Wolf -- say it's even more important than food.)

Plus, lack of sleep makes you look like crap. No need to crow about functioning on just four hours of sleep; after all, sleeplessness not a sign of virility. 

THE TWEAK:

Stop pounding caffeine after noon.

THE REASON:

I've wavered on this point before, and I sure love me a good cuppa coffee (the cold-brewed stuff is like crack to me). But in the end, I'm kinda-sorta coming around to the Whole9's way of thinking. Caffeine's a potent stressor, and promotes a stress response that I don't need. Plus, if I keep chugging it in the P.M., it's going to keep wreaking havoc on my sleep patterns. Not good.

So starting now: No more coffee after noon. (Read the Whole9's Coffee Manifesto here.)

THE TWEAK:

Reduce my intake of nuts and seeds -- and when I do indulge, I'm going to reach for macadamia nuts and hazelnuts over all others.

THE REASON:

Nuts and seeds are incredibly nutrient-dense foods, which makes 'em a great addition to any diet.

But the concern is that the polyunsaturated fatty acid (PUFA) content in all nuts and seeds have a pro-inflammatory profile, with higher ratios of Omega-6 to Omega-3 fatty acids. By now, we all know why it's important to reduce the markers of systemic inflammation by maintaining a ratio closer to 2:1 or 1:1 than the standard American diet's ratio of upwards of 30:1, right? Besides, there's the whole Chris Masterjohn line of thought about the connection between PUFA degeneration and atherosclerosis.

Of course, some nuts have very low PUFA content (only 2% of the fats in mac nuts are PUFAs, for example), and in the end, they're a net nutritional plus. Others, though, are pretty damned high in PUFAs. (For instance, 72% of the fats in walnuts are pro-inflammatory PUFAs.) So going forward, I'm going to be a more discriminating nut eater -- and favor mac nuts in particular, which studies suggest offer a host of other health benefits as well.

Yes, there's some debate over this stuff (isn't there always?), but even beyond the whole systemic inflammation argument, I've found that it's just way too easy for me to mindlessly binge on nuts. Nuts are super dense in calories. (Just one cup of macadamia nuts, for example, contain almost 1,000 calories.) I'm not a calorie counter at all, but I'm addicted to nuts. If left unchecked, my nut consumption would grow to the point that weight maintenance would surely become an issue. And while nuts are certainly "Paleo" (excepting those "nuts" that aren't actually nuts at all, like peanuts) 'cause cavepeople could eat 'em, that doesn't mean they're the optimal source of dietary fat for modern humans. I think I'm going to try to mindlessly binge on eggs and avocados instead.

THE TWEAK:

Cut the cheese. (HAR HAR! I meant cutting it from my diet.)

THE REASON:

I've already cut most dairy out of my diet, save pastured butter/ghee, the cheese on my burgers/in my salads, and a little Greek yogurt when it's cooked in a few of the dishes that M makes. But after listening to the Whole9 folks lay out their case against dairy, I'm considering eliminating cheese from my diet entirely. In particular, cheeses have an acidifying effect on the body, and an "acid-producing diet promotes bone de-mineralization (i.e. osteopenia and osteoporosis), and also contributes to the following maladies and illnesses: kidney stones, age-related muscle wasting, hypertension, stroke and asthma." Yeesh.

Plus, the beta-casomorphins that are created in the cheese-making process are literally addictive. That's right: When milk is turned into cheese, it becomes dairy crack. And crack is wack.

THE TWEAK:

Eat something starchy/carby immediately post-workout.

THE REASON: 

I'm still doing the intermittent fasting gig (and am enjoying its benefits), so this will require some re-jiggering of my early-morning fasted training routine.

It won't hurt me if I fail to refuel my muscles with some carbs and protein after a long, intense metcon. But the body's uptake of nutrients is most efficient in the half-hour after intense exercise. During this short window, our muscles are particularly insulin-sensitive, so we take advantage of a mechanism called “non-insulin mediated glucose transport” to shove some nutritious carbs into our systems. Protein can also help with refilling our glycogen stores and decreasing the inflammation caused by intense exercise. In other words, we recover faster.

So I'm now considering downing some sweet potato, beets, parsnips, chestnuts or winter squash after hard WODs. (But I'm also considering staying the course and not eating anything, per my current practice and Mat Lalonde's words of wisdom.) [UPDATE: See notes by The Lazy Caveman and The Nutty Kitchen below -- I am now officially off the fence!]

By the way, the Whole9 warns against eating fat or fruit as part of the post-workout meal -- fat'll slow down the body's ability to replenish your muscle glycogen, and the fructose in fruit will prioritize the replenishment of your liver glycogen -- not your muscle glycogen.

THE TWEAK:

Try to get over my aversion to olives, because they're awesome sources of fat (assuming no preservatives or other additives are in the mix).

THE REASON:

The best monounsaturated fats recommended by the Whole9 are avocados, avocado oil, hazelnuts, macadamia nuts, olives and olive oil. I already eat copious amounts of everything on the list except olives. And I am nothing if not a completist.

THE TWEAK:

Seriously cut back on fruit, and stop drinking juice altogether.

THE REASON: 

Honestly, I stopped drinking juice eons ago, and I don't go crazy with fruit. I just stuck this one in here just for those of you who still haven't gotten the memo that eating fruit is fine -- but in moderation. (We're talking one to two servings a day.) I get the feeling there are those of you out there who think that going Paleo is a license to go to town on smoothies, juice, and berries in everything. If you're out there, here's why you should watch your fruit intake:

Fruit is not as nutritionally dense as most vegetables. The top ten vegetables on the ANDI (Aggregate Nutrient Density Index) scale range from kale (score: 1000 -- perfect!) to arugula (559). But the most nutrient-dense fruit -- strawberries -- gets a score of just 212.

Fruit is too often used as a crutch by perfectly well-meaning Paleo adherents who rely on fruit to satisfy their lingering sugar cravings. Do you find yourself piling your plate high with fruit for breakfast? Snacking on bananas and grapes all day? Constantly adding fruit to meals just to add some (totally unnecessary) sweetness? Juicing fruit -- thereby removing all the good stuff in order to concentrate the liquid sugar into drinkable form? STOP IT. 

THE TWEAK: 

Never cook with olive oil again.

THE REASON:

"Never" is probably too strong a word. And I should have qualified that statement further by saying "high-heat cooking." Still:

From what we learned yesterday, olive oil -- while mostly comprised of good monounsaturated fat -- still contains proportionally greater amounts of unstable PUFAs than other cooking fats that are available to us (like coconut oil, ghee, etc.)

PUFAs happen to have a low smoke point (the temperature at which the fat begins to smoke and break down chemically). And they're also the most susceptible to oxidation. And oxidation is bad news.

As Inhuman Experiment put it:

What about olive oil then? Even though everyone seems to love olive oil in general, there's something of a debate going on over whether it should be used for cooking purposes. My opinion is that ... it's not the worst choice but it's not the best either. The smoking point of extra virgin olive oil seems to vary from 160 to 190 °C, depending on the free fatty acid content. Virgin olive oil, however, has some properties that make it more heat-tolerant than most other oils...

So which oils should you use for cooking? For sautéing and cooking at light to medium temperatures, my choice would be the ones on the left of the graph: coconut oil, ghee, butter, palm oil, and lard. If you stay below 170 °C, you're in pretty safe waters in terms of oxidation regardless of which one of them you choose. Virgin olive oil seems like a viable choice, too; just make sure the particular olive oil you're using it doesn't start smoking.

But why even bother cooking with olive oil when I can just use the humongous vats of coconut oil and ghee in my pantry for all my cooking needs? I'll just save the EVOO for non-heated applications (e.g., in dressings, etc.)

THE TWEAK:

Break open the vat of duck fat we have sitting in the freezer.

THE REASON:

Note that I didn't say I was going to cook exclusively with duck fat, or that duck fat is superior to all other forms of cooking fats. I just said I was going to break it out.

Still, duck fat (along with beef tallow and goat fat) is -- according to Whole9 -- preferable to cooking with lard. Why? Because lard (and all pork products) generally come from pigs that eat at least some shitty stuff. There's no such thing as a "grass-fed" pig, because pigs aren't ruminants like cows. They're natural omnivores like you and me. So even pastured pigs who are given freedom to root around and eat whatever they can find in the wild nonetheless are provided with supplemental food -- often in the form of cheap grains and corn. (One exception: The pastured pigs at Full of Life Farm, from which we just bought half a pig.)

Besides, duck fat tastes good.

LDL: It Ain't All Bad

When considering cholesterol numbers, most people -- doctors included -- use a simple but flawed shorthand:

• High HDL: Good!
• High LDL: Bad!
• High total cholesterol: Bad!

When you get your blood cholesterol analyzed, these numbers are often all that come back from the lab. But we know that the reality’s not quite that simple. After all:

LDL cholesterol can no longer be identified as the single source of all heart trouble. Those pamphlets adorning your doctor's waiting room may portray LDL as a kind of lone gunman taking a bead on your heart, but they hide a basic fact of science: "Bad cholesterol" is at best a poor shorthand for four major types of independently behaving LDL, each with its own implications for heart disease. We ignore the distinctions at our peril.

In fact, some types of LDL are pretty innocuous, while other forms are dangerous. The big, fluffy LDL particles are generally benign -- they don’t affect heart health. But small, dense LDL particles are bad news, triggering the inflammation that causes cardiovascular disease. People typically have a mix of large, small, and medium-sized LDL particles, but you’re obviously better off if the bigger, fluffy stuff predominates.

And here’s the thing:

A diet high in saturated fat mainly boosts the numbers of large-LDL particles, while a low-fat diet high in carbohydrates propagates the smaller forms.

Sadly, “[t]he typical LDL test doesn't distinguish between large and small LDL particles -- it can't even spot the difference.” And as a result, even today, most doctors don’t concern themselves with this critical distinction, relying instead on total LDL numbers or total cholesterol numbers to indicate what course of medical action to take. But by lumping all the forms of LDL together, “[w]e may be medicating many people who have no clear need for medication, using drugs that don't target the right particles, and replacing foods that are benign with foods that are anything but.”

Thankfully, not too long ago, Ronald Krauss of Children’s Hospital of Oakland and his colleagues developed a device capable of distinguishing between and precisely measuring LDL and other lipoproteins to provide a much more accurate picture of cardiovascular health. Krauss and his partners have also identified the best predictors of cardiovascular disease. In order of most predictive to least, they are:

• High levels of small and medium-sized LDL particles combined with low HDL (pretty darn predictive of heart disease!)
• Low HDL levels (kinda/sorta predictive!)
• High total LDL levels (not very predictive!)

And utterly not predictive at all? Total cholesterol.

BUT: The test that Krauss developed isn't widely available. Most doctors are still going by the old standby measurements, and looking solely at total cholesterol, HDL, and LDL numbers. Ugh.

The upshot: If you’re like me -- a Paleo convert whose diet contains relatively large quantities of saturated fat and cholesterol -- you might get lab results that, on their face, look a little baffling:

• Total cholesterol: 261 mg/dL (Yikes -- that's super-high!)
• HDL: 100 mg/dL (But wait -- HDL is fantastic!)
• LDL: 97 mg/dL (Just barely within the range of “optimal,” right?)

I have no idea whether my LDL particles are large or small, but given my diet, I’m assuming the former. (Probably not a bad assumption, given that M and I eat almost exactly the same diet, and her LDL particle size was recently tested and confirmed as predominantly Type “A”: big and fluffy.) And my HDL is through the roof. I'm not at risk for cardiovascular disease.

But if you were to ask my doctor, he'd probably tell you another story based on my total cholesterol.

Science can sometimes be slow to progress, but we've got to get more sophisticated testing out there. Otherwise, the problem is that lowering your total cholesterol or LDL -- without knowing the type of LDL particles you have -- can cut both ways:

Just because you have less of the symptom (statin users take note) doesn't mean you'll have less of the disease. A drop in your total LDL cholesterol might mean nothing at all. A higher LDL cholesterol reading, for that matter, could simply mean you are a healthy person who has learned how to build an amazing sauce out of wine, garlic, shallots, butter, and heavy cream.

Or, if you’re M, a fantastic dish of sous vide pork chops seared in melted lard.

Link Dump: Thanksgiving Edition

It's been a long time since I served up a bunch of links -- so here goes:

• Cooking with butter this Thanksgiving? Wondering if it’s Paleo-approved? The Whole 9 folks weigh in.

• We still eat butter, by the way. We get the grassfed stuff -- KerryGold – from Trader Joe’s. Also: organic ghee from Purity Farms.

• You know your pain-in-the-butt relatives are going to ask you over Thanksgiving dinner why you’re risking your health by eating saturated fats instead of lowfat items like bread and rice. Point them to this meta-analysis, which examined 21 studies involving more than a third of a million subjects. It concluded that there is no link between saturated fat intake and increased risk of cardiovascular disease.

• These researchers also pointed out that replacing saturated fat in your diet with carbs causes the formation of small, dense LDL particles – bad news! Thus, “dietary efforts to improve the increasing burden of [cardiovascular disease] risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity."

• Really. Throw around terms like “atherogenic dyslipidemia” at the dinner table. It’ll shut everyone up.

• And if some crazy uncle asks, tell him that contrary to reports, saturated fat won't mess up your sperm count. (Especially if you’re female.)

• Do watch your sugar and carb intake, though. According to the Healthy Skeptic, “normal” fasting blood sugar isn’t what your doctor says it is.

• But frankly, “[y]our post-meal blood sugars and A1c levels are more important” than your fasting blood sugar level. So try not to eat a doughnut-stuffed turkey, brined in Dunkin’ Donuts coolattas and served with coffee gravy and mashed hash browns.

• Another question you might be asked between bites of ham by your God-fearing family and friends: How can a good Christian go Paleo? Jimmy Moore surveyed the big names in caveman eating -- take a look and see which answer resonates best with you. (My two cents? You’re not going to fry in hell for eating Paleo. There are other, much better reasons to cast you into eternal damnation, like the fact that you secretly watched that porn clip of Maren from P90X.)

Cavemen for Christ?

• Speaking of Jimmy, he recently posted an interview with Mat Lelonde, hero to all science-minded low-carb Paleo eaters. Listen to it here.

• Try to enjoy yourself this Thanksgiving, and don’t spend the long weekend severely restricting your caloric intake and exercising like a maniac. Really – it's not good for you.

• Finally, when you're ready to work off Thursday's dinner, check out this old but super-awesome interview with Starting Strength’s Mark Rippetoe about the best way to get in shape. It’s only ten minutes long, but it’s chock-full of great fitness advice, such as: “Learn how to squat. It works more muscles than any other exercise, it’s harder, it’s a longer range of motion, and it will make more difference in your appearance over a shorter period of time than any single thing you can do. You have to learn how to squat correctly. Correctly is below parallel.”

Listen to it here:

(Photo: Tammy Green)

Stop With The Egg Whites

The New Yorker's food issue is out this week, and it features a lengthy piece about April Broomfield, the chef/owner of NYC's The Spotted Pig and The Breslin -- both of which are awesome for meat-lovin' Paleo eaters like me. Last month, M and I hit The Breslin for brunch, and ordered two full English breakfast plates, piled high with porky goodness, and with no beans or toast to spoil the fun.

We clearly did not do an adequate job of educating one of our brunch companions about the place, though. And as I mentioned in a previous post, he's not on the Paleo train. After scouring the menu in vain for something -- anything! -- that the USDA Food Pyramid and conventional dietary wisdom would smile upon, he asked our server whether the vegetable frittata could be made with egg whites. "No," she replied.

Of course, the server's intent wasn't to steer him towards better health. Chances are, she subscribes to the same beliefs that most people hold about the dangers of egg yolks and saturated fats and everything else on The Breslin's menu. I seriously doubt she's read Gary Taubes.

But you know who has? Director/producer/screenwriter/novelist Nora Ephron. She most certainly would not have asked for fucking egg whites.

Ephron was being interviewed by Michael Krazny on NPR's "Forum" this morning. I know next to nothing about Nora Ephron, other than that she wrote "When Harry Met Sally" or something, so I was only half-listening -- until Krazny gently chided her about her position on eggs and cholesterol. My ears perked up.

"Eating the cholesterol in eggs doesn't raise your blood cholesterol!" she countered. Krasny shot back that the Mayo Clinic says she's wrong. She stuck to her guns. And she happens to be right.

Here's what I dug up from an old HuffPo blog post of Ephron's on the subject:

[D]ietary cholesterol has nothing whatsoever to do with your cholesterol count. This is another thing I've known all my life, which is why you will not find me lying on my deathbed regretting not having eaten enough chopped liver. Let me explain this: you can eat all sorts of things that are high in dietary cholesterol (like lobster and cheese and eggs) and they have NO EFFECT WHATSOEVER on your cholesterol count. NONE. WHATSOEVER. DID YOU HEAR ME? I'm sorry to have to resort to capital letters, but what is wrong with you people?

Which brings me to the point of this piece: the egg-white omelette. I have friends who eat egg-white omelettes. Every time I'm forced to watch them eat egg-white omelettes, I feel bad for them. In the first place, egg-white omelettes are tasteless. In the second place, the people who eat them think they are doing something virtuous when they are instead merely misinformed. Sometimes I try to explain that what they're doing makes no sense, but they pay no attention to me because they have all been told to avoid dietary cholesterol by their doctors. 

According to yesterday's New York Times, the doctors are not deliberately misinforming their patients; instead, they're participants in something known as an informational cascade, which turns out to be a fabulous expression for something that everyone thinks must be true because so many reputable people say it is. In this case, of course, it's not an informational cascade but a misinformational cascade, and as a result, way too many people I know have been brainwashed into thinking that whole-egg omelettes are bad for you.

So this is my moment to say what's been in my heart for years: it's time to put a halt to the egg-white omelette.

Hear, hear.

David H. Freedman wrote in this month's Atlantic about how the health studies you hear about on the news are almost universally fraught with error and bias -- and then the information cascade takes over and we go flying off the cliff with all the other lemmings. So what happens when another study comes out and draws the opposite conclusion -- which, by the way, happens ALL THE TIME?

Too late. We're already in freefall -- and we didn't even get to enjoy the frittata with the awesomely delicious egg yolks.

Am I About to Drop Dead of a Heart Attack?

This morning, I attended a health fair at work and got my blood work checked for the first time since going paleo. (Unfortunately, the visiting clinic didn't offer the full panoply of tests – just the basics.)

I fully expected some big changes in my cholesterol numbers. After all, over the past six months or so, I’ve increased my saturated fat consumption by approximately a bazillion percent. (Which, by the way, isn’t hard to achieve, given that I used to abstain from eating anything with saturated fat – including meat – before converting to a paleo diet. Heck, less than a year ago, I was ordering meals from a macrobiotic society every Monday night. And now, I'm subsisting on what most would consider a high-fat diet.)

But when today's results came in, my total cholesterol count still gave me a jolt: 261 mg/dL. That's almost 100 mg/dL higher than it was last year.

A health advisor at the fair frowned at the number, and then handed me this handy chart:

“Your total cholesterol level is alarming," she began. "You may want to talk to your doctor about statins. Right now, you're clearly at risk for heart disease.”

Uh, oh. That doesn't sound too good.

More after the jump...