Muscle Cramps? It May be a Magnesium Deficiency

We’ve all been there; having a good night’s sleep and suddenly an extreme cramp in the calf. They can be excruciating and it’s hard to know what to do about them. While cramps can stem from various causes, one frequently overlooked factor is magnesium deficiency. Magnesium plays a crucial role in muscle function, and inadequate levels can lead to increased susceptibility to cramping. Here’s a closer look at the connection between magnesium deficiency and muscle cramps, along with practical steps to address and prevent them.

Magnesium is an essential mineral involved in many physiological processes, including muscle contraction and relaxation. It works with calcium to regulate muscle contractions by controlling the movement of ions across the cell. When magnesium levels are low, this regulation can become impaired, potentially leading to muscle cramps and spasms.

Some deficiencies go unnoticed for years, quietly affecting our well-being in profound ways. Magnesium deficiency typically slips under the radar. Despite its critical role in numerous bodily functions, magnesium deficiency remains prevalent across various demographics worldwide. So, why is this essential mineral so often lacking in our diets?

Our dietary habits have shifted significantly in recent decades. Processed foods, refined sugars, and PUFA rich diets have become commonplace, often at the expense of nutrient-dense foods like leafy greens, nuts, and seeds—excellent sources of magnesium. This dietary shift means that many people simply aren't consuming enough magnesium-rich foods to meet their daily requirements.

Magnesium content in our food is directly influenced by the magnesium content in the soil where crops are grown. Modern agricultural practices, including the use of chemical fertilizers, have depleted soils of essential minerals like magnesium. As a result, even if we consume vegetables and fruits, their magnesium content may not be as high as it once was.

Stress has a direct impact on our nutrient absorption. In our fast-paced, stress-filled lives, our bodies may require more magnesium than usual. Stress, both physical and emotional, depletes magnesium levels in the body. Factors like excessive alcohol consumption, certain medications (e.g., diuretics, PPI’s), and even intense exercise can increase the body's demand for magnesium, further exacerbating deficiency.

Hydration is obviously important, particularly for those in warm climates that are active. Most athletes are aware of the importance of hydration, however fail to replace the electrolytes. Magnesium is one of these electrolytes. When we sweat, we lose both water and electrolytes. Replacing the water is a great idea, but if the electrolytes are not replaced, the kidneys will just continue to excrete the water to maintain balance. So, adding electrolytes to water is a sneaky way to get hydrated faster. 

Even if we consume magnesium-rich foods, factors such as gastrointestinal disorders (e.g., Crohn's disease, celiac disease, low stomach acid) or aging-related changes in digestive efficiency can impair magnesium absorption. This means that individuals with these conditions may need to consume higher amounts of magnesium to achieve adequate levels in the body.

Magnesium deficiency often presents with subtle symptoms or mimics other health issues, making it challenging to diagnose without specific testing. Symptoms such as muscle cramps, fatigue, and irregular heartbeat can easily be attributed to other causes, delaying proper identification and treatment of magnesium deficiency.

Encouraging a diet rich in magnesium-containing foods such as leafy greens, nuts, seeds, is important. Magnesium content for animal meats can vary depending on what they are fed. For example, grass fed grass finished beef has about twice as much magnesium as soy and corn fed beef. For those at risk or with confirmed deficiencies, magnesium supplements can be an effective way to bridge the gap.

Advocating for sustainable agricultural practices that prioritize soil health can help restore the nutrient content in our foods. Research into the optimal levels of magnesium intake for different demographics and health conditions is also essential to guide clinical practice.

So the key takeaways are:

1. Increase your intake of magnesium-rich foods such as leafy greens (spinach, kale), nuts and seeds (almonds, pumpkin seeds), and grass fed beef.

2. If you struggle to meet your magnesium needs through diet alone, consider taking a magnesium supplement. Magnesium glycinate is the best one. 

3. Maintain a balance of water and electrolytes.

4. Manage stress as much as you can. When we are in a sympathetic state, we have poorer nutrient absorption.

5. Don’t watch TV while you eat. TV is stimulating and therefore sympathetic. You’ll literally absorb less nutrients.

Low Stomach Acid and Reflux

If you google what causes GERD or heartburn, you will most likely find foods that cause too much acid such as tomatoes, chocolate, coffee and alcohol. However, low stomach acid may be to blame. 

GERD (gastroesophageal reflux disease) happens when ANY amount of stomach acid reaches the esophagus. This is due to an inappropriate opening of the LES (lower esophageal sphincter). So then the question is, what causes the LES to open? Newer research has pointed to an increase in intra-abdominal pressure and this may be due to low stomach acid.

Stomach acid is vital to breakdown food, absorb nutrients, and kill off pathogens that we ingest with food. As we age, we produce less stomach acid and this allows undigested food to sit in the gut and ferment, which can lead to an overgrowth of bacteria in the small intestine. This is known as SIBO (small intestinal bacterial overgrowth). Bacteria produce gasses as a waste product. This in turn creates an increase in abdominal pressure and causes the LES to open. 

Here is the problem; most people will take medicines such as PPIs and antacids chronically. These medications were initially intended for short term use. Overuse can lead to chronically low levels of stomach acid and worsen the problem over time. The antacids may alleviate the symptoms in the short term, but just exacerbate the problem long term. 

Low stomach acid may not be the only reason for reflux, but it is common. Luckily, it can easily be managed with some diet and lifestyle changes. Removing the foods that trigger reflux to start so that you can stop using medications like PPIs and antacids. Some may benefit from the use of digestive enzymes under the supervision of their healthcare provider. 

Triage Theory and Longevity

There has been a lot of talk about longevity lately, with the understanding of telomeres, sirtuins, and the rise in popularity of the work of David Sinclair. An interesting theory has arisen from Dr. Bruce Ames, who has been a molecular biologist and in the nutrition space for decades. He came up with the term “Triage Theory” as a way to understand how the body uses micronutrients.

First, a reminder; macronutrients are your fats, proteins, and carbohydrates. Micronutrients are your vitamins and minerals. For this conversation, we are interested in the micronutrients only. 

Dr. Ames postulates that you can group micro’s into 2 buckets…survival, and longevity. As the theory goes, the body will prioritize survival over longevity. The body will ration the micronutrients it needs to avoid things like rickets or beriberi. Then the rest is used for things that promote longevity such as DNA. If we are deficient, the processes that promote longevity will be sacrificed for survival. 

If this theory is correct, this is a massive paradigm shift in how we think about micronutrients. This means that a moderate deficiency may not kill us in the short term, but will be reducing our life expectancy.

There are about 40 micronutrients that we know of that are required to sustain life. Most reference ranges reflect a minimum to survive. But is this optimal? Are these the levels we need to thrive, not just survive? Are we shortening our lifespan? 

Let’s look at vitamin K for example. Vitamin K has several functions. A key function is in coagulation, which is vital for life. If you get a cut, the wound needs to coagulate to heal. If it doesn’t, you’ll bleed out and die. 

Vitamin K also is important for calcium metabolism and transport. We all know that calcium is important for bones and teeth. However, just taking a calcium supplement alone may be a bad idea (Tankeu et. al, 2017) because the calcium will end up in the tissue and bloodstream causing calcification of arteries because it needs vitamin K to transport it to the skeletal system. 

So if we have just enough vitamin K, we can survive a wound. That is the lower limit for survival. If we accept the lower limit, we risk calcification of the arteries. We should be asking not only how much do we need to survive, but how much do we need to thrive? 

If you are looking for a reliable source of information on micronutrients, check out the Linus Pauling Institute.

Reference:

Tankeu AT, Ndip Agbor V, Noubiap JJ. Calcium supplementation and cardiovascular risk: A rising concern. J Clin Hypertens (Greenwich). 2017 Jun;19(6):640-646. doi: 10.1111/jch.13010. Epub 2017 May 2. PMID: 28466573; PMCID: PMC8030811.

Iron Overload

Iron deficiency is extremely common and can be one of the causes of anemia. However, too much iron can be a problem as well and is known as iron overload. Iron overload is associated with metabolic disorders, gout, cardiovascular disease, hormone problems, immune imbalances, and musculoskeletal disorders.

Iron is an essential micronutrient and serves many functions in the body and helps deliver oxygen to tissues through hemoglobin (blood) or myoglobin (muscle). Iron is not absorbed by the body, it first has to be oxidized to form ferric oxide, then it hits the stomach acid and becomes ferrous iron where it then gets absorbed in the GI tract. Most iron is found in the hemoglobin (70%) and about 15% is in myoglobin. A small amount circulates in the serum, and the rest is stored. 

Ferritin is a storage molecule and when supplies are ample, iron gets stored in ferritin. This is important to know because if you are doing a blood panel, ferritin is a marker that is a strong indicator of your iron levels. Serum iron is the least sensitive marker for iron levels. This is because many things can offset the serum iron levels, such as alcohol, drugs, oral contraceptives, aspirin, metformin, stress and sleep deprivation. 

Ferritin is the first marker to go out of range, but there is something else to know about ferritin. Bacteria and viruses can proliferate when they have access to iron, so the body wisely locks up iron in ferritin to protect the body. So if you are ill, ferritin levels will rise. In this way, ferritin is a marker for inflammation. 

So what happens when iron levels are too high? Symptoms can include extreme fatigue, joint pain, palpitations, abdominal pain, depression, impotence, and skin bronzing. Some causes of iron overload include hereditary hemochromatosis (mutation of gene C282Y or H63R), sickle-cell anemia, alcohol abuse, viral hepatitis, iron supplementation, or a diet high in iron. Substances that increase iron absorption include:

• Foods high in vitamin C

• Foods high in beta carotene

• HCL supplements

• Meat (particularly red)

• Sugar

• Alcohol

So if you are experiencing any of these symptoms, it’s best to get a blood panel and find out your iron status. Remember, serum iron is the least sensitive marker so a full iron panel that includes ferritin would be more precise. 

If you’ve done a 23 and me genetic test, you can find out if you are susceptible to hemochromatosis. To find out, fill out the form below for a free download:

Iodine Deficiency

Iodine Deficiency is an extremely common problem and the effects can be hidden. Iodine is an essential for life and is important for the synthesis of thyroid hormones. Deficiency can lead to hypothyroidism, goiters, and some lesser known problems. Some food sources can inhibit iodine absorption and are termed “goitrogenic”. 

Iodine is found in the upper crust of the earth as a trace element. Because of glaciation and flooding during the Ice Age, it was distributed mostly in the soil and waters of coastal areas (Leung et al., 2012). Food sources that are high in iodine include seafood such as oysters, shrimp, fish, and seaweed. It is also found in livestock in coastal regions depending on the soil, but because of intensive cropping and the use of alkaline fertilizers, iodine levels have been depleted (Kapil, 2007).

The role of iodine in production of thyroid hormones is well established, and deficiency can cause decreased production of T3 and T4. T3 is an important hormone that affects many tissues of the body and regulates body temperature, heart rate, metabolism, and development of fetuses and children. T3 increases the basal metabolic rate, so when it is low from an iodine deficient state, it can slow metabolism. The pituitary gland detects that T3 is low and in response, secretes TSH (thyroid stimulating hormone) in an attempt to reestablish balance. This can lead to hypertrophy of the thyroid and endemic goiter. 

Prior to the 1920s, iodine deficiency had become prevalent in the Great Lakes, Appalachians, and Northwest regions of the U.S. This area became known as the “goiter belt” and between 26-70% of the children had a visible goiter. For decades, most table salts have been sprayed with iodine to counteract iodine deficiency. In May of 1924, iodized salt first became available, however in 1926 there were reports of thyrotoxicosis (Leung et al., 2012). Perhaps the pendulum swung too far in the opposite direction. As usual, there is probably too much of a good thing and there is such a thing as iodine toxicity. Some salts such as Redmond, contain naturally occurring iodine (as it is mined from underground) and may be a good alternative to table salt.

That being said, iodine deficiency and hypothyroidism are much more common. There is another variable to this equation and it comes from sources that compete with iodine. There is a class of foods that are “goitrogenic”. Glucosinolates are a compound that are found in the plant order Brassicales. This is a natural plant defense and when the plant is chewed or cut, the glucosinolate is converted to isothiocyanate which can inhibit iodine uptake (Felker et al., 2016). Brassicales include foods such as the cruciferous vegetable; broccoli, kale, bok choy, brussel sprouts, and cauliflower. Fully cooking these vegetables significantly reduces these defense chemicals, but it unfortunately also reduces the beneficial nutrients. 

Another potential problem is fluoride. Both iodine and fluoride are halogens and compete with each other in the body. Unless you are living on a property with a well, water is fortified with fluoride, and it is in most toothpastes. Fluoride toxicity has been linked to thyroid disease (Singh et al. 2014). 

References: 

Felker P, Bunch R, Leung AM. Concentrations of thiocyanate and goitrin in human plasma, their precursor concentrations in brassica vegetables, and associated potential risk for hypothyroidism. Nutr Rev. 2016;74(4):248-258. doi:10.1093/nutrit/nuv110

Kapil U. Health consequences of iodine deficiency. Sultan Qaboos Univ Med J. 2007;7(3):267-272.

Leung AM, Braverman LE, Pearce EN. History of U.S. iodine fortification and supplementation [published correction appears in Nutrients. 2017 Sep 05;9(9):]. Nutrients. 2012;4(11):1740-1746. Published 2012 Nov 13. doi:10.3390/nu4111740

Singh N, Verma KG, Verma P, Sidhu GK, Sachdeva S. A comparative study of fluoride ingestion levels, serum thyroid hormone & TSH level derangements, dental fluorosis status among school children from endemic and non-endemic fluorosis areas. Springerplus. 2014;3:7. Published 2014 Jan 3. doi:10.1186/2193-1801-3-7

High Blood Pressure? Drop the Sugar.

For years, we’ve been told to avoid salt as it increases blood pressure. There is more to the story than that. After all, there is what is known as “salt sensitive hypertensives”. So why do some people seem to be sensitive to salt, and others are not? Whenever this pattern arises, there is some more digging to be done. Perhaps the link is sugar.

But first, let’s discuss how salt can raise blood pressure. Salt is necessary for human life and it’s part of muscle contraction. Our bodies rely on a balance of water and salt. This balance is detected in our kidneys, which signals to our endocrine system where the balance stands. Too much salt, the pituitary secretes vasopressin to tell the kidneys to hold on to water. Not enough salt, the adrenal glands secrete aldosterone to tell the kidneys to hold on to salt. 

Water chases salt, so where there is more salt, there is more water, and total blood volume increases. This means blood pressure will increase as well. Increased insulin levels raise aldosterone (Kubzansky & Adler, 2009). A diet that is chronically high in carbohydrates will lead to insulin resistance, and therefore more aldosterone when carbs are eaten. So this may explain why some are sensitive to salt, and some are not. Perhaps those that are salt sensitive, are insulin resistant. Quite simply: a diet high in carbs>insulin resistance>increased aldosterone>increased salt and water retention>elevated blood pressure. 

Another way that sugars may increase blood pressure is through its effect on the blood vessels. Insulin has two important effects on the vasculature. Normally, insulin suppresses cytokines, adhesion molecules, and reactive oxygen species (the damaging stuff for vessels). It also stimulates nitric oxide release, a known vasodilator (widens the vessel). In an insulin resistant state, this hormone no longer exhibits its effects (Fonseca, 2007). So now you have a tube that is thickened from the inside, and narrowed because of the lack of nitric oxide; a double whammy.

That’s 3 ways that sugars can increase blood pressure. And that’s just what we know of. Time and time again, we learn that the farther we stray from how our ancestors ate, the worse our health becomes. 

References:

Fonseca VA. The effects of insulin on the endothelium. Endocrinol Metab Clin North Am. 2007 Dec;36 Suppl 2:20-6. doi: 10.1016/s0889-8529(07)80009-0. PMID: 18407031.

Kubzansky LD, Adler GK. Aldosterone: a forgotten mediator of the relationship between psychological stress and heart disease. Neurosci Biobehav Rev. 2010;34(1):80-86. doi:10.1016/j.neubiorev.2009.07.005

How Dietary Fats May Influence Migraines

Anyone who has experienced a migraine can tell you just how horrific they can be. In high school, I used to get them and it felt like someone was dropping acid on my brain. I would have to lock myself in a room with the shades drawn and suffer through it, often to the point of vomiting. While there are many triggers to migraines, there are some easy dietary changes you can try that may influence it. 

The way we have eaten as a species has dramatically changed. We’ve introduced some nasty, non-species appropriate foods into our diets. If you’ve been following my nutrition blog at all, I’m sure you’ve picked up on the fact that vegetable oils, a.k.a. Industrial seed oils, take the blame for many of the problems we face. This is no exception. And should we be surprised that if we ingest something that was intended initially as a lamp oil and machine lubricant has some negative consequences? 

Vegetable oils are a type of polyunsaturated fatty acid (PUFA). PUFAs are an essential fatty acid and include omega 6 and omega 3. The problem is, the ratio of omega 6 to 3 has drastically changed. Historically, we ingested these PUFAs at a ratio of 1:1 and in the last 3 decades, that has jumped to 20:1 with omega 6 far outweighing omega 3 (Simopoulos, 2016). The reason there has been a massive change in the ratio is because of the uptick in vegetable oils in our foods, which are an omega 6 oil.

In July of 2021, a systematic review, which is one of the highest levels of evidence, sought to determine the link between diet and migraines (Burch). They found that a diet with a normal ratio of omega 6 to 3 significantly reduced headache frequency and intensity. Omega 6 and omega 3 are precursors to a molecule known as oxylipins. Oxylipins have opposing effects when it comes to regulating pain and inflammation in the body, depending on their precursor. Oxylipins from omega 6 are pro-inflammatory whereas when derived from omega 3, it is anti-inflammatory. 

Additionally, we know that adipose tissue (fat tissue) can secrete cytokines which signal inflammation. A diet that is high in omega 6 and low in omega 3 increases the risk for obesity (Simopoulos, 2016). When there is inflammation in the gut, it can travel to the brain and cause headaches via the gut-brain axis (Arzani et al., 2020). 

The results are in. Vegetable oils can have a cascade of negative consequences in the body. The problem is they are in so many food items. If it has a label, chances are it contains vegetable oil. Here are ones to avoid:

Soybean oil

Safflower oil

Canola oil

Ricebran oil

Cottonseed oil

Corn oil

Grapeseed oil

Sunflower oil

And where do we get omega 3’s? Oily fish like mackerel and salmon, oysters, sardines, eggs, and grass fed red meat. 

References:

Burch, R. (2021). Dietary omega 3 fatty acids for Migraine. BMJ. https://doi.org/10.1136/bmj.n1535

Simopoulos, A. (2016). An increase in the omega-6/omega-3 fatty acid ratio increases the risk for obesity. Nutrients, 8(3), 128. https://doi.org/10.3390/nu8030128 

Dietary Causes of Vertigo (BPPV)

Benign paroxysmal positional vertigo, or BPPV for short, is a debilitating condition that causes severe room-spinning dizziness with changes of head position. If you’ve heard of ‘crystals being loose in the ear’, this is BPPV. It is usually called ‘idiopathic BPPV’, which simply means we don’t know the cause. Head trauma can cause it, but for many patients that deal with this, they haven’t had any trauma. Some recent research has proposed that there is likely a dietary component of this condition in the form of changes in carbohydrate metabolism. 

First, a quick overview on the inner ear. You have 3 semicircular canals in your inner ear. They are full of two layers of fluids, the endolymph and perilymph. The endolymph contains more potassium ions, and the perilymph contains more sodium ions. This gradient differential creates a potential to conduct nerve impulses. One suggestion of a possible dietary cause is as simple as an electrolyte imbalance, particularly sodium, as it may interfere with the nerve impulse. 

At the base of the semicircular canals, there is an organ called the utricle which has otoconia (the crystals) and hair cells attached to it. In BPPV, the otoconia degenerate and make their way into the canals, causing severe room-spinning dizziness. Degeneration has been linked to a number of causes, including vitamin D deficiency (Talaat et al. 2016). 

There also has been studies that show a correlation between dysfunctions in carbohydrate metabolism and BPPV. It is well known that chronically high levels of insulin can affect the cardiovascular system and cause hypertension. The endolymphatic sac has a high level of insulin receptors (Bittar et al. 2004). So it would follow that any problems with insulin, such as diabetes, would have an effect on inner ear function. The research supports this idea and in a Brazilian study conducted in 2015 (Webster et al.), followed a group of 72 patients that had BPPV, and followed them for 4 years. They found that recurrence of BPPV with patients that had hyperinsulinemia to be 4.6 times greater than those without, and recurrence of patients with hyperglycemia to be 2.47 times greater than the general population. Also, hyperinsulinemia has been associated with endolymphatic hydrops (a different form of dizziness) and there have been studies that have suggested endolymphatic hydrops may cause BPPV (Tanimoto et al., 2008). So perhaps hyperinsulinemia may be a common underlying cause.

Lastly, pH levels also appear to have an influence on the crystals. An acidic diet can cause erosion of the crystals. During sleep, shallow breathing can cause respiratory acidosis, and low blood pH. It is common for BPPV to happen first thing in the morning. Additionally, diabetes and gout can decrease blood pH, leading to BPPV (Han & Kim., 2020). 

Alas, more evidence that a high carbohydrate diet is probably not the best for everybody. The research is not conclusive, but there is a pretty strong signal.

Feeling Dizzy? We have a program that can help you resolve it, mostly on your own.

References: 

(PDF) vestibular impairment secondary to Glucose Metabolic ... (n.d.). Retrieved September 15, 2021, from https://www.researchgate.net/publication/262483036_Vestibular_impairment_secondary_to_glucose_metabolic_disorders_reality_or_myth. 

Han, D.-G., & Kim, D.-J. (2020). The evolutionary hypothesis of benign paroxysmal positional vertigo. Medical Hypotheses, 134, 109445. https://doi.org/10.1016/j.mehy.2019.109445 

Talaat, H. S., Kabel, A.-M. H., Khaliel, L. H., Abuhadied, G., El-Naga, H. A., & Talaat, A. S. (2016). Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin d deficiency. Auris Nasus Larynx, 43(3), 237–241. https://doi.org/10.1016/j.anl.2015.08.009 

Tanimoto H, Doi K, Nishikawa T, Nibu K. Risk factors for recurrence of benign paroxysmal positional vertigo. J Otolaryngol Head Neck Surg. 2008 Dec;37(6):832-5. PMID: 19128712.

Webster, G., Sens, P. M., Salmito, M. C., Cavalcante, J. D., dos Santos, P. R., da Silva, A. L., & de Souza, É. C. (2015). Hyperinsulinemia and HYPERGLYCEMIA: Risk factors for recurrence of benign paroxysmal positional vertigo. Brazilian Journal of Otorhinolaryngology, 81(4), 347–351. https://doi.org/10.1016/j.bjorl.2014.09.008 

Glutathione

When it comes to antioxidants, glutathione is the king of the jungle. It boosts metabolism, takes stress off the liver, supports the immune system, and protects the body from oxidative stress. It is composed of 3 amino acids, L-glutamine, glycine, and cysteine. Deficiency can lead to serious problems, but the good news is that we can get it through diet. 

First, let’s discuss oxidative stress, or oxidation. Oxidation is why a banana left out turns brown. Cellular damage occurs because of oxidation. It signals inflammation in the body. Where does this oxidation come from? Reactive oxygen species (ROS), otherwise known as free radicals. They can come from external stressors like cigarette smoking, metals in foods, pollutants, excessive exercise, and stress. They can also come from internal mechanisms and are a byproduct of metabolism. How does the body mitigate oxidation? You guessed it, antioxidation. Although there are many antioxidants, glutathione is the most important one. 

At any given point, we have a pool of glutathione to mitigate oxidative stress and these external and internal stressors soak up the pool of glutathione. NSAIDs, such as acetaminophen can severely deplete glutathione levels. Chronically depleted levels of glutathione can cause a whole host of problems such as food sensitivities, autoimmune disorders, some cancers, and even adverse reactions to covid-19.

Unfortunately, using glutathione as a supplement appears to be ineffective. However, giving your body the building blocks that form glutathione can be beneficial. N-Acetyl-Cysteine has been touted as a way to increase glutathione. You can also get these building blocks from our diet. High quality animal meats and eggs are a good source of these building blocks. Also, you can get them from cruciferous vegetables such as broccoli. Milk thistle and vitamin C may also help. 

Type 3 Diabetes

Type 3 diabetes is a new (and not quite accepted yet) term to describe the effects that diabetes can have on the brain. It describes the progression of diabetes to Alzheimer’s disease. The correlation between diabetes and Alzheimer’s is well documented, and this blog will aim to describe the proposed mechanism.

Just a quick reminder; diabetes is directly affected by insulin. There is either not enough insulin (type 1), or too much production due to insulin resistance (type 2). Type 2 diabetes is the one that is implicated in Alzheimer’s disease. 

Alzheimer’s is complicated, and the current understanding of the disease process postulates that progression is due to a build up of a protein called amyloid beta peptide. These form plaques that affect brain function. Your brain cells have receptors of insulin, so when it is released from the pancreas, it has a direct effect on the brain. When the brain becomes insulin resistant, more insulin has to be released to have the intended response. The plaques in patients with Alzheimer’s are formed in the space between nerves of the brain, not inside the nerves. An overabundance of insulin causes the nerves to release the amyloid beta protein into the space between the nerves (Gasparini et al., 2001). 

Alzheimer’s accounts for about 80% of all dementia. Vascular dementia is another form where the blood vessels aren’t functioning normally. There is a cause and effect relationship between hyperinsulinemia and hypertension. Insulin increases blood pressure by increasing sodium absorption in the kidneys, activating the fight or flight nervous system, and causing the blood vessels to thicken. Conversely, high blood pressure causes decreased delivery of insulin and glucose to the muscle cells, resulting in impaired glucose uptake (Salvetti et al., 1993). 

These are just a few of the mechanisms of how insulin resistance may be causing dementia. The more you read on insulin resistance, the more you learn just how horrible it is. For example, too much insulin will make you gain weight. Fat cells are like endocrine organs, meaning they can secrete signaling molecules. One of the molecules they secrete is cytokines, which cause inflammation. Inflammation causes further insulin resistance, which causes more inflammation, and the cycle repeats. This chronic systemic inflammation eventually reaches the brain. 

Another problem is that many people are insulin resistant and have not been diagnosed. If you are overweight and have high blood pressure, you are very likely to have insulin resistance. A few other signs of insulin resistance are dark patches of skin around the armpits and neck, and also skin tags which are little growths of skin. By the way, you don’t have to be overweight to be insulin resistant. You can be T.O.F.I., which stands for “thin on the outside, fat on the inside”. Fat can form around your organs. 

If you have some of these symptoms, you may want to speak to your physician about adopting a low carb, high fat diet. Also, you can order a self test kit to check your A1C. Find the test here, and use the code DPT20 for 20% off. 

References: 

Gasparini, L., Gouras, G. K., Wang, R., Gross, R. S., Beal, M. F., Greengard, P., & Xu, H. (2001). Stimulation of β-Amyloid Precursor Protein Trafficking by Insulin Reduces Intraneuronal β-Amyloid and Requires Mitogen-Activated Protein Kinase Signaling. The Journal of Neuroscience, 21(8), 2561–2570. https://doi.org/10.1523/jneurosci.21-08-02561.2001 

Salvetti, A., Brogi, G., Di Legge, V., & Bernini, G. P. (1993). The Inter-Relationship between Insulin Resistance and Hypertension. Drugs, 46(Supplement 2), 149–159. https://doi.org/10.2165/00003495-199300462-00024 

Stop With the Egg Whites Already

Ok, I’m guilty of this too. I was doing the egg white omelettes with wheat toast and no butter back in the day. I thought I was doing it right. It’s sad to think of all those yolks I wasted. 

The egg white, is about 90% water, and 10% protein. That’s it, there’s not much to the egg white. Egg yolks are so nutrient dense and they contain the macros and micros that you want. It’s about 60% fats, 35% protein, and the rest is carbs. Fats are good, particularly the saturated fats. Our nervous system is made primarily of fats and they are essential to survival. 

Additionally, egg yolks are a powerhouse of essential amino acids, vitamins, and minerals. For starters, they are a great source of: vitamins A, D, E, K, B1, B2, B5, folate, choline, and minerals calcium, iron, magnesium, phosphorus, potassium, selenium, and zinc. They raise HDL levels and lower triglycerides (which is what you want). 

So why have they been demonized? Cholesterol. Eggs are high in cholesterol. Let me start by saying cholesterol is good. Why would our bodies produce something that is bad for you. And oh yeah, all animals produce cholesterol. Is this an accident? I think not. In fact there is a condition called Smith-Lemli-Opitz syndrome that is a genetic mutation causing low levels of cholesterol and is deadly if not addressed. One way these patients do better is a prescription of egg yolks. So why are we told cholesterol is bad? 

It’s a long story, but the short of it is that cholesterol is transmitted by a molecule called LDL (what is typically called the ‘bad cholesterol’). It is more like a bus ushering the cholesterol into other cells. There is a ‘key card’ on the LDL’s surface; a protein called apo B. When the LDL arrives at a cell, the cell recognizes the key card, and lets the cholesterol in. Sometimes, the key card gets damaged, and the cells no longer allow the cholesterol in. This is part of what leads to plaques in arteries. So what leads to this damage? A diet high in sugar and industrial seed oils, aka the standard American diet. For more on this, check out this article. 

So as long as you avoid packaged goods and don’t have a cookie problem, egg yolks are one of the best foods you can have. 

Why People with Hypoglycemia Should Eat a Low Carb Diet

Whatever it is, the way you tell your story online can make all the difference.

As a child, I was diagnosed with hypoglycemia. I had the typical symptoms; I was tired, shaky, irritable, and would have brain fog. My parents were told to keep me away from sweets and for years, I didn’t have candy. I remember even having pancakes with syrup would cause severe nausea and I’d have to lay down. I never really understood that if I had low blood sugar (hypoglycemia), why would putting sugar in the system bother me? It would seem that would be the way to fix it.

As usual, the answer to this is much more nuanced as it is the human body. It’s not just a simple input/output machine. Part of the answer is due to homeostasis, and the other part has to do with the endocrine system. 

I’ll give an analogy for the way homeostasis works. Imagine driving on a highway on a cold night, and you hit a patch of black ice. You start to fishtail out of control and then overcorrect the steering wheel to now fishtail in the opposite direction, but to a lesser extent. You tug the wheel back and forth until you finally straighten back out. This is how our bodies react to rapid swings in blood chemistry. 

When you eat a meal high in carbs, the endocrine system reacts by overcorrecting, for individuals that are carb sensitive. Insulin is secreted by the pancreas and wipes out the sugar by ushering it into muscle cells and the liver. Now the body is in a hypoglycemic state. 

The traditional medical answer is usually to add more sugar back into the system, but that is addressing the symptom rather than the root cause. Why not just stop eating high carb meals? The carbs are causing the spike in insulin and subsequent drop in blood sugar. Carbs are non-essential to the human diet. We are able to produce glucose in our bodies via the liver in a process called gluconeogenesis. 

One of the issues that arises in type 2 diabetics is insulin resistance. All cells have receptors for insulin, and when someone has a diet of high carbs over long periods of time, the receptors for insulin become resistant, and the cells don’t allow glucose in. Insulin has many functions, one of which is to suppress gluconeogenesis. So when the liver becomes insulin resistant, gluconeogenesis is not suppressed (Hatting et al., 2017). So now the liver is producing glucose, and more glucose is flooding the body through the diet. Now we are in a hyperglycemic state, and this is where much of the damage of sugars occur, furthering the disease process of diabetes. 

Glucagon is another player in this situation. It has the opposite effect of insulin; it draws sugars out of cells back into the bloodstream. Why not increase glucagon in the diet when we are in a hypoglycemic state? Turns out that eating a moderate amount of protein can stimulate glucagon secretion (Schmid et al., 1989). 

In short, a diet low in carbs and high in proteins and fats will keep blood sugars at normoglycemic levels, and can prevent the development of metabolic dysfunction. 

References:

Hatting, M., Tavares, C. D., Sharabi, K., Rines, A. K., & Puigserver, P. (2017). Insulin regulation of gluconeogenesis. Annals of the New York Academy of Sciences, 1411(1), 21-35. doi:10.1111/nyas.13435

Schmid, R., Schusdziarra, V., Schulte-Frohlinde, E., Maier, V., & Classen, M. (1989). Role of amino acids in stimulation of POSTPRANDIAL INSULIN, Glucagon, and Pancreatic POLYPEPTIDE in humans. Pancreas, 4(3), 305-314. doi:10.1097/00006676-198906000-00006

Why “Calories in, Calories out” is Broken

We’ve been told for decades to eat less and move more. This is the caloric deficit paradigm, and I’d argue it’s not the best way to lose weight. Although it does work, it requires the tedious task of counting calories and leads to a lot of hunger. If our bodies were as basic as an automobile, it would make some sense. But we are much more complicated than a car. The good news is there is a better way that doesn’t require calorie counting. 

Here’s the problem: we’ve been told to eat a diet rich in complex carbohydrates 6 times a day. Then we have to work out to a point where we’ve burned more than we’ve consumed. Well if you’ve had starches and carbs 6 times a day, you are constantly spiking your insulin levels. Insulin removes glucose (carbs) from your bloodstream. So every time you eat a carb rich diet, your pancreas floods the body with insulin. And I’m talking not only about rice and pasta, but also fruits and vegetables. This potent hormone has many roles, and one of them is to build. It can build muscle tissue, fatty acids in the liver, and it builds adipocytes, or fat cells. So when insulin is secreted, the body's ability to burn fat is suppressed. 

Calories in, calories out can work, but the real reason it is broken is that it places to blame on the individual. It requires a lot of exercise, and being in a near constant state of hunger. Hunger is one of our prime drivers, and unless you have extreme will power, hunger will win. So the person that has difficulty losing weight with this paradigm feels guilty that they can’t control their very normal instinct for hunger. 

Luckily, our body can utilize two fuel sources; carbs and fats. If we stop spiking our insulin levels, it allows for fats to be burned. You can do this with an animal-based diet, or by intermittently fasting. Fasting triggers ketosis which is the process of burning fats. Additionally, it encourages our body to be metabolically flexible as I explain in this article. If you try one of these methods, you will lose weight. If you plateau and still want to lose more weight, then you can look at your calories to see if there is a surplus. The best part of this strategy is that you rarely go hungry as our fat storages are far greater than our carb storages. 

I want to be clear that I do not think that carbs are the devil, but there are many benefits to allowing your body to occasionally burn fats rather than carbs. Additionally, insulin resistance is at epidemic levels, and part of the reason for this is that we continue to pump carbs into our bodies. 

The Key to Improving Your Metabolism

Metabolic dysfunction is rampant in the United States. The majority of Americans have an underlying metabolic dysfunction. Obesity is usually blamed for many of the problems that Americans face such as stroke and heart attack, but obesity is just one of many symptoms of a greater problem. That problem is metabolic dysfunction.

To understand metabolic dysfunction and how to correct it, we first have to understand exactly what metabolism is. Metabolism is the way the body converts food into energy. There are 3 macronutrients that we consume; proteins, fats, and carbs. The body converts mostly fats and carbs for energy. Protein is generally used to build parts of the body and is not relevant for the rest of this blog post. The process of converting carbs into energy is called glycolysis, and the process of converting fats into energy is called ketosis. The ability of the body to readily take energy from both sources is called “metabolic flexibility”.

When we consume a diet that is primarily carbs, as we’ve been told to do for so many decades, our bodies learn to rely on glucose for energy. Then it becomes difficult to burn fats for energy. This is termed “metabolic inflexibility”. This becomes problematic for a number of reasons. First off, the body is only able to carry a small tank of carbs on the body. It gets stored in the liver and in muscle, and can circulate in the bloodstream. Roughly 2000 calories can be stored in this way. Once we use that up, we will get hungry, or rather hangry as we are low on energy. Especially if your body has not adapted to going into ketosis, or fat burning. We carry much more fat on the body, even if you are slim, than we do carbs. Additionally, when fats are being used for energy, it burns cleaner and causes less oxidative stress. 

When you eat a carb heavy meal, your pancreas secretes insulin. Insulin ushers the circulating glucose from the bloodstream into the liver and muscle tissue. If you have lived a life of constant carb consumption, and are spiking your insulin levels continually, you run the risk of becoming insulin resistant. This leads to type 2 diabetes. 

Insulin is a potent hormone that has many functions. One of its functions is to dictate which fuel source is being consumed for energy. When insulin is secreted, carbs are being used. When insulin is lower, fats can be utilized. So the key to burning fats is to keep insulin levels low. 

How do we do that? Prevent insulin spikes by eating a low or zero carb diet. Even if it's an intermittent strategy, most people will benefit because the majority of Americans are never in ketosis. In fact, the main reason people seem to do well with intermittent fasting is that they are giving their bodies a chance to use up their glucose, and trigger ketosis. If you have difficulty because you are getting hangry, you can just try avoiding foods that are high on the glycemic index to start, and then eventually progress to a zero carb diet. The key is to avoid insulin spikes, to allow for fat burning with the end goal of metabolic flexibility. 

12 Common Nutritional Deficiencies in Vegetarians

The nutrition world can be confusing and there seems to be opposite recommendations for just about any food out there. And it may be for good reason; there is not one diet approach that is perfect for everyone. With that being said, it is important to understand the pros and cons of diet styles. Most diets will be deficient in some areas which can range from minor symptoms, to more dangerous consequences. For the purpose of brevity, this article will list the more dangerous problems that can occur because many of the milder symptoms overlap and include nausea, fatigue, weakness, confusion, etc. It is important to note that some of these nutrients can be toxic in excess, including the fat soluble vitamins, A and D. 

1. Vitamin A: Also known as Retinol, it is important for vision. It is found mostly in animal products such as liver, eggs, dairy and oily fish, so it can be difficult for vegetarians to get a good source of vitamin A without supplementation. Deficiency can lead to eye disorders. 

2. Vitamin D: Is involved in absorption of calcium and phosphorus to support strong bones and teeth. It also has a role in breaking down the membrane around viruses. Deficiency can lead to rickets and osteoporosis. Vitamin D is found in cod liver oil, egg yolks and red meat. Vitamin D can be produced from sunlight so it is likely more of an issue for people living in colder climates. 

3. Leucine: Is a branched chain amino acid (BCAA) and is involved in protein synthesis and energy production. Deficiency can lead to a loss of muscle mass and hair loss. It is found mostly in meat, fish, eggs, and dairy but is also in legumes and pumpkin seeds.

4. Glutamine: is another amino acid and is a precursor to arginine. It is involved in protein synthesis and immune function.It is also involved in wound healing, reducing cortisol levels, and promotes gastrointestinal health. Strenuous exercise can reduce glutamine levels and lead to suppressed immune function. It is found in almost every food that is protein based. 

5. B12: Boosts energy, helps form blood cells, and prevents brain atrophy. Dietary sources of vitamin B12 occur primarily in animal products such as lamb, beef, herring, mackerel, pork liver, oysters, poultry, clams, and eggs. To get enough B12, vegetarians have to supplement or ingest food that has been fortified with B12 such as tofu. Deficiency can lead to anemia.

6. Creatine: rapidly replaces ATP in fast twitch muscle fibers, improving power output. It also reduces muscle cramps. Beef is high in creatine, however when cooked, it transforms into creatinine, a waste product of creatine. Deficiency can lead to CDS (creatine deficiency syndrome) and cause developmental delays, intellectual disability, seizures, and movement disorders. 

7. Taurine: is an amino acid that plays a role in brain tissue and nervous system functioning. It is also involved in blood pressure regulation and eye health. Deficiency can lead to weakening of the heart muscles, retinal degeneration and eventually blindness, and fetal abnormalities. 

8. Carnosine: is synthesized from beta-alanine and L-histidine. Carnosine is involved in antioxidant activity, improves copper uptake, and reduces the fatigue caused by muscle acidosis. It is found in muscle tissue so animal products are high in carnosine. Deficiency can cause developmental delays, nerve tissue degradation, and tremors. 

9. DHA (Docosahexaenoic Acid): is an Omega-3 fatty acid and competes with arachidonic acid, and is therefore anti-inflammatory. They also thin the blood, reduce clotting, and may raise HDL. Many children and adults with ADHD have a deficiency in DHA. Emerging evidence has linked behavior disorders with chronic inflammation of the brain. DHA is found in fish oils and grass fed beef. 

10. Heme Iron: is crucial in delivering oxygen to our tissues of the body. Although you can get iron from plants, it is non-heme iron and less absorbable in the body. Iron deficiency can lead to anemia which can cause fatigue, headaches, restless legs, and oddly enough, the desire to chew ice. 

11. Calcium: is important in bone health and controlling blood pressure. It is important to have zinc and vitamin D in the diet to absorb and use calcium, and these tend to be deficient on a plant-based diet. Calcium deficiency can cause osteoporosis, tingling, cramps, and spasms. 

12. Zinc: is important in growth and repair of muscle. It also has a role in the immune system and prevents RNA replication in viruses. Deficiency can lead to hair loss, and lack of smell and taste. 

Sugar and Arthritis

If you have knee arthritis, I’m sure you’ve been told that you should lose weight. For decades, we’ve assumed that arthritis is caused from “wear and tear” and is just caused by repetitive mechanical loading. So if you’re overweight, the joints take on more compression, eroding cartilage faster. But are we sure that is all that is going on? 

If mechanical compression causes arthritis, then how do we explain the piles of evidence that running is good for your knees, not bad. When it comes to research, there are varying degrees of evidence. Randomized controlled trials (RCTs) are pretty top notch, but even better than that is a systematic review. This means that all of the RCTs on a certain topic are summarized. A 2011 systematic review (Urquhart et al.) on physical activity and knee joint health found that “physical activity is beneficial, rather than detrimental, to joint health”. They go on to say that physical activity is also associated with an increase in cartilage volume (yes, increase) and a decrease in cartilage defects.

We do see that when someone loses just 10% of their body mass, they experienced significant pain resolution or reduction, reduced inflammation, and improved function (Messier et al., 2013). We have assumed that it just decreased mechanical compression, but are we sure? 

We also know that diabetics, who tend to have high glucose concentrations, are at high risk for early onset arthritis. In 2016, (Courties & Sellam) published an article that surmised that low grade inflammation and the induction of oxidative stress and cytokines contribute to joint related pain. 

When sugar is in close proximity to a protein, it attaches to it. This is a process known as glycation. This is what is being measured in a HbA1c test. Once the protein is glycated, it changes to advanced glycation end products (AGEs). These AGEs are able to crosslink proteins and cause collagen stiffness. This leads to tissue remodeling and degradation (Degroot et al., 2014).

The good news is that this goes both ways. A low carb, high protein diet can improve tissue remodelling of the extracellular matrix and improve tissue quality. An RCT published in 2019 (Strath et al.), found that low carb diets are more effective than low fat diets in reducing pain intensity from knee arthritis.  

I intentionally chose the picture for this article to include table sugar and strawberries. This is because when I say sugar, I really mean carbohydrates. That is glucose, sucrose, galactose, fructose, etc. Now I don’t mean to vilify carbs, but it is well known that the average Americans consumes an over abundance of carbs, partly because we have been told for decades to “carb up”. Still to this day, dietary guidelines are still heavy on the carb portion. Some of the current ideas behind new diets like the carnivore diet, is to eat like our ancestors. If you think about it, our ancestors didn’t have fruits and vegetables around all the time, and their diet was mostly meat-centric. Not to say that fruits and vegetables are bad, rather we probably take in more than our ancestors did. 

So the next time your achy knee acts up, instead of rushing out to get an injection or swallowing some anti-inflammatories, try cutting back on the carbs for a week. It may be all that you need. 

References:

Courties, A., & Sellam, J. (2016). Osteoarthritis and type 2 diabetes mellitus: What are the links? Diabetes Research and Clinical Practice, 122, 198-206. doi:10.1016/j.diabres.2016.10.021

Degroot, J., Verzijl, N., Wijk, M. J., Jacobs, K. M., El, B. V., Roermund, P. M., . . . Lafeber, F. P. (2004). Accumulation of advanced glycation end products as a molecular mechanism for aging as a risk factor in osteoarthritis. Arthritis & Rheumatism, 50(4), 1207-1215. doi:10.1002/art.20170

Messier, S. P., Mihalko, S. L., Legault, C., Miller, G. D., Nicklas, B. J., Devita, P., . . . Loeser, R. F. (2013). Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among Overweight and Obese Adults With Knee Osteoarthritis. Jama, 310(12), 1263. doi:10.1001/jama.2013.277669

Strath, L. J., Jones, C. D., George, A. P., Lukens, S. L., Morrison, S. A., Soleymani, T., . . . Sorge, R. E. (2019). The Effect of Low-Carbohydrate and Low-Fat Diets on Pain in Individuals with Knee Osteoarthritis. Pain Medicine, 21(1), 150-160. doi:10.1093/pm/pnz022

Urquhart, D. M., Tobing, J. F., Hanna, F. S., Berry, P., Wluka, A. E., Ding, C., & Cicuttini, F. M. (2011). What Is the Effect of Physical Activity on the Knee Joint? A Systematic Review. Medicine & Science in Sports & Exercise, 43(3), 432-442. doi:10.1249/mss.0b013e3181ef5bf8

Weight Loss and Iron Deficiency

Do you crave ice? Do you have restless leg syndrome? Or maybe you have chronic fatigue and look pale. Do you get short of breath? Do you bruise easily? These are all signs of iron deficiency. Did you know a deficiency in iron can inhibit your ability to lose weight? Let’s dig into it. 

Iron deficiency is extremely common, and it is a type of anemia. According to webmd, It affects about 20% of women, 50% of pregnant women, and 3% of men. Part of the reason that women are more affected is that women tend to eat less red meat. Another reason is blood loss during menstruation, and increased need for iron (because you are supporting another life) during pregnancy. 

With the movement towards plant-based eating, the problem will certainly rise. Iron comes in two forms; heme iron (from red meats) and non-heme iron. Although you can get some iron from plants, it comes in non-heme iron form, which is less well absorbed by the body. Additionally, plants contain polyphenols, which inhibit absorption of iron. Vitamin C can enhance absorption of iron (Ems, Lucia & Huecker, 2020). 

Why is iron important? Many proteins and enzymes in the body require iron to function. A vital protein involved in energy pathways of the body (electron transfer) is called cytochrome. With iron deficiency, cytochrome is unable to do its job and energy production plummets (Blayney et al., 1976). This is the reason for fatigue in iron deficiency. If you’re fatigued, it’s difficult to get your exercise in and will limit weight loss. 

Another interesting point on iron is its relationship with inflammation. Iron is stored in the body by a molecule called ferritin. Bacterial replication requires iron, so when you have an infection, the body wisely locks the ferritin so that the bacteria cannot use it to replicate. Although this is a protective process and necessary, now the body cannot use iron. A similar process occurs with chronic inflammation (Ueda and Takasawa, 2018). So chronic inflammatory processes like diabetes, obesity, and auto-immune disease can lead to chronic iron deficiency. This is called functional iron deficiency.

So if you eat red meat, the darker the better. The pigment of the meat is from myoglobin, which contains heme iron, not from the color of blood. If you don’t eat red meat or are on a plant-based diet, it will be important to consult with a physician to ensure proper iron levels. If you have a chronic illness causing inflammation, the root cause of the inflammation will need to be treated first. 

References: 

Blayney, L., Bailey-Wood, R., Jacobs, A., Henderson, A., & Muir, J. (1976). The effects of iron deficiency on the respiratory function and cytochrome content of rat heart mitochondria. Circulation Research, 39(5), 744-748. doi:10.1161/01.res.39.5.744

MR;, E. (n.d.). Biochemistry, Iron Absorption. Retrieved January 06, 2021, from https://pubmed.ncbi.nlm.nih.gov/28846259/

Ueda, N., & Takasawa, K. (2018). Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease. Nutrients, 10(9), 1173. doi:10.3390/nu10091173

“Bad Cholesterol” - The Truth About LDL

For decades, we’ve been told that LDL (low-density lipoprotein) is the bad cholesterol and is what causes atherosclerosis, or “clogged arteries”. This is a gross oversimplification and is not accurate. So if you have a blood panel and find out that you have high LDL, it may not necessarily be bad, more assessment has to happen. 

The plumbing analogy is usually used to describe what happens in an artery. The misconception is that heart attacks and strokes are caused by a clogged pipe. Pouring drano down the pipe should clear it out. What is really happening is that vegetable oils and sugars are more like pouring a corrosive acid down the pipe and it damages the pipe walls. Then a fragment breaks off and that is what causes heart attacks and strokes. 

For those that don’t like chemistry, I’ll cut right to the chase. LDL is a transport molecule and is not what causes atherosclerosis. When the LDL molecule or its components get damaged, that is when there is cause for concern. It’s a bit like a bunch of drunk guys damaging some property, then the cops show up and blame the cab driver that brought them there. We don’t have it quite right. 

Blood Panels don’t measure cholesterol, they measure lipoproteins. Lipoproteins are transport molecules, moving cholesterol from the liver to the bloodstream and back. LDL picks up cholesterols in the liver and becomes a ‘full bus’, dropping off cholesterol to various parts of the body. HDL (high-density lipoprotein) returns as an empty bus that returns to the liver to pick up cholesterol. This is a simplification and there are other states of lipoproteins but is important to note that cholesterol is vital to life. It is just that LDL has been associated with heart disease in observational studies, but these studies don’t tell the whole story. 

All humans and animals produce LDL. So why, from an evolutionary perspective, does it make sense that the body would produce something that is just bad for us. It doesn’t quite add up. Could it be that there is something else at play? 

One of the persistent ideas with lipoproteins is that the size matters. The smaller they are, the more dangerous because they can infiltrate the blood vessels, or so the theory goes. However there is a flaw in that logic, as even the smallest LDL molecules are bigger than the HDL (so called ‘good’ cholesterol). See the chart below: 

We used to look at total cholesterol and we were concerned with getting that number down. Then we broke it into HDL (good) and LDL (bad). The LDL category can be broken into two subcategories, either a healthy (stable) or unhealthy (unstable) molecule. If it is healthy, there are no negative effects. If it is damaged, then it can begin to line the arteries. What damages it? Oxidation. Oxidation is what happens to bananas and apples when left out. These are fruits that are low in antioxidants and aren’t able to prevent oxidation well. Oxidation at the organic level can modify and damage molecules and cause them to become unstable and behave differently. 

Before we get into what causes oxidation, first we have to understand the LDL molecule. Fats do not dissolve in water so they need a vehicle to move them into cells where they are supposed to go. An LDL molecule has a membrane that encases fats, and has proteins in the membrane. The one we care about for this article is called apoprotein B, or apoB for short. It’s important because when the LDL molecule reaches a cell, it recognizes apoB and allows the molecule to be taken into the cell to do its job. Without it, the LDL molecule would just circulate in the bloodstream.

When LDL molecules and their components get oxidized, they have one of two fates. When they are only minimally modified, they are still recognized by cells and are allowed in (Dinicolantonio & O’Keefe, 2018). Now they can inhibit enzymatic activity and damage the cell. When the apoB proteins are modified, now the receptors of the cell no longer recognize the LDL and block it from entry. This keeps it in circulation and attracts white blood cells since the immune system sees it as a threat. The white blood cells secrete other inflammatory mediators and all this damages the arterial wall. Then ruptures start to occur in the wall and blood clots there to prevent you from bleeding to death. It does its job in that regard but all it takes is a clot to break off to give you a heart attack or stroke (Malhotra et al., 2016). 

How are these LDL molecules damaged? Simple sugars and vegetable oils (polyunsaturated fatty acid, or PUFAs for short). Sugar minimally modifies LDL through oxidation (Prasad et al., 2014). Vegetable oils are produced by extracting oil from a seed or vegetable like corn. They have to be exposed to high levels of heat for extraction. This process makes the PUFAs unstable and when they come into contact with LDL, it causes oxidative stress to the molecule. In particular, it affects the apoB protein so that cell receptors don’t recognize the molecule and now the molecule is circulating in the bloodstream. It can’t stay in circulation for eternity, so it now becomes embedded in arterial walls. Historically, vegetable oil enriched foods like margarine, have been recommended to reduce LDL. But they do that by reducing circulating LDL by leaving a fatty streak (Ganesan et al. 2019) in your artery which is obviously the opposite of what you want. 

In short, saturated fat makes your cholesterol rise, but oxidation is what makes it go bad. At all costs, avoid industrially processed vegetable oils and refined sugars. 

References: 

Dhar, I., & Prasad, K. (2014). Oxidative Stress as a Mechanism of Added Sugar-Induced Cardiovascular Disease. International Journal of Angiology, 23(04), 217-226. doi:10.1055/s-0034-1387169

Dinicolantonio, J. J., & O’Keefe, J. H. (2018). Omega-6 vegetable oils as a driver of coronary heart disease: The oxidized linoleic acid hypothesis. Open Heart, 5(2). doi:10.1136/openhrt-2018-000898

Ganesan, R., Henkels, K. M., Wrenshall, L. E., Kanaho, Y., Paolo, G. D., Frohman, M. A., & Gomez-Cambronero, J. (2018). Oxidized LDL phagocytosis during foam cell formation in atherosclerotic plaques relies on a PLD2-CD36 functional interdependence. Journal of Leukocyte Biology, 103(5), 867-883. doi:10.1002/jlb.2a1017-407rr

Malhotra, A., Redberg, R. F., & Meier, P. (2017). Saturated fat does not clog the arteries: Coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions. British Journal of Sports Medicine, 51(15), 1111-1112. doi:10.1136/bjsports-2016-097285

WHAT SHOULD I EAT?!?

Ughhh.

This should be simple. We all overthink it. Here are some simple rules to live by:

1. If you feel horrible after eating it, stop eating it

2. If it doesn’t rot, don’t eat it

3. If it’s white, don’t eat it

4. Sugar=bad

5. Vegetable oil=bad

It’s that easy. Does real food come in cellophane? No. Stop it. Don’t eat it. Most of the grocery store is garbage. Stay on the perimeter; fruits, veg, meats, fish. Almost everything in the aisles is bad for you. Besides maybe pickles.

Ok, rant over.

So knowing what not to eat should be simple. Let’s get into some specifics of what to eat. The easiest thing to do is eats tons of vegetables, with lots of variety, and raw is better. Fish and meats should be the best quality you can afford and also have a lot of variety. Meat on the bone is particularly good. Fermented foods and organ meat are also fantastic for you.

I recently heard a podcast from Kelly Starrett and Juliet Starrett called ‘The Ready State’. By the way, I highly recommend it; it’s entertaining and chock full of knowledge. Dr. Cate Shanahan was the guest and the episode blew my mind. I already had a good understanding of how to eat but my food selection has changed since this episode. I am seeing and feeling the results. Dr. Cate’s website has tons of good information, and she has written two books: ‘Deep Nutrition’ and ‘Food Rules’. Here are the ‘Four Pillars’ as Dr. Cate explains them:

1. Fresh Food (antioxidants)

2. Meat cooked on the bone (connective tissue and joint health)

3. Sprouted and fermented food (gut health and immune system)

4. Organ meats (powerhouse of vitamins and minerals)

I want to pay some special attention to vegetable oils. They don’t get a lot of attention and they should. We all know the damage sugar causes and is probably the number 1 thing to avoid, so I won’t elaborate on that. We are finding out that there can be catastrophic damage caused by vegetable oils, and they are EVERYWHERE. When you decide to stop ingesting it and start reading labels, it is terrifying just how rampant it is. Even in baby formula.

Why are vegetable oils so bad for you? I’ll let Dr. Cate tell you:

“These oils contain a high percentage of polyunsaturated fatty acids (PUFAs). PUFAs are unstable, and break down rapidly when exposed to chemical stress. Ever heard of varnish? It’s what carpenters use to finish wood. Varnish is made from vegetable oils, including soy and linseed (which is rich in omega-3, like canola), because these oils are chiefly composed of PUFAs. PUFAs react with oxygen in the air to help polymerize the varnish into a nice hard coating that helps preserve the wood.

Varnish is good for your floors, but not so good for your brain, your arteries or mitochondria. I elaborate on that below, throughout this blog, and in Deep Nutrition chapters 7 and 8.

A little bit of PUFA is not a problem for us, we actually need some. And when we get PUFA from whole foods like sunflower, chia or flax seeds, it’s well protected by antioxidants nature builds into the seed. These protectants get stripped away during the industrial scale refining of sunflower and the other vegetable oils, and that’s just the beginning of the problems with vegetable oils.

The refining process not only strips away antioxidants, it makes PUFAs toxic by exposing them to heat, pressure, metals and bleaching agents. This chemically alters the molecules into a wide variety of potent toxins with long names like 4-hydroxynonanal and 4-hydroxyhexanol, aldehydes, and others. These molecules are toxic because they promote free-radical reactions that damage our cellular machinery including mitochondria, enzymes, hormone receptors, and DNA.”

If you want more information, grab either of her books “Food Rules” or “Deep Nutrition”. Not a reader? Check out the ready state podcast to get the cliff notes version: HERE. Spoiler alert, you will never want to ingest vegetable oil again. However, you will feel better and look better.

For reference, here is a chart to help with your oil selection:

Boost Your Immune System at this Critical Time - Supplementation

We all know the critical role of diet, exercise, and quality sleep plays at keeping a robust immune system. But what role do supplements play in contributing to the immune system? There are two supplements that you should consider; zinc and vitamin D, particularly now with the coronavirus pandemic. 

Zinc is a mineral that has many important roles in the body including cell replication, DNA synthesis, and growth. It also has a reputation for boosting immunity. Research has shown that athletes, particularly endurance athletes, tend to have deficiencies in zinc (Cordova & Alvarez-Mon, 1995). Three decades of work have indicated that zinc deficiency quickly deteriorates antibody and cell-mediated responses. Even short periods of zinc supplementation can improve immunity (Fraker et. al, 2000). Zinc supplementation has been found to reduce pneumonia in children (Lassi et. al, 2016). Moreover, it appears that zinc can directly disrupt the RNA replication process that allows for viruses to propagate (Read et. al, 2019). However, megadosing is not recommended as it can reduce copper, another mineral that aids the immune system. Foods that contain sources of zinc are meats, whole grains, liver, eggs, seafood, oysters, oatmeal, peas, beans, and maple syrup. Interestingly, lack of zinc has been associated with loss of smell and taste (Zumkley, 1985), which is a commonly reported dysfunction with coronavirus. 

Vitamin D functions to activate the immune system, and deficiencies have been correlated to increased risk of viral infections (Beard et. al, 2010). Some viruses have a lipid membrane outer coating, acting as a shield (this is called “enveloped”). Vitamin D appears to be able to disrupt the shield and break it down (Beard et. al, 2010). One study suggested that vitamin D supplementation reduced the incidence of influenza during the winter months in school children (Mitsuyoshi et. al, 2010). However, vitamin D is fat soluble, meaning that it can be toxic in high levels and RDAs (recommended daily allowances) should be followed. Food sources of vitamin D include eggs, butter, cream, halibut, fish liver oil, mackerel, salmon, sardines, and shrimp. Also, about 15 minutes of sunshine can give you adequate vitamin D. 

As always, consult with your physician if you are thinking about supplementation, as there is a such thing as toxicity and the can interact with medicine. Stay safe out there. 

References: 

Cordova, A. “Behaviour of Zinc in Physical Exercise: A Special Reference to Immunity and Fatigue.” Neuroscience & Biobehavioral Reviews, vol. 19, no. 3, 1995, pp. 439–445., doi:10.1016/0149-7634(95)00002-v.

Fraker, Pamela J., et al. “The Dynamic Link between the Integrity of the Immune System and Zinc Status.” The Journal of Nutrition, vol. 130, no. 5, Jan. 2000, doi:10.1093/jn/130.5.1399s.

Lassi, Zohra S, et al. “Zinc Supplementation for the Prevention of Pneumonia in Children Aged 2 Months to 59 Months.” Cochrane Database of Systematic Reviews, Apr. 2016, doi:10.1002/14651858.cd005978.pub3.

Zumkley, H., et al. “Zinc Metabolism during Captopril Treatment.” Hormone and Metabolic Research, vol. 17, no. 05, 1985, pp. 256–258., doi:10.1055/s-2007-1013508.

Read, Scott A, et al. “The Role of Zinc in Antiviral Immunity.” Advances in Nutrition, vol. 10, no. 4, 2019, pp. 696–710., doi:10.1093/advances/nmz013.

Beard, Jeremy A., et al. “Vitamin D and the Anti-Viral State.” Journal of Clinical Virology, vol. 50, no. 3, 2011, pp. 194–200., doi:10.1016/j.jcv.2010.12.006.

Urashima, Mitsuyoshi, et al. “Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza A in Schoolchildren.” The American Journal of Clinical Nutrition, vol. 91, no. 5, Oct. 2010, pp. 1255–1260., doi:10.3945/ajcn.2009.29094.