When Placebo Is Not Really Placebo

Posted on May 14, 2013 by

Can we all agree that a placebo should be a physiological inert substance?

Please, take a moment to ponder this question. By sharing this common belief we face a harsh reality, and must admit the throne we have placed Evidence Based Medicine (EBM) has problems, or perhaps the more modern term, “issues”.

And yet so many clinical trials are not using proper language. If we want to compare drugs, treatments, or food constituents against other drugs, treatments, or food constituents then that is a different study; not a placebo study. This might come as a huge surprise, but clinical trial after clinical trial repeatedly is touting their study as a placebo controlled trial and yet in the actual study the placebo used is an active chemical compound! The most recent example of this comes from a New England Journal of Medicine paper out of Italy looking at omega-3 fish oil vs. placebo to determine if the cumulative rate of death, non-fatal myocardial infarction (MI), or non-fatal stroke would be different between the two treatments.
What was there placebo?
olive oil

Olive oil…

…not a placebo

They chose olive oil because it is a physiologically inert substance that has no cardio-protective effects known to this date. WAIT!

stop sign

 

 

OOPS? Olive oil just happens to have a TON of data to support it’s efficacy for cardio-protection. In fact the NEJM just published a study on the Mediterranean diet which had either 1 L of olive oil added to it or walnuts and showed that compared to the other diet, a 3% absolute risk reduction or 33% relative risk reduction in heart disease.  So again, I ask if we are trying to determine if fish-oil is helpful vs. placebo, why are we not using placebo?  I understand that masking patients from the treatment would be difficult but either we truly do a placebo study or we should say  that it didn’t really matter if we use fish-oil or olive oil.
A quote from the recent fish oil study, “by the end of the trial the overall cardiovascular risk profile had improved in both groups.”
In fact a recent meta-analysis from JAMA on omega-3 supplementation shows that when olive oil is the “placebo” fish oil doesn’t perform better.

I continue to question excessive use of PUFA.  Should they be in our diet?  Absolutely.  But how much?  Here’s a good answer:

“JERF” -Sean Croxton from Underground wellness

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Why we get fat: Gary Taubes visits Bastyr University

Posted on May 4, 2013 by

As most of you know by now, we are in what we call an “obesity epidemic.” We can point fingers in a lot of directions because of course there are multiple people/organizations responsible. In this talk given at Bastyr University on Thursday, Gary Taubes poses an alternative hypothesis for the cause obesity. The video links are at the end of the post.


why we get fat

One of the interesting concepts that he brings up is the things people do to prepare for a feast. When you know you’re going to have a large meal later in the day (maybe thanksgiving?) what do you do to prepare? Eat less and exercise more, right? Isn’t this the same advice overweight/obese people are given to lose weight? Eating less and exercising more both generate hunger. So, perhaps that isn’t the best solution to weight loss.

Another concept he brought up was that healthcare professionals turn to medical textbooks for every disease except obesity. For this, they turn to physics: calories in, calories out. The energy that people consume can only be lost by expenditure (via metabolism). This makes sense, however, not everybody burns calories the same way. As we know, the human body is clever. Somebody who semi-starves themselves becomes more efficient in burning their stored energy. Evolutionarily, this is has helped our species survive for longer periods of time without food.

Regarding obesity and overeating, Which comes first the growth or the excess food consumption? If we think about a growing child, does he eat A LOT and exercise very little because he simply enjoys eating and is lazy? Or, is it because there are hormones in his body telling him to grow (growth hormone, etc)? We can think of obesity in these terms. There is a hormonal imbalance that is telling the body to grow, so to compensate, the person eats more!

These are just some of the points that Gary Taubes has touched on in his presentation. These were my interpretations of what I heard and what I’ve studied previously, I recommend listening to it and interpret it for yourself.


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Protein for the Elderly

Posted on April 27, 2013 by

Ok, I am going to start off this post by saying that if you are not >80yrs of age, you do NOT qualify as being elderly, despite the fact that the research paper I will be un-packing is based off 75 year old men.  65? 70? 75 = NOT OLD!.  >80? … a little OLD.  But who cares?  Functional?  Ah, the golden question!  Function matters, not age, unfortunately these correlate very well with each other.

Older-man-exercising-001

Or if you want to see what consistency in diet and nutrition look like at 75 yrs old check out Clarence Bass.

 

So on to protein!  Protein gets digested in your stomach and small intestine, and then absorbed in the small intestine.  As you absorb protein, your pancreas releases insulin to allow protein to be transported into the muscle cells.  Simple enough.

But here is the problem:  As we age, insulin resistance becomes an issue which means less protein is going into the muscle cells.  Less protein in, less muscle building, and you have what researchers are calling “anabolic resistance.”  This means less muscle mass, leading to increased all-cause mortality.  Want to live long?  You’ve GOT TO BE STRONG!  So simple, it rhymes!  Having a strong grip, core and leg musculature seems to be the most important, which makes sense as these muscles are constantly needed for daily activities.

The researchers in this paper took 24 males, aged approx. 75 yrs. and divided them into 2 groups and wanted to look at their muscle protein synthesis.

  • 20g protein
  • 20g protein + 40g Carbohydrate (CHO)

 

Turns out, adding carbohydrates to the drink didn’t matter that much.  So in older aged men, adding carbohydrate to protein did not increase muscle protein synthesis.  Also of note was the difference of insulin secretion between the groups.

(EMPTY CIRCLES ARE PRO only)

protein elderly graphprotein elderly graph fig 4

 

SOURCE:

Carbohydrate co-ingestion with protein does not further augment post-prandial

muscle protein accretion in older men.  Hamer et al. Nutrition and Metabolism 2013.

 

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A Tea formula or your favorite flintstone vitamin?

Posted on April 22, 2013 by

On Friday, I acquired signs and symptoms of a good old viral infection.  Low-grade fever, runny nose, sore thoat, cough, all the classic signs and symptoms of a viral infection.  To enhance my body’s natural defense systems I used a few anti-viral tinctures that I had on hand, one being from Heron Botanicals, and the other one being a tincture that I had made from Dr. Tilgner’s book.  The formula I made was

  • 40% Echinacea angustifolia, otherwise known as (OKA) Echinacea
  • 30% Commiphora molmol (OKA) Myrrh
  • 20% Hydrastis Canadensis (OKA) Goldenseal
  • 10% Phytolacca Americana

WANT A GREAT PLACE TO BUY HERBS and SPICES?  CLICK HERE

Truth be told, this formula tastes horrible!  I forget what percentage of alcohol I used to preserve it, but it is definitely not your favorite Flintstone vitamin, for sure!

flintstones

THE EPIPHANY

It wasn’t until I was re-organizing my bookshelf that I stumbled upon Rosemary Gladstar’s awesome book for teas, tincture, salves, etc.

One of the sore throat formulas I made for myself is below and comes from page 96 of Herbal Medicine by Gladstar.

THROAT SOOTHER TEA

2 tsp Licorice root

1 Inch cinnamon stick

1tsp Marshmallow (Althaea officinalis)

1 inch ginger root

I decocted all herbs for 15 minutes.

WHAT’s A DECOCTION?

A fancy word for saying I brought a pot of water to boil, then simmered the herbs for 15 minutes covered.

NOTE- Her formula calls for Echinacea but I didn’t have any.

What if I Don’t have all the herbs to make this formula?

I love licorice, but it is quite often that I don’t have the roots in our house.  So when I do have a sore throat, but don’t have the herbs from above…

 

I use this formula

From Dr. Jane Guiltinan

½ Lemon

1 tsp salt

1 cupwater

1/8tsp of Cayenne pepper

I generally will gargle this for 30seconds to 1 minute

As always, check the disclaimer

 

 

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Simple Workout Nutrition Strategies

Posted on April 10, 2013 by

A question I get asked quite frequently is, “what should I eat pre/during/post workout?” The only words out of my mouth are generally “what are your goals?” You see there is often a huge difference between research settings and practical nutrition strategies. This article will focus on strategies I use if my training is either focused on building muscle or maintenance. A few years back, I can remember a client who was having trouble gaining weight. He was a tall, surfer build, 170 pound male who wanted to gain 20lbs. That’s no joke. Rather than creating an overly complex solution, I asked if dairy was a part of this persons diet and if they tolerated it well. He happen to love milk and had no signs of dairy sensitivity. I informed him that if my goal were to gain 20lbs and I didn’t have a dairy sensitivity, that I would drink a 0.5-1.0 gallon of milk/day. Otherwise known as GOMAD. What happened? In conjunction with the strength program I designed for him, he gained 20lbs in about 6 weeks. There are countless research papers in the literature documenting milk and chocolate milk as superior to whey protein for building muscle. Why is milk so superior? It’s a probably the most anabolic food there is other than breast milk. Milk is designed for babies be they cow, goat, or baby human to grow strong and healthy bodies. Milk is very insulinogenic meaning that it produces a dramatic insulin response which is absolutely essential for growth, switching the body from a breakdown mode to a repair, build, and grow mode. Some people have raised concerns about people drinking milk and the way we produce most commercial milk needs to be improved, for which I WHOLE HEARTEDLY agree. For a wonderful presentation on some milk science watch the following video.

“Dairy, Hormones, and Human Health” by Pedro Bastos, MA, MS from Ancestral Health Society on Vimeo.

AND if you think milk is going to give you heart disease and diabetes think again. GOMAD is a short term strategy (4-6 weeks) I use when I want to put on muscle and find it works really well.

But what do I use during a workout for energy and maintenance of blood sugar if fat loss OLYMPUS DIGITAL CAMERAIS NOT my goal? I am a huge fan of eating 1-2 tablespoons of honey during my workout depending on duration. It’s a simple form of calories AND carbohydrate.  In one paper, Kreider et al. showed that while varying the type of sugar used (honey, sucrose, maltodextrin) + protein did not change the insulin response post-exercise but that blood sugar levels were more stable with honey.  I think it tastes delicious too.

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Why should you eat fermented foods?

Posted on April 5, 2013 by

I’ve recently begun exploring this avenue of food preparation/consumption since I found I do not tolerate dairy well. Yogurt is an easy probiotic food to eat if you tolerate dairy. I needed to find other ways to get my probiotics in foods especially since taking a probiotic powder/pill is much less appealing, personally.

These are some the foods that I'm currently fermenting (left to right): kombucha, iranian garlic torshi, moroccan preserved lemons, and mixed sauerkraut

These are some the foods that I’m currently fermenting (left to right): kombucha, iranian garlic torshi, moroccan preserved lemons, and mixed sauerkraut

Fermented foods have been traditionally used for as long as people have been collecting and storing food. They quickly began realizing it was difficult to maintain their quality without some mode of preservation. They probably used sea water to ferment their foods since it already had salt in it.

Historically:
The Vikings of Scandinavia remained healthy on long voyages out on the sea long after all the fresh food had been eaten. Sauerkraut (fermented cabbage) was the most common fermented food consumed. The Vikings found that consuming sauerkraut kept them from getting scurvy, a result of vitamin C deficiency.

Side note: Sometimes I feel people don’t totally give our ancestors as much credit as they deserve. Even though they didn’t know the names and chemical structure of all the different nutrients in foods, they still observed a visible effect. In this case, they didn’t know what vitamin C was, but they still saw a significant change when foods containing this nutrient were eliminated from the diet.

Now that we have refrigerators and other modes of food preservation, why should you still consume fermented foods?

Well, preservation is only one of the many benefits of ferments. Here are a few more:

• Ferments are resistant to microbial spoilage and development of toxins
-The acid creates an environment that inhibits the growth of certain  pathogenic bacteria, preserving the food from harvest to the time of consumption

• Biological enhancement of nutritional value
-Increases digestibility of starches
-Increases vitamin levels, antioxidants, omega-3 fatty acids
-Degrades proteins into amino acids (more bioavailable)

• Breakdown anti-nutritive compounds
- Trypsin inhibitors and phytates

• Bioproduction of Enzymes, anitibiotics, and anticarcinogenic substances

• Probiotic
-Promotes the growth of healthy flora throughout the intestine
-Encourages peristaltic movements

• Improvement of lactose metabolism
-In lacto-fermentation, starches and sugars in vegetables and fruit are converted into lactic acid by the many species of the lactic-acid producing bacteria, lactobacilli

• Improvement of appearance, flavor, texture and consistency

• Affordable
-No need for special equipment or machines like those used in cooking, pasteurizing, canning, freezing, drying, sterilizing, and irradiating

• Stimulate the immune system

I will post a video some time in the next weeks on how to make sauerkraut. For the time being, I will recommend a few of the sources that I use regularly:
Ferment resources

Nourished Kitchen

The Art of Fermentation by Sandor Katz

Real Food Fermentation by Alex Lewin

Nourishing Traditions by Sally Fallon and Dr. Mary Enig

Written By: Anisa Woodall

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People You Should Know About- My Mentors

Mentors are people whose teachings have influenced my direction, actions, and behaviors in life. They are a small group of people who matter a lot to me, whose wisdom I respect and who I can count on with sage advice be it direct or indirect when my path seems muddy. One thing that might surprise you is that one of my mentors I have never met, so let me introduce you to him now. His name is Paul Chek

Paul Chek is founder of the Chek Institute and has been a Holistic Health Practitioner for over 28 years. I first learned about Paul Chek through some other personal trainers in NC. They told me he talked about poop, diet, working out, and WORKING IN. This immediately drew me in as far too few people talk about proper bowel health and ALMOST NOBODY talks about working-in. Everybody goes to the gym to work out, but are people ever going to the gym to work in? With that as my introduction I began studying every piece of Paul Chek material, physical and digital, I could get my hands or eyes on.

I read his seminal book How to Eat, Move, and Be Healthy several times, watched youtube videos for hours on end, and listened repeatedly to his mp3 lectures. I took 3 of his courses including Scientific Back Training and Scientific Ab Training. These are by far among the best take-home courses I have ever studied.

What I feel most people miss about Paul Chek is how HOLISTIC his approach is. I have never, NEVER, EVER heard someone talk as knowledgeably about holistic medicine and create such synergy between exercise, nutrition, ayurvedic medicine, TCM, religion; everything.

While I have learned tons of USEFUL/PRACTICAL skills from Paul Chek, I have learned that to be a great health practitioner, one needs to “Walk the walk”, and not just “Talk the talk.” Too many people talk about health and yet trash their bodies with cigarettes and drugs. People talk about healthy eating but eat processed garbage. This doesn’t mean Paul is perfect. (Quick aside- If we are all imperfect then is that not perfection?) I think we get religious about things, especially food, and that if you eat a healthy diet 95% of the time, (Or whatever % above 80 you want to pick), and then eat something less healthy 5% of the time, then people call you a fraud, cheat, and a liar. THIS MISSES THE POINT! We eat a healthy diet so we can think clearly, be healthy, enjoy relationships with friends, and EXPERIENCE the world. When you are sick, fat and depressed the experience you have is a totally different one. After you have experienced BOTH, then you have the opportunity to choose which one you desire and if it aligns with your dream.

For all those interested, I CANNOT recommend Paul Chek’s Blog enough. From metaphysics to holistic medicine, this is where it is at!

Talking the talk at 50 years OLD!

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