Intermittent Fasting Can Help You Live Longer!

References: NEJMHarvard Health BlogNewsweekCNNLongoNutritional MetabolismAnnual Review of Nutrition,

We have tons of evidence that fasting works well on longevity in animals. There is proof that reducing calories 30% makes chimpanzees live much longer. Rats having their calories compacted into short time periods lose weight, while those same calories spread out make for weight gain. Now the prestigious New England Journal of Medicine is weighing in with a review of the evidence for fasting. What an article for New Years!

The idea is simple. They define intermittent fasting as daily structure of calories, not weekly or monthly. Compact all your calories into 8 hours a day, better at 6. Don't eat breakfast and hold off lunch till two. The alternative schedule is to cut your calories two days a week to 500 calories. These ideas are close to Longo'sresearch that looks at the generation of stem cells in addition to weight loss. What is now new is the world is waking up to the idea. It is going mainstream. In fact, it's making headlines in America's #1 medical journal, the New England Journal of Medicine.

All the major news outlets covered it this week and considering New Year's Eve coming up and everyone in America feeling fat, it's a good topic. The explanation they give is clumsy so let me give you the easier to understand concepts again. The key is how to make the transition from burning carbs to burning fat painless and easy so that you don't feel famished, and fail. How can you diet and not be hungry? You have to eat in a fashion that doesn't lock up your fat cells. It's all about insulin.

Here goes! Your body can only store about 1500 calories of carbs. We call that storage form of carbs glycogen. 1500 calories is about 12-16 hours of energy. When carbs are around, they are your preferred fuel. When you eat 3 meals a day, spread over 14 hours, you are always running on carbs, thereby secreting insulin and never turn on the genes and enzymes that help you burn fat, which require insulin to be absent. You keep invoking the release of insulin which blocks the transition to running on fat. Insulin blocks ketone formation for about 24-36 hours every time you stimulate its release which can be accomplished with as little as three french fries, a mouthful or two of rice, half a piece of toast or one chocolate bonbon out of the Christmas box. I've shown its effect on me with 1/12th of a honeycrisp apple. The bigger problem with teasing insulin is that you get starving, I mean STARVING hungry if your 1500 calorie tank drops below 750 and you are in "carb mode". You can't beat that. You feel like you are going to die. So you fail.

But running on fat isn't hard if you turn the genes on that help you make fat. The key appears to be eating foods that don't touch insulin and instead, make short-chain fatty acids called ketones. The ketone called beta-hydroxybutyrate (BHB) is the kingpin. And the biggest advance in understanding weight loss is knowing that green vegetables are digested by the bacteria in your gut into BHB. Green vegetables are thought of as carbs, but they are really secret fats because they get digested into BHB in your gut. BHB is only 4 carbons long but it is called either a ketone or a short chain fatty acid. But it has no impact on insulin. Nadda. None. Zip. Nope. Nuttin! All that is left is waking up the genes and enzymes that help you run on BHB. That is the key to weight loss.

A 14 hour fast will have you making BHB at a level of 0.1- 0.5 guaranteed. Every time. If you do it daily, you get it daily for 2-3 hours. For 2-3 hours you are burning fat, losing weight and invoking all the genes to help you do it better the next time. A 16 hour fast will do it more. An 18 hour, more. It's pretty satisfying to see the mainstream NEJM finally write a review on it. It's basic mammalian physiology.

But if you are going to to to all that bother, add the foods that propel you to make more BHB on its own. Don't eat any old calories when you eat. Focus on getting JUST green, above-ground vegetables with fats that easily break down into BHB. Olive oil, coconut oil, macadamia, walnut or avocado oils if you want to be fancy. Longo's formula is to have a 50:50 mix of vegetables and fat, mostly from nuts. But Longo's is more ambitious than just weight loss. He is after resilience and the restoration of stem cells. That takes 5 days in a row of eating no food that stimulates insulin. 18 hours just doesn't do it for stem cells. As least not that we are aware of yet.

Without insulin, your fat cells open wide open. You get all the calories you need flooding out of your pudgy, mushy, wicked, greedy fat cells. Let it go. It's called real weight loss! Yippee. Freedom. You don't feel hungry. You do feel cold because your metabolism will slow some 30% for discretionary stuff like body temperature. You can put on a sweater or a blanket. It's a new feeling, though. It's not hungry. I call it "hollow". I sure can eat. But I am also able to resist. And that leads to success. Weight loss. Mental clarity. Resilience. Stem Cells. Ha!

WWW: What will work for me. I'm doing it this week. Join me. 800 calories for 5 days. I measure my ketones twice a day with a Ketone Meter called Keto-Mojo. It's easy to learn how to use. Costs about $ 1 per test but motivates me as it's never more than 6-8 hours in the future that I'm going to measure it again. It is very satisfying to watch it rise. And any time I cheat, I can see the impact on the next time I test. Like when I ate my 1/12th of an apple and 12 hours later my BHB was half of what it should have been. That tiny bit of sweet made me squirt out a tiny bit of insulin. But insulin is so potent, it suppresses ketones for up to 24 hours.

Pop Quiz: 

  1. To lose weight, you have to teach your body to run on what fuel? Answer: ketones, or short-chain fatty acids. BHB.
  2. You make your own BHB when? Answer: When you are burning fat as fuel instead of carbs. (That's called weight loss). And when you eat green vegetables: that's called smart eating.
  3. Can I get BHB from food sources? Answer: For sure! You can pay through the nose to buy it as a supplement. Shark Tank was all in on investing in BHB startups last year. Or, you can have Bulletproof coffeefor breakfast every day, or coconut oil.
  4. What happens if I get weak in the knees and sneak in a tiny chocolate that I got for Christmas? Answer: Your body rejoices and squeals in glee. You put out insulin and your fat cells slam shut for the next 36 hours. 6 hours later you are starving hungry. It's a very balanced, nuanced switch. Like a tiny transistor on a microchip, your endocrine system is mind-bogglingly delicately balanced. Bummer.
  5. Why is BHB so important? Answer: It is the entry compound into the electron transport chain. That means it is central to energy metabolism. That means it is more important than simple carbs. It's what every animal that eats plants uses to run its energy supply. Foundational. Made by the bacteria in our gut when we eat green vegetables.
Increased Body Fat Makes the Brain Shrink Faster

Increased Body Fat Makes the Brain Shrink Faster

References: NewsweekAging Research ReviewsCell MetabolismFrontiers in NeurologyNature MedicineFrontiers in Physiology,

There is beginning to be a robust literature that goes as follows, your brain shrinks as your waistline gets bigger. Simple. Plain. Awful.

This week's study is from England looking at 4,431 adults over 6 years with a variety of measurements, including body mass index muscle mass and "fluid intelligence." Women with more lean muscle mass had better fluid intelligence. Part of that showed up with lower white counts in folks with smaller waist sizes. It appears that biological age (related strongly to muscle-to fat-ratio is more important than chronological age at predicting brain function. (Fluid intelligence is defined as the ability to solve problems and think logically in novel situations. You want it.) 
But there are many more. A couple of months ago researchers from Yale published an article showing that a high fat, high carb diet (Ours, here in America.) activates all the wrong things in your brain leading to inflammation. Half your brain is computer chips, called neurons or brain cells, and the other half are glia. The glial are the insulation and protectors of the computer chips. Part of them are called micro-glia and they are in charge of immune activation. They can be little tigers when needed. They act like white blood cells out in the periphery but they don't move. They have the same surface activating proteins on them as white cells, so they really are part of the white blood cell community. A high fat diet activates a protein called UCP2, or uncoupling protein, that shinks the mitochondria in the hypothalamus, your metabolism control center.. Your brain gets the wrong message. It thinks you need to eat more. So, you do. You get fatter.

But it's even more nuanced and complicate than that. It's the health of your gut too, as 70% of your immune system is around your gut. Inflame your gut, and you set off your immune system in the microglia in your brain. Your gut, your brain and your immune system are one integrated team.

And finally, what your metabolism is yearning for, aching for, begging for is beta-hydroxybutyrate, the ketone you make when you run on fat, or lose weight. It's also the ketone you make when you eat green vegetables. It's the ketone that disappears for up to 36 hours when you eat one mouthful of sugar, one quarter of an apple, one 3 oz sweet potato, 3 French fries. I know because I have measured my beta-hydroxybutyrate with a finger stick when on my 5 day fast mimicking diet and I've had all those things happen to me. But if I eat a triple portion of spinach, or Brussel's sprouts, my beta-HB doesn't budge. The bacteria in my colon make green vegetables into beta_HB, just like gorillas. Green vegetables are effectively not carbs, they are a unique form of fat - short chain fatty acids, that is. And they have no impact on insulin, or your microglia. In fact, au contraire, they heal the damage caused by the double layered hamburger with bacon you had for lunch. 
And that brings us back to insulin, the hormone you secrete when you eat too much meat, one mouthful of potato, rice, bread or sugar, or the flavor sweet. Insulin is the final Darth Vadar of nutrition. Insulin resistance is at the core of cognitive decline.

WWW: What will work for me. This should be easy. My brain is aching for me to allow it to run on Beta-hydroxybutyrate instead of glucose. If I can last more than 12 hours every night, my BHB level is 0.1. By 14 hours I'm often up to 0.7. I don't get to 3.0 until I pass 48 hours, but that is with eating 800 calories a day of green vegetables and fat. So, an overnight fast with compressing my calories into 8-10 hours, my brain gets healing BHB every night. Once a month, I can blast off for 5 days and really get a dose. Now, all I have to do is exercise and keep my lean body mass fit and trim. New Year’s Resolution I plan to keep.

Pop Quiz

  1. As a general rule, there is a correlation here between waist size and what? Answer: Brain size, inversely set. Put on weight, your brain gets smaller.  
  2. Fluid intelligence is? Answer: The ability to solve new problems in unfamiliar surroundings.
  3. What's the team of three organ systems that sets the inflammation in your brain? Answer: Brain, Immune and GI. 
  4. What proportion of your brain is actually white blood cells? Answer: Roughly 50%
  5. What class of foods are best for your brain? Answer: Green, above ground vegetables. They get digested into beta-hydroxybutyrate (bHB) to a large degree by the bacteria in your gutl. bHB has no impact on insulin, so insulin drops.
Air Pollution Kills, Rapidly and Surely

References: Science DailyNEJMScienceNewsScience DirectBrainNew York Times,

You can't see it. You may not be able to smell it. But those tiny particles put out by fires, factories, busses are there in the air. The NEJM study quoted here is a massive study looking at 652 cities over 30 years. On average, an increase in 10 micrograms per million particles over two days results in a 0.44% increase in mortality, almost immediately. "Our data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe." Ouch! 
What I found somewhat startling and counterintuitive, there was actually a higher mortality for places that are cleaner but then have a short-term burst in pollution. Places like where you live, and you thought were clean. At least, most of the time. 
The authors claim that the smaller the particle, the further it can penetrate into the lungs. All that is true. But what about the brain? 
There are particles that we can now measure that are smaller, and we measure in billionths per meter. And they get into your brain! By performing cognitive studies in children with controls from unpolluted cities, including dogs in both places who subsequently have their brains examined under microscopic and MRI exams, pollution gets into your brain and results in measurable immediate damage. A similar study in Brain shows that for each quartile increase in 2.5 particles you get a 19% decline in recent memory performance in elderly women. 
This is a very interesting confluence of research. The cutting-edge research on CIRS (Chronic Inflammatory Response Syndrome) is that your brain is damaged by the toxins than make CIRS (Mostly molds). And we know that the MARCONS bacteria release two proteins that continue to lower MSH, the hormone that mediates many of the eccentric symptoms of CIRS. MARCONS is in your nose and the toxins thereby emitted are proximate to your brain. Just like the tiny particles in air pollution. Neither mold toxins nor air pollution particles are visible, but their effect is very real. The tiny particles of air pollution probably penetrate deep into your lung and also get into your circulation setting off innate immune responses, similar to mold.

WWW: What will work for me? Well, I've become much more conscientious about changing my air filters on my furnace and keeping the HEPA filter in our home cleaned up with new filters. And I'm thinking about where I go on vacation. Do we go to exotic cities that are filled with pollution? Do we make choices about where we live based on the cleanliness of the air? Do we vote based on who makes it a priority?

Pop Quiz

  1. Excess cardiac mortality takes years to develop from the extra fumes of diesel busses and diesel cars? T or F. Answer: Patently false. For every 1/2 percent increase in microparticles, there is a statistically significant increase in mortality almost immediately.
  2. Microparticles cause their damage how? Answer: The smallest ones can penetrate very deeply into your lungs and likely get into your circulation, setting off immune responses over your whole body. That would be one working hypothesis that would explain the epidemiology.
  3. You can smell the pollution that makes microparticles? Answer: False
  4. Children living in high pollution cities perform just as well on standardized testing? T or F. Answer: False
  5. Elderly women in polluted cities show what with micro pollution? Answer: Increase cognitive decline.
Building Resiliency with Mindfulness

References: Resilient by Rick HansonGreater Good MagazineOpen Journal of Social SciencesFrontiers in Psychology,

Resiliency, one of the strongest correlates of longer, happier living is a vital component of thriving 100-year-olds. Rick Hanson lists 12 features of resiliency but mindfulness comes up first. He defines mindfulness as being fully in the present and not distracted or ruminating with monkey chatter in your brain. 
Just like the phrase, "You are what you eat", your brain becomes what you think. We have remarkable neuroplasticity in our brains and anything we do repeatedly sets up reinforcement. "Neurons that fire together, wire together." is the adage. Left to their own natural devices our brains wander from fear to fear ending up focusing on anxiety, and pain, protecting us from the world's assaults. That leads to depression and unhappiness. Can you focus your attention on what is nourishing, life-giving and joyful long enough to draw then into you and make your wiring of that sort? Can you teach your brain to be calm in a crisis? 
Our brains are crying out for a little help. It's easy to be mindful when you are sitting before a lake with beautiful sunshine. It's a little harder to be mindful when you are in an argument with someone you love. "Mindfulness holds your reactions in a spacious awareness that is itself never disturbed by whatever passes through it." Practice that.

Start by being mindful of being mindful. Notice the time you get lost in a reverie. Notice your moments of pleasure. Focus on the gift of a warm bath when you shower. Find simple tiny bits of nature, the squirrel bounding along, the welcome of a dog, the shape of the clouds. Let your brain settle on them and be aware of it. 
As that becomes more available, find a way to make that happen every day. Meditate in whatever fashion you will do every day. By meditation, I mean focusing your brain on one simple thought, be it your breath, the houses on your block, the favorite reading from your own religious tradition. Repeat it while being aware of repeating it. Again. Again. Your brain will wander. Brink it back without recrimination. Calm down the monkey chatter. Again. Again. Strengthen your ability to focus and stay focused.

Now, extend that into your inner refuges. A refuge is anything that protects, nurtures or uplifts you. Places, friends, churches, libraries, parks, pets, memories of Grandma's embrace or cooking. When you identify your refuge, spend time in it. Invite your friends over. Go to the library. Be aware of how delicious your refuge feels.

And then Be in the moment. Notice what your feelings are. Let go of the negative parts of the experience and try to take on that which feels good and nurturing. 
There is so much beauty to mindfulness that it is foolish to think that one simple column can cover it. It is worthy of being trained in it. It is worthwhile seeking out a coach who will guide you in it. It is so powerful, it will change your life for the better time and again, in every venue, for every one of us.

And this is the path to resiliency.

WWW: What will work for me. I stumbled into the world of meditation in medical school and practiced that form I learned then for about 20 years. I still do when I'm trapped in a place where I have no escape: a plane seat for take-off, a doctor's office lobby, arriving too early for an appointment. I think mindfulness is a bigger artform with more maturity to it. It really is there for you to use. I can feel the sense of good energy and vitality flowing into me when I am mindful of my being mindful. And when upset, it is a delicious tool to pull out to calm the monkey chatter of trivia and meaninglessness. And I am so mindful how grateful I am of the whole field of functional medicine, and how lucky I was to stumble into it before I got too old. I'm not too old yet!

Pop Quiz

  1. What is mindfulness? Answer: Staying present in the moment rather than being distracted or ruminating.
  2. Why is it important? Answer: It is one of the cardinal features of resilient people.
  3. How can you be mindful right now? Spend a few seconds enjoying the fact that you can read this column, take a comfortable deep breath and you have a whole new day ahead of you.
  4. What is the best way to build mindfulness? Answer: Practice whatever form of structured meditation you will do every day.
Building Resiliency: Don't Visit Pity City

References: LamondCurr Geront Ger Res., J. Psychiatric Research, Philip Chard,

What's resiliency? The most straightforward definition is that resilience connotes the ability to adapt positively to adversity. Folks who are 100 years old have it. If you are 60, or 50 or 40, and you want to live to be 100, it might just serve you well to start developing resiliency in yourself. In fact, as best we can tell, being resilient might be one of the strongest predictors of healthy aging. Hmmm. Sounds good. 
How do you measure it, define it, study it? If you look at the Connor-Davidson Resilience Scale of 1395 women over age 60 in San Diego, you will find that four factors stand out: (1) personal control and goal orientation, (2) adaptation and tolerance for negative affect, (3) leadership and trust in instincts, and (4) spiritual coping. The strongest predictors of in this study were higher emotional well-being, optimism, self-rated successful aging, social engagement, and fewer cognitive complaints. 
My eye caught #2, adaptation and tolerance for negative affect. Why? Because of a recent lecture by one of Milwaukee's leading lights on psychological wellness, Philip Chard, entitled "Realistic Optimism. In that brilliant lecture, he warns that one shouldn't spend too much time in Pity City. "You can visit Pity City, but you shouldn't take up residence there." 

What does that mean in regard to resilience? You can acknowledge your pain and hurt from life's left turns. You can name it. You can declare it. But then the parking meter runs out and you need to get out of town. Leave life's hurts behind you. (Isn't that easily said.). It's the practice that is the hard part. To leave painful events behind, you have to practice. And when you see that hurt and leave it behind, you essentially build the psychological muscles, the inner strength, to do it again with harder stuff. "Don't get your undies in a bundle," said your Grandmother. "Don't be such a pity pot," quotes Holly Whitcomb in her book, "The Practice of Finding" where she details self - pity as an obstacle to gratitude. Gratitude leads to "enough". Leaving one little hurt behind you and defining yourself as able to do so inherently defines you as able, as strong enough to overcome that little annoyance. Psychological pushups. 
It's practice that may be the key. Rick Hanson, Ph.D., in his book "Resilient: How to Grow a Core of Calm, Strength and Happiness" details the process of building that resilience. He notes that it is crucial to notice the behaviors you want, then savor them, repeat them, remember them and strengthen the neuro-circuits in your brain with that repetition and remembering. Build brain muscle with the little stuff, and then you have the capacity to survive life's outrageous slings and arrows.
What happens when you indulge in self-pity? You build the opposite. You are inherently defining yourself as a victim, powerless and unable. The logic appears stronger and stronger in your own brain as you argue for your own victimhood. The longer you linger in Pity City, the more you reinforce the circuits in your own brain that you are weak, ineffective and powerless. And that correlates in opposition to resilience. You become passive, inactive and in chronic anxiety.

Sign up for Philip Chard's weekly blog. Watch for his next public lecture.

WWW: What will work for me? I love the phrase "Pity City". It makes the context of psychological pain have an element of humor that disarms the gloomy doom of adversity. "Sounds like the parking meter is running", I say when I hear the whisper of complaint. I've named it, I've felt it. I'm allowed 15 minutes. After that, I get a parking ticket for lounging around too long in Pity City. As best I can tell, I pay a visit to that suburb several times a day. I'd rather laugh at myself and relish my abandoning it. "Tick, tick, tick.." muses my spouse when she hears me gripe. "The Meter is running! Do you need more coins or shall we get on with it."

Pop Quiz

  1. Define resilience! Answer: "the ability to adapt positively to adversity"
  2. Why is it important? Answer: Folks who develop resilience live longer, happier lives.
  3. How can I develop it? Answer: Practice on the little stuff.
  4. How long am I allowed to linger in Pity City? Answer: until the parking meter runs out.
  5. What happens when I let "my undies get unbundled"? Answer: you claim your inner toughness and strength. And you give a nod to your tough old Grandma with all the wisdom of her ages, as resilient and centered as she was.
Insulin release and artificial sweeteners

References: Biomedical ResearchScience DailyNature CommunicationsDiabetes Poster Presentation 2017Medical News TodayTime MagazineJr Sci Food AgPLosOne,

Are artificial sweeteners safe for you? What effect do they have on weight? How do I sort all this out? 
The first and foremost point to understand is that insulin is not, repeat NOT your blood sugar controlling hormone. It is your calorie STORAGE hormone. It is the hormone you secrete when carbs are abundant (just before winter) when it is critical that you put on weight so that you have a margin of calories to make it through the winter. Insulin is the key driver to weight gain. Hence, it's absence is the key driver to weight loss. With adult-onset diabetes, folks become insulin resistant, have quite high insulin levels but ironically also high glucose levels. 
How is insulin released? This is important to understand. It is not just in response to blood glucose. It's first release occurs because of the flavor sweet on the tongue. That's called the cephalic phase. Then, the rate of rise of glucose in the blood has a direct impact. We call that the glycemic index of food. The higher the glycemic index, the faster the rate of rise. The faster the rate of rise, the more insulin is secreted.

This unpacks and explains the confusion over blood glucose levels and artificial sweeteners. If your blood sugar doesn't go up with the use of an artificial sweetener, does that occur because your insulin level went up faster and earlier? Did you have a burst of insulin that camouflages your metabolic response making it look like the artificial sweetener was just dandy and safe to use?

That's the confusion that you will see in the discussion about artificial sweeteners. Those folks who are trying to get you to buy the stuff will say "blood glucose didn't rise" as though that was a virtue. At first blush, you believe them and eagerly sign on to use the sweeteners. 
But cracks appear in the scientific edifice. Clear data shows that folks using artificial sweeteners gain weightDrinking a diet soda a day results in weight gain. Why is that? It's because the endocrine effect of insulin lasts longer than the glucose. When you stimulate insulin, your body is really thinking there are carbs arriving in the stomach and you will have glucose showing up in the blood for the next 4-12 hours. No surprise then that insulin lasts at least 6-8 hours. If you have insulin around for that long and didn't have any calories to actually show for it, what happens to your blood glucose 4-8 hours out? Bingo: it is lower than it would have been and you are hungrier to make up for it. You eat more before satisfied. You gain weight. 
Another way to look at it is the effect of insulin on ketones. Ketones are made when you are digesting and burning fat (weight loss). Ketones are present only when your insulin level is very low. I can't find any original research on ketones except my own repeated experiments on myself. Once I am in a ketogenic state, meaning beta-hydroxybutyrate above 2.0, the consumption of 70 calories of carbs in the form of a single small sweet potato will lower my ketones for up to 36 hours before they recover to the prior level. That happens even when I'm in a Fast Mimicking state of only 800 calories a day. You could make the argument that insulin has some residual endocrine effect for up to 36 hours. 

So what happens with artificial sweeteners? That's the rub. The most widely quoted study in Jr Sci Food Ag claims that stevia is great because it keeps blood sugar lower than anything else. But to your and my eyes, that should now shout out at you, "It means your insulin was higher than anything else!" This may be why Jason Fung claims in the Obesity Code that stevia raises insulin more than table sugar. And that is horrible. If artificial sweeteners control your blood sugar better, but really actually raise your insulin higher, then they are worse for you than we imagined. You will get fatter, faster. It's the very nature of the flavor sweet. And being 300 times more potent than sugar, as Stevia is, is actually a curse, not a blessing.

What's a person to do? We need to think of food as having an insulin index more importantly than a glycemic index. Our ability to flex our fuel source between carbs and ketones (sugars and fats) is completely dependent on the presence of insulin in a responsive, supple state. Artificial sweeteners screw that up.

WWW: What will work for me. We have discussed the disruption of your brain with artificial sweeteners but the concept that even stevia increases my insulin is sobering. I just can't say that stevia is benign. I'm weaning myself down off the flavor sweet. I'm using half a packet of Stevia in a cup of coffee as my current goal.

Pop Quiz:

  1. What determines the glycemic index? Answer: The rate of rise of blood glucose from any given food compared to pure glucose. Pure glucose is assigned 100 and other foods are percentages of that. The glycemic load combines the rate of rise with the total carb count, which also matters.
  2. Artificial sweeteners do what to insulin? Answer: The flavor sweet on the tongue set off insulin secretion as part of the cephalic phase of insulin response, just like the sight and smell of food.
  3. People who use diet sodas lose weight? T or F. Answer: False, they gain weight.
  4. Some of the artificial sweeteners were found during the course of looking for what environmental poisons? Answer: Pesticides. (Splenda or sucralose resulted.). But the analogy is there. They really are metabolic poisons, best avoided and weaned off.
  5. Some of the artificial sweeteners were found during the course of looking for what environmental poisons?     Answer: Pesticides.   (Splenda or sucralose resulted.). But the analogy is there.  They really are metabolic poisons, best avoided and weaned off.
Prolonged Sitting Isn't Helped by Fish Oil, But Exercise, Fidgeting, and Standing Does Help

References: Appl Phys Nutr Met., Am Jr Phys Heart Phys,Inter Jour Mol Med., Cosmic Heart, Human Heart,

This is so sobering! You just can't sit for 3 hours at a time. It's a big, fat problem. It makes "endothelial dysfunction" in the walls of your arteries. The language that is used sounds like this: "sustained reduction in blood flow-induced shear stress" is what happens when you sit too long. 
What on earth is shear stress? You might be surprised to take a deep dive into how much is known about it. It's the nugget of what is actually happening in your arteries when a pulse of blood good by. Your arteries stretch, but they also have surface shearing on the face of cells exposed to the blood flowing by. They get stretched by that flow. That sets of "activation of ion channels and of G proteins, induction of oscillations in intracellular calcium concentration, alterations in the expression of various important genes, and extensive cytoskeletal reorganization". 
But that's not all. You thought your heart was a pump, pumping blood. Reconsider that. It is probably actually more like a hydraulic ram encouraging the momentum of swirling blood, all of which has negative ions on the surface that electrically and magnetically repel the cells from the negative ions on the surface of the endothelium. Just like fluid naturally flows down your bathtub drain in a swirl, your arteries may be much the same. Now, your bathtub is explained by the Coriolis effect of momentum, perhaps we are more attached to Mother Earth ourselves by magnetism and gravity. Your heart may be sucking blood more than pumping. (Read Cowan's book: Cosmic Heart, Human Heart.). But all that swirling and flowing causes your artery cells to have a special set of forces on their surfaces. Sitting screws that up. 
And you sit all day long. I sit all day long. Desks. Easy chairs. Televisions. Computers. Cell phones. Couches. Plays, concerts, airplane rides, car rides, church, temples, ...we sit. Prior to civilization, prior to chairs and leather upholstery, we stood and walked. The Hazda (the world's most Stone Age tribe) walk 29,000 steps a day. Yesterday I went for a 6-mile hike and put in 18,000 steps, but the day before, I sat and got 1,850 steps. Bummer.

That's the takeaway from this week. Sitting makes the lining of your arteries dysfunctional. They can't do their normal, proper shear-stress thing. Taking fish oil for 8 weeks won't fix it. Prior exercise helps a littleStanding eliminates it. Even "fidgeting" as defined by wiggling your leg for one minute every 4 minutes helps. Ha. Standing eliminates it. 
What's a modern office worker to do? We know what we should do. It's doing it that is hard. Stand. Standing desks, standing at home, walking.

WWW: What will work for me. I was quite inspired with a visit to my new granddaughter in Geneva, Switzerland. Her father (my son) stands at his desk all day long. Doesn't even have a chair. (Note the change of emphasis from son to the new "princess" who gets all the attention). We need to find ways to make this work. It's the getting up and down all day long that helps. Fidgeting helps. Getting up and down helps.

Pop Quiz

  1. What is your average step-count per day? Answer: About 5,500. Almost everyone else on Earth walks more.
  2. How does blood flow through your arteries? Answer: It probably spins through, repelled by electrical forces of sulfate ions on the surface of red cells, which explains how red cells can get through capillaries smaller than themselves.
  3. What is shear stress? Answer: the normal ebb and flow, like seagrass in waves, over the surface of your cells.
  4. What is the problem with sitting? Answer: We have a reduction of that shear stress response because our blood flow is simply stopped and plugged up by sitting.
  5. What's the solution? Answer: Anything but sitting. Fidgeting will work, every four minutes. Standing is better. Walking wins.
Celery Juice - Miracle or Sham?

References: New York TimesKim KardiashianDr MercolaMedical Medium's Celery JuiceNatural Medicine JournalAdvances in Regenerative BiologyUS WeeklyDirty Dozen Vegetables,

Ok, everyone is doing it! You can't miss Kim Kardashian no matter where you hide, so when she touts celery juice, you hear about it. US Weekly will tell you all the stars snarfing it down. If you want to look like Jennifer Anniston, go for it. Even the staid New York Times has run an article about it. A little more "out there" is Dr. Mercola who actually has a staff that digs into research and produces reasonably broad scoped articles, albeit all aimed at selling something he has for sale. He likes it. 
That's not what caught my eye. My attention got caught when one of my clients returned from a health spa where he embarked on a 10 day fast, given only a glass of celery juice twice a day to soften the absolute calorie restriction. He lost over 30 pounds, normalized his blood pressure, felt great. I want to dig into the. connection with fasting, and whether the celery juice thing is anything special or apart. It certainly has hit the wires, in part also driven by the "Medical Medium", a highly publicized self-made health guru who waves his arms around people and tells them their medical problems, and gives a lot of them celery juice, and a fast. Anthony Williams, the so-called "Medium", with no degree in anything but 4 New York Time's Best-Sellers, has abook on celery juice you can read. I did. I'm not here to argue his credentials, or veracity, I'm trying to explore the idea and be open to new concepts, no matter how close to the left-field foul ball line that idea comes. 
Does it have extra nutrients in it? Well, yes. It has a great compound called apigeninwhich provides stem cells an extra boost and appears to have anti-cancer effects and neuron supports effects. Both not bad. One reasonable study looking high blood pressure and 150 mg of celery seed extract in a day, thereby getting 3-n-butylphthalide (3nB), showed blood pressure would dropping 8 mm over 8 mm - equivalent to any pill on the market. Finally, it has a great dose of molybdenum, a trace mineral needed to detox heavy metals. No problem there. 
So, do we believe the hype? Is it hype? There is precious little hard evidence and tons of high-intensity promotion. Celery is on the dirty dozen list of pesticide plants, so you may be a little put off by too much of a good thing. What I believe is that we have to get back to the gut and its biome. If it is made happy, many good things follow. The thousands of yet-to-be-discovered compounds and their even more amazing interactions suggests we are still scratching the surface of what is good for us. Do we need more vegetables? Emphatically, yes! Do we need the fiber in the vegetables? Yes again. (So what are you doing juicing?). Might there be some credibility to celery juice? I haven't a clue. But if Jennifer Anniston says it's true, then half of America is in.

WWW: What will work for me? I'm trying to construct a rational, effective method of fasting and I'm suggesting that either cucumber or celery juice may be the two ritualized nutrient liquids you could take that allow you to fulfill your need to eat daily meals, just for the sake of ritual, and that don't break your ketosis. When I do my 10-day fast, I'm going to dust off my juicer and add this to the regimen. I'll keep track of my own data with ketones and electrolytes. But I suspect the issue is more the fasting than the juice. Time will tell. I'm not looking for any major medical center to fund a research project that takes people off their pills and cures their weight gain their blood pressure, their gut disorders.....

Pop Quiz

  1. Celery juice is pretty high in sugar, like apple juice? T or F. Answer: False, almost none so you won't endanger your ketosis.
  2. We know all the nutrients in plant juices? Answer: False: Tip of iceberg only-much less their nuanced, synergistic interactions.
  3. There are many thousands of folks who swear by the benefit of celery juice? T or F. Answer: Yup.
  4. Celery is safe to eat as much as you want. Answer: Whoa Nellie. It's on the dirty dozen list. Please wasn, rinse, soak in something or other.
  5. You will look just like Jennifer if you drink a glass of celery juice a day. Answer; Close your eyes, count to 10 - and it's true!
Insulin Levels Predict Heart Disease Better than Cholesterol

References: Cardiovascular Diabetology 2018J Eval Clin PractHarvard Health BlogCell Metabolism, Fung's Obesity Code,

Obsessed with your cholesterol level? Your doctor tell you that you need to be on statins? Are you a slim, trim 62 year old with a cholesterol of 2018 thinking you will die soon if you aren't on a statin? Then you fit right in to the 2019 medical model of heart disease care, that is deeply flawed. The flaws started to show 5 years ago from the HUNT II studyof 10,000 Norwegian women that showed that women with cholesterols over 200 live longer than those under 200. (Oops!). And by the way, you most likely don't need to be on statins. How do you know? How can you make sure? 
As elegantly explained in this week's review article, the core defect in coronary artery disease is insulin signalling. The net effect is incredibly nuanced through many intricate, cross-matching mechanisms and you can get lost in the details. But, an elegant model that explains it all is as follows. You have about 186,000 insulin receptors on a healthy fat cell. Two have to be next to each other to trigger the uptake of insulin. When you are slender, fat cells are smaller and insulin receptors are closer to each other. You only need a very low insulin level to get effective control of glucose. Skinny people have low blood sugar and low insulin levels. As you get larger, you don't make more fat cells, they just get larger. But in that size increase, they don't make more insulin receptors. The insulin receptors get further apart. You need higher insulin receptors to trigger proper blood sugar control. You get bigger and bigger, your blood sugar rises more and more. 
Here is the catch. You can only make so much insulin in a lifetime. It's as though you were only given a million units of insulin to use up in a lifetime. If you are skinny, you only use up 10 units of insulin a day. That means you have enough insulin to last 273 years. If you use 45 units a day, you will run out by age 60. Oddly enough, that's just when many folks become diabetic and need to be put on various insulin treatment drugs. But if you examine those folks who are becoming "diabetic", you will find that their insulin is 23, allegedly in the normal range. The problem is that they are overweight (by a lot) and what their body "needs" is an insulin level of 50, and they just can't make it. Well, their doctor puts them on insulin, cranks up their level to 100 and sure enough, controls their diabetes, and they get even fatter.

What would happen if they were to lose weight? Smaller fat cells, closer insulin receptors, demand for insulin drops. In fact, on a vegan, green vegetable diet, their demand for insulin drops in hours. Hours. Their blood sugar normalizes in hours as they switch over their bodies from glucose metabolism to the necessary ketone metabolism involved in weight loss. It feels rough for a day or two as the cellular mechanisms of ketone metabolism haven't been aroused or activated for decades and need to be woken up. But wake up they do. Weight loss ensues. Receptors get closer to each other. Lower and lower levels of insulin is needed and all the nuanced, intertwined mechanisms of high insulin caused damage go away. And heart disease risk plummets. 
Don't measure your cholesterol. It is an indirect, tangential look at your insulin level. You have high cholesterol because you are eating too many triggers for insulin release like too many carbs, grains, sugar, and animal. Stop eating that. Switch to vegetables and healthy oils (olive, macadamia, avocado, coconut) and delicious spices. Measure your insulin level and do everything you can to get it down to below 5. Don't settle for the "normal" range your lab says for insulin (3-29). Healthy is below 5. Period. Excellent is below 3.5. Included in the "normal" range are all those millions of folks who are overweight and headed for the cath lab and open-heart surgery.

It sounds complex but it's actually elegantly simple. It is complex. It is incredibly nuanced, but it has this simple driving mechanism: your insulin level is defined by the size of your fat cells, your diet (as driven by consumption of glycemic carbs, sugar, and animal), and your activity. And that drives your heart disease risk.

WWW: What will work for me. I've been measuring insulin levels for 10 years now. It works. It is an accurate, responsive, predictive model of those folks in trouble, and those folks getting out of trouble. It responds rapidly to dietary changes. On the fast mimicking diet, it drops to 5 and under in 3 days, exactly in sync with ketones showing up. Try it. You can get your own lab. If it isn't below 5, I would hazard the guess your waist size isn't ideal. Get it there. I just ordered new pants. I'm finally below 38 inches.

Pop Quiz:

  1. A cholesterol level of 200 and above means you should be on a statin. T or F. Answer: that is the American Heart accepted threshold. It is driven by a 30 billion dollar industry, paying for a lot of cardiologists to do flawed research that is looking at the wrong picture. Read the HUNT study from Norway and ponder why women live longer with cholesterol over 200. (Hint: they have large, fluffy, harmless LDLs. It's small dense ones, driven by high insulin that cause trouble.)
  2. Insulin level reflects what? Answer: The standard answer is the level of insulin resistance but the operative model proposed here is better explained by the spacing of insulin receptors over ever-enlarging fat cells. Lose weight, make your fat cells smaller and receptors closer, and your insulin level goes down.
  3. What is wrong with high insulin? Answer. Wow, read the review article. There must be at least 20 separate, destructive, overlapping, functions of insulin; everything from increasing smooth muscle proliferation in artery walls to more oxidized LDLs to more t
  4. What happens to insulin when you fast, or fast-mimick by eating only green vegetables (that make beta-hydroxybutyrate)? Answer. Plummets. I mean, fast.
  5. Does this mean you can cure diabetes by losing weight? Answer: Yup. If you can reduce your demand from insulin from 45 units a day to 2 units a day, the 50,000 units of insulin your pancrease still has in it will last you decades, with good control, instead of months with marginal control. But you have to lose the weight.
Why do I Need More Iodine?

References: Living NaturallyTher Adv Endo MetaboHuffington PostGuardianJr CancerNIH Fact Sheet on IodineWHO Iodine Prophyllaxis after Nuclear AccidentCanadain Jr Surg,

Svent-Gyorgi got the Nobel Prize in Medicine in 1937 for the discovery of Vitamin C. He lived much of his later life in Maine, working at the Woods Hole Oceanographic Institute. He attributed much of his longevity to iodine, taking 1,000 mg a day. Did you get that? 1,000 mg. You are getting 0.250 mg a day if you are an average American eating iodized salt, and taking no extra.

What caught my eye this week was the amount of iodine you get in amiodarone, the number one anti-arrhythmic in the world. A standard 200 mg dose of amiodarone will give you 75 mg a day of iodine. Given its standard metabolism, you will get 6 mg of elemental iodine a day. Whew! But that correlates with my childhood in India, where I took iodine pills all the time for water purification. We didn't when we lived at home, but with any travel, hiking, going into town or whatever, we had a bottle of iodine tablets that I used liberally to purify water. I would guess that I took at least 2-10 pills of iodine a month.

Now, in America we are all spastic about iodine toxicity because of one really bad research article that has never been refuted. Done in rats, it suggested you get a short-term reduction in thyroid function when you take a large dose of iodine. Projected onto humans, it has led us to believe that too much iodine will suppress our thyroid long term. However, there has been no evidence and no proof of that being the case.

Guy-Abraham at UCLA posited an alternative approach. He measured how much iodine one has to take to excrete 90 % of it in the urine in the following 24 hours: the standard measure of sufficient mineral intake. That comes out to 12.4 mg a day. That's quite different than 0.25 mg we are getting in America. It is certainly much less than the 1,000 mg Svent-Gyorgy took.

Why do we need so much? This is another whole rabbit hole to go down but I believe we are all bromine overdosed. Bromine, a halide ion just one notch above iodine in the periodic table, acts chemically just like iodine but has never ever been in the human food chain until 50 years ago. But we flippantly add it to all our bread products because it helps make bread more elastic. Even China has banned bromine. But not us. And your carpet and furniture are soaked in it as a fire retardant.

Iodine is pushed off its receptor by bromine. That's the rub. To reverse bromine toxicity, which our FDA denies, you have to take more iodine. The bread industry is tougher and pays more to politicians than you do, so it doesn't get studied. (Listen to me! Don't I sound a little paranoid? Doesn't make me wrong, just wary.)

But do you need more iodine? Yup! How much? Guy Abraham may have it right. He estimated 12.4 mg a day. I've been telling folks at least 12.4 mg twice a month which increases your intake 5-6 fold over what you get now. Svent-Gyorgi lived to age 93 on 500 times that dose. I suspect the range of safety is larger than what we have thought in the past. But I have one client who has taken 12.4 mg a day for 10 years now and it cured her neurological condition. If you have fibrocystic breast disease, that is likely an iodine deficiency syndrome. Breast cancer? Please, please take iodine!

WWW: What will work for me. I believe we are all tip-toeing along the edge of severe iodine deficiency. I have been taking 3-4 pills a month and think I will up my game to at least double that. I've been doing it for over 10 years now, and had a childhood similar to that. I don't eat much bread at all, except when I'm in Europe (where bromine is banned). I think we are also all bromine contaminated, if not poisoned. Ironically, it's the use of an artificial medication, amiodarone, that woke me back up to the importance of iodine. Bless dear old Svent-Gyorgi.

Pop Quiz

  1. Who was Svent-Gyorgi? Answer: Nobel Prize for Vitamin C who took 1 gram a day of iodine: 6,000 times the RDA of our current American guidelines (150 mcg a day).
  2. How much Iodine are the Japanese taking around Fukushima? Answer: 100 mg a day. (And we haven't heard of a huge epidemic of thyroid disorders from them.). That is 600 times our current RDA in America.
  3. Do we need more iodine today than 100 years ago? Answer: Emphatically yes. We have been inundated with bromine in many forms. In America, we have been curiously inattentive to it. Europe and even China have banned bromine from bread. We pour it in. But fire retardants made from bromine are all around you.
  4. If you have breast cancer, should you be on more iodine? Answer. Probably but if you have fibrocystic breast disease, (the number one risk for breast cancer) - you MUST be on it.
  5. What can you do to eat more iodine in food? Answer: seaweed. Cod. Shellfish. And that will get you to 200-250 mcg a day. Maybe one 40th of what you need. Eat up. Maybe you just need a pill because of all the bromine in your ecosystem.