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Fasting for renewal and rejuvenation

Fasting stimulates autophagy, mitophagy, stem cell production, detoxification, mitochondrial biogenesis, neurogenesis, and neuroplasticity. Fasting also down-regulates muscle catabolism and up-regulates growth hormones to preserve muscle tissue. Because all of these are crucial for health and youthfulness, but tend to decrease rapidly with age, regular fasting is by far the most effective way to naturally slow down ageing and prolong health.

Autophagy means self-eating but refers to the breaking down and removal of damaged tissues, cells, and cellular component to reuse the molecules of which they are made to build new, healthy cells and tissues.

Mitophagy is the same but for mitochondria. Those damaged and dysfunctional are broken down into their constituents to be made available for rebuilding new ones, which is called mitochondrial biogenesis. Fasting is the most effective way to stimulate autophagy and mitophagy primarily through activation of a special enzyme, Adenosine Monophosphate-activated Protein Kinase, or AMPK for short. Fasting also increases production of nerve growth factor that stimulates the growth of new brain cells, no matter how old you are.

Stem cells have as their main purpose to repair tissues. Stem cell activity is highest in embryos and babies, and steadily decreases with age. Stem cell regeneration is strongly stimulated by fasting, but it’s uniquely related to the burning of fat for fuel, and not to the fasting itself. We know this because genetically switching off fat-burning in fasting mice stops stem cell production.

Detoxification takes place through the release of toxins from tissues. Biological survival mechanisms have evolved to sequester into fat cells chemicals and heavy metals from the bloodstream, and isolate them from damaging more sensitive and biologically active tissued and organs in the rest of the body. When fat cells split open to release the energy stored in the fatty acids they stockpile, these toxins are released into circulation for elimination.

Neurogenesis refers to the making of new neurons (brain cells), and neuroplasticity refers to the creation of new synaptic connections and nerve flux pathways in the neural network of the brain. This is without a doubt one of the most remarkable benefits of fasting.

brain-bright

(Image credits here)

All of these biological mechanisms have deep evolutionary roots. We know this because they are common to the most complex (and thus most recent), and to much simpler (and thus much older) organisms. It is most likely in these deep evolutionary roots that the remarkable healing power of fasting comes from.

Autophagy, mitophagy, stem cells, and ketones

Fasting stimulates the breakdown dysfunctional proteins and cellular components, the preservation of active muscle tissue, and the rebuilding of new proteins and cells upon refeeding. (Read here an excellent article by Dr Jason Fung on the up-regulation of muscle preservation during fasting.) The acute stress of vigorous exercise, especially of strenuous resistance training, stimulates autophagy in much the same way as fasting does. Both stimulate mitochondrial biogenesis. Does this sound inconsequential to you? It really isn’t.

First, the accumulation of damaged cells and cellular debris can be equated to senescence. And senescence can be equated to death. Or rather, the accumulation of death in the body. Death, in this sense, is not really binary, it’s not like one moment we are alive, and the next we’re dead. It’s much more like we accumulate, over time, dead and dysfunctional cells, dead and dysfunctional mitochondria, dead and dysfunctional organelles. Little by little they accumulate, but there’s a threshold. There’s a point beyond which no more death can be accumulated inside the body. And when that threshold is reached, life can no longer be sustained. This is when we die. We call this ageing. The slowing down of things, the loss of energy, the loss of vitality, the loss of strength and flexibility, and the loss of mental acuity and intelligence. But it is, in reality, nothing other than the gradual the loss of life through the gradual accumulation of death.

Second, mitochondria are the source of all the energy that is produced and made available to the body. The mitochondria in the cells produce ATP (adenosine triphosphate), the energy currency for all cellular operations and transactions. And no matter how you look at it, every last little bit of energy that is needed to do anything at all comes from these mitochondria in the cells throughout the body. A tiny drop or increase in energy production in the mitochondria would result in a massive effect on your strength, speed, endurance, resilience, but also concentration and sharpness of mind. Why?

Because there are around 30 trillion cells, and most have between 1000 and 2500 mitochondria each. That makes tens of thousands of trillions of mitochondria. The average cell uses 10 billion units of ATP per day, which means an average adult needs about 3 x 10^25 units of ATP per day. Now you can imagine what happens if the ATP production per mitochondria drops or increases by a tiny fraction, say of just a thousandth of a percent. Because there are so many mitochondria, the magnitude of the effect would be enormous.

Do you remember the “blues and greens” that Jeremy Renner and the other agents carried in little aluminum cases around their necks in the Hollywood film The Bourne Legacy? Remember how much they enhanced both physical and mental performance? This is what these little pills’ main purpose was: to increase mitochondrial energy production efficiency.

We don’t usually think about it in this way, but we should. Doing so, we would understand how important it is to support the body in cleansing and clearing out damaged tissues and cellular components so that they don’t accumulate. And we would also understand how important it is to support the body in rebuilding new, healthy cells and mitochondria to maintain optimal function for as long as possible.

Stem cells everywhere in the body appear to love fat-burning. Because fasting triggers fat-burning in basically every cell of the body, it also triggers an explosion in stem cells activity. It is this explosion of stem cell activity that powerfully stimulates tissue repair and regeneration throughout the body’s tissues.

Ketones are produced in the liver by transforming free fatty acids into beta hydroxy butyrate and acetoacetate through beta-oxidation. Ketones are the preferred fuel for the brain and heart, because burning ketones to generate energy (ATP) produces much fewer reactive oxygen species (free radicals), and thereby significantly reduces oxidative damage to the muscle cells in the heart and the neurons in the brain. Isn’t that so amazing?

The relationship between nutritional ketosis and fasting is simple: the brain is one of if not the most crucial organ because it regulates and coordinates almost everything that happens in the body; the metabolic activity of the brain can be fuelled by glucose or ketones; as blood glucose concentration drops and thus becomes less abundant, ketone production in the liver increases to ensure an adequate supply of fuel to the brain. Glucose levels naturally drop within a few hours, even after a carbohydrate-rich meal, due to the action of insulin. Fasting lowers and maintains low blood glucose levels over significantly longer periods of time. Therefore, in general, the longer the fast, the more ketones are produced, and the more are in circulation in the bloodstream.

Burning ketones for fuel stimulates the production, within cells, of antioxidants like superoxide dismutase (that transforms the superoxide radical into molecular oxygen and hydrogen peroxide), and catalase (that breaks down peroxide). Both the superoxide radical and the hydrogen peroxide molecule can cause many types of cellular damage if not neutralised or broken down as early as possible. So, the more ketones available, the more cellular superoxide dismutase produced, and the less cellular damage from free radical damage sustained. Isn’t this amazing?

Ketones also stimulate the production of adenine dinucleotide phosphate (NADPH) and NAD coenzyme that recharge antioxidants like glutathione, ubiquinol, and vitamin C to a functional state. Major functions of NADPH include recharging antioxidants; providing electrons for the synthesis of fatty acid steroids, proteins, and DNA; and acting as the substrate for NADPH oxidase (NOX) which plays a key role in immune function. 

MCT oil and caprylic acid, both derived from coconut oil, are directly and easily converted to fuel and ketones by the liver to fuel brain and heart, and that will therefore bring your lucidity and clarity of mind and thinking. For this reason, they are excellent supplements to take in the morning and during the first part of the day, but should be avoided in the evening because they can lead to hyper-alertness and interfere with a restful sleep. MCT oil shouldn’t be used in case of liver disease.

Nutritional ketosis improves insulin sensitivity, stimulates fat loss, improves mental clarity, reduces risk of cancer, and increases longevity. It reduces cellular damage and inflammation through much lower free-radical and inflammatory cytokine production.  And it also increases cellular and tissue repair by stepping up autophagy, mitophagy, and stem cell activation. All of these benefits are consequences, direct and indirect, of sustained low glucose and low insulin levels, and of the derivation of cellular energy from fats and ketones rather than from glucose. In short, nutritional ketosis is amazingly—actually almost supernaturally—good for you.

Toxins and Detoxification

We are all exposed to many toxic chemicals. No matter where we live, and no matter what we do: mold toxins; heavy metals like Hg, As, Pb, Cd from air, water, and food; arsenic (As) from pressure-treated wood, electronics, herbicides; lead (Pb) from gasoline, water pipes, paints; cadmium (Cd) from fertilizers; copper (Cu) as a by-product of many industrial processes that builds up in soil and water; pesticides and herbicides like glyphosate; PAH (polycyclic aromatic hydrocarbons) produced from the combustion of fossil fuels; BPA (bisphenol A) and phtalates used to make plastics; dioxins and dioxin-like (PCBs) from industrial chemical processes; heterocyclic amines from grilling at high heat; hexane, a neurotoxic chemical used to extract more oil from nuts and seeds (including coconut). The list goes on and on.

These are in the soil, in the food, in the water, and in the air. They are also in the soaps, shampoos, creams, makeup, and the countless number of chemical cleaning agents manufactured and sold the world over that we use in our homes. Obviously, the more of them you avoid direct exposure to the better. Consuming toxin-free food as much as possible, and using the simplest and most natural household and personal care products is an essential first step. But if embryos, as protected as one could ever be deep in a mother’s wombs and behind several layers of protective membranes and mechanisms, are known to accumulate toxins, then what about us?

Most of these chemical toxins are fat-soluble. The biochemical processes that have evolved to transport and isolate environmental toxins, whatever they may be, into fat cells is a remarkable survival mechanism that has without a doubt played an important part in allowing living organisms to evolve over the past 3.5 billion years into increasingly more complex plants and animals. However, the Industrial Revolution led to an explosion of human-made chemicals into the environment the pace of which has never ceased to increase.

Did you know that strawberries contain a fibre called fisetin that help remove and eliminate senescent cells from the body, which is essential for prolonging health? But did you know that they are also some of the most chemically contaminated foods together with spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes, bell peppers? Among the least contaminated are avocados, sweet corn, pineapple, cabbage, onions, sweat peas, papaya, asparagus, mangos, eggplant, honeydew, kiwi, cantaloupe, cauliflower, and broccoli.

In the past four decades only, more than 85 thousand different chemicals have been released into the environment. And the amount has only increased with time. One of, if not the most dangerous is Monsanto’s infamously well-known glyphosate because it is the most heavily used broad-spectrum herbicide of all time: from 1974 to 2016, soils, waters, plants, and animals have absorbed 1.8 million tons in the US alone, and 9.4 million tons worldwide.

Since 1974 in the U.S., over 1.6 billion kilograms of glyphosate active ingredient have been applied, or 19 % of estimated global use of glyphosate (8.6 billion kilograms). Globally, glyphosate use has risen almost 15-fold since so-called “Roundup Ready,” genetically engineered glyphosate-tolerant crops were introduced in 1996. Two-thirds of the total volume of glyphosate applied in the U.S. from 1974 to 2014 has been sprayed in just the last 10 years. The corresponding share globally is 72 %. In 2014, farmers sprayed enough glyphosate to apply ~1.0 kg/ha (0.8 pound/ acre) on every hectare of U.S.-cultivated cropland and nearly 0.53 kg/ha (0.47 pounds/acre) on all cropland worldwide. (Environmental Sciences Europe, 2016, 28:3)

Our fat cells are the body’s chemical storage facility. The more of them there are, the more chemicals can be stored. The less body fat there is, the less chemicals are stored. And if your storage unit is full, then no matter how hard you try, you won’t be able to add another piece of furniture. This is also true for the body’s chemical storage capacity.  This is both good and bad, but for different reasons.

More storage allows the organism to survive and function even in the face of significant chemical contamination. But the more chemicals are stored in the body’s fatty tissues, the more the organism as a whole becomes contaminated, and the less able it becomes to function optimally. A large dose of chemical exposure, say from a chemical leak, would require a large fat storage capacity in order to prevent overwhelming the rest of the body’s organs and systems. In such circumstances, someone with more body fat would be better off than someone with less.

But for most of us, this kind of acute exposure from a chemical accident in our near vicinity is not much of a concern. Moreover, you shouldn’t imagine that because chemical toxins are stockpiled in fat cells to minimise exposure in other tissues that they have no effect. Does burying radioactive waste makes it innocuous? It makes it a lot less dangerous and damaging, that’s for sure. But only in the short term, and to some extent, because the radioactive wastes leak out into the soil and the ground water.

The same is true for the chemicals stored in our fat cells. The storing of them protects us from the major toxic effects of direct and large scale exposures, but there is some leaking of these toxins out into the system, especially over time, and as our storage tanks get full. In general, therefore, this is what we should be concerned about: the low-grade chronic exposure and its long-term effects. And the less fat storage, the less chronic exposure there will be.

Fasting regularly and smartly, is the best way to both clear out the storage tanks, and  shrink the overall storage capacity for chemical toxins, thus minimising the amount of leaking taking place on a day-to-day basis. So, here’s what we need to know about this:

The more access to fat stores for fuel, the more toxins are mobilised and released from the tissues. This is what we stimulate in the most efficient manner when we fast, because the body needs to sustain all of its cellular processes by burning fat for fuel. But fat loss releases toxins in bloodstream. And this is good because toxins are mobilised.  Detoxification, however, must be supported in order for the toxins to be excreted. Otherwise they are released into circulation and can be very damaging. It is for this reason that water fasting is in general not a great idea: it releases too many toxins too quickly, and offers no mechanisms for bindings and eliminating them.

Once toxins are liberated, they must be bound to something in order to be eliminated. To be liberated, toxins are first made water soluble by the addition of a hydroxy (OH) radical. This is essential for elimination, but it makes the toxin more reactive. In a second stage, the now water-soluble but reactive toxin, is conjugated by the addition of a methyl, sulfur, or acetyl group, or else of an amino acid like glycine or glutathionine, in order to be made less reactive. After this, it is transported out of the cell to be eliminated through urine, sweat, or stools.

The detoxification process is supported by facilitating urination (drinking more); facilitating passive sweating (sauna, near-IR is best); eating cruciferous vegetables (broccoli, cauliflower, cabbage, Brussel sprouts, and kale); and supplementing with toxin binders (activated charcoal, chlorella, chitosan, psyllium husks, and citrus pectin). Actually, fat regain following fat loss, something which is very common, is almost certainly a protective mechanism to sequester the toxins that were released but not eliminated. And sweating has to be passive, because exercise suppresses detoxification: the system can be either in fight-or-flight or in rest-and-repair mode; exercise is associated with the former.  

Effective detoxification depends on healthy intestinal function. A compromised gut lining allows toxins from the foods or process of digestion to enter the bloodstream. This leads to chronic inflammation and a chronically triggered immune system that eventually results in autoimmune conditions. Fasting reduces gut permeability by enhancing integrity of gut lining: it induces a metabolic switch to fat-burning in the intestinal stem cells that significantly enhances their function, and promotes the healing of the junction between gut lining cells, as well as gut flora diversity.

Resistant starches are good because they feed the gut bacteria, and do not break down into glucose. They are found in under-ripe bananas, papayas, and mangos. Most notable is that if rice is cooked with coconut oil, allowed to cool for 12 hours, and reheated, it will increase in resistant starch by a factor of 10! This reduces calories that would be absorbed from the starch going to glucose by 60%! This simple preparation of the rice turns it from a damaging high-sugar food to avoid, into a beneficial prebiotic. Quite amazing, isn’t it?

How to fast: first steps

Now, before going any further, you should not fast if you are underweight or malnourished; pregnant or breastfeeding; or if you have excessively high uric acid levels. Fasting while underweight or malnourished will exacerbate the negative consequences of the malnourishment. Fasting while pregnant or breastfeeding will release toxins that could potentially be highly detrimental to the baby. And because fasting naturally increase uric acid levels due to the process of cellular cleaning, it could, if starting from an already excessively high concentration, be damaging to the organism. Otherwise, fasting will in general be very beneficial.

First, because fasting strongly influences the regulation of the circadian rhythm, and because one of the most important functions of sleep is to clean out the brain from the byproducts and wastes of its metabolic activity during the waking hours, we should never eat during the night, and always allow at the very least three but preferably four to five hours from our last bite to the time we go to bed. This is necessary to set the conditions for a deep, restorative sleep that keeps our brain in good shape. This is true independently of everything else. So, you can start doing this right away without even having to do any prolonged fasting.

Second, in order to avoid a negative impact on your mental and physical performance during the fast, the body should be adapted to using fat for fuel before you start fasting. You will feel shitty otherwise. I have written two articles that relate to this: Keto-adaptation for optimal physical performance and The crux of intermittent fasting. You should read both. It’s important to understand the biochemical and physiological foundations of why we do things in a particular way. Otherwise, we will lack the intellectual understanding on which depends our ability to make informed choices, but also out resolve to see them through.

Third, in order to have a smooth transition to longer fasting periods, you need to increase your fasting window gradually: to gradually increase the time between your last bite in the evening, and your first bite the next day. Let’s say your sleeping schedule is near optimal, sleeping from 22:00-23:00 to 7:00-8:00. Let’s also assume that you make sure you leave 4 hours before going to bed so that you have your last bite of food around 18:00. Everyone should fast for at least 12 hours. That’s the minimum to aim for, and it requires very little effort.

It would be much better to fast for at least 14 hours, in which case you would wait until 9:00 before having any food. A 16-hour fast would bring you to 11:00 for a late breakfast or early lunch. An 18-hour fast would have you eating lunch at 13:00. And a 20-hour fast means you would be having your first meal around 15:00. Take as long as you need to gradually go from the minimum of 12 hours to at least 16, 18, or even 20 hours.

When you can do this, you will know for sure that your metabolism is well fat-adapted, that your liver is producing ketones efficiently to nourish your brain during fasting periods, that the coarsest detoxification has to a great extent taken place during those weeks or months you have been adapting to longer fasting periods, and that you are now ready to extend your fasts to 24 or 36 hours once in a while, or as much as a couple of times a week. It is far more beneficial on the long term to fast for shorter periods of time every day, then it is to fast for a longer time less frequently. Because each time we fast and then refeed, we activate and benefit from the health-promoting and youth-enhancing mechanisms of the body.

Eating protein activates the mTOR (mammalian or mechanistic target of rapamycin) pathway, which is a powerful catabolic (tissue breakdown) that raises blood sugar levels. Hence, in general, we should keep protein intake to the optimal minimum for our needs. That’s something like this:

  • Young: 1g/kg of lean body mass per day
  • Older: 1.2g/kg of lean mass per day
  • Athletes: 1.5g/kg of lean mass per day

It’s important to remember that beyond the minimum optimal amount, protein intake should be adapted to level of activity: more activity means more protein, and less activity means less protein. Once you are well fat-adapted—after about 8 weeks on a very low carbohydrate diet—you should make a point of having a high fruit and/or starch day once a week. This will ensure that you maintain metabolic flexibility and a perky insulin response. Long term nutritional ketosis can lead to a sluggish insulin response, higher-than-optimal glucose levels and thus glycation, and otherwise unwanted biochemical and hormonal adaptations, which will prevent fat-loss and promote muscle breakdown. Variety stimulates metabolic flexibility.

But make sure it’s clear to you what this means: it means staying in nutritional ketosis for at least 5 days per week. And having a high-carb day means having between 100 and 150 g of sugar/starch from fruit, sweet potatoes, or rice. You should also make that high-carb day a low-fat day. In addition, digestion quality must remain your top priority. This means having your fruit or starches on their own as much as possible, and avoiding combining them with a lot of protein, which will compromise the digestion of both.

How to fast: specifics of keto-fasting

Very importantly, clearance of damaged cells and cellular debris or damaged organelles takes place during fasting, but rebuilding of organelles, cells, and tissues, most notably liver rejuvenation, occurs during refeeding.

Ketofasting following Dr Joseph Mercola’s method is partial fasting lasting ideally around 24 to 36 hours and up to 48 hours. It starts after the last meal of the day, extending over the course of the day following that, either ending with a meal 24 hours later; extending through a second night and ending at the start of the next day for the 36 hour fast; or extending 48 hours to latter part of the day. We saw why water-fasting is not something most of us should be doing in this day and age, and why it’s important to support the detoxification process while fasting. This requires some inputs: it requires protein (amino acids), mitochondrial support, and toxin binders.

The notion of breaking a fast is often taken as binary: we are either fasting or we are not. To some extent this is true. But in many ways it is not. It depends a lot on what it is that we ingest. The essential point is that the benefits of fasting come from maintaining very low blood sugar levels, remaining in nutritional ketosis, and therefore keeping the body in a cleanse-detoxify-repair mode.

Hence, there is a big difference between ingesting a teaspoon of coconut oil or a teaspoon of honey: both provide some calories, but the former supplies only fatty acids that actually promote nutritional ketosis, while the later supplies only simple carbohydrates that will immediately raise blood sugar levels and suppress ketosis, albeit temporarily, and more or less, depending on several other factors defining the body’s metabolic state and efficiency. So, in this regard, it’s better to think of fasting as grey rather than strictly black and white. Naturally, it’s really not an issue to have cucumber and celery with salt, for example.

Protein intake, needed to support the detoxifications processes, should be about half of your daily requirement, for example, 45 g instead of 90 g for 60 kg of lean body mass exercising 3-4 per week. During fasting, protein should not be branched-chain amino acids (BCAAs) nor animal protein rich in BCAAs, because they activate the mTOR pathway that inhibits autophagy. The rest of the calories should be from fat to reach 300-600 kcal from coconut oil, MCT oil, or caprylic acid. Even small amounts of 85% chocolate for which each 10 g square provides 5.3 g of fat, 0.8 g of protein, and 1.5 g of sugar, amounting to 62 kCal of which 48 are from fat, 3.2 from protein, and 6 kCal are from sugar. These are all considered supplemental levels.

In fact, because the purpose of eating protein is to supply amino acids in support of basic functions and detoxification, it is most effective to replace protein intake by an amino acid supplement. And because converstion of protein to amino acids is at most 1/3 efficient, meaning that the highest quality animal protein (e.g., beef) will yield at most 1/3 of its amino acid contents once digested, we can replace 45 g of protein by 15 g of amino acids. Splitting this intake into 4 doses of 4 g each makes for a good rhythm of taking these every couple of hours over 8 hours or so. And they can be taken together with the chlorella and spirulina supplements as well as the phospholipids.

Even though exercising suppresses hunger due to the increase of stress hormones, unfortunately, it also suppresses detoxification. For this reason, you shouldn’t do strenuous exercise on fasting days. Focus on rest and repair.

Supplements to support autophagy and toxin elimination include:

  • Ubiquinol 100-150 mg twice to support mitochondrial energy production, regulate gene expression of processes related to inflammation, growth, and cellular detoxification.
  • Phosphatidylcholine and broad spectrum phospholipid to support rebuilding and thereby eliminating chemicals from cell membranes, especially in the brain.
  • Probiotics (not dairy-based) to help rebuild/balance gut flora if digestion is suboptimal. Keep in mind that the natural flora of the gut is adapted and adapts according to food and drink intake, as well as to the daily rhythms.
  • Bitters to support the liver in cleansing and elimination (e.g., Dr Shade’s Liver Sauce by Quicksilver Scientific; Swedish Bitters by Flora or by Maria Treben; herbs like Gentian, Dandelion, Goldenrod, Myrrh.)
  • Binders to support elimination of toxins, all to be taken on an empty stomach to not interfere for nutrient absorption in the gut:
    • Psyllium husks (1 tbs 1-2 times/day) stirred into a large glass of water—binds to stuff in gut to eliminate in stools;
    • Charcoal capsules (3 caps 1-2 times/day)—binds and removes pathogenic bacteria, Pb, Hg, and excess Fe;
    • Chitosan (2-3 g)—binds and removes heavy metals and radionucleotides;
    • Modified citrus pectin (5 g 1-3 times/day)—binds and removes dead/weak cells;
    • Chlorella—binds and removes Hg, but also provides a balanced plant protein.

Refeeding is as important as fasting, because this is when the rebuilding takes place. It is very important to remember that. Unless you are overweight and carrying around a lot of energy reserves in the form of extra body fat, intermittent fasting is not a matter of replacing three meals with only one. You need to provide the body with all the energy, macro and micro nutrients it needs to thrive. This remains true under all circumstances. Therefore, you need to make sure to not fall into the trap of eating 1/3 of what you normally would, and grow thinner and  thinner with time. That is not the point, and is obviously not sustainable in the long term. You need to provide the bodymind all the nutrition and calories it needs. The key is that this is true on average: If you don’t eat for extended periods of time, you naturally need to eat more when you do.

Concluding remarks

As time goes on and as our technological means of detailed investigations at the cellular level improve, we discover more and more amazing health-enhancing mechanisms through which fasting acts on the organism to make it stronger, more resilient, more functional, and more youthful.

But beyond all the super cool details about the mechanisms by which fasting works its magic on our body and brain, the essential message here is that fasting is really good for us. It’s in fact so good that it’s amazing. And considering that it can stimulate the growth of new mitochondria and even new brain cells, we could even say that it’s miraculously good for us.

Having understood that it is the combination of the fasting period and the refeeding that follows which makes the magic happen, the natural question is how can we maximise this. And the answer is quite simple: we fast and refeed frequently. We fast long enough to activate the health-enhancing cleansing, detoxification, and preservation mechanisms and pathways, and refeed with the most nutrient dense and nutritious foods to maximise the efficiency and effectiveness of the rebuilding and renewal mechanisms and processes.

Once well keto-adapted, and after a period of gradual adaptation to longer fasts, it becomes very easy, and even natural, to fast daily from 18:00 to 12:00 or even 14:00. It even becomes easy and natural to eat two small meals or a single large meal just once a day. In this way, we can get the benefits of fasting and refeeding every single day. Of course, longer fasts of 2, 3, or 4 days will go deeper in stimulating the cleansing, preservation, and repair potential of the fast. But the longer the fast, the more difficult it grows to maintain, and the less frequently it can be done because the rebuilding in between fasts must also be longer. After all, our daily requirements for calories and nutrients is what it is, and although we can easily postpone providing the organism what it needs to function optimally for some time, everything it needs must eventually nevertheless be provided.

This is therefore what I do. A daily fast of about 16 to 20, and usually 18 hours. Once or twice a week a full day’s fast with a single large meal, but typically one small meal around 14 and one larger one around 17 or 18. A comprehensive daily supplement programme; bitters over extended periods a couple of times a year; binders like psyllium husks semi regularly according to need based on quality of bowel movements, and smell of underarm sweat; maximum hydration and alkalisation of body fluids during the fast; and most fundamentally, maximum nutrition at refeeding. Maximum nutrition and nutrient density from plant foods, and maximum nutrition and nutrient density from animal foods. And the final note I’d like to leave you with is this:

The process of ageing is the process of dying. And this process of ageing and dying is a very slow and gradual process of accumulating dead and dysfunctional cells, mitochondria, organelles, and tissues. As these accumulate, we age and die. The faster they accumulate, the faster we age and die. The more we have accumulated, the closer we are to the end, to the threshold beyond which the organism cannot sustain its activity. Fasting—and this is the single most essential benefit of fasting—is by far the most effective way to slow down, minimise, prevent this continuous accumulation of death, and instead promote and stimulate cleansing, renewal, and rejuvenation within this organism that we call our bodymind.

I hope all of what we saw here together will help you enhance your health, and improve the quality of your life.

 

This article is inspired by and primarily based on KetoFast by Dr. Joseph Mercola.

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Is it possible to make universal recommendations about health?

Focus these days tends to be on individuality. Especially in this age of genetic testing. The fact is, however, that ahead of individual differences, we are all human. Not only that, but as far as we know today, with the latest studies of mitochondrial gene evolution and transmission, we are all descendants of the same group of homo sapiens from the south western coast of Africa. Hence the question: can we make universal recommendations?

Imagine we could examine every human being on the planet, and assess organ function. For example, examine function of the kidneys, liver, pancreas, gall bladder, stomach, small intestine, and large intestine. Would we find differences in how these are working from one person to another? Of course we would! That’s obvious. But does that have to do with inherent individual differences, or does it have to do with acquired differences that have developed over time for a range of different reasons? What if we were to ask this question instead: is there a difference, from one person to another, in how these organs are meant to work, a difference in how these organs should be working?

If that were the question, we would most certainly agree, together with probably all anatomists and physiologists, that all of these organs, and the rest of the internal organs of our organism, are meant to work in the same way. That all these organs, no matter in which person they happen to be, and no matter how they are currently working, are nevertheless meant to work in precisely the same way to perform precisely the same functions. And this not only in humans, but also in most animals with whom we share these fundamental anatomical and physiological characteristics. This naturally points not to individual differences but to inherent similarities as the fundamentally essential.

It is however quite easy to understand why there is so much emphasis on individuality. Aren’t we all unique and different? Aren’t we all so special in this uniqueness? Don’t we all have to learn to listen to our inner voice and pursue what we need to feel fulfilled in our own unique way? And how cool it is to be able to know our genetic profile, our own, completely unique, personal, and individual genetic profile? How special does it make us feel to know that there isn’t a single other person that has the same genetic profile as us?

What if everyone was brought to believe that each type of cancer is different, not superficially but fundamentally, and that in addition, each type is expressed differently in each individual because of the different interactions with their unique genetic makeup? That it is necessary to treat each individual cancer and each individual person with a drug that is genetically tailored just for them in their particular situation? What if we were brought to believe that this was the case for most illnesses and chronic diseases: that what is needed are specific drugs for specific conditions that are genetically tailored to each person? What endless possibilities! What awesome growth potential! What amazing investment opportunities! And what astronomical potential for returns on investments!

Contrast this with a position holding that cancer is a metabolic disease, and that no matter what kind it is, fundamentally cancer is always caused by a mitochondrial dysfunction that leads to excessive fermentation of glucose for fueling accelerated reproduction and a cellular activity that has become undifferentiated, and that therefore, all cancers can be prevented and even reversed by effectively starving the cancer cells of fuel by maintaining very low glucose and very low insulin levels in the bloodstream to ensure that healthy cells derive their energy from fatty acids and ketones, while the weakened and dysfunctional cancer cells starve and die. What growth potential? What investment opportunities? What returns on investments?

Contrast this with a position holding that all chronic diseases are also rooted in metabolic dysfunctions, and arise, simply and naturally, in a rather predictable manner, from things like chronic dehydration, chronic dysfunctions in digestion, absorption, and elimination, chronic nutritional deficiencies, biochemical imbalances, accumulation of metabolic acids and wastes, and result from all the consequences brought on by these dysfunctions and imbalances over years and decades that grow in severity in time until we are really quite sick, but all of them very simply prevented and treated with proper self care, hydration, and nutrition. Again we can ask, what growth potential, what investment opportunities, what returns on investments?

Whatever your personal inclination about any of this, it’s definitely something to keep in mind when evaluating statements concerning the general applicability versus the individual tailoring of treatments for ailments and approaches to health.

My position is simple:

  • as living organisms and complex animals, all humans are basically the same in anatomy and physiology;
  • there are obvious differences from one person to another that must be taken into account when considering each person individually; but
  • on the whole similarities are many and fundamental, while differences are fewer and generally superficial.

This is not to say that differences can be dismissed or even overlooked. Of course not. There are important differences in the expression of fundamental genes like the MTHRF gene that regulates methylation in the body, and which hence directly affects the body’s biochemistry and state of health. Similarly, there are important differences in response to sunlight and vitamin D metabolism from one person to another, even people from the same general gene pool. But these are nevertheless superficial compared to the totally fundamental considerations of how cells, organs, systems, and hormones work.

With all of this in mind, let’s come to the main point: what recommendations I would make with confidence to any adult not suffering from a major disorder, younger or older, weaker or stronger, more fragile or more robust, knowing that these recommendations would in no way be harmful, and would instead be helpful to improve health. They are presented in order of importance.

  1. Drink plenty of water and eat plenty of unrefined salt with meals. This is essential for proper hydration on which every cell relies, and proper kidney function on which the organism as a whole relies.
  2. Get at least 8 hours of quality sleep per night, on a regular schedule, somewhere between 21:00 and 8:00 the next day. Nothing is more important for health than sleep, and there is no way in which we can make up for a lack of it.
  3. Practice intermittent fasting. Nothing offers a more effective way to cleanse, repair, heal, and optimise cells, tissues, organs and metabolic function than fasting.
  4. Eat only nutrient dense whole foods. Ideally organic and pasture raised, focusing on high quality animal protein and fats, and micronutrient dense plant foods, avoiding all processed carbohydrates, lectins from grains and nightshades, and any foods to which you may be intolerant (e.g., dairy, eggs, nuts, etc).
  5. Take vitamins A, D3, and K2. These are fundamentally important fat-soluble vitamins, essential for healthy gene expression, calcium metabolism, healthy bones and teeth, and healthy arteries and soft tissues throughout the body.
  6. Take baking soda. Start the day with half to three quarters of a teaspoon of baking soda dissolved in a large glass of water on a completely empty stomach. This is the easiest way to supply the most important alkaline compound used by the body, and offset the acid load and potential accumulation in tissues of metabolic acids.
  7. Take iodine. This is essential for healthy thyroid, mammary, and glandular function in general. But iodine is needed in every cell, and basically everyone is iodine deficient. Unless you live by the sea and eat fish and seafood regularly, you need extra iodine (either in pills or by eating sea vegetables).
  8. Take magnesium. This mineral is also needed by all cells, but especially muscle cells that need and use up magnesium in order to relax, and our soils are globally deficient in it. Thus, naturally, so are we. Contraction of muscle requires calcium, which is quite abundant in our diet; relaxation requires magnesium, which is, on the contrary, rather scare in our food supply.
  9. Practice resistance training. Focus on large compound exercises like the deadlift, squat, benchpress, and standing overhead press. There is no way more effective to maintain a strong and healthy balanced musculature, nervous system, skeletal structure, and hormonal system than whole body exertion through complex lifts with sufficient resistance.
  10. Find purpose and fulfillment in your life. This is fundamental. Without a sense of purpose we feel useless, unneeded, unwanted. Without a sense of fulfillment from what we do, we feel hollow, empty, worthless. It is therefore essential to find and to actively seek to maintain a strong sense of purpose, and a feeling of fulfillment in life. Do not take this lightly. Look into it and find it.

Here you have it: ten simple recommendations for a healthy life. And, from the perspective presented here, ten universal recommendations for any adult without a major disorder requiring specific considerations, which are sure to not cause harm, and instead sure to bring about improvements and benefits to metabolic, hormonal, muscular, skeletal, and physiological functions of the organism as a whole. Therefore, in conclusion, I would say that yes, it is possible to make universal recommendations about health.

 

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Insulin and Triglycerides

Every time I review someone’s blood test results, and then discuss with them what they mean and what they should do to improve their numbers, there’s something I almost always have to explain. And this was the relationship between fasting insulin and triglyceride levels.

Take a look at this plot:

trigs_vs_insulin_gb

Plot showing ten pairs of measurements of insulin and triglycerides, made from the same blood samples. They were collected between 2011 and 2017, and all are from my own blood tests.

It shows measurements of insulin concentration on the horizontal axis in mili units per millilitre (mIU/ml), and triglyceride levels on the vertical axis in milligrammes per decilitre (mg/dl). This is a correlation plot in which independent measurements of one variable are plotted against independent measurements of another in an attempt to see if there is a relationship between them.

Is there an order in the way the dots are organized? They are clearly not randomly distributed as a circular cloud of dots—it would mean that there is no relationship. Instead, we see what looks like a linear relationship in which lower values of insulin correspond to lower values of triglycerides, and higher values of insulin correspond to higher values of triglycerides. It’s not a straight line, but it’s definitely a clear linear relationship, and the value of the correlation coefficient, which quantifies how tight the relationship actually is, of just under 0.9 is pretty close to 1. In other words, it’s a pretty tight linear relationship.

Triglyceride is a fancy word for fat or lipid, because fat molecules are composed of three fatty acids held together by a glycerol structure. This is what triglyceride refers to. The amount of fat in the blood is affected by the amount of fat we eat, and the amount of body fat we have. Naturally, after a fatty meal, triglyceride levels will increase as the fat goes from the digestive system into the blood, they will reach a maximum, and then start to go down. The longer we wait before we eat again, the lower they will go. But there’s a few complications.

The first is that depending on the amount of insulin, one of whose jobs it is to transport nutrients into cells, whatever is circulating in the blood—and this includes glucose, of course, but also protein and fat—will in general be stored away faster if insulin is higher, and slower if insulin is lower. This means that if you eat fat together with sugar or starch, the whole lot will be packed away, and mostly as fat, minus the little bit of glucose your muscles and liver have room to store up as glycogen.

The second is that depending on the state of insulin sensitivity—the fundamental parameter that determines how well or poorly cells can use fat for fuel—triglycerides will in general be used up faster if we are more insulin sensitive and slower if we are more insulin resistant. This means that in the morning, twelve to fourteen hours after having had the exact same meal, the more insulin sensitive person will have lower triglyceride levels than the more insulin resistant.

And in fact, no matter if we have a measure of fasting insulin or not, and no matter how little we know about the person’s overall health, fasting triglyceride concentration is probably the best general marker of insulin sensitivity. Nevertheless, because their levels fluctuate quite a lot over the course of each day as a function of what we eat and drink, it is true for triglyceride levels as it is true for many other blood tests that are affected by the kind and amount of food and drink we’ve had over the last days, and most importantly by the amount of sweet or starchy carbohydrates.

Now, take a look at this second plot:

trigs_vs_insulin_final

Plot showing, in addition to the 10 points shown in the first plot (in red), another 20 pairs of measurements of insulin and triglycerides, also all from the same blood samples, but from seven other persons.

It shows the same 10 data points shown in the first plot from my own results, but with another 20 pairs of measurements taken from other people that I’ve coached and helped with the interpretation of their results. You can see that the relationship is better defined because of the additional points that now together cover a wider range of values on both axes.

However, you can also see that, the relationship is not as tight. In particular, there are a few points that are quite far off the main trend—mostly those at the top of the plot with high triglyceride and low insulin values. We see how these off-trend points affect the tightness of the relationship seen in the initial data set when we compare the values of the correlation coefficients. These off-trend points lead us to the third complication I wanted to bring up.

But first, please take a minute to consider the matter: What could lead to having low insulin and at the same time high triglycerides? What could be the cause of the difference between my numbers, which did contain some very low insulin levels, but all of which were paired with equally low triglyceride values, and this other person’s numbers? What causes insulin to go down? What happens when insulin is low? What could cause triglycerides to go up while insulin is low?

Insulin, no matter how high it is, will start to go down when we stop eating. The longer we fast, the lower it will go. Each person’s baseline will be a little different depending mainly on their metabolic health and their body fat stores. The more efficient the metabolism is at using fat for fuel—the more insulin sensitive, the lower insulin will go. But also the lower the body fat stores are, the lower insulin will go. On the flip side, the more insulin resistant and the fatter we are, the longer it will take for insulin to drop and the higher it will stay at baseline.

This is pretty shitty. I mean, as we develop insulin resistance, average insulin levels will become higher and higher. As a result we’ll store calories into our growing fat cells more and more easily, and will therefore become fatter and fatter, faster and faster. But fat cells also secrete insulin! So, the more fat cells there are, the higher the insulin levels will be, and the harder it will be to lower our basal insulin. To burn fat, we need to lower insulin levels. The fatter we are, the higher the insulin levels will tend to be. And the fatter we are, the harder it will be to lower insulin levels.

It’s a bit of a catch, but in the end, it’s not such a big deal because basically everyone who is overweight and who starts to fast and restrict carbohydrates melts their fat stores away very well. It works incrementally: insulin goes down a little, insulin resistance is reduced a little, fat-burning starts; insulin goes down a little lower, insulin resistance is further reduced, fat-burning increases; and on it goes, until we have lost all those extra kilos of fat that we were carrying on our body, be it 5, 15, 20, 35, 60 or even 100 kg of fat! It’s just a matter of time.

Now, after this little tangent on insulin and fat stores, we can come back to those anomalous points in the plot, the most conspicuous of which is the one just below 120 mg/dl of triglycerides but only 3 mUI/ml of insulin. Have you come up with an explanation? Here is mine:

That point is from one of my wife’s blood tests. It is unusual because it was done after 24 hours of fasting. My 24-hour fasting blood test done a number of weeks before, and my numbers were 41 for trigs at 2.3 for insulin. The difference between her and I was that I was already very lean, whereas she wasn’t. Therefore, as she fasted, her insulin levels dropped very low, and then the body started releasing its fat stores into the bloodstream in high gear. This is why her triglyceride levels were this high while her insulin was that low. It’s almost certainly the same for the other two points up there with trigs at 110 and 90 with insulin around 4 and 2.5 (the latter one of which is also my wife’s).

Since we did many of our blood tests around the same time, there are 9 data points from her on the plot. Several are in the centre of the main trend at insulin values between 6 and 7, but I’d like draw your attention to her lowest insulin value that was measured at 1.8, and at which time her trigs were at 57, and her lowest triglyceride level of 48, at which time her insulin was at 2.2. This shows that on average her values are a little further along the trend than mine are because of the small difference in body fat, but that she has good insulin sensitivity, and a well-functioning metabolism that can efficiently use fat for fuel.

The other off-trend point, but in the other direction on the right hand side, with insulin just above 10 and trigs around 65, is from my mother’s first blood test which I ordered and included insulin and trigs, before I got her off carbs. She was 82 at the time, eating a regular kind of diet, but not a very nutritious or varied diet with plenty of bread and cheese, because she had serious problems moving around and taking care of herself while still living alone. And so, it’s just the result of being older, having plenty of carbs, but not being highly insulin resistant nor highly overweight. Her baseline insulin levels were just generally higher because of her age and diet, but her trigs weren’t excessively high.

However, after just four days of intermittent fasting on a very low carb regime with most calories coming coconut oil spiked green juices and coconut milk smoothies, her insulin went from 10.3 to 4.7, and she lost 5 kilos, which, of course, were mostly from the release of water that the body was retaining to counter the effects of the chronic inflammation that immediately went down with the very-low carb regime and fasting.

Later, having sustained this strict green healing protocol for about 6 weeks, her numbers were at 2.9 for insulin and 56 for trigs. And by then she had lost another 5 kg, but this was now mostly fat. She had, at that point, recovered full insulin sensitivity, had lost most of her body fat stores, and overhauled her metabolism. She was 83 at that time, which shows that this sort of resetting of the metabolism can work at any age.

On this note, let’s conclude with these take-home messages:

First, the next time you get a blood test, request that insulin and triglycerides be measured, because it’s the only way to know what your fasting insulin actually is, and because it is very telling of your level of insulin resistance or sensitivity, overall metabolic health, as well as your average rate of ageing as we’ve seen in a previous post on insulin and the genetics of longevity.

Second, when you get the results back, you will be able to tell from your triglycerides concentration, in light of your insulin level, either how well the body is using fat for fuel—in the case you are already lean, or how fast you are burning your fat stores—in the case you still have excess body fat to burn through.

And third, resetting metabolic health can be done at any time and at any age, and is yet another thing that shows us how incredible our body is—the more we learn generally or individually, the more amazing it reveals itself to be.

 

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Want to lose weight? Here’s what you need to know in under 1000 words

One, you don’t want to lose weight: you want to lose fat. You don’t want to lose muscle or bone because they are very important functionally and metabolically. What you want to lose is fat. So weight loss needs to be reworded as fat loss.

Two, roughly speaking, the body is generally either storing surpluses or using reserves.

Three, the major fuels for the body are glucose and fatty acids.

Four, for the body to use fat reserves, insulin levels must be low. Fat cannot be efficiently utilized as long as insulin is high, because insulin promotes storage.

Five, the thyroid gland regulates metabolism and brain function. It requires adequate amounts of iodine without which it cannot work properly. To ensure healthy metabolic function, iodine supplementation is critical.

That’s what you need to know. If you want more details, I can expand a bit.

Insulin regulates fat storage

Every second that we are alive, trillions of biochemical reactions take place. The energy currency is adenosine triphosphate, ATP. Mitochondria produce ATP primarily using glucose or fatty acids. Fatty acids produces a lot more, but glucose is much easier to use. Both are used but one always dominates. In general, if there is glucose to be used, fatty acids are not much. For fat loss, we want to promote fat burning for ATP production to fuel cellular activity.

High glucose levels from carbohydrate intake trigger insulin secretion. This is necessary to bring the glucose into the cell, and to get rid of it from the bloodstream where it causes damage to the tissues by glycation. Within the cell, glucose can be either fermented without oxygen or oxidised with oxygen. Lower oxygen levels (and very high short term metabolic needs) promote fermentation. Higher oxygen levels (and lower metabolic ATP production rates) favour oxidation. More fermentation leads to greater accumulation of lactic acid, which further decreases oxygen levels. Red blood cells do not have mitochondria and therefore can only produce ATP by fermenting glucose.

Lower glucose leads to lower insulin. This triggers the release of fatty acids and glycogen into the bloodstream. If sustained, low glucose leads to the production in the liver of ketones primarily to fuel the brain whose cells can either use glucose, ketones, or medium chain fatty acids because longer molecules cannot pass the blood-brain barrier.

The higher the glucose, the higher the insulin, and the faster the uptake and storage of nutrients from the bloodstream into cells. The lower the glucose, the lower the insulin, and the faster the stored fat can be released and used.

insulinFatStorageFatRelease

Amount of glucose stored as fat and amount of fat released from fat cells as a function of insulin concentration. Plot taken from https://optimisingnutrition.com

The most metabolically active tissue is muscle. The more muscle we have, the more energy is used, and the faster both glucose and fat are burned to supply fuel to the cells. The more we use our muscles, and the more intensely we use them, the more they grow, and the more efficiently they burn both glucose and fat. Also, the stronger the muscles, the stronger and denser the bones will be. This is very important.

Therefore, as we burn more fat, we burn fat more efficiently. As we use our muscles more intensely, we burn more fat. And as we build more and stronger muscle, we burn even more fat even more efficiently, and make the bones stronger.

Different Carbohydrate Intolerance Levels

These mechanisms are universal in animals, but each animal is different, and each person is different. As far as fat loss is concerned, the individuality of people is related to their predispositions to insulin resistance and carbohydrate tolerance, (or actually, intolerance). Every person is differently intolerant to carbohydrates and differently predisposed to insulin resistance.

This is why in a group eating the same diet, there are people who are thin, people who are chubby, people who are fat, and everything in between. Basically, the greater the predisposition to insulin resistance (and the more sedentary), the lower the tolerance to carbohydrates will be, and the fatter you will tend to get. In contrast, the lower the predisposition to insulin resistance (and the more active), the higher the tolerance to carbohydrates, and the thinner you will tend to be.

This translates into different thresholds in the amount of carbohydrate we can eat without negative metabolic consequences, and consequently, the amount under which we must stay in order to burn fat instead of storing it. As a guideline, if you want to burn primarily fat for your body’s energy needs, this threshold would be around 20–25 grams per day if you are fat; around 30–50 gram per day if you are neither fat nor thin, and could be around 80–100 grams per day if you are very thin.

But no matter what your personal threshold happens to be, it will always be the case that the lower the intake of carbohydrates, the lower the glucose and insulin will be, and the more efficiently your body will burn fat as fuel.

Fat Loss Rate

The amount of fat that is burned is determined by the energy balance. The greater the total amount of energy we use, the greater the total energy needs. Total energy needs will mostly be met by energy from food intake and energy from fat reserves. If food energy intake is high, the need for stored energy will be low. If intake is lower, the need for energy from fat reserves will be higher.

Pushing this to the limit—maximal usage of fat stores—we would provide the protein necessary to maintain muscle and other active tissues and nothing more. In this situation, basically all energy needs would be supplied by stored fat reserves and glycogen when needed. This is greatly enhanced by resistance training.

The amount of protein needed is proportional to muscle mass and muscular activity. As a guideline, you can use 1–1.5 grams per kg of lean mass per day in the case of little physical activity, and 2–3 g/kg/d in the case of high muscular activity levels. Excessive protein is not great, but more is almost always better than less.

Fat burning and protein synthesis can be further optimised by intermittent fasting. Extending the time between feedings allows glucose and insulin to drop lower, which increases the rate of fat burning. And by eating fewer but larger amounts of protein in a meal is better because protein synthesis increases in proportion to the amount consumed.

Thyroid function regulates metabolism. Iodine is used in every cell, but in the thyroid, it is concentrated to more than 100 times the average of other tissues, because iodine is the main structural component of thyroid hormones. Iodine supplementation is critical because most soils are highly depleted. It is water soluble and very safe to supplement with.

Summary

  • High insulin from carbohydrate intake promotes fat storage.
  • Low insulin from restricting carbohydrates promotes fat loss.
  • Individual predispositions determine the threshold of carbohydrate tolerance.
  • Below this threshold fat is used as the main source of cellular fuel.
  • The rate of fat loss depends on balance between energy needs and energy intake.
  • Maximal fat loss rates are achieved by supplying just the protein needed to sustain lean tissues.
  • Iodine supplementation is critical to healthy thyroid, metabolic and brain function.

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Eat your salt, and eat your fat

A couple of months ago, I had just gotten to the locker room at the gym, when a buddy of mine came in. Changing into his workout clothes, looking at himself in the mirror with his shirt off, he said he was tired of this layer of fat over his abs, that he just couldn’t get rid of it no matter how much he tried. He’s a handsome Columbian guy in his mid thirties, super nice, friendly, and easy going, big open smile with nice white teeth. He’s well built, strong, with balanced musculature but … there’s not much definition.

Everyone wants to be cut, of course, and when you’re working out 5 or 6 times a week, like he does, and you can’t get cut, you get frustrated by that. Quite understandable. Meanwhile, I work out typically three times, and I’m “rallado” as he says to me. In english, the term is shredded: so lean that under tension, we see the muscles fibres. In my case, we can see them in every muscle, including the abs. He knew that, obviously, since I’ve been like this ever since we first met a year and a half ago. The only thing that’s changed is that I’ve put on some muscle and use heavier weights in my workouts.

And so, naturally, that was my queue:

– You just need to cut the carbs. The fat is going to melt off on its own in no time. Especially if you are working out the way you do. Just stick to meat and vegetables. Make it simple for yourself. Have eggs and avocados for breakfast, and meat and veggies the rest of the time. If you can skip breakfast, that’s even better: you’ll give your body a longer time to burn fat.

– Alright! I’ll try it!

After our workout, we said goodbye, and he told me he was going to Columbia for a while for his work (he’s part of a several-generation, several-family-member meat business based there, but lives here in Madrid with his wife and young child). He said that even though they always serve so rice, pasta, and potatoes with every meal, he would do his best to stick to the plan of having only meat and veggies. I gave him a good handshake, told him he could do it, and that it was important to be strict for the first month to allow for a good transition to fat-burning.

A few weeks later, he came back. We bumped into each other at the gym again. I was doing chest and back, he had come to do shoulders. He looked noticeably different: his face was smaller, his features more defined, his neck was thinner and more visible, his eyes were whiter and his skin was smoother. He looked 5 years younger! As soon as I saw him, I told him he looked very good, thinner in the face and neck, younger, and clearly healthier. He was happy to hear me say it, of course. He said that many people had told him that he looked younger, and obviously, he could also see it himself when he looked in the mirror. But it’s always nice when someone tells us we look good; it doesn’t happen very often. He had already lost 4 kg.

We saw each other a few more times at the gym like that, working out, but it took a while before he told me that he was feeling weak, that he couldn’t push as much weight as before, that he was often tired, and strangely, often in an angry mood. Naturally, he thought it was because he wasn’t eating carbs. That somehow he was carb-deficient.

– Do you add plenty of salt and fat with your meals meat and veggies?

– No! I don’t! I haven’t added salt to food in years. And I don’t add fat either.

– That’s the problem. You need to start right away. Lots of salt, and lots of fat with your food, whenever you eat.

– What kind of salt, and what kind of fat?

– Unrefined sea salt, organic butter and coconut oil, and olive oil with salads. With every meal. When you go low carb, you not only get rid of accumulated water in your tissues due to the chronic inflammation triggered by carbohydrate exposure (that’s why your face and neck thin out in the first week or two), but you also excrete more salt in the urine. It’s crucial to eat plenty of unrefined salt every day.

butterAndSalt

Organic butter and unrefined salt

 

Two days later, when I got to the gym, he was already into his workout, and he was pushing heavy weights on the benchpress, he was walking around with a spring in his step, and he was smiling. I didn’t even need to ask, but I did anyway:

– So, how are things going? Lots of salt and fat?

– Yes! And I feel great! I feel strong, I feel powerful, I’m not tired, and I’m not angry anymore.

– Fantastic! Glad to hear that. And from now on, you’ll always feel like this. No ups and downs, no weakness or lack of energy, no hunger pangs, no mood swings.

Each time we saw each other at the gym in the next weeks, I could tell he was getting more defined. The last time we met, he was again walking around feeling strong and working heavy weights with a smile on his face, and he looked ripped, a lot more defined. And he knew it too. I could tell by the self-confidence.

When we parted, I told him he looked good, that he looked more defined, and more energetic. He was happy: “Thanks a lot for all your advice. It’s really made a huge difference. I feel great, and my abs are starting to show!”

Not eating enough salt and not eating enough fat is a classic mistake that too many people do. We have been brainwashed into thinking we should avoid fats and we should avoid salt. So, when we cut the carbs, we continue to avoid fat and avoid salt. Then, we get tired and weak, and we think it’s because we don’t eat carbs. Totally not! We’re just not getting enough salt and fat.

And so, we have to repeat this, and repeat it over and over again. Eventually, it sinks in. Especially when we feel the difference it makes. Just like it happened in this case with my Columbian buddy at the gym. So, what’s the moral of the story?

You want to feel strong, and energetic? You want to look healthy and young? You want to get ripped with tight 6-pack abs? The formula is simple:

Cut the carbs. Fast intermittently. Drink alkaline water on an empty stomach. Work heavy weights 3 times a week. Eat enough protein. Eat your salt. And eat your fat. Try it. You’ll see. It works like a charm.

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Living healthy to 160 – insulin and the genetics of longevity

Of the most remarkable discoveries of the last 15 years, discoveries that might well turn out to be the most remarkable of the 21st century, are those of the telomere—a little tail at the end of our DNA whose length tells us how long we have left to live, and of the enzyme telomerase—the specialised protein whose job it is to try to repair the telomeres so that the cells (and we) can live longer and, from an evolutionary perspective, increase the probability that we’ll have more babies. This and other research into the biology of ageing and the details relating to the transcription of DNA, and the expression or suppression of genes is truly amazingly fascinating. I will turn to this in time, but think it would be jumping the gun to do so now.

What is definitely one of the most remarkable discoveries of the 20th century pertains to the hormone insulin. I am not, however, here referring to the fact that its discovery revolutionised medicine by allowing the saving of countless diabetics from highly premature and painful deaths, usually preceded by torturous amputations of their feet or legs and all the of the horror and misery brought on by these seemingly barbaric and radically extreme measures. (And don’t for one second imagine that such amputations are a thing of the past: I know for a fact—heard directly from the mouth of a practicing orthopaedic surgeon—that amputations are the reality of his everyday, performing sometimes two in a single day.) I’m not either, at least this time, talking about insulin as the master metabolic hormone that regulates the storage into cells of nutrients circulating in the bloodstream. What I am referring to as one of the 20th century’s greatest discoveries in regards to insulin is that of its role in regulating the rate of ageing.

Something that is almost as remarkable is that we hardly ever hear or read about this. For me, that’s really strange. But whatever, I’m not going to hypothesise and speculate to come up with an explanation for why this is. Insulin as regulator of the rate of ageing is what we’ll look at in this article.

Why do mice live two years but bats fifty? Why do rats live three years, but squirrels fifteen. Why do some tortoises live hundreds of year? Why do the smallest dogs, like Chihuahuas, live about twenty years, while the largest, like Great Danes, live five to seven years only? And why do we, humans, live around 80 years, rarely making it to 90, and very rarely to 100 years of age? It is this line of questioning that triggered in the late 80’s and early 90’s a geneticist working in evolutionary biology to hypothesise, for the first time, that ageing could be genetically regulated, at least to a certain extent.

It was the discovery and subsequent realisation in evolutionary biology at that time, that a large number of fundamental cellular processes and mechanisms regulated by a variety of genetic expressions were common to widely different organisms. The realisation was that because all animal life must necessarily share a common ancestor, it is not only logical that the most fundamental functions of cells and especially of how genes express themselves under the influence of hormones essential for life could be the same, but that it should be, to a great extent, expected to be that way. And even though these considerations may seem obvious in retrospect, the fact is that there was only one person with this knowledge, asking these questions, and having the means to do something about seeking an answer to some. Cynthia Kenyon, Professor at UCSF, was this person.

The subject was quick to choose: the tine worm that Kenyon had already been studying for years, C. elegans, was perfect because it is simple but nonetheless a complex animal, and because it has a short natural lifespan of about 30 days. The first step was clearly defined: find at least one long-lived individual. What seems very surprising from our current vantage point it that she couldn’t readily find one: she couldn’t convince anyone to join with her in this endeavour. Everyone was at that time convinced that ageing was something that just happened: things just wore out and deteriorated with use and with time; nothing to do with genes. But how could this be if different species—some very physically similar—are witnessed to have such widely different lifespans? It just had to be genetic at some level, Kenyon thought. Eventually, after a few years of asking around and searching, she found a young PhD student that was up to it, and set out to find a long-lived mutant.

A number of months down the road a long-lived mutant was found and immediately identified as a ‘DAF-2 mutant’. This mutation made the DAF-2 gene—a gene responsible for the function of two kinds of hormone receptors on a cell’s membrane—less active. The next step was to artificially create a population of DAF-2 mutants and see how long they live, statistically speaking, compared to normal C. elegans. It was found that the genetically ‘damaged’ worms, the ones for which they had turned down the expression of the DAF-2 gene, lived twice as long: starting with exactly the same number of worms, it took 70 days for the last one of the mutants to die compared to 30 days in the normal population.

But an additional observation was made: the curve that traced the fraction of worms remaining was stretched by a factor of two from about the start of adulthood for the mutants. They had the same relatively short childhood but then for the remainder of their lives, for every day in the life of the normal worms, the mutants would live two days. The most impressive was that they were really half their chronologically equally aged cousins in all respects: external appearance, level of activity and reproduction.

To make your appreciate this point as much as you should, this observation with respect to not just the lifespan but notably the healthspan of C. elegans would translate in human terms in someone being 80 years old but looking and acting like a 40 year old in the sense that nobody could tell that they were not 40, let alone 80 years old. Just like Aragon in the The Lord of the Rings. This person would be like a 40 year old at 80, like a 60 year old at 120, and like an 80 year old person coming to the end of their life by the time they were 160! Can you even imagine that? Hard isn’t it. But this is exactly what Kenyon and her team were looking at in these experiments with these little worms.

Now they wanted to understand the effect of the DAF-2 gene, or rather, understand the effect of suppressing its expression in the DNA of each cell’s nucleus at different developmental stages. If it was turned off completely, the worms would die: clearly, DAF-2 expression, at least in C. elegans, is essential for life. If it was suppressed immediately after birth (hatching), the little worms would enter the Dauer state in which they don’t eat, don’t grow, don’t reproduce, and basically don’t move either: they just sit and wait. Wait for what? For better times!

This Dauer state is a remarkable evolutionary adaptation seem in some species that allows the individual to survive during periods of severe environmental stress such as lack of food or water, but also high UV radiation or chemical exposure, for example, for long periods of time with respect to their normal lifespan in a very efficient kind of metabolic, physiological and reproductive hibernation. What’s really cool is that inducing worms out of the Dauer state, no matter how long they’ve been in it, they begin to live normally again, moving and eating, but also reproducing. So, in the Dauer state C. elegans literally stops ageing altogether and waits, suspending metabolic activities and physiological functions until conditions for reproduction and life become adequate once again.

celegansfasting

Taken from Worms live longer when they stop eating  (http://www.bbc.co.uk/nature/2790633)

If DAF-2 expression was turned back up to normal, then they moved out of Dauer and resumed their development stages equivalent to childhood, teenage-hood, and then adulthood, but didn’t live any longer as adults. Finally, suppressing DAF-2 expression at the onset of adulthood resulted in the extended lifespan as originally observed. The conclusion was therefore clear: DAF-2 expression is essential for life and necessary for normal and healthy growth and development in immature individuals from birth until they reach maturity, and suppressing DAF-2 expression was only effective at extending both lifespan and healthspan in mature individuals.Going further, they now wanted to understand how DAF-2 suppression actually worked to extent healthspan: what were the actual mechanisms that made the worms live longer when DAF-2 expression was turned down. For this, Kenyon’s team needed to look at all of C. elegans’s 20000 genes and figure out how they affect each other. (Note that this is also more or less how many genes we have, but C. elegans has only 3 chromosomes and is also hermaphrodite.) The sequencing of the worm’s genome was done in 1998, and what was found after analysis was very interesting:

The DAF-2 gene activate a phosphorylation chain that attaches phosphate groups onto the DAF-16 transcription factor. In normal individuals the DAF-2 gene is expressed normally, the phosphorylation chain works unimpeded, and the DAF-16 transcription factor is inactivated. In the mutants, the DAF-2 gene expression is suppressed, and as a consequence, the DAF-16 transcription factor is not inactivated and instead accumulates in the nucleus. There, DAF-16 encodes what Kenyon’s team showed to be the genetic key to health and longevity they were looking for from the start of this now decade long pursuit: the FOXO gene.

What does FOXO do? It promotes the expression of other genes, at least four other genes: one responsible for manufacturing antioxidants to neutralise free radicals the largest amount of which are produced by the mitochondria as they make energy for the cell, a second responsible for manufacturing ‘chaperons’ whose role as specialised proteins is to transport other proteins and in particular to bring damaged ones to the cell’s garbage collector and recycling facility to promote the replacement of those damaged proteins by new and well-functioning ones; a third responsible for manufacturing antimicrobial molecules that increase the cell’s resistance to bacterial and viral invaders; and the fourth that improves metabolic functions and in particular fat transport (reduce) and utilisation (increase).

It is these four genetically regulated cellular protection and repair mechanisms, the cumulative combined effects of all these increased expressions of antioxidants, chaperons, antimicrobials and metabolic efficiency—all of them at the cellular level—that allow the lucky DAF-2 suppressed mutants to live twice as long twice as healthy. Remarkable!

Now that all the cards about how the long-lived mutants actually live twice as long as expected under normal conditions are laid on the table, and that there is only one detail I left out of the story up to this point, tell me: can you guess what are the two sister hormones to which the cell’s sensitivity through the activity of its receptors for them are controlled by the DAF-2 gene? It’s a trick question because I told you half the answer in the introduction: The DAF-2 gene encodes the hormone receptors for both insulin and the primary form of insuline-like growth factor IGF-1. Surprised? It isn’t surprising, really. In fact, it all makes perfect sense:

Insulin and IGF-1 promote growth; nutrient absorption and cellular growth and reproduction are essential for life and thus common to all living organisms, including the more primitive of them like yeasts; growth in immature individuals is fundamental for health and for ensuring they reach maturity; but growth in adults, in mature individuals, just means ageing, and the more insulin and IGF-1 there is, the faster the rate of cellular damage and deterioration, the more genetic mutations from errors in transcription, the more pronounced the deterioration of the brain and the heart, of the arteries and the veins, of the muscles, the bones and the joints, and obviously, the faster the rate of ageing. Because what is ageing if it is not the word we use to describe the sum total, the multiple negative consequences, the end result of all of these deteriorations in these vital organs and systems but also everywhere else throughout the organism, all of it starting at the cellular level, in the nucleus of every cell.

About the necessity of insulin for normal growth, you should definitely not think that these observations impliy we should stimulate insulin secretion in the young in order to ensure proper growth. Totally not! The body knows exactly when and how much insulin is needed at any given time. In fact, any additional stimulation of insulin promoted by eating simple and starchy carbs actually deregulates the proper balance of hormones that the body is trying to maintain. This deregulation from a sugar laden diet in children is the very reason for many wide spread health problems in our youth most important of which is childhood obesity and the metabolic and physiological stresses this brings on. So, leave it to mother nature to know how to regulate the concentration of insulin in the bloodstream. Do not disrupt the delicate biochemical balance by ingesting refined carbohydrates: it’s the last thing anyone needs for good health and long life.

The first results were so interesting that several other groups joined in this research into the genetics of ageing. Not as much as one would think, but at least a handful of other groups began to apply and expand the techniques to other species. Unsurprisingly, the same effects, although with different magnitudes, were seen in these very different species, from an evolutionary standpoint: fruit flies and mice. In addition, the connection was made with lifespan-extending experiments using calorie-restriction, which have also been carried out on mice and other animals (we’ll look into this another time). And beyond the work around DAF-2, DAF-16 and FOXO, Kenyon’s group investigated other ways to influence lifespan and found two more.

The first was by disabling some of the little worm’s sensory neurones of which there are very few, making it easy to test and determine the influence they have separately and in combinations. They tested smell and taste neurones, found that disabling some would extend lifespan while disabling others didn’t. They also found that disabling different combinations of smell and taste neurones could have nulling effects. The second was playing with the TOR gene expression. For now, however, we will leave it at that.

As the fact that it is rare and relatively hard to come by this work without actually looking for it, there is something else I find very hard to comprehend. In Kenyon’s various lectures on this work, there is usually a mention of the biotech company she founded called Elixir Pharmaceuticals and how they aim to find one or more drugs that can suppress DAF-2 expression in humans without causing negative side-effects in order to extend lifespan and healthspan as was done in C. elegans with genetic manipulation. That’s fine, and does make sense to a certain extent, especially if we can find not chemical drugs but natural plant-derived compounds that have this effect on us.

The thing that doesn’t make sense and that is hard to understand from the naive perspective of the honest scientist looking for the simplest possible solution to a problem of inferring something we don’t know from information that relates to what we want to know: in this case this mean the simplest way to make the best use of this information and apply what we have learnt from these two and half decades of research in a way that we know would be beneficial in promoting a longer and healthier lifespan in humans without risks through the introduction of foreign substances in our body. Because they haven’t, here I offer my attempt to do this.

We have, thanks to Kenyon and others, understood in great detail how lifespan in complex organisms can be, to a great extent, genetically regulated, and which genes, transcription factors and mechanisms are involved in the process of regulating the rate of ageing in conjunction with the propensity for developing age-related degenerative diseases. In the final analysis, the main players are the DAF-2 gene that tunes up or down the sensitivity of insulin and IGF-1 receptors, the DAF-16 transcription factor that encodes the FOXO gene but is made inactive by the expression of DAF-2, and the star FOXO longevity gene that promotes the expression other genes responsible for stimulating the cell’s most powerful protection and repair mechanisms.

We have, from many decades of research on calorie-restriction and fasting in animals including humans (and which we’ll explore elsewhere), understood that this is an extremely effective way to extent both lifespan and healthspan and basically eliminate the occurrence of age-related degenerative diseases by greatly increase resistance to health disorders of all kinds. Some key observations on calorie-restricted animals include their very low blood levels of sugar, insulin and IGF-1, high metabolic efficiency and ability to utilise fat demonstrated by low blood levels of triglycerides, and their remarkably younger appearance with increased energy and activity levels.

And finally, we have, from more than a century of observations and research, concluded that diabetics, whose condition is characterised by very high levels of blood glucose, insulin and triglycerides, are plagued by a several-fold increase in rates of cancer, stroke, heart disease, kidney disease, arthritis, Alzheimer’s and dementia, basically all the age-related degenerative diseases known to us, and in addition, also a several fold increase in their rate of ageing based on the spectrum of blood markers used for this purpose, their appearance, but also on the length of their telomeres.

Is it not, therefore, obvious from these observations that high blood sugar, high insulin and high triglycerides are hallmarks of accelerated ageing and a propensity for degenerative diseases, while low blood sugar, low insulin and low triglycerides are instead necessarily related to extended lifespan, extended healthspan and increased resistance to all disease conditions including those categorised as degenerative, and this, independently of the actual mechanisms involved?

Is it not, therefore, plausible from these observations that the genetic mechanisms relating to the function of the DAF-2 gene, DAF-16 transcription factor and FOXO gene in conferring to the DAF-2 mutants twice as long a life can, in fact, be activated and enhanced epigenetically by creating an environment in the organism that is conducive to it: simply by keeping blood sugar, insulin and triglycerides as low as possible? In other words, isn’t it plausible from these observations that by manipulating the biochemistry to ensure that blood sugar, insulin and triglycerides are throughout the day and night as low as possible depending on the organisms requirements, that this will actually translate into the activation of the FOXO gene to enhance protection and repair at the cellular level and thus extend lifespan and healthspan?

And what is, not only the easiest and simplest, but also the most effective way to do this? It is to eliminate insulin-stimulating carbohydrates—sugars and starches—from the diet completely. This, within 24-48 hours, will allow sugar levels to drop to a functional minimum. The low blood sugar will allow the pancreas to reduce production and insulin levels to drop bit by bit. Lowered insulin will eventually allow the cells to start using the fat circulating in the blood, and in time, increase in efficiency, thereby dropping triglyceride levels lower and lower.

Why is it you think that Kenyon never mentions this anywhere? Do you think that this has simply not occurred to her? I honestly don’t know. But if there is a single thing to remember it is this: insulin is necessary for life; in the immature individual, insulin regulates growth; in the mature individual, insulin regulates the rate of ageing and the propensity for degenerative diseases. Hence, if you are a mature individual, and by this I mean full grown, and if you want to live long and healthy, the very first thing you need to do is to keep the concentration of insulin circulating in your blood as low as possible. Everything else that we can do to extend healthspan and lifespan is secondary to this.

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Two short fat-loss tales

– You look like you’ve lost some weight.
– Yes, I have! I’ve lost 12 kg in 4 months. You remember, a year ago, I told you I would do my own diet, and I did!
– That’s great, congratulations!
– You know what I did? I stopped eating junk. I didn’t do anything else. I stopped eating chocolate bars and candy; cakes, cookies and ice cream; chips and fried foods, and that’s it. I eat everything: anything that is a whole food, and I do have bread and potatoes, rice and pasta, as well as cheese and fruit. I didn’t do anything crazy or radical, I just eliminated junk food from my diet.
– That’s really good. I’m happy for you. Keep it up!

This is how went a short conversation I had recently with a colleague who, a couple of years ago, was one of the 25 people who attended the talk I gave at ESAC: Water, sugar, protein and fat. It could be (I’d like to imagine) that the talk was like a little seed in her mind that was what eventually grew into enough of a motivation to start what she had been doing for a few months already, making her feel really great about it, as anyone would, of course. And I’m really happy for her, and also very happy to possibly having been a little positive influence somewhere along the line.

Another colleague stopped by my office in the spring to ask about the fitness club (a club to encourage people to exercise by subsidising part of the monthly membership to a great sports club close to where we work for which I was president for several years until a month ago or so). He mentioned in passing that he wanted to start doing sports in order to lose weight. Naturally, I immediately said that exercising wasn’t really the key to fat-loss. He was surprised, as most people are when they hear this. Being interested and inquisitive about this point (he works as a scientist, after all), I gave him a 10-minute summary of the biochemistry of fat loss, and he left very motivated to start on his fat-loss programme.

About one month later we crossed paths on the main road in front of the canteen. He looked much thinner: he actually looked quite trim considering that as little as four weeks before he not only looked but was definitely quite chubby.

– Things are going well, I see! You look like you’ve lost a lot of weight already.
– Yes, I’ve lost 10 kg. Now, after the first four weeks, I’ve started to eat carbs again, but I’m eating 1500 calories and exercising every day. I started eating some complex carbs because I need energy.

I masked my internal cringing, and just said “well, you are much leaner than you were. Good job and keep it up!” But I thought: What in the world!?! How did he come to think like this after I explained to him how fat loss works, and which he seemed to understand? The thing is, he did cut out all carbs for four weeks—there’s no way in the world he would have lost this much fat any other way—but for whatever reason, he now thought he should start again because he was exercising every day and therefore “needed energy”. He really didn’t understand the most important points I had tried to relate in that chat we had in my office. I am, in any case, very happy for him as well, because it is always better to be leaner than fatter, especially considering that a lot of the excess fat accumulating in our abdominal cavity is stuffed in between and all around our vital and digestive organs, putting constant pressure on everything in there, and that’s really bad.

Now, I would like to think that all of you readers of this blog already know what I want to point out and explain in regards to these two short fat-loss tales. Whether you do or not, I thought it was a good occasion to review the essentials of fat-loss in a quick and focused but more informal style than in other articles I have written. You are more than welcome to take a few minutes and try to guess what I’m about to explain about these two cases before moving your eye gaze down onto the first line of the next paragraph.

Why did the first colleague I talked about lose so much weight? Is it because she started exercising? No. She never exercised and still doesn’t. Is it because she starved herself on a low-calorie diet Weight Watchers style? No. She hasn’t been hungry because she hasn’t tried to eat a lot less, and has three meals a day without paying close attention to how much and is certainly not counting calories. Is it even because she stopped eating “junk food”? No, it’s not. The reason why she has lost this weight seemingly so easily is only because she markedly decreased the amount of sugar she ate, which immediately translated in lower blood sugar levels throughout the day and night, which in turn translated into lower insulin levels also throughout the day and night. As insulin drops, fat-burning starts.

Will she continue to lose her fat reserves indefinitely at this rate until there are none left? No, she won’t: fat utilisation, and therefore fat-loss rate, is inversely proportional to insulin levels. So, the lower the blood sugar, the lower the insulin, and the lower the insulin, the faster the fat-loss rate. Because she still eats sugar in the form of starches, the sugar/insulin concentration will only sometimes drop low enough for fat-burning to start, and will not drop very low and stay there to allow the metabolism to fully adapt and settle into a stable and more or less constant fat-burning mode. She will remain in intermittent fat-burning and sugar-burning. Because her fat reserves are at this stage still very large (from the organism’s perspective they are still effectively infinite), the relatively lower blood sugar for periods of several hours will prompt the body to continue to let go of these excessive fat reserves relatively easily until a steady state is reached and fat-loss stops. At that point she will still have plenty of excess body fat, but will be unable to lose any more without dropping insulin levels lower.

Of course, eliminating junk food—mostly commercial sweets and fried stuff—and feeding ourselves with actual food, no matter what it is, makes a huge difference. This is definitely the very first step in any change of diet towards better health. That’s obviously not something worth debating or even discussing. The point is that no matter what the changes in the diet, the biochemistry of fat loss is always the same, and it is the same for everyone. Everything is about insulin for the very simple reason that it is insulin that shuttles nutrients from the bloodstream into cells. This is true for sugar, protein and fat. But insulin is released by the pancreas primarily in response to the presence of sugar in the blood (but also in the absence of stress hormones which block insulin’s action to retain the sugar in circulation as long as the “potential threat” remains). The gist of it is: high insulin—nutrient storage, low insulin—nutrient release; high insulin—fat storage, low insulin—fat-burning.

What about the second colleague exercising and eating only 1500 calories that include starches and some fruit? He will continue to lose fat until the body determines that the bulk of the really excessive fat reserves have been spent, and then will stop. This will happen probably somewhere around 20% body-fat for guys and 30% for women, but will depend on age, exercise level, food, etc. So, he will get lean enough to appear slim, feel light, and also feel pretty good about himself every time someone compliments him on his figure. The more serious problem for him is that exercise, and especially the aerobic exercise like running that he is does to “burn more calories”, breaks down muscle quite quickly but it is not rebuilt.

The low calorie intake places the metabolism in calorie-deficit given that an average man needs about 1500 calories just for basic metabolic functions. This means that all additional calorie requirements have to come from somewhere other than the food that is eaten. Ideally, of course, these would come from fat reserves of which there are plenty; that’s the idea of the low-calorie dieter. But this will and can only happen if insulin levels are at rock bottom: I mean 1–3 units. Otherwise, the body will cannibalise its muscles because it can most easily get the easiest-burning cellular fuel it needs by converting protein into glucose. And the result? Over time he’ll lose most of his muscle, will retain that 15-20% fat, and will inevitably acquire the skinny-fat look. You know what I mean: the look of a slow, 40-50 year-old long-distance runner on a typical high-carb “runner’s diet” who looks skinny but giggly, with barely any visible muscle and no definition at all: muscle tissue broken down and not rebuilt; fat reserves not used because insulin is too high.

Had you guessed all that? Do you now understand how to burn fat without hunger and without losing muscle? Drop sugar levels, drop insulin levels: lose the fat reserves, keep the muscle. Eat fibrous veggies, lots of unprocessed fats and enough clean protein; don’t eat any sugar or starch. Very simple.

And here’s a teaser for a future series: if you want to build muscle and maximally slow down ageing, you will—in addition to this kind of shift in diet—also start lifting weights: squats and dead lifts, bench press and overhead standing press, bent-over rows, dips and pull-ups; and the heavier and more strenuous the better!

But if you’ve never done any of that, don’t go out and start lifting as much as you can right away because you’ll hurt yourself: you have to start slow, and have impeccable form and technique before starting to put on more weight. However, the fact is that there is really nothing more effective than heavy weight lifting to correct metabolic imbalances, postural problems, muscle and joint weaknesses; to burn fat, build muscle, and increase bone density; and totally rejuvenate the body and restore a incredibly youthful hormonal profile. The most amazing thing is that this is true for men and women of any age. I hope to find the time and write about this in the not-so-distant future.

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One of Hitler’s most devastating gifts to humankind

The Third Reich, under its Fuhrer’s rule from 1933 to 1945, but especially during the second world war, was in more ways than those most obvious to us, masterfully devastating in the scope and effects that would have its scientific research programmes.

One of the branches in which laboured a great deal of keen scientific minds was that of biological warfare with the use of poisonous chemical agents. What could be the most effective means to impede, disable, neutralise or completely remove someone’s abilities to fight or even resist? It would be to sever the connection between the central nervous system and a vital organ: pretty simple and definitely very effective.

German determination, dedication, focus, methodology and efficiency is well recognised and highly appreciated all over the world. This is true today as it was then, and if in this day and age it means to us more in terms of German technology—great industrial machinery and equipment, great cars, great appliances, great electronics—together with the fact that, on the world’s stage, we can trust their government’s word and commitment to seeing things through unwaveringly to the end, it certainly would have had a different connotation to the millions who suffered under the Germans during the great war, be it directly or indirectly. Regardless of these considerations, however, these qualities of determination, dedication, focus and efficiency are excellent qualities, well established in German culture and society, and obviously foundational in making the country a powerful and stable industrial and political leader.

It was to be expected that those scientists tasked to identify, develop and refine the biological and chemical technologies necessary to accomplish their intended function of quickly, silently and as effectively as possible disable the human target without as much as a single drop of blood being shed in the process, was indeed accomplished, and masterfully so. The result was chemical agents that were called ‘nerve gas’.

Nerve gas worked exactly as it was intended: it broke the biochemical connection between the brain and the heart. More specifically, it inhibited the enzyme cholinesterase whose critical function is to break down excesses of the neurotransmitter acetylcholine that enacts the brain’s messaging to the heart in order to avoid overstimulation. Acetylcholine is there to trigger the firing of neurons that control heart and bowel function. It sits in the synapses, the gap between neurons, and does this. The mechanism to ensure that there is enough but not excessive acetylcholine nerve stimulation, is the enzyme-depended breakdown of any surplus acetylcholine. Without optimal function of the enzyme cholinesterase, acetylcholine accumulates between neutrons and induces overstimulation, which can quite effectively bring the heart to a stop without bloodshed, without pain, without any noise, and without any drama: just quickly and effectively.

How does nerve gas work today? Precisely in the same way it did in 1945. It was recognised early on in this research that most, and maybe all animals, no matter how large or small, share if not identical, very similar biochemical and hormonal pathways, especially in terms of nervous system function. Can you see where this is leading?

The technological developments during the era of the second world war were tremendous: the planes, the cars and trucks, the tanks,  the guns, the bombs, and all the physics and engineering, the chemistry and the biochemistry involved. It really was revolutionary in regards to the power available at our fingertips to do whatever we could imagine or whatever was needed to make things simpler, easier, more efficient. What came of all this was global, widespread use of large , complex machinery and global, widespread use of chemical for anything and everything we could think of.

The shift from traditional family farming, which since it began 10000 years ago was always done on really very small scales, and naturally with the largest workable and sustainable variety of plant species being grown together, to the modern ways that could best accommodate the limitations imposed by using great big machines instead of our hands to tend the fields, gave way to huge monocultures, which in turn, gave way to huge problems with insects attracted to these particular species of plants being grown without the natural balancing effects of competing or antagonistic insects attracted to different plants growing side by side in the small space of the family garden.

Just follow this impeccable human logic: nerve gas kills humans by blocking the action of the enzyme cholinesterase required to regulate the amount of stimulation triggered by the neurotransmitter acetylcholine that controls heart function by adjusting neuron firing and breakdown rate; all higher animals, including insects, have similar functioning nervous systems because we all evolved from the same primitive ancestors whose most essential function were controlled by their nervous system, whatever form it took; we want to cultivate huge fields of monocultures because it is efficient in producing large quantities of food without much time or labour by using large machines to take care of these field; unfortunately, large monocultures attract disproportionally large numbers of the same kinds of pests that then have free reigns over the plants cultivated because they have no other insects to compete against; insects are affected in similar ways as we are by nerve gas, but because they are much smaller, because we are so much larger and stronger than they are, they would be lethally affected by small quantities of nerve gas while we would not, or at least not very much.

It’s perfect! Amazing! We spray diluted nerve gas on our large mono-cultured crops, kill all these awfully annoying insects that are trying to eat our food, and then simply collect everything intact and in perfect condition. This is the magic of industrial chemistry. What do we call this diluted nerve gas, these chemical agents? Pesticides, of course. Very popular right from the start, but incredibly more popular today than 70 years ago.

In fact, pesticides are more than 30 times more popular today than they were in 1945. Every year we dump more than four billion pounds of pesticides on the soil of the Earth. Four billion pounds worldwide, and one quarter of this—one billion pounds—is used in the US alone!

As can be expected from our amazing human ingenuity, cleverness, tenacity and industriousness, there are now tens of thousands of different kind of ‘nerve gases’ with different purposes, different functions, different effects and different potencies. We are so darn good, so clever at improving things, making them longer lasting, more effective, more targeted, more concentrated, and naturally… more lethal.

The obviousness of the truth is painful and so we look away: all pesticides are neurotoxic because this is how they function to kill pests. But since we are also a pest of sorts, they are neurotoxic to us in the same way as they are to those insects we want to get rid of. As a result, we are killing the insects, and we are killing ourselves. Moreover, we are doing it better and better each year and with every passing day. That’s the long and short of it. Sorry to be the bearer of such bad news.

Yes, we can eat our own home-grown stuff, and exclusively organic and pasture raised food—I do and have been for the last 18 years since graduating from McGill in the spring of 1996. But pesticides are in the rivers, oceans and water tables, as well as in the air, the clouds and the rain. And this, in ever-increasing concentrations. What we can do is try to protect ourselves as best we can by minimising our ingestion of and exposure to such poisons by all the means available to us, integrate continuous detoxification practices in our daily life, and do whatever we can to shift the balance of policymaking towards the support of small scale organic farming and away from the industrial monoculture model pervading over so much of the planet. Maybe the trends will change, and maybe sooner rather than later, but it’s hard to tell.

With the opportunity and truly great privilege we have to be alive and able to look back onto the past, and consider anew the circumstances, events and developments that took or might have taken place with a fresh perspective encompassing a multitude of informative elements available to us now but that were not at the time, I believe that nobody could have foreseen that the chemical technology of biological warfare agents developed during the second world war in Germany would become so incredibly popular as to pervade the entire planet to the extent of reaching virtually all ecosystems from the poles to the equator, up and down and all around to the most isolated and distant. And although seldom recognised as such, it is this, one could argue, that has had the most important and pervasive negative impact on humankind, one of the most devastating consequences of Hitler’s lethally poisonous legacy: the gift of pesticides.

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The crux of intermittent fasting

It is less than futile, in fact, it is outright nonsensical, to argue in favour of or promote an explanation that is in contradiction with observational evidence. What is required is to find, or at least try to find, a sound and well-founded explanation. And not just for some of the observations, but for each individual observation, as well as for the entire ensemble of observations. This is what we should do.

Fasting means not eating; everyone knows that. The meaning of the word has been loosened to include not consuming appreciable amounts of calories, as in doing a green juice fast, for example, but which should instead rightly be called a cleanse. The expression intermittent fasting implies a cycle of some kind, and is used to mean not eating for periods of 16, 18, 24 or 48 hours, but on a regular basis, like every week or even every day.

Fasting has been known and recognised for its often quasi-miraculous curative effects for thousands of years. Indeed, it is possible to find accounts of individuals recovering from just about any ailment and disease imaginable simply from fasting long enough. It seems, however, that fasting as a healing modality, has, over the past couple of centuries, steadily grown less popular in the medical profession and, as a consequence, also in the general population.

A resurgence of scientific interest over the last decades in the benefits of fasting for treating various degenerative conditions like arthritis and cancer, but also for extending healthy lifespan about which I will write at one point in the future, has brought it back into the spotlight, especially in circles of optimal health enthusiasts, which includes some gym go-ers and body builders interested not so much in optimal health, but mostly in losing fat and gaining muscle.

Therefore, there has been quite a few people trying out or adopting intermittent fasting for periods of a few weeks to a few months, or even longer, but reading things here and there shows that they have had varying success given their initial motivations, whatever those might have been.

Ori Hofmekler was one of the first to popularise the idea of intermittent fasting with his book The Warrior Diet. He has continued to write and to encourage intermittent fasting for a wide range of benefits, especially in regards to the goal of improving body composition, as one of his last titles expresses perfectly: Maximum Muscle, Minimum Fat.

Dr Hertoghe, the world famous endocrinologist and anti-ageing specialist, as well as Mark Sisson (Primal Blueprint) have also been vocal and influential proponents of intermittent fasting for a while. More recently, Dr Mercola did several interviews with Hofmekler, and wrote a few articles on the topic, sharing his experience and enthusiasm for the health and fitness benefits intermittent fasting can bring. These are just some of the well known players that I know of and respect in the natural health community, that have endorsed and promoted this kind of cyclical fasting.

Naturally, as is the case for almost any topic we can think of, there are opposing opinions and, in fact, bashing of intermittent fasting as a means to improve health and body composition, especially in the popular fitness and gym culture. And, as is also the case for almost any topic we can think of, contradictory views and opinions are usually caused by misunderstanding, or at least, incomplete understanding of the elements involved, and in particular the more subtle ones.

On the one hand, we have the proponents claiming that we can very effectively get much healthier, with much improved energy levels, mood, digestion, and natural detoxification and excretion of metabolic acids; normalise and recover the optimal balance of specific hormones, and eventually, of the entire hormonal system; over time lose all excess body fat reserve, increase flexibility and hasten recovery, better preserve our precious muscle tissue and build more very efficiently. And these are just some of the claimed (but also documented) benefits of intermittent fasting.

On the other hand, the nay-sayers and bashers report that these claims are more than just false, they are, in fact, often the exact opposite of what they have found or seen for themselves or in others coming to them for help and expert advice. Reports of feeling really terrible, with massive headaches, bad digestion, awfully low energy levels, and thus, obviously, very bad and destructive moods; loss of some fat but also, over time, of lots or maybe even most of their muscle tissue; extreme hunger, with frightening ravenousness when evening mealtime comes around, leading to monstrous, uncontrolled and uncontrollable overeating without discrimination of food kinds or quality, and over time, showing obvious signs that can be identified as those associated with eating disorders.

How is it possible to have research, studies and documented cases—plenty of documented cases—that provide observational evidence—proof, if you prefer—that support the claims of both of these camps? How can we observe and actually measure such profoundly different consequences in different people that are supposed to follow comparable diets, consequences that are diametrically opposed to one another. In other words, observational evidence that appears to be completely and totally contradictory?

A simple approach, the one espoused by many, maybe most, of the intermittent fasting bashers, is to just say that proponents are wrong and imagining things, letting themselves be fooled by the hype, but actually blind to the reality of the detrimental consequences of practicing cyclical fasting.

For me, the only satisfactory approach is the one that seeks to explain all the observations, to reconcile all the observational evidence, and make sense of the entire ensemble of information available through a physiology and biochemistry based explanation that is complete. I also think it is fair to say that there are more better informed proponents than there are opponents, but this is not obviously the case, and I would thus not bet much on this claim.

Here it is, the crux of the matter, the one single crucial element needed to understand and explain the wide spectrum of apparently contradictory observations that is overlooked because it is misunderstood:

The body’s response to intermittent fasting is entirely dependent upon the state of one’s metabolism, and everything about it hinges on the physiology of nutritional ketosis. 

In fact, the vast majority of the benefits of intermittent fasting are those derived from nutritional ketosis but heightened by the fasted state, and therefore, can only become manifest if the fasting individual is keto-adapted and remains in nutritional ketosis most of the time.

You might be thinking: what in the world is nutritional ketosis, and where’s the explanation for the contradictory observations? Nutritional ketosis is the metabolic state in which the liver manufactures ketone bodies from fat to provide fuel for the brain cells that can only use glucose or ketones for their energy needs. This only happens if and when circulating insulin levels are low, and when blood glucose stays below 80-90 mg/dL for a period of 24-48 hours (generally speaking, on average, and in normal circumstance). The reason is fat will not be burned for fuel is there is plenty of glucose in the blood, and in order to burn fat, insulin must be low.

This metabolic state is induced either by fasting—this is the quickest but also most extreme way to do it, or by eliminating insulin-stimulating carbohydrates (sugars and starches) from the diet—this is by far the easier and obviously much more sustainable way to do it. The longer it is maintained, the better adapted the metabolism becomes. But before ketones are produced to fuel the brain, the body goes through metabolic changes to which it tries to adapt as best it can. The most important but also most severe of them all, is the fundamental shift from using glucose as the primary fuel, not just for the brain, but for all cellular energy needs in the body, to using fats, both from body fat reserves and from food.

The bane of our time is global, chronically elevated insulin levels. Hyper-insulinemia, as it is technically called, sits squarely as one of the root cause of all the diseases of civilisation that kill most (90%) of us today, more or less uniformly across the planet. What does this have to do with our considerations of intermittent fasting? It has everything to do with it:

Insulin is the master hormone that orchestrates the metabolism in what relates to storage and usage of macronutrient (carbs, fats, and proteins) at the cellular level.

Chronically elevated insulin always and inevitably leads to insulin resistance. Insulin resistance means that cells do not respond to insulin as they should, and require ever increasing concentrations of insulin in order to move glucose into the cell. And ever increasing concentrations of insulin means ever increasing inability to use fat cellular fuel, with particular difficulty in unlocking and tapping into the usually greatly overabundant reserves of body fat.

What is truly remarkable is that insulin resistance, even if it has been developing and growing steadily with each passing day and with each high carb meal or snack over our entire lifetime, it can be reversed in weeks when insulin-stimulating carbs are eliminated from the diet: 48 hours to enter nutritional ketosis; one week for water retention release, initial intestinal detox and basic adaptation to fat-burning; four weeks for functional keto-adaptation; and 8 weeks for complete keto-adaptation.

Eliminating insulin-stimulating carbs eliminated the need for large insulin secretions by the pancreas. Therefore, both glucose and insulin concentrations steadily decrease with time, and eventually fat-burning and ketone production kicks in, marking the first step in the transition of the metabolism from sugar-burning to fat-burning, which is what we referred to as fat- or keto-adaptation.

There is a catch though: before fat-burning and ketone production begins, the metabolism of the insulin resistant individual will go through withdrawal from its sugar addiction. First, sugar levels start to drop. After a number of hours, 3 to 4 hours say, blood sugar is too low to supply enough fast-burning glucose to cells for their metabolic activities. Because insulin remains high, and because the body is highly insulin resistant, as we said, it is not possible to use fat from the body’s fat stores. Therefore, it is the liver that comes to the rescue and begins to convert its stores of glycogen into glucose and pumping that into the bloodstream to provide cellular fuel.

Within a few hours, however, the glycogen in the liver is depleted, and blood sugar drops once again, and lower still. Because the body remains unable to tap into its fat reserves due to the state of insulin resistance, it has, at this point, no choice but to turn to muscle tissue, from which it is far easier to breakdown protein and manufacture glucose than it is to start burning fat. And thus, the muscles are eaten away in order to provide the glucose to all of the multitude of insulin resistant (sugar-addicted) cells throughout the organism.

We now come to the final analysis of our observational evidence in regards to intermittent fasting, and consider two scenarios that can explain, as it rightly should, the ensemble of observations in its entirety, and thus clarify and reconcile the apparent contradictions that are seen, and which lead to serious confusion about the issue, even, and maybe especially, among our health, fitness and bodybuilding experts.

Scenario 1: We take a perfectly keto-adapted person who has been eating a diet devoid of insulin-stimulating carbs for a long time, and who therefore always has very low glucose and insulin levels, and as a consequence, exquisite insulin-sensitivity. What happens if they stop eating? Nothing special, really. Their body is always using fat and ketones to supply all healthy body and brain cells with their metabolic energy needs. So, if there is no fat that is provided through the digestive system, then it is taken, without any trouble or noticeable changes in energy levels or concentration, from the body’s fat reserves that are always plentiful, even in the leanest among us with single digit body fat, because 1 gram provides 9 calories, which means that we need only about 200 g for a whole day of normal activities, and have at least 5 kg at any given time (8.5% fat on 60 kg body weight).

Moreover, if we exercise during the fast, there is no noticeable difference because at low intensity, cellular energy needs are taken care of by fat which is continuously released from the fat stores into the bloodstream, while at higher intensity the glycogen stored in the muscle cells themselves, can be used in the form of quick burning glucose together with additional supply from the liver than converts its stores of glycogen if need be (if stress hormones are secreted).

So, biking and working out with weights, for example, is perfectly fine and actually feels great. Even more interesting is the fact that stimulating the muscular system by exercising while fasting triggers the release of various hormones in addition to growth hormone for which there is nothing more effective than fasting, whose purpose is primarily to preserve those physiologically important muscle tissues as essential for functional survival, while breaking down to recycle the proteins of other tissues which are not required like lumps, tumours, and scar tissue. And this means that the hormonal environment created by exercise under fasting conditions is conducive to both preserving and building more muscle, all the while also expediting and maximising fat-burning. And this is what is observed.

Hunger is present at times, but is certainly far from being problematic. There are no headaches, no stomach pains, no sleepiness, no scattered mental discursiveness, no problems concentrating or working. Sitting down to eat the evening’s nutrient-dense, enzyme-rich and high fat meal with adequate amounts of protein for tissue repair and muscle building, is nourishing, perfectly satisfying, and well digested throughout the evening and night, as long as we eat several hours before going to bed. No over-eating, no cravings, no psychological disturbances, no problems at all. A picture of perfect metabolic efficiency.

Scenario 2: We take an average but pretty active person from the general population who eats a standard diet with plenty of insulin-stimulating carbs, both simple sugars, and complex carbs in the form of pasta, rice, whole grain bread, etc (70% of calories), and who therefore always has high blood glucose and insulin levels, and as a consequence, pretty strong insulin resistance. What happens if they stop eating? We saw this earlier: blood glucose drops, but not insulin; the liver starts to pump out glucose to pick up the slack, and runs out after about 3-5 hours; sugar drops once more, but not really the insulin; since fat stores cannot be tapped into, muscle tissue is broken down to manufacture glucose; longer period of fasting means more muscle breakdown.

If we exercise gently, things are fine at first because we can tap into the glycogen stored in the muscles, but will soon get much worse because we increase the energy demands, but continue to be unable to use body fat stores, and therefore increase the rate at which muscle tissue is broken down, especially if we do weights and high intensity training.

Low intensity aerobic exercise depletes glycogen from the muscles and when it runs out, we feel exhausted, completely flat out. (This is the same as hitting “the wall” in long distance events, and only occurs because the body cannot readily tap into its fat reserves: a well keto-adapted athlete never really hits any such walls!) Far worse is high intensity exercise, which causes more intense and faster muscle breakdown, the higher the intensity, the more muscle breakdown.

Waking up in the morning after a night’s sleep (and unconscious fast), we are starving, dearly longing for the bread, the jams, the cereals, the orange juice, the waffles, the maple syrup, and everything else we can imagine, but we hold out and go to work. Every hour is excruciating, terrible headache, hunger pains throughout the abdominal cavity, but when these subside, we are falling asleep, with a complete inability to concentrate on anything at all. We feel like shit.

By the time evening rolls around, we are so ravenous we would eat a horse. So we sit down and eat, and eat, and eat everything we can get our hands on: pizza, pasta with sauce and cheese, garlic bread with butter, steak and potatoes or french fries, and then desert, sweets, oh man, we waited all day to eat, and now we can eat anything and everything we want, because tomorrow we’ll be starving again for the whole day. We get up in the morning, and the whole cycle starts over again.

Over time we kind of get used to it, but because we don’t understand the most essential element of the whole thing—nurturing nutritional ketosis—we remain just as insulin-resistant, every day we feel shitty, every night we eat like a pig, and throughout the whole time, more or less, we break down muscle, and our insulin resistance prevents appreciable fat loss. After doing this for a while and seeing the detrimental effects of this regime, we go seek help from a fitness expert. They tell us that this intermittent fasting thing is a load of shit, and as them, grow instantly convinced that all the stuff people say about the benefits it can bring for optimal health and improved body composition is also a load of shit: if it didn’t work for me, then it simply cannot work for anyone.

Unfortunately, neither we nor the fitness expert understands enough physiology, biochemistry, and endocrinology to be able to make sense of these conflicting and contradicting accounts, personal experiences, and observations reported in the scientific literature, and just settle into this view that it really is a load of BS, and that it might work a little, sometimes, on some people, but not on others, and no matter what, it always leads to pathological states of mind, if not full fledged eating disorders.

It is my hope, however, that you are now able to see how these very observations, as conflicting, contradictory, and certainly quite puzzling as they may seem at first, can be explained and reconciled marvellously well in light of a better understanding of the basic principles of energy metabolism, and of the remarkable but unfortunately almost universally misunderstood state of nutritional ketosis, that most medical professionals usually mistake for the pathological condition of diabetic ketoacidosis.

Finally, in closing, I have a confession to make: I have been experimenting with intermittent fasting in one form or another for many years now. I never eat anything before midday, and on most days until about 14:00, which makes it an approximately 18-hour fast from 20:00 the night before. On weekends, I fast until noon, and then go do weight training. On those days, I usually eat for the first time around 17:30, and make that my single meal of the day. On some days I eat a large lunch and dinner to increase my overall calorie and protein intake. I usually workout 3-4 times a week, and usually in the late afternoon-early evening.

I have not experienced loss of muscle since I dropped the insulin-stimulating carbs from my diet in 2007. Both muscle tone and strength is maintained very well even after long periods without resistance training. I have, however, never made a particular effort to gain muscle mass. This year, I would like to see how much muscle I can put on, and will thus put the science to the test for myself. If you are interested, don’t worry, I’ll keep you posted. If you’re not, then that’s fine too.

But if there is a single thing you must remember from what I wrote, it is this: you can only really benefit from intermittent fasting when you are keto-adapted, and remain in a state of nutritional ketosis the majority of the time. Otherwise potential benefits are lost, and the practice can become rather detrimental.

hunterslookingoverplain

How long do you think these hunters hunt each day? Do you think they have a big breakfast before going, or a large lunch while they are out? How long do you think they are out before they settle back around the fire in their village to have their main meal of the day? And what do you think they will eat when they do return with their catch of the day?

(This article was written after reading this article by Dani Shugart on T-Nation sent to me by a friend who knew I would have some remarks to make, and probably some clarifications to bring to it.)

Understanding digestion

There are four things about digestion that I believe to be essential to understand, remember, and always keep in mind. The first is that although the environment of the stomach can be, and is generally at least mildly acidic, the intestines must be alkaline. The second is that the level of acidity inside the stomach depends on what is in it: it is in response to whatever comes into the stomach that specialised cells of its lining secrete hydrochloric acid in greater or lesser amounts. The third is that only protein requires a highly acidic environment to be properly broken down into the amino acids that make up protein before moving on into the small intestine; fats and carbohydrates neither require nor stimulate the secretion of acid in the stomach because they are broken down in the alkaline environment of the intestine. And the fourth is that water is totally crucial to the proper function of all digestive organs, and to the whole process of digestion from start to finish.

digestive_system_with_labels

Model of the human digestive system with labels

Because proteins are so hard to break down, they must remain in a highly acidic environment in the stomach for about 3 hours before the resulting chyme should be, can be, and is normally transferred to the small intestine. (Obviously, the time depends on the amount.) And the more acidic the environment of the stomach, the better it is for the breakdown of protein, but also to protect the organism by destroying pathogenic bacteria that could have come with the protein, as is presumably often the case in the wild.

In addition to the hydrochloric acid secreted by the stomach, protein-digesting enzymes (proteases) like pepsin are also secreted by the stomach when it contains protein. Moreover, the acid activates the inactive forms of the enzymes prorennin and pepsinogen into their active forms: rennin is necessary for digesting milk protein, and pepsin breaks down the proteins into polypeptides. It is very important to remember that the stomach has cells that sense what nutrients are present, so that it knows what and how much to secrete for their digestion.

Many people suffer simultaneously from amino acid deficiency, and the consequences of putrefaction of undigested protein in the intestine, even though they eat plenty, if not too much protein, because their stomach does not produce the amount of hydrochloric acid that is needed for proper protein breakdown. In fact, this is very common in older people, but it is also a problem in the middle aged and even in young adults. This problem can be partially remedied by taking hydrochloric acid supplements with protein meals, an approach that works very well for the elderly, but addressing the fundamental issues that lead to digestive dysfunction is obviously most important. The digestion of fats and carbohydrates is entirely different.

Simple carbohydrates eaten on an empty stomach will move out of it and into the intestine in a matter of minutes. This is why blood sugar levels go up almost instantly when we eat or drink simple carbs like whole fruit or fruit juice. Starchy carbohydrates begin to be broken down into sugar when they come into contact with those enzymes in the mouth whose purpose it is to do this (primarily amylase), and will be broken down completely over the course of a few hours, not in the stomach, but in the small intestine.

The same goes for fat: fat or oil by itself eaten on an empty stomach will swiftly move to the small intestine as it does not need an acidic environment, and thus simply does not need to stay in the stomach. But unlike carbohydrates, fats need to first be emulsified into droplets that can mix in the watery environment of the small intestine. This is done by the bile produced by the liver, but stored and secreted by the gall bladder into the small intestine. The emulsified triglycerides are then broken apart by pancreatic lipase that separates the glycerol backbone from the three fatty acids. The free fatty acids are absorbed in the small intestine and into the bloodstream by passive diffusion (as is water).

Another important difference between the digestion of carbohydrates and fats is that while it is no problem at all for fat to sit in the stomach for hours, together with the protein being broken down by the acidic chyme, carbohydrates, and especially simple carbs, start to ferment very quickly if they do not move out of the stomach. This is what gives rise to the characteristic bloating that we feel when we eat simple carbs together with other foods, but especially when combined with any kind of protein, the best example of which is having sweet things either with or after a large meal that typically contains plenty of protein, such as the terrible habit of having fruit after the meal, as is done in most western countries, as opposed to the much wiser habit of eating the fruit as a starter, before the meal, as is done in some other cultures. Bloating, burps, gas, stomach aches, etc, as well as really bad digestion followed by really poor absorption all result from the fermentation of the simple carbs that remain in the stomach for longer than a few minutes, as they normally would, before passing to the small intestine, as well as the incompatibility of various digestive enzymes, each with its own specific nutrient to break down, released into the intestine by the pancreas, all trying to do their work, but clashing against one other in the process.

Therefore, to properly digest protein there should be no simple or starchy carbohydrates in the stomach for the entire breakdown process that lasts about 3-4 hours for a normal (smallish) meal. In addition, there should not be any alkalising liquids like alkaline water, sodium bicarbonate water, lemon water, or green juice in the stomach, because they will work to neutralise the acid needed to break down the protein, and thus cause bad digestion and stomach aches. You can try any of the combinations described here if you want evidence through personal experience, but I’m sure you have experienced most of them at various times, although most probably unaware of it. I guarantee that it works in exactly the same way for everyone, even if some are definitely more sensitive than others.

In case you don’t know or don’t remember from other articles, I think no one should consume simple or starchy insulin-stimulating carbohydrates because their consumption in any amount inevitably damages body and health in any one of several very predictable ways. The reason why I am emphasising these points about carbohydrate digestion is not only because the majority of people in the world get most of their calories from insulin-stimulating carbohydrates, but also because these carbohydrates are most disruptive to digestive health in many more ways than we tend to know or consider.

I have written recently in the article Detoxification about the disastrous consequences on the digestive system of a diet consisting mostly of simple or starchy carbohydrates, all of which are caused by chronic acidosis of the intestine. To recover from or avoid these digestive disorders and the diseases that result from them, it is of paramount importance to, on the one hand, eliminate these acid-forming sugars and starches, and on the other, alkalise as much as we can the intestinal tracts on a continual basis, day after day, and year after year.

The natural consequence of these facts and considerations is that the most healing and health-promoting of diets is one that consists primarily of alkalising drinks and foods—alkaline water, green juices, lemon water, and green and leafy vegetables—and in which energy needs are covered by the best fats—coconut oil, raw grass-fed butter, wild fish and meats, and whole, soaked nuts and seeds—with protein consumption kept to the essential minimum based on individual needs.

Water is exceedingly important for digestion, and I have written about this in Why we should drink water before meals. The two most crucial roles of water in the digestive process are: First, to provide the stomach the level of hydration needed to make, maintain and adjust the thickness and consistency of both the layer of mucus that protects the lining of the stomach from the corrosive acidic secretion required for the breakdown of protein, and for of the chyme itself during the initial phases of digestion when it is churned by the stomach. Second, to provide the pancreas the required hydration for it to be able to produce the all-important pancreatic fluid (bicarbonate solution) whose purpose is to neutralise the acidic chyme once it is transferred from the stomach to the small intestine, as well as to carry the enzymes produced by the pancreas to break down those foods that do not themselves carry and provide the enzymes needed for their proper digestion.

As is always the case for everything that relates to health, we can only truly understand by understanding the physiology—how things work. The digestive system is the one around which all other systems are arranged because the health and survival of the organism as a whole depends entirely on it. And the key to optimal digestion and health is the understanding that the stomach only needs to be acidic when there is protein in it, the intestine must always be alkaline, and the digestive system as a whole always requires a good supply of water.

Therefore, we should aim primarily to alkalise and hydrate by drinking lots of alkaline mineral and chlorophyll rich drinks together with liberal but appropriate amounts of unrefined sea salt (see How much salt, how much water, and our amazing kidneys); consume plenty of fat; always consume protein either by itself, with fat or with green vegetables, but never with simple or starchy carbohydrates; if you eat simple carbs such as sweet fruit, make sure you eat it by itself on an empty stomach; and always make sure that when you eat protein, the environment of the stomach is kept acidic, and thus do not have any alkalising liquids for at least 60 minutes before and 3 hours after the protein meal, but also make sure to have at least half a litre of plain water, at least half an hour before eating.

Keeping to these simple principles will ensure optimal digestion, optimal digestive health, and optimal overall health, day and day, and year after year, throughout life, from childhood to old age.

Everything is in the biochemistry

The trillions of cells that make up the body don’t give a shit if you are happy and joyful, or dissatisfied and angry. They only know biochemistry, nothing else. The fact is that in regard to health, biochemistry is everything, and everything is in the biochemistry. This means that absolutely everything in the body is defined and determined by the biochemistry, and that everything we eat, drink and do, but also everything we think, feel and believe, defines and determines the biochemistry of the body.

There is no doubt that any negative stressor, including and maybe especially the various states of dissatisfaction and unhappiness most of us cycle through each day, are truly poisonous to our health. But no matter how complex the details of this may seem, no matter how much or how little of it we understand or realise, the imbalances caused by every negative stressor will be seen clearly in the biochemical tracers that can be tested for and measured. And it is those tracers together with every other bioactive molecule that define and determine all cellular functions and interactions on which depends health or disease. For example, morning cortisol levels above 10 micrograms/dl most probably means too much stress on a daily basis, independently of its causes, and cortisol levels below 5 most likely means adrenal fatigue from chronic stress over an extended period of time, also independently of what has caused this. These observations have nothing to do with how you feel about it, and the stress hormones secreted by the adrenal glands do not know what you think or feel or believe about anything at all; they just respond to the biochemical conditions in the body.

If you are chronically stressed, unhappy and generally feeling shitty, it is certain that your biochemistry is not in balance, that as a result of this your health suffers, and that you absolutely need to do something to change and improve your situation. If, on the other hand, you are feeling happy and enthusiastic, and everything seems perfectly fine, this does not imply that your biochemistry is in balance, and it certainly does not imply that it is optimal. This is obvious considering that more or less everyone in western countries dies between 65 and 85 of heart attack, stroke, cancer, diabetes and Alzheimer’s. I’m sure you’ll agree that it would be silly to say that all of these people—in this case about 90% of the population—die because they are unhappy and stressed, or that if they were as happy as can be, they would not get sick.

Feeling happy and joyful does not in the least make us immune to disease. My dad was a remarkably happy and joyful fellow for most of his life, but he was fat from the age of about 25, was taking various medications from the age of about 50, and increasing in number with time, just as his parents, and just as most people today, and he died rather unexpectedly (isn’t this almost always the case?), at home, from heart failure due to extreme dehydration as a consequence of four days of intensive chemo intended to treat a rapidly growing cancerous sarcoma in the arm. This happened even though he walked into the hospital with a spring in his step, and the belief of a good natured, joyful man that he would make it through this thanks to his positive attitude, and his lack of fear about this whole cancer thing. Obviously he was proved direly wrong, and so were the stupid, incompetent doctors that recommended that treatment to this obviously fragile 70 year-old man with highly compromised health.

The chemo administered intravenously, burned through him from the inside: he had continuous diarrhoea with no control of his bowels, but every time he drank even a sip of water, he said it felt like fire burning through his throat. So, he couldn’t drink. Amazingly, the nurses that came to measure his blood pressure, which must have been low and dropping by the hour, must not have noticed or found this problematic, because they didn’t bring him back to the hospital and put him on an IV in order to provide the water and salt needed to keep the heart and kidneys working. Living 5600 km away and 6 hours ahead, I was made aware of all of this in retrospect with several days delay, and was unable to do anything about it in time. Everything happened really quickly: four days of chemo, and he was dead seven days later.

It is one thing to know and say that negative stress, whatever form it takes, poisons our health, and indeed makes us weak, tired, and prone to developing a wide range of disease conditions. But it is another entirely different thing to say that if you are happy and joyful you don’t really need to worry about what you eat as long as you eat a “healthy” and “balanced” diet, and enjoy what you eat. That’s plain wrong, objectively false. And what does “a healthy” or “balanced” diet mean anyway? A little bit of everything? Certainly not! And isn’t this what we are aiming to define as precisely as possible through reading, studying, personal experience and investigation, and efforts towards the noble goal of achieving perfect health?

Why brush your teeth with Tooth Soap instead of with Colgate, Crest, Tom’s or nothing at all? Is it because it makes you happier, or it is because you know it’s better for the teeth? It’s the latter, of course. And independently of your state of happiness and joyfulness, Tooth Soap is better for your teeth and your health than Colgate, (and a high quality natural bar soap is even better and much cheaper). In exactly the same way, a green juice made entirely of green vegetables is a million times better for you than a fruit smoothie with bananas, apples and berries, or peaches, apricots and carrots, or whatever you like. And this is independent of your state of happiness or unhappiness, even when considering that drinking the fruit smoothie may make you feel “better” and happier than drinking the possibly (but not necessarily) bitter and astringent green juice.

Why? Not just because the fresh green juice is so objectively excellent for your health in so many ways, but primarily because each droplet of insulin in your blood beyond the strict minimum needed by the body at any given time damages the cells and tissues throughout, from the toe nails, the hair, and the skin, to the eyes, the optic nerve, and the brain cells, in the entire circulatory system, and to and from every cell, tissue and organ in every part of the body. Therefore, because insulin is raised above the strict functional minimum more and more by every single additional gram of insulin-stimulating carb you eat or drink, this means that every one of these grams of carbs harms the body in some way. The green juice can be said to be objectively good in the absolute sense of the word, while the fruit smoothie can be said to be objectively bad, also in the absolute sense of the word. Yes, I’m sorry to have to repeat this, but sweet fruit other than berries is bad for your health. And fruitarians, like Steve Jobs for most of his adult life, well: pancreatic dysfunction, failure or cancer (as was the case for Jobs), and otherwise cancers of all other kinds will almost inevitably come to anyone who eats only fruit for an extended period of time. This is entirely independent of what you think about it, what you feel about it, and how happy or unhappy you are when you eat or in general. It’s objectively thus, based solely on the biochemical effects of these foods on the body and its metabolism.

Going further still with the biochemical connections, everything we eat can either relieve inflammation or cause it, relieve acidosis or cause it, and therefore, either relieve bodily stress or cause it. All insulin-stimulating carbs directly and indirectly cause inflammation, cellular damage, acidosis, and thus physiological stress. This physiological stress not only compounds with the psychological stressors, but actually causes additional psychological stress, even if it is not perceived as such, simply because stress hormone levels are higher. As a consequence, we are more sensitive, more delicate, more prone to anxiety and nervousness, more easily startled and generally edgy, all of which just means we are stressed, more stressed.

There’s just no way around this: the bodymind is a seamlessly bound whole in which everything affects everything else, in all ways and at all levels. And once more, from the cellular perspective, the cells really don’t care in any way about how you feel, what you think, what you believe and how joyful or happy you are. How could they? They only strive to survive as best they can in the environment of the body, and they experience the consequences of everything we eat, drink, do, think and feel compounded and mixed together, only through how all of this is expressed in the complex biochemical makeup of that inner environment.

An excellent illustration of the importance of optimal biochemical balance is B12 deficiency induced disease conditions such as depression, psychosis, bipolar mania, schizophrenia and paranoia. You can take someone suffering from any one of these conditions that would be almost certainly, and thus inevitably wrongly, diagnosed as psychiatric in nature, give them all the drugs you wish, all the attention, love and caring, all the therapy and counselling in the world, and nothing will make them better. Only correcting the B12 deficiency will make them better. And often almost immediately so, within days, through daily injections of 1-2 mg doses of methyl-cobalamin.

I do not put into question the intentions and sincerity of health writers and bloggers. What I put into question is the advice given that has the potential to reach countless thousands, and cause harm to those who, looking up to these health role models, choose to follow their recommendations. Since we are concerned with optimal health, we need to be accurate and scrutinising. We need to be clear and sharp, pragmatic and scientific, and come to solid conclusions based on facts, in this case, physiological, biochemical and metabolic facts. And this cannot be done without, on the one hand, a thorough understanding of physiological, biochemical and metabolic functions, and on the other, measurements of the blood markers that are the most direct means we have to look inside, so to speak, in order to objectively assess the state of health or disease of the body.

(This was written in response to a comment by Gabriala Brown (Tooth Soap) about a comment I made in reaction to a post by Frederic Patenaude on Kevin Gianni’s Renegade Health blog. If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.)

The kidney: evolutionary marvel

Kidney stones appear at all ages. They are common in older people, but also in the middle aged. They are seen in infants and toddlers, but also in teens and young adults. About 80% of them are calcium stones, 10% struvite stones (from urinary tract infections), and 10% crystallised uric acid, but uric acid ‘seeds’ also promote the formation of calcium stones. That this is so naturally implies that chronic kidney dysfunction must also be common.

Pain associated with a kidney stone can be sharp or dull, mostly depending on the size of the stone either partially blocking or passing through a calix in the kidney or the ureter from the kidney to the bladder, and usually expresses itself as pain in the back or side (easily mistaken for muscular strain), in the abdominal area (easily mistaken for indigestion) or in the groin above which sits the bladder. That such a pain should appear and persist when there are no reasons to suspect either muscle soreness or indigestion indicates that the problem may well be with one or both of the kidneys.

We take almost everything for granted. That we should have air that is not toxic to breathe, water that is not polluted to drink, food that is not contaminated to eat. That we should have a comfortable and warm place to live and work, hot water to shower and bathe whenever we wish, running water wherever we find ourselves. That there should be living plants, insects and animals; soils in which can be planted seeds that will grow; rivers, lakes, seas and oceans in which fish can live, thrive and multiply; mountains, forests and plains in which trees, bushes and grass, beasts, birds and bugs, and every living thing can also not just survive, but thrive. We take these for granted, maybe all the time, and if not, probably most of the time. It is, unfortunately, more than obvious that we should not.

That we take almost everything for granted is even more remarkable when we consider this bodymind (that we customarily and mistakenly call ours), with its countless numbers of specialised cells and tissues, its amazingly intricate organs and systems, and its multitude of facets and functions. What happens when we breathe in, and then when we breathe out? What happens when we drink a glass of water or when instead we drink a glass of juice? What happens when we drink a glass of Coke or a glass of wine? What happens when we eat something: when we eat an apple or a cucumber, a carrot or a celery stick, a potato or an avocado; when we eat an almond or a walnut, pumpkin or sunflower seeds; when we eat meat or fish, eggs or cheese, olive oil, fresh butter or coconut oil; and what happens when we eat burgers and fries, doughnuts, cookies, cake and candy? What happens in the stomach, in the pancreas, in the liver, in the gall bladder, in the small intestine and in the colon? What happens during the process of digestion? How does digestion take place? What happens in the kidneys? What happens in the bloodstream? What happens in the brain?

Most of us have no idea. But we should, should we not? We take it all for granted: that everything will just work; everything will take care of itself; the body will take care of us. Although this can happen, sometimes, in general it doesn’t. But it should, shouldn’t it? Why does it escape us so thoroughly that this bodymind—every single cell in it—is entirely made from what we eat, drink and breathe? It is so obvious and yet it eludes us. And so, we must consciously come back to this again and again.

When we begin to explore the physiology of the body to find out how things work, we find that both the complexity with which we can appreciate, and the understanding of the various functions and interactions, arrange themselves in layers from coarse and superficial to more subtle and profound. Inevitably, as appreciation and understanding deepen, it becomes impossible to find all of it anything less than amazing. And although this can be said for many, maybe even for all organs, it is particularly true in this case: the kidney is an evolutionary marvel, a true jewel of physiological evolution in animals.

The kidney is without any doubt one of, if not the most refined organ both in architecture and function. To pack together so many tiny, delicate structures, working both independently and in unison in an array of such intricate, complex and subtle functions and interactions is truly mind boggling and awe inspiring. This fact is totally underappreciated. And for this very reason, I feel it is important to bring this to your attention before moving on, so that it can remain clear throughout your reading of this article. I hope that with an understanding of what the kidneys do, how they function and what they need, this appreciation will become permanent for you, coming up on its own every time you drink a glass of water, and also every time you remember that you should have.

What we need to know

The kidneys are two bean shaped organs typically 11 cm in height, 6 cm across and 3 cm thick, on top of which sit the suprarenal (as in: above-the-kidney) or adrenal glands. They are located deep in the abdomen close to the spine, one on either side, in the area of the lower back, just below the rib cage, protected in part by the last couple of ribs but mostly by the tick muscles of the back. The kidney has four main components: a thin layer that covers it like a thick skin called the capsule; a thicker layer just beneath the capsule called the cortex (outer layer), in which are most of the arteries and veins; the inner layer called the medulla (middle layer) constituted by conical structures called the pyramids (there are usually 7 of them in humans) with their wide part or base in the cortex and their tips pointing inwards towards the innermost  part of the kidney; and finally the pelvis (base) with its calyces connecting to the ureter.

kidneyDetails

As for everything that relates to health, understanding how to promote optimal function of a cell, tissue, organ or system requires understanding how it works. It is important to remember that every living cell and organelle does what it does not for our sake, but to maximise its own prospects for survival. When we understand what an organ is trying to do, then we can understand what is needed to make sure that it can do it with ease and efficiency. And when the organ functions with ease and efficiency, it functions optimally. This is the approach to use to maximise our prospects for living a long, healthy and happy life.

So, what is the kidney trying to do?

One: Take out of the blood metabolic wastes and toxins, primarily urea, uric acid and creatinine, all resulting from protein metabolism, while keeping as much as possible of the useful stuff, especially water, minerals and amino acids. Two: Maintain blood electrolyte balance (sodium, chloride and potassium; calcium, magnesium and phosphate), pH (bicarbonate and hydrogen) and osmolarity (concentration of solutes in general). Three: Regulate body fluid content and blood volume and pressure. Sodium is the most important electrolyte and blood pressure regulator, and therefore most closely monitored by the kidney.

What are the main metabolic waste products?

Urea results primarily from the breakdown (oxidation) of amino acids that are not used to build tissue, i.e., protein intake in excess of what can be used at any given time to build and repair cells, (but also from our own tissues). Urea also result from the conversion of ammonia, another byproduct of protein digestion which is so acidic that in high concentration it can cause cell death. The kidney, therefore, tries to eliminate as much as possible of the urea, recycling only what it must depending on the body’s needs, especially to increase water re-absorption when there is dehydration.

Uric acid comes from the breakdown of purines. Some are present in our own cells, and so the natural recycling of the components of dead ones produces uric acid on a more or less continual basis and at a more or less elevated rate depending on how quickly cells are dying (the rate of ageing). Purines are also present in foods we eat and drink: mostly protein-rich foods and alcohol containing drinks like wine and beer. The more purines are present, the more uric acid is produced. All the uric acid needs to be eliminated. When the urine is too concentrated and acidic, however, uric acid cannot be dissolved and thus crystallises.

Creatinine is a breakdown by-product of creatine phosphate, an energy storage molecule used mostly in cells with fluctuating energy needs like those in the muscles and brain. Creatine is made from three amino acids in two steps: the kidney combines the arginine and glycine, and then the liver binds on methionine. Creatine is then transported in the bloodstream to muscles where it is made into creatine phosphate and back to creatine as needed. In the first few seconds of an intense muscular effort or brain activity, creatine phosphate can lend a phosphate group to ADP (adenosine di-phosphate) to form ATP (adenosine tri-phosphate, the energy currency of cells), and help supply the needed energy. Very conveniently, if later there is extra ATP floating around not being used, creatine will take back a phosphate group from the ATP molecule, leaving the latter as ADP, and storing the former for future needs as creatine phosphate once more. Creatine is eventually broken down to creatinine and must be completely eliminated by the kidneys. The need for and use of creatine phosphate depends primarily on muscle mass and level of activity.  Therefore, so does production of creatinine.

How does the kidney do what it does?

By filtering the blood. And the kidneys filter a lot of blood. About 25% of all the blood coming out of the heart flows through them. This is on average 1.2 litres per minute, which amounts to more than 1700 litres per day! Since there are 4-5 litres of blood in the body, it means that every drop goes through the kidneys about 400 times each day! Since the overall flow and pressure of the system must be maintained, only around 20% of the blood flowing through the kidney is filtered (that’s 240 ml/min and 340 l/day). The renal artery supplies the blood, and branches out into smaller arteries that also branch out into smaller arterioles all the way to the filtering unit. Because half of the blood volume is water, this amounts to 850 (1700/2) litres per day flowing through the kidneys. Filtering 20% means that 170 litres of water are filtered each day. Therefore, if one litre of urine is produced and excreted over the course of 24 hours (that’s pretty typical, unfortunately), it means that 169 out of 170 of these litres of water are reabsorbed: a reabsorption efficiency of 99.4% (169/170)! Producing two litres of urine eases this down to an efficiency of merely 98.8% (168/170). Now, that’s what we call high running efficiency.

But what does ‘filtering the blood’ actually mean and how is this done exactly? In each kidney there are about 1 million miniature filters called nephrons; they run from the lower part of the cortex deep into the pyramids. It is in the nephron that the blood is filtered and the urine produced in five main stages, first through Bowman’s capsule (1) and into the proximal convoluted tubule (2), then along the loop of Henle (3) and into the distal convoluted tubule (4), and finally out through the collecting duct (5) and into the ureter to the bladder. The filtrate and the concentrated blood course separately through the nephron only once on a one-way trip through the interstitial medium in which it is embedded in distinct but intertwined vessels. Along this winding course take place the delicate regulation of blood pressure, the filtration, the reabsorption of water and useful substances, the concentration of wastes into the filtrate that will become urine, and the regulation of water content and electrolyte balance. Here’s a description of how it works:

Stage one: Bowman’s Capsule    The blood coming into the nephron first enters a little spheroidal structure 0.3 mm in diameter (Bowman’s capsule) where about 20% of it is mechanically filtered to separate the fluid part called the plasma from the solids. It is ‘mechanical’ in the sense that it is pressure driven and based on particle size: smaller stuff like water, minerals, glucose and amino acids, together with the metabolic waste like urea and uric acid pass through, whereas large stuff like blood cells, proteins and fats do not. This is similar to how a water filter works: the water goes through the porous but densely packed carbon or ceramic block that stops most of the large particles like chemicals and metals, but allows the water to pass. And just as the filtering efficiency of a given filter depends on the pressure of the water supply, the filtering through the glomerulus in Bowman’s capsule depends intimately on the pressure of the blood supply. If the pressure is too low, the filtering is inefficient. But if the pressure is too high the delicate filtering structures are damaged. The pressure must therefore be just right for the circumstances, (the conditions being obviously very different when we are running and when we are sleeping).

Stage two: The Proximal Convoluted Tubule    The fluid moves from the capsule into the proximal (as in: close-by) tubule. The blood moves from the larger afferent (as in: towards) arteriole where the pressure is monitored before entering Bowman’s capsule, into the smaller efferent (as in: away-from) arteriole after passing through the glomerulus. It is now much thicker and more concentrated. Here, most of the water (about 65%) and almost all sodium are reabsorbed from the filtrate back into the blood, in addition to all of the glucose and amino acids, (none should end up in the urine), and some urea. If the pressure is even slightly lower than it should, the juxtaglomerular (as in: next-to-the-glomerulus) pressure-sensing cells in the afferent and efferent arterioles, secrete renin that flows into the bloodstream, and stimulates the release of angiotensin I from the liver, which is then converted in the lungs to angiotensin II, a powerful vasoconstrictor that promotes the contraction of the blood vessels to raise blood pressure, but also triggers the secretion of aldosterone in the adrenal glands, which in turn stimulates more reabsorption of water and salt in the nephron, also for the purpose of raising blood volume and pressure.

Stage three: The Loop of Henle    Most of the water and salt, and all the organic molecules like glucose and amino acids are reabsorbed from the filtrate back into the blood through a network of tiny blood vessels (capillaries) in the first part of the proximal convoluted tubule, straight after its emerging from Bowman’s capsule. From there, the vessel changes in shape and direction, and becomes what is named the Loop of Henle: a crucial element of the nephron that has a water-permeable descending limb and a water-impermeable ascending limb. As the filtrate travels down, water moves out because of the higher concentration of sodium in the embedding interstitial medium, and is reabsorbed by tiny capillaries back into the blood. The deeper it descends, the higher the sodium concentration grows, the more water comes out of the filtrate, and thus the more concentrated it becomes. As the concentrated filtrate travels back up along the ascending limb of the loop, it is sodium that is now pulled out, but this time by active transport through little pumps instead of by osmosis as for the water in the descending limb. This is necessary to recover as much sodium as possible and maintain the gradient of concentration of the interstitial medium in which the loop of Henle is embedded.

Stage four: The Distal Convoluted Tubule   The next leg of the trip—a very important one indeed—is through the distal (as in: distant) tubule. It is here that pH and electrolyte levels are regulated. It is also here that we find the chemo-sensing macula densa cells tucked in between the afferent and efferent arterioles, next to their pressure-sensing juxtaglomerular cells. Blood pH is regulated by either absorbing bicarbonate and secreting protons to increase acidity, or vice versa, (without a doubt the much more common alternative), by secreting bicarbonate and absorbing protons to make the blood more alkaline.  Sodium can be left to be excreted or it can be reabsorbed and potassium secreted into the bloodstream under the influence of the hormone aldosterone, and calcium can also be excreted or reabsorbed but in this case under the influence of parathyroid hormone or PTH.

Stage five: The Collecting Duct   The distal convoluted tubule is endowed with a system of collecting tubules to which is delivered the filtrate, (now practically urine), and that merge into the main collecting duct that carries the liquid to the ureter into the bladder. On this final stretch in the collecting duct through the interstitial medium of the nephron, a little more water can be squeeze out of the already concentrated urine. This, however, only happens in the presence of the very important hormone vasopressin (also called anti diuretic hormone or ADH), which is secreted when the body is dehydrated.

This amazing process takes place in millions of nephrons tightly packed and organised in each of the two kidneys, continuously throughout the day and night, from the moment the kidney starts to work in the not yet born child, to the moment we die, either from kidney failure or something else. And to appreciate just how amazing it really is, consider this back-of-the-envelope calculation: 1 million nephrons are packed into 7 pyramids makes about 150 000 per pyramid. Taking a pyramid to be a cone with a base of 2 cm in diameter gives a surface area for the base of about 3 cm squared (Pi*R^2, and R=1). Dividing 150 000 nephrons by this surface area in which all of them must be packed gives a density of 50 000 nephrons per squared cm. Since there are 100 squared mm in 1 squared cm, this makes a density of 500 nephrons in every square mm over the surface of the base of each pyramid, and remember that they must all squeeze in together even more as they penetrate towards the tip of the pyramid and its collecting calyx. Can you even imagine how small this is, without even considering the incredible complexity with which it all works? Gray’s Anatomy states that the thin part of the Loop of Henle is 30 microns in diameter, whereas its thick part is 60 microns, and it is safe to assume that most tubular parts of the nephron are probably also in this range. This is truly amazing. But appreciating this, we can also appreciate how incredibly fragile each nephron must be. And by the way, once a nephron is dead, it’s dead forever.

Now, blood pressure is intimately related to blood volume (amount of water in it) and blood osmolarity (the concentration of solutes, mostly sodium, and to a lesser extent the other electrolytes as well as glucose). Maintaining these in balance is essential to the functioning of everything in the body. For this reason, there are pressure sensors throughout every blood vessel, and osmolarity sensors in the hypothalamus of the brain, as well as highly sensitive sensors of both kinds in the kidney itself. A drop in volume sensed by the pressure sensors in the blood vessels, or a rise in solute concentration sensed in the hypothalamus, will trigger the release of vasopressin from the pituitary gland. Vasopressin will signal the kidney (the collecting duct) to release more water for reabsorption into the blood stream, in order to counter the drop in blood volume and rise in solute concentration. Vasopressin, just as angiotensin, will make the blood vessels constrict and tighten to maintain the blood pressure constant. It will also stimulate the secretion of glucose from the liver in case fast reaction times become necessary, as well as clotting factors and platelets to make the blood thicker and stickier, and prevent excessive blood losses in case of injury. All of these are part of the standard stress response. Vasopressin will also stimulate the secretion of the stress-induced adrenocorticotropic hormone or ACTH that will act to reinforce all of the above in what will amount to a heightened stress response.

Dehydration—especially chronic dehydration—is probably the greatest source of physical stress in most of us. We, unfortunately, tend to live our lives completely oblivious to this fact, and therefore suffer the consequences a little more acutely with each day that passes.

What we need to do

Although all of this is in many ways awfully complicated, what we need to do to make sure the kidneys function properly is quite simple: drink more water, take more magnesium and less calcium, alkalise the body and its tissues.

More water   This is by far the most important: proper hydration by drinking plenty of water—not fluids in general, just plain water—especially in the morning when the body is most dehydrated, before eating anything, and then before each meal.

Imagine what would happen to a water filter if the incoming water were just slightly cloudy with dissolved clay particles? It would work, but over time, (obviously faster than it would in the absence of clay), it would get clogged up. Now, what if there were more fine clay particles? The filter would get clogged up faster given that its role is to stop and store the particles so that the water coming out can be clean and clear. But in addition to that, because the incoming water would necessarily be thicker and more viscous, the filter would not work as well under the same pressure. To work properly it would need a higher pressure to help push through the more viscous water, but this higher pressure (if it could be adjusted upwards) would inevitably stress the filtration system as a whole and thus shorten its ‘life’. What if, in the extreme, the incoming water were really thick, brown and muddy? It’s pretty simple: no water would make it out of the filter because it would instantly clog up.

This analogy is definitely not exact but it is clear and adequately illustrative. To function well, the kidney needs the right blood pressure, blood flow, blood volume, blood viscosity and osmolarity (concentration). As soon as either pressure, volume or sodium concentration drops, the renin-angiotensin-aldosterone is activated and reinforced by the stress response related to secretion of vasopressin (anti diuretic hormone), all acting to constrict the blood vessels, make the blood more viscous and increase reabsorption of both water and sodium to re-establish a functional equilibrium. Imagine now this thick, viscous, sticky blood going through the exceedingly fine arterioles and capillaries in the nephron, and the difficulty with which wastes would be filtered out and dissolved in the water that should be available but isn’t. Now, picture this happening throughout the 24 hours of the day, week after week and year after year. It’s no wonder kidney problems are so common!

So, at the very least we should drink one litre before breakfast and 500 ml before each of the other two meals, allowing each time 30 minutes for the water to be absorbed into the digestive system and then into the blood before eating. It is better to drink more than this, always on an empty stomach, and to take enough unrefined sea salt to match our water intake. Doing this is already enough to ensure proper kidney function and elimination of the bulk of the metabolic wastes through the urine, preventing in this way the formation of kidney stones.

More magnesium and less calcium   The formation of calcium stones is more than obviously related to the fact that we are all in general over-calcified and vitamin K2 deficient, consuming way more calcium than the magnesium and not enough vitamin K2 needed to keep that calcium from settling and crystallising in our tissues, blood vessels, joints, and kidneys. Therefore, to avoid calcification we must avoid over-consuming calcium, and we must supplement with magnesium and vitamin K2. This will also, over time, dissolve existing calcium stones and other sites of calcification in soft tissues.

More alkaline and less acidic   The kidney’s main purpose is to excrete acidic wastes by dissolving them in water. But all digestive and metabolic wastes are acidic, and there are many sources and forms of acid wastes that all contribute to increase the overall acid load on the body. In particular, refined sugars and protein. The heavier the load, the more acidic the blood becomes. Since the blood must remain alkaline, the acid can be eliminated, neutralised or stored in tissues. All three lines of defense are used: the kidneys try to eliminate as much as possible, alkaline minerals like calcium, magnesium and potassium are pulled out of the bones to neutralise blood acidity, and excess acid is stored away in tissues. Everything is done to take it out of circulation. The more acid is stored, the more acidic the tissues become. And the more acidic the body is, the less is its alkalising potential and the harder it is for the kidneys to dissolve and eliminate the acid that should be eliminated on a continual basis. There are fundamental physiological arguments that explain how tissue acidosis is at the root of literally every health problem and disease, (I will write about this more specifically on other occasions), but even without any further considerations, the only sensible conclusion is that the less acid-forming foods and drinks we ingest, the healthier the tissues, the kidneys and the body will be.

The most strongly acid-forming foods are refined sugars. Next are meats, eggs and milk products, then flours, grains and starches. The most strongly alkaline-forming (acid-neutralising) foods are raw and green vegetables, especially salads and leafy greens, as well as watery vegetables like cucumbers and celery. The more chlorophyl, the more alkalising. Parsley, basil, cilantro and all grasses are therefore alkalising and cleansing superstars.

Looking beyond single foods we find that certain combinations make the results indigestible and thus promoting of either putrefaction (protein with sugars or starches) or fermentation (simple sugars with most everything else). Both of these lead to the formation of a lot more acid waste in the digestive system a great part of which ends up the bloodstream. Adopting an alkaline diet will very quickly help balance blood pH and promote maximum excretion of acid wastes. Over time, this will allow the body to not only recover proper digestion and elimination on a meal-per-meal and daily basis, but also to eliminate acidic wastes stored in our tissues throughout the body, thus ridding it of aches and pains, the potential for chronic inflammation or infection, as well as for more serious degenerative diseases like arthritis, cancer and multiple sclerosis, for example.

Last words

And finally, to stop taking so many things for granted is simple. We just need to pay attention to the details of our life and allow ourselves to be surprised, intrigued, inspired, and amazed by what we encounter. Nothing more. We need to open to how things present themselves, and just feel sensations with the actual feeling of the hands and fingers, of the feet and toes, of the belly, the chest, the back and neck. Really feel what is felt: the glass in the hand, the water in the mouth and then flowing in the throat and into the stomach. Actually see what the eyes are seeing: not things but forms and colours, light and dark, space and expansiveness in all directions. Actually hear what is heard in the whole space of hearing. This is how we can stop taking things for granted. Just paying attention to our life with our life. That’s all.

If you want to read more about water, salt and kidney function you can read How much salt or how much water? For more information about the importance of water in digestion and health read Why we should drink water before meals and Water, ageing and disease. For more on calcification, the importance of minerals in general and magnesium in particular, you can read Minerals and bones, calcium and heart attacks, Why you should start taking magnesium today and Reversing calcification and the miracle of vitamin K2 For more on the importance of proper hydration in treating chronic inflammation read Treating arthritis I: super-hydration, alkalisation and magnesium.

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Two articles that changed my life

Two days ago, on October 23, I turned 40. For me, it feels different than every other birthday I have had: it feels like the marker of the transition between what can be considered young adulthood from 20 to 40, and middle adulthood from 40 to 70, which is then simply followed by old age. Maybe this is also linked to the fact that from the time I started competing, first in running track and field, then in road cycling, duathlon (running and cycling), off-road cycling and eventually in long distance running, I have always been in the normal, standard 18-40 category (like almost everyone else, I thought). And now, starting with my first race in the first level Seniors from 40 to 50 a couple of weekends ago in Bordeaux at the Ariane Cross 2012, I am definitely, and will be for the next 10 years, in the over 40 category. So, I have been reflecting a little on the past and the future: What is really important to me, what have I done and accomplished, what do I want to do in the future and how can I get there? Simple questions whose answers are not so simple.

In this context, I want to share two articles that completely changed my life, and completely changed my state of health, in some respects, rather suddenly, and in others, gradually over the years. Interestingly, I stumbled upon and read them both in the same week almost exactly five years ago. I won’t summarise, discuss their contents, nor describe the positive effects the simple but radical changes in dietary habits they prompted me to instil have had on me, on my wife Kristin and on our son Laurent. I simply encourage you to read them for yourself, and sincerely hope they will benefit you as much as they have us, and, I am sure, everyone who has ever read and applied the information they contain to their diet.

What is clear to me now much more than it has in the past, is that no matter what information we are presented, its impact depends entirely on how receptive we are to it. And this depends on all of what we know and think we know, on how we understand the connections between everything we have been exposed to, on our habits and tendencies, on previous experiences throughout our life, and very importantly, on the circumstances that form the context in which the information is brought to our attention. Thus, let me hope that these two articles come at a time that is ripe for you to appreciate their importance in regards to your own health, that of the people you care about, and everyone else for that matter.

The two articles are Insulin and Its Metabolic Effects by Ron Rosedale, MD (you can get the pdf here), and The Skinny on Fats by Mary Enig, PhD (get pdf here). After reading them, please consider sending this link to those you know who will or even possibly appreciate it. As you will see from the few case histories at the start of Rosedale’s presentation, the question of understanding and controlling insulin can really be a matter of life or death.

Healthy and lucid from childhood to old age

So you’ve been around for 70 years, and you’re still well enough to read this. Have you actually made it past 75, 80 or even 85? This is really great! Through a combination of different factors, various reasons, personal habits and choices, you have made this far.

Maybe because of your genetic makeup: Your parents and grand-parents all lived well into their 80’s or 90’s by following a kind of innate, traditional wisdom based on the understanding that we really are what we eat, in a very real sense, and you’ve done more or less the same, following in their footsteps.

Maybe because you have always been moderate in your eating habits: You’ve never been overweight; you’ve never eaten much sweets or deserts; you’ve never eaten much preserved meats and canned foods; you’ve never drank much alcohol; you’ve never drank sweetened soft drinks, juice or milk—mostly just water, always paying attention not to drink too much coffee or strongly caffeinated tea.

Maybe you have made it this far because you have also been moderately active throughout your life, never exercising too much or too intensely, but always quite regularly: Walking; doing light exercises for your joints (rotations of the arms for your shoulders, stretches for your neck and back, and exercises for your knees); riding a bike a couple times a week in the good season, not getting off the bike but instead riding up those hills; maybe you went skiing a week or two most years; went for long walks or even hikes in the mountains during holidays; or did a little swimming in the sea or in lakes when the occasion presented itself.

The golden middleas my grand-father called it: everything is moderation. And he almost made it to 90 years of age! But no matter what the reason is, it is truly wonderful that you have indeed made it this far. Then again, you might be young or middle aged, but interested—maybe somewhat, maybe highly, but nonetheless interested—in being healthy and lucid for as long as possible, and hopefully well into your old age.

Either way, young or old, you live in this modern world like most of us. You live in a city, you drive a car, you work in an office, you fly or flew often on business trips, maybe even several times per week. You eat meat and fish; bread, potatoes, rice and pasta; fruits and vegetables, all from the supermarket.  And so you have, throughout your life, been continuously exposed to increasing amounts of chemicals, heavy metals and various other toxins in our environment, most of which have been accumulating in your tissues. You live in the modern world like most of us, and so you have taken medication on various occasions during your life: antibiotics a few times, maybe some pain killers, maybe some sleeping pills, maybe simple anti-histamines when you had a cold. Maybe you are and have even been taking medication on a daily basis for some “minor” but “chronic” condition.

You live in this modern world and so you have been told to drink plenty of fluids and that salt is bad and should be avoided. You’ve been told that fat in general, but especially saturated fats and cholesterol, are bad because they cause heart disease: they cause your arteries to clog up with fatty plaques that eventually block them to give you a heart attack. You’ve been told to avoid them as much as you can, and instead to consume polyunsaturated vegetable oils, plenty of whole grains and cereal products, legumes, plenty of fruits and vegetables, and so you have done that: you have decreased or almost eliminated your intake of butter, eggs, fatty cheese, fatty yoghurt, red meat—never ever eating the fatty trimmings, and also of the fatty skin on chicken or fish.

Consequently, you have increased your intake of morning cereal—but only sugar-free whole grain cereal like muesli; increased your intake of bread—but usually whole grain bread; increased your intake of rice—but usually brown rice; increased your intake of pasta—but usually also whole grain pasta; and increased you intake of potatoes—but never fried, only baked, steamed or boiled potatoes.

Maybe your total lipoprotein levels are around 220 or 240 mg/dl, and you have been told that this is too high, and for this reason you have tried to further reduce your fat intake, and are even taking statins or other cholesterol-lowering drugs, every day, just like hundreds of millions of other people in this modern world.

Unfortunately, you have not been told that you should be drinking water; not fluids in general, and that there are many reasons water, ageing and disease are intimately connected—the lack of water, that is. In addition to that, you have not been told that it is not enough to drink some water sometimes: it is essential to drink water before meals. Unfortunately, you have not been told that sodium is one of the most important minerals for health: why else would the kidneys, without which we cannot live for more than a few days, go to such great lengths to prevent its excretion in the urine, and keep it in the blood if it wasn’t? But even more unfortunately, you have not been told that minerals in general, are essential for health, and that unrefined sea salt contains all naturally occurring trace minerals is proportions that closely match those of several of our bodily fluids. And that furthermore, proper bodily function depends intimately on the balance of the minerals available, and that our salt-phobic and calcium-phillic society has led to most of us becoming completely over-calcified while growing more and more deficient in the rest of the trace minerals, and in particular magnesium. The link between generalised magnesium deficiency and minerals, ageing and disease are now everywhere painfully obvious.

Unfortunately—and indeed very sadly—you have not been told that cholesterol is absolutely vital for life and good health: that it forms the membrane of every single cell in your body and in that of every animal, that your entire nervous system and especially your brain are built using cholesterol and depend intimately on the availability of plenty of cholesterol, that your hormonal system relies completely on cholesterol for building hormones, and that your best defences against infectious and inflammatory pathogens are in fact the lipoproteins carrying around the precious cholesterol throughout your body. You have not been told that cholesterol is so important that it is manufactured continuously by our liver to keep up with the body’s needs, and that therefore, the cholesterol we eat does not in any ways raise lipoprotein concentrations. You have not been told that in addition to cholesterol, fat is also essential for building hormones, essential for absorbing minerals from the intestines into our bloodstream, essential for the binding of these minerals into the bones and teeth, essential for energy production in every cell of our body.

Furthermore, you have not been told that saturated fats like those found in animal products and coconut oil are molecularly stable, whereas unsaturated and particularly polyunsaturated oils such as those that make up all vegetable oils are molecularly unstable, some more than others, for the double bonds between carbon atoms in the chain that forms the fat molecule are weak and readily broken to permit some other unstable molecule seeking a free electron to attach in order to make the final molecular configuration stable. But that those unstable compounds are actually scavenging around for any electron to bind to, and unfortunately most of the time if not always, these free-radicals will attach themselves to healthy tissue without proper enzymatic action to guide them in the proper place and position, thus damaging our tissues.

In fact, you have not been told that all large studies that have been conducted to evaluate the “health-promoting” properties of polyunsaturated fats have not only failed to do so, but instead have shown that the more polyunsaturated oils we consume, the more atherosclerotic plaques develop in our arteries, and therefore the more likely we are to suffer a heart attack or stroke. And that on the contrary, the more saturated fats we consume, the less plaques we have, and consequently, the less likely we are to have a heart attack or a stroke (see any of the books about cholesterol in Further readings).

You have not been told, that for millions of years our species has evolved consuming most of its calories in the form of saturated fats from meat and animal products—in some cases exclusively from these, from coconut and palm oil (where these grow), and to a much lesser extent from polyunsaturated fats, and this only in whole foods such as fish, nuts and seeds—never concentrated into vegetable oils.

Unfortunately—and indeed very sadly—you have not been told that we were never meant to eat simple or starchy carbohydrates: that eating such carbohydrates always triggers the pancreas to secrete insulin in order to clear the bloodstream of the damaging glucose in circulation, that chronically elevated glucose levels lead to chronically elevated insulin levels that in turn lead to insulin resistance—first in our muscles, then in our liver, and finally in our fat cells—which leads to type II diabetes, to heart disease from the buildup of plaque in the coronary arteries and vessels, and to Alzheimer’s and cognitive degradation from the buildup of plaque in the cerebral arteries and vessels.

Unfortunately—and indeed very sadly—you have not been told and have not considered that all the multitude of chemicals and heavy metals that we are exposed to in the medications we take, in the air we breathe, in the water we drink, in the food we eat, in the soaps and shampoos we use, and in the household products we employ to keep our house sparkling clean and bacteria-free, accumulate in our bodies. They accumulate in our fat cells, in our tissues, in our organs, in our brains. They burden, disrupt and damage our digestive system, our immune system, our hormonal system, our organs, tissues and cells. Sometimes they reach such concentrations that we become gravely ill, but none of the doctors we visit in seeking a solution and relief understand why. Most often, however, we don’t get gravely ill but instead start developing different kinds of little problems: we get colds more often and take longer to recover, we get mild but regular digestive upsets that we can’t explain and that seem to get worse with time, we get headaches and have trouble sleeping, we feel depressed, tired, alone, helpless, not acutely but enough to disturb us enough that we notice it.

Finally, and maybe most importantly, you have not been told how truly essential vitamin B12 really is, but how, for a variety of different reasons, blood concentrations B12 decrease with age, and eventually dwindle to very low levels. That B12 is essential most crucially to preserve the myelin sheath that covers all of our nerves healthy, and thus crucially important for everything that takes place throughout the nervous system, which means, everything in the body and brain. Levels of B12 should never go below 450 pg/ml, and ideally should be maintained at 800 pg/ml throughout life, from childhood to old age hood.

Can we do anything about all this?

The most fundamental point to understand is that everything about your health depends on the state of health of your digestive system. All absorption of nutrients and elimination of waste happens in the digestive system. Since our health depends on proper absorption and efficient elimination, the digestive system should be our first as well as our main concern.

The first step is to rebuild and establish a healthy intestinal flora of beneficial bacteria (breakdown and absorption), and at the same time begin to detoxify the body and clean out the intestines (elimination). This is done by taking high quality probiotics to supply beneficial bacteria on a daily basis, high quality chlorella to both supply a lot of micronutrients and pull out heavy metals, and water-soluble fibre like psyllium husks to clean out the intestines by pushing out toxins and waste products. If you are not already taking these, read Probiotics, chlorella and psyllium husks.

The second step is by far the most important, and in fact, crucial dietary change necessary to achieve optimal metabolic health. It is to eliminate simple and starchy carbohydrates from you diet, and replace them with more raw vegetables—especially green and leafy salads and colourful vegetables such as red and yellow peppers, more nuts and seeds—especially raw and soaked, more good and efficiently absorbed protein—especially eggs, fish and raw cheeses, and much more saturated fats—especially coconut oil (at least 3 tablespoons per day) and butter. Doing this is  essential for the systemic detoxification, rebuilding and then maintaining a healthy digestive system. Everything should be organic: you obviously don’t want to be adding to your toxic load while trying to detoxify.

And the third step is to supplement our now-excellent, health-promoting diet with a few essential and very important nutrients that are, for most of us, difficult to obtain. The only such supplements that I believe to be essential, and that my family and I take daily, are: Vitamin B12 and vitamin D3—the most important supplements to take for overall health, but in which we are almost all deficient; Krill oil—a high-quality, animal-based omega-3 fat with its own natural anti-oxidants, highly absorbable, and particularly important for proper brain function; Ubiquinol—the reduced and thus useable form of coenzyme Q10, critical for cellular energy production, and a powerful lipid-soluble anti-oxidant that protects our cells from oxidative damage, but both of whose synthesis as CoQ10 and conversion from CoQ10 to ubiquinol drop dramatically after about age 30-40; Vitamin K2—essential for healthy bones but very hard to get other than from fermented foods, which we typically eat little of.

In addition to these, we usually always take Astaxanthin and turmeric—very powerful antioxidants with amazing general and specific anti-ageing health benefits, and also sometimes take a whole-foods-multi—basically dehydrated vegetables and berries made into a powder and compressed into a pill for extra micronutrients. (You can read about all of these supplements on Wikipedia or any other page you will find by doing an internet search.)

I tend to buy our supplements from Dr Joseph Mercola, (whose website also provides a lot of info about these and other supplements, as well as about a multitude of other health-related issues and conditions), because I trust that his are among if not the best on the market: there’s really no point in buying cheap supplements at the pharmacy, and risking doing yourself more harm than good, as would happen with a rancid omega-3 supplement, or a synthetic Vitamin D, for example.

Staying healthy and lucid is, in reality, quite easy and simple. Unfortunately, most of us, including, and maybe especially our medical doctors, just don’t know how. And so, medical diagnostic and high-tech treatment technologies continue to improve and develop, and medical expenditures continue to rise throughout the modern world, but we are sicker than ever: more obesity, more diabetes, more strokes, more heart attacks, more cancers, more Alzheimer’s, more leaky guts, more ulcers, more liver failures, more kidney failures, and on and on. There is more disease, more pain, more suffering and more premature deaths. And all of it is completely unnecessary and avoidable by such simple and inexpensive means as those outlined herein. The only critical point is that only you can do it; nobody else can do it for you.