The weight loss conundrum

Disclaimer: this post expresses my personal opinions. Fancy that. On my personal blog too. And guess what, this opinion may even be different to yours. You can let me know if you agree or disagree with the views expressed here. You might even go as far as to tell me that I am wrong. I may or may not care about that. Enjoy reading.

Phew. Now that we got that out of the way let’s talk weight loss. Everyone on the internet knows that the best way to get traffic is to tag your pearls of wisdom  “weight loss tips” and “Jessica Biel’s diet secrets”. I have neither. Sorry. But this post was mostly brought on by the frustration that the topic of losing body mass is still a priority not just in conventional women’s magazines but in ancestral health community.

You know the one: “Yes, I’ve given up grains because Robb Wolf told me to, I don’t eat refined carbs after reading Gary Taubes, I stopped sugar after watching that Lustig’s video and I force down a tablespoon of fermented cod liver oil since attending Weston A.Price conference. I feel great but… How do I lose another 10kgs?”

And of course there is no shortage of available experts on the interwebz:
- eat less carbs
- eat more safe starches
- introduce interval training
- stop HIIT to salvage your burned out adrenals
- eat sauerkraut for healthy gut
- calories don’t matter
- calories matter
- start IF
- use FitDay to track your daily intake
et cetera.

It’s all very sad.

In the meantime the average long term success of most weight loss strategies is around 1%. Yeah, sure, most people do it wrong. They choose the wrong diet (Lemon Detox, anyone?), they choose the worst possible exercise (if you are a female with a cup size C and above, for god’s sake stop running). And they just don’t have the willpower that the new dieter has (sarcasm font). Because the new dieter knows that he/she will be different. I will be in that 1% who does it right and stays skinny ever after. The End.

There are numerous reasons why weight loss strategies fail. And there are numerous reasons why they succeed. Temporarily. You can lose weight in literally thousands of different ways: Paleo, low fat, low carb, low calorie, ketogenic, vegetarian, aerobic exercise, HIIT, IF, bariatric surgery, liposuction…

That’s why the to and fro arguments on which approach is better for weight loss is kinda pointless. YES! YOU CAN LOSE WEIGHT EATING MARS BARS AND DRINKING COKE! (feel free to leave this page at this point and celebrate).

We have this love and hate relationship with a number that determines our body mass. Lily Allen famously said: “And everything’s cool as long as I’m getting thinner”. There is another number that we have become very preoccupied with in the last few decades: serum cholesterol. Chasing that number (down) is the name of the game, mostly by pharmacological means. Of course, you could tilt this snow globe upside down and decide that the number per se is not very meaningful and in fact represents some other pathological process in the body. Ideally you would choose an intervention that both addresses the cause of the problem and pushes that number in the direction you want. A nutrient-rich diet free of processed junk and pro-inflammatory toxins accompanied by reasonable physical activity is likely to address the chronic inflammatory state that leads to dyslipidaemia and therefore drop the dreaded cholesterol numbers down and please your conscientious doctor.

But sometimes it doesn’t get you to the magic 5.5 mmols that your doctor wants to see. Just like your 6 month foray into the Paleo diet fails to get you to that elusive number that determines your weight, size and consequently happiness. Time to go on PaleoHacks and shout for help.

I am not having a go at the desire to be slimmer. Sure, I wouldn’t mind losing a few kgs. I also wouldn’t mind losing my freckles or having bigger hands (it sucks trying to find surgical gloves that fit). Neither affects my sense of self worth.

So for what it’s worth, these are my ideas in relation to weight loss (note, doesn’t say FOR weight loss):

I am overweight? Oh thank you, kind sir, I wish I knew this earlier! Let me just switch to a healthy diet and start running.

1. If your primary focus is weight loss you are already behind the eighth ball. If being skinny was a powerful motivator we wouldn’t have 2/3rds of Western world overweight or obese. Wanting to lose weight tends to screw with people’s heads even with the best foundation: they start stressing (excess cortisol=bad), they start reducing/counting/starving/hating their bland food/exercising at 5am and generally stop listening to the bodies.

Things are quite different when you eat to nourish every cell in your body. Shift your focus to wellness and flip the switch.

1a Unless you have congestive heart failure or chronic kidney disease, chuck your scales. Like now. Get up and throw them in the bin.

2. Start with having a nutrient-rich diet and get rid of junk. Use whatever framework takes your fancy: Paleo, primal, perfect health diet, whole30, Mediterranean, vegetarian (gasp! ). Minimize the “healthy” versions of unhealthy food, you don’t want any food holding you emotionally hostage.

Until you have that down pat, forget the words “Do you have these pants in a smaller size?”

3. Find a regular consistent physical activity you enjoy. I know exercise is supposed to be about torture. That’s ok if you enjoy torture, no judgement here. Do something you can see yourself doing regularly in a year. Or five.

3a. Do not ramp up the volume/intensity of the said activity to accelerate weight loss beyond the level you see yourself comfortably doing long term. Did I hear you say “bootcamp”? Pfft.

4. You cannot fix self esteem issues with weight loss. The two have very little to do with each other.

4a. In the same vein, having weight loss as a dangling carrot in the future can derail your enjoyment of today. Don’t put off activities, clothes or happiness until you get thinner. See point 1.

5. It seems that the thoughts of weight loss frequently return when people are still longing for a six pack in spite of measurable improvements in their physical and mental health. This is where we hit a little snag.

Let’s say you start off in the obese category. Up to a certain point weight loss and health gains go together. Then you reach a state where your body is happy, healthy and well-nourished. To lose more subcutaneous fat from this point will not gain any further health benefit. In fact, you may dip down into negative territory. If you are body builder, dancer, gymnast or any athlete dependent on low body mass this is the risk you have to take. If you are a suburban mother of 2, disappointed she doesn’t look like her graduation photo any longer, you may be playing a dangerous game. If you still choose to continue down this path that’s cool. Your choice. It’s way harder to shift the happy-healthy weight so you may have to pull out all stops. Some of those deviate even further from the path to long term health and wellness. Obviously if you are naturally lean and small you have to flip this scenario 180 degrees. Getting massive past the point of diminishing returns may not be optimal for your body either.

When I see an obese patient I do not have an overwhelming desire to help them lose fat. To me their weight is nothing more but an external manifestation of serious internal issues.  I worry about their risk of heart disease, diabetes, Alzheimer’s and autoimmune conditions. I feel the same level of concerns for the skinny-fat: normal BMI with little muscle and obvious visceral adiposity.

Incredibly sexist and quite offensive to naturally thin women. However we don’t think twice when the ads are turned the other way around.

For a health-conscious and somewhat rebellious community we are still remarkably superficial and eager to conform to the current body image stereotype.

Minimalist shoe review and Sunday primal living

Sunday posts are not supposed to be sciency right? Having a weekend off is a luxury and I like to treat it as such. Hence I decided to be a lazy tart and sleep in till 7.30am. A vat of coffee, a quick social media catch up and I was out the door to test my new Lucy VivoBarefoots.

I abhor the term “barefoot technology” because it sounds just a gimmicky as ShakeIt weights but I do agree with a concept that walking on 3 cm of very expensive rubber, otherwise known as “conventional sneaker”, is utter nonsense.

VivoBarefoot EvoII in their better days

I never got into Vibrams (I don’t like the idea of rubber between my toes or people jeering in glee as they point to my feet) but I own a pretty nice pair of VivoBarefoot EvoII which I wear to the gym or operating theatres. Which is pretty much the same thing. Their only problem is that they are damn slippery when you leave the safety of the indoor environment, especially if you like jumping on rocks. So to avoid ending up in my own emergency department I normally wear Sketchers. Yeah yeah, I know, don’t judge me.

I really didn’t want slippery soles here

My usual long walk is around 2.5 hrs which takes me down the coast and back, and has a good mix of beach walking, rock hopping, trekking up and down the hills between coves and a few steep sections through the rainforest. The sole of the Lucy is supposed to be ultra thin (3mm) and puncture resistant but it doesn’t feel quite as paper thin as the EvoII, which together with a pretty thick top covering adds to the sturdier feel. The first climb up the rocks went without a slip up but I did slide down a steep path on gravel a couple of times, gracefully landing on my buttocks, although I don’t know whether it was the shoe or my slightly tired quads. The harder top lining started to put a little pressure on my Achilles tendon after 2 hrs but wearing socks helped. The toe cage is wide enough for my narrow foot but if yours is on the wide side you may find it a little constricting.

Terra Plana sizing tends to run small. I normally wear 38 but ordered 39 in these and they were perfect with a sock. Interestingly, I also ordered VivoBarefoot Mary-Janes and they were a bit big in the same size.

Overall, a good walking shoe which feels more like a conventional shoe although does provide the benefit of good proprioception and a light feel.

The rules of the game: get to the other side without touching the sand. GO!

As always, my weekend walk provides me with a few excitements (I am a simple creature and get excited easily). A huge 1.5m goanna decided to leisurely cross my path causing a temporary bladder spasm and a jerky and too-slow reach for the camera. Gotta love Australia.

A young bright gen-Y sitting on a rock overlooking the ocean spreading Nutella on several pieces of white toast. I kid you not.

The usual quick eyes-on-the-sand dash through the nudist beach was again unsuccessful. The happy-in-his-bare-glory gentleman spotted me and jumped out of the bushes to take a lazy stroll towards me. Exhibitionism ain’t nudism.

Fun times.

As I finish off this post I notice that Victoria Prince has also recently written about her hiking adventures. Which makes me think that we have either all run out of science to talk about (unlikely), we are sick and tired of banging our heads against the wall (quite possible) or we are just moving past the obsessive food-will-cure-all-ails mentality. While it indeed starts with food, there is more to health and wellbeing than what you put in your gob.

Also a topic of our recent presentation at Whole9 seminar in Boston, non-nutrition lifestyle factors are starting to become a more prominent feature in this community. Thank heavens for that. At one stage it looked like we were turning into indoor nerds glued to our computers, obsessively arguing over minute details of the latest Pubmed offering, occasionally emerging from the social media dramas to bash our bodies in the variety of HIIT smashfit pursuits. Whaaat? Somebody still doing that? Crazy folks.

 

Rainforest stair sprints. Or walks.

Anyway, the majority of my activities nowadays are slow intensity performed in a glycogen-depleted state (and when Jamie finally writes up his AHS presentation I will have something to reference!). I try to go for 20-30min walk most days before work, fuelled by caffeine and nothing else; do yoga and strength training once or twice a week. Going for longer and more challenging walks on the weekend fits right into this schedule. So that’s my Slow Movement covered.

 

My shadow is not taller than me = vitamin D production

Sun exposure is another area I consider a powerful factor in overall wellbeing. Vitamin D is certainly the shiz nowadays but let’s not forget about other benefits of sun exposure: mood enhancing qualities, pain relief, better sleep, eye and skin health.

And finally, there’s something about the expansive vistas, the sound of the ocean and the smell of the rainforest that we, as humans, have long felt a connection with. We have seen a few studies emerge showing the benefit of being close to nature (Mark Sisson has written a good overview about it. What hasn’t this man written about???). But I like to look at this from another point of view. It’s not that being close to nature is better for us, it’s just our indoor artificially-lit air-conditioned existence is so very bad. Going back to nature is…well, natural. It’s another one of these instances when feeling “low level crap” has become the norm.

 

Well-deserved: scrambled eggs with lox, avocado, duck pate and local vintage cheddar

Hope you can find some restorative activity, sunlight, fresh air, awe-inspiring views and simple pleasures in your Sunday.

As if you need another AHS wrap up post…

 

There have been a few wrap up posts on AHS already, some complimentary, some provocative. I will try to add my bit which will be purely my opinion on the event I have been looking forward to since last year and my impressions of it.

For those who are in the dark about what I am on about (gasp!) here is a good “AHS for dummies” round up. Also Beth has put together quite a list of AHS wrap ups for all your evolutionary medicine science and gossip needs.

Boston Gardens

To start with, I went this year in a purely observatory capacity. If you wondering why anyone would endure 24 hr flying time plus layover in 3 cities, here is my main reason. Evolutionary medicine in Australia is still for weird hippies and charlatans, not for Sydney University-trained doctors. Being in a group of passionate people, some including distinguished scientists, medical professionals and clinicians, was gratifying and encouraging.

*And before I get accused of ignoring minorities and lay folk: I see AHS as a primarily academic event designed to open the doors to new hypotheses, share scientific research and help move evolutionary medicine into mainstream consciousness. I think PaleoFX and its organisers, Keith and Michelle Norris, filled the niche of taking theory to practice very efficiently, and if I can ever afford 2 trips to the US a year (poor medical resident here) I would not hesitate to go. I think it’s fantastic that AHS is open to the lay public (let’s face it, the discerning Paleo “lay public” keep everyone on their toes) but I wouldn’t want for the conference to lose its academic edge. And if I ever want a Paleo group hug I will go to a Paleo meet up.*

Recalling my inability to sit through University lectures, I knew I couldn’t attend every talk so I tried to hedge my bets and pick from the program. Some I got right, some I didn’t. A few times, I opted to hear the “big names” only to miss out on a fascinating talk from a less known figure in the other room. I have already marked the ones I would like to download to watch on video.

The dairy debate continued in the ice-cream parlour

Rating on some memorable talks I saw in no particular order:

1. Dan Lieberman on evolutionary principles. A great talk to open up the symposium and a must-see for anyone as an Evolution 101 refresher. It set a nice tone to the event, steering it away from the romanticised hunter-gatherer image.

2. Dr Peter Attia gave an awesome lecture on cholesterol. This was probably the most sciency talk of the whole seminar and in my opinion the best. I wish I had a lecture like this in medical school! I will definitely re-watch this one on video, this time taking thorough notes. Highly recommend regardless of your knowledge level, you will learn something anyway.

3. Jamie Scott spoke about using evolutionary principles for endurance training. He effectively melted a few brains by stating a strong case for low intensity work performed in glycogen-depleted state. For the crowd largely indoctrinated enthusiastically involved in Crossfit it was a hard sell but I think he got a few converts.

4.  Dr O’Keefe on the effects of prolonged endurance exercise on cardiovascular system. He described exercise-induced cardiomyopathy in ultra-endurance athletes. As a runner himself, his position was a little biased toward running and in my view his recommended dosages (45-60 min 5 times a week) were still too high. Also he didn’t mention the significant degenerative joint effects and chronic inflammation on the body. Overall, the talk was very interesting and definitely something that running-obsessed Americans need to see (OMG, do you, people, do anything else other than run???)

5. Chris Kresser on iron overload. Chris gave a good view of haemachromatosis, its diagnosis, manifestations and treatment. Most of this material had been extensively covered in my medical school lectures (yes, believe it or not, they DO teach us something). I would have liked to hear a theory on the evolutionary explanation of haemachromatosis and Seth Roberts, I think, asked Chris that question but I didn’t gleam much from the response. Worth watching if you think that Paleo is a free pass to eat meat like it’s going out of fashion.

6. J. Stanton on hunger. JS presented very convincing evidence that hunger is a normal physiological response to the lack of nutrients to the cells (who would’ve thunk it, huh?) rather than a massive character flaw possessed universally by the fatties. It was a great complement to his series of posts on hunger (which are excellent to read). JS is, ahem, an unusual personality with a brainpower that makes the rest of us feel like schoolchildren. He was openly critical of the food reward theory during his presentation, however, when we all went out for dinner that night, he was extremely gracious and kept saying that he felt very honoured that people like Stephan (Guyenet) attended his talk. You can read Stephan’s review of this talk here.

7. Dr Terry Wahls gave an inspiring talk about managing own multiple sclerosis with MS. However, I was already familiar with her very excellent TED talk (which you should definitely see if you have been under a rock somewhere) and not sure I got much more out of this presentation.

8. Robb Wolf‘s talk about implementing Paleo diet principles at Reno municipality is inspiring to watch especially if you are interested in public policy and how to bridge the gap between a Paleo community, often seen as alternative and (let’s face it) weird, and real world. Big picture stuff.

9. Dr Emily Deans have a presentation on food and mental health. She gave a good overview of how fructose and trans fats affect us not only metabolically but also psychologically. It was fascinating to see the diametrically opposed views on sugar and mental health: does it make you happy or not?

10. Dr Andreas Eenfeld was a surprise to me. Even though he presented on carbohydrate controversy (yawn) he managed to make it entertaining (yes, really) and light-hearted. I thoroughly enjoyed it.

Watching squirrels was somewhat more entertaining than a safe starch debate

By the way, I think the whole audience was tweeting. It was absolutely surreal to listen to one talk and read tweets from the next room with people raving about the speaker I was missing.

Talks I cannot wait to see on video:

1. Peter Gray on the role play in the development of social and emotional competence. Here is a great example of his work and if I knew he was in the next room I would have dumped Stephan Guyenet in a heartbeat (sorry!)
2. Ubuntu: a paleolithic perspective on human community and health by Frank Foresich
3. Oxidative stress and CHO intolerance by Chris Masterjohn
4. Paleo nutrition and the brain by David Pendergrass.

Overall impression:
It was disappointing to see a few negative posts from attendees, in particular some who felt not included due to their age, appearance, weight, or some other factor. I was not aware of any such tension during the conference, except to note that people were quite naturally gravitating towards their friends and acquaintances, and of course “Paleo celebrities”. I find this community remarkably inclusive but then I am not an idealist and generally do not expect much of people. I certainly would never anticipate Robb Wolf to come up to me and strike up a conversation. Being quite introverted, I spoke to people who approached me or were introduced by others, and relaxed in the courtyard when the crowds got too much.

I would love to come back next year and reconnect with some new and old friends.

A few thanks:
To Ann and Dave Wendell – for making the most of the Aussie-Kiwi rivalry and teasing the hell out of us.
To Victoria Prince – for feeding us home cooked meals, taking us berry picking and showing us the green and luscious part of New Jersey
To J Stanton – for challenging our brain cells and being a very exciting dinner guest
To Jude – for her Aussie accent, sense of humour and constant and inappropriate swearing
To Melissa and Dallas Hartwig – for great conversations, amazing (very well organised!) meals, unwavering support and a hefty dose of inspiration

Many more Twitter names came alive (hey, these people do actually exist) and I fear I’ll miss someone if I start naming them but I enjoyed meeting all of you.

See you all next year.

Big jet plane

I hate packing and always leave it till the last moment. But I finally conquered my procrastination and now (kind of) ready to jump on the plane to head off to Boston. As excited as I am to be in the midst of the biggest gathering of primal and ancestral health minded people in the world, I don’t think I will have it in me to write long Oscar-worthy reviews. Hopefully I’ll still have my Twitter and Facebook to share the overall buzz with those of you who are eagerly following the event. I was doing it last year so I hear ya!

See you after the AHS12!

The spice of life

I’m sick of nutritional thought-terminating clichés. They are repeated ad nauseum everywhere from morning TV to a doctor’s surgery. One of my pet peeves is “Eat a wide variety of food“. I was not surprised to see this statement in the recent draft of Australian Dietary Guidelines.

What does it even mean?

There seems to be a strange notion floating around regarding our human nutritional  requirements. Since we need a wide variety of micronutrients and each food (apparently) only contains a limited amount, we best to stay on the safe side and eat a little bit of everything. This idea is perpetuated by the constant mentions of newly discovered “miracle” compounds in the media.

Reading all these you would be forgiven to think that to obtain optimal health you need a fridge full of exotic berries from Africa, a pseudo-grain from South America, tea leaves grown on a particular valley in Sri Lanka and a vegetable you have never heard of from the Pacific islands.

The ADG draft pitches another argument in support of the variety theory:

“Dietary variety has the benefit of diluting potential toxicants found naturally in food”

They go on to mention the potential vitamin A toxicity from excess liver consumption (most westerners today would gag at the mention of liver anyway) and a potential of mercury poisoning from fish for pregnant women (enough to scare off anyone from consuming any measurable quantities of DHA/EPA. What? Babies’ brains need those?)

This makes no sense (#FFS).

Let’s take ourselves from our first world everything-is-readily-available-when-I-need-it mentality and apply some good old fashioned common sense and a bit of evolutionary logic. Is it really likely that the compound which will turn on some beneficial gene expression in humans world wide just happens to be only found in a berry from Colombia? Hey, evolution, that’s a major oversight! It took the rest of us, non-Colombian population, 2 million years to work out how to build planes and stuff and this perfect nugget of nutrition was sitting there all this time?

It amused me no end that quinoa made it into the list of cereals recommended to be eaten as part of the 5 food groups daily (Guideline 1) in Australia.

“Eat a wide variety of nutritious foods from these five food groups daily: 3. grain (cereal) foods mostly wholegrain, such as bread, cereal, rice, pasta, noodles, polenta, cous cous, oats, quinoa, barley”.

But enough about South American wonder foods. What about a humble blueberry? All those anthocyanins and phenolics repairing the oxidative damage inflicted by the food group number 3. Has to be good for you, right? And lucky for us, health-conscious consumers, blueberries are available all year around courtesy your friendly local supermarket giant.

I still remember picking wild blueberries in a Russian forest as a child. We looked forward to a month-long blueberry season,  doing a few forest trips around July to check if berries were ready for picking. Some super keen villagers would go a few days early just to beat the crowds, their payback for keenness was a few extra hours of forest-wandering. The official start of the season would see whole families venture into the woods, each person laden with a ten litre bucket, me, a child, proudly carrying a one litre container. People would gorge on blueberries for a few short weeks, sell the excess, make mountains of blueberry jam. Every kid would be walking around with a dead giveaway of blueberry gluttony: purple lips. And then it was over for another year.

Think of it next time you buy your punnet of blueberries in the middle of February.

In the world where most fruit, vegetable and berries are farmed and/or transported across the planet we have lost a concept of seasonality. Even a 100 years ago these foods were not available everywhere all year round.  Is there any scientific evidence to suggest that eating food out of season or out of your area is harmful? Nope. But I don’t see any sense in chasing variety for variety’s sake.

“The most recent dietary survey data available for Australian adults – the National Nutrition Survey 1995 – showed an increasing number of foods being consumed by adults in that year compared with 1983 [44]. It is expected that the variety of foods consumed has continued to increase since 1995. This is largely as a result of cultural diversity in the population arising from waves of immigration from European countries after World War II and Asian and African countries since the 1970s [99, 100]. Initially, new varieties of fresh fruit and vegetables, grain (cereal) foods and different types of meat and legume/beans became available. Increasing demand for convenience and/or fast foods – also as a result of changes in social and economic conditions – has led to the availability of approximately 30,000 different types of foods and drinks [101]. However, many of these – particularly snack and fast foods and drinks – are energy-dense and nutrient-poor, so care is required to choose diets consistent with the Guidelines [102]. ” (the draft of ADG)

(my bold italics)

30,000 types of food? Looks like our diet is varied enough. And it’s not just the snacks, fast foods and drinks. Ask your grandmother if she knows what cous cous is (forgo this step if you grandmother is from North Africa).

Wow so much variety!

I am not for a minute suggesting that you should stick to the boring bland diet of steak and 3 veg (of which one is potato, the other is corn, the third is beans). But the concept of “you will develop a secret micronutrient deficiency unless you eat a huge variety of foods just in case” is dubious at best.

Once again they missed the mark, mistaking quantity for quality.

Milan vegetable market.

Lessons from history

Dairy products – foodstuffs made from mammalian milk.
Food Standards Agency UK

Cute child - check, sexist humour - check, false health claims - double check.

I hope you don’t eat margarine. Just like I hope you don’t smoke, drink alcohol excessively or do illicit drugs. Since margarine hasn’t been on my shopping radar for a while I just walk right past the brightly lit refrigerated shelves with hundreds of colourful tubs and packages straight to the “naughty corner” where a few lonely packs of butter have found refuge.

But recently a thought struck me as I was passing all that splendour: what is margarine doing in the dairy section of the supermarket? Or listed as “dairy” on the supermarket websites?

I will not bore you with the debunking of the so-called health claims of margarine. They all go along the lines of “we will save you from a certain death caused by the saturated fat in butter clogging your arteries”. Yawn. You can read  about the saturated fats here (Gary Taubes “What if It’s All Been a Big Fat Lie?”), here (Stephan Guyenet “Butter, Margarine and Heart Disease”) and here (Sylvan Lee Weinberg “The Diet-Heart Hypothesis: a Critique”).

Instead, I want to step away from the health conundrum to explore the history of margarine and its amazing rise from a lab-created inferior butter substitute to a major item in our shopping carts. I found myself more and more intrigued by the history (of food) as I get older which is scary because I find myself turning into my father: “Back in the days of the Empress Catherine the Great…” If you are under 30 and you are already bored come back in a few years.

History of margarine

Surprisingly enough, we can actually blame the French for the birth of margarine. The shortages of butter were crippling for the fat-loving nation in the middle of the 19th century. The war with Prussia was on the horizon and everyone knows you can’t feed cereal to soldiers. At the Paris World Exhibition in 1966 Louis Napoleon III announced a contest for the development of an acceptable butter substitute. In 1869 a French chemist by the name of Hippolyte Mège-Mouriés applied for a patent for a substance made from beef tallow emulsified with skim milk. He called it margarine, after a margaric fatty acid (considered a separate fatty acid at the time), and was subsequently awarded the government prize. The food industry began mass production but the product never took off. We can only imagine what the French public thought of spreading a colourless derivative of beef fat onto their morning croissants. My sympathies are entirely with them.

The Dutch firm Jurgen, one of the founding firms of Unilever (aha!),  bought the patent in 1870 and made a few improvements on the taste and the marketing. Other Northern European countries got in on the act, realising the potential of the new product.  It took awhile for the dairy industry to see the looming danger but by the end of the 19th century several countries had legislation in place to protect butter from the new kid on the block. The most bizarre of the margarine regulation laws was to have it coloured unappetising pink. Not surprisingly, it didn’t last.

As you can see at this point margarine is still largely an animal product. But with the growing shortages around the time of World War I and the development of food science new raw materials were required. The solution came in form of “vegetable” oils: soybean, cottonseed, canola, corn.

Quotation marks around “vegetable” are my little act of defiance against the food  industry which wants us to believe that these are vegetables because it makes it sound oh so wholesome. Until I see a potato oil on the shelf they are not vegetable oils (not even corn which is, of course, a grain)

The problem with oils is that they are, well, oily. But turns out that if you push hydrogen atoms through the oil under pressure in the presence of a metal catalyst such as nickel or palladium, you can solidify the oil. This basic biochemistry site gives a good description of what happens with unsaturated acids during hydrogenation.

Partial hydrogenation of unsaturated fatty acids leads to the formation of trans-fatty acids. Yep, we all know they are the real bad guys. Oops.

Over the next few decades margarine continued to develop as a combination of animal fats and seed oils. World War II brought the food rationing, relaxed legislation, (some might say more money behind the margarine manufacturers) which led to the margarine taking over the spread role from butter for the first time. The dairy industry was running out of ideas; their last resort was the colour advantage. Margarine companies were not allowed by law to mix yellow colouring into their product however they successfully circumvented that difficulty by selling a separate colouring which a housewife could mix with the margarine and serve to the unsuspecting dinner guests. The animal fat portion all but disappeared as the grain industries swelled up with government subsidies, especially in the US.

In the post war 1950 the diet-heart hypothesis started to make waves in the scientific and nutrition world and all of a sudden margarine went from a inferior and apologetic butter substitute for the poor to a heavily marketed health product. Housewives did not have to be ashamed of serving margarine in a butter dish any longer. Dr Ancel Keys said it was ok.

The rest, as they say, is history.  The word “margarine” is not even used very much anymore. Now we buy “spreads“, some of them are a combination of dairy and seed oils, some are pure seed oils promoted for their “heart healthy” polyunsaturated fat content. It is practically impossible to tease out which is which.

"When school is out each child needs their sandwich with Jurgen's Planta" 1916-1917. Run, kiddies, run!

Manufacturers still have to tread a thin marketing line between taste (the smooth softness and dairy aroma of butter) and the perceived unhealthfulness of saturated fats. Oh, how the tables have turned.  Now they apologise for butter. The fundamental difference between two products has been carefully ironed out and nowadays the terms “butter” and “margarine” are mostly interchangeable in the eyes of general public. So much so that if you ask for “butter” in a restaurant you are just as likely to get margarine.  If you attempt to raise the issue with an unsuspecting young waitress (poor thing,  she had no idea what she was in for when she was approaching my table), you’d be met with a blank look. Isn’t it the same thing? No, my dear, they are not. Just like when I order a piece of steak I don’t expect you to bring out a slab of tofu coloured red.

When can we restart calling these “foods” what they actually are? Imitation products,  lab-created and mass-produced to utilise agrarian commodities and chemically manipulated to suit the nutritional fad of the month.

And here is a little video on how to make butter.

How to make butter

I’m baaack!

Exactly one month ago my life was in perfect order. I was living in the relatively quiet part of a certain mildly disreputable Sydney suburb. I got up with an alarm clock every morning, put on a pair on sensible flat shoes (for running around the wards), a decent skirt and a top which wouldn’t raise eyebrows in the hospital. I would spend 1 hour on the train catching up on Twitter, Facebook and medical news on my iPad, the next several hours - diligently performing my duties as a medical student and pre-intern. One hour on the train writing a new blog post or commenting on some new nutrition rubbish in the mainstream media while foaming at the mouth. Gym, dinner, bed, rinse, repeat. And I thought I was so alternative. Ha!

This December saw this orderly (albeit quite boring) life turned upside down. I now wake up to the sound of kookaburras outside my window. I draw back the huge french windows to open up the lounge room to a little courtyard. If it’s not raining I grab a towel and walk down to the beach. The local beach is open for dogs and they run a riot looking quite delirious with happiness. Doggy cocaine. I walk on the sand and then over a little wooden staircase to get to the next bay where dogs are not allowed but children look just as delirious. I’m a sucker for punishment and spend about 20 minutes getting pummeled by the surf. I walk back to the house wrapped in a towel.

Spending 3 weeks with no workable internet saw me go through several stages of withdrawal: 1.frustration, 2.despair, 3.indifference, 4. what internet? it’s beautiful outside! My daughter loves every minute of being here. We went to the markets, picked strawberries, walked through the rainforest, explored local shops, learned a piano duet and went at least 7 days without eating out (that must be a record).

Funny thing: this month I spent less time thinking/talking/writing about Primal and Paleo lifestyle but I feel like I have really lived it. And it feels amazing. My Mum used to say that being close to nature made her soul rest. I was a nerdy stay-at-home teenager who bitterly resented my parents’ attempts to drag me out of the house on a weekend for skiing, camping or other nature-related activity of dubious value. I made a mental note yesterday to call my Mum and tell her that I now know what she was talking about all these years ago.

I am looking forward to starting work on January 15 and yes, I’m very aware that my life will be turned around again. But nothing can take away from the fact that I can now go for a bike ride before work, my daughter can go bodyboarding after school and my partner and I can have a stroll on the beach after dinner.

Lifestyle is so much more than just what you put in your mouth. If you eat Primal you might still be caught in the suburban trap just like I was. Getting rid of processed food-like substances is just the beginning.

New Zealand and Paleo friends

My week away from blogging was not spent in idleness. I spent 8 days in New Zealand, this trip was very productive from the point of view of Paleo, connections and more food for thought for my blog.

New Zealand is a gorgeous country. You get a sense that you are in for something special when you see the majestic mountain ranges sloping into the green water out of the airplane window. Together with Australia it’s one of the few Western countries where you can still drive past cows peacefully grazing on grass of the greenest colour imaginable.

iPhone photos do not do it justice

Visiting Christchurch for the first time was a powerful experience for me. It’s a quaint little city (by Sydney standards) still bearing visible scars of the earthquakes which changed the lives of its inhabitants. The walls of beautiful old churches, like the shadows of former life, standing in the midst of piles of bricks behind safety gates. Giant cracks in the middle of city streets partially filled up with concrete. Big signs urging caution on typical office buildings. Huge shipping containers stacked on top of one another at the bottom of the cliff on the side of a busy road protecting from boulders falling from above. All reminding us that we are all at the mercy of the force more powerful than we can imagine. And no, I’m not religious.

Like many other people around the world, I had wondered why do the people stay? 7000 aftershocks later, why would you not pack up your life and start over somewhere else? Where you wouldn’t have to worry about getting a restaurant table under a chandelier?

Maybe because it’s so utterly beautiful. A place where you can go out on a bike ride along the water edge, climb a steep hill to the coffee place up the top and descent to the luscious valley below. Nice. You can Paleo the hell out of this place.

And they seem to be getting on with their life just fine. Good on them, Kiwis. After flogging the Aussies (and the French, and everyone else) at the Rugby World Cup they have even more reasons for some well-deserved NZ pride. Respect.

I didn’t just travel across the ditch to admire the views. One of the goals of the trip was some Paleo networking, catching up with two of the heavyweights of the Antipodean Paleo community: Jamie Scott, a.k.a. That Paleo Guy, and Julianne Taylor from Paleo & Zone Nutrition Blog.

I cannot express what a relief it is to talk to people who understand you, who read the same studies, who get just as frustrated at the limitations of the conventional diet, health and exercise advice. Jamie played a gracious host in Christchurch and showed me around the city, his favourite cafés and cycling routes. We discussed high fat nutrition for athletes, agreed that #contextmatters when it comes to “safe starches”, shared our mutual plans for the Ancestral Health Symposium in 2012.

Jamie and I, about to tuck into a hearty breakfast

I met the lovely Julianne in Auckland and over our 3 hour lunch we discussed everything from thyroid health to the challenges facing medical professionals, body image pressure and undiagnosed gluten intolerance.

Julianne and I: turns out hair colour is not the only thing we have in common

Auckland, the city of sails (=winds), with its 7 seasons in one day, showed us glimpses of sunshine. The world cup fever has largely subsided however the Kiwis were still happy to remind us, the Aussies, who came out on top. The Auckland part of my trip was closely aligned with fitness industry, especially group fitness, and I will probably talk about my ideas on fitness in another post.

For those who are involved in Paleo/primal lifestyle and education in North America it is probably hard to understand how isolated we can feel on the other side of the globe, with the Internet being our only link to this community. Meeting like-minded people was like a breath of fresh air: no need to moderate your language or be tentative in offering different hypotheses. I came back home feeling recharged and fired up for more learning, sharing and blogging.

“Something is rotten in the state of Denmark…”

Edwin Booth as Hamlet, 1870. Source: Wikimedia Commons

Ah, Marcellus, something certainly is not right in the fair state of Denmark as of last Saturday. In case you have missed the hullabaloo in Europe, a new surcharge, colourfully dubbed by the press “the fat tax”, took effect in this small Scandinavian nation on October 1, 2011. As usual, it didn’t take long to generate a massive media hysteria. After reading over 20 reports on the internet and getting thoroughly confused by factual contradictions I managed to pull out the following info:

  • the tax applies to all foods containing >2.3% saturated fats
  • each kg (=2.2lbs) of saturated fat will collect a surcharge of 16 kroner (=$US 2.87)
  • the tax is introduced as part of obesity-fighting measures and $218 million US dollars expected to be raised will go towards preventative health
  • the goal of this intervention is to reduce saturated fat intake in Denmark by 10% and butter intake by 15%

As this article eloquently puts it:

“The new tax will be levied on all products including saturated fats, from butter and milk to pizzas, oils, meats and pre-cooked foods…”

Interestingly, Copenhagen Post was seemingly concerned about other foods items:

“The biggest price increases will be seen on fatty staple foods like butter, oils and high-fat dairy products like whipping cream and crème fraiche…”

Let me for the moment pass over the ridiculousness of the sentence which lumps an ancient traditional product like butter together with pizza and pre-cooked food-like-substances-in-a-box. To be perfectly honest, I know very little about Denmark. My impressions largely consist of Vikings, dams, environmental activism, Princess Mary, beautiful images of Copenhagen and yes, butter. So after 4 days of self-imposed post-exam laziness I got my iPad out and started reading up on the Danish health, economy, agriculture and food consumption.

Warning: a few graphs coming your way.

First a few Denmark trivia facts (Source: NationMaster.com country statistics)

1. The population estimate in Denmark today is over 5.5 million with population density of 129 per km2

2. According to the latest WHO data (2008) the actual obesity rate in Denmark is 18.2% not 10% as widely reported

3. Danish Big Mac Index is the fourth highest in the world at US$4.49

4. An average Dane goes to 6.1 doctor consultations a year

5. The life expectancy at birth is 77 for men and 81 for women, lower than in Finland, Sweden and even Australia (in your face, Danes! Even with our diabetes-crippled legs and sky-rocketing obesity rates we live longer!)

6.The average tax burden is 46%

7. Denmark is widely considered one of the happiest and least corrupt countries on the planet (not sure how it tallies with both #5 or #6 but good for them)

The World Health Organization updates a regular Non-Communicable Diseases profile for each country. You can look Denmark up here. Allow me share a few more interesting facts from that profile.

I was surprised to note that 24.6% of Danes still smoke cigarettes daily, a figure much higher than 16.8% of smokers in Australia or 15.6% in the US. If I had to choose a public health intervention…

Let’s take a look at the trends of some chronic disease markers as defined by the WHO: BMI, fasting blood sugar, systolic blood pressure and total cholesterol.

Blue line = men, orange line = women

Both average BMI and fasting blood sugar have been steadily climbing. That’s clear enough according to public health warriors. Butter -> extra calories -> overweight -> diabetes. This is how the conventional wisdom goes, n’est ce pas? Strangely enough, both systolic blood pressure and total cholesterol have decreased in the same period of time:

Obviously, this is just observational data and it doesn’t offer any causative relationship. Correlation does not mean causation (repeat this statement like a mantra if you work in public health). It could be that while the Danes still enjoy their high-fat dairy and meat their busy physicians prescribe them lots of antihypertensives and statins. If only we could get the Danish public to reduce their wicked butter and cheese habits, increase their intake of whole grains and vegetables and bingo! we would see those numbers plummet, life expectancy jump up, muffin tops melt away, relieved cows will be doing a happy dance.

Luckily my curiosity didn’t stop there. I wanted to see just how gluttonous the Danes apparently are. (Clarification: I don’t think they are gluttonous. As far as I’m concerned their government tells them that they are. I’m just following that logic). Statistics Denmark  kindly provides all sorts of fascinating data free of charge. I pulled out some food consumption data in Denmark and ran a comparison between the years 1990, 2000 and 2009. And in case you are wondering, I totally cherry-picked my data, using only 13 out of available 55, just because I found them most illuminating but you can look up the raw data yourself here StatBank Raw Data. Click on the chart for better resolution.

 

Human consumption kg per capita per year

Turns out that our butter-loving Danes are not eating that much butter after all: only 1.9 kg per person per year. So a desired 15% decrease in butter intake will result in…drum roll…1.6 kg per person. They consume 4 times more margarine than butter however thankfully their margarine consumption has also been declining in the last 20 years. What else can we see? Overall reduction in meat consumption since the 1990: 105.2kg to 83.6 kg. They certainly eat more beef and veal (18.8 → 24.8) but almost halved their pork consumption (64.2 to 35.8). Offal consumption is less than half of what it was even 20 years ago. In keeping up with the low fat trend, whole milk dropped 65% while white water, pardon me, skim milk jumped up over 400%. We have some increases in wheat flour and other grains, including a dieter’s staple, oats.

The other numbers that we are all dying to see are of course soft drinks (soda), industrial seed oils, sugar and the one I was always wondering about, a humble coffee shop favourite, the danish (do they even eat those?).

Overall Denmark looks like an awesome country: rich history, friendly people, gorgeous architecture. It’s a shame that their outgoing government in the desperate show of “we really care” brought a ridiculous tax which promises so much but delivers nothing other than panic at the supermarkets and more guilt about eating butter. I’d still love to come for a visit but next time I’ll bring my Lurpak from Australia.

“Dangerous habits” of celebrities

I’m still doing research and writing on children and catch up growth. This is a just little interlude.

Source: Wikimedia Commons

I have never thought I’d be writing a post about a celebrity. I’m not very celebrity-savvy mainly because I don’t read women’s magazines or watch much TV. I have only just found out that there is a person out there named Snooki and apparently she is as famous as Meryl Streep. I’m still perplexed about this but it just shows you that I’m way behind the times.

However, I know a few things about Miranda Kerr. She is Australian, she is gorgeous, married to Orlando Bloom (I hope my readers over 35 know who he is) and she is a Victoria Secret model. Not my typical blogging subject but bear with me. She first came on to my nutrition radar when she recently had a baby and continued to be remarkably sensible about it. Miranda was breastfeeding right left and centre and seemed hellbent on doing it well past the obligatory couple of months of breastfeeding for a celebrity. I was writing a few breastfeeding posts at the time and was impressed in spite of myself.

Miranda caught my eye again recently when she got into some hot water about eating coconut oil. Those of you in the Paleo world and my long time readers know that coconut oil is mostly made up of saturated fats, in particular MCTs (medium chain triglycerides). I first heard this story on the news. Yes, I know, a celebrity giving diet advice somehow makes the evening news. This is how it went down.

About a week ago the world of fashion, beauty and Botox went into meltdown when reports were published of Miranda Kerr “revealing her beauty secrets” to Australia’s Cosmopolitan.

I’ve been drinking it since I was 14 and it’s the one thing I can’t live without…I will not go a day without coconut oil. I personally take four tablespoons per day, either on my salads, in my cooking or in my cups of green tea.”

Big, big mistake, Miranda. You see, if you only followed some normal garden-variety weird celebrity diet and exercise plan nobody would have batted an eyelid. Look how many options you had available!

“Being vegan – eschewing all animal products – is a pretty hard slog.  But you can’t deny that it’s good for the environment, and good for our bodies, too.’
“Colonic irrigationist to the stars (yes, this is somebody’s actual job description) recommends Quintone, naturally harvested from oceanic vortex plankton blooms, it’s taken in liquid form and comes in a vial. It’s purely organic and is never heated, meaning that it is accessible by the human body: it’s easily absorbed in the intestinal tract, ie digestible.”

“BENEFIBER: This powdery fibre substance is flavourless but it packs a punch. Celebrities put it in their coffee or sprinkle it on their salads as it helps move food through you system more quickly.”

So in the world of the wacky, surely, Miranda’s “coconut oil habit”, as it was described by some of the media, is not much of a big deal? Not so. As we know many people feel very uncomfortable about saturated fats, and even more uncomfortable about the possibility of saturated fats being good for you. Subsequently, the attacks had a whiff of pathetic desperation.

The headlines went ballistic:

Doctors slam Miranda Kerr’s coconut oil habit
Experts warn against Miranda’s coconut oil habit (you’d think they were talking about cocaine!)
Experts doubt coconut oil will give you a body like Miranda Kerr’s (d’uh)
Miranda Kerr touts coconut oil, experts baulk
Habit harmful
Hollow promise

Wow, some strong words there. This stuff must be truly poisonous. Let’s see what the experts had to say.

“But experts said the oil, which is a saturated fat with a high calorie count and few vitamins and minerals, should not be consumed in such large doses, ABC News reported. The World Health Organization has also warned the oil could contribute to an increased risk of coronary heart disease if taken to excess. Keith Ayoob, director of the nutrition clinic at the Children’s Evaluation and Rehabilitation Center at the Albert Einstein College of Medicine, said the oil will not give you the body of a supermodel.
“She’s getting two and a half times the amount of saturated fat I would recommend for a person consuming 2,000 calories per day,” he said.
Dr. Robert Eckel, director of the General Clinical Research Center at Colorado Health Science University in Denver, also expressed concerns about the effect of the oil on a person’s cholesterol.
“Saturated fat intake does contribute to LDL [low-density lipoprotein] cholesterol, and that has been pretty well documented by research,” Eckel said referring to “bad” cholesterol.

Now I’m not advocating to listen to any celebrity for diet advice. But in Miranda’s defense:
1. She didn’t advocate that everybody does it
2. She is not talking about injecting bacterial toxins or getting a surgical cut to insert silicone balloons in her chest. It’s a natural product and a big part of the traditional diets of the Pacific populations, for crying out loud.
3. There are plenty of experts out there who will be willing to bet their career that coconut oil is good for you. Wonder why nobody interviewed them.

A few days ago Miranda put this message on her personal blog (the blog which incidentally has articles on organic farming, milk alternatives and gluten-free food) :

“I never did an interview with Australian Cosmopolitan magazine and unfortunately they have misquoted and misrepresented comments posted on my blog. When it comes to coconut oil, I personally find it beneficial and use approximately four teaspoons of coconut oil a day (in my salads and meals), not tablespoons. Everyone is different, but that is what works for me and I prefer it as a substitute to other oils more readily used in day-to-day food preparation and cooking. I suggest people consult with their health practitioner for what is right for them.”

Miranda’s perfect complexion might be good enough reason for some to indulge, albeit guiltily, in some coconut treats. For those of us who prefer more convincing arguments, here are some easy-to-read sources that are good to share with your fat-phobic friends.

1. Mary Enig PhD “Latest studies on coconut oil”

2. B.F. Fife “Coconut oil and health” Page 49 from “Coconut revival:new possibilities for the “tree of life” Proceedings of the International Coconut Forum 2005

3. Coconut Research Centre (also contains a collection of scientific articles)

4 G.Taubes “What If It’s All Been a Big Fat Lie? ” the original and still the best article on anti-fat hysteria