Archive for August, 2017

Interesting items from my inbox and elsewhere …

Given all the arterycloggingsaturatedfat! headlines we’ve seen over the years, I have to admit this headline made me chuckle:

Low-fat diet could kill you, major study shows.

That’s from an article in The Telegraph, and I’d say it’s wee bit overblown. We are, as usual, talking about an observational study. Here are some quotes from the article:

Low-fat diets could raise the risk of early death by almost one quarter, a major study has found.

The Lancet study of 135,000 adults found those who cut back on fats had far shorter lives than those enjoying plenty of butter, cheese and meats.

Researchers said the study was at odds with repeated health advice to cut down on fats. Those doing so tended to eat far too much stodgy food like bread, pasta and rice, the experts said, while missing out on vital nutrients.

Yeah, yeah, okay. So the real risk (again, in an observational study) is consuming too many processed carbs.

An article in Science Daily provided less-dramatic quotes:

Contrary to popular belief, consuming a higher amount of fat (about 35 per cent of energy) is associated with a lower risk of death compared to lower intakes. However, a diet high in carbohydrates (of more than 60 per cent of energy) is related to higher mortality, although not with the risk of cardiovascular disease.

The data are from the Prospective Urban Rural Epidemiology (PURE) study which followed more than 135,000 people from 18 low-income, middle-income and high-income countries. The study asked people about their diet and followed them for an average of seven and half years.

The research on dietary fats found that they are not associated with major cardiovascular disease, but higher fat consumption was associated with lower mortality; this was seen for all major types of fats (saturated fats, polyunsaturated fats and mono unsaturated fats), with saturated fats being associated with lower stroke risk.

We’re talking about food questionnaires and all the usual problems with observational studies on diet and health. I wouldn’t make too much of this one. But since observational studies were the source of arterycloggingsaturatedfat! hysteria in the first place, I suppose it’s nice to have one to wave in the faces of the anti-fat warriors. Fair is fair.

A man-tax for vegans?

A vegan restaurant in Australia has started charging men extra for the same meals. An article in The Sun explains why:

A cafe is making waves after it began charging blokes more money in a bid to close the gender pay gap. The feminist vegan owner of Handsome Her eatery in Melbourne, Australia, is making them pay an 18 per cent “man tax” as well as giving women priority over seating.

A feminist vegan owner. Sounds like a fun person to be around. I’m thinking of a joke …

Q: How many feminist vegans does it take to change a light bulb?
A: Your aggressive humor is NOT FUNNY, you ciscentric ANIMAL MURDERER!!

Anyway …

Owner Alex O’Brien told Broadsheet website: “I do want people to think about it, because we’ve had this (pay discrepancy) for decades and decades and we’re bringing it to the forefront of people’s minds.

“I like that it is making men stop and question their privilege a little bit.”

I don’t know the breakdown in Australia, but in the United States, 79 percent of vegans are women. So I wonder if the “man tax” might make a few men stop, question their privilege, then go order a hamburger at another restaurant.

This may ignite a new debate about the costs of obesity.

WCPO in Cincinnati reported on an unusual fire:

A “freak accident” started an unscheduled fire Wednesday night at the Hillside Chapel Crematory in Cincinnati, owner Don Catchen said.

“My operator was in the process of cremating remains and (the body) was overly obese and apparently it got a little hotter than the unit is supposed to get,” Catchen said. “One of the cremation containers that we had close got caught on fire and that’s what burnt.”

I’m not overly obese, but I like to think I could start a similar fire just because so much of my body mass began as sausage and bacon.

The danger of fires when cremating obese bodies isn’t an entirely unknown issue for the funeral service profession: “As you may realize, when a morbidly obese person is cremated, there’s a danger of what can only be called (in layman’s terms) a ‘grease fire,'” according to Caleb Wilde, a licensed professional who runs the blog Confessions of a Funeral Director.

In October 2014, a Virginia facility caught fire while cremating a 500-pound body. Fire investigators there said excessive heat ignited rubber roofing near the crematorium’s smoke stack. Another fire, two years earlier in Austria, left firefighters “covered with a layer of sooty grease.”

Good grief. If this keeps up, Meme Roth will be demanding higher funeral costs for obese people.

Global Warmi –er, Climate Change, part one.

Some perfesser I saw interviewed years ago explained the politics of how to get a study funded in today’s academic environment: if you title your proposed paper something like The Migratory Patterns of Squirrels, you probably won’t get funding. But if you title it something like How Gobal Warming Is Affecting The Migratory Patterns of Squirrels, you will get funding. Then you can study those migratory patterns.

I thought about that while reading this article in Science News:

A dinner plate piled high with food from plants might not deliver the same nutrition toward the end of this century as it does today. Climate change could shrink the mineral and protein content of wheat, rice and other staple crops, mounting evidence suggests.

Selenium, a trace element essential for human health, already falls short in diets of one in seven people worldwide. Studies link low selenium with such troubles as weak immune systems and cognitive decline. And in severely selenium-starved spots in China, children’s bones don’t grow to normal size or shape. This vital element could become sparser in soils of major agricultural regions as the climate changes, an international research group announced online February 21 in Proceedings of the National Academy of Sciences.

That global warmi—er, climate-change thing sounds awful. If only we could identify the major causes.

Global Warmi –er, Climate Change, part two.

Thank goodness, an article in the U.K. Daily Mail tells us what’s driving climate change:

Feeding our beloved cats and dogs plays a ‘significant role in causing global warming’, a shocking study has revealed.

My, that is shocking … the shocking part being that anyone believes this hysterical nonsense.

Pets have heavily meat-based diets which requires more energy, land and water to produce.

Rascal, our family cat, is a sweet little dude. In fact, he’s lying at my feet as I write.  But I’m pretty sure if I stopped feeding him a meat-based diet, he’d sneak into the bedroom some night and rip chunks of flesh from my face.

Research from the University of California, Los Angeles, found pets are having a big impact on environmental issues such as climate change.

You mean there are other environmental issues pets are affecting? Are they causing acid rain too?

Feeding cats and dogs is creating the equivalent of 64 millions tons of carbon dioxide a year in the US alone, according to shocking new research.

That’s twice the reporter was shocked. She should probably find somewhere to calm down … say, in a vegan restaurant that charges men extra. She’ll get priority seating.

The paper found pets are responsible for 25 to 30 per cent of the environmental impact of meat consumption in the US.

So it’s not the pets themselves; it’s the MEAT that’s causing all that climate change. Maybe we should all become vegetarians to save the planet. But then we’d have to deal with …

Global Warmi –er, Climate Change, part three.

Perhaps ordering a salad instead of a burger won’t save the planet after all, according to an article in Scientific American:

Bacon lovers of the world, rejoice! Or at the least take solace that your beloved pork belly may be better for the environment in terms of greenhouse gas emissions than the lettuce that accompanies it on the classic BLT.

This is according to a new study by researchers at Carnegie Mellon University who found that if Americans were to switch their diets to fall in line with the Agriculture Department’s 2010 dietary recommendations, it would result in a 38 percent increase in energy use, 10 percent bump in water use and a 6 percent increase in greenhouse gas emissions.

And here I thought I was ignoring the USDA dietary guidelines because they’re full of @#$%. Turns out I was also saving the planet. Pass the bacon.

The reason for this is because on a per-calorie basis, many fruits, vegetables, dairy and seafood—the foods the USDA pushes in the guidelines over sugary processed food and fats—are relatively resource-intensive, the study finds. Lettuce, for example, produces three times more greenhouse gas emissions than bacon.

Chareva grew some lettuce this year. I didn’t think to go out to the garden with some equipment and measure the gases they were emitting. An opportunity lost.

“You cannot just jump and assume that any vegetarian diet is going to have a low impact on the environment,” said Paul Fischbeck, professor of social and decision sciences and engineering and public policy and one of the authors of the study. “There are many that do, but not all. You can’t treat all fruits and veggies as good for the environment.”

Fischbeck said that even though it seems counterintuitive, the best diet for the environment would be terrible for a person’s health. “If you totally forget health, which diet would have best impact on the environment?” Fischbeck asked. “You’d eat a lot more fats and sugars.”

Hmmm, in that case, here’s how I suggest we handle all this conflicting data: eat the diet that’s best for your health, period. If you feel guilty about including climate-damaging meat in your meals, do your part for the planet by getting rid of your meat-eating dog.

Or maybe not …

Global Warmi –er, Climate Change, part four.

Here are some quotes from a PBS article online:

If you’ve decided to go vegan because you think it’s better for the planet, that might be true—but only to an extent.

A group of researchers has published a study in the journal Elementa in which they describe various biophysical simulation models that compare 10 eating patterns: the vegan diet, two vegetarian diets (one that includes dairy, the other dairy and eggs), four omnivorous diets (with varying degrees of vegetarian influence), one low in fats and sugars, and one similar to modern American dietary patterns.

What they found was that the carrying capacity—the size of the population that can be supported indefinitely by the resources of an ecosystem—of the vegan diet is actually less substantial than two of the vegetarian diets and two out of the four omnivorous diets they studied.

Lower carrying capacity? Must be all that lettuce in the vegan diet …

If modern agriculture in the U.S. were adjusted to the vegan diet, according to the study in Elementa, we’d be able to feed 735 million people—and that’s from a purely land-use perspective. Compare that to the dairy-friendly vegetarian diet, which could feed 807 million people. Even partially omnivorous diets rank above veganism in terms of sustainability; incorporating about 20 to 40% meat in your diet is actually better for the long-term course of humanity than being completely meat-free.

Well, that is a relief. Especially in light of …

Americans eating more beef.

Here are some quotes from an article in USA Today:

As backyard grills fire up this summer, one thing is clear: Americans no longer have a beef with beef.

Thanks to lower prices, more disposable income and a guarded thumbs-up from the wellness community, the once-maligned meat is now seen by many shoppers and diners as an ingredient in a well-balanced and even trendy diet.

Americans ate an average 55.6 pounds of beef in 2016, up from 54 pounds in 2015, according to the Department of Agriculture. This comes after a decade during which U.S. beef consumption plummeted 15%.

The article attributes much of the rise in beef consumption to falling prices, but then adds this:

The increase of meat-intense diets, such as paleo and keto, has also jump-started America’s rekindled love affair with all things cow. Gone are the days of dismissing meat as a heart attack inducer or the unsophisticated grub of Middle America. Now, there’s a premium segment that’s lighting up diners, thanks to their increased demand for organic and grass-fed beef.

As an unsophisticated inhabitant of Middle America, I’m happy to include beef in my grub. But I may have Chareva start charging me a man-tax.

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My mom called on Saturday to tell me she’d found a digital picture frame I gave her 10 years ago.  You know, the kind that displays a slide show of pictures, dissolving from one to the next. She told me she both laughed and cried.

She laughed at the pictures of my girls as toddlers – they were quite expressive back then. She cried because some of the pictures were of my dad with the girls. He was so tickled by them, even though his memory was already starting to fade. I know he’d enjoy them immensely today if he were alive and coherent.

Today would have been my dad’s 83rd birthday. I thought about that while looking at my favorite picture of him, the one I keep in my office at home. He’s 57 years old in the picture, and the traits that most defined his personality – the intelligence and the wit – are obvious in the eyes.

I’ll give you just one example of his sense of humor: many years ago, during a conversation about burial vs. cremation, Dad said, “When I die, dump my ashes in the water hazard on the 17th hole at Lincoln Greens. I’d like to spend eternity with my golf balls.”

Dang, what I wouldn’t give for one more conversation with the man.

When his birthday comes around each year, I take it as a reminder of This Is Why We Do What We Do. When I was born, Dad was only 24. He began fading noticeably around age 70, when I was 46. It was painful to witness, but I was approaching middle age or already in middle age, depending on how you define it.

By contrast, I turned 45 the week after my daughter Sara was born. I was 46 when Alana came along 18 months later. If I fade at age 70, they’ll only be in their twenties. I like to think they’re going to want my fatherly advice for many more years beyond that. And even if they don’t, it’s like I said in Fat Head: I want to dance at their weddings. I want to play with my grandkids.

Chareva’s dad turned 75 on Saturday – in a hospital. He was hobbled by a stroke more than a year ago, and a few weeks ago, he fell and broke his hip while attempting to limp to the bathroom in the middle of the night. Fixing the hip required surgery. He ended up with blood clots in his legs, so he needed another surgery to implant a mesh designed to keep the clots from reaching his brain. Not exactly a happy birthday for him.

My dad smoked until he was 58, he drank too much, he didn’t exercise, and he paid little attention to his diet. Chareva’s dad did exercise and was a lean-mean-dancin-machine well into his sixties, but he kept eating his bagels and chocolate candies even after being diagnosed with type 2 diabetes.  I think it’s a fair bet the ever-worsening diabetes led to the stroke.

I’m not criticizing them; I’m just pointing out that the lifestyle decisions we make have consequences.

We’ve both seen our dads lose their quality of life by age 74. I’ll be that age in 15 years, and when I think about what our dads went through, I say to myself, No way in hell. In my nineties, maybe, but not in my seventies.

This Is Why We Do What We Do. It’s nice when people express genuine surprise that I’m pushing 60 (as happened at the office last week), it’s great to be able to do physical farm work on Sunday morning and still hit the gym for a workout on Sunday afternoon (as happened yesterday), and it’s satisfying to wear smaller pants now than I did 20 years ago.

But that’s not really what this is all about. It’s about feeling confident that if I avoid stepping in front of the proverbial bus, I’ll be dancing at my daughters’ weddings … and perhaps watching their daughters graduate from high school.

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Several people have emailed to ask if I’m going to watch and critique What The Health, the latest vegan-propaganda movie.

Uh … no.  I see no reason to torture myself.  I’m pretty sure I can guess what kind of “science” they quote throughout: the same cherry-picked observational studies they cite in all the other vegan-propaganda films and books.  I dealt with the topic long ago in a post titled To The Vegetarian Evangelists.

I did hear that the film claims eating one egg damages your health as much as smoking five cigarettes.  To any vegans who believe that, I’ll make you an offer: I’ll continue eating three eggs per day, and you start smoking 15 cigarettes per day.  Then we’ll compare health status 10 years from now.

Nina Teicholz, author of the terrific book The Big Fat Surprise, already shredded What The Health on the Diet Doctor blog.  ‘Nuff said.

But just for grins, I thought I’d post a speech given by Dr. Georgia Ede in which she goes through the (ahem) “evidence” that the World Health Organization (WHO) cited when it claimed meat is a carcinogen — a claim repeated in What The Health.  (If you think WHO’s stance on meat is anything other than political, you need to seriously rethink their motivation on this and almost every other issue.  Same goes for the United Nations, the parent organization of WHO.)

Anyway, here’s the speech.  Enjoy.

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I’ll turn 59 in November. That means in just 15 months, I should start taking a statin. That’s the conclusion of a new study reported in the U.K. Independent online:

Almost every older person should be taking statins, a new study has found. Almost all men over 60 and women over 75 should be taking the drugs, the research found. And more than a third of people between 30 and 84 should be allowed to do so.

Sure, let’s put all older people on statins. Society would really benefit by having more older folks with memory problems and damaged muscles.

The sweeping findings could suggest that GPs will be asked to prescribe the drugs to the majority of their patients, leading to huge strain on doctors.

That was, of course, my first concern as well. Oh my goodness! If we start giving statins to all older people, won’t that be a strain on doctors?!

The research looked to investigate the effects of guidance that was set by the National Institute of Health and Care Excellence (Nice) in 2014. That controversial ruling allowed many more people to receive statin therapy on the NHS, since it suggested that anyone with cardiovascular disease should be given the drug, and anyone with a more than 10 per cent chance of developing it in the next 10 years should take it too.

The latest study, published in the British Journal of General Practice, examined the algorithm endorsed by Nice for the assessment of CVD risk and compared it to data from the 2011 Health Survey for England to estimate the number of people who are eligible for statin therapy under the guidance.

Let me explain how that algorithm works: if you’re a male older than 60 or a woman older than 75 and still have a pulse, statistics say there’s a decent chance you may have a heart attack at some point in the future, so the algorithm says you should be on statins. The actual health of your heart doesn’t figure into it much.

Last month, I admitted that I’m a member of the anti-statin cult that Dr. Steve Nissen (America’s Statinator-In-Chief) blames for scaring people away from these wunnerful, wunnerful, life-saving drugs. So you won’t be surprised that I’m under orders from the cult leaders to explain why guidelines that would put nearly all older people on statins are complete nonsense. (I’m also under orders to smack myself in the head with my t-post hammer if the post doesn’t draw at least a thousand views, but I’m negotiating on that one.)

Advertisements for statins throw out impressive-sounding claims, such as reduces the risk of heart attack by 33 percent! If you didn’t know any better, you’d think a third of the people taking statins are saving themselves from a heart attack.

But of course, that’s not the case. That figure is derived from results like this: in a statin trial lasting some number of years, two of every 100 patients with known heart disease who took the statins had a heart attack, while three of every 100 patients with known heart disease who took a placebo had a heart attack. Two is one-third less than three, so the relative reduction is 33 percent.

But in absolute terms, it means for every 100 patients who took the drug, one was saved from a heart attack. So the number needed to treat (NNT) is 100. That’s the figure that matters.

There’s a site called The NNT that provides exactly those kinds of figures. Here’s what it says on the home page:

We are a group of physicians that have developed a framework and rating system to evaluate therapies based on their patient-important benefits and harms as well as a system to evaluate diagnostics by patient sign, symptom, lab test or study.

We only use the highest quality, evidence-based studies (frequently, but not always Cochrane Reviews), and we accept no outside funding or advertisements.

The b.s. guidelines suggested by the new study say almost everyone over a certain age should be on statins, whether they actually have heart disease or not. Here’s what The NNT tells us about statin trials conducted on people who don’t already have heart disease:

Benefits:
None were helped (life saved)
1 in 104 were helped (preventing heart attack)

Compare the statin groups to the placebo groups, and the combined results say not a single death was prevented by the statins. The statins prevented an average of one non-fatal heart attack for every 104 people who took them for five years.

Wowzers. Doesn’t that make you want to run out and fill that statin prescription as soon as you turn 60?

But wait, let’s not forget to look at the other side of the equation:

Harms:
1 in 50 were harmed (develop diabetes)
1 in 10 were harmed (muscle damage)

And keep in mind, these figures are mostly from studies published by the makers of statin drugs. In other words, they’re the most positive studies. We don’t know how many studies conducted by Big Pharma were simply dumped because the results were less-than-positive. Here’s what the gang at The NNT says on the subject:

Virtually all of the major statin studies were paid for and conducted by their respective pharmaceutical company. A long history of misrepresentation of data and occasionally fraudulent reporting of data suggests that these results are often much more optimistic than subsequent data produced by researchers and parties that do not have a financial stake in the results.

The combined results of these mostly-positive studies say 10% of the people on statins suffered muscle damage. I’ll bet you dollars to donuts (and you can keep the donuts) the figure in the real world is much higher. When Big Pharma conducts these studies, they screen out patients who report side effects from other drugs. So the population that goes into the study is less likely to experience side effects than the population at large.

But what the heck, let’s suppose the figure is actually the 10% reported in the studies instead of the 25% or greater I suspect we’d find in the real world. And let’s suppose you’re a man 60 or older, or a woman 75 or older, with no previous heart attacks or known heart disease. Let’s put you in a group of 100 of your peers and give you all statins. Here’s what would happen, according to the most positive data Big Pharma can produce:

  • One of you will be prevented from having a non-fatal heart attack, but none of you will be prevented from actually dying. (And preventing the one non-fatal heart attack will likely only apply to the men.)
  • Two or more of you will develop diabetes you wouldn’t otherwise have had (which increases the odds of heart disease or stroke down the line).
  • Ten or more of you will end up with damaged muscles, thus seriously reducing your quality of life.

I think we should ignore this latest edition of the Statins For Everyone! guidelines.

At least that’s what the cult leaders told me to say.

 

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No post today, other than to mention that we enjoyed the Great Eclipse of 2017.

Our property is about 15 miles south of the zone of totality — a term I never heard until recently.  We wanted the full experience, so we drove north to the Green Door Gourmet, a 350-acre organic farm outside of Nashville that puts on a number of events during the year.

That’s Chareva, her mom, and the girls in the radical-lookin’ shades below.  (Chareva’s dad, unfortunately, is still in the hospital after falling recently and breaking his hip.)

The shot below was taken just a few minutes before the total eclipse.  Amazing how much light there was, even with the sun mostly obscured.

The picture below was taken right around the time of the total eclipse.  My Canon camera does a fine job in low light, brightening things up a bit, so it actually appeared darker outside than the image suggests.

Once again, the camera exaggerated the ring of light around the moon in the photo below, but here it is anyway.  To the eye, the ring of light was just barely visible around the edges.

Two minutes of darkness, then it was all over.  Quite an experience, though.

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A doctor from Mexico emailed today to tell me he enjoyed the previous two posts on calories. He apologized for his English (which a lot better than my Spanish), so I cleaned up the spelling and punctuation a bit, but here’s how he views the explanation that people get fat because they consume more calories than they burn:

It’s like saying it rains because water falls from the sky.

Somebody replies, “No, really, WHY did it rain?”

And you shout, “BECAUSE WATER FELL FROM THE SKY! ARE YOU DUMB?”

Yes, it’s true that when it rains, water drops fall from the sky, but that is not WHY it rains. You are simply saying it’s raining because it’s raining. What is the meteorological explanation? What conditions get together to cause the rain?

And later in the email:

In weight gain, the cause in the majority of the cases is the alteration of the hormonal pathway that normally controls that area of the physiology. The human body has multiple mechanisms of regulation. For everything else, scientists have very complex biochemical explanations. But for obesity, all they have is a religious explanation of gluttony and sloth, expressed in a mathematical form.

The hormone that controls the storage of energy is insulin. There are other factors in obesity, but all of them are affecting the hormonal, physiological mechanisms of control.

Well said, Doctor – in any language.

As for those other factors, I thought I’d mention a couple that I left out of the previous posts because the posts were already lengthy.

How many fat cells do you have?

This is an area I hope gets a lot more attention in future research. Apparently scientists have only known since 2008 that the number of fat cells we carry as adults is constant. Here are some quotes from a New York Times article:

Every year, whether you are fat or thin, whether you lose weight or gain, 10 percent of your fat cells die. And every year, those cells that die are replaced with new fat cells, researchers in Sweden reported Sunday.

The result is that the total number of fat cells in the body remains the same, year after year throughout adulthood. Losing or gaining weight affects only the amount of fat stored in the cells, not the number of cells.

“There is a system waiting to be discovered,” said Dr. Jeffrey S. Flier, an obesity researcher and dean of Harvard Medical School.

Dr. Flier and other obesity researchers cautioned, though, that even if scientists knew how the fat cell system worked, it was not clear that it would be safe or effective to treat obesity by intervening. One of the hard lessons of the past couple of decades has been that the body has redundant controls to maintain weight.

Redundant controls to maintain weight? Nawww, this stuff’s simple. If you consume fewer calories, your body goes and retrieves calories from your fat cells to make up the difference, and you lose weight. Works that way for everyone … although I seem to recall writing this in the Fat Head Kids book, in the chapter where we explained that Marty Metabolism, the ship’s chief engineer, is like a super-complicated software application:

Like all important apps, Marty’s code includes something called redundancy. That’s a programmer’s term that means if one block of code doesn’t work, the program switches to another … and another, and another, until the command is obeyed.

Anyway, back to the New York Times article:

“This is a new way of looking at obesity,” said Dr. Lester Salans, an obesity researcher and emeritus professor at Mount Sinai School of Medicine in New York.

“I suspect that the body’s regulation of weight is so complex that if you intervene at this site, something else is going to happen to neutralize this intervention,” Dr. Salans said.

Complex regulation? If you intervene, the body may respond by neutralizing the intervention somewhere else?

Geez, these obesity researchers just don’t seem to get it. It’s a simple matter of calories in vs. calories out, so just cut the calories. No other intervention needed.

There was a time a few decades ago, before the current interest in how the brain regulates how much is eaten, when obesity researchers spent all their time studying and discussing fat cells. Investigators discovered that fat people had more fat cells than thin people and that fat cells shrank with weight loss and bulged with weight gain.

The result was the fat cell hypothesis, a notion that obsessed researchers. Fat cells, the hypothesis said, are laid down early in life and after that, they can change only in size, not in number. When people lose weight and their fat cells shrink, that creates a signal to fill the cells again, making people regain.

There’s more to the article, but here’s the important point: Yes, it appears that when we get fatter as kids, we do so mostly by creating new fat cells. But when we get fatter as adults, we do mostly by enlarging our existing fat cells.

I poked around online for more information and found that some researchers believe (but haven’t proved) the number of fat cells we’re born with is largely genetic. In other words, people with a tendency to get fat easily — a trait that clearly runs in families — may have been carrying more fat cells from birth.

I also found that lean people typically have between 25 billion and 35 billion fat cells, while fat and obese people may have anywhere from 75 billion to 150 billion fat cells. (Another study, by the way, demonstrated that adults can grow new fat cells if they gorge themselves to gain weight quickly, but it’s a few billion, not an extra 100 billion.)

So … let’s suppose I make it to adulthood at a lean 15% body fat and have 30 billion fat cells. Let’s also suppose I’m six feet tall and weigh 200 pounds. That means I’m carrying 30 pounds of fat – one pound for each billion fat cells. Let’s suppose that’s the normal size for fat cells.

Now suppose my best friend is also six feet tall and has about the same lean body mass, but is cursed with 150 billion fat cells, perhaps because of genetics, or perhaps because he became very fat as a kid.  Or perhaps a bit of both.

If his fat cells are the same size as mine, he’ll be carrying 150 pounds of fat. I weigh 200 pounds (170 lbs. lean, 30 lbs. fat), but he weighs 320 pounds (170 lbs. lean, 150 lbs. fat). I’m at 15% body fat, he’s at 47% body fat … but our fat cells are the same size.

If I live on pizza and beer during my 20s and balloon up to 250 pounds, I’m not saying it would easy to lose the weight. But to return to 200 pounds, I’d only have to shrink my overly-large fat cells back to their normal size.

But for my obese buddy to get down to 200 pounds, he’d have to shrink all his fat cells to one-fifth their normal size and keep them shrunk. I’d be very, very surprised if those redundant controls to maintain weight don’t fight against that.

So if change my diet and get back down to a lean 200 pounds, and my buddy changes his diet but only manages to get down to 245 pounds, it still means he shrunk his fat cells to half their normal size, while I merely shrunk mine back to normal. I’d be a bit of a jackass if I judged him a failure because he’s still 45 pounds overweight. His weight loss was almost certainly more difficult than mine, and will be more difficult to maintain.

Gut Bugs

In my review of the 2017 low-carb cruise, I wrote this:

Another lecture I enjoyed was delivered by Erynn Kay, a physician’s assistant who works with Dr. Jeffrey Gerber. She spoke about the importance of feeding our good gut bacteria – a topic I don’t believe gets enough attention in low-carb circles. Our hunter-gatherer ancestors weren’t gathering bacon, after all. They were gathering plants with fibers that feed the gut microbiome.

If you’re trying to lose weight by living on cheeseburgers, bacon, eggs, butter, heavy cream and a bit of broccoli now and then, you’re not feeding your gut bugs. Bad idea. That’s why there’s a chapter in the Fat Head Kids book titled To stay healthy, you need to feed trillions of your closest friends.

One of the low-carb doctors who does write extensively about the importance of feeding the gut microbiome is Dr. William Davis, author of Wheat Belly and, more recently, Undoctored.

Speaking of Undoctored, pardon me while I go on a bit of sidebar rant …

————————————————

In Undoctored, Dr. Davis stresses again and again that we can’t simply trust the health-care system (which he points out is a sick-care system that has little to do with health) to take care of us. We have to pay attention and be our own advocates.

We saw another example of that recently. Chareva’s father was hobbled by a stroke many months ago. He’s also an insulin-dependent type 2 diabetic. He recently fell and broke his hip while trying to limp to the bathroom in the middle of the night.

After surgery to repair the hip, he was placed in a rehab center. Someone forgot to tell someone else he’s a diabetic, even though it was written on the admission form. He wasn’t given insulin for four days, and only then because Chareva’s mom asked someone on the staff how his blood sugar was doing. Then, and only then, did a nurse finally check his blood sugar. It was over 600, and had probably been that high since he was admitted.

In an age when one-fourth of all senior citizens are type 2 diabetics, how in the @#$% do you not check a 75-year-old man’s blood sugar?

Don’t just trust the medical staff to pay attention and do their jobs. Ask. Demand.

End of rant.

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Anyway, here’s a video by Dr. Davis I think everyone on a low-carb or keto diet should watch and consider carefully:

In a post back in 2015, I explained why I went back to a high-protein diet. It’s still low-carb, but not VLC, and not ketogenic.  I gave the same explanation, albeit more briefly, during a Q&A session aboard the low-carb cruise later that year.

(Jimmy Moore was so upset with me for explaining why I dropped the keto diet, he bought me drinks in the bar later, encouraged me to give another presentation on the next cruise, and made plans to visit over Thanksgiving. You know how these with me or against me types think.)

Going with a low-carb approach (75 to 100 grams per day, sometimes a bit more) certainly gives me more flexibility. I like that. But more importantly, it means I can eat more of the foods that feed the gut microbiome.

Since I knew I’d be writing this post tonight, I measured and counted the ingredients in two of my meals today instead of just eyeballing them. I looked up the calorie and macro counts. I also checked my blood sugar reactions.

Breakfast was three eggs, two tablespoons of butter, a cup of shredded cheese, and a medium potato — cooked and cooled and then rewarmed. Add plenty of salt, mash it all together, and it’s delicious. It comes out to 770 calories, 37 grams of protein, 32 carbs. An hour later, my glucose peaked at 121. It was at 85 an hour after that.

Dinner was 4 ounces of chicken breast meat, one cup of refried black beans, one cup of shredded Mexican cheese, two tablespoons of sour cream, some hot sauce, and a big scoop of salsa. It comes out to 640 calories, 55 grams of protein, 41 carbs, and – the important part – 13 grams of fiber from the black beans. That’s the feed-the-gut-bugs part of the meal. My glucose peaked at 110.

In a podcast interview with Tim Ferriss, Dr. Peter Attia said most of the patients he put on ketogenic diets did very well. They lost weight and their lab markers moved in the right direction. But he said a dozen or so patients didn’t do well at all. Their markers moved in the wrong direction, and some of them gained weight quickly. So he did the smart thing and took them off the diet.

When asked, he said he doesn’t know why some people don’t get good results. Based on what Dr. Davis explained in the video, I’d say failure to feed the good gut bacteria might be part of the problem.

So don’t do that.  Feed your little friends.

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