Although the title of his piece alludes to the fact that while statin use does lower cholesterol, it also increases your risk for diabetes by 9%, the crux of his post dealt with the overall foolishness of trying to treat chronic/lifestyle diseases with medications. Here’s a telling quote (the bold type is my addition),

The fundamental focus of lifestyle or functional approaches (which includes nutrition, exercise, and stress management) is the restoration of normal function and balance in each individual. When you do this, risk factors and symptoms go away automatically. Conventional interventions, on the other hand, are primarily focused on blocking, interfering with, or excising a biochemical or physical manifestation of disease. This is the reason biology shifts towards normal when using lifestyle medicine, instead of medication, and the only side effects are good ones: weight loss, more energy, better sleep, increased well being, a reduction of most disease, and increased longevity.

While it is still a matter of public debate, there is ample evidence that lifestyle therapies equal or exceed the benefits of conventional therapies such as medication and surgery. Nutrition, exercise, and stress management can no longer be considered alternative medicine. They are essential medicine, and often the most effective and cost-effective therapies to deal with the chronic disease epidemic that afflicts millions of Americans and is now the primary cause of death worldwide.

He also goes on to highlight the work of another doctor, Dr. David Ludwig, who suggests that our current dietary recommendations have been a key player in this increase in chronic disease.

A sentiment I echo 100%.

Dr. Ludwig points out that our singular focus on nutrients in isolation (i.e. carbs vs. fats. vs protein vs. vitamin C vs. fibre, etc) has led us to being a nation who “knows” more about our food than ever before, yet who understand absolutely nothing.

Let’s face it, the human body is pretty intelligent and remarkably adaptable. The adaptability is why we have civilizations that can exist on diets where over 80% over their energy comes from carbohydrates and others where less than 5% of total energy comes from carbohydrates or how it’s possible to have civilizations where daily alcohol consumption is integral to a healthy lifestyles and others where the best health is achieved by teetotalers.

And yet “nutrition experts” will argue till they are blue in the face about the superiority of one diet over another (high carb vs. low carb, vegan vs. meat centric, etc). “Experts” who suggest that by adding a particular “super food” to your diet, your health will dramatically improve. Or that the best dietary solution for everyone is contained by some generalist food guide.

Right.

As a result of the bastardization of our understanding of health over the past 50-100 years, we now have millions of people looking for the magic pill we can take that will “cure obesity”, “stop cancer” or “eliminate heart disease”. Which is sad… so sad.

Health Care in the Year 2010

Optimal health isn’t about putting more synthetically-derived compounds into your body, it’s actually about doing the opposite. If you want the “secret” to better health, here it is:

Stop

• Eating crap. Seriously, your diet sucks.
• Relying on prescription medication to treat chronic disease.
• Stressing about everything. Most things just aren’t that important.
• Expecting your health to improve without any effort on your behalf.

Start

• Moving more. Exercise isn’t a punishment, it’s a celebration of what makes us human.
• Building and sustaining meaningful relationships. Facebook is fun, but will it help you move a sofa?
• Appreciating that results take hard work. Although building a house out of bricks takes longer than one built out of straw, it also won’t crumble the first time the wind picks up.
• Eating whole foods. Don’t worry about calories, macros or % daily value. Your grandparents never knew how many calories were in the stew they ate, but they knew that eating stew was better for them than eating ice cream… and not one of them got diabetes at the age of 35.
• Making sleep a priority. It’s the cheapest and most dramatic body composition tool we have.

So there you have it, 9 “secret” strategies to implement today to dramatically overhaul your life. I realize that nothing on this list is either shocking or new, but that’s beside the point. The point is we need to start doing these things, otherwise our collective health will continue to spiral downwards.

Till next time, train hard and eat clean!

Related posts:

1. Multivitamins: Does a Body Good?
2. 30 Things I’ve Learned by 30
3. H1N1: Looking Back 1 Year Later

Although certain cooking methods are less favourable (i.e. boiling), cooking actually enhances your body’s ability to absorb other nutrients. For demonstration purposes, I’ve included a study that looked into various cooking methods used with broccoli. Additionally, it compared both fresh and frozen vegetables.

J. Agric. Food Chem. 2010, 58, 4310-4321

If we look at the dotted line, that’s the value of raw vegetables. With the exception of boiling, the other cooking methods either preserve nutrition quality at 80% or better and occasionally, make nutrient absorption superior to the raw version. Fresh vegetables are generally superior nutritionally to frozen vegetables, but both are good for you.

Canned vegetables are much poorer options nutritionally as they are packed with salt and occasionally can pick up harmful residues from the inside of the cans (particularly acidic vegetables like tomatoes: The 7 Foods Experts Won’t Eat).

The key when cooking vegetables is to limit how much direct time they are cooked in water, as many of the water soluble vitamins and phytochemicals leach out into the water. A quick cook in the microwave or steaming are both vastly superior cooking methods in this regard. A light stir-frying can also be used to preserve high levels of nutrition quality.

These rules about cooking vegetables don’t apply to leafy greens (they are best eaten raw) or really watery vegetables like cucumber. However, any vegetable with an appreciable fibrous content (i.e. broccoli, cauliflower, Brussels sprouts, carrots, peas, beans, asparagus etc) benefit from a light cooking method.

One final cooking tip, you never want to cook vegetables to the point of being mushy or discoloured. Only cook vegetables just long enough that they start to soften, but still retain their crunch.

So now you know, both fresh and lightly cooked vegetables are equally beneficial for you, just in different ways. If you struggle to digest raw vegetables (and many people do) then giving them a quick steam is a surefire way to make them easier on your system, while still giving you all the nutrition you need.

Till next time, train hard and eat clean!

Related posts:

1. Healthy Ideas for the Lazy: Vegetables in a Bag
2. Man Up and Eat Your Vegetables
3. Novel Vegetable Recipes: Cauliflower Shepherd’s Pie

Our national holiday marks the unofficial start to our all-too-brief summer season and what is more quintessential Canadian summer than rushing outside to soak up some rays?

But before you run off to the beach or up to the cottage, you mustn’t forget about protecting yourself from the sun, right? I mean, that’s the message we’ve had drilled into our collective psyches over the past 30 years, often through the use of creative ad campaigns.

Take Australia’s sun protection message that began in 1981: Slip-Slop-Slap. This campaign, which counsels people to “slip on a shirt, slop on sunscreen, and slap on a hat”, has been heralded as both ingenious and necessary, given that Australia has one of the highest rates of skin cancer in the world.

Click here to view the embedded video.

Clearly, governments around the world have decided there’s tremendous value in promoting the message: too much sun exposure = skin cancer.

Given how diligent we, as Canadians, seem to be about applying sun screen before any outdoor activities, it appears as though we’ve received the “protect yourself from sun message” loud and clear… only one small problem: this message is in stark contrast to the data.

Don’t believe me? Take a look for yourself…

Remember when I mentioned that Australia started their Slip-Slop-Slap campaign in 1981? Well shortly after launching their sunscreen campaign, look at what happened to their skin cancer rates:

These data slides are taken from a presentation done by Ed Gorham and colleague from the Faculty of Family and Preventatitve Medicine at the University of California, San Diego. The following data slides come from their presentation on vitamin D, skin cancer and sunscreen (accessible at: Skin Cancer Sunscreen Dilemna).

Yowsa. That’s a pretty dramatic increase in skin cancer incidence. But one could argue these results are an aberration. Let’s see what other data is out there.

Off to the US where Connecticut, amazingly, has maintained a tumor registry ever since the 1930′s. Why they have such detailed records is beyond me, but I’m not complaining; it makes for a great analysis of historical trends. What do we see there?

Seems that up until about 50 years ago, synthetic sun screens of any kind were non-existent, as were skin cancer rates. Then in Connecticut, like in Australia, there is quite the damning evidence that once sunscreen use became more prevalent, skin cancer rates also rose dramatically. This is not good.

However, before we get too crazy, let’s acknowledge that this data is correlational. I suppose these relationships could be mere happenstance… except when you start to include controlled studies, you get a similar story.

Wow. At best, these data suggest that sun screen doesn’t work. At worst, they suggest that using sunscreen slightly increases your risk of developing skin cancer. Just what the heck is going on!?!?

Let’s consider the human-sun relationship logically for a second. Up until relatively recently on the evolutionary time-scale, humans were exposed to the sun’s rays pretty much 365 days a year without the benefit of sunscreen. We simply wouldn’t have been able to survive in cold climates, therefore we would have migrated to live in relatively warm climates with plenty of sun exposure.

But did our ancestors routinely die of skin cancer while living in warmer climates? Impossible to say, however, we need not only delve into historical speculation. We can actually test the sun exposure = skin cancer hypothesis today.

If sun exposure = skin cancer, if would be reasonable to expect that skin cancer rates would be highest in those areas of the world hovering around the equator, as they get sunshine year-round.

But when we look at these data, tell me what you see:

Data obtained from the Cancer Research UK website

It certainly doesn’t appear that people living in sunny areas of the world are particularly predisposed to developing skin cancer. Nor is it a slam-dunk argument that only fair skinned individuals get skin cancer, as Eastern Europeans and the Japanese are both quite fair skinned, yet exhibit low rates of skin cancer.

If anything, it seems as though nations that get less sun exposure, or whose vocations tend to be indoors, rather than outdoors seem to be at greater risk for developing skin cancer.

Hmmm… could it be that the fact that humans managed to co-exist with ample sunlight for millennia upon millennia without any problems should tell us something? Might routine sun exposure actually be health promoting? Might our recommendations for sun avoidance be grounded in folly?

If you answered yes, yes and yes, pat yourself on the back. The reason why sun avoidance and an over-prescription of sunscreen makes zero sense has to do with vitamin D production.

Our uncovered skin produces vitamin D following sun exposure. Specifically, our skin produces vitamin D after exposure to UVB light (the wavelength most prevalent between 10 AM and 2 PM). In as little as 20 minutes of UVB sun exposure, a human will produce anywhere from 10,000-20,000 IU of vitamin D.

I know our current recommendation for vitamin D is only 400 IU per day and that you fear producing 20,000 IU of vitamin D might cause you to overdose. I mean, who hasn’t heard that fat soluble vitamins, like vitamin D, are potentially toxic? That the sun’s rays between 10 AM and 2 PM are the most “deadly”? Thankfully, the reality is that you’ve got nothing to fear.

In theory humans can overdose on vitamin D supplements, but one lovely fact about our physiology is that we shut off vitamin D production once we reach an optimal level. Our bodies are pretty smart like that.

Well realizing that our bodies have evolved a mechanism of producing a critical nutrient from the sun and a natural mechanism to cease production when we have enough is certainly comforting. But what about the recommendations saying we only need 400 IU of vitamin D per day?

Turns out that that amount of vitamin D is enough to prevent rickets, but nowhere near the amount needed to optimize your immune system and hormone regulation as a whole.

Now I’ll be the first to caution anyone against deliberately cooking themselves to the point of getting a sunburn. However, even a mild sunscreen, SPF 8, will block over 90% of our vitamin D production.

For a northern nation where UVB sunlight is virtually non-existent from October through April, limiting our already brief window of natural vitamin D production doesn’t seem like all that smart of an idea.

Good Canadian… bad science

But what exactly does vitamin D do for us?

Vitamin D is actually a group of fat-soluble secosteroid hormones. Given that it is a hormone, vitamin D has a wide range of effects on the human system. Among the systems or conditions that benefit from vitamin D are:

• immune system function
• influenza protection
• heart disease
• stroke
• hypertension
• autoimmune diseases
• diabetes
• depression
• chronic pain
• osteoarthritis
• osteoporosis
• muscle weakness & muscle wasting
• birth defects
• periodontal disease
• and 17 types of cancer!

Phew. That list is quite extensive isn’t it? If you said that vitamin D positively affects every single meaningful healh condition currently affecting humankind, you probably wouldn’t be too far off the truth.

Obviously I’m going to draw your attention to the last point, that increasing vitamin D production protects against 17 types of cancer. Even if we could conclusively prove that excess sun exposure caused skin cancers (and from the data above, it doesn’t really appear that way), does it make a whole lot of sense to increase your risk for all of the above disorders in order to protect yourself from one of the most treatable forms of cancer?

Recently, Dr. Mike Eades (a bariatric doc and someone with a strong appreciation for evidence-based medicine) wrote a couple of brilliant articles about sun exposure and cancer rates. If you’ve got 5 minutes, I strongly recommend you check his most recent post: Heliophobe Madness.

Among the many valuable points he makes, is a stunning comparison between the mortality from skin cancer vs. breast, colon and prostate cancers, three cancers that are linked to a deficiency of vitamin D. He quotes data from the American Cancer Society which reports that in the US in 2009, 40,230 people died from breast cancer, 32,050 from prostate cancer and 51,370 from colon cancer. That makes 123,650 individuals who died from these cancers combined.

By contrast, 8,700 US individuals people died from skin cancer. So even if sun exposure leads to skin cancer, we are pushing an intervention, massive sun screening, to protect against one of the mildest and most treatable forms of cancer, in exchange of increasing people’s risk of developing far more deadly forms of cancer.

Makes sense to me… or not.

Since this post has already gone on forever, I’ll wrap it up here. But if you are interested in learning more about vitamin D and the misguided science behind sunscreens, I suggest you check out this short video:

Click here to view the embedded video.

If you’ve got an interest in learning more about this important topic, I urge you to check out Ed Gorham’s excellent presenation on vitamin D production, sun exposure and sun screens:

Click here to view the embedded video.

Alright now… go enjoy yourself some of the health promoting UVB sunshine. Just don’t try to get an entire summer’s worth of sun exposure in a day

Till next time, train hard and eat clean.

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2. Multivitamins: Does a Body Good?
3. Take Statins, Get Diabetes

During an interview the other day, I was asked whether multivitamin supplementation was necessary or even beneficial. Although it’d be nice to have a definitive answer to both those questions, like most other aspects of nutrition, the answer is usually “it depends”.

A lot of time and words have been spent debating the relative merits of multivitamins. The common argument against multivitamin use is that people can meet all their nutrient needs from food alone. This statement presupposes two things: 1) nutrient needs are defined as the amounts required to prevent acute disease (i.e. rickets, scurvy, or pellagra) and 2) most people are willing to eat a healthy diet.

In reality, gearing nutrient recommendations towards the prevention of acute disease is a little shortsighted. Although our dietary recommendations do keep people from suffering the immediate, ill-effects of insufficient vitamin and mineral intake, there is growing evidence that many of our current recommended intake levels are insufficient for the prevention of chronic diseases such as cancer or heart disease.

Take for example, vitamin D. Our current recommended intake of vitamin D is 400 IU, which we’ve determined to be adequate to prevent rickets. However, general consensus is that vitamin D intake at the level of 1000-2000 IU is optimal for cancer prevention. Given a glass of milk only provide 100 IU of vitamin D (1/10th the required amount) and that most people aren’t salivating at the prospect of consuming the three cans of sardines daily needed to cross the 1000 IU threshold, opting to go the supplement route starts to sound a whole lot more appealing.

A second problem with saying that people can get all the vitamins and minerals they need from food is that they don’t. Astonishing as it may sound, as many as 35% of North Americans are not even consuming the 5 servings of vegetables and a fruit a day considered to be the MINIMUM requirement. Clearly, the “eat healthy” message has yet to sink in for many North Americans. Considering we can’t convince people to do the bare minimum, getting people to consume enough vegetables and fruit to optimize health is likely a pipe-dream.

Even the conservative American Medical Association has changed their anti-multivitamin stance in 2002 to endorse the utility of multivitamin supplementation in the war against chronic disease. But simply recognizing multivitamins as potentially beneficial is not enough, people need guidance in making proper choices.

One of the problems with supplements of any type is the issue of quality. Just as the “beef” in a McDonalds hamburger is a very different animal than grass-fed, organic, free-range beef (pun fully intended), the quality of many supplements lining the shelves tends to be quite variable. Remember, just because you can buy 240 multivitamin pills for $15, doesn’t mean you should. Quality comes at a price, whether we are referring to food or supplements.

Many cheap supplements are cheap for a reason. They may not contain what they claim to on the label, they may be providing an inferior form  of the supplement in question or they may contain such a low dose of the active ingredient that no possible benefit could ever be obtained even if you were to consume the entire bottle in a single sitting (warning, don’t ever consume a whole bottle of anything just to test this theory).

An additional consideration is absorption. People in the nutrition business love the phrase, “you are what you eat”. Not a bad saying, however in the interests of accuracy it should be, “you are what you absorb”. If you aren’t absorbing your food or supplements properly, then you are flushing money and potential health benefits down the drain. Considering vitamins and minerals, minerals in particular, are poorly absorbed at the best of times, the issue of bioavailability is a very real concern.

One of the most useful reviews I have come across on the topic of multivitamins is the Multivitamin Guide, written by Lyle MacWilliams (download available here: Multivitamin Guide: 2009 Edition). In the guide, McWilliams has short-listed 510 multivitamin formulations currently sold in Canada and the US. and gives each product a percentage ranking out of 100. He bases his rankings on a number of factors including:

Out of the 510 products he tested, a mere 8 scored higher than 80%. His top 4 formulations: Essentials by USANA Health Sciences, Ultra Preventative X by Douglas Laboratories, Extend Plus by Vitamin Research Products and Life Force Multiple by Source Naturals are superior products offering considerable benefit. Unfortunately, none of these products can be considered cheap, as the cost per day ranges from $1.50-$2.50. While these products might exceed the budget of most people, keep in mind they back up their costs with high standards of purity and bioavailability.

Among the guide’s most eye-opening findings was that the majority of the popular “one a day” tablets were essentially worthless. Manufacturers such as Centrum, Jamieson, Equate, Kirkland, Life, and One a Day all scored pretty abysmally, with GNC not doing much better. These products scored so poorly, it’s not a stretch to say they add little benefit to anyone’s diet and should largely be avoided.

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Therefore, to answer those questions from earlier, are multivitamins beneficial or necessary? In terms of benefit the answer should be: no, not if you are buying a cheap multivitamin. If, however, you are opting for a high-quality multivitamin, your health stands to benefit in a meaningful way.

As to whether multivitamins are necessary, let me put it this way. If your diet consists predominantly of pesticide-free, in-season vegetables and fruits, sprouted grains and a proper complement of organically-raised, pasture-fed animal proteins, then you’re pretty set from a vitamin and mineral perspective. Alternatively, if you tend to be a creature of habit who eats the same foods every day and whose diet contains a meaningful percentage of processed foods, then adding a high-quality multivitamin is a wise investment.

Remember, your goal should always be to focus on food first and supplements second. No pill in the world will undo a steady diet of deep fried candy bars and Frappamocachocolatto frozen beverages. But with today’s radically altered food supply, increasing environmental toxins and constant stressors, a high-quality multivitamin can help “fill-in the cracks” in anyone’s diet.

Making it a priority to invest in high quality foods and supplements is a smart decision. Even if you aren’t prepared to shell out $2 a day for a multivitamin, there are many products available to suit everyone’s tastes and budgets. To assist you in making an informed decision, I strongly recommend the Multivitamin Guide as the place to start.

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2. Guinness, Does a Body Good?
3. Blinded by the Light