The Potato Diet

Wednesday, December 19, 2012
In 2010, I wrote a series of blog posts on the health properties of potatoes (1, 2, 3).  The evidence showed that potatoes are non-toxic, filling per calorie, remarkably nutritious, and can be eaten as almost the sole source of nutrition for extended periods of time (though I'm not recommending this).  Traditional South American cultures such as the Quechua and Aymara have eaten potatoes as the major source of calories for generations without any apparent ill effects (3).  This is particularly interesting since potatoes are one of the highest glycemic and most insulin-stimulating foods known.

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Food Reward Friday

Friday, December 14, 2012
This week's "winner"...

The Pizza Hut hot dog stuffed crust pizza!

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Is it Time to Re-write the Textbooks on Insulin and Obesity? Part II

Thursday, December 13, 2012
A new paper published on December 6th in the journal Science once again tackles the question of whether elevated insulin drives the development of obesity (1).  Mice were generated that lack Jun kinases 1 and 2 specifically in immune cells, impairing their ability to produce inflammation while having very few off-target effects.  These mice do not become insulin resistant when placed on a fattening diet, and their insulin levels do not increase one iota.  Are they protected from obesity?  People who read the last post should know the answer already.
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More Predictions of Rate Shock Because of the New Health Law

Last week, I reported on my informal survey of health insurance companies and their estimate for how much rates will rise on account of the Affordable Care Act ("Obamacare").

Today, there are press reports quoting the CEO of Aetna with their estimate. The Aetna estimate is worse than mine.

From Bloomberg:

Health insurance premiums may as
much as double for some small businesses and individual

Conservative States: Do a Partnership Exchange? Expand Medicaid?

Sunday, December 9, 2012
Should states build their own health insurance exchanges under the Affordable Care Act (ACA) ("Obamacare")?

Should states expand their Medicaid programs under the ACA?

These are the tough questions many, particularly conservative, states are now wrestling with. While it is too late for a state to now decide to build an exchange before the fast approaching launch date, it is still possible to

Food Reward Friday

Friday, December 7, 2012
This week's "winner"... Kellogg's Krave cereal!



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Is it Time to Re-write the Textbooks on Insulin and Obesity?

Thursday, December 6, 2012
A recent study in Cell Metabolism by Dr. Arya Mehran and colleagues found a result that, according to a press release, "could overturn widely accepted notions about healthy eating habits" (1), and has set the Internet abuzz.

In this study, researchers generated mice that lack one copy of the pancreatic insulin gene, and compared them to mice carrying both copies (2).  Then, they exposed both groups to a fattening diet, and found that mice lacking one copy of the insulin gene secreted less insulin than the comparison group (i.e., they did not develop the same degree of hyperinsulinemia).  These mice were also completely resistant to fat gain, while the comparison group became obese.  The authors came to some rather grandiose conclusions based on these results, suggesting that the "accepted model" that hyperinsulinemia is the result of obesity is "incompatible with our results that put the insulin hypersecretion genetically upstream of obesity".  Ergo, diet causes hyperinsulinemia, which causes fat gain.  It's a familiar argument to those who frequent Internet diet-health circles, except in this case the hyperinsulinemia is caused by a high-fat diet.

The problem is that the "accepted model" they want to replace overnight didn't come out of thin air-- it emerged from a large body of research, which was almost completely ignored by the authors.  When carefully considered, this evidence suggests an alternative explanation for the results of Dr. Mehran and colleagues.

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The Affordable Care Act: Ten Months to Launch "Obamacare"––Get Ready for Some Startling Rate Increases

Tuesday, December 4, 2012
What will health insurance cost in 2014?

Will the new health insurance exchanges be ready on time or will the law have to be delayed?

There Will Be Sticker Shock!
First, get ready for some startling rate increases in the individual and small group health insurance marketplace due to the changes the law dictates.

In a November 2009 report, the CBO estimated that premiums in the individual

The Feds Will Administer the Insurance Exchanges for Twice What it Costs to Administer Medicare

Friday, November 30, 2012
The Obama administration just released another set of regulations, the "Draft Notice of Benefit and Payment Parameters for 2014."

Among many other things in the 373 pages, they have announced their proposed assessments to cover the cost of running the federal exchange.

In order for the feds to administer the new insurance exchanges, they have proposed a fee of 3.5% of premium on each insurance

Food Reward Friday

This week's winner... the Starbuck's Double Chocolaty Chip Frappuccino!



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Food Reward Friday

Friday, November 23, 2012
This week's winner: poutine!


While not as appetizing looking as the Monster Thickburger, poutine is probably more popular.  For those who aren't familiar, poutine is a large plate of French fries, topped with gravy and cheese curds.  It originated in Quebec, but has become popular throughout Canada and in the Northern US.

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Food Reward Friday

Friday, November 16, 2012
This week's winner: the Taco Bell Doritos Locos Taco!

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Healthcare System

Wednesday, November 7, 2012
Importance Of Technology In Healthcare System Healthcare is a business today and like any other business the major motto is profit. But at the same time technological advances are required because until and unless the caregivers provide advanced technology and advanced result the patients will not trust them. In most of the countries healthcare is in private sector and the completion has only improved the standard. Use of technology is not only noticed in the use of advanced diagnostic and surgery machineries, but it is also noticed in the administrative system. People want things to be more professional and for that automated report generation, data maintenance, online registration and checking, and other facilities are enabled. Different Sections Of Healthcare Today, healthcare is not only limited to doctors and patients. Many new professions have developed in this industry and both the professional and the patients are taking advantage of them. Posts such as clinical assistant, nurse, nursing assistant, therapist, medicine supplier, administrative staff and many more have come in the existence. Each of them has enriched the industry in its own way. The education and qualification needed for each of them is different and people are earning a lot of money by getting involved in these jobs. Cost Of Healthcare And Medical Insurances The cost of healthcare is not the same in all healthcare systems around the world. In some countries healthcare is a privilege offered by the government to its people. The cost here is quite less and in many cases the industry comes under the public sector or is partially managed by public sector. But in some other countries the cost is high but thanks to the medical insurances available for the people there, it can be afforded by many people. It is seen that in the third world countries the cost is still out of the reach and as the literacy level is low, people don't have much knowledge about insurances. Scope Of Development In Healthcare Though healthcare systems around the world has improved quite a lot in last few years, there are scopes of improvement still left in it. In some countries the technological advances can be accessed only by the rich. This is not a good sign because the poor are still suffering and dying. There are several researches carried out for finding medicine for life threatening diseases such as AIDs and cancer and in many cases success is achieved. A lot of investment was made for these researches. Though the good results are visible to the world the cost seems to be high. Healthcare system around the world is a growing sector of the market and as time will progress it will be enriched even more with new technique and new thoughts.

The 2012 Elections and 2013––We Face a Daunting To-Do List

The Affordable Care Act ("Obamacare") is now settled law.
It will be implemented. It will also have to be changed but not until after it is implemented and the required changes become obvious and unavoidable. We can all debate what those things will be (cost containment is on top of my list) but it doesn't matter what we think will happen––time will tell. 

There are and will be more lawsuits.
I

An Encouraging Trend

Sunday, November 4, 2012
I was in the Seattle/Tacoma airport today, and I noticed quite a few people taking the stairs even though they're flanked by escalators.  It's been my impression lately that more people are using stairs than even five years ago.  I used to be the only weirdo on the stairs, but today I shared them with about ten other people.  I know Seattle isn't necessarily representative of the nation as a whole, but I (optimistically) think of it as the vanguard in this respect.

One of the healthiest things a person can do is build exercise into daily life.  You don't have to be Usain Bolt or Lance Armstrong to reap the benefits of exercise.  In fact, evidence is accumulating that moderate exercise is healthier than extreme exercise.  Taking the stairs instead of the elevator/escalator, walking or jogging even a modest amount, or standing for part of the day, can have an immediate, measurable impact on metabolic health (1).

Maybe it's macho, but I'll feel defeated the day I need a giant energy-guzzling machine to take me up a 15 foot incline.  I have legs, and I intend to use them.  Escalators are good for people who are disabled or have very heavy bags, but the rest of us have an opportunity to use our bodies in a natural and healthy way.  Part of the problem is how buildings are designed.  Humans tend to take the path of least resistance, and if the first thing we come across is an elevator, and the stairs are grimy and tucked away down some side hallway, we'll tend to take the elevator.  Architects in some places are building in more prominent stairways to encourage gentle exercise throughout the day.

Food Reward Friday

Friday, November 2, 2012
This week's lucky winner... the Hardee's MONSTER THICKBURGER!



Two 1/3 lb beef patties, four strips of bacon, three slices of American "cheese", mayo and bun.  This bad boy boasts 1,300 calories, 830 from fat, 188 from carbohydrate and 228 from protein.  Charred and fried processed meat, fake cheese, refined soybean oil mayo, and a white flour bun. You might as well just inject it directly into your carotid artery.  Add a large fries and a medium coke, and you're at 2,110 calories.  Who's hungry?  Actually I am.  

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Food Reward Fridays

Friday, October 26, 2012
Each Friday, I'm going to post a picture of a modern food so ridiculous it makes you want to laugh and cry at the same time.  I'm doing this for two reasons:
  1. To raise awareness about the unhealthy, fattening foods that are taking over global food culture.  These are highly rewarding, highly palatable, energy-dense foods that drive people to eat in the absence of hunger, and continue eating beyond calorie needs.  In many cases, the foods have been specifically designed to maximize "craveability" and palatability.
  2. Because it's funny.
Without further ado... the first lucky winner:
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Tips For Anti Aging Skin Care

Tuesday, October 23, 2012
Getting good anti aging skin care advice can be difficult, especially without having to spend a lot of money. Thankfully, much of the anti aging skin care products and advice on the market doesn't really have to cost that much money. A lot of what is especially useful in the fight against aging is actually available in the home, making do-it-yourself regimens more possible than ever. For anti aging skin care, one of the best places to start is with body weight. As long as body weight stays similar to what it was in the late teens, skin care has a solid foundation to build upon. Of course, gaining weight is a part of life and there are few people who weigh what they did when they were eighteen. An anti aging alternative is to take supplements (buy vitamin b6 tablets or any vitamin b 50 complex product). These enable the skin to heal and grow properly without applying direct topical medications or serums to the face. An anti aging alternative is one of the best weapons in anti aging skin care. The chemicals in supplements can boost the output of the cells and the mitochondria, preventing the breakdown of the cells. The link between anti aging and food is also important. This is because anti aging skin care begins with taking care of what's inside. Skipping a meal a day or reducing food intake can have a direct effect on skin care. This occurs because of the reduction of insulin intake. Of course, a balanced diet will likely have the opposite effect. Other people swear by topical solutions such as anti aging lotions. These products, applied directly to the skin, can increase the vitamin count on the surface of the skin. Anti aging lotions are a common weapon in the anti aging skin care battle, but it is often not the most useful or beneficial. Instead, a basic regimen of some of the ideas we've mentioned combined with an anti aging lotion can be the best way to combat signs of aging. Anti aging skin care is about total body care. Taking care of the outside of the body and the surface of the skin will only combat half of the problems that lead to aging, so a full anti aging skin care plan must also look within.

Candy at the Cash Register

Saturday, October 20, 2012
Last week, the New England Journal of Medicine published an interesting editorial titled "Candy at the Cash Register-- a Risk Factor for Obesity and Chronic Disease."  This fits in well with our discussion of non-homeostatic eating, or eating in the absence of calorie need.

There are a few quotes in this article that I find really perceptive.

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Anti-Aging Research

Wednesday, October 17, 2012
Anti aging research provides a lot of information on the process of anti aging and the medications involved. The main goal of this research is the development of effective anti aging medicines and treatments. Many anti aging sprays, capsules, pills, tablets and therapies are the outcome anti aging research. Anti aging research aims to prevent, slow, or reverse the aging process. It is proved that some substances found in food and wine can extend human life. According to new anti aging research, caloric restriction with sufficient nutrition is the only way to reduce aging. Many findings of anti aging research confirm that natural herbs such as nopal cactus, gymnema sylvestre, reishi mushroom, konjac mannan, wild American ginseng and blueberry leaf can increase longevity. Along with caloric intake, there is a trend to use the fasting method to help extend life. Fasting has benefits beyond extending life; it is effective in helping overcoming certain diseases. When the intake of food is eliminated for a period of time, the body has a chance to repair itself through natural processes. According to anti aging research, the human growth hormone (HGH) can help with weight lose, boost the immune system, improve memory and mood, lower blood pressure, gain lean muscle and help in many other ways. With the recent discovery of anti aging mortality genes, genetic anti aging research has become a hot topic and many scientists are joining in. Recent research aims to reveal anti-aging technologies that could prolong your life span by as much as 25 years.

Private Health Insurance Exchanges––Will They Save Money? Will the Idea Grow?

Tuesday, October 9, 2012
Private health insurance exchanges will save employers money but not make health insurance cheaper.

Because private health insurance will save employers money, they will grow.

Will Private Insurance Exchanges Reduce Health Insurance Costs?

There's lots of buzz these days about private insurance exchanges. The idea is to give employees more choice in purchasing their own individual coverage

Photos and More Gardening

Thursday, October 4, 2012
I've needed new professional and blog photos for a long time.  My friend Adam Roe was in town recently, and he happens to be professional photographer, so he graciously offered to snap a few shots.  Despite less than ideal conditions, he did an outstanding job.  Here's a larger version of the photo on my profile (which Blogger shrinks down to a tiny thumbnail):


To see more of Adam's work, head over to his Facebook page, and don't forget to 'like' and share it if you enjoy it.  Adam is currently based in Berlin.

Gardening Update

Here's a photo of today's harvest (taken by me, not Adam; you can tell by the poor focus and primitive lighting):

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Will Many of the Smallest Employers Circumvent the Affordable Care Act by Using Self-Insurance?

Tuesday, October 2, 2012
Not surprisingly, only about 10% of firms with fewer than 200 workers take advantage of self-insurance––and almost no very small groups (fewer than 50 workers) use the product. It just isn't worth it for these small employer groups to take the risk that they will either have too many claims or very big claims from their workers––that is what insurance companies are for.

Already, 96% of workers

The Medicaid Controversy––The Republican Governors Should Put Up or Shut Up

Friday, September 21, 2012
Indiana, New Mexico, and Wisconsin are asking the federal government
to exempt people making between 100% and 133% of the poverty level from
the upcoming Medicaid expansion.

These Republican governors need to put up or shut up.

Ever since the passage of the Affordable Care Act (ACA), Republican governors have been clamoring for block granting Medicaid.

The Supreme Court ruled that a state

More Thoughts on Macronutrient Trends

Friday, September 14, 2012
I had a brief positive exchange with Gary Taubes about the NuSI post.  He reminded me that there's an artifact (measurement error) in the USDA data on fat consumption in the year 2000 when they changed assessment methods.  Here are the USDA data on macronutrient consumption since 1970, corrected for loss (28.8%) but not corrected for the artifact:
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Romney Intends to Repeal “Obamacare” in 2013—Has He Thought Through the Unintended Consequences If He Does?

Thursday, September 13, 2012
Romney says he will repeal “Obamacare” if he is elected. Given that this has been part of his platform from the beginning of the campaign he is entitled to do that if he wins.

I did not support passage of the Affordable Care Act (ACA) in 2010 because I saw it as an unaffordable entitlement expansion with no real hope of containing costs.

But the practical reality of killing the Affordable Care

Common Ingredients of Anti-Aging Supplements

It is rather painful to see the signs of age catching up with you day by day or more realistically minute by minute. However, the endeavors to discover and invent newer and newer technology has come as a boon for mankind as a whole as now there are treatments, anti aging supplements and procedures that would help you turn back the body clock by quite a few years. The anti-aging supplements help you to get back those glorious days of your life that almost seemed like the bygone era. Many of the anti-aging supplements are extracts from natural and nutritious products and therefore, widely recognized as natural anti-aging supplements and nutritional anti-aging supplement. These anti aging supplements have no drawbacks or side effects, if consumed in the proper manner. However, the effects of these anti-aging supplements can really be magical at times. The natural anti-aging supplements are created or produced from natural ingredients gifted to us by the Mother Nature. The natural anti-aging supplements help reverse and maybe also stop the body clock for a few years giving you that much needed confidence and glow to see you through the rigmaroles of today's highly competitive everyday life. The skin goes through very tough conditions everyday and the drying of the skin due to several factors results in aging. The nutritional anti-aging supplements can be consumed as in the form of skin care supplements that can be useful, it can show you the difference in just a matter of days. A balanced diet and taking the right nutritional anti-aging supplements is more than half the battle won against your strong opponent -age. The nutritional anti-aging supplements bridge the gap by providing the much needed nutritive supplements that are so very important for the body. The anti-aging supplements are made up of a number of ingredients that help rejuvenate the skin and give it back the lost moisture to tone up the skin and do away with the sagging layer. Some of the common ingredients found in the anti-aging skin care supplements include zinc, phosphorous, Vitamin A, C, D, E and K; inositol, choline, calcium, copper, iodine, Gingko Biloba, anti-oxidants, fibre, collagen, protein, essential fatty acids, selenium, amino acids to name a few. Although the composition of the individual anti aging supplement might change as per the manufactures, however on the whole the ingredients used in the anti-aging supplements has only aim to provide those essential elements in your body that you have lost or reduced over a period of time. All these ingredients aim at re-hydrating the skin and gifting it that lost glow. If the anti-aging supplements, whether you choose natural anti aging supplement or nutritional anti aging supplement, consumed together with a balanced diet can do wonders in very less period of time. As we all know that these anti-aging supplements are likely derived from the natural products, so we do not have to worry about any side effects, although you still need to take it as per the prescribed dosage. After consuming any anti aging supplement for a few days, you will definitely feel like asking "Mirror, Mirror, on the wall..."

Nutrition Science Initiative (NuSI)

Wednesday, September 12, 2012
Some of you may have heard of an ambitious new nutrition research foundation called the Nutrition Science Initiative (NuSI).  In this post, I'll explain what it is, why it matters, and how I feel about it-- from the perspective of an obesity researcher. 

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Calories and Carbohydrate: a Natural Experiment

Monday, September 10, 2012
In the lab, we work hard to design experiments that help us understand the natural world.  But sometimes, nature sets up experiments for us, and all we have to do is collect the data.  These are called "natural experiments", and they have led to profound insights in every field of science.  For example, Alzheimer's disease is usually not considered a genetic disorder.  However, researchers have identified rare cases where AD is inherited in a simple genetic manner.  By identifying the genes involved, and what they do, we were able to increase our understanding of the molecular mechanisms of the disease.

The natural experiment I'll be discussing today began in 1989 with the onset of a major economic crisis in Cuba. This coincided with the loss of the Soviet Union as a trading partner, resulting in a massive economic collapse over the next six years, which gradually recovered by 2000. 

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Obama vs. Romney: A Detailed Analysis of Mitt Romney’s Health Care Reform Plan

Let’s take a look at Mitt Romney’s Health Care plan using his own outline ("Mitt’s Plan") on his website.

Romney's approach to health care reform summarized:

"Kill Obamacare" - There seems to be no chance Romney would try to fix the Affordable Care Act––he would repeal all of it.
No new federal health insurance reform law - There is no indication from his policy outline that he would try to

A Late Summer Harvest

Wednesday, September 5, 2012
It's been a good year for gardening in Seattle, at least in my garden.  Thanks to great new tools* and Steve Solomon's recipe for homemade fertilizer, my house has been swimming in home-grown vegetables all summer.  I'm fortunate that a friend lets me garden a 300 square foot plot behind her house.  Here's a photo of part of today's harvest; various kale/collards, zucchini, tomatoes and the last of the pole beans:


Perfect for the Eocene diet.  

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Does Calorie Restriction Extend Lifespan in Mammals?

Wednesday, August 29, 2012
Until about two years ago, the story went something like this: calorie restriction extends lifespan in yeast, worms, flies, and rodents.  Lifespan extension by calorie restriction appears to be biologically universal, therefore it's probably only a matter of time until it's demonstrated in humans as well.  More than 20 years ago, independent teams of researchers set out to demonstrate the phenomenon in macaque monkeys, a primate model closer to humans than any lifespan model previously tested.

Recent findings have caused me to seriously question this narrative.  One of the first challenges was the finding that genetically wild mice (as opposed to inbred laboratory strains) do not live longer when their calorie intake is restricted, despite showing hormonal changes associated with longevity in other strains, although the restricted animals do develop less cancer (1).  One of the biggest blows came in 2009, when researchers published the results of a study that analyzed the effect of calorie restriction on lifespan in 41 different strains of mice, both male and female (2).  They found that calorie restriction extends lifespan in a subset of strains, but actually shortens lifespan in an even larger subset.  Below is a graph of the effect of calorie restriction on lifespan in the 41 strains.  Positive numbers indicate that calorie restriction extended life, while negative numbers indicate that it shortened life:

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AHS11 Talk Posted

Wednesday, August 22, 2012
After a one-year delay, my talk from the 2011 Ancestral Health Symposium is online with slides synched.  The talk is titled "Obesity: Old Solutions for a New Problem", and it's an overview of some of the research linking food reward to food intake and body fatness.  This is the talk that introduced a fundamentally new idea to the ancestral community: not only does the chemical composition of food matter, but also its sensory qualities-- in fact, the sensory qualities of food are among the primary determinants of food intake.  I didn't come up with the idea of course, I simply translated the research for a more general audience and put my own evolutionary spin on it.

The talk would be a bit different if I were to give it today, as my understanding of the subject has expanded, and my speaking skills have improved.  However, the central message remains as true today as it was a year ago.  You can find the talk here.

The slide synching was done by an extremely generous man named Ben Fury.  As you can see in the video, he did an excellent job.  Without Ben, this video would have remained in internet limbo forever.

Below, I've published a message from Ben explaining the interesting work that he does.  Please contact him if you think it's interesting.

A Message from Ben Fury

I was writing a book on health, fitness and diet in 2009 when my house burned down in the Station Fire, along with 165,000 acres of my beloved Angeles National Forest. Since then, I've had a series of people needing help come through my life, that have upgraded and morphed my talents...

Seniors with chronic pain, falls, brittle bones, and stiff shrunken muscles.
Diabetics with out of control blood sugars, going blind, and having limbs lopped off.
Neurologically challenged people with spastic limbs and foggy brains.
Fat, listless, unhappy people with no idea how they got that way, seeing no way out of the darkness.
Each of them needing help in different ways, but all with an underlying theme of what works to help heal our conditions:
  •     Remove flour, sugar, beans, and heavily processed oils from our diet. Eat real food.
  •     Get strong.
  •     Get flexible.
  •     Stop ceding health responsibility to outside forces, and take charge of our own wellness.
  •     Only use truly evidence based medicine. Don't just pop the latest pill or get the latest surgery all the other people are doing. Be wary of the disease mongers in both the conventional and alternative camps.
  •     Find our "happy thoughts." Use the simple restoratives of sleep, play, and reflection, to let go of pain, find inner peace, and let in joy and purposeful outer direction.
The methods to accomplish these goals are varied, and I have both non-profit and for-profit ventures to share them.
Their websites are currently in development.
The for-profit is BenFury.com
The non-profit is PainRelieversUSA.org , whose mission statement is:

To move beyond pain management...
and learn to live pain free.


Feel free to write to me  at:
 ben [at] benfury dot com

Anti-Aging Remedies

Anti-aging remedies are solutions to slow, halt or reverse the human aging process. Hormones, antioxidants, and other preventive agents are used to aid anti-aging. Many hormones are applied to the tissues to get the specific effect. Growth hormone, melatonin, estrogen, testosterone, and DHEA (dehydroepiandrosterone) are the main anti-aging endocrines injected into the body. They enhance body stamina, immunity and muscle mass, eliminate cellulite and increase your memory. DHEA, existing in the body in the form of estrogen and testosterone, improves your libido, energy, muscles and immunity and decreases fat. Anti-aging cocktail supplements, rich in melatonin, served as a sleep-aid. Antioxidants, which contain vitamin C, vitamin E, beta carotene, and the co-enzymes superoxide and dismutase, help cut down the tendency of aging by fighting harmful molecules. They are normally found in fruits and vegetables or naturally in the body. Antioxidants are best to slow down age related conditions such as macular degeneration, cancer, and heart disease. A number of other things are recommended to halt the aging process - fresh water, magnets, and light-emitting devices are among the popular ones. The advanced technology in medical science has brought in a high acclivity in anti-aging treatment. Cosmeceuticals and hair dyes, dermabrasion, cosmetic surgery, laser resurfacing are commonly used to reverse aging. Smoking cessation, exercise, and dietary modification are factors that help you reverse aging. Using sunscreen protection and natural protection against cancer, including laetrile cream, estrogen blockers, and reservation, early detection and prevention of diabetes, heart disease, and osteoporosis, maintaining sexual performances, and mind-body connection are the main points to take into account. Anti-aging evaluation and treatment plans serve to solve a number of aging related problems in the initial stage. Hormone replacement therapies, anti-oxidant analysis and appropriate supplementation, examination of bio-markers of aging, immune protection, and DNA repair are part of the anti-aging medical treatment. Almost all anti-aging supplements are not properly tested, so using these suppliants may tend to cause side effects. An expert anti-aging physician may be consulted.

Romney vs. Obama: The Romney-Ryan Medicare Plan Compared to the Obama Medicare Plan—Who’s Telling the Truth on Medicare?

Monday, August 20, 2012
They both are and they both aren’t.

I’ve never seen a week in health care policy like last week. The media reports have to be in the thousands, all trying to make sense of the furious debate between Obama and Romney over Medicare.

As someone who has studied this issue for more than 20 years, it has also been more than exasperating for me to watch each side trade claims and for the press to try

Ancestral Health Symposium 2012

Thursday, August 16, 2012
I recently returned from AHS12 and a little side trip to visit family.  The conference was hosted at Harvard University through the Harvard Food Law Society.  Many thanks to all the organizers who made it happen.  By and large, it went smoothly.

The science as expected ranged from outstanding to mediocre, but I was really encouraged by the presence and enthusiastic participation of a number of quality researchers and clinicians. The basic concept of ancestral health is something almost anyone can get behind: many of our modern health problems are due to a mismatch between the modern environment and what our bodies "expect".  The basic idea is really just common sense, but of course the devil is in the details when you start trying to figure out what exactly our bodies expect, and how best to give it to them.  I think our perspective as a community is moving in the right direction.

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Wyden and Ryan—One is Up and the Other is Down—and They Are Both Telling the Truth

Monday, August 13, 2012
Republican Vice Presidential pick Paul Ryan isn’t the only one Democrats are piling on this week. The knives have come out for Senator Ron Wyden, the Oregon Democrat.

I guess that isn’t a surprise. If Ron Wyden is right on Medicare then so are Paul Ryan and Mitt Romney.

The fundamental problem here is that the Democrats have decided that their best path to victory in the November elections is

Lorcaserin: the Latest FDA-approved Obesity Drug

Saturday, August 4, 2012
The FDA recently approved a new drug called lorcaserin (brand name Belviq) for the treatment of obesity.  Lorcaserin causes an average of 13 lbs (5.8 kg) of weight loss over a year, compared to 5 lbs (2.2 kg) for placebo (1), which is less than the other recently approved drug Qsymia (formerly Qnexa; topiramate/phentermine).

Learning about obesity drugs is always a good opportunity to gain insight into the mechanisms that underlie the development and reversal of obesity.  If you've been following this blog for a while, you already have a pretty good guess what organ this new drug acts on.  Make your guess and read on!

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Two Great Quotes About Obesity (technical)

Thursday, August 2, 2012
By Dr. Hans-Rudolf Berthoud, from a recent paper, "The Neurobiology of Food Intake in an Obesogenic Environment" (1).  I came across it because it cites my review paper (2).  My perspective on obesity is similar to his.  From the abstract:
The modern lifestyle with its drastic changes in the way we eat and move puts pressure on the homoeostatic system responsible for the regulation of body weight, which has led to an increase in overweight and obesity. The power of food cues targeting susceptible emotions and cognitive brain functions, particularly of children and adolescents, is increasingly exploited by modern neuromarketing tools. Increased intake of energy-dense foods high in fat and sugar is not only adding more energy, but may also corrupt neural functions of brain systems involved in nutrient sensing as well as in hedonic, motivational and cognitive processing.
And a nice one from the conclusions:
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How Should Science be Done?

Tuesday, July 24, 2012
Lately I keep running into the idea that the proper way to do science is to continually strive to disprove a hypothesis, rather than support it*.  According to these writers, this is what scientists are supposed to aspire to, but I've never actually heard a scientist say this.  The latest example was recently published in the Wall Street Journal (1).  This evokes an image of the Super Scientist, one who is so skeptical that he never believes his own ideas and is constantly trying to tear them down.  I'm no philosopher of science, but this idea never sat well with me, and it's contrary to how science is practiced. 
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New Review Paper by Yours Truly: High-Fat Dairy, Obesity, Metabolic Health and Cardiovascular Disease

Sunday, July 22, 2012
My colleagues Drs. Mario Kratz, Ton Baars, and I just published a paper in the European Journal of Nutrition titled "The Relationship Between High-Fat Dairy Consumption and Obesity, Cardiovascular, and Metabolic Disease".  Mario is a nutrition researcher at the Fred Hutchinson Cancer Research Center here in Seattle, and friend of mine.  He's doing some very interesting research on nutrition and health (with an interest in ancestral diets), and I'm confident that we'll be getting some major insights from his research group in the near future.  Mario specializes in tightly controlled human feeding trials.  Ton is an agricultural scientist at the University of Kassel in Germany, who specializes in the effect of animal husbandry practices (e.g., grass vs. grain feeding) on the nutritional composition of dairy.  None of us have any connection to the dairy industry or any other conflicts of interest.

The paper is organized into three sections:
  1. A comprehensive review of the observational studies that have examined the relationship between high-fat dairy and/or dairy fat consumption and obesity, metabolic health, diabetes, and cardiovascular disease.
  2. A discussion of the possible mechanisms that could underlie the observational findings.
  3. Differences between pasture-fed and conventional dairy, and the potential health implications of these differences.

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What Causes Type 2 Diabetes, and How Can it be Prevented?

Thursday, July 19, 2012
In the comments of the last post, we've been discussing the relationship between body fatness and diabetes risk.  I think this is really worth understanding, because type 2 diabetes is one of the few lifestyle disorders where 1) the basic causes are fairly well understood, and 2) we have effective diet/lifestyle prevention strategies that have been clearly supported by multiple controlled trials.

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Anti-Aging Foods

Wednesday, July 18, 2012
Anti-aging is the process of delaying the effects of aging by applying preventive methods, exercise, and avoidance of health hazards. Anti-aging foods promote endurance, longevity, restful sleep, vitality, and energy while offering a general sense of calm and well being. They help the whole body function by boosting blood formation, tissue re-building, blood purification, reducing chronic health deceases, and preventing anemia, arthritis, fevers, liver spots, and muscular dysfunctions. Anti-aging is not a sickness; however, it retards the normal growth of the body. Proper nutrition regenerates new cells and slows down the aging process. Anti-aging foods reduce excess free-radical contents in the body and improve immune resistance. They promote life extension by lowering cholesterol and triglycerides considerably and speed up the body metabolism and fat-burning capabilities. The anti-aging foods help you improve skin tone and prevent sagging skin. Consumption of vitamin enriched foods, such as fruits, oily fish, and grains helps fight lifetime deceases such as high blood pressure, cancer, cataracts, macular degeneration, and blindness. In addition to regular diets, specialty diets are also prescribed by specialists in anti-aging therapy. Wrinkle-free skin in aged people is proof of the good effects of anti-aging foods. Naturally available foods with anti-aging factors include avocado, berries, cruciferous garlic, ginger, nuts, soy, whole meal pasta and rice, watermelon, and fresh water. Foods rich in antioxidants such as citrus, carrots, spinach, tomatoes, almonds, berries, and bell peppers, as well as the nutrients calcium, zinc, beta-carotene, and vitamin-B are popular anti-aging foods.

Interview with Aitor Calero of Directo al Paladar

Thursday, July 12, 2012
Aitor Calero writes for the popular Spanish cooking and nutrition blog, Directo al Paladar ("straight to the palate").  We did a written interview a while back, and he agreed to let me post the English version on my blog.  The Spanish version is here and here.

Without further ado, here it is:

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The Game’s Not Over, and It May Not Even Be The Real Game

Tuesday, July 3, 2012
by Brian Klepper

Like most health law watchers, I was surprised by the recent Supreme Court decision. I'm sure that on this issue, as with everything else, zealous responses rationalize the result and split the country down the middle.

I expected the Court to be purely partisan, but apparently Chief Justice John Roberts, acknowledging the gravity of his role, saw his way clear to support the

Why Did Energy Expenditure Differ Between Diets in the Recent Study by Dr. Ludwig's Group?

Sunday, July 1, 2012
As discussed in the previous post, a recent study by Dr. David Ludwig's group suggested that during weight maintenance following fat loss, eating a very low carbohydrate (VLC) diet led to a higher metabolic rate (energy expenditure) than eating a low-fat (LF) diet, with a low glycemic index (LGI) diet falling in between the two (1).  The VLC diet was 30 percent protein, while the other two were 20 percent.  It's important to note that these were three dietary patterns that differed in many ways, and contrary to claims that are being made in the popular media, the study was not designed to isolate the specific influence of protein, carbohydrate or fat on energy expenditure in this context. 

Not only did the VLC diet lead to a higher total energy expenditure than the LF and LGI diets, the most remarkable finding is that it led to a higher resting energy expenditure.  Basically, people on the VLC diet woke up in the morning burning more energy than people on the LGI diet, and people on the LGI diet woke up burning more than people on the LF diet.  The VLC dieters burned 326 more calories than the LF dieters, and 200 more than the LGI dieters.

It's always tempting to view each new study in isolation, without considering the numerous studies that came before it, but in this case it's essential to see this study through a skeptical lens that places it into the proper scientific context.  Previous studies have suggested that:
  1. The carbohydrate:fat ratio of the diet has little or no detectable impact on energy expenditure in people who are not trying to lose weight (2, 3).
  2. The carbohydrate:fat ratio of the diet has little or no detectable impact on energy expenditure in people who are being experimentally overfed, and if anything carbohydrate increases energy expenditure more than fat (4, 5).
  3. The carbohydrate:fat ratio of the diet has little or no detectable impact on energy expenditure during weight loss (6, 7, 8), and does not influence the rate of fat loss when calories are precisely controlled. 
This new study does not erase or invalidate any of these previous findings.  It fills a knowledge gap about the effect of diet composition on energy expenditure specifically in people who have lost weight and are trying to maintain the reduced weight.

With that, let's see what could have accounted for the differences observed in Dr. Ludwig's study.
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Do You Have Any Idea How Close the Affordable Care Act Came to Being Toast?

Thursday, June 28, 2012
I expected Supreme Court Justice Anthony Kennedy to vote to toss the individual mandate. I had no doubt the other three conservative justices would want the whole of the Affordable Care Act thrown out.

I also expected the four liberal justices to support both the individual mandate as well as the entire law.

About everyone expected Roberts and Kennedy to vote alike.

If Roberts had gone with

New Study: Is a Calorie a Calorie?

A new study in JAMA led by Dr. Cara B. Ebbeling and colleagues purports to challenge the idea that all calories are equally fattening (1).  Let's have a look.  When thinking about the role of calorie intake in body fatness, there are basically three camps:

1.    Calories don’t matter at all, only diet composition matters.
2.    Calories are the only thing that matters, and diet composition is irrelevant.
3.    Calories matter, but diet composition may also play a role.

The first one is an odd position that is not very well populated.  The second one has a lot of adherents in the research world, and there’s enough evidence to make a good case for it.  It’s represented by the phrase ‘a calorie is a calorie’, i.e. all calories are equally fattening.  #1 and #2 are both extreme positions, and as such they get a lot of attention.  But the third group, although less vocal, may be closest to the truth. 
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The Supreme Court Ruling on Health Care, Its Impact on Medicaid, and 29 Republican Governors--Be Careful You Might Get What You Wish For

Conservatives wanted the Supreme Court to do the work of killing the Affordable Care Act (ACA) for them. They didn’t get their wish but the Court may have put conservatives into a political corner they will find very uncomfortable.

Under the new health law, the Medicaid program will be substantially expanded. Those making up to 133% of the federal poverty level (about $30,000 in annual income

The Supreme Court's Decision on the Affordable Care Act

In the immortal words of Rosane Rosana Dana, "Never mind."From the SCOTUS blog live in the court room: "Chief Justice Roberts' vote saved the ACA."On to the elections.

How to Look 10 Years Younger - 3 Anti Aging Traps to Avoid

Tuesday, June 26, 2012
If you are trying to look 10 years younger or more, there is no shortage of information or products to help you achieve your goal. Nowadays, it seems everywhere you turn there is some new product or cosmetic procedure claiming to remove wrinkles, restore elasticity, bring back radiance... the list goes on and on. But before you try that breakthrough product or visit that hot new medical day spa there are 3 anti aging traps you need to know about. Fall into one of these, and no matter what products you are using, you could be undermining your results without even knowing it. Anti Aging Trap #1- No Passion for Anti Aging or Complete Acceptance of the Aging Process "Passion for anti aging?" you say. "Of course I have passion for anti aging. Why do you think I spend hundreds of dollars on products and procedures?" Let's make one thing clear- passion for anti aging and looking 10 years younger has nothing to do with how many products you buy or how many visits you schedule with your plastic surgeon. Passion for anti aging starts in the brain: For example: Every morning when I wake up, the first thing on my mind is anti aging. I am constantly researching, studying, putting test ideas into practice to stay and feel younger and more vibrant. I thoroughly enjoy it and a day doesn't go by without me thinking about anti aging and trying to look 10 years younger. Now I know everyone doesn't or even can't wake up with anti aging on the brain. There are kids to get off to school, jobs to go to, bills to pay; the list goes on and on. But to really achieve any level of anti aging, you do have to have some passion for it. Why? Because passion for anything, whether it be looking 10 years younger, losing weight, or getting a promotion starts in the brain. The moment you set your mind to achieve something your brain immediately goes into overdrive coming up with ideas to bring this plan to fruition. Passion is the fuel which drives this process. The more passionate you are about an idea, the higher the probability that you will achieve what you desire. Unfortunately, anti aging or trying to look 10 years younger or more quickly loses momentum. This is because many people feel there are only a few options to truly stay youthful. Once they start to age, they believe the only options they have are plastic surgery or Botox. Which brings us to the next anti aging trap: Anti Aging trap #2- Overloading On Plastic Surgery and Cosmetic Procedures I recently met a 48 woman who was obviously addicted to plastic surgery. Her face was smooth, taut and unlined. She had no wrinkles on her forehead, around her eyes or around her mouth. But guess what? She didn't look ten years younger. She looked like a 48 year old woman that had a lot of work done. Her face was mask-like, even when she smiled. You can see this look on a lot of celebrities (Courtney Cox, Nicole Kidman, Joan Rivers). Maybe that's why some people think it is the best way to fight the aging process. People love to emulate their favorite stars. Now I'm not against plastic surgery. Compared to only 10 years ago, plastic and cosmetic surgery has come a long way in helping people everywhere to look and feel younger. And perhaps that's the problem. Because it has become so much more affordable it is now the quick fix instead of the last resort. Too much plastic surgery or cosmetic procedures will not make you look 10 years younger. It will however make you look strange, unnatural and like a plastic surgery junkie. Anti Aging Trap #3 Setting the Bar Too Low When I ask women what they really want to achieve from all the effort they put into staying youthful, more often than not most of them respond with the following: "I want to look good for my age." The only way I know how to respond to this statement is "Why?" If you truly want to look good for your age, no matter if it's 30, 40 or 50+ then I say go for it. You could probably achieve your goal in a matter of months if you haven't done so already. But know this: You will never go to a college sporting event and be mistaken for a coed by 4 different students. You won't be able to wear a mini skirt and look "age appropriate". (Sorry to use that phrase. I actually despise it but that's a whole other article.) You will never go for a jog and have 3 seventeen year olds on scooters ask what college you go to. Why? Because "looking good for your age" is setting the bar way too low. Sure you look good, but only for your age. It's the equivalent of the comment: "you throw pretty good for a girl". You want to look good period. You want to look so good that no one can say you look good for your age because no one can tell how old you are. I know plenty of women aged 40+ who can and have been mistaken for a college coed. Who still have the ability to pull off a mini and flip flops. And who have 17 year old boys waving to them from their motorcycles and scooters Now that we discussed the 3 Anti Aging Traps and how easy they are to fall into, let's talk about the good news. Look at the following quote: "Anti Aging to us is a lifestyle. My wife and I decided a long time ago that we weren't going to age. We were going to eat right, constantly try new things, take care of our bodies. But most importantly, we set our mind to it and I guess we're doing all right."-from a 52 year old man and his 46 year old wife. This quote came from a married couple I recently met who I had guessed to be in their mid thirties. The man confessed to me that he was actually 52 years old and his wife was 46. I was pretty stunned. Being as obsessed as I am with anti aging, I can usually guess peoples' ages pretty well. So this really threw me for a loop. This couple looked, walked and talked like they were 35 years old. And a young 35 at that. It was truly amazing and I couldn't stop looking at them. So how were they able to look at least 10 to 15 years younger? Is it possible that they had some plastic surgery? They were very open and honest about their beauty regimen and upkeep. They told me they have had "absolutely no Botox". And no plastic surgery. They both have skin peels every six months to rejuvenate their skin. They eat no processed food whatsoever and a lot of fresh fruit and vegetables. They exercise 5 days a week, stretch extensively to stay flexible and agile and keep abreast of new innovations in the anti aging industry. Everything they told me was fascinating and their plan was obviously working for them. But I kept going back to their original quote: "My wife and I decided that we weren't going to age." That small statement is one of the key reasons why they are able to stay so vibrant and young looking. In their mind, they wouldn't accept the aging process and when they had that affirmation set firmly in their brain that set in motion a life-long plan of fighting aging at every turn. Once that affirmation was solidly in place, everything else that followed became second nature to them. And that is the true key to anti aging and staying young and vital. Believing with absolute certainty that you can. So stay passionate about anti aging, don't overload on cosmetic and plastic surgery and set that bar way up high. When you avoid these anti aging traps, you'll be surprised how quickly your body and mind respond. You may just wake up a couple months from now looking 10 years younger.

What Puts Fat Into Fat Cells, and What Takes it Out?

Monday, June 25, 2012
Body fatness at its most basic level is determined by the rate of fat going into vs. out of fat cells. This in/out cycle occurs regardless of conditions outside the cell, but the balance between in and out is influenced by a variety of external factors.  One of the arguments that has been made in the popular media about obesity goes something like this:  


A number of factors can promote the release of fat from fat cells, including:
Epinephrine, norepinephrine, adrenocorticotropic hormone (ACTH), glucagon, thyroid-stimulating hormone, melanocyte-stimulating hormone, vasopressin, and growth hormone
 But only two promote fat storage:
Insulin, and acylation-stimulating protein (ASP)*
Therefore if we want to understand body fat accumulation, we should focus on the latter category, because that's what puts fat inside fat cells.  Simple, right?

Can you spot the logical error in this argument?

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What Would Health Insurance Cost if the Supreme Court Overturns the Individual Mandate But Leaves the Insurance Reforms in Place?

That will be the big question on Thursday if the Court throws out the mandate and the parallel insurance reforms that would require health plans to take all comers without regard to their health status and require insurers to cover pre-existing conditions.

But before we get to that scenario, let’s look at another possibility.

The Court Overturns Both the Individual Mandate and the Insurance

A Pressure Cooker for the 21st Century

Tuesday, June 19, 2012
Pressure cookers are an extremely useful kitchen tool.  They greatly speed cooking and reduce energy usage by up to 70 percent.  This is because as pressure increases, so does the boiling point of water, which is the factor that limits cooking speed in water-containing foods (most foods).  If it weren't for my pressure cooker, I'd rarely eat beets or globe artichokes.  Instead of baking, boiling or steaming these for 60-90 minutes, I can have them soft as butter in 30.  But let's face it: most people are intimidated by pressure cookers.  They fear the sounds, the hot steam, and the perceived risk of explosion.  I escaped this because I grew up around them.

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Health And Fitness Training – Fitting Fitness Into Your Busy Day

Friday, June 15, 2012
When it comes to health and fitness training time is always an issue. Some of us are busy, some of us are very busy, and some of us are so busy we don’t even know which way is up. Sound familiar? If you are the kind of person who is on the go the minute the alarm rings in the morning to the minute your head hits the pillow at night this article is for you. If you have kids who eat up all your time and you dream of a little time to yourself, this article is for you. If you want desperately to get fit but other commitments are making it next to impossible this article is for you. Here’s the good news, getting fit doesn’t take that much time. You need to address two areas in your life; exercise and diet. In fact, if you are stuck for time to workout, the diet portion is going to have more of a drastic effect on your fitness. Think about it, if you don’t have time to burn the calories then you need to cut them from your diet. Wait a minute! You are probably thinking to yourself that food is one of the only sources of pleasure in your busy day. I agree with you, it should be. Eating well better darn well also be delicious. If it isn’t then you are doomed to fail your diet. So understand what I am saying, you will eat well but you must also enjoy your food. I am not talking about a radical starvation diet or diet extremes where you avoid carbs or fats at all costs. Your diet should be well-balanced. Here are a few golden rules for dieting: 1. Drink 2 to 3 litres of water a day 2. Avoid processed foods 3. Avoid foods with refined sugar Here’s a last tip, if you are the type who eats a lot of fast food because you are so busy, just make better choices. Order water instead of pop with your meal. Have a salad instead of fries with your burger or sandwich. Have honey instead of sugar in your coffee. All these small choices made day after day will add up in the long run. Think about it, maybe you have been putting on 5 to 10 pounds a year for a few years. Not a lot of weight over the course of a year. This slow addition of fat has been because of all these small choices. So you don’t have to make big changes to reverse this weight gain. As for a fitness routine do one set of the following as you roll out of bed in the morning and just before you go to bed at night: 1. Push ups 2. Lunges (Take a long stride of a stance and do 1 set each for side) 3. Crunches (Remember to hold your hands by your ears, not inter-laced behind your head – don’t pull on your neck while you do these) 4. IF YOU ARE FEELING AMBITIOUS – Chin ups ( you can get a chin up bar that installs in a door frame for around $20 from most sports stores) If you follow a simple fitness routine like the one outlined above you will definitely get strong. This will result in a sleek and shapely physique. As you lose weight and shed fat you will reveal this new toned body. Fitness workout programs don’t have to be a one or two hour ordeal. It can be and short and sweet if that is all you have time to do. What is important is that you do something to keep your body strong and performing well. One day at some point in the future you just may have more free time to join a gym or a running club or whatever you like to do. When that day comes you will be ready for it because this little fitness exercise plan and simple diet has kept you fit.

New Study Demonstrates that Sugar has to be Palatable to be Fattening in Mice

Wednesday, June 13, 2012
Dr. Anthony Sclafani's research group just published a study definitively demonstrating that high palatability, or pleasantness of taste, is required for sugar to be fattening in mice (1).  Dr. John Glendinning was lead author. Dr. Sclafani's group has done a lot of excellent research over the years.  Among other things, he's the person who invented the most fattening rodent diet in the world-- the 'cafeteria diet'-- composed of human junk food. 

Mice and rats love sweet food and drinks, just like humans.  If you give them a choice between plain water and sugar water, they'll overconsume the sugar water and become obese.  I have argued, based on a large body of evidence, that the reward value and palatability* of these solutions are important to this process (2, 3, 4).  This is really just common sense honestly, because by definition if the solution weren't rewarding the mice wouldn't go out of their way to drink it instead of water, the same way people wouldn't go out of their way to get soda if it weren't rewarding.  But it's always best to confirm common sense with research.
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Sugar Intake and Body Fatness in Non-industrial Cultures

Saturday, June 9, 2012
Around the world, non-industrial cultures following an ancestral diet and lifestyle tend to be lean. When they transition a modern diet and lifestyle, they typically put on body fat and develop the classic "diseases of civilization" such as diabetes and cardiovascular disease.  If we can understand the reasons why this health transition occurs, we will understand why these problems afflict us today.  Research has already identified a number of important factors, but today I'm going to discuss one in particular that has received a lot of attention lately: sugar.

There's an idea currently circulating that sugar is the main reason why healthy traditional cultures end up obese and sick.  It’s easy to find non-industrial cultures that are lean and don’t eat much sugar, and it’s easy to find industrial cultures that are obese and eat a lot of it.  But many factors are changing simultaneously there.  We could use the same examples to demonstrate that blue jeans and hair gel cause obesity.  If sugar is truly the important factor, then cultures with a high sugar intake, but an otherwise ancestral diet and lifestyle, should also be overweight and sick.  Let’s see if that's true. 

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The Solution to Anti-Aging Skin Care

The anti-aging skin care field has boomed, with hundreds of new products being introduced to the market on what feels like almost on a daily basis. This has resulted in what we may call "skin care overload." People have become overwhelmed and confused by the countless number of ingredients we are told are necessary for anti-aging. It has become impossible to access and apply even a fraction of these ingredients due to the cost and time involved. We feel compelled to buy multiple products every month and layer them on in order to do the most for our skin. But, as we fill our medicine cabinets with creams and serums, we are faced with the daily questions of which shall we use, which are safe and which actually work? It has been long overdue that the various categories of anti-aging and the anti-aging ingredients themselves be ordered and categorized so that a comprehensive approach to anti-aging may be put into place. Firstly, there are many features to skin aging and people will show one or more features over time, but may differ in the features of skin aging that plague them. For example, some people develop sagging or laxity to the skin due to genetic factors, but may have little or no sun damage. Others may be covered with sun spots but have no sagging or wrinkling. The following is a validated classification scheme which allows for each clinical feature of skin aging to be assessed separately on a 4-point grading scale (mild, moderate, advanced, severe): Classification of Skin Aging: Laxity (Sagging) Wrinkles Redness Brown discolorations Solar elastosis (Yellowing) Irregular texture Abnormal growths (keratoses).1 This classification scheme of skin aging includes a severity scale as mentioned above (0=None, 1=Mild, 2=Moderate, 3=Advanced, and 4=Severe) which allows researchers or users to rank each individual person's skin aging according to feature and severity. This scale was shown to be very useful in testing anti-aging treatments and has been published in the Journal of the American Academy of Dermatology.1 Older scales tended to lump different features together into broad categories, which became less useful as treatments became more specific in targeting various facets of skin aging; for example as anti-pigment or anti-redness or anti-wrinkle. With this current anti-aging scale, our anti-aging products may be quantitatively tested to determine which individual categories of skin aging they treat and how effective they are in each category. This also allows us to hone our anti-aging regimen to our needs and to compile or group the ingredients in each category that are most effective so as to cover all categories of anti-aging in a logical manner. The next challenge was to classify the plethora of anti-aging ingredients on the market based on the features of skin aging that they targeted or treated. I then created a classification scheme of the categories of anti-aging targeted by the ingredients that have emerged over the past decade: Anti-Wrinkle - DNA Defense - Barrier Fortification Anti-Redness - Cellular Restore - Emollient/Moisturizer Anti-Brown Discoloration - Damage Reversal - Pro-Skin Thickness Anti-Oxidants - Aging Repair - Re-Texturize With this classification scheme, we can appreciate why people have become so overwhelmed and why they have accumulated shopping bags full of skin creams in order to meet their needs! Nevertheless, as anti-aging ingredients have emerged targeting each of these categories, ideally one would want to incorporate the best ingredients of each category in a single daily regimen to optimally treat skin aging. Each individual may differ in which category of anti-aging they need most, yet in order to prevent and reverse all the signs of skin aging, it is still optimal for all categories to be covered by an anti-aging regimen. It is important to familiarize yourself with which ingredients fall in each category, so that you can incorporate several of each group into your skin regimen, or look for a product that covers the various categories of anti-aging in a logical way. Examples of key active ingredients shown to yield resulst in each category of anti-aging include: peptides for anti-wrinkles, plant-derived polyphenols and bisabolol for anti-redness, amino acids for anti-brown discolorations, vitamins C, E and ferulic acid for anti-oxidant, DNA repair molecules such as acetyl tyrosine and proline for DNA defense, resveratrol for cellular restore, bark extract or phoretin for damage reversal, Helianthus annuus and Ilex paraguensis extracts for aging repair, dimethicone for barrier repair, glycerin and soy lecithin for emollients, hyaluronic acid for boosting skin thickness, and mushroom extracts and sodium lactate for smoothening abnormal texture. In sum, the field of anti-aging now has validated classification systems for the various categories of skin aging and for the plethora of anti-aging ingredients so that we can assess and determine which anti-aging actives we want in our medicine cabinet and to make certain that we cover the various categories of anti-aging in our daily regimen. With this scientific basis, we may now intelligently assess anti-aging products for their ability to comprehensively cover all the various categories of skin aging and include the various categories of anti-aging ingredients available. Finally, these comprehensive, validated classification and grading scales provide a framework for solving the anti-aging conundrum with a system for categorizing skin aging and classifying anti-aging actives to make sure you cover all your skin's anti-aging needs. (C) NY Derm LLC, 2010. 1) Alexiades-Armenakas, M, et al. Journal of the American Academy of Dermatology 2008 May;58(5):719-37; quiz 738-40. Dr. Macrene Alexiades-Armenakas M.D., Ph.D., F.A.A.D., Derm-Scientist®, holds three Harvard degrees, a bachelors of arts (BA), a medical degree (MD) and a doctorate (PhD) in genetics, is double Board-Certification in Dermatology in the US and EU and Director of her own Private Practice and Research Clinic in Manhattan. Her 20+ year background in research included plant molecular biology, cell and developmental biology, genetics, photobiology and mammalian stem cell biology. She served as consultant to L'Oreal, ran clinical trials for pharmaceutical and laser companies, and serves as beauty judge to many magazines, including Allure and In Style. The go-to skin expert for identifying actives proven to deliver results in the laboratory, clinical trials and in practice, she developed a highly advanced technology 37 Extreme Actives® high performance anti-aging cream, capable of suspending and microtargeting the greatest variety and number of proven actives in a single cream, a comprehensive product logically designed to address all the categories of skin aging. The One-Step Skincare Solution™ is the breakthrough that revolutionizes skincare and does the thinking for you. This patented advanced cream technology was designed to suspend and microtarget 37 potent actives in a single cream, which have been proven by independent testing to deliver results in all categories of skin aging.

Headache Migraine Surgery - Things You Need to Know

It May Be Tempting If you have ever considered having headache migraine surgery, then I can bet that you have had one of those days where you thought your head was literally going to explode. Some of you may have a job, kids, and countless duties around the house, and headache migraine surgery may seem like a good idea for you. Well let me tell you right now that in brain surgery, the bad sides always overrule the good. A True Story I knew a person once names Sharon Bennett who had severe migraines every week. These migraines were such a disturbance in her life that she could not find a job, or even find time for her children. One day however, Sharon decided to take headache migraine surgery in an attempt to solve her migraine problems. The operation was successful, and it cut the migraine frequency down to every month rather than every week. What They Missed This sounds like a success story, but let me tell you this. The problem is that it involves injecting Botox into muscles located around the head, effectively paralyzing them. While headache migraine surgery is an effective way to reduce the frequency of headaches, it is a very unnatural and dangerous way to fight migraines. There are countless natural alternatives to fight migraines and even prevent them from occurring in a way that headache migraine surgery cant. You will save hundreds of dollars in using proven, natural methods. There really is no point to even consider headache migraine surgery. The facts speak for themselves: - It is unnatural - Can have almost fatal side effects - Very costly - Largely under proven, not enough cases to properly confirm benefits - Better results using natural methods - No conclusive long-term benefits Waste No More Time In Considering Unsafe, Unnatural Methods. Renew Your Body With The Natural Way! Are your migraines so intense and happen so often that they made you come to surgery as a last resort? You will be delighted to hear that there is one more proven, safe, and absolutely natural method to make migraines history! Your new life starts here, with this very helpful Free Mini-Guide. It teaches you all about what causes migraines and how they affect us, why medications are not the best way to treat migraines, and the most common triggers of migraine headaches. However, the only REAL, safe, and effective way to get rid of your migraines for good would be to purchase a guide. This guide will save you hundreds of dollars you would be spending on drugs and surgeries, so come see Natural Migraine Solutions, a powerhouse guide which will guarantee you a migraine free life with only natural methods. You will call yourself a fool for ever considering having surgery after using this guide, believe me.

Calories Still Matter

Tuesday, June 5, 2012
The Centers for Disease Control's NHANES surveys documented a massive increase in obesity in the United States between the 1960-62 and 2007-2008 survey periods (1).  In 1960, 13 percent of US adults were obese, while in 2008 that number had risen to 34 percent.  The prevalence of extreme obesity increased from 0.9 to 6.0 percent over the same time period!

Something has changed, but what?  Well, the most parsimonious explanation is that we're simply eating more.  Here is a graph I created of our calorie intake (green) overlaid on a graph of obesity prevalence (blue) between 1970 and 2008:

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How Bad is Fructose? David Despain Interviews Dr. John Sievenpiper

Monday, May 28, 2012
In my article "Is Sugar Fattening?", I discussed a recent review paper on fructose, by Dr. John Sievenpiper and colleagues (1).  It was the most recent of several review papers to conclude that fructose is probably not inherently fattening in humans, but that it can be fattening if it's consumed to excess, due to the added calories.  Dr. Sievenpiper and colleagues have also written other papers addressing the metabolic effects of fructose, which appear to be fairly minor unless it's consumed to excess (2, 3, 4, 5).  The senior author on these studies is Dr. David Jenkins at McMaster University.  David Despain, a science and health writer who publishes a nice blog called Evolving Health, recently interviewed Dr. Sievenpiper about his work.

It's an interesting interview and very timely, due to the recent attention paid to fructose in the popular media. This has mostly been driven by a couple of high-profile individuals-- an issue they discuss in the interview.  The interview, recent papers, and sessions at scientific conferences are part of an effort by researchers to push back against some of the less well founded claims that have received widespread attention lately.

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Lower Blood Pressure Naturally

Monday, May 21, 2012
Recently, Chris Kresser published a series on dietary salt (sodium chloride) and health (1).  One of the issues he covered is the effect of salt on blood pressure.  Most studies have shown a relatively weak relationship between salt intake and blood pressure.  My position overall is that we're currently eating a lot more salt than at almost any point in our evolutionary history as a species, so I tend to favor a moderately low salt intake.  However, there may be more important factors than salt when it comes to blood pressure, at least in the short term. 

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Nutrition As a Core Service in the Healthcare System

In recent years, national health authorities have placed significant efforts on fighting Obesity, as it is the main cause of many dietary-related diseases such as Type 2 Diabetes, Coronary Heart Disease, osteoarthritis and some forms of cancer, with significant costs to governments and national incomes. In spite of this, the concept of including a vital service such as Nutrition therapy in hospitals' treatment plan still remains largely unattended. Further to this, despite the noticeable revival of related services, especially in the area of complementary therapy, little has changed with regards to nutritional offerings. It is true that we all need food to nourish our body, to survive, socialize, entertain, express our gratitude, sooth our senses etc., yet we tend to ignore its very contribution to health and wellness when it comes to hospital planning and design. Maybe we are all too familiar with food since we ingest it in almost every hour of the day in some shape or form and hence its impact on our health and wellness takes relatively back stage. Surprisingly, in spite of the huge growth of the private health industry in recent years, the role of Nutrition within such a prosperous environment has yet to be fully acknowledged. The majority of hospital, clinic and centre planners, developers, investors, owners and directors appear to be somewhat hesitant of encompassing such a 'less-accentuated service' into their menu planning. There is a general reluctance and apprehension with regard to the viability of Nutrition in an overwhelmingly treatment-based environment. Such reluctance may stem from the engraved lack of appreciation of the financial effectiveness of such a service and the role it can serve to patients/clients, owners and shareholders. Its perceived roles seem to be limited to the vaguely understood concept of dieting and/or diet sheets. And despite the general awareness of the role of diet in health and wellness, many hospital strategic planners hospital do not seem to put this into practice within the clinical environment (probably because hospitals are traditionally associated with the treatment of the communicable diseases, rather than addressing the inner health of the individual in the wider sense. However, in recent years Nutrition at large has gained enormous popularity, as today's generation are indeed becoming more health conscientious and more and more studies have substantiated the link between today's modern diseases which are largely non- communicable in nature and nutrition. Contrarily, the prevalence of overweight and obesity, particularly amongst adults, continues to grow to a record high, being described as the most common and fastest growing epidemics in the Western world. It is estimated that more than 35% of the US population are obese, and Europe is not far behind from following this trend. In fact it has recently been revealed that approximately one in four (25%) of the UK population is currently obese, and this is predicted to rise to 50% by the year 2030. Nevertheless, only one in four obese patients (25%) receives treatment and those who do seek assistance have a 90% chance of failure. We have known for years that overweight and obesity are most prevalent in the affluent nations, which are characterised by wealth and an abundance of convenient and ready-made foods. This is complicated further by a sense of lack of time for meal preparation and a high-tech environment leading to a passive environment and sedentary lifestyle. Amongst the public at large, there seems to be little progress as to how to tackle the worsening obesity epidemic. There is also confusion between healthy eating, which ought to be adopted by everyone and the ongoing taboo of dieting. Furthermore, little attention is given and inadequate effort is put into actively changing certain lifestyle factors, which are imperative to achieving optimum health and wellbeing. Indeed, the intensive commercialised advertising of health and diet-related products and services, combined with inaccurate advice given by seemingly unregulated industries coupled with the presence of unqualified or self taught practitioners and the so called dieting gurus, has certainly made it difficult for the layperson to differentiate between what is sound advice and what is merely a good marketing gimmick. As a result, much of the efforts made by national and international health organisations (often led by healthcare professionals) to counteract these odds fall short of reversing the obesity epidemic. Undoubtedly, the private health sector is well positioned to provide a wholesome approach to nutritional wellness. The majority of private hospitals, have the preliminary infrastructure to cope with such demands. For instance, nearly all hospitals are equipped with or have access to the most up to date diagnostic laboratories and treatment procedures, as well as the required medical and nursing staff and evidently a pharmacy. Indeed, these are the key prerequisites to any clinical establishment willing to embark on this fast growing market. What is subsequently required from such institutions is to enhance their existing services by adding a dedicated Nutrition and Dietetics centre led by properly trained staff, a well equipped fitness centre run by qualified instructors, a well resourced physiotherapy department, well-trained catering staff and possibly a swimming or thalassotherapy pool. It is true to say that different hospitals offer different services, and the level of focus on Nutrition may vary from one establishment to another. However, it is also true that improving overall health is gaining popularity, driven by genuine and measurable market demands and a widespread public awareness of the relationship between diet, nutrition and health. In order to achieve the desired results for both patients/clients and owners, Nutrition services have to be combined with other core services, such as Medical, Complementary, Fitness, Food and Beverage, together with strong PR and Marketing initiatives.

Beyond Ötzi: European Evolutionary History and its Relevance to Diet. Part III

Thursday, May 17, 2012
In previous posts, I reviewed some of the evidence suggesting that human evolution has accelerated rapidly since the development of agriculture (and to some degree, before it).  Europeans (and other lineages with a long history of agriculture)  carry known genetic adaptations to the Neolithic diet, and there are probably many adaptations that have not yet been identified.  In my final post in this series, I'll argue that although we've adapted, the adaptation is probably not complete, and we're left in a sort of genetic limbo between the Paleolithic and Neolithic state. 

Recent Genetic Adaptations are Often Crude

It may at first seem strange, but many genes responsible for common genetic disorders show evidence of positive selection.  In other words, the genes that cause these disorders were favored by evolution at some point because they presumably provided a survival advantage.  For example, the sickle cell anemia gene protects against malaria, but if you inherit two copies of it, you end up with a serious and life-threatening disorder (1).  The cystic fibrosis gene may have been selected to protect against one or more infectious diseases, but again if you get two copies of it, quality of life and lifespan are greatly curtailed (2, 3).  Familial Mediterranean fever is a very common disorder in Mediterranean populations, involving painful inflammatory attacks of the digestive tract, and sometimes a deadly condition called amyloidosis.  It shows evidence of positive selection and probably protected against intestinal disease due to the heightened inflammatory state it confers to the digestive tract (4, 5).  Celiac disease, a severe autoimmune reaction to gluten found in some grains, may be a by-product of selection for protection against bacterial infection (6).  Phenylketonuria also shows evidence of positive selection (7), and the list goes on.  It's clear that a lot of our recent evolution was in response to new disease pressures, likely from increased population density, sendentism, and contact with domestic animals.

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Beyond Ötzi: European Evolutionary History and its Relevance to Diet. Part II

Monday, May 7, 2012
In previous posts, I described how Otzi was (at least in large part) a genetic descendant of Middle Eastern agriculturalists, rather than being purely descended from local hunter-gatherers who adopted agriculture in situ.  I also reviewed evidence showing that modern Europeans are a genetic mixture of local European hunter-gatherers, incoming agricultural populations from the Middle East, neanderthals, and perhaps other groups.  In this post, I'll describe the evidence for rapid human evolution since the end of the Paleolithic period, and research indicating that some of these changes are adaptations to the Neolithic (agricultural/horticultural/pastoral) diet.

Humans have Evolved Significantly Since the End of the Paleolithic

Evolution by natural selection leaves a distinct signature in the genome, and geneticists can detect this signature tens of thousands of years after the fact by comparing many genomes to one another.  A landmark paper published in 2007 by Dr. John Hawks and colleagues showed that humans have been undergoing "extraordinarily rapid recent genetic evolution" over the last 40,000 years (1).  Furthermore:
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Media Appearances

Saturday, May 5, 2012
Last October, I participated in a panel discussion organized by the Harvard Food Law Society in Boston.  The panel included Drs. Walter Willett, David Ludwig, Robert Lustig, and myself, with Corby Kummer as moderator.  Dr. Willett is the chair of the Harvard Department of Nutrition; Dr. Ludwig is a professor of nutrition and pediatrics at Harvard; Dr. Lustig is a professor of clinical pediatrics at UCSF; and Kummer is a food writer and senior editor for The Atlantic
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Beyond Ötzi: European Evolutionary History and its Relevance to Diet. Part I

Saturday, April 28, 2012
In the previous post, I explained that Otzi descended in large part from early adopters of agriculture in the Middle East or nearby.  What I'll explain in further posts is that Otzi was not a genetic anomaly: he was part of a wave of agricultural migrants that washed over Europe thousands of years ago, spreading their genes throughout.  Not only that, Otzi represents a halfway point in the evolutionary process that transformed Paleolithic humans into modern humans.

Did Agriculture in Europe Spread by Cultural Transmission or by Population Replacement?

There's a long-standing debate in the anthropology community over how agriculture spread throughout Europe.  One camp proposes that agriculture spread by a cultural route, and that European hunter-gatherers simply settled down and began planting grains.  The other camp suggests that European hunter-gatherers were replaced (totally or partially) by waves of agriculturalist immigrants from the Middle East that were culturally and genetically better adapted to the agricultural diet and lifestyle.  These are two extreme positions, and I think almost everyone would agree at this point that the truth lies somewhere in between: modern Europeans are a mix of genetic lineages, some of which originate from the earliest Middle Eastern agriculturalists who expanded into Europe, and some of which originate from indigenous hunter-gatherer groups including a small contribution from neanderthals.  We know that modern-day Europeans are not simply Paleolithic mammoth eaters who reluctantly settled down and began farming. 

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The Medical Loss Ratio (MLR) Report—Just Fiddling While Rome is Burning

Thursday, April 26, 2012
Today’s headline was, “Millions Expected To Receive Insurance Rebates Totaling $1.3 Billion.”The Kaiser Family Foundation estimates that 3.4 million people in the individual market will receive $426 million in consumer rebates because of the Affordable Care Act's new MLR rules. In the small group market 4.9 million enrollees will see $377 million in rebates, and 7.5 million people will get $540

Lessons From Ötzi, the Tyrolean Ice Man. Part III

Tuesday, April 24, 2012
There are two reasons why I chose this time to write about Otzi.  The first is that I've been looking for a good excuse to revisit human evolutionary history, particularly that of Europeans, and what it does and doesn't tell us about the "optimal" human diet.  The second is that Otzi's full genome was sequenced and described in a recent issue of Nature Communications (1).  A "genome" is the full complement of genes an organism carries.  So what that means is that researchers have sequenced almost all of his genes. 

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Lessons From Ötzi, the Tyrolean Ice Man. Part II

Tuesday, April 17, 2012
Otzi's Diet

Otzi's digestive tract contains the remains of three meals.  They were composed of cooked grains (wheat bread and wheat grains), meat, roots, fruit and seeds (1, 2).  The meat came from three different animals-- chamois, red deer and ibex.  The "wheat" was actually not what we would think of as modern wheat, but an ancestral variety called einkorn.

Isotope analysis indicates that Otzi's habitual diet was primarily centered around plant foods, likely heavily dependent on grains but also incorporating a variety of other plants (3).  He died in the spring with a belly full of einkorn wheat.  Since wheat is harvested in the fall, this suggests that his culture stored grain and was dependent on it for most if not all of the year.  However, he also clearly ate meat and used leather made from his prey.  Researchers are still debating the quantity of meat in his diet, but it was probably secondary to grains and other plant foods. It isn't known whether or not he consumed dairy.

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Exercise and Food Intake

Monday, April 16, 2012
The New York Times just published an article reviewing some of the recent research on exercise, food intake and food reward, titled "Does Exercise Make You Overeat?".  I was planning to write about this at some point, but I don't know when I'd be able to get around to it, and the NYT article is a fair treatment of the subject, so I'll just point you to the article.

Basically, burning calories through exercise causes some people to eat more, but not everyone does, and a few people actually eat less.  Alex Hutchinson discussed this point recently on his blog (1).  Part of it depends on how much fat you carry-- if you're already lean, the body is more likely to increase hunger because it very much dislikes going too low in body fat.  Most overweight/obese people do not totally make up for the calories they burn through exercise by eating more, so they lose fat.  There is a lot of individual variability here.  The average obese person won't lose a substantial amount of fat through exercise alone.  However, everyone knows someone who lost 50+ pounds through exercise alone, and the controlled trials support that it happens in a minority of people.  On the other side of the spectrum, I have a friend who gained fat while training for a marathon, and lost it afterward. 

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Next Primal Chef Event Sunday 5/20

Sunday, April 15, 2012
Gil Butler has been working on a television show called Primal Chef, where he invites local chefs to make creative dishes from a list of Paleo ingredients, in a designated amount of time.  The format is reminiscent of Iron Chef.  The food is judged afterward by figures in the Paleo community.  Robb Wolf was a judge on the first episode.

Gil has invited me to be a judge on the next show, along with Sara Fragoso and Dr. Tim Gerstmar.  The next day, Sunday April 20th, Gil is organizing a catered Primal Chef event in Seattle, with Paleo dinner, speakers, entertainment, prizes, and a screening of part of Paleo Chef episode 1.  You can read the details and sign up here.  I won't be speaking because I don't have time to put together another talk right now, but I will be attending the event. 

Lessons From Ötzi, the Tyrolean Ice Man. Part I

Tuesday, April 10, 2012
This is Otzi, or at least a reconstruction of what he might have looked like.  5,300 years ago, he laid down on a glacier near the border between modern-day Italy and Austria, under unpleasant circumstances.  He was quickly frozen into the glacier.  In 1991, his slumber was rudely interrupted by two German tourists, which eventually landed him in the South Tyrol Museum of Archaeology in Italy. 

Otzi is Europe's oldest natural human mummy, and as such, he's an important window into the history of the human species in Europe.  His genome has been sequenced, and it offers us clues about the genetic history of modern Europeans.

Otzi's Story

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