Beyond the Paleo Diet

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Copyright © 2010 Hans Wu All Rights Reserved

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Disclaimer This book is not intended for the treatment/prevention of disease. My advice does not substitute for medical treatment whatsoever. Everything has been provided for informational purposes only and all recommendations outlined herein shall not be adopted without consultation with a doctor. Use of guidelines in this book is at your own risk and is your responsibility.

Author's Note The ideas explained and discussed in this book are by no means novel discoveries. Most things have been discussed and researched in the literature and online communities for many years now. This eBook is just an explanation for what I have implemented in my life and recommend for others. For more information visit my blog Beyond Paleo. The url is: http://beyondpaleo.blogspot.com If you have any questions you can contact me at: [email protected] Hans Wu (2010)

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Acknowledgements There have been many resources online that I have used to discover many of the issues discussed here, my home forum is the Immortality Institute (http://www.imminst.org) where the participants have already discussed the various ideas laid out in the book before I even had the capability to understand them all, so I would like to thank all the users there. If you do not know by now, I hate to proofread and my grammar is horrendous, so I would like to thank Lisa Ma for taking the time to look over the book and correct my numerous mistakes. If there are still mistakes it is her fault. Last but not least I would like to thank my mother for entertaining these crazy ideas that I have tried to implement in the household. Sounded crazy at first but the results are undeniable. Also thanks for reading the book, not the highest quality you will ever see but hey it is free.

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About This Book Everybody has their own idea of what healthy eating is. People shun certain foods and eat others with gusto with nothing to base their ideologies on other than the word of the “experts” and how they feel. Over the years I have found that expert opinions are usually conflicting and that how you feel is not a good barometer for your health; the body adapts and the mind overpowers. Over the years I have tried to combine my interest in science and motivation to live a long healthy life and work my way from the bottom up to determine what in our lifestyle can be beneficial or detrimental to our health. If you have every worked in a hospital or experienced the slow unrelenting loss of function that older folks experience, you know it is something that one definitely wants to avoid. My goal is not to be bed bound at 100, instead it is to be able to carry my great grandchildren on my shoulders. For years I have been reading books, research papers, and articles in the field of nutrition, exercise, and health. Henry Ford said that “thinking without constructive action becomes a disease.” This is an attempt at constructive action.

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Table of Contents Introduction ................................................................................. 7 Chapter 1: The State of Nutrition ................................................ 9 Chapter 2: The Paleolithic Diet .................................................. 12 Chapter 3: Calories and Nutrients .............................................. 30 Chapter 4: Weight Loss/Gain ..................................................... 44 Chapter 5: Minimizing Damage .................................................. 53 Chapter 6: The Natural and Supplements .................................. 63 Chapter 7: Maintaining the Body ............................................... 71 Chapter 8: Biometric Measurements ......................................... 77 Chapter 9: Perpetual Leanness .................................................. 84 Chapter 10: Paleo Shoes, Posture, and Sitting ........................... 93 Chapter 11: How Much Life Left?............................................... 98 Appendix I: Olive Oil................................................................. 105 Appendix II: Acne and Balding ................................................. 110 Appendix III: Skinny Fat Body Type .......................................... 115 Appendix IV: Riskier Supplements ........................................... 117 Appendix V: Bodyweight Exercises........................................... 122 Appendix VI: Soft Tissue Therapy and Stretching .................... 123 6

Introduction Take care of your body with steadfast fidelity. The soul must see through these eyes alone, and if they are dim, the whole world is clouded. ~Johann Wolfgang Von Goethe Evolution created intelligent but imperfect self-repairing machines. Our cells and tissues are constantly wearing out and being regenerated and most of the time we don’t even notice it. We age because of this incomplete process. As we exhaust our cells, it gets repaired, but it is never like the original. Slowly over the years the gap between our original state and repaired state widen expressing itself as the typical changes of old-age. Only recently has this “gap” come to the forefront. In the past we suffered from infectious diseases, injuries, and starvation; most of the world still does, but modern science has focused on the new problem of chronic diseases (that is where the money is). For those reading this book, you are probably more likely to die of the diseases of civilization than the more “tropical” diseases. Modern technology has rid us of many diseases that would otherwise end our lives when we turn 40; instead we now live until 80, a territory where evolution has not had a chance to act upon. In return for our extended lifespan, technology has made us stressed, out-of-shape, and overweight. While we have doubled our lifespan in the last century (and will be able to extend it in the next), people now suffer from diabetes, heart disease, and dementia. It is not exactly my preferred way to live the last half of my life. One extreme intervention for preventing this suffering is Calorie Restriction with Optimal Nutrition (CRON). This is a lifestyle where you consume less than you expend but achieve all your required nutrients. The metabolic adaptation that takes place extends maximum lifespan (probably your best bet to achieve 120 years of age), but also keeps you younger at the older age. The Okinawans probably 7

went through some form of Calorie Restriction due to poverty from World War II and they are the healthiest and longest living population on earth for now. Am I practicing Calorie Restriction? Not yet. Despite the attractions of CRON I cannot bring myself to implement it. The benefits are that it extends health (physical and mental) and life span, the cons are emaciation. Doesn’t seem like a very bad trade-off, and I don’t have a good reason for not doing it, but it’s like when you know you should write that thank-you letter but you don’t. You don’t have a good reason for not doing it but you still don’t do it. Instead of implementing CRON, I have tried to develop a lifestyle regimen which is a happy middle ground between an extended health/life-span and the lack of emaciation, and this book is my attempt to share it. Due to the internet and the accessibility of information everyone today is trying to improve their health. People nowadays want to understand their conditions more than ever. Most want to take an active role in their own health in hopes of living a healthier and happier life. There is a lot of information out there and it is hard to sift through it all. My book is just one of many, I cannot guarantee the ideas are right, but that’s up to you to decide. Everyone should try to understand the human body and learn how to treat it well. It may not seem urgent to keep yourself healthy now, but your actions today will affect you for the rest of your life. The damage may not be apparent when you are young but it is happening and will show itself down the road.

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Chapter 1: The State of Nutrition It is no measure of health to be well adjusted to a profoundly sick society. ~Krishnamurti The modern food guide was not created until 1992. By this measurement the science telling us what to eat is only 18 years old, a science in its infancy stage. Nutrition and metabolism are intertwined and metabolism is an incredibly complex topic. While a lot of work has been done in the field what is right and what is wrong is still under debate, despite what the “experts” will tell you. To settle all this we should base our theories on the results of Random Controlled Trials (RCTs) but this is very hard to perform on humans Most of our data comes from epidemiological studies and experiments performed on rats/mice. Epidemiological studies are a problem because of mutlicollinearity: some things just go together and make it hard to determine which one is responsible. In nutritional epidemiological studies they take a group of people, ask them what they eat, and determine which ones died of a heart attack (or cancer, or got Alzheimer’s) then do a lot of complex math and see which ones match. This is where multicollinearity comes in. If saturated fat and carbohydrates commonly show up together in food products how do you determine which one is the cause of heart disease? For example, if you find that people who eat donuts get more heart disease, what in the donut is causing the problem? You can do as much math as you want but you won’t find the answer, but at the same time that doesn’t mean you won’t come up with an answer. There are better ways to do these studies such as prospectively, longitudinally, interventional but I won’t go into detail regarding those. 9

The other problem is the data collected from rats, mice and hamsters. Let’s say we used lions instead for our studies. We feed it celery for 6 months and we are surprised it died of a heart attack, we feed it beef for 6 months and they are perfectly healthy with clean arteries. Then the newspapers can say that celery causes heart disease, and then the researchers can use their data and find a relationship between celery and heart disease (I have seen weirder correlations). It’s too bad lions don’t have a shorter life-span. Mice and rats do have a shorter life, in that way we don’t have to wait decades for the results of a study to come out. The problem is what do rats eat? They are herbivores. Their natural diet is a bunch of plants with hardly any cholesterol or saturated fat. If we feed it lots of fat no doubt something bad happens. Beginning in 1992 the US government began recommending a diet high in whole grains and low in animal products (a highcarbohydrate low-fat diet). This began to alter our psychology of what was considered healthy. With the fear of saturated fat spreading across the nation, the only thing left to turn to was carbohydrates and the industry jumped at the idea of low-fat products, which suddenly meant that high-carbohydrate diets were good. The agriculture industry (which provides the grains we use to make processed foods) had developed into a very powerful entity which now greatly influences our food choices. If you look at the advisory panel for the USDA Dietary Guideline recommendations it does not seem very impartial. One dietary regimen that I thought cut through all these problems was the Paleolithic Diet. It is based on the principle that what helps us maintain our health is what we evolved to eat. Just like a cow eats grass and lions eat meat, in our natural environment we eat a certain way. The problem is that the diversity of the human diet is vast. Some are high-carbohydrate and some are low-carbohydrate, but this is a recent phenomenon. Anthropology shows that we evolved in the equatorial region of Africa for millions of years and the diet present there is probably 10

the diet we are adapted to consuming. Also, despite the variation in diets, there are strong commonalities between them all. This idea of the Paleolithic diet will be the foundation from where we will start and improve our nutritional choices.

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Chapter 2: The Paleolithic Diet Red meat is not bad for you. Now blue-green meat, that‟s bad for you! ~Tommy Smothers Theodosius Dobzhansky wrote an essay in 1973 titled, “Nothing in Biology Makes Sense Except in the Light of Evolution.” This is the principle that the Paleolithic Diet is based on. We are what we are because we ate what we ate. Through millions of years we consumed foods available to us in nature which have now allowed us to become what and who we are today. Gary E. Belovsky (1986) modeled Hunter-Gatherer Foraging and in a table he laid out the calories from meat and vegetables of various tribes (reproduced partially here):

Meat (%) Vegetables (%) Intake (g/ind)

!Kung Winter 31 69 740

!Kung Fall 90 10 816

Source: Belovsky BE. Hunter-Gatherer Foraging: A linear Programming Approach. Journal of anthropological Archaeology.1987. 6, 29-76. As far as I know we evolved from the tribe of the !Kung, who live in equatorial Africa. By taking an average of the winter and fall percentages we see that we probably ate half our calories from plant sources and the other half from meat. The ratios aren’t that important. What we can see from the table is that we are omnivores. We ate both vegetables and meat (especially if we could get our hands on it). We are not made to be vegetarian (like many people would lead you to otherwise believe). 12

To understand why this diet has so much appeal you would have to understand evolution. Here’s a small refresher course that I hope helps. I love Kent Hovind’s explanation of evolution: “Twenty million years ago there was the big bang. 4.6 billion Years ago the earth cooled down. It rained on the rocks for millions of years and turned into soup, and the soup came alive 3 billion years ago. So your great great great great great great grandpa was soup.” This tells you what happened but not how it happened. Before we start I want to say that this is a thought experiment, I apologize for any inaccuracies portrayed here. So, imagine a population of 10 primates living in the jungle. They all eat leaves. One day a primate happens upon some meat (I don’t know how) and eats some of it and dies. Its digestive tract hasn’t evolved to consume raw meat. Soon the primate is replaced. Another day another primate finds some meat and eats some, by some quirk of the randomness of nature (mutations) this primate has developed not only the digestive capability of digesting meat but also has developed a taste for it. This primate then has children who also have the same quirk, but this new primate also utilizes the nutrients better (another mutation) and thus develops bigger muscles and brains. This bigger muscled, more brained primate is liked by more females thus also has more children with the same quirks. So on and so forth until the meat eating primates’ move somewhere else to find more meat. The vegetarians stay behind to become chimpanzees and apes, the omnivores move on to become us. Extend this process down to minute-details over millions of years and there you have human evolution. The first primate died because of the lack of ability to digest meat. This is because it didn’t have the mechanisms to digest it. This principle also applies to us. There are some things that we haven’t developed the mechanisms to digest yet and probably never will (considering human evolution has either completely stopped or at least slowed down incredibly). 13

However the thing about evolution is that it only acts up to the point of reproduction (or maybe a little bit farther, grandmother effect). So while it may provide us with big muscles in the shortterm it probably doesn’t extend it into the long-term. This is the trade-off we see with CR. By restricting calories we signal to the body that it is not a good time to reproduce (bring a child into the world) so the body should try its best to preserve itself until times are more plentiful. That is not to say we should ditch the Paleolithic Diet (PD), but there are lessons we can learn from it. Nature did not intend us to grow old and ill. We were designed to die young, of old age, but free of disease. – Ernst L Wynder and Marvin M Kristein Note: One way of extending the human lifespan would be to implement a policy stating couples cannot have children until 60. Therefore only those with good enough genes to reproduce at 60 will be able to have children. The people with bad genes will not have children thus those won‟t get passed down. This would be artificial selection. Not something we can implement ethically/morally, just interesting.

Grain and Anti-nutrients Nature is a battle for survival. We survived because of our brains; other animals survive through sheer size, speed, or just really good camouflage. Every species has adapted to their environment and there’s balance in the world (at least without us). Plants also survived, probably the best the most successful (except maybe insects). However plants are immobile, sure some are lethal physically (e.g. venus fly-trap), but most must utilize other methods to protect themselves. One method is antinutrients which are found in high amounts from legumes and grains. Vegetables such as broccoli, kale, tomatoes, etc… seem to have defenses too but we seem to be much better adapted to these than the ones found in grains and legumes, most likely because grains and legumes only became a large part of our diet 14

10,000 years ago, which is a far cry from the millions of years we have been evolving. There are two important classes of antinutrients: class A (the protease inhibitors and lectins) and class B (the antiminerals e.g. phytate). Protease inhibitors block your digestive enzymes preventing it from breaking down protein. Lectins are plant proteins that bind to carbohydrate moieties on our cells. This is a special type of anti-nutrient that everyone should take the effort to either destroy or just simply avoid. Lectins are dangerous because they bind to carbohydrates found on your gut cells, and of course these carbohydrate groups have other function besides being bound by an anti-nutrient. When lectin binds it can lead to a host of problems. You can think of the carbohydrates on your gut as a lock and the lectin as a key. Normally the lock should not be opened because your gut protects you from the outside world (just like our skin). You would not want your skin to have gaping holes, so following this train of thought, you definitely do not want your gut to have holes. When the lectin (the key) binds to the carbohydrates (the lock) it opens a door that leads to malfunctioning membranes and proteins, and may even cause inflammation and autoimmune disorders. Could it be that it is our modern consumption of lectin that leads to obesity? The study below speculates that the holes caused by lectin will allow lectin into the bloodstream, where it can then bind to a bunch of other carbohydrates in the blood (like the brain): Jönsson T, Olsson S, Ahrén B, Bøg-Hansen TC, Dole A, Lindeberg S. Agrarian diet and diseases of affluence--do evolutionary novel dietary lectins cause leptin resistance? BMC Endocr Disord. 2005 Dec 10;5:10.

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By consuming large amounts of lectin (from grains, peanuts, beans, etc…) you will be opening yourself up to the risk of autoimmune disease: Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Br J Nutr. 2000 Mar;83(3):207-17. The consequences of lectin consumption are not things you want to deal with. Another question we may have: do dietary lectins cause disease? Freed DL. Do dietary lectins cause disease? BMJ. 1999 Apr 17;318(7190):1023-4 Phytates (or phytic acid, or IP6) are a strong acid that binds to divalent and trivalent heavy metal ions which then form insoluble salts (not absorbable), for e.g. zinc, calcium, magnesium and other trace minerals. Oxalic acid is another class B anti-nutrient. There are doubts as to whether class B antinutrients can cause deficiencies in the diets of western societies considering the amount we eat, but if you’re not getting enough minerals in the first place large amounts of the anti-nutrients will probably be detrimental. Both of these classes are found in large amounts in grains (e.g. wheat, barley, maize, rye, rice etc…) and legumes (e.g. soybeans, beans, peas). The good thing is that we can inactivate these anti-nutrients. Why not just avoid them? Well because they are just too damn tasty (they also contain nutrients too). A dentist named Weston A. Price traveled the world over 60 years ago studying the dental health of isolated populations. What he found was that many of the people in areas untouched by Western civilization had very healthy teeth. They had proper jaw development, very little tooth decay, and were all generally 16

in very good health. He wrote about his findings in a book titled, “Nutrition and Physical Degeneration” published in 1939. Price found that cultures who consumed grains or beans took great effort to prepare them properly. They removed the bran, ground the grains, soaked them and also fermented them. That seems to be quite a bit of work but the benefits are numerous (and tasty). For a very detailed overview of fermented cereals around the world the Food and Agriculture Organization (FAO) of the United Nations published a book in 1999 titled, “Fermented Cereals a Global Perspective”. Amazingly, the effort put into grinding, soaking and fermenting is able to inactivate and break-down the various anti-nutrients found in plant material and then heating it finishes of the job for most of them. Stephan over at Whole Health Source, a blog, has this recipe: Soak brown rice in dechlorinated water for 24 hours at room temperature without changing the water. Reserve 10% of the soaking liquid (should keep for a long time in the fridge). Discard the rest of the soaking liquid; cook the rice in fresh water. The next time you make brown rice, use the same procedure as above, but add the soaking liquid you reserved from the last batch to the rest of the soaking water. Repeat the cycle. The process will gradually improve until 96% or more of the phytic acid is degraded at 24 hours. Very simple process that takes very little effort.

Wheat The wheat we know today traces back to a wild grass called Triticeae. From what I’ve read it has a very pleasing flavor, so that’s probably why it got utilized from the beginning. The 17

modern wheat we consume today arose from a variety of wheat called einkorn which had 14 chromosomes. Through artificial breeding and selection we now utilize a variety of wheat that contains 42 chromosomes. There are numerous reasons for this, including easier seed collection as well as improved texture from increased gluten content. Gluten is a protein found in wheat. In patients with celiac disease their immune system reacts to gluten and in turn causes immune system to attack the gut. The result is flattening of the villi:

On the left the increased surface area increases nutrient absorption, on the right, the surface area is less thus decreasing nutrient absorption. Common symptoms are failure to thrive in children, diarrhea, abdominal pain, and nutrient deficiencies. There is speculation (especially in the Paleolithic Diet world) that many react to gluten but just lack the symptomatology. There are beliefs that gluten causes leaky gut syndrome, which then leads to various other disorders. Also it seems that when gluten breaks down it causes opioid-like peptides to be produced, causing addiction (discussed in Chapter 4): Bernardo D, Garrote JA, Fernández-Salazar L, Riestra S, Arranz E. Is gliadin really safe for non-coeliac individuals? Production of interleukin 15 in biopsy culture from non-coeliac individuals challenged with gliadin peptides. Gut. 2007 Jun;56(6):889-90. 18

While the Bernardo et al (2007) study is preliminary (only 6 subjects) what they found was that non-celiacs also responded to gluten (had an inflammatory/immune response). There is an hypothesis by Dr. Fine (from Enterolab.com) that only 0.4% of the population is not reactive to gluten because certain proteins (HLAs) found on most of our cells are reactive to gluten and only 0.4% of the population do not have those proteins. So even if you do not have out-right celiac disease, you may have some sort of reaction to it. This is not good considering that these holes in your gut will allow bacteria and toxins through, leading to many problems down the road (possible autoimmune diseases): Drago S, El Asmar R, Di Pierro M, Grazia Clemente M, Tripathi A, Sapone A, Thakar M, Iacono G, Carroccio A, D'Agate C, Not T, Zampini L, Catassi C, Fasano A.Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastroenterol. 2006 Apr;41(4):408-19 Beyond the gluten there are the dangers of wheat germ agglutinin (a lectin, see section above). There are some researchers who think that lectin causes celiac’s disease rather than gluten. While the whole issue of gluten is questionable, the issue of wheat lectins is definitely not: Pusztai A, Ewen SW, Grant G, Brown DS, Stewart JC, Peumans WJ, Van Damme EJ, Bardocz S. Antinutritive effects of wheatgerm agglutinin and other N-acetylglucosamine-specific lectins. . Br J Nutr. 1993 Jul;70(1):313-21 This evidence, combined with the fact that Weston A. Price discovered cultures who consumed wheat but only consumed it in the form of sourdough bread (which is fermented, which may alter the gluten), gives me reason to avoid it.

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No Soy for the Boy Besides the anti-nutrients found in soybeans, there are other substances found in soy that probably have detrimental health effects (this may be more applicable to males than females, but I strongly caution against soy in either case). Soy is commonly touted as a health food these days because it seems to be a good source of protein (but the anti-nutrients interfere with that), low in fat (just because it is low in fat doesn’t mean it is good for you), and apparently the “healthy” Asians consume tons of it. If you have ever been to some of the Asian countries it is true that they consume tofu (which probably contributes to their shorter stature) but it is not their main source of protein. It is almost always a side dish, and most times it has been fermented (which removes the anti-nutrients, but not the isoflavones). While there are numerous speculative mechanisms by which soy could provide health benefits to the consumer, I have yet to see solid evidence that the isoflavones being consumed confer any benefits; if anything all I see are risks. Genistein and daidzein are phytoestrogens found in soy protein. They are very weak estrogen mimics, meaning they do things that estrogen does but much more weakly (so you have to take an larger amount to equal the estrogen your body produces to create the same effect). While in pre-menopausal women the phytoestrogens may not have an effect, in post-menopausal women and males, it has a marked effect. As an analogy, think of the young healthy female as a big bucket full of water (estrogen). If you put a drop of water (phytoestrogen) into it there won’t be a big difference. On the other hand, think of males and postmenopausal females as a thimble with water, if you put a drop into it there is a considerably larger effect. The connection between estrogen and breast cancer is conflicting, so is it even worth it to take the risk? For males, there is research to show that soy consumption leads to decreased sperm production/quality and decreased testosterone production. In these studies, healthy males consumed 60mg of 20

the soy isoflavon, approximately 30g of tofu per day (2mg of isoflavones per 1g of tofu). This is really not a lot. While there seems to be support for the aging effects of testosterone (eunuchs live longer and castrated dogs also live longer), the decreased testosterone may perhaps be a benefit for longevity. At the same time, I do not think the trade-offs are very impressive. Finally, my biggest problem with soy is the possible effects it has on the brain: White LR, Petrovitch H, Ross GW, Masaki K, Hardman J, Nelson J, Davis D, Markesbery W. Brain aging and midlife tofu consumption. J Am Coll Nutr. 2000 Apr;19(2):242-55. Here is a prospective epidemiological study (which is a good type of study) showing the effects of tofu consumption on brain degeneration. They found that adults consuming tofu daily had worse memory performance than those who did not consume tofu. This is quite scary because Alzheimer’s is one disease I would rather avoid. There is not enough evidence to speculate on what the possible mechanism may be; it could be the isoflavones, the aluminum, etc. While various soy studies have shown beneficial effects, those were short-term studies; this one was a long-term high quality study. For more information there is a great article: “Soy What? The jury's still out on soy's benefits” by David Schardt. The choice to consume soy is up to you. The benefit/risk ratio does not seem very favorable to me. It really depends on where your goals are: Male – If you want to have breasts, be impotent, and imbecilic then be my guest. Female – If you want to risk breast cancer and brain atrophy then soy is the key.

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Vegetable Oils If vegetables are healthy, shouldn’t vegetable oils be healthy? It really depends. If you can press it out of the plant in question it seems okay. If you must extract it with modern processing, that is another question. By Weight Polyunsaturated % Monounsaturated % Saturated %

Soybean Oil 57

Margarine Butter 34

3

Olive Oil 8

Lard

26

49

29

75

44

15

17

56

16

42

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This is a table with some commonly used fat sources. McDonalds used to use lard, but after the saturated fat scare they changed to corn oil (similar to margarine). Others in the food industry did the same and the result was trans-fatty acids. By comparing soybean oil and lard we can see that there is a large difference. The soybean oil (modern processing) has a very high polyunsaturated fat content (very high in omega-6 fatty acids), while the lard is higher in saturated and monounsaturated fatty acids. Based on the Paleolithic Diet we should be consuming a fatty acid profile closer to that of lard rather than margarine or soybean oil. There are many important differences between polyunsaturated fatty acids compared to monounsaturated and saturated fatty acids. The first is the hormonal effect in the body. The polyunsaturated fatty acids can be split into two groups, the omega-6 fatty acids (n-6) and omega-3 fatty acids (n-3). These are known as the essential fatty acids (EFAs). They are required for important production of various factors our bodies require to survive. Generally n-6 are inflammatory (they cause things to become red and swollen), while n-3s are anti-inflammatory (e.g. fish oil, aspirin). Therefore, if you consume a diet that is high in n-6 and low in n-3 your bodily state is skewed towards 22

inflammation. Short-term inflammation is necessary, its longterm inflammation that can cause problem. If your blood vessels are constantly inflamed something is bound to happen. With the introduction of soybean oil, corn oil, and margarine to replace our traditional fat sources, the n-6/n-3 ratio has been strongly skewed towards n-6 with commonly known dietary ratios today of 20:1. Compare this to our Paleolithic ancestors, who probably had ratios closer to 1:1. You cannot necessarily solve the problem by increasing your n-3 intake. Instead, it is important to bring your n-6 intake down because of the other important differences between the fatty acids type: oxidation and reactivity.

Monounsaturated

Polyunsaturated

Saturated

The basis of the fatty acid names are descriptive of how many double bonds each type has. The number of double bonds is important because it determines how reactive it is in the presence of oxygen or free radicals. It’s a tough concept to explain so hopefully you have had some chemistry classes. All you really need to know is that the more double bonds it has the more chances there is for it to “break” (oxidize). There is not only controlled oxidation of fatty acids (beta and alpha), but autooxidation (happens by itself) as well. The type of damage that happens in autooxidation is bad because it perpetuates more damage. Just think about keeping nonhydrogenated margarine at room temperature and butter at room temperature and seeing which one goes rancid faster. The increased rancidity in butter is due to autooxidation, a process that also happens within the body.

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The important thing to realize is that the type of fatty acids you consume in your diet ends up being the type of fatty acids your body utilizes. The more polyunsaturated fatty acids (the ones more likely to go rancid) causes your body to go rancid (the actual process is a bit more complicated). One of the numerous mechanisms by which CR works is by decreasing the incorporation of polyunsaturated fatty acids into cells. So we should try the same by using safe oils: Coconut Oil Palm Oil Avocado Olive Oil (please see Appendix I) Animal Fats Our diets should be mostly saturated fats and monounsaturated fats, leaving polyunsaturated fat consumption to our intake of foods such as nuts, avocados, and the 3 servings of fish per week (and maybe some flax seed oil).

Weston A. Price Nutrients Through his research he discovered the importance of fat-soluble vitamins and found that there were several nutrients that provided the populations he studied with such incredible dental health. They were Vitamin D3, Vitamin A, and Activator X (later found out to be Vitamin K2). Recently there has been considerable research done on these vitamins. Weston A. Price was definitely ahead of his time in this field. Vitamin D3 This has actually been misclassified as a vitamin, for in reality it is a hormone. Vitamins are something our body cannot create thus we must obtain it from the diet. On the other hand, 24

hormones are closely regulated by our body and are created under the correct circumstances. D3 is a hormone because we produce it from the sun. A young man near the equator standing naked in the sun for 30 min can produce up to 20,000IU. This may seem like a lot but under these conditions the body regulates itself (like he was designed to). The government sets the maximum recommended intake at 2000IU. This is the minimum I recommend. If you are supplementing with Vitamin D3 you should obtain it in a softgel form (because its D3 is fat-soluble and tablets don’t have fat). For more information on the importance of D3 you should visit the Vitamin D Council’s Website (http://www.vitamindcouncil.org). There is a lot of research that shows that if you are deficient in Vitamin D3 (which most people in western society are) you are at much higher risks for cancer, infectious diseases, osteoporosis, muscle loss, etc. Start dosing with 20IU/lb of bodyweight for 3 months and then get a blood level test from your doctor. Aim for 3050ng/ml (75-125nM/L). Vitamin K2 The Institute of Medicine has set an RDA for Vitamin K, but that is for the plant form (phylloquinone) AKA Vitamin K1. What we are interested in is the animal form K2. Sources for K2 usually come from pastured butter, organ meats, dairy, and fermented products, many of which we do not consume today. K2 is important not just for bone health but for other reasons as well: Supports endocrine function Reduces chronic inflammation Decreases mortality rates Proper development and growth for children There is a great article on the Weston A. Price Foundation website by Chris Masterjohn: On the Trail of the Elusive XFactor: A Sixty-Two-Year-Old Mystery Finally Solved (http://www.westonaprice.org/abcs-of-nutrition/175-x-factor-isvitamin-k2.html). 25

Today, all newborns in developed countries get an injection of Vitamin K. The reason is because nowadays newborns lack Vitamin K due to 2 reasons: 1) poor placental transport of Vitamin K, and 2) lack of production of Vitamin K due to sterile gut flora. I seriously doubt that thousands of years ago a baby had to have vitamin K injections to be healthy. The problem may be due to the fact that the majority of the developed world ingests Vitamin K1 instead of K2, the plant form rather than the animal form. It seems that K1 has problems passing through the placenta but K2 doesn’t seem to have as much of a problem: Iioka H, Akada S, Hisanaga H, Shimamoto T, Yamada Y, Moriyama IS, Ichijo M.A study on the placental transport mechanism of vitamin K2 (MK-4). Asia Oceania J Obstet Gynaecol. 1992 Mar;18(1):49-55 From this we see that thousands of years ago our ancestral mothers consumed Vitamin K2 from their organ meats and fermented foods, allowing the fetus to receive adequate Vitamin K from both the placenta and breast milk and thus side-stepping the need for injections. Japan has one of the lowest infant mortality rates in the world (recently surpassed by Singapore and Sweden). I would not say that their standard of care is better than everyone else’s or that their technology is better. There may be some cultural issues involved, but one difference that I have seen is that newborns in Japan receive Vitamin K2 (the animal form) while most other countries utilize Vitamin K1. There are many forms of K2 (due to differences in the length of the carbon chain) but two forms with plenty of research behind them are MK-7 and MK-4. MK-7 comes from fermented plant products such as natto, and MK-4 comes from the organs of animals. If you choose to supplement with MK-7 45mcg seems to be enough per day, if you choose MK-4, 1mg per day is needed. 26

Just like at one point Vitamin D3 was considered the miracle vitamin, the next one the media stumbles upon will probably be Vitamin K2. Vitamin A Vitamin A is an interesting vitamin in that it also has hormonal actions on the body. It definitely works in synergy with Vitamins D3 and K2. There are studies showing the risk of fractures with high intakes, but most of that research has probably been done on populations deficient in K2 and D3, because these nutrients are very important for bone health. If studies come out with data that show those with higher intakes of Vitamin A done in people not consuming D3 and K2 it does not apply to us. However this is the only data we have for long-term Vitamin A intake so it is better to be safe. If you eat a varied enough diet with enough beta-carotenes and consume meat daily, then you probably do not need a Vitamin A supplement. There does seem to be evidence that some people with polymorphisms (altered genes) may prevent the conversion of beta-carotene to retinol. I do not know how you could figure out if you have that polymorphism, but I suspect hyperkeratosis of your skin may be a sign that you are deficient in Vitamin A, either by not ingesting enough beta-carotene, or not converting it. Keratosis pilaris (bumps on the back of your arm) seem to respond to Vitamin A supplementation but the data is scant. If you do supplement I wouldn’t recommend more than 1500IU a day, and you must consume Vitamin D3 and K2 to hopefully prevent possible bone fracture. Most multivitamins have large doses of retinol (Vitamin A) so be careful.

Fructose/Sugar Table sugar is half fructose and half glucose. You may know fructose as the fruit sugar/”natural” sugar. It's commonly used as 27

a sweetener as it is almost twice as sweet as glucose, but fructose causes a very different metabolic response than glucose does: Stanhope KL, Schwarz JM, Keim NL, Griffen SC, Bremer AA, Graham JL, Hatcher B, Cox CL, Dyachenko A, Zhang W, McGahan JP, Seibert A, Krauss RM, Chiu S, Schaefer EJ, Ai M, Otokozawa S, Nakajima K, Nakano T, Beysen C, Hellerstein MK, Berglund L, Havel PJ. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009 May;119(5):1322-34. What was found in this study was that the group consuming fructose gained the same amount of weight as the glucose group; however, the fructose group gained it all around their abdomen. This is called visceral or central adiposity. Waist size is one of the best predictors of metabolic syndrome because that huge belly is a sign that your metabolism is damaged. Your body has three main types of fat stores: intramuscular lipids, subcutaneous/deep subcutaneous, and visceral/central adipose tissue. The subcutaneous type is found under the skin, this is the type that you measure when looking at skin folds. The visceral type is the poisonous type. Visceral adipose tissue is located around your organs. An especially important organ with regards to diabetes, heart disease and metabolic syndrome in general is the liver. Visceral adipose tissue doesn't respond to hormones like normal adipose tissue should. The turn-over rate with visceral adipose tissue is very high (even in the presence of insulin), and it is constantly releasing free-fatty acids (even when in the fed-state). It also releases inflammatory hormones and interacts with the hepatic portal vein (which is very important in signaling the metabolic state of the body). All of this coupled together interferes with the normal processes that should occur when you consume food and when you are not consuming food. If you continuously feed this adipose tissue then at some point your body just gives up. 28

Fructose is commonly found in large amounts in sodas, candies, and anything that has been sweetened. And yes, it is also found in fruit. This does not mean you shouldn't consume any fruit, as fruit has a lot of beneficial factors in and of itself. It's just best not to make fruit a central of your diet. Two servings of fruit a day should be enough to get the benefits. The problem with fructose is that the other parts of the body don’t have the mechanisms necessary to deal with it, but the liver does. So when it passes through the liver the body tries its best to metabolize it. Nowadays most peoples’ glycogen liver stores are constantly full so what happens is that fructose becomes involved in lipogenesis (making of fat) which then leads to fatty livers (like with alcohol). If you suffer from gout, it may be the fructose that is the problem: Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, Ouyang X, Feig DI, Block ER, Herrera-Acosta J, Patel JM, Johnson RJ. A causal role for uric acid in fructoseinduced metabolic syndrome. Am J Physiol Renal Physiol. 2006 Mar;290(3):F625-31. Gout is a painful disorder caused by the crystallization of uric acid in your joints and soft-tissue. Uric acid is one of our natural antioxidants we utilize when under stress. Usually our kidneys are pretty good at getting rid of it when it’s not needed, however, under hyperinsulinemia (high insulin levels) due to diabetes/metabolic syndrome, the kidneys have trouble filtering uric acid as well as salt (which leads to high blood pressure). Kidney problems coupled with the fructose-induced uric acid production leads to gout.

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Chapter 3: Calories and Nutrients „Tis not the eating, nor „tis not the drinking that is to be blamed but the excess. ~John Seldon For this section I recommend getting used to the program CronO-Meter (http://spaz.ca/cronometer/):

There are tons of different programs available to track your diet but this one is free, up-to-date, and gets the job done. It’s also open source!

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Calories The amount of energy your body burns in a day is represented by the calorie. The resting metabolic rate (RMR) is a measurement of how much energy your body requires in a day if you just sat there for 24 hours. Everyone’s RMR is different (just like everyone’s set-point is different) but there are equations out there that can help you estimate your daily requirements. The most accurate equation is probably the Katch-McArdle formula which is based on lean body mass (LBM). This equation requires your body-fat percentage, which most people don’t know. The other formula is the Mifflin-St Jeor Equation: Male: BMR = 10×weight(kg) + 6.25×height(cm) - 5×age + 5 Female: BMR = 10×weight(kg) + 6.25×height(cm) - 5×age – 161 Multiplied by an activity factor: 1.200 = sedentary (little or no exercise) 1.375 = lightly active (light exercise/sports 1-3 days/week, approx. 590 Cal/day) 1.550 = moderately active (moderate exercise/sports 3-5 days/week, approx. 870 Cal/day) 1.725 = very active (hard exercise/sports 6-7 days a week, approx. 1150 Cal/day) 1.900 = extra active (very hard exercise/sports and physical job, approx. 1580 Cal/day) A male who is 70kg, 170cm, and 20 years old has a BMR of 1667.5, and including his activity factor (1.200), his daily caloric requirement is 2000 calories. The best way to determine your maintenance calorie level would be to observe your normal eating habits for one week by measuring and weighing everything that you eat. Taking the 31

average amount per day out of those 7 days would be your required daily caloric intake for weight maintenance. I’ve done this many times and the Mifflin-St Jeor equation is actually very close to my number.

Macronutrients Protein, carbohydrate, and fat are the macronutrients. In terms of calories this is how it breaks down: 1g of protein = 4 calories 1g of digestible carbohydrate = 4 calories 1g of fat = 9 calories Others: 1g of fiber = 1-2 calories, 1g of alcohol = 7 calories In the end, calories do count. If you want to lose weight you have to eat below maintenance; if you want to gain weight you eat above. While it is calories that account for your overall weight, there are factors we can manipulate that hopefully increase our non-fat mass while decreasing fat mass (discussed in Chapter 9)

Protein Protein is an essential nutrient, our bodies can make the fats and carbohydrate we require but without protein we cannot survive. While very low carbohydrate diets and very low fat diets are possible, a very low protein diet is not; this would lead to protein deficiency (Kwashiokor) and result in death. Consequently, when designing a proper diet the first consideration should be protein intake. The RDA for protein is 0.8g/kg of bodyweight, however Flango et al. (2010) have recently shown that there is “evidence that protein requirements have been significantly underestimated,” and that the RDA should probably be closer to 1.0g/kg.

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Athletes regularly consume 2.2g/kg of protein per day to achieve higher performance and muscle mass. This can be accomplished via two important pathways: insulin-like growth factor-1 (IGF-1) and the mammalian target of rapamycin (mTOR) pathway. Both pathways are involved in causing growth. However, this may be detrimental to long-term health. Calorie restriction inhibits these pathways, and while they may not be the main mechanisms through which CR acts, they are definitely important. Excess calories and dietary protein (specifically leucine and methionine) activate these pathways. I have chosen to consume a more moderate amount (between 1.0-1.25g/kg/day) because personally, I’m not interested in growing; I am interested in extending my health-span. While 1.0g/kg of protein is good enough to maintain a moderate amount of muscle, it’s decidedly not enough for significant muscle growth. Osteoporosis High protein intake is usually explained as bad because of the increase in acid it causes the body. When things head to your kidneys to be filtered it is either in the form of an acid or a base, and protein causes more acid at the kidneys. Acid is supposed to be bad because the only way your body can buffer it is by removing calcium from the bones (which is basic) thus neutralizing the acidity, but this causes calcium loss which then leads to bone loss (osteoporosis and osteopenia). It definitely makes sense, but as always the body is much more complicated than that and we should be consuming more than the RDA rather then less. Osteoporosis is a disease where your bones are not as strong as they should be. If a teenager tripped and fell, he would be able to get back up without an issue, however if a senior with osteoporosis tripped and fell they have a very high chance of fracturing/breaking a bone. If they happen to break a very big bone (e.g. pelvis) they die. So this is something we have to try 33

our best to avoid. Some commonly recommended prevention interventions are weight-training (stresses the bones causing them to grow) and increased calcium intake from supplements. While the former has supporting data, the latter is conflicting. As you read in Chapter 2 Vitamin K2 and Vitamin D3 are very important for bone health. While things are changing, most calcium supplements do not contain these other vitamins and most people do not take enough of K2 and D3 to have a large effect. So while calcium intake is important, you have to also consume K2 and D3 (note: avoid supplements that contain magnesium and calcium, because they compete with each other for absorption). Most of the studies that the acid-base theory was based on did not reflect reality (pure protein instead of whole food protein sources, small sample size, and errors in the methods). It is fairly clear now that adequate protein is required for calcium homeostasis and hormonal support for the bones: Hunt JR, Johnson LK, Fariba Roughead ZK. Am .Dietary protein and calcium interact to influence calcium retention: a controlled feeding study. J Clin Nutr. 2009 May;89(5):1357-65. This was a random controlled trial (very good) showing that higher dietary protein intake was associated with greater retention of calcium than the lower dietary protein intake. For older folks it is recommended that they consume over the RDA (>0.8g/kg) thus I recommend 1g/kg as mentioned above: Cao JJ, Nielsen FH. Acid diet (high-meat protein) effects on calcium metabolism and bone health. Curr Opin Clin Nutr Metab Care. 2010 Aug 16 Whether this whole acid base theory has any relevant significance I do not know. Long term metabolic acidosis definitely seems bad for the bone, but it also seems protective against heart disease. 34

Get your RDA of all nutrients, do some weight-training, adequate protein (1g/kg), and get the fat soluble vitamins (K2 and D3) and you might stave of osteoporosis.

Carbohydrates Many people blame excess sugar and carbohydrate intake for the increase in chronic diseases today, and I would have to agree. This is not to say that you should not eat any carbohydrates whatsoever, but you should definitely eat within your body’s ability to deal with the load. Diabetes is a disease of insulin resistance that comes about due to overloaded energy stores. Your body stores carbohydrates and fats in 3 places: muscles, adipose tissue, and the liver. The adipose tissue stores it as lipids, muscles have the ability to store it both as glycogen and lipid droplets, and the liver stores it as glycogen (but pathologically can also store tons of fat). When the adipose tissue is full and the skeletal muscles are full, the extra carbohydrates and fats you consume in your diet float around in the blood causing a host of problems (hyperglycemia). When you eat pure carbohydrates (not including fructose), your body goes into carbohydrate oxidation mode and shuts down fat oxidation (saving the fat). When you eat a mixture of carbohydrate and fats, the carbohydrate is preferentially burned and the fat gets stored. If you eat pure fat, fat oxidation is bumped up because of the lack of carbohydrate. Now this all sits on a spectrum. If your metabolic rate is 2000 calories a day, and you consume 2000 calories of carbs, it’ll burn off the 2000 (unless you are diabetic). If you consume 1000 calories of carbohydrate and 1000 calories of fat, you’ll burn it all off but you would never tap into your fat stores. To tap into the fat stores you must create a caloric deficit; the body has to have a reason to tap the fat on your body.

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It is common belief that obese people eat a ton of food. While that may have previously been true, they don’t eat 4000 calories per day forever; if they did they would just gain more and more weight. A lot of people claim they have a slow metabolism, but in reality their metabolic rate divided by their lean body mass is very similar to normal people, if anything it is a bit higher (fat is metabolically active too). It’s not that their metabolism is slow; instead, their body’s ability to defend the set-point in the face of excess calories is not as effective as a lean person’s. Let’s say a male who is 180 pounds with a metabolic rate of 2000 calories consumes 4000 calories for a couple of months because of stress, and as a result he balloons up to 250 pounds of mostly fat. After this, he goes back to his original 2000 calories/day diet. Good news: he won’t gain anymore weight. Bad news: even though he’s eating much less, he still won’t lose the weight. To lose weight you must tap into your body’s fat source. Ingested glucose shunts to 3 pathways: glycolysis, glycogenesis, and the hexosamine biosynthesis pathway (HBP). Glycolysis is where you use the glucose as fuel, glycogenesis is where you build more glycogen, and HBP helps signal your cellular energy levels (among many other functions). As mentioned before, today’s society suffers from excess energy intake. When you satisfy your caloric needs glycolysis is full, and when you eat lots of carbohydrates your glycogen stores are full. In the end, the only pathway left is HBP, and HBP activation leads to insulin resistance. One way to avoid this fate is to ensure you glycogen stores are low. If your glycogen stores are low your body has space to store the incoming carbohydrate. This way if you ever do consume junk-food high in sugar/carbohydrates (e.g. pasta) on special occasions, your depleted glycogen stores can be utilized to sidestep the excessive glucose intake (and maybe even offer a margin of safety in caloric intake). 36

Human glycogen stores are around 15g/kg of bodyweight. For a 70kg male that turns out to be 1050g of carbs (4200 calories). That means 2200 calories over maintenance; this is a considerably large margin of safety in case you cheat that day. The important thing on that day would be to not consume any fat because it would just get stored. Beyond these facts, there’s also the danger of hyperglycemia (aka high blood sugar). Hyperglycemia is a very damaging condition because of the reactivity of sugars like glucose (causes glycation, see Chapter 5). One interesting aspect of low-carbohydrate diets is ketosis. Ketones are a break-down product of fatty-acids and many tissues in the body can utilize it as an energy source. When glucose is absent or low, the body produces ketones so that glucose can be saved for the brain. There may be benefits to ketones but I haven’t been fully convinced as of late, and the safety of long-term ketogenic diets are untested. I choose to stay at the border into ketosis at 100-120g of carbohydrate a day (excluding fiber). I actually intermittently enter ketosis due to fasting and resistance training which depletes glycogen. Everyone’s brain is around the same size, so we all utilize similar amounts of glucose. This means 100-120g is set for everyone. It’s important to get the 100g of carbohydrate because this circumvents the need for gluconeogenesis, which is the creation of glucose from amino acids and glycerol. Considering our lower protein intake, it would be best to save the amino acids for what the body requires and provide the glucose directly from our diet. This also helps save our muscles from being catabolized to provide the amino acids. Fiber Fiber also falls into the group of carbohydrates so it will be discussed here. Much of the anti-nutrients I discussed above are present in the bran of grains which people love to consume as a 37

fiber supplement. I prefer to get my fiber from non-grain sources such as green-leafy vegetables, root vegetables, mushrooms, and nuts. In total I get 30-40g of fiber a day. I’m not certain as to what the optimal fiber intake is, but I have found that 30-40g of fiber from fibrous vegetables is needed to help reach the RDA of all the nutrients. Intake of indigestible carbohydrates does have other benefits besides keeping you regular and promoting satiety through volume. One of them is the production of butyrate in the colon and the maintenance pf healthy flora in the gut. Something that has been spreading in naturopathic magazines and journals is the concept of the leaky gut. Basically, your gut is only supposed to allow nutrients through and keep toxins and poisons out. However, because of damage to the gut through consumption of lectins (remember chapter 2), excess sugar intake, not enough fiber and too much gluten, holes develop in our intestinal wall allowing everything to get through, leading to various problems. I don’t know if leaky gut syndrome actually exists but this certainly illustrates the importance of your gut flora (gut bacteria). They are a part of us and help us regulate our metabolism and protect us from the outside environment. Without them we would die, so it is important to keep your gut bacteria happy and healthy. This can be accomplished by getting your fiber and consuming fermented food products (e.g. cheese, yogurt, kimchi, sauerkraut, etc.). There is extensive research connecting fiber and the prevention of colon cancer. It may be multicollinearity again, but it may also be the phytate that helps prevent colon cancer.

Fats So far we have established that a 70kg man should be consuming 70g of protein, 100g of digestible carbohydrate and 30g of fiber. This total caloric intake comes out to 740 calories. Considering he probably requires 2000 calories a day to maintain his weight that leaves 1260 calories for dietary fat, which turns out to be 140g. In reality, if he incorporates this lower38

carbohydrate/moderate protein intake diet he will spontaneously decrease his caloric intake. This would cause loss of body fat (granted if he performs resistance exercise and watches his nutrient timing). Some nuts, some cheese, some olive oil on your salad, some fatty cuts of meat and some flax seed oil and you’re there. Considering the carbohydrate intake and protein intake, this diet automatically becomes a high-fat diet. This is good for several reasons. Firstly, fat is satiating which helps control caloric intake. Studies show that low-carb diet spontaneously help patients decrease their caloric intake, so maybe we can get some benefits of calorie restriction after all, especially considering our use of intermittent fasting in all this. Secondly, the fats help keep our body functioning smoothly as it helps support hormone and neurotransmitter levels, provides us with more stable energy levels throughout the day, gives us better skin, etc.

Micronutrients/Phytonutrients Dr. Bruce Ames, who has done considerable research on Alpha Lipoic Acid and Acetyl-L-Carnitine, has also established a theory of aging: Triage Theory. Basically, without optimal nutrition the body sacrifices short-term survival at the expense of long-term survival. Each micronutrient your body uses is involved in some important process to keep you alive, so if you are missing one of them or some of them the mechanisms involved in keeping you alive are not functioning optimally, leading to DNA damage, cell damage, oxidative damage, etc. By using the program Cron-O-Meter and measuring your food intake for a week you should get an idea of which vitamins and minerals you are deficient in. The other component is the phytonutrients. Phytonutrients are the substances found in vegetables which seem to confer health benefits upon the consumer. Unlike the anti-nutrients in grains, the phytonutrients have probably been consumed by our 39

ancestors for millions of years as hunter-gatherers. There is an interesting theory about xenohormesis which suggests that as environment conditions worsen, plants alter their phytonutrient content and thus mammals that consume these plants begin to prepare their bodies for the tough times ahead. You’ve probably heard about ORAC values, a measurement of the antioxidant capacity of substances in a test tube. This really has very little to do with how the same substances function inside our bodies. We are not looking at ORAC scores, we want phytonutrients which have strong evidence backing their benefits such as I3C from broccoli, ECGC from green tea, and allicin from garlic have other functions beyond their antioxidant capacity. If you are getting the 30-40g of fiber from fibrous vegetables then you should be getting plenty of phytonutrients. Some fruits and vegetables with research supporting their benefits and should be eaten often are: Broccoli Blueberries Green Tea Dark Chocolate Olive Oil Many of the beneficial phytonutrients are found in the peel of the fruit. Many people are afraid of the chemicals and other substances on it, so what I recommend is either soaking the vegetables/fruit in water with a very light amount of soft detergent or purchasing one of those all-natural vegetable washers or detergents. Heck I even eat the orange peel because of the benefits of d-limonene (if you ever have heart burn give some orange peel a try). In terms of micronutrients it’s probably best to aim for 1.5x the RDA just in case. With value investing, a very common principle is the margin of safety, meaning that if you want to buy something you think is worth 1 dollar, it’ll be better if you spent 50cents just in case your estimate is wrong. I would say that the 40

use of Cron-o-meter and relying on your measuring and weighing skills definitely constitutes an estimate.

Carninutrients Just like plants have phytonutrients, meat has carninutrients (carni- stands for carnivore). There are various carninutrients that we consume which are beneficial. A lot of research has been done with regards to vegans/vegetarians because of their lack of meat intake. If they don’t consume meat they don’t get the following carninutrients: Taurine Carnosine Creatine Vitamin B12 There are many more but these are just some of the important ones. Take taurine as an example: Sebeková K, Krajcoviová-Kudlácková M, Schinzel R, Faist V, Klvanová J, Heidland A. Plasma levels of advanced glycation end products in healthy, long-term vegetarians and subjects on a western mixed diet. Eur J Nutr. 2001 Dec;40(6):275-81. This study found that vegetarians have higher plasma levels of advanced glycation end products (see Chapter 5). It is suspected that lack of taurine might be the cause. If you do decide to be vegetarian make sure to get your bases covered by supplementing with the carninutrients.

Is Meat Bad For You? If you have read the Paleolithic diet chapter you know we probably evolved on meat. As you are also aware of now, meat has carninutrients which have beneficial properties. The orthodox view of our society is that saturated fat causes heart disease. This whole scare probably started with Ancel Key’s 41

“Seven Country Study.” Then came the “China Study” by Colin Campbell which blamed fat consumption on the various diseases in Chinese populations. With this bias the problem of multicollinearity took its place and we have this connection today, saturated fat causes heart disease. Nowadays we use cholesterol levels as a risk factor for heart disease, and we use the reasoning that saturated fat raises cholesterol and cholesterol causes heart disease. Then we do a bunch of studies showing that saturated fat raises cholesterol, which should then lead to heart disease. My understanding of heart disease is this:

As you get older you accumulate fatty streaks (this is normal), but as the fatty streaks get worse (and your blood vessel get more inflamed due to other factors) macrophages invade the blood vessel and eat up the fat. As they eat the fat they get bloated and become foam cells (which are found in plaques). As you can see the blood vessel shrinks and become much smaller (on the right). What causes this accumulation of fatty streaks and macrophages? It is probably oxidized LDL (oxLDL). The fatty streaks are deposited by lipoproteins. Fatty acids don’t flow through the blood by itself, it is usually attached or contained in lipoproteins. There are different classes of lipoproteins, and that is where you get HDL, LDL, and triglycerides (I will be discussing these in the biometric chapter). OxLDL is bad because the fatty acids get damaged then become small. This leads to shrinkage in the size of the LDL particle and a change in shape. When it changes shape, the body utilizes it less effectively and thus it floats around, leaving time for the fat to become oxidized in the blood. As it gets more and more oxidized, the fat becomes sticky and attaches to the blood vessel. 42

If you remember from chapter 2 on the Paleolithic Diet, the type of fatty acid most likely to become oxidized is polyunsaturated fatty acids (the one with lots of double bonds). Your lipoproteins are in the contents of whatever you are eating; if you eat tons of PUFAs you’ll get tons of PUFAs in your lipoproteins. If you consume lots of saturated fats you get saturated fats in your lipoproteins. It’s true that the plaques (that block the blood vessels) are made out of fat (and various other materials) but blaming it on saturated fats is jumping the gun. What is it then? Is it the protein that’s bad for you? Well you need that protein so no. There is one thing that makes meat bad, namely its high fat and protein content. This is due to the methods by which meat is usually prepared these days. Cooking fats with protein at high temperatures (grilling, baking, frying, etc.) is a very bad idea because at these high temperatures, oxidation is rampant and the formation of glycative-damaged products is very high. It’s not that meat in and of itself is bad, it’s the way that it is prepared that is bad. We all know consuming burnt material isn’t good, but it doesn’t have to look charred for it to be burnt!

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Chapter 4: Weight Loss/Gain Don't dig your grave with your own knife and fork. ~English Proverb Eating and storing is much more evolutionarily advantageous than not eating and not storing. This is the Thrifty Gene Hypothesis: those more likely to store energy are more likely to survive. It is much harder to lose fat than gain fat. While your body does gain weight when you eat more and lose weight when you eat less, it is much more complicated than that. We all have a programmed set-point. It is a weight range that our bodies fight to maintain. If you have tried a diet before you know how hard it is to lose weight and keep it off. For example, I am 5’10” and weigh 175lbs at 10-11% body-fat. On an average daily basis I consume 2100 calories to maintain this composition. If I ever wanted to get down to the single-digit body fat levels I would be required to decrease my caloric consumption down to probably 1700-1800 average daily. While I may be able to achieve those caloric intakes for a while soon metabolic adaptations will take place that will make me colder, less likely to exercise, dreaming about food, shot libido, loss of muscle mass, all which are the result of going below your set-point because the body is trying its best to conserve energy and make you eat. If I eat over setpoint, like 2600 calories a day, my metabolism will go up, I will have more energy, and I would gain weight. Everyone’s body tries its best to defend a set-point, and every person has a different in response when defending the set-point. You probably seen those very thin people who eat a ton and yet stay thin; they have a very good defensive mechanism. If one day they eat a ton, they are more likely to become active and increase exercise and non-exercise activity thermogenesis (such as tapping their legs and fidgeting).

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The big problem here though is that our set-points are much more likely to go up, than it is to go down. Set-point is by feedback to the brain and in general I consider there to be two pathways: the Reward pathway and the Fed pathway. The reward pathway has to do with how happy you feel after eating. For example, if you have ever been stressed or got dumped you are much more likely to eat sweets and carbohydrates. The simple reason for this effect is that these types of foods raise dopamine. Under these conditions the reward pathway is below its natural set-point so the body tries to raise it by any means necessary, thus eating. This pathway is usually responsible for addiction to drugs such as cocaine and nicotine. After smoking for months, your brain is used to a higher dopamine level and when you try to stop smoking, it’s hard because your dopamine levels drop, so most people begin to eat, but sooner or later they start smoking again. One thing you see with addiction is that, the person never “breaks” the addiction, they just use “willpower” to overcome it, but they will always crave it under similar circumstances. As you can see set-points usually go up, but doesn’t come back down (just like weight gain), this is because on the way up the body is adapting to stronger signals (more dopamine), but on the way down it has nothing to adapt to because if set point were to move lower, it has to adapt to a lack of signal. The Fed pathway is where the body tells itself it is full. If you eat and your stomach is full or your body knows it’s gotten enough calories your appetite gets suppressed. If you ate an extra 1000 calories the day before and didn’t exercise it off, today you’re not as hungry so you spontaneously eat less. Then why do we get fat if the Fed pathway works. It stop workings because of the reward pathway, that feeling of happiness overrides the fed pathway, ever hear of the saying “there is always room for desert.” So what happens is that one day you start consuming a lot of junk food constantly stimulating the reward pathways (which the body likes) and a few months later your 15lbs heavier (freshman 15).

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Why would nature develop such a detrimental mechanism? In our natural environment it is not detrimental at all; in nature we do not have constant access to concentrated sugar, wheat, and fats. Today we do have access to these supernormal stimuli. We have existing mechanisms which are supposed to respond to thing in nature like sweetness (sweet potato, occasional fruit, rare access to honey), but today this response becomes exaggerated because our access to it is exaggerated. Our bodies did not evolve to be in the presence of donuts and cookies, it evolved to be in the presence of berries and potatoes. It is the supernormal stimulus that causes the reward pathway to shortcircuit our fed pathway, sooner or later our fed pathways get damaged (leptin resistance, insulin resistance) and we suffer the consequences (diabetes, heart disease, obesity). This is why most diets never work, sure you can follow it for a couple of months at best but sooner or later our body wants to get back to set-point. What can we do then? The first thing is not to gain the weight in the first place. But if you have gained the weight there are some things we can utilize that might fix the system a bit. Weight loss is a long-term goal. No one is looking for a shortterm fix, anyways yo-yo dieting probably isn’t the best thing for your metabolism: Steen SN, Oppliger RA, Brownell KD. Metabolic effects of repeated weight loss in wrestlers. JAMA, 1988 Jul 1; 260(1):4750 What the study found was that wrestlers who cycled their weight up and down had a slower metabolism compared to those who did not. This is commonly seen in those who diet and then suddenly gain back more weight than they started with. It is known as the rebound effect and is present in many systems in the body. 46

So we don’t want a short-term solution. A long-term solution has two qualities that make it work: Flexibility (rigidity causes to much mental stress) Adherence (you have to be able to follow it long-term) A big reason why diets fail is because of the rigidity imposed by the rules. Let’s say you are on a low-calorie diet trying to cut fat, one day you eat a couple cookies and all of a sudden your 500 calories over your limit. At this point the mental stress caused by this low-calorie eating breaks your will-power causing you to give up on the diet and binge 2000 calories over your limit. Later you suddenly realized what you’ve done and decide to give up on the diet. Or another example, you are dieting and one day you are invited to a party with lots and lots of food. The environment causes you to lose control and again you give up on the diet. What we want is a way to increase the flexibility of the diet, we don’t want a plan after the fact, we want it before the fact. By planning this cheat day ahead of time we can mentally prepare ourselves for the repercussions and take steps to offset that day. This is where fasting comes into the picture. Fasting is where you do not eat for a set number of hours. I consider fasting to be greater than a 16 hour period where you do not ingest calories. There’s lot of talk out there about not skipping meals, your metabolism will slow down, it’ll hurt you gut, bad for your health, blah blah blah blah blah. I mean it does make sense but the problem is that just because it makes sense doesn’t mean its right. Of course your metabolism slows down compared to when you were eating, but it doesn’t slow down to zero. If you consume 500 calories your body has to digest and process those 500 calories. If your body utilizes 500 calories to digest 500 calories that is a very inefficient storage system (goes against the thrifty gene hypothesis), so it must take less to digest 500 calories, lets say 50. Then we store 450 calories. Sure your metabolism is faster by consuming that meal but it doesn’t speed up enough to overcome the extra 450 calories stored. The smart thing to do would be to just not ingest those calories in the first 47

place. What about for health? I have never read anything about how constantly exposing your arteries to influx of dietary products is healthy. If anything it is damaging. There is a lot of damage that occurs in the post-prandial state (after eating) and there is a lot of research about how to minimize post-prandial damage (see Chapter 5). I will discuss this concept of fasting more in a later chapter, but for now all you have to know is that fasting is beneficial, not fasting is harmful. So let’s say you are going to a big party where you know you can’t resist. Why not just create a huge caloric deficit the day before or on that day. If the party is on Friday, fast for 16 hours on Wednesday and Thursday, after the fast eat a normal sized meal. That way you just created a deficit of probably 2000 calories, and then do your thing on Friday. If you throw in some resistance training on Friday in the morning or before the party that’s even better for calorie partitioning (more on this later too). Don’t be too hard on yourself when you fall of the bandwangon. You have 100 years to live, one day isn’t going to put a huge dent in your lifetime. The next part of a successful long-term diet is adherence. It has to be a diet you can follow. It doesn’t take too much willpower (this also ties into flexibility) and is also a diet you don’t feel deprived of. This is where the low-carbohydrate diet comes into the picture. I discussed many of the issues in the previous chapter but I will go over them again. Blood glucose helps regulate your appetite. Your brain is a very selfish organ and it always gets what it wants. Because if it doesn’t you die. That hunger you get after eating a highcarbohydrate snack isn’t “real” hunger in the sense that you should eat something because your body is running below its setpoint. No it’s “fake” hunger, because of that quick spike in your blood sugar levels, excess insulin was produced which causes your blood sugar to fall below baseline, which means less sugar for your brain so your brain wants you to eat. This is the whole 48

low-blood sugar thing people experience when they are hungry. What it leads to is consumption of sweets and constant grazing throughout the day. I’m sorry but we are not cows or apes. Humans probably went through periods of fasting, where they hunted (exercised) and then consumed after a successful hunt. Our bodies have adapted without the need for a constant infusion of glucose. The reason people rely on snacks nowadays is because this constant grazing has shut-down fat-burning mechanisms. This leads into a hotly debated topic of the Metabolic Advantage (MAD). The metabolic advantage is a state that lowcarbohydrate dieting confers upon its user by allowing intake of unlimited about of fat/protein in the absence of carbohydrate but still leads to weight loss. While if you consumed the same amount of calories on a high-carbohydrate diet you would be humungous. There’s good points on both sides but from my reading of the research it definitely doesn’t seem like unlimited calories. There probably is a metabolic advantage for those with a derangement in their leptin/insulin signaling systems but outside of those folks, the metabolic advantage probably doesn’t exist, in my honest opinion (At most the metabolic advantage seems to be 300 calories). So if the metabolic advantage probably doesn’t exist on the low-carbohydrate diet why do I recommend it? I recommend it for its other qualities: It’s tasty More satiety Stable blood sugar Breaks the supernormal addiction (at least gives you the willpower) If you are consuming low-carbohydrate, then the calories has to be made up with something else, either protein or fat. Now protein isn’t a good idea, because excess will become glucose, and probably leads to aging (more on this later). So what is left is fats. 49

Carbohydrate loading is easy and also fun while we’re doing it. Athletes and bodybuilders can easily consume over 3000 calories of carbohydrate in a day. There’s something unsatiating about carbohydrates. I could easily eat a whole box of cereal in one sitting (depending on the box probably 2000 calories) but could you eat 2000 calories of cheese? The funny thing is that I would probably be hungry after the box of cereal (resulting low blood sugar) but with the cheese I would be full and disgusted for the day. By lowering your carbohydrate intake you not only stop consuming the junk-food but it allows you to increase the fat content of the diet which keeps your blood sugar level and satiety centers satisfied. The other benefit of a low-carbohydrate high-fat diet is it turns up fat-burning machinery (this doesn’t mean you burn more fat from your body, that will depend on your caloric intake). This spares glucose for the brain while the rest of the body runs on fats (ketones). The ketones may also have beneficial properties themselves. Beyond the ability of low-carbohydrate high-fat diets to control your caloric intake, a low-carbohydrate diet also has benefits that will prevent the damage of your cells. This is important for the prevention of chronic illnesses as we get older. Left out of the discussion is the importance of exercise. Remember I said set-point doesn’t go lower, well it seems when exercise is applied it does go lower (it also seems that way with fasting too). By combining exercise, fasting, and a lowcarbohydrate diet a body fat percentage for males below 15% and for females below 25% should be fairly easy to attain and maintain.

Body Types You probably heard of the term endomorph, mesomorph, and ectomorph. It usually specifies the type of body that people have naturally. The endomorph has a very easy time gaining weight as 50

fat; their metabolism is less likely to compensate for the extra calories they consume and they are more likely to gain fat instead of protein. This ratio of fat and protein is called the Pratio (protein/fat). Dulloo AG, Jacquet J, Girardier L. Autoregulation of body composition during weight recovery in human: the Minnesota Experiment revisited. Int J Obes Relat Metab Disord. 1996 May;20(5):393-405 This study shows from the famous Minnesota Experiment that every individual has there own P-ratio, thus putting them on the spectrum between ectomorph and endomorph somewhere. An ectomorph would gain more muscle than fat (if they can gain) and a mesomorph gains equal amounts of both. Apart from the P-ratio there are two more components that determine your body type: speed of your metabolism and how effectively you unconsciously control calorie intake. Your metabolism is actually made up of a couple of parts. There is there basal metabolic rate (BMR) I mentioned in the beginning of Chapter 3. There is the thermic effect of activity (the activity factor you multiply by, the more you exercise the more you burn), the thermic effect of food (it takes calories to digest food) and the biggest factor, the non-exercise thermic effect of activity (NEAT) which are movements outside of exercise such as shaking your leg, fidgeting your hands, bouncing up and down in your seat. NEAT can actually burn off up to 700 calories a day depending on the person. While the movements may seem small it adds up over the entire day. The other component is how well you control your caloric intake around your set point. Some people control it really well, some people don’t.

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Endomorph Low P-ratio Low NEAT Does not control caloric intake well Ectomorph High P-ratio High NEAT Controls caloric intake well Mesomorph In the middle What determines your body type? In the end it is probably genetics and the environment in which you grew up, but I believe they can be overcome with hard and smart work (Chapter 9). Recently a new phenotype has been described and that is the skinny-fat bodytype. The skinny-fat body type are the people that are thin but have metabolic dysregulation just like someone that is overweight with insulin resistance. While other people would gain weight, the skinny-fat person does not gain weight but can still end up with Type II diabetes (discussed in Appendix III). 52

Chapter 5: Minimizing Damage About the only thing that comes to us without effort is old age. ~Gloria Pitzer Aging is a disease because of damage. Just like the transmission of a car gets worn-out, every cell in your body gets worn-out. Unlike a car though, you can’t replace your cells with new parts. The damage created is just a part of being alive. Our body tries our best to fight the entropy but evolution just did not have the need to act on the parts that would keep us alive forever. Even though we cannot prevent all the damage from occurring we can try our best to minimize it. It just makes a lot of sense that we should minimize damage to our bodies, we don’t need to increase the speed by which we age. Source: Cai W, He JC, Zhu L, Chen X, Wallenstein S, Strike GE, Vlassara H. Reduced Oxidant Stress and Extended lifespan in Mice Exposed to a Low Glycotoxin Diet. Am J Pathol. 2007 June; 170(6):1893-1902 In this study Cai et al show that the group of mice consuming a lower AGE diet lived longer. AGE definitely is not good for mice, but they also aren’t good for humans. There is also a study showing that by combining a high AGE diet with CR, the CR benefits are abolished (no lifespan extension). Clearly this type of damage should be minimized.

Lesson on Survival Curves Kaplan Meier survival curves are useful because they allow you to look at how a population is doing. On the x-axis (horizontal) you have age of death (or some function of time) and on the yaxis you have the percent still alive. So for example, we’ll use the black line. At the very left up top, 100% of the rats are alive, 53

by the time you move along the line and get to the middle 50% are alive, then at the bottom 0% is alive. So the lines can take different paths. It can become more square, meaning less rats die near the beginning, but then suddenly drop off at around the same age (like humans), or that there is a very high death rate throughout the lifespan creating the blue line (not accurate because the blue line also shows a decrease in lifespan). The other way it can move is parallel, the graphs could shift to the right showing that at each time period the rat is living longer, thus extending life span.

So in our example above with mice and AGE diets, the AGE-fed mouse is the blue line and the controls were the black line (a CRmice would be the red line). There are two sources for this type of damage: your blood sugar levels and the damaged intermediates you consume in your diet.

Blood Sugar High blood sugar is a dangerous thing. The body keeps blood sugar regulated in a fairly narrow range through various hormones (e.g. insulin, glucagon, glucocorticoids, epinephrine). If your glucose levels are too low you die (the brain needs glucose); if your glucose levels are too high, nothing acute happens, but high glucose levels eventually lead to diabetes. How well you body responds to your carbohydrate intake depends on many factors such as source of carbohydrate, how 54

much fiber, protein, and fat you consume, how long since you last ate, exercise, etc. However, the major factor is your insulin sensitivity. When you ingest a bowl of white rice (which is just starch and water), the amylase (enzyme) in the mouth begins digesting the starch molecules, which continue to be broken down in your small intestine. It then gets broken up into tiny glucose molecules, which are then absorbed through the hepatic portal vein and released into blood for all the cells in your body. Your body cannot really burn off all the carbohydrates at one time, so now the muscles, adipose tissue, and liver suck it up from the blood to prevent it from doing damage. This absorption of glucose from the blood depends on a hormone called insulin, which is released when you eat in preparation for storage. For many reasons, consuming too many calories and excess carbohydrates leads your muscles, adipose tissue and liver to stop responding to insulin. This can lead to high blood sugar levels (hyperglycemia) and then diabetes. Since your liver cannot respond to insulin anymore, it believes that you don’t have enough glucose in the blood, which then causes it to start pumping out glucose into the blood, making matters even worse.

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Glucose may not sound damaging, but in large amounts it is. In the picture above (on the left) you have a normal shaped protein. Protein does its job because of its shape; if you change its shape you change the protein. Usually for a protein to do its job it has to fit into another protein that accepts its shape (like a key and lock). If the protein’s shape is changed it will no longer work properly (the key doesn’t fit). The picture on the right is the same protein but with a glucose molecule attached to it (the circle), by attaching a sugar to the protein it alters its shape, and the shape is no longer allowed to do its job (it becomes damaged). It becomes attached through a reaction known as the Maillard reaction. This may not seem like such a big deal since new protein can be created and usually old protein can be broken down, but what we are worried about are the proteins that stay with us forever, such as the proteins that make up our arteries and the proteins that make up our neurons. If they get damaged, they don’t get removed or replaced. Glycation doesn’t just end with the proteins. It can also cause damage to fats. PUFAs are very reactive, and under high temperatures they are reactive with sugars too. By damaging the protein and lipids of the body, more and more damage occurs in a vicious cycle. Glycative damage is actually one reason oxLDL are produced. As the arteries get damaged by the excess sugar, inflammation occurs and more macrophages are produced. A good way to measure this type of damage is testing glycated hemoglobin. Hemoglobin is the protein that carries oxygen in the blood, thus it shares its environment with glucose. Red blood cells have a turnover rate of 120 days, so as the hemoglobin gets damaged and removed, new undamaged ones are made to replace them. From this you can find the percentage of hemoglobin that is damaged. The more glucose you have in the blood, the higher the percentage.

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To get this test go to your doctor and ask for it. You preferably want a level between 4% and 6%, however if you are already diabetic aiming for below 7% is good. In normal healthy individuals, glycated hemoglobin is a good measure of how well you handle post-prandial hyperglycemia. Post-prandial meaning after eating. Your blood glucose doesn’t spike up and down randomly throughout the day for no reason, it usually follows what you consumed. If you ate 250g of carbohydrate then your blood glucose will spike much more than if you ate 100g. If you happen to have a blood glucose meter I prefer to keep post-prandial glucose below 120mg/dL, this is where my 130g of carbohydrate a day number also came from. Here’s another example to further stress the damaging nature of glycation. Meat undergoes the Maillard Reaction, this is what gives it the flavor when you grill it. Te Maillard reaction is what leads to browning and it is also what leads to burning. This process occurs in the body. The higher your blood sugar goes, and the longer you stay in that environment the more “browning” and “burning” occurs to the cells in your body. If you cook your meat at a very low temperature it takes the meat longer to burn into nothing, more normal glucose levels slow down the damage you accumulate. To prevent blood sugar spikes, consume fiber with your carbohydrate sources (vegetables) and have some fats to slow digestion. Also make sure to get your exercise and consume a lower-carbohydrate diet because this depletes glycogen stores, increasing insulin sensitivity (the emptier your energy stores are the faster and more they can store).

Glycemic Index The glycemic index is a measurement for how different food types spike your blood sugar level. This would be a useful tool if everyone ate only one food at a time, but I consider it a moot point considering people consume mixed meals. Sure, white rice 57

has a high glycemic index, but when you eat it with a bunch of broccoli, some meat, and fruit, what is the glycemic index measuring exactly? The glycemic index diet probably works because it tells you to eat more vegetables and less sugar.

Damaged Food-Products Besides the glycation that occurs inside your body, you should also be worried about the glycation in the food you digest outside of your body. In the study I mentioned at the beginning of the chapter, it showed that the AGEs in your diet matter. Fried meat, bread crust, and evaporated milk are all processed at high temperatures which lead to excessive glycative damage. Here’s a table showing the AGE content of a selection of foods: Food Pasteurized skimmed milk Pasteurized whole milk Evaporated whole milk Butter Cheese Raw minced beef Boiled miced beef Fried minced beef White bread crust

AGE 0.35 0.52 46.2 0.37 5.80 0.72 5.02 11.2 37.1

Source: Goldberg T, Cai W, Peppa M, Dardaine V, Baliga BS, Uribarri J, Vlassara H. Advanced glycoxidation end products in commonly consumed foods. J Am Diet Assoc. 2004 Aug;104(8):1287-91 For a more recent list it can be found in this study: Uribarri J, Woodruff S, Goodman S, Cai W, Chen X, Pyzik R, Yong A, Striker GE, Vlassara H. Advanced glycation end products in foods and a practical guide to their reduction in the diet. J Am Diet Assoc. 2010 Jun;110(6):911-16.e12 58

What was found in the study by Uribarri et al (2010) was that: Fats contain more AGEs Meat is the largest contributor Carbohydrate groups contain the lowest Grains, legumes, breads, vegetables, fruits, and milk are the lowest in AGEs Another interesting point in the paper was that if you marinate your meat in acidic vinegar the AGE content is reduced by 50%. What we learn from all this is that high temperatures for long periods of times are damaging. We should cook in moist heat and lower temperatures. Between time and temperature, which one is more important? Well, the rate of chemical reaction is usually exponential with temperature and linear with time, so it is better to cook at lower temperatures for longer, then higher temperature for short periods. Why don’t we just consume grains, breads, and legumes all the time? Firstly, meat has carninutrients we should be getting, and we must also be aware of balancing blood sugar and the consumption of dietary AGEs. Diabetes is a disease due to high blood sugar, so I think keeping your blood sugar under control is more important. Basically, stay away from processed foods (high temperatures, especially evaporated products like infant formula) and when you cook meat, steam it or boil it after marinating it in vinegar and various spices. Also, always use moist heat to make dishes, there really is no reason to be frying your vegetables in oil. You can quickly heat them on a pan with water then add the oil later if necessary.

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Iron Levels Women have monthly cycles which cause them to lose ~30mg of iron every month while males gain ~1mg of iron per day after the end of their growth period. There may be many explanations as to why women live longer than men (~7 years longer, e.g. estrogen, disposition) but one interesting possible reason is that men get overloaded with iron as they age and women do not (until they hit menopause). Overall, our bodies are actually fairly good at regulating iron stores. At the same time, hemachromatosis (a disease which causes iron overload in humans) shows us the dangers of excess iron: liver damage, diabetes, heart disease, arthritis. We can see that excess iron is a bad thing. Iron causes all these problems because of its interaction with the free radicals that are produced from metabolism. The free radicals by themselves are not that damaging, however, when combined with free iron the damage is increased. The more iron there is, the more damage that occurs. Alzheimer’s, diabetes, and liver disease are all associated with increased iron stores in their respective locations. Here is a prospective study showing the association between high iron stores and atherosclerosis: Jehn ML, Guallar E, Clark JM, Couper D, Duncan BB, Ballantyne CM, Hoogeveen RC, Harris ZL, Pankow JS. A prospective study of plasma ferritin level and incident diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol. 2007 May 1;165(9):1047-54. The problem with many supplements and fortified foods is that they are very high in iron. Not only that, but people go out of their way to purchase extra iron supplements. Nowadays many people also take multivitamins which contain Vitamin C. Mixing Vitamin C and iron together is bad because not only does Vitamin C increase iron absorption, but it also reacts with it causing the production of free radicals. Dietary iron is usually not a big problem (as long as you implement the interventions 60

discussed below) because it comes with substances that protect the body from the damage (e.g. phytochemicals, carnosine, taurine). Most multivitamins include the entire RDA for iron, so if you are eating a wholesome diet you are getting 2x the RDA. There are two types of iron: heme-iron (found in red meat) and non-heme iron (found in vegetables, grains, legumes). Absorption of non-heme iron really depends on the environment where various fatty acids, proteins, and vitamins/minerals can affect its absorption, but overall the absorption of non-heme iron is not very good. Non-heme iron makes up ~85% of dietary intake. Heme iron is absorbed very well thus while it only contributes ~25%, it provides more iron to our bodies than nonheme. Based solely on this we can conclude that we should not consume any meat. Yet just like many things regarding your health, just because too much is bad does not mean that none of it is better (e.g. protein See Chapter 2). In my opinion, it is better to be on the lower side than the higher side. However, decreasing dietary iron should not be the goal because dietary iron helps outcompete cadmium and lead in our intestines thus preventing heavy metal toxicity. Instead we should be focusing on how to get rid of the excess in men (unlike women, men do not have cycles). Exercise is good for getting rid of iron because just by sweating and breaking our cells we lose 1mg from exercise (so you have to sweat!). The other thing we can do is to donate blood: Meyers DG, Strickland D, Maloley PA, Seburg JK, Wilson JE, McManus BF. Possible association of a reduction in cardiovascular events with blood donation. Heart. 1997 Aug;78(2):188-93 What was found in this study was that men who donated blood were less likely to have heart attacks (which is a good thing). 61

Donating at least twice a year is good. Not only do you help others but you also help yourself in the process. The other thing you can do is to supplement with an iron chelator such as phytate (see Appendix IV), other phytonutrients also work (such as those found in green tea). Phytate is very good at binding iron, but the thing to watch out for is to not go overboard (or else you get anemia). So if you do plan to supplement with phytate, make sure to get your ferritin (this stores iron) levels checked. We want it on the low side, but not past it.

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Chapter 6: The Natural and Supplements Better to hunt in field, for health unbought, than fee the doctor for a nauseous draft. ~John Dryden A lot of this book has discussed the Paleolithic diet: we evolved in nature to eat certain things, therefore it may seem like what is natural is best, ergo what is natural cannot do any harm. This is the naturalistic fallacy. If everything in nature was good for you, why are there poisonous plants and mushrooms? Clearly we need to view what is “natural” with a more skeptical eye. If you walk into a supplement store today you will see numerous herbal extracts, vitamins, minerals, amino acids, and other ingredients. If you ask the sales clerk if all this stuff is safe they would say, “oh yeah it’s all natural” and the customer will buy the supplements, take them home, and consume them without knowing that there could be consequences down the road. When you spend money on something that is supposed to make you healthier, one should definitely apply a more skeptical eye to what they are buying. We aren’t supposed to be looking for what is natural; we want to look for what is safe and effective. Now safety is not something that can always be judged, so when you consume something it should definitely have a very high benefit to risk ratio. Every supplement you consume outside of whole foods means taking a risk, if you want to take that risk, the trade-off better be beneficial. Let’s take aspartame and stevia for example. Both are zero calorie sweeteners commonly used in products today for those who do not want to consume sugar. Aspartame is regularly blamed for causing cancer, and stevia is championed as being all-natural, thus entirely safe. I prefer my drinks with aspartame. While stevia has been used by for generations by South American Natives, this type of data doesn’t have any edge on 63

clinical data (outcome trials, animal toxicity data, prospective epidemiology). Just because it has been used historically doesn’t mean that it’s safe. How is one generation supposed to link cancer 40 years down the road to their ingestion of stevia leaves? If stevia caused diarrhea I can see how they would make the connection. To determine what is safe and effective we must turn to the scientific method, and so far aspartame, sucrolose, splenda all have this type of data behind it while stevia does not.: Magnuson BA, Burdock GA, Doull J, Kroes RM, Marsh GM, Pariza MW, Spencer PS, Waddell WJ, Walker R, Williams GM. Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. Crit Rev Toxicol. 2007;37(8):629-727. The most convincing study is this one that has life-span data: Source: Soffritti M, Belpoggi F, Degli Esposti D, Lambertini L, Tibaldi E, Rigano A. First experimental demonstration of the multipotential carcinogenic effects of aspartame administered in the feed to SpragueDawley rats. Environ Health Perspect. 2006 Mar;114(3):379-85.

What they show in the study is that the rat fed aspartame and the control rats had the same lifespan. In other words aspartame did not cause more deaths despite what the conclusion of the study states (the data was probably due to chance because the researches were just really bad at taking care of the rats, many rats died prematurely). If anything, the female group seemed live longer when fed aspartame. So for the occasional treat I see no reason why I would choose regular soda over diet-soda (30 grams of sugar or couple 180mg of aspartame).

Supplements The supplements you should be taking should really be determined by your diet. After a week of tracking with Cron-OMeter you should have a good idea of what you are deficient in. If for some reason you can’t reach 1.5x the RDA for each 64

vitamin and mineral, you can decide to take a supplement. Buying a supplement is a hard decision, because not only do you have to buy the right form of the ingredient, you should also try your best to buy a high-quality supplement so that you get what you are paying for. Beyond the “active” ingredient in the pill, it can also contain other ingredients that are used to fill up the pill and also make it easier for the machines to pack the pill: Lubricants. Fatty acids, or stearates, which speed up manufacturing. Disintegrators. Cellulose or sodium lauryl sulfate that help the pill breakdown. Binders. Promotes cohesion, like polyethylene glycol. Diluents. Fillers, such as starch that increases the bulk of a product. This is by no means an exhaustive list but you should be aware of what you are putting in your mouth. If you take a look at pharmaceutical drugs most pills don’t have more than 5 of these other ingredients. The less it takes to make the pill, the higher quality the pill usually is. Some other ingredients I stay away from are: Propylene Glycol Artificial Colorings Sweeteners Sodium Benzoate Aluminum Silicate While ones I consider safe are: Magnesium Stearate Gelatin Stearic Acid Lecithin 65

Cellulose Di-Calcium Phosphate Glycerin These lists are by no means extensive but just keep an eye out for how other ingredients there are. I have found some very pricey supplements with 8-10 other ingredients. Which supplements should you be taking then? Well there iss the Weston A. Price nutrients, vitamins A, D3, and K2 (MK-7 or MK-4) and maybe some magnesium and a source of omega-3s, because modern diets are usually deficient in these nutrients. Vitamin D3 This is not actually a vitamin but a hormone that our bodies require to function optimally. Back near the equatorial region of Africa we probably produced tons of Vitamin D3 due to exposure from the sun. In 20 minutes our bodies have the capacity to produce 20,000IU of Vitamin D3, yet for most of us, when we go outside we cover ourselves up, stay in the shade, and slap on sunscreen. These are actually fairly smart things to do considering that UV light causes skin aging, damage, and maybe cancer, but doesn’t do much for our Vitamin D status. So the first thing you should be supplementing with is at least 2000IU of Vitamin D3. What should optimally be done is to supplement with 25IU/lb of bodyweight then get blood tests performed measuring your levels to ensure that you are in the optimal range >30ng/ml and less than 50ng/ml. You can read more about Vitamin D and the Vitamin D Council website. When you purchase the supplement ensure that it is in a softgel form because Vitamin D3 is fat-soluble, and tablets don’t have any fat.

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Vitamin K2 We are animals so we use K2, but K2 is found mainly in cheese, organ meats, and fermented soybeans; many foods people do not consume today and because of modern processing even if you do they are not present in large enough amounts. This means we should probably supplement with it. Most people associate vitamin K with bone health and this is true. Vitamin K2 helps activate Vitamin K dependent (VKD) proteins allowing the body to bring the calcium to where it is needed, instead of letting the calcium float around in the body possibly leading to calcification (heart disease). Beyond just bone health, it has an array of other benefits: Cancer Neuroprotection Cardiovascular health Dental health There are two forms: MK-7 and MK-4. MK-7 comes from fermented soybeans while MK-4 is the endogenous animal form. If you take MK-7 take 45mcg a day, if MK-4 take 1mg a day. Also ensure that it is in a softgel form. Magnesium If you’ve analyzed your diet you are probably deficient in magnesium. It takes conscious effort to design a diet sufficient in magnesium so most people would rather supplement with it. Even though I do achieve the RDA I choose to supplement with some extra to get over the RDA just in case. In the distant past, the majority of our magnesium was probably from our water intake. Nowadays we filter our water and it basically has no minerals in it. Supplementing with 250mg of extra magnesium a day would benefit a lot of people in terms of bone health, cardiovascular health, and diabetes. 67

There are many different forms of magnesium but a cheap and absorbable form to take would be magnesium citrate. Make sure to stay away from magnesium oxide. While the oxide form is the most popular, it’s not as absorbable as other forms. The reason oxide is used is because the pills are smaller than if you used citrate.

Omega 3 Fatty Acids I actually don’t recommend fish oil unless you have neurological problems. The reason for this is that the very long chains of polyunsaturated fatty acids in fish oil will be incorporated into the inner mitochondrial membrane and possibly reduces your lifespan. I am not saying that omega-3s are not beneficial, just that I would rather get my n-3s from shorter chain fatty acids. If you remember the section on vegetable oils in Chapter 2, double bonds are more likely to react and oxidize. Well, the PUFAs in fish oil have the most double bonds you will find. The more fish oil you consume the more long chain PUFAs in your body. For an introduction to this aging theory read here: Hulbert AJ.Explaining longevity of different animals: is membrane fatty acid composition the missing link? Age (Dordr). 2008 Sep;30(2-3):89-97. Basically what has been found is that species with more long chain PUFAs in their membranes live a shorter life than those with less PUFAs. It is interesting to note that CR also reduces the incorporation of long chain PUFAs into the membranes. What do we supplement instead? Well get your fish three times a week, and the rest of the days supplement with 6g of flax seed oil (1 tablespoon). Common arguments against this are that flax seed oil conversion into animal form omega 3 fatty acids are inefficient (~10%), but 68

just because it is inefficient doesn’t mean it doesn’t happen at all. Research has placed optimal amounts of omega-3 intake at around 250mg (which comes out to 3 servings of fish per week). One tablespoon of flax seed oil is enough to make 250mg. This may seem like a mechanistic argument (which is bad) but there is also research to show that flax seed oil has just as good cardiovascular outcomes as fish oil. You may also have heard of the flax seed and prostate cancer association. If it is the lignans in the flax seed, the oil doesn’t have any lignans so it doesn’t matter. If it is the actual oil itself, well a new study out in March 2010 showed that there is no connection: Carayol M, Grosclaude P, Delpierre C. Prospective studies of dietary alpha-linolenic acid intake and prostate cancer risk: a meta-analysis. Cancer Causes Control. 2010 Mar;21(3):347-55 It looks at prospective studies (which is good) and they found no connection. The Rest of the Nutrients It’s preferable if you get the rest of your nutrients from food, but if you find it hard I suggest topping it up with a multi-vitamin. The only good brand of multivitamins out there is AOR. Don’t take the full-dose, a partial dose will do. I only suggest a partial dose because unless you are munching on sugar all day, you do ingest nutrients. Most of the multivitamins designed nowadays follow the principle “the more the better,” which is good for the companies because that’s what people will buy, but it is not good for you. As I mentioned in chapter 2, too much pre-formed Vitamin can double your risk of fractures, too high of a zinc-copper ratio leads to prostate cancer, too much copper can lead to dementia, extra selenium (and most multivitamin has a lot of that) can lead to diabetes, too much folic acid and thiamine will cause cancer down the road. Most multi-vitamins these days contain a lot of these vitamins and 69

minerals, because these vitamins and minerals are what customers actually seek out. If someone buys a multivitamin it is not rare to see them taking an extra b-vitamin supplement (way too many b-vitamins) and some extra zinc. Just a quick note on folic acid, if you consume 100mcg of folic acid from food you absorb 50mg, if you consume 100mcg from supplements you absorb 100mcg. The RDA is set for food intake not supplement intake. Toxicity is not the only problem. It’s the design of the multivitamin that is also something one should pay attention too. There are eight forms of Vitamin E, most vitamins use alphatocopherol which can decrease your body’s stores of the other forms of Vitamin E (in nature the gamma-tocopherol is the one that is consumed in higher amounts). The beta-carotene is usually synthetic (cheaper to make), inclusion of various herbal extracts with no evidence backing up its safety or efficacy, and also inclusion of various phytonutrients that are beneficial but not in high enough dosages to have an effect (included for cosmetic purposes). Many also include green tea extract, which binds to minerals decreasing absorption, as well as magnesium oxide instead of the other forms because it fits into a smaller pill. However, it is not absorbed properly. Not only is taking a full dose and badly designed multivitamin incredibly dangerous, but at best you are just wasting your money. As I said, I only know a couple of companies that design their multivitamins and do not suffer from these deficiencies, and one of them I trust is AOR. Be careful out there because your life and health depends on it. Please see Appendix IV for more risky supplements that I believe may also beneficial.

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Chapter 7: Maintaining the Body Fasting is the greatest remedy, the physician within. ~Philippus Paracelsus Our world is full of stress. We experience internal (e.g. free radicals, oxidative stress) and external stress (e.g. toxins, lack of food). Many people assume that no stress is best but that may not be true. Our bodies are very adaptive and when exposed to various stimuli, our body is capable of up-regulating protective mechanisms, which we can then utilize when the stress disappears. So it seems like the right amounts of stress, intermittently in various forms, is probably good for us in the long-term. This is called hormesis. Some examples of hormesis are: exercise, alcohol, fasting, eating vegetables (xenohormesis); some more controversial ones are radiation and small doses of poison. As we all know, exercise is good for you, but too much leads to overtraining and down the road your body is going to breakdown. There is evidence to show that alcohol intake probably leads to better cardiovascular health (20g or so a day), perhaps through the production of hydroxytyrosol (which is also found in large amounts from high quality olive oil). Plants also elicit these mechanisms in us. As I mentioned in the anti-nutrient section of Chapter 2, plants develop defensive mechanisms to protect themselves from predators. While we may not be adapted to grains we may be adapted to the various green vegetables and fruits found in nature that we would feed on, so we've adapted to these poisons. “That which does not kill us makes us stronger,” to a degree.

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Hormesis probably played a role in our evolutionary history by selecting those who had mechanisms in place that could be upregulated when exposed to stress, thus preparing them for larger stresses in the future. Those without the gene that leads to upregulation probably died off when those large stresses came about. For an example of the importance of hormesis we will use exercise. When you exert yourself your blood starts pumping and you take more breaths because your body requires more oxygen. It is the utilization of oxygen that produces the free radicals that everyone takes antioxidants to prevent them from damaging our cells. Quite intuitive, isn’t it? Take antioxidants that soak up free radicals so no damage is done and thus we are healthier. But no, that's not what happens. There's an evolutionary reason for these free radicals, which is to help up-regulate stress coping mechanisms (and exercise is a stress). In this study: Ristow M, Zarse K, Oberbach A, Kloting N, Birringer M, Kiehntopf M, Stumvoli M, Kahn CR, Bluher M. Antioxidants prevent health-promoting effects of physical exercise in humans. Proc Natl Acad Sci USA. 2009 May 26; 106(21):8665-70 What they found was when vitamin C (an antioxidant) was given to an untrained individual performing exercise, the beneficial effects of exercise was blocked. It seems that free radicals help signal, telling the body it has to adapt. This is a very good example of the difference between “it makes sense that it should do this” vs. “does it actually do this.”

Autophagy and Fasting Calorie restriction may also work its magic through autophagy (self-eating). Our bodies are constantly making new enzymes, cells, and other stuff all the time. Our bodies aren't perfect so it’s bound to make numerous mistakes in our lifetime. Also 72

considering the damage we do to it by the crap we eat and the stress we experience, it is a surprise we don’t age faster. While our body does have mechanisms by which to deal with some of it, we never get into the optimal state to remove the garbage. Today we are taught to eat 3 square meals a day and maybe even have some snacks when hungry. We are constantly in a fed state, and never have a chance to enter the fasted state. We are always trying to build and store nutrients instead of breaking them down. The only times that we may be in the fasted state is when we are asleep but that doesn't take into account the fact that lots of people eat very late night snacks. So let’s say you don't eat for 24 hours (fasting). During the 24 hours your body still needs to run on something so it taps into your body’s own energy stores. It requires glucose for the brain, which the body can produce by breaking down liver glucose stores. If your liver glucose stores are low, the body tries to leave the glucose for the brain and instead breaks down fatty acids into ketones. This allows other tissues to use ketones while the allimportant brain can still get its glucose. Another source of glucose would also be amino acids. But this isn't amino acids from your muscles, its most likely the crap that doesn't work and instead is floating around in your cells and body. Basically, by not eating your body decides to recycle the garbage. So as you can see, if you never fast, or never eat below maintenance (i.e. calorie restriction), you never get to take out the garbage. Also there's the added benefit of ketones (if your liver glycogen stores are depleted, which we will do with resistance training, Chapter 6, and low-carb diets). There are some common myths associated with not eating and I will address the two important ones here: Metabolism slows down: FALSE Heilbronn LK, Smith SR, Martin CK, Anton SD, Ravussin E. Alternate-day fasting in nonobese subjects: effects on 73

bodyweight, body composition and energy metabolism. Am J Clin Nutr. 2005 Jan; 81(1):69-73 What this study shows is that the metabolic rate did not slow down. It also showed that the use of fats as energy increased (as it should). Even if metabolism did slow down, it wouldn't slow down enough to overcome the deficit you created that day. On that day you created an 800 deficit, by finishing the fast with a 1200 calorie meal. Do you really expect your metabolic rate to slow down to 1200 within 24 hours? Muscles will break-down: FALSE Norrelund H, Nair KS, Jorgensen JO, Christiansen JS, Moller N. The protein-retaiing effects of growth hormone during fasting involve inhibition of muscle-protein breakdown. Diabetes. 2001 Jan;50(1):96-104 So by fasting you actually increase growth hormone, which has the effect of helping you retain your muscle mass. It doesn't make any sense for your body to directly attack your muscles and start breaking them down for energy. You need muscles to hunt and survive. If anything, it definitely seems like for effective muscle growth to occur, periods of nutrient depletion are required. This may be due to the rebound effect the body experiences when going from the fasted state to the fed state. At a minimum I recommend fasting 2x per week for 24 hours, then ending the fast with tons of vegetables, and some meat, and some carbs. A 24 hour fast would work like this. On Monday, finish your last meal at 6pm then don't eat until 6pm the next day. Then choose another day to do that. I've actually included my fasting schedule 74

into a larger scheme combining calorie cycling and resistance exercise. One problem with fasting is that it brings you into an insulin resistant state because you are burning fat during that 24-hour period. Insulin resistance is beneficial under this circumstance because the glucose should be saved for the brain. However, breaking a 24-hour fast with one meal may put quite a bit of stress on the body, especially if your meal contains carbohydrates. What I have been doing over the past couple of months is consuming a small meal beforehand with some carbohydrate, protein, and fiber; usually just a salad with a small sweet potato, or some oats with lean chicken breast that will return insulin sensitivity before I consume my larger meal. When I say small, I mean very small. One bowl of vegetables with about 20g of carbohydrate and 1 serving of lean chicken breast.

Supplementation During Fasting On fasting days, do not consume antioxidants. It may be that it is the increased free radicals (just like with exercise) that provide the benefits. A research paper published in 2010 found this: Underwood BR, Imarisio S, Fleming A, Rose C, Krishna G, Heard P, Quick M, Korolchuk VI, Renna M, Sarkar S, GarcíaArencibia M, O'Kane CJ, Murphy MP, Rubinsztein DC.Antioxidants can inhibit basal autophagy and enhance neurodegeneration in models of polyglutamine disease. Hum Mol Genet. 2010 Sep 1;19(17):3413-29. Just like Vitamin C inhibited the beneficial adaptations of exercise, excess antioxidants may even prevent basal autophagy; the type of autophagy that happens on a regular basis. Better rethink those antioxidant supplements.

Fasting versus Calorie Restriction Intermittent fasting (IF) is commonly described as calorie restriction without the calorie restriction. It extends life but you 75

still get to eat the same amount of calories as before. Careful analysis of the data shows this is probably not true, there is simply no life extension without loss of bodyweight (implying reduced caloric intake), and looking at the autophagy data those that lost the most bodyweight due to fasting had the most autophagy. There has been research done comparing different measurements such as insulin sensitivity between CR and IF. The data is conflicting, but one of the most recent and well-done studies done in humans has shown that IF does not provide the benefits of CR if calories consumed are the same (and weight is maintained). This agrees with the rat/mice data (IF does not extend life without calorie restriction), however, one difference that has been shown is that IF may offer greater protection of the brain than CR: Mattson MP, Wan R. Beneficial effects of intermittent fasting and caloric restriction on the cardiovascular and cerebrovascular systems. J Nutr Biochem. 2005 Mar;16(3):129-37. Fasting and calorie restriction are not the same thing, and I am not recommending you consume all the calories you didn’t eat one day in the day after. While IF may not provide the life extending benefits of CR, there are benefits and it is better than not doing anything at all.

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Chapter 8: Biometric Measurements Friend to Groucho Marx: “Life is difficult!” Marx to Friend: “Compared to what?” Modern medicine has provided us with many ways to measure our health. Some tests I wish I could afford are the genetic screening provided by 23andme and the Biophysical250, which tests 250 biomarkers (basically most of them in existence). To judge your health you do not need all those 250 markers, but there are some important ones that you can easily ask your doctor to prescribe and then interpret yourself.

Vitamin D3 I discussed the importance of Vitamin D3 in Chapter 2. Take 20IU/lb of bodyweight for 3 months then get a blood test and aim for 30-50ng/ml (75-125nM/L). If your doctor doesn’t want to give you that blood test either try and convince him (read the Vitamin D Council Website) or find another doctor. An alternative would be to just pay for one from the Vitamin D Council Website (as of August 2010 it costs 65USD).

Lipid Profile This test gives you 4 numbers, total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TG). This is my lipid profile as of July 2010: TC: 5.47mmol/L (211mg/dL) HDL: 2.53mmol/l (98mg/dl) LDL: 2.69mmol/L (104mg/dL) (calculated) TG: 0.51mmol/L (45mg/dL) 77

The LDL number is not actually measured, instead it is estimated from the Friedewald equation which estimates LDL based on TC, HDL, TG. It is actually inaccurate when TG are as low as mine are, and as low as most low-carbohydrate dieters are, there has been a new equation for low TG created: Ahmadi SA, Boroumand MA, Gohari-Moghaddam K, Tajik P, Dibaj SM. The impact of low serum triglyceride on LDLcholesterol estimation. Arch Iran Med. 2008 May;11(3):318-21. Friedewald (1972) Formula: LDL = TC - HDL - TG/5.0 (mg/dL) Iranian (2008) Formula: LDL = TC/1.19 + TG/1.9 – HDL/1.1 – 38 (mg/dL) Using the new formula my LDL is actually 1.91mmol/L (74mg/dL), which is lower the American Heart Association guideline! If you are low-carbohydrate dieting and your doctor is trying to interpret your profile, make sure to provide them with the real numbers, and maybe even educated them on these new findings. Dr. Ronald M Krauss determined two patterns for the lipid profile, A and B. The A pattern profile is where the LDL (the socalled “bad” cholesterol, looks more like a band-aid to me) is large and buoyant. OxLDL are the small dense LDL of pattern B. So pattern A is good and pattern B is bad. Since most doctors do not prescribe VAP tests to actually measure LDL size and particle number we have to estimate. As you know, oxLDL is bad, so Pattern B is very bad. Pattern A is what we want. Pattern A is usually present if you TG are low and your HDL is high. Pattern B is present if TG are high and HDL are low. This can be represented in the TG/HDL ratio, which is one of the most accurate predictors of heart disease based on your typical lipid profile test.

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Diet, micronutrients, and exercise determine your lipid profile. If you consume the American Heart Association (AHA) low-fat diet you will inevitably end up with Pattern B (ironic eh?), if you consume low-carbohydrate high saturated fat you will end up with Pattern A. The triglycerides are very representative of your carbohydrate intake. If you consume lots of carbohydrates, your triglycerides are high, the high carbohydrate intake also somehow decreases HDL (by somehow increasing an enzyme that breaks down HDL). Saturated fat also helps boost HDL. After knowing this, it definitely seems like the whole lipid profile thing was just a measurement of your carbohydrate intake, which represented your intake of processed junk foods. After a couple years they found that total cholesterol didn’t tell much so they then focused on LDL, then LDL didn’t tell much and now its TG/HDL, but the TG/HDL ratio is low only when you are consuming saturated fat and low carbohydrate (with an exception, which is calorie restriction). Magnesium and various other nutrients also seem to have a connection with the lipid profile but the mechanisms are not clear yet, but just know it’s important to get your nutrients. Also, exercise increases HDL and decreases TG. We want Pattern B, not Pattern A. Even after knowing all this, government and medical society recommendations are still to lower TC, instead of focusing on the profile itself. A study in 2008 done in Japan found that cholesterol levels above 5.18mmol/L (200mg/dL) were at lower risk of dying than those with lower cholesterol levels ( Pull-ups --> Ab Wheel on Knees --> etc...

High Intensity Low Volume (HILV) 30 min workout: 2-3 sets, 3-6 reps. Alternating lower-body and upper-body. Weighted Squats --> Weighted Pushups -> One-legged Squats --> One-armed Pushups --> Weighted pull-ups or One-arm Pull-ups --> Ab Wheel on Toes -> etc... 87

Note: please see Appendix V for discussion of some bodyweight principles.

Monday 8:00am LIHV Workout

Tuesday Wednesday Thursday Friday

6:00pm Eat dinner, a 24 12:00pm hour Eat fast. largest meal of No the day more eating 6:00pm after Start 8:00pm eating (better again for whenever, sleep). but stop eating by 6:00pm

Saturday Sunday

6:00pm 8:00am Rest day Eat HILV dinner, a Workout 24 hour 12:00pm fast. Eat largest 12:00pm meal of No more Eat first the day eating meal of after the day 8:00pm 6:00pm Start (better If you do eating for want to again sleep). include whenever, one day but stop of eating by cheating 6:00pm this is the day to do it. 8:00am LIHV Workout

Rest days. Stop eating food every night at 8:00pm though. Fasting on this day is up to you. Sometimes I do sometimes I don't.

There are 2 (sometimes 3) 24 hour fasts in the week. I do not workout on fasting days because that would just speed up muscle catabolism, instead, I workout on days that I eat. When you exercise there are a lot of beneficial adaptations that take place in terms of nutrient portioning and body composition (increased blood glow, GLUT4 upregulation). So if you consume your meals after working out, hopefully the nutrients get taken up by the muscles instead of the fat. Low intensity high volume days are interspersed with fasting days because this helps with glycogen depletion. By depleting 88

glycogen it leaves room for the extra carbohydrate days that might come on Friday (for example if you cheat). By depleting our calorie stores between Monday to Thursday we take advantage of the low calorie days to burn fat. The resistance training is meant to help you retain your muscle mass and not lose it in the 4 days. Then comes Friday, where you crank up the intensity which then sets into motion muscle building factors and you can take a break for 3 days to allow for adequate recovery. I do not know if this actually works but I have seen beneficial effects over the last couple of months. I am sure that if you included carbohydrate in the rest days (Friday-Sunday) you would actually be able to increase muscle mass without gaining fat (a lean bulk). Since that is not my goal I have settled on this schedule to allow for workouts, fasting, and recovery. For now this seems optimal to me.

Exercise Supplements If you walk into a supplement stores you find various workout supplements. There are pre-workout, intra-workout, postworkout, pre-sleep formulas and many more. Many of the expensive brands contain 50 or more ingredients and the amounts/dosages are all hidden under the term “proprietary formula.” Most people continuously switch between various products and brands because they just do not see the claimed effects, so how proprietary can it really be? These claims include: Increase muscle mass by 300% Boost testosterone by 800% Gain 6 lbs of lean mass in two weeks Lose 2 inches of your waist in 2 days Third party research/Backed by Science These claims seem unlikely, and to tell you the truth they are. They aren’t false but they aren’t true either. For example, by 89

claiming an increase of lean muscle mass by 300%, are they saying that if you have 100lbs of lean mass you will suddenly have 300lbs of lean mass by taking their supplement, or do they mean they found in some obscure study done on rats where the circumference of their forelimb increased from 0.00001 to 0.00003 gain 6lbs of lean mass? Water is lean mass too; I can drink 6 lbs of water pretty easily. Lose five inches? By not eating for two days I can drop 2 inches (I just urinated it out). Don’t waste your money on these products, because they just do not do that much. If there are benefits they are incredibly small, and the risks you’re taking are incredibly big. Remember our benefit to risk ratio, well in these situations it is really low. A commonly utilized ingredient in workout supplements is arginine. It is used because it is a precursor to nitric oxide (NO) that dilates blood vessels and gives users that “pump” they feel when they exercise. NO is actually a very important molecule inside of your body, the NO pathway is involved with many different processes. For example, blood vessel dilation under stress: the ability of your blood vessels to react is very important for your survival, and by supplementing with arginine you are basically short-circuiting that process. Not only that, by supplying excess arginine which is then converted to NO by your body, you may be suppressing your endogenous production of NO later on in your life when you discontinue the arginine. In my opinion the risk is too high and the benefits are nil. Another claim for arginine is that it boosts growth hormone: Marcell TJ, Taaffe DR, Hawkins SA, Tarpenning KM, Pyka G, Kohlmeier L, Wiswell RA, Marcus R. Oral arginine does not stimulate basal or augment exerciseinduced GH secretion in either young or old adults. J Gerontol A Biol Sci Med Sci. 1999 Aug;54(8):M395-9. This study shows that arginine does not increase growth hormone; instead it may even decrease GH after your workout, again interfering with a possible adaptation to exercise. 90

The other widely sold product is branched chain amino acids. I doubt we truly require these isolated. If you consume adequate protein (especially in the form of whey) you are getting a large amount of BCAAs already (whey is 25% BCAA while beef is 15%). BCAAs are expensive and useless if you are ingesting adequate protein. However there are benefits, if you don’t ingest adequate protein BCAAs will help with retaining muscle mass and might also boost your immune system in times of sickness when you cannot ingest enough food. If you truly want to gain muscle, there are only three things you need: whey protein, creatine monohydrate, and caffeine. (I won’t go over all the forms of creatine but the monohydrate form is the tried and tested one, sure the other ones don’t cause bloating, but that is probably because it doesn’t work).

Stretching and Balancing Our joints are supported by muscles, connective tissue, ligaments and for them to function optimally and without pain everything must be in balance so that the joints are not pulled apart (e.g. hips, ankles, knees, and especially the shoulders). Commonly utilized bodyweight exercises are pull-ups, pushups, and squats and if not balanced can cause muscular imbalances. The pushup for example depends on the contraction of your chest and hips so to balance this we throw in a stretch that is very similar to the plank exercise for abs except the other way around:

So you basically make yourself into a table. This helps to extend the chest and hips. It is sort of like the opposite of a pushup. At 91

first you may have tightness in your shoulder not allowing you to flatten out completely but with practice you’ll get there. The squat relies on the contraction of your psoas muscles and many others in the front of your body, thus to counteract that we utilize a back bend (which I took from Yoga):

This helps extend the front of the body. Now to balance the pull-up we also use another position from Yoga called the downward dog:

This position activates your back muscles to help support the position. Ensuring muscular balance helps prevent pain and injuries that will occur down the road as our bodies wear out. There are many other therapies just as trigger point therapy and soft tissue massage which I will refer you to better resources in Appendix VI.

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Chapter 10: Paleo Shoes, Posture, and Sitting In our natural state we did not have chairs to sit in, nor did we have folk wisdom guiding our posture. Our ancestors most likely all moved in an optimal state with optimal positioning. This chapter will explore some of these issues.

Shoes Running shoes are terrible. We did not evolve in the presence of running shoes, or even shoes in general; we evolved with our bare feet touching the dirt and rocks on the ground. We ran barefoot, we walked barefoot and we stood and sat barefooted. The mechanics of motion when wearing shoes and not-wearing shoes are different. For example, go run on the grass with your thick-soled, supported arch, raised heel running shoe, then try it bare foot, it’s quite a different experience. With shoes we tend to flex the foot and strike the heal, while bare feet our foot position is more relaxed and its more of a front-mid foot strike. What I have done is bought some very expensive shoes to mimic our natural state. There’s Vibram Five Fingers and then for something more natural, Vivo Barefoot shoes. Both are well made but pricey. However, you’ll thank yourself for spending the money. The way you feel by activating the proper muscles and technique for walking/running is something worth spending the money on. Related to barefoot states, our feet have also been in contact with the ground. The ground from before is not smooth and homogenous like the floors we experience today. It’s much more varied and for the uninitiated its also much more painful but you’ll get used to it. By evolving barefoot our bodies have also developed mechanisms that react to various stimulations of the foot: 93

Li F, Fisher KJ, Harmer P. Improving physical function and blood pressure in older adults through cobblestone mat walking: a randomized trial. J Am Geriatr Soc. 2005 Aug;53(8):1305-12. So, every once in a while go walk on some rocks/pebbles. Nike can’t improve upon something that evolution has taken millions of years to perfect.

Posture The picture on the right is the posture most people today are told is the proper posture. Shoulder’s back head up, which causes an excessive curve in the lower back. But in reality based on traditional populations the posture on the right is more “natural.” Hip back until you can drop a straight line down from the hip socket to the ankles. To counteract the weight backwards we must lean forward (think caveman like) then we pull our head up and back. This gives us a much straighter spine. If you have children you will notice that this is how your children stand. The posture on the left is held up by your muscles and ligaments while the posture on the right is held up by each and every bone sitting on top of another. For more information read Esther Gokhale’s book “8 Steps to a Pain-Free Back” (it is accessible for free on Google Books). Also, make sure to read the section on sleeping (stretch lying on the side).

Sitting Today we sit on reclining chairs and stools, when we “do our business” we sit on a toilet rather than squat over a hole. The 94

back problems and hip problems commonly found among people today may have roots in the lack of indigenous squatting done today. What is the indigenous squat?

You keep your heels flat on the ground. Feet a bit wider than shoulder width apart, then take your glutes straight to the floor. Many people have problems with this at first, their behind cannot pass parallel. This is tightness in your hips. If you have problems, try holding onto something in front while squatting down. If you can get all the way down, it is more of a stability issue (not activating the right muscles). With practice you will get there. Every day you should take some time to get down into this position and open the hips and stretch the spine. Here’s a research paper using X-rays to study the quality of the spines comparing indigenous populations to Western society: Farhni WH, Trueman GE. Comparitive Radiological Study of the Spines of a Primitive Population with North American and Northern Europeans. J Bone Joint Surg Br. 1965 Aug;47:552-5 It is probably the squatting that provided indigenous populations with their higher quality spine. 95

If you watch Western people squat, to get their posterior down to the ankles they have to lift their heels from the floor. Lifting the heels defeats the purpose.

Sleeping and Circadian Rhythm Just like in the past we did not have chairs and shoes to alter our physical form, we did not have constant sources of light throughout the day. The earth rotates within a 24 hour period. In nature certain things happen when there is light and certain things happen when it is dark. By developing an internal 24 hour clock our bodies can carry out processes at the right time of the day and night. These internal timers can be found all the way down to cyanobacteria who upregulates photosynthetic machinery during daylight hours so it can absorb the most of amount of light. The presence of circadian rhythms in bacteria, plants, reptiles, and mammals shows that it probably confers some type of advantage which helps species survive. In humans we can see the diurnal rhythms in our hormone levels (e.g. leptin, cortisol), behavior, body temperature, liver metabolism, and much more. What has been shown is that by deviating from this 24 hour synchronicity humans can develop all forms of metabolic disorders (e.g. diabetes, cancer, heart disease, all things we are trying to avoid): Scheer FA, Hilton MF, Mantzoros CS, Shea SA .Proc .Adverse metabolic and cardiovascular consequences of circadian misalignment. Natl Acad Sci U S A. 2009 Mar 17;106(11):44538. In the study by Scheer et al what they show is that by extending the human circadian rhythm from 24 hours to 28 hours decreases leptin levels, increases glucose levels, increases insulin resistance, and alter lipid homeostasis which is all associated with metabolic syndrome (which we want to avoid). This is probably why shift workers and night-workers are associated 96

with increased risk of heart disease, diabetes, obesity, and cancer. Not only that, what has also been shown is that species who deviate from the 24 hours the most also have decreased lifespan: Wyse CA, Coogan AN, Selman C, Hazlerigg DG, Speakman JR. Association between mammalian lifespan and circadian freerunning period: the circadian resonance hypothesis revisited. Biol Lett. 2010 Apr 14. Lots of factors affect your internal clock (such various nutrients, caffeine, alcohol) but one of the ways your internal clock synchronizes to the rotation of the earth is through light. So it is important to make sure that you do not alter your circadian rhythm too much. You should go to sleep at around the same time everyday, wake up and make sure you get exposure to enough natural light in the morning. Also ensure that you do not consume food later in the day (because glucose, protein, and fats do alter the rhythm too), thus the association between altered circadian rhythm and obesity. Some things I implement in my life to improve sleep quality is to use black-out shades (because I do prefer to sleep later). I also utilize a program called f.lux (http://www.stereopsis.com/flux/) which dims the computer screen thus decreasing the amount of light into the eyes when the sun is down. Also ensure that lights are turned down later in the day.

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Chapter 11: How Much Life Left? Storing your car in New York is safer than entering it in a demolition derby. But not much. ~Daniel S. Greenberg Currently maximum human lifespan is thought to be 125 years, which is just shy of the record holder Jeanne Calment, 122 years. The rest of us probably have no chance of reaching such an advanced age. To become 120 years old you would have to have incredible genetics (look at the supercentenarians that smoke and drink) or implement calorie restriction, and maybe even have to do both. The Leiden University Medical Center has studied populations of older individuals. One population study of 420 Caucasian families which included long-living members has turned up some very interesting data. Numerous studies have been released looking at various health factors (remember Chapter 8) and it was found that the children of centenarians have similar biometrics as their parents. For example, measurements of serum glucose, triglycerides, insulin, blood pressure, thyroid hormone and insulin sensitivity were all much more favorable than matched partners (such as the centenarian’s son’s wife who does not have centenarian parents). What this shows is that extensive longevity has a very strong genetic component. What is interesting is that calorie restriction takes a person without centenarian parents and alters the biochemistry and metabolism of the practitioner to match those of the very longliving. CR increases insulin sensitivity, lower blood glucose, allows for the same cholesterol profile (high HDL, low LDL, triglycerides, and overall low cholesterol), low blood pressure, and the same thyroid hormonal profile (high TSH, with normal T4, suggesting TSH resistance, by today’s measurement this would be hypothyroidism, however, it is not pathological in centenarians and CR-folk). Considering that CR actually slows 98

down the rate of aging, I think that CR-folk can probably reach up to 110-120 years old depending on their genetics and when they started practicing, earlier being better. CR done today is practice in conjunction with Optimal Nutrition (ON), while centenarians probably do not practice ON. If those who are genetically gifted practiced CRON, I would suspect that they could live beyond 120.

Life Span It may seem like we have extended our lifespan in the last 1000 years. The ancient Greeks, Romans, and Egyptians had a life expectancy of 30, now we can expect to live up to 80 (Japanese women can expect to live up to 86.44). Its seems we easily doubled our life span and if you plot it, it looks like we are gaining a solid 2.5 years every decade in a straight line with no plateau in sight. If you plot human survival curves it definitely seems very square, but the squaring effect stopped at about 1950 (figure 3 in the study below) and seems to be shifting parallel: Westendorp RGJ. What is healthy aging in the 21st century? American Journal of Clinical Nutrition, Vol. 83, No. 2, 404S409S. Remember Chapter 5?

In 1950 we reached the black line and now the survival curve seems to be moving like the red one. As I said in the beginning 99

of the chapter, maximum lifespan seems to be 125 years and I suspect that this has always been the case for thousands of years. The jump in life expectancy had nothing to do with our understanding of the biology and underlying mechanisms of aging, it had to do with eliminating factors that kill us (e.g. infectious diseases, acute injuries, starvation) and securing things that keep us safe (e.g. health care, food, refrigeration, sanitation). With the help of modern technology we have eliminated most causes that kill us prematurely and now we are exposed to aging itself. The previous gain in life expectancy isn’t something we should expect to see again because now it is different. Instead of preventing the bacteria from killing you, you have to prevent your metabolism from killing you, and so far the only way to slow that down is through calorie restriction. How long can you expect to live by implementing my suggested changes into your lifestyle? If CR-folk can reach the age of 110120, with the interventions in this book it may be possible to live to 98-100. Here is some data to back it up: Mackenbach JP, Kunst AE, Lautenbach H, Oei YB, Bijlsma F. Gains in Life Expectancy after Elimination of Major Causes of Death: Revised Estimates Taking into Account the Effect of Competing Causes. Journal of Epidemiology and Community Health (1979-), Vol. 53, No. 1 (Jan., 1999), pp. 32-37 Mackenbach et al (1979) determined that by preventing heart disease, cancer, and various other diseases (e.g. diabetes, stroke, etc…) one can expect to gain 10 years in their life expectancy. What if we were to try our best to optimize ALL our risk factors? Let’s take 11 of them: diastolic and systolic blood pressure, smoking, vital capacity index, blood glucose, hematocrit value, body mass index, serum cholesterol, sex, pulse rate, and left ventricular hypertrophy. If we made all these measurements into the lowest risk factor group, how long can we expect to live? Luckily the math has been done: 100

Manton KG, Stallard E, Tolley HD. Limits to Human Life Expectancy: Evidence, Prospects, and Implications. Population and Development Review, Vol. 17, No. 4 (Dec., 1991), pp. 603637 Manton et al. optimized the 11 risk factors above and predicted that life expectancies up to 100 years old can be achieved. Since models are usually wrong, and regarding age people like to be optimistic, as well as factoring in the “luck of the draw” (genetics) I estimate that I can personally live to 90-95 years old (10% down adjustment). Just a big fat guess but I feel confident about this number.

Health Span Even if we took the pessimistic view of 90, I would still implement the lifestyle described in this book. Healthy life expectancy is the number of years one can live with minimal morbidity. For example, let’s say you live until 90 but have diabetes for 15 years, then cancer for 10. Your healthy life expectancy from birth is only 75. Japan has the longest healthy life expectancy: Takeda S.[Healthy life expectancy and the standardized mortality ratio for the elderly in Japan's 47 Prefectures] [Article in Japanese]. Nippon Koshu Eisei Zasshi. 2007 Jan;54(1):25-31 It seems the longest health span is 80-84. This is quite close to the life expectancy of 86 (I know I’m mixing up data but close enough). From all the research, health span and life span are closely correlated, healthier people just tend to live longer. But as lifespan begins to reach the maximum (outside of anti-aging interventions) morbidity will be compressed as people get healthier. Even if I were to only achieve 86.44 (not saying I’m a 101

Japanese woman, just that this is a number for the healthy) I would be glad that I gained 10 years of healthy lifespan where I am not suffering from cancer, diabetes, heart disease, and Alzheimer’s. I have volunteered at a care home for over 4 years and had the chance to work at a hospital for 1 year, the way that seniors spend the rest of their lives in these situations is not something I want to go through. When I am 80 years old I still expect to be able to walk on my two feet without help, get out of a chair, pick up my great-greatgrandchildren, lift weights, and debate/discuss with the younger generation. To do that you must keep your body and mind healthy at a young age.

Where to Now? Research in the field of aging is exploding. Of course, there has been some resistance (hey, death is “natural”) but sooner or later we will have interventions that will expand both our health span and our life span. The common interpretation of anti-aging interventions is that you will be 120 years old but be more decrepit than a 90 year old (which is really bad), but this is not how these interventions will work. The new technologies being developed will not make you “older,” instead it will extend you lifespan by making you younger. The first development that will come will probably be CR-mimetics. These are pharmacological interventions that will mimic the metabolic altering effects of CR, after that it will be Strategies for Engineered Negligible Senescence (SENS) (read Aubrey De Grey’s book on this matter, “Ending Aging”). SENS isn’t about trying to mimic the effects of CR, it goes beyond that in that it is trying to go into our bodies and fix/reverse/remove the damage that happens. If the damage is gone then the cause of aging is diminished. This seems like a tall order but it is definitely possible.

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It is because of SENS that I have put serious thought into adopting CRON (please donate to SENS). It is the only way of ensuring maximally robust lifespan, and this is important because of the speed at which science advances. Less than 20 years ago we did not have the internet, and now it permeates almost every facet of our world. Science and technology build upon themselves and with each new block they reach farther heights than ever before. To take advantage of these new discoveries from SENS one has to have a body that is robust enough to deal with the effects of these new drugs/interventions. If you reach the age of 70 but can hardly move and have dementia, you will not be able to survive the application of the new technologies. However, if you are 70 years old with robust health (like with CRON) then you can. Let’s say the intervention extends your life by 10 years, because of that one discovery, more will come and within those 10 years another intervention will come along extending life another 20 years, and so on and so forth, until immortality is reached (this is by no means farfetched). I am not saying that these interventions will be created in my lifespan or yours, but the thing is that you never know, and it would be best to not only live as healthily as possible, but to live as long as possible. The only way to achieve the maximum is through caloric restriction (this speeding up of technology is known as the Singularity, read Ray Kurzweil’s book, “The Singularity is Near”). (If you plan on practicing CR make sure to do tons of research. Roy Walford‟s book “Beyond the 120 Year Diet : How to Double Your Vital Year” is a good place to start. As far as I know the downsides are: loss of libido, hunger, social struggles and emaciation) I think that I have taken this lifestyle as far as it can go, the only other place to enter now is the world of the extreme, calorie restriction with optimal nutrition. Will I enter that realm, I don’t know yet, but it is best to decide sooner rather than later.

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Concluding Thoughts My goal when I started researching all this was to try my best to prevent the chronic illnesses. I saw how much pain they can cause to everyone. Just take Alzheimer’s for example: lifeless eyes with no sense of self, time, or place, a dreadful disease with a slow progression that places strain on yourself as you lose your soul as well as strain on your family, friends and society. Even if you wanted to end it you couldn’t because you have basically disappeared. Everyone’s goal in this life is different, but I am certain that no one wants to end up in such decrepitude. The regimens laid out in the book will help with preventing this, screw the USDA Food Guide and the American Diabetes Associate Diet, throw out common “wisdom” and rely instead on hard science. The basic principle of this book is: eat the right foods, but not too much; allow the body to take out the garbage; be conscious of what you put in your body; and exercise.

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Appendix I: Olive Oil There has been a Slow Food movement in our Western culture. The idea that we can access authentic traditional cuisine through local food, as well as the proliferation of extra virgin olive oil (EVOO) are both prime examples of this movement. Today, the best selling brands are the ones with the name of countries like Italy, Spain, and Greece plastered on the front signaling the source of the oil and providing a connection between the consumer and the country of origin. However, large producers have taken advantage of our love of olive oil and many of your purchases today are not as high a quality as you would think. In terms of olive oil, quality is very important, because without it you are just consuming another plain old oil without the flavor, aroma, or the health benefits of olive oil that has been used for hundreds of years. After reading an article on olive oil and then doing some research, the health benefits of olive oil were pretty clear. The Mediterranean diet definitely seemed to confer lots of health advantages to the user and olive oil seemed to be the difference (among many others). Thus, even though everyone is afraid of fat nowadays, olive oil is still a best seller. Is it the monounsaturated fat and low saturated fat in the olive oil that provides the health benefits? Well, after learning about the Paleolithic diet and looking at the research, saturated fat does not seem to be a problem. Comparing the monounsaturated fat intake of the U.S: Dougherty RM, Galli C, Ferro-Luzzi A, Iacono JM. Lipid and phospholipid fatty acid composition of plasma, red blood cells, and platelets and how they are affected by dietary lipids: a study of normal subjects from Italy, Finland, and the USA. Am J Clin Nutr. 1987 Feb;45(2):443-55.

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It was probably not the monounsaturated fat so that left the polyphenols: Konstantinidou V, Covas MI, Muñoz-Aguayo D, Khymenets O, de la Torre R, Saez G, Tormos Mdel C, Toledo E, Marti A, RuizGutiérrez V, Ruiz Mendez MV, Fito M. In vivo nutrigenomic effects of virgin olive oil polyphenols within the frame of the Mediterranean diet: a randomized controlled trial. FASEB J. 2010 Jul;24(7):2546-57. The polyphenol content varies depending on the quality of the olive oil, which in turn depends on many factors: where the olive was grown, how it was harvested, how it was grown, when it was harvest and grown, at what maturity level was the olive, the transportation, milling, packaging and storing all affect the polyphenol content, quality, taste, and aroma of the oil. In the past couple years, chemical tests have been developed to determine if the oil is adulterated, but of course not all oils are tested and as individual consumers it is fairly hard to get all the oils in your grocery tested. However, there is another way to determine the content, which is tasting. Tasting works because many of the polyphenols provide differing flavors to the oil, e.g. oleuropin is bitter, and various other polyphenols and substances found in olive oil provide various effects such as pepperiness, fruitiness and bitterness. Buying high quality olive oil is important because since the popularity of olive oil increased, many companies and producers have been adultering the oils we purchase in stores. While a high-quality olive oil may cost 20-30 dollars per 500ml, we can nowadays buy it for less than 10 dollars per liter. Some things I have read about is mixing olive oil with cheaper oils like soybean oil, corn oil, hazelnut oil (which made me sick considering how much I try to avoid those oils), adding chlorophyll (green color), beta-carotenes and other things to vegetable oils to make it look like olive oil, labeling normal lowquality olive oil as extra virgin olive oil. Over the past couple years there has been huge scandals involved in sham olive oils 106

thus necessitating the need to create ways to detect them, which there are many of now, but regulatory bodies do not have the capacity to test all oils so it is left up to the consumer to be able to determine what is real extra virgin olive oil.

Tasting Why is the label “extra virgin” important? This is a term from the International Olive Oil Council that signifies that the oil must have passed certain chemical tests, be fault free, and passed rigid taste tests. However, these tests aren’t exactly in place to ensure quality, but are just there to ensure that the oils are deemed edible. If there is a defect the oil is labeled as virgin, and if it is inedible it is labeled as lamp oil (scary thought that lots of people may be consuming lamp oil grade). Thus we either have to pay independent labs to test our oils, which can get expensive, ask the producer to provide us with independent tests they have performed (and not all companies are happy to oblige) or we try our best to use our senses to taste for extra virgin olive oil qualities. The first thing is that the oil has to lack defects. On the picture you can see the various defects; I have had experiences with oils 107

that have tasted rancid, sour, and metallic, but were labeled as extra virgin. The positive attributes are harder to get used to and it would be best if you go to an olive oil tasting session, or visit a gourmet store and ask if you could taste the various olive oils on the shelf (some are happy to oblige). These positive attributes are important because it is the health conferring polyphenols that provide these various palates. The bitterness and fruitiness should be a flavor you taste/smell in good extra virgin olive oil, while the pungency is the pepperiness you will feel when swallowing that stings the back of your throat. Below is an example of each category: Defects Fusty: Brined olives, lactic acid. Musty-Humid: Mouldy Muddy: Stale muddy water, baby vomit, wet soil. Sour: Vinegar Metallic: Metal on teeth (try some Epsom salts). Rancid: stale oil (try leaving raw walnuts in a room for a couple of days) Positive Attributes Fruity: Grass, orange, lemon, apple, nutty, leafy, almond, eucaplyptus, perfumy, buttery. Bitter: grapefruit rind, tonic water. Pungent: chili, makes you cough, hot, pepper. Always check for a date on the product you are buying, making sure it is not too old (also taste for rancidity, it is a very bad sign). There is a process to tasting olive oil (just like wine) and this is due to the fact that our noses and our tongues are connected (oil should be at around room temperature): 108

1. 2. 3. 4. 5.

One tablespoon in small container with lid Swirl: releases aroma Smell it: you should have a fruity smell Slurp: this brings in air which spreads the flavor/aroma Swallow: it should sting and last for a bit.

For more information buy Deborah Krasner’s book, “The Flavors of Olive Oil: A Tasting Guide and Cookbook.”

Chemical Tests Some producers do have certificates of authenticity (COAs) on hand that might show the free fatty acid level and peroxide levels. These are important because it tells you how well the oil is stored and how “fresh” it is. Fats are usually in the form of triglycerides. When the fat becomes red, part of it breaks off (bad storage) the fats, which are actually acids, creating acidity. So COAs testing olive oil usually give an acidity value that should be lower than 0.8%. The other important value is oxidation/peroxidation. This is a measurement of how damaged the fats are (due to heat, light, preparation). We don’t want damaged lipids so this value should be 20mEq/kg or less. While we can taste for polyphenols it is not the most accurate way to determine the concentration. Many of the studies seem to show that consuming polyphenol oils with content of 300mg/kg and above are the best. If the producer is willing to provide a test on the polyphenols, that would be great.

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Appendix II: Acne and Balding There are a couple disorders that affect our self-esteem today that our ancestors probably did not have to experience, obesity, acne, and balding. By setting up a lifestyle that can prevent metabolic syndrome we can prevent the damaging psychological effects these disorders have and hopefully be on our way to achieve a healthy body image.

Acne In western populations acne affects up to 95% of adolescents and 50% over the age of 25. The economic and psychological effects are undeniable and best avoided. However in huntergatherer/traditional populations there have been no reports of acne in the anthropological reports: Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, BrandMiller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002 Dec;138(12):1584-90. It is commonly stated that acne has no relation to diet and that it is mainly genetic but taking into the account that acne is fairly recent phenomenon genetics just does not explain the pervasiveness of this ailment in western society. Acne vulgaris (vulgaris meaning common) develop because of many factors: 1) pores get clogged because excess skin cells clog the pores (hyperkeratinization); 2) increased sebum production (which is the waxy/oily substance your skin produces to protect/maintain itself); 3) Propionibacterium acnes colonizes follicles causing inflammation. Below is a picture I drew depicting the usual path that a pimple takes. First the gray stuff gets produced in to large amounts, which then clogs the pores as 110

more gets produced and as sebum gets produced. It then causes and the bacterium is allowed to proliferate which then causes the big red bump all over your face.

Our skins should not have evolved so that everyone gets acne, it should only occur to signal to the other sex that something is wrong with the metabolism. The metabolism goes awry because of your hormones and hormones depend on diet (and genetics but only in special cases). Polycystic ovary syndrome (PCOS) affects women and is characterized by excess androgen (male hormones), too much insulin, and insulin resistance. PCOS patients often struggle with acne. These hormonal profiles are associated with acne in “healthy” people and by correcting the hormone levels acne lesions decrease: Smith RN, Braue A, Varigos GA, Mann NJ. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci. 2008 Apr;50(1):41-52. The diet is a very important factor that determines insulin levels. By elevating insulin with a high carbohydrate diet, it activates pathways which then results in increased androgen production. This leads to elevated insulin-like growth factor 1 (IGF-1) and decrease insulin-like growth factor binding protein 3 (IGFBP-3) [which bind IGF-1, thus resulting in more free IGF-1]. Somehow this leads to low amounts of retinoids in the skin which is responsible for keeping cell proliferation at proper levels (thus the use of retinoids to treat acne). So to stop this progression we have to lower insulin and we lower insulin through a low111

carbohydrate diet (like the one espoused in this book). By lowering insulin we prevent the hyperkeratinization, excess sebum production and even lower inflammation. Without the environment of excess growth (caused by IGF-1, insulin, and androgens) the bacteria is not allowed to grow excessively. I briefly discussed the glycemic index in chapter 4. Many studies on acne these days utilize the glycemic index instead of actually controlling total digestible carbohydrate intake. This is probably the reason why the studies are equivocal. One low glycemic index diet can lead to an overall high carbohydrate intake (grains), while another will lead to a low carbohydrate intake (mostly vegetables). So just make sure to keep you blood sugar and insulin levels under control and your acne will soon go away. Note: Foods like milk and chocolate have also been implicated in causing acne. I suspect that milk might be a problem because of the growth factors present in the milk (which also raises IGF1, possibly so if you are trying to get rid of acne you should probably stop the milk intake). Chocolate is not a problem unless you are consuming milk chocolate. Milk chocolate is not “real” chocolate in the sense that most of it is sugar and milk. If you like chocolate go for 90% and above dark chocolate and the acne problem should go away.

Male Pattern Balding (MPB) Here is a disorder that men will pay thousands and thousands of dollars per year to prevent and hopefully reverse. For now totally reversing hair loss is a dream (except for maybe implantation) and slowing it down and stalling it has nightmarish side effects (depending on the method implemented). Some of the most common drugs utilized today are DHT lowering drugs which stops the enzyme that converts testosterone to DHT. While DHT is one of the many culprits the whole pot of risk factors which is metabolic syndrome is in my opinion the greatest cause of MPB:

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Su LH, Chen TH. Association of androgenetic alopecia with metabolic syndrome in men: a community-based survey. Br J Dermatol. 2010 Aug;163(2):371-7. Epub 2010 Apr 23 From what I have seen metabolic syndrome (e.g. large waist circumference, beer belly, bad diet, acne, fat mass) is correlated with MPB. Also it seems that those who consume low-fat diets and exercise a lot (such as marathon running) are also predisposed (remember Chapter 9, probably has to do with the damaging diet they consume, exercise does not prevent illness!). What this all points too is that in general metabolic syndrome causes hair loss because of the inflammation, higher DHT levels, and insulin resistance: González-González JG, Mancillas-Adame LG, Fernández-Reyes M, Gómez-Flores M, Lavalle-González FJ, Ocampo-Candiani J, Villarreal-Pérez JZ. Androgenetic alopecia and insulin resistance in young men. Clin Endocrinol (Oxf). 2009 Oct;71(4):494-9 This connection has only recently been studied and there are many issues to tease out. Some studies show that those with MPB have higher levels of testosterone but metabolic syndrome decreases total testosterone and sex-hormone binding globulin. The way most hormones work is that they are created by cells but also present in the blood stream is a binding factor that inactivates the hormone. This is done so that there are always hormones in the blood but when needed the binding factor can be broken down to release more hormone instead of making more hormone from scratch. Treatments such as DHT lowering agents do seem to work so it does have an effect but for all I know it is preventing the damaging effects of high insulin, glucose, and inflammatory levels. Metabolic syndrome may decrease total testosterone but free testosterone could be higher or the conversion to DHT could be higher or sensitivity of the 113

hair follicles to DHT is higher. But one thing for sure is that if you want to keep your hair, do not use steroids and do not get metabolic syndrome.

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Appendix III: Skinny Fat Body Type The skinny fat body type has become a problem over the years, not only for those trying to gain muscle but also as a health policy subject. We are not surprised when someone says that the United States is suffering from a diabetes epidemic, but most are surprised that China is also suffering an epidemic. It is true diabetes is usually associated with obesity, but obesity describes body fat, and thin people can be fat too. There are two types of ectomorphs, the ones that stay “ripped” while consuming 8000 calories and another softer ectomorph: these are the skinny types. Mandavilli A, Cyranoski D. Asia's big problem. Nat Med. 2004 Apr;10(4):325-7 China’s diabetes problem (now 1 in 10) went undetected because the measurements we utilize today only apply to Caucasians e.g. waist size and body mass index. While these are good measurements for most Westerners, most Asians fall into the skinny fat phenotype (I think it is probably the lack of proper nutrition in most Asian countries). So, people see a country of all underweight people and assume there is no problem. The individuals themselves also assume there’s no problem. I know many people who eat like shit all the time and they say it is no problem because they are not fat. But they are fat, and they are doing just as much damage to their bodies as the obese are. This phenotype is due to genetics (mainly your predisposition towards an anxious personality) and probably undernutrition while in the womb and as an infant: 115

Freedman LS, Samuels S, Fish I, Schwartz SA, Lange B, Katz M, Morgano L. Sparing of the brain in neonatal undernutrition: amino acid transport and incorporation into brain and muscle. Science 1980 Feb 22;207(4433):902-4 The brain gets what it wants, and when it doesn’t, other tissues are not allowed to develop properly such as the muscle tissue. This also stresses the body probably priming your neural circuitry for a less stress-robust personality (leading to overproduction of cortisol which is a hard environment to build muscle in and also decreases anabolic hormones). For some reason, this body type leads to tall and long bone structures that stretch the muscle, decreasing the amount of tension you can place on the muscle. There is also a decrease in fast-twitch muscle fiber, which leads to the soft look many skinny-fat types have. Skinny fat types are not just a problem for Asians; I have seen them from all cultures. I suspect they have very high amounts of visceral adipose tissue. In the study above about China, you can find a picture comparing the body fat between a normal weighted Caucasian man and a typical skinny-fat south Asian. The Caucasian man has 10% body fat, and the skinny-fat Asian has 20% (but by all means the Asian looks much thinner than the Caucasian). The moral of the story is that even though you are thin you are not safe. Your best bet would be to get the blood tests (in Chapter 8) and determine your health.

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Appendix IV: Riskier Supplements Some other supplements that I personally take that I think are worthwhile are: Lithium Phytate (IP6) Beta-alanine Taurine Acetyl-L-Carnitine and Alpha Lipoic Acid

Lithium [1.25mg/day] This mineral is not on the Institute of Medicines official list of essential vitamins and minerals but there is convincing evidence that humans do require it and consumed it in times past: Schrauzer GN. Lithium: occurrence, dietary intakes, nutritional essentiality. J Am Coll Nutr. 2002 Feb;21(1):14-21 We most likely got the lithium from our drinking water: Ohgami H, Terao T, Shiotsuki I, Ishii N, Iwata N. Lithium levels in drinking water and risk of suicide. Br J Psychiatry. 2009 May;194(5):464-5; discussion 446. What the study shows is that populations with more lithium in the drinking water are happier and at less of a risk of suicide. Most people know of lithium as an anti-depressent, but those are pharmacologically high dosages greater than 120mg per dose. It seems our unofficial RDA for lithium is probably around 1mg/day.

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Lithium is interesting because of the neuroprotective properties is can confer at higher dosages but there is speculation that this also occurs at lower dosages: Chuang DM. Neuroprotective and neurotrophic actions of the mood stabilizer lithium: can it be used to treat neurodegenerative diseases? Crit Rev Neurobiol. 2004;16(12):83-90. I take 1.25mg per day because the pills usually come in 5mg dosages.

Phytate (IP6) [2g/day] In Chapter 2, phytate was labeled as an antinutrient. IP6 binds to covalent ions rendering them inabsorbable thus wasting them. If you eat over the RDA some phytate in your grains and bran should not be a problem, but for me I would rather not dump my minerals in the toilet. Phytate does have numerous benefits and the research has been going on for years and years. Kumara V, Sinhab AK, Makkara HP, Beckera K. Dietary roles of phytate and phytase in human nutrition: A review. Food Chemistry Volume 120, Issue 4, 15 June 2010, Pages 945-959 It is very effective in preventing colon cancer (at least in rats, but it probably transfers to humans in this case), modulates the immune system and has an anti-inflammatory effect. I break it down in my legumes and grains but I also choose to supplement with it as a pill. If you do choose to supplement it, consume it away from food, two hours after a meal or two hours before. Besides the anti-cancer effect, the prevention of calcification of tissues (which Vitamin K2 also prevents) as well as the decrease in iron content in men can be a benefit in the long-term.

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Beta-alanine [2g/day] This altered amino acid is a precursor to the dipeptide carnosine. Carnosine prevents cell damage and aging, it also prevents glycation end-products: Alhamdani MS, Al-Azzawie HF, Abbas FK. Decreased formation of advanced glycation end-products in peritoneal fluid by carnosine and related peptides. Perit Dial Int. 2007 JanFeb;27(1):86-9 While you can buy carnosine in a supplement, I prefer to utilize beta-alanine because 1) it is cheaper and 2) the human data showing tissue elevation of carnosine is very extensive. Vegetarians lack beta-alanine.

Taurine [250mg/day] The reason for supplementing with taurine is a paleolithic one. Taurine is found in high concentrations from seafood and organ meats. Cooking also destroys about half of it from the meat we commonly consume today. While some mammals produce taurine by themselves, other mammals such as cats and humans rely on dietary ingestion. Taurine is involved in many activities: preventing atherosclerosis, modulating intracellular calcium, osmoregulation, preventing glycation, and possibly even preventing the transfer of diabetes from the mother to the fetus: Bouckenooghe T, Remacle C, Reusens B. Is taurine a functional nutrient? Curr Opin Clin Nutr Metab Care. 2006 Nov;9(6):72833 Vegetarians lack taurine.

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Acetyl-L-Carnitine (250mg) and Alpha Lipoic Acid (150mg) These two are in my opinion the riskiest of them all. The data on the long-term safety of these supplements are lacking but the benefits sure seem impressive. L-Carnitine is something we consume in our diet from meat. It is involved in transporting long chain fatty acids from the outside of the mitochondria to the inside of the mitochondria where it gets burned. Therefore there is speculation that ALCAR deficiency may cause insulin resistance because the fat trapped in the muscle has nowhere to go. Acetyl-L-Carnitine is just Lcarnitine with an acetyl group attached, making it more absorbable and also helping it reach the brain better. The data in rats regarding mitochondrial regeneration is very impressive: Aliev G, Liu J, Shenk JC, Fischbach K, Pacheco GJ, Chen SG, Obrenovich ME, Ward WF, Richardson AG, Smith MA, Gasimov E, Perry G, Ames BN. Neuronal mitochondrial amelioration by feeding acetyl-L-carnitine and lipoic acid to aged rats. J Cell Mol Med. 2009 Feb;13(2):320-33. The data regarding ALCAR in humans also shows its safety. Most studies are done in humans regarding Alzheimer’s disease and weight loss. While the positive effects seem very weak, I use it as a preventative measure to keep my mitochondria healthy. Most studies use alpha lipoic acid and acetyl-l-carnitine together because they are synergistic (carnitine also seems to increase free radical production while alpha lipoic acid soaks them up, however, the studies used very high dosages of l-carnitine, much higher than what we consume). My main reason for supplementing lipoic acid is for the post-prandial effects as it definitely seems to help with glycative products in type II diabetics:

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Mittermayer F, Pleiner J, Francesconi M, Wolzt M. Treatment with alpha-lipoic acid reduces asymmetric dimethylarginine in patients with type 2 diabetes mellitus. Transl Res. 2010 Jan;155(1):6-9. There are two forms of Alpha Lipoic Acid you can purchase: racemic (normal) or the stabilized R form. We are interested in the R form because the racemic (normal) form contains the Sform, which is not found in nature.

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Appendix V: Bodyweight Exercises An important part of various exercises is to utilize the full-range of motions. Sure, cutting the distance you have to move by a couple inches makes it easier, but it would be better to activate as many muscles as possible. Let’s take the pushup for example: As you move down your hips should not sag downwards. Keep them up by pushing the glutes up. The chest should touch the floor then when you go up and reach the very top, and make sure to activate the various muscles around your shoulders and ribs, and also try to extend up as far as possible. Most people just wait until their elbows lock and then head back down, what we want to do is reach the top and try and reach more. Hopefully you can feel the difference.

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Appendix VI: Soft Tissue Therapy and Stretching Beyond your muscles and bones there is connective tissue, ligaments, tendons, etc. sitting in between everything else. These can be injured just like your muscles can. I don’t know if huntergatherer/traditional populations required soft tissue therapy and stretching, but they didn’t sit in front of a computer in a chair, using keyboards and mice, and playing console games with controllers by contorting their body in weird positions then keeping it there for hours on end. Over the years of playing video games, sitting in front of the computer and playing sports I have developed pains in various part of my body. This usually goes away when I exercise but would later come back with a vengeance. It wasn’t anything excruciating, it was just very annoying. Soon I discovered soft tissue therapy and it has been a godsend: Muscles: Testing and Function, with Posture and Pain by Florence Peterson Kendall (Editor), Elizabeth Kendall McCreary (Author), Patricia Geise Provance (Author), Mary McIntyre Rodgers (Author), William Anthony Romani (Author) The Trigger Point Therapy Workbook: Your SelfTreatment Guide for Pain Relief, Second Edition Clair Davies (Author), Amber Davies (Author), Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists Thomas W. Myers LMT NCTMB ARP Certified Rolfer (Author) 123

These three books are great in terms of helping you understand where the pain comes from and also helping you solve it.

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