Monday, March 1, 2010

Book Review: S.P.E.E.D.

This book was sent to me by Matt Schoeneberger, who co-authored it with Jeff Thiboutot. Both have master's degrees in exercise science and health promotion. S.P.E.E.D. stands for Sleep, Psychology, Exercise, Environment and Diet. The authors have attempted to create a concise, comprehensive weight loss strategy based on what they feel is the most compelling scientific evidence available. It's subtitled "The Only Weight Loss Book Worth Reading". Despite the subtitle that's impossible to live up to, it was an interesting and well-researched book. It was a very fast read at 205 large-print pages including 32 pages of appendices and index.

I really appreciate the abundant in-text references the authors provided. I have a hard time taking a health and nutrition book seriously that doesn't provide any basis to evaluate its statements. There are already way too many people flapping their lips out there, without providing any outside support for their statements, for me to tolerate that sort of thing. Even well-referenced books can be a pain if the references aren't in the text itself. Schoeneberger and Thiboutot provided appropriate, accessible references for nearly every major statement in the book.

Chapter one, "What is a Healthy Weight", discusses the evidence for an association between body weight and health. They note that both underweight and obesity are associated with poor health outcomes, whereas moderate overweight isn't. While I agree, I continue to maintain that being fairly lean and appropriately muscled (which doesn't necessarily mean muscular) is probably optimal. The reason that people with a body mass index (BMI) considered to be "ideal" aren't healthier on average than people who are moderately overweight may have to do with the fact that many people with an "ideal" BMI are skinny-fat, i.e. have low muscle mass and too much abdominal fat.

Chapter 2, "Sleep", discusses the importance of sleep in weight regulation and overall health. They reference some good studies and I think they make a compelling case that it's important. Chapter 3, "Psychology", details psychological strategies to motivate and plan for effective weight loss.

Chapter 4, "Exercise", provides an exercise plan for weight loss. The main message: do it! I think they give a fair overview of the different categories of exercise and their relative merits, including high-intensity intermittent training (HIIT). However, the exercise regimen they suggest is intense and will probably lead to overtraining in many people. They recommend resistance training major, multi-joint exercises, 1-3 sets to muscular failure 2-4 days a week. I've been at the higher end of that recommendation and it made my joints hurt, plus I was weaker than when I strength trained less frequently. I think the lower end of their recommendation, 1 set of each exercise to failure twice a week, is more than sufficient to meet the goal of maximizing improvements in body composition in most people. My current routine is one brief strength training session and one sprint session per week (in addition to my leisurely cycle commute), which works well for me on a cost-benefit level. However, I was stronger when I was strength training twice a week and never going to muscular failure (a la Pavel Tsatsouline).

Chapter 5, "Environment", is an interesting discussion of different factors that promote excessive calorie intake, such as the setting of the meal, the company or lack thereof, and food presentation. While they support their statements very well with evidence from scientific studies, I do have a lingering doubt about these types of studies: as far as I know, they're all based on short-term interventions. Science would be a lot easier if short-term always translated to long term, but unfortunately that's not the case. For example, studies lasting one or two weeks show that low glycemic index foods cause a reduction in calorie intake and greater feelings of fullness. However, this effect disappears in the long term, and numerous controlled trials show that low glycemic index diets have no effect on food intake, body weight or insulin sensitivity in the long term. I reviewed those studies here.

The body has homeostatic mechanisms (homeostatic = maintains the status quo) that regulate long-term energy balance. Whether short-term changes in calorie intake based on environmental cues would translate into sustained changes that would have a significant impact on body fat, I don't know. For example, if you eat a meal with your extended family at a restaurant that serves massive portions, you might eat twice as much as you would by yourself in your own home. But the question is, will your body factor that huge meal into your subsequent calorie intake and energy expenditure over the following days? The answer is clearly yes, but the degree of compensation is unclear. Since I'm not aware of any trials indicating that changing meal context can actually lead to long-term weight loss, I can't put much faith in this strategy (if you know otherwise, please link to the study in the comments).

Chapter 6, "Diet", is a very brief discussion of what to eat for weight loss. They basically recommend a low-calorie, low-carb diet focused on whole, natural foods. I think low-carbohydrate diets can be useful for some overweight people trying to lose weight, if for no other reason than the fact that they make it easier to control appetite. In addition, a subset of people respond very well to carbohydrate restriction in terms of body composition, health and well-being. The authors emphasize nutrient density, but don't really explain how to achieve it. It would have been nice to see a discussion of a few topics such as organ meats, leafy greens, dairy quality (pastured vs. conventional) and vitamin D. These may not help you lose weight, but they will help keep you healthy, particularly on a calorie-restricted diet. The authors also recommend a few energy bars, powders and supplements that I don't support. They state that they have no financial connection to the manufacturers of the products they recommend.

I'm wary of their recommendation to deliberately restrict calorie intake. Although it will clearly cause fat loss if you restrict calories enough, it's been shown to be ineffective for sustainable, long-term fat loss over and over again. The only exception is the rare person with an iron will who is able to withstand misery indefinitely. I'm going to keep an open mind on this question though. There may be a place for deliberate calorie restriction in the right context. But at this point I'm going to require some pretty solid evidence that it's effective, sustainable, and doesn't have unacceptable side effects.

The book contains a nice bonus, an appendix titled "What is Quality Evidence"? It's a brief discussion of common logical pitfalls when evaluating evidence, and I think many people could benefit from reading it.

Overall, S.P.E.E.D. was a worthwhile read, definitely superior to 95% of fat loss books. With some caveats mentioned above, I think it could be a useful resource for someone interested in fat loss.

58 comments:

  1. From your review, Steve, two things wrong stick out. First, if you research the studies you will find that exercise does not result in long term weight loss. Good thing to do and to be should be recommended, but it puts people off trying to lose weight by insisting that they must do it to lose weight.

    Secondly, the whole "moderate diet" does not hold up. Gary Taubes points out that the first tract on weight loss back in 1858 told people to cut out sweets and starches and this still holds up today. Stop eating flour, cornstarch and sugar and eat what you want otherwise and you will lose, permanently, 25 to 40 pounds, lose your pot belly, lower your blood sugar, lower any Type II Diabetes, stop IBS symptoms, and generally feel better.

    This goes against the grain with the PHD Nutritionists out there. Talking about this to them is akin to discussing Lutheranism with a 16th Century Catholic Bishop. The main difference is that the PHD can't burn you at the stake for your ideas.

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  2. I am also skeptical of the calorie-restriction idea. I've recently come across this Low-Methionine diet idea - which is basically a vegan diet (meat, eggs, fish have high methionine levels).

    It has been proven to prolong life in animal studies, as well as delay the onset of cancers, cardiovascular disease, and other diseases of aging. Maybe cutting calories is good for health simply because it means a lower methionine intake.

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  3. Amazing how many diet ideas are out there. The accepted diet by the Establishment is Low Fat with the Heart diet of no Sat Fats and low cholesteral as the accepted wisdom.

    Turns out "Low Fat" means "High Carb" and is what Sumo wrestlers and NFL linemen eat to GAIN weight.

    The "Heart Diet" hypothesis has also been discredited. But the Food PHD's won't accept that.

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  4. "They ... recommend a ... low-carbohydrate diet"

    Doubtless good advice for the over-weight, as you say. And I suppose *moderate* consumption of carbohydrate-rich food and avoidance when it's refined is wise advice for us all.

    It's interesting that this is becoming more common advice (but more in the U.S. rather than elsewhere, possibly). Doubtless such advice has an uphill struggle against entrenched beliefs in diet circles and in government, and (like the sensible advice to avoid vegetable oils and fats) treads on the toes of agribusiness. Some people, of course, go too far, regarding perfectly good foods as completely "taboo"; and some go low-carbohydrate and low-fat, which seems really inadvisable. But some progress.

    Of course, it's not just what you eat, but also what you drink.

    I'd be interested to know whether the authors comment on that. AFAICT, paediatricians are now finding that behind every "fat kid" there's a fizzy drink habit. Similarly, how much adult obesity -- particularly male "middle-aged spread" -- is down to alcohol? I hasten to add that I enjoy a drink, appreciate the historical and cultural resonances of brewing and viticulture, and dislike the puritanism that makes too much of the drawbacks. But I wonder how big a part drink plays. And perhaps many adults are drinking sugary soft drinks, too.

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  5. I think low-carbohydrate diets can be useful for some overweight people trying to lose weight, if for no other reason than the fact that they make it easier to control appetite. In addition, a subset of people respond very well to carbohydrate restriction in terms of body composition, health and well-being.

    Stefan, I'm aware that you are less enthusiastic than many about the notion of carb avoidance for insulin/glucagon control and the related paleo thing.... But what about the idea that the liver's production of glucose from protein is a better way of maintaining blood sugar levels and general well-being?

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  6. "Stop eating flour, cornstarch and sugar and eat what you want otherwise and you will lose, permanently, 25 to 40 pounds, lose your pot belly, lower your blood sugar, lower any Type II Diabetes, stop IBS symptoms, and generally feel better."

    You forgot to include the words "the first time." Low-carb doesn't work as well the second time you try it, as even Dr. Eades has admitted. I know this from personal experience.

    The first time I tried low carb (~1999) and lots of exercise I lost weight, but I became addicted to caffeine because a low carb diet plays hell with your adrenal glands. Once I stopped coffee the exercise stopped too and the weight slowly came back. The second time I eliminated all sugar, white flour and corn starch from my diet (~2008) I felt better and my health improved, but I didn't lose any weight. Not one pound.

    And once I added back complex, unprocessed starches to my diet my health got even better. Digestion improved, sleep improved, skin improved. Everything. It's really just sugar, white flour and cornstarch - not carbs generally - that cause the problem.

    It's like fats. The natural fats are perfectly healthy, and necessary, but the unnatural Frankenfats (like Corn Oil) screw up your health. Same for carbs. Avoid the manufactured stuff and revel in the natural. Eat your frickin' yams.

    So what I am trying right now? I am trying a high-protein, no-fat, low-calorie diet[1] with just enough carbs to stay out of ketosis. Dr. Evans and Dr. Strang showed back in 1929[2] that this diet could bring about significant weight loss in the obese without any loss of lean body mass. I belief the reason most modern weight-loss diets make you fatter in the end is because they force you to consume your lean body mass and put your metabolism into famine mode. Avoiding these two problems may allow lasting weight loss. We'll see.

    [1] http://cusickonnutrition.blogspot.com/
    [2] http://jama.ama-assn.org/cgi/content/summary/97/15/1063

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  7. Cusick said...
    "So what I am trying right now? I am trying a high-protein, no-fat, low-calorie diet[1] with just enough carbs to stay out of ketosis."
    I hope you meant "no-fat, other than EFAs".

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  8. Nigel,

    You are correct. It's really "minimal" fat, as some fat simply cannot be avoided. I eat lean cuts of meats and wild caught fish for my protein, so some fat is eaten there. I also take a single fish oil tablet in the morning. I get enough.

    Regards,
    Brock

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  9. Cusick,

    In the past I was able to lose weight pretty quickly with high protein diet you describe, but I put it back on very quickly too. Your mileage may vary. I think maybe if spent more time transitioning out of the diet it might have had better success.

    Bill Millan,
    As you mentioned, this last diet I have been on I did basically just cut out the sweets and starches and lost around 50 lbs. I replaced all my starches with black beans (and made sure I had at least a tablespoon of olive oil or butter with every meal).

    I stopped losing weight though when I was still 20 lbs above my goal. What I am trying now is to cut out the beans and stick with green vegetables (and I am using coconut oil much more). I do see some progress, but it is still early on.

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  10. I noticed a comment about "when I tried it a second time." There isn't any "second time" for heart patients to avoid sugar, wheat or corn. You are off them for life.

    I use only butter and olive oil. No "industrial" oils. Very heavy meat diet. Eggs and bacon. rib roast. home made chili with very few beans. One meal a day of oat bran, ground flax seed and oatmeal.

    I am surprised that no one has commented on my "exercise is a waste of time for losing weight" statement.

    Yes, I am a follower of Dr William Davis at "Track your Plaque." My first scan was 322. Second one, a year later, was 219.

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  11. "I am surprised that no one has commented on my "exercise is a waste of time for losing weight" statement."

    Why are you surprised? You thought that Stephan would attract Establishment types? ;)

    "One meal a day of oat bran, ground flax seed and oatmeal."

    So you're NOT on a low-carb diet then. Okay. My point was that low-carb dieting seems to be detrimental to health in the long run. I know many cases of this myself. But you're not low carb. You've just cut out the processed crap. Good.

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  12. Let's just say, "it's not much carb." The key is the kind of carbs. I stay off grains, but do use 1/2 cup of oatmeal a day.

    When you eliminate sugar, wheat and corn, half the grocery store disappears. I mainly eat fat and protein. As you all know, we don't need carbs to live. I got down from a 32 BMI to a 28 in six months. 30+ pounds, by eleminating those three items, plus potatoes and rice, which I hardly ever eat anyway.

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  13. "Chapter 2, "Sleep", discusses the importance of sleep in weight regulation and overall health. "

    But do they discuss how to get it?? As a chronic insomniac, I am constantly frustrated by advice to sleep more and better with absolutely no real-world advice on how to do so. For the record, I am hip-deep in "sleep hygiene" cliches, but the insomnia persists.

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  14. Hi Bill,

    Treadmill jogging doesn't do much for fat loss, but HIIT seems to be different. The effect of exercise on fat mass depend on what type of exercise you use.

    Hi Kathy,

    Good point. I don't recall if they discussed that.

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  15. The effect of exercise on fat mass depend on what type of exercise you use.

    There is a lot of anecdotal out there that says exercising helps you lose weight, but the mega studies of the studies just doesn't show the results standing up. I think the NBC show about the fatties losing weight does a lot of harm to the idea of getting people to diet. It leads them to believe that they will have to go to the gym if they want to lose weight. They show them sweating all day in a gym. But they don't show them eating a limited low-carb diet, which is where the weight is really lost. No fun watching that.

    My 30+ pound weight loss was done without increasing my limited exercising.

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  16. Hi Bill, the studies you're referring to were done on treadmill-type exercise, which is the kind that's ineffective for fat loss. HIIT for fat loss has data behind it, although it needs more.

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  17. All "exercise for weight loss" is based on the "calories in, calories out" concept. Which is not how our bodies work.

    My operational definition of life is that it is:

    "an open, thermodynamic process that organizes energy."

    But our bodies can act thermostatically. Handling food intake and outgo on a basis of maintaining a static situation. We don't automatically add an exact amount of weight when we eat, and lose it when we exercise. That is a logical sounding fiction.

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  18. Changing the meal context can lead to real improvement ... one of my New Year's resolutions a few years back was to pay attention and never eat to the point where I was completely full or stuffed. This lead to a loss of ~2 pounds per month for 8 months.

    Did I eventually give up and give in to eating in a hurried, mindless fashion? Yes, and I gained some weight back. I would compare this to exercise; it does work, provided one sticks with it.

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  19. HIIT does not rely on the "calories in, calories out concept". It's about changing hormone sensitivity. Don't throw the baby out with the bathwater here.

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  20. Christina,

    I've read that about methionine, too. I've also read that increased levels of insulin shorten lifespan. Maybe there are even more pathways that respond to dietary triggers. There are helpful elements of many animal foods, too. (Including fat-soluble vitamins, other amino acids (like carnosine), B-vitamins, choline, and, yes, cholesterol.) On a vegan diet, I feel very ungrounded. I sleep terribly and am hungry and shaky all the time. The carbs just seem to zoom around in my system without enough fat and protein to keep me on an even keel. I kind of wish I could do it, but apparently it's not for everyone. I seem to be an obligate omnivore.

    It's also worth noting that the "healthy" "lean" animal proteins so often recommended are the highest in methionine. (I looked this up.) They include egg white, poultry, and fish. Some nuts are high. Red meat and dairy are pretty low on the list.

    It might be worthwhile to eat the egg yolks and throw away the whites!

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  21. "One meal a day of oat bran, ground flax seed and oatmeal."

    "I stay off grains, but do use 1/2 cup of oatmeal a day."

    If you have oatmeal, flax and bran every day-- you're ON grains, Bill.

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  22. Bill, while I sympathize with your argument about exercise/fat loss, I think HIIT is a whole different animal, and doesn't rely on the calories in/calories out concept at all. Read "Body by Science" by Doug McGuff for an in-depth discussion of how HIIT works for fat loss (he also explains why traditional cardio does not work).

    As Stephan pointed out, it has much more to do with insulin sensitivity, hormone signaling, etc. HIT works fast twitch glycolytic muscle fibers, as opposed to the slow twitch fibers that are worked with "cardio" type exercise. The metabolic effects are much, much different.

    David

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  23. Wheat is the really bad grain. Dr Davis found out a few years ago that when he took his heart patients off wheat, their small dense LDL dropped like a stone. In addition, they lost 25 to 40 pounds, their pot belly disappeared, their sugar level stopped, Type II diabetes receded, IBS stops.

    I have seen the same kind of results.

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  24. All "exercise for weight loss" is based on the "calories in, calories out" concept. Which is not how our bodies work.

    Sorry Bill, but that's just wrong. Moderate (like walking and yoga) and High-Itensity (like sprinting and HIIT) exercises changes your hormone sensitivities and gene expression in a fat loss promoting way. This is well shown.

    Wheat is the really bad grain.

    Sorry again Bill, but this is also wrong. Very wrong. There's nothing inherently bad about wheat (or rice, or corn, or potatoes, or rye, or the oats you eat). Many healthy cultures have thrived for centuries on these food sources. The problem lies with the overly stale, overly processed, overly "enriched" white flour "food products" available in most places in the USA. If you had access to fresh ground, whole kernal wheat flours you would be just fine.

    If you personally can't handle wheat, that's a problem with your digestive system, not wheat.

    -Brock

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  25. Stephen,

    Would you differentiate CRAN from IF? Same result, chronic vs. acute stimulus.

    Best,
    Skyler

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  26. Sorry, Brock. We will have to "agree to disagree" about exercise and wheat. When I run into your kind of oppo, I drop it.

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  27. Ideas which given by you are really nice and imperative for me.
    Anti Aging

    Thanks,
    Chris

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  28. "Sorry, Brock. We will have to "agree to disagree" about exercise and wheat. When I run into your kind of oppo, I drop it."

    Ok Bill. You don't have to engage if you don't want to. But why single me out for disagreement? You saw that Stephan disagrees with you on the exercise bit too, right? So do Art De Vany and Mark Sisson, as well as the authors of SPEED and Body by Science. What do you know that they don't? I have an open mind if you've got evidence.

    As for wheat, I've got your opinions, but no facts to consider. What evidence do you have that it's the bad grain? You have the fact that you cut out overly-processed nutrition-free white flour and your health improved, but what else? What do you tell the Europeans, Arabs, Persians and Indians who have been eating wheat for millenia and displaying good health? What do you say to Dr. Weston Price, author of Nutrition and Physical Degeneration, or Dr. Robert McCarrison, author of Studies in Deficiency Disease? Both Drs. Price and McCarrison recognized the harmful effects of white flour and white rice, but also considered (and empirically showed very convincingly, IMO) that fresh ground, whole kernal wheat could be part of a healing and healthful diet.

    When the facts change my opinion changes, so I'm open to any facts you've got showing the harmful effects of fresh ground wheat. Got any?

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  29. I hate it when guys get into pissing contests about who is right and who is wrong. Get over it, Brock: Bill doesn't want to piss versus you.

    Also, there's abundant evidence against eating grains: WAP found they were sprouted, fermented, soaked to reduce the bad actors within them. There's lots more anti-grain info out there: look for it.

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  30. Jim,

    There's a difference between a "pissing contest" and discussing matters of scientific fact. If someone isn't interested in having their opinions questions they shouldn't air them in a discussion forum.

    We're not discussing personal preferences here, such as "Do you like the taste of wheat?". This is science. If two people disagree as to a matter of fact, one of them is wrong - and both should be interested in figuring out which one.

    As for Price, neither he nor McCarrison soaked, sprouted or fermented the wheat in their healing diets. It was just fresh ground. You can do that if you like, but it doesn't seem to be necessary.

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  31. What convinced me about wheat was going off it and seeing the results. I have never been what I would consider to be "bothered" by it in the "gluten is bad" sense. But Dr Davis tells people what will happen to them when they quit. I experienced these things. when I went off it. Rather that get down in the weeds here, the best way I know is to read his blog about it. "The Heart Scan Blog." http://heartscanblog.blogspot.com/search?q=wheat

    "Everybody knows" that whole grains are better for you than white bread. But Davis has taken it to the point that "no grains" are better for you than "whole."

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  32. I am so glad to have found this blog with its information and comments.
    Pertaining to grains, would using bran (as in oat bran) just be focusing on the 'bad players'?
    Also, I want to add the RSS feed for this to my My Yahoo page, but there is something wrong with the URL's. Can anyone help here?
    Thanks much,
    Judy

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  33. I am so glad to have found this blog with its information and comments.

    Dr Davis's blog saved my life, Judy. Because of it, I got a heart scan and had them do a body scan at the same time. Turned out I had, for my age, "moderate" CAD. A 322 score at age 73. The body scan turned up kidney cancer. I was able to get the cyst removed without losing a kidney.

    I lost 30 pounds by stopping sugar, wheat and corn. That dropped me from a 32 BMI to a 28. Went from high in sdLDL to high in large buoyant LDL. Dropped my scan score from 322 to 219 in one year.

    Most Cardio's will tell you this is impossible.

    The key to getting my CAC score down was taking 6000IU of D-3 daily to get my blood serum level over 80 and keep it there.

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  34. Re: Kathy "For the record, I am hip-deep in "sleep hygiene" cliches, but the insomnia persists."

    You may be interested in Delayed Sleep Phase Syndrome

    http://en.wikipedia.org/wiki/Dsps

    be sure to click on link to Phase Response Curve under Light Therapy.

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  35. Bill,
    That's quite a saga.
    Personally, I prefer to swim in waters that the standard medical crew either has no clue about or deems 'impossible'. Began many years ago when I was still pretty clueless, but by eating liver instead of taking their iron pills I raised my blood iron so far, so fast that the Dr. concluded that the first test must have been in error.
    I have been sugar-free for about 20years and now am recently gluten-free. Looking to learn more and keep tweaking.
    As to Vit. D3, I stepped into Dr. Cannell's stream some months ago. However, one of my current tracks is working on some balancing there, particularly regarding Vit. A. If you have not seen http://www.westonaprice.org/The-Cod-Liver-Oil-Debate.html I would recommend it for your consideration.

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  36. On the subject of methionine, while it is hard to eat a low methionine diet since it is in so many things, there are things you can do to lower methionine in vivo:

    1) drink alcohol (in moderation). Methionine is used to remove alcohol from the body.

    2) supplement with l-serine and glycine (see my post here: http://tinyurl.com/reduce-methionine referencing PMID 5471055).

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  37. I have been advising against Cod Liver oil for years, and Cannell laid it out very well this month.

    Corn Starch is also a problem and I avoid it. Check out the glycemic index and load on wheat and corn.

    Not only can you test your D level quite easily, it's now possible to test your EPA+DHA omega 3 level though a Lab in Texas. I get three grams of it from fish oil daily. Use 30% fish oil to get it, so I take a total of 10 grams of fish oil a day. Others who are taking this much find the test shows their blood level is at 8 to 10%, the ideal amount, according to the lab.

    The only other major CAD item I take is Slo Niacin, made by a top Lab House, Upsher Smith.

    These three supplements, plus the elimination of sugar, wheat and corn, will do more for your CAD than anything else you can do, IMO.

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  38. Bill,
    Thankfully I do not have CAD, as far as I know. I also do not have insurance or funds to spend on doctors or testing, which I would do some of on my own given the funds.
    I'm interested in truth in all areas of life, including health, diet and nutrition. Unfortunately, there is a lot of conflicting information out there and, in the end, each of us has to decide who & what we are going to believe.
    Although I learn a lot from Cannell, I find myself after a wider field of input and am more inclined to believe the WAP info about Vit. A at this point.
    I continue to search and evaluate-hence my arrival at this blog.

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  39. @ Judy
    Vitamin D Council Newsletter Vitamin A & Cancer
    high retinol intake completely thwarted the beneficial effects of vitamin D, stating, "a higher retinol intake, approximately > 4,800 IU/day, appears to counter the beneficial effect of vitamin D . . ." In other words, exactly what the British Medical Journal paper found with colon cancer.

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  40. I am a big believer in Heart and body scans for people over 50. I paid a grand here in Waikiki for a heart and body combo. Others who post to me have got heart scans for as little as $99. It is 100% effective for ID of CAD if you are far enough along to have hard plaque, which 95% are.

    A body scan is the ONLY way for early detection of kidney cancer. By the time you have symptoms, you usually lose a kidney. Although if you do have it, check out getting it taken care of my freezing or heat. One hell of a lot less invasive.

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  41. Ted,
    Indeed, the Cannell stance you site is what I believed until recently, however it is discussed and countered in length in this article http://www.westonaprice.org/The-Cod-Liver-Oil-Debate.html
    and I am in process of gathering all info I can and readjusting my thinking and believing on the subject.

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  42. ANTIOXIDANT SUPPLEMENTS MAY INCREASE MORTALITYAmong low-bias trials, use of beta carotene, vitamin A, and vitamin E was associated with a 7 percent, 16 percent and 4 percent (respectively) increased risk of mortality

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  43. Just shows again that there is not a food or supplement that you can consume that someone will not get an article up on the Net opposing it.

    Which is great. We get these issues out in the open much more easily now.

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  44. @Ted: when talking about vitamin E, the great majority of people supplementing are taking alpha tocopherol which depletes gamma tocopherol. Better E supplements have more gamma than alpha, but only a minority of people taking E take the better forms. Similarly with folate, most people take the poison known as folic acid rather than folinic acid or methylfolate. The headlines however don't make these distinctions, but the devil's in the details.

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  45. Bill Millan,

    Beans are carbs too.

    Are you sure you are not getting too many carbs?

    Like gluten and grains, the outside shell contain lectins and phytic acid which are anti-nutrients which bind up chromium, magnesium, zinc, iron, B12, B-vitamins and many other important nutrients that prevent optimal hormone and metabolic and anti-cancer protective mechanisms.

    (Paleo/evo= no bean, no peanuts, no corn, no soy, no grains, no oats)

    Good luck!
    G

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  46. I am more concerned with eliminating the three that I consider contribute the most to CAD, sugar, wheat and corn. This eliminates the "simple starches."

    That lowers carb intake, and with my meat and protein intake, fat and protein comprise the bulk of my food now.

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  47. Bill Millan, here's something interesting to think about. Based on articles Stephan has posted on fiber and butyrate production, the probable mechanism for oat products to lower the risk of CAD is the butyrate that their fiber encourages in the colon. (I could be wrong here.)

    Based on his articles, I purchased some Inulin. Pretty cheap (NOW brand), only ingredient listed is its source, Jerusalem artichokes. So it is essentially non-carb, since the small intestine can't absorb it, but achieves the same goal (I think) as the oats and oat bran.

    Plus, and here's something I didn't expect...if you put a spoonful in your mouth it tastes like a cookie! I'm trying to think of a way to bake with it...

    Anyway, sounds like you are doing fine on your program but if you wanted to cut carbs even further and achieve the same effect as the oats, you could probably use inulin.

    Scott W

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  48. Bill Millan,

    Have you ever considered ck'ing ur glucoses 30min after meals? 60min after meals?

    Spikes > 140 are associated with inflammation. Which lead to other conditions (obesity, abdominal white adipose, sdLDL, low HDL, cancer, arrhythmias, afib, osteoporosis, autoimmune disorders, CAD).

    As Scott W mentioned fiber like Glucomannan provided the building blocks for bacterial fermentation (and BUTTER/butyrate) and even BETTER without the glucose or insulin spikes.

    -G

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  49. Thanks for your comment, Scott. One of the things that sugar, wheat and corn do when you eat them is build your insulin resistence. Cutting them out reduces it.

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  50. The Internet has revolutionized Medicine. The Docs are not aware of what it has done to them yet. I have built up an expertise on how to detect and treat stable CAD that surpasses the average Cardio. i am a layman concentrating on a very narrow area. It's the one that affects ME. They have little or no interest in the above. Their hearts are in the Cath lab. That's where the money is.

    They tell the PCP's to guess if the patient has heart disease and to treat with "aspirin, a low fat diet, and a statin." Tell the patient to go to the ER when they have chest pains.

    Doctors think of themselves as "The Wizard of Oz" and their patients as "Brainless Scarecrows." Most are still practicing "Med School" Medicine.

    Heart disease kills 1/3 of the people in this country and we don't even use the CAC heart scan as a screening tool to find people with it.

    Criminal.

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  51. When one starts to feel heavy as if one is being squeezed, it is a typical chest pain. The pain is felt under the breast bone or sternum. This type of pain occurs after some activity or high levels of emotion. Rest and nitroglycerin help to provide comfort. Those having the typical chest pain are more at risk of having CHD than those with atypical chest pain.

    Among the other symptoms of heart disease are: shortness of breath, heart attack and fatigue with activity or exertion. A heart attack can often be the first sign of CHD. There are many tests that help to diagnose CHD. A doctor, usually, does more than one tests before diagnosing CHD. Read More On Heart Disease

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  52. Stephan, you indicate that you don't put much stock in calorie restriction. What is your take on IF?

    There seems to be a consensus even between the "establishment" and "anti-establishment" types that it has merit.

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  53. There are a lot of good books on out there about living well. I'm most excited about one called "Looking Good Naked". I think this book could help people eat well and love their bodies. Feeling comfortable in your skin is so important to being happy.

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  54. Hi Stephan


    I think that the classic caloric model of obesity is a complete failre.

    Gary Taubes' greatest contribution towards understanding it better is his overwhelmingly strong case against the conventional caloric model.

    The caloric model of obesity is a theory born of logic alone and completely ignores the evidence. Specifically:

    *Why we have a worldwide epidemic of obese 6 month olds

    *Why we have extreme poverty and malnutrition going hand in hand with obesity.

    Calorie theory proponents never have any answer when asked this.

    Obesity is a serious chronic medical condition of fat cell dysregulation. People like Jillian Michals are cluless. They do not understand obesity - what caused it, how it develops and how to treat it. The people ( victims really) on The Biggest Loser are victims of useless advice - a complete scam.

    As far as exercise- I think Mark Sisson correctly believes that the reason for its benefit is that it affects fat cell signaling ( along with proper Paleo diet) , it is not the "calories it burns".
    Gary's best lecture is this:

    dhslides.org/mgr/mgr060509f/f.htm

    Take care,

    Razwell

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  55. Hi Stephan!
    Great blog on your review is spot on!
    Andreas

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  56. "When you eliminate sugar, wheat and corn, half the grocery store disappears."

    You're not kidding! Where I live there are still a lot of slim fit healthy elderly people around. I usually meet them in the butcher's and the vegetable shops. Go figure.

    Haven't read this book but it sounds not dissimilar to

    http://metaboliceffect.wordpress.com/

    These days I tend to look more for the similarities rather than differences in people's approaches to diet and metabolism.

    I have a specific problem with wheat spiking my postprandial blood glucose worse than most other carbs. Curiously even wheat bran can do this (I suspect the wheat germ agglutinin) and I'm not the only one on the family with this party trick. I can eat small quantities of oatcakes, quinoa and even rice without this occurring (the definition of "small" increases from morning to evening by around a factor of three or more: I assume this is changing insulin resistance which is what the wheat appears to hack).

    But them I'm weird, despite having almost diabetic BG and *very* diabetic lipids all my life I remained skinny until I met a dietician. Only the combination of extra carbs and severely reduced fat caused this to occur so now I eat the exact opposite

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  57. I was so excited to come across your introduction of the fourth chapter of the book on exercise. There are many research findings as to the usability of exercise alone to combat obesity. However, it is safe to say that physical fitness is essential in developing one's self-esteem. Besides, regular exercise and dieting prevents obstructive sleep apnea which is related to obesity. No wonder some of my friends frequent the gym located in our place. I also enrolled in a fitness program with my wife in one of the best fitness centers in Glendale.

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