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Frequently Asked (Medical) Questions

For my inquisitive friends and former patients: Answers to the most common questions I’ve had recently, for your entertainment and conversation. Please email if you have counterpoints, questions, or comments!

Should I take Vitamin D? Depends- Deficiency symptoms may also be due to hormonal changes, digestive difficulty, as well as not enough pineal gland stimulation by sunlight which will throw off the circadian rhythm and confuse other bodily processes. It seems not harmful to take up to 2000 daily, but, especially since it’s a hormone, I’d pay attention to finding out why someone is deficient in the first place, getting natural light at appropriate times, and fixing any digestive difficulty, as well as intaking adequate nutrition.
* and if you do take it as a supplement, remember it is fat-soluble (like A, E, and K), so you need to take it along with food with fat in it, or your body won’t absorb it!

Should I try the raw food diet? While not inherently harmful, it’s not a long-term healthy plan for most people. Keep in mind that we humans grew large brains because we started cooking our food (and getting more nutrients out of it, leaving our bodies’ digestion energy to be used in other ways), so the argument that raw is healthier is completely wrong. Nutrition content of different vegetables and foods depends on each food (check out the book “eat wild” if you’re intrigued), and different people have different digestive strengths. Keep in mind also that your body has to ‘cook’ everything you put in it to be able to use the nutrition from it, so eating only raw is a huge energy requirement for your body as well. Many people feel amazing when they start a raw food diet, likely because they’ve stopped eating processed food and things that may not be very healthy for them. But the worst diet-induced digestive and immune dysfunctions I’ve ever seen have actually been in raw-foodists that have been eating that way for 3-7+ years. It seems that, like everything else, the best idea is to eat a variety- in this case a variety of raw and cooked food, depending on your personal digestive strength and nutrition needs. For most people, I suggest between 10-40% raw (most of it vegetables). The higher percentage is if you are trying to lose weight, have a particular health concern, or are doing it for religious/meditative reasons. The lower percentage is for those with weak digestion who are building a better gut flora profile which may need to be done gently.

Should I eat more vegetable oils and spreads instead of animal fats? No, there is not enough evidence in my opinion that ‘vegetable oils’ are better for us (except olive oil). The issue may have more to do with whether the fat is oxidized or not. To decrease your free-radical intake (to help decrease artery damage), cook with liquids more often (add water to steam-stirfry, braise, poach, and boil when practical and tasty), use oils with lower smoke points like olive oil for water-cooking and raw preparation, and use oils with higher smoke points (pasture-grazed ghee or fair trade/organic coconut oil) when you absolutely must cook at a higher temperature (roasting and pan frying should be rare).

Should I eat fewer animal products if I am trying to be healthy, lose weight, or prevent heart disease? Not unless you consume an inordinate amount (= two or more meals daily). Eating animal products isn’t inherently harmful. Instead, pay attention to the quality of what you eat. Consume only animal fats from animals that have been only pastured (happily and sustainably raised chickens, pigs, sheep, and goats, or wild sustainably hunted animals if you’re into that), and especially only grass fed cow products like beef and dairy and butter. Several studies now show the improved nutrition profiles of these and their anti-inflammatory properties, just like many studies show the harmful effects of corn fed and feedlot-raised cow products. Some fish consumption seems to be beneficial as well, but not shrimp, and others only from sustainably managed fisheries, and not from farms (especially farmed salmon which can be as unhealthy as corn-fed beef; the exception may be oyster farms). Mostly, decrease your risk of all of those things and improve your heath by meditation, exercise, and moderate eating.
* the caveat here is cured (processed with salt, smoke, etc) meat products (such as hot dogs, sausages, bacon, ham, kebab meat, etc)– these have been proven to cause the most cancer of any food and cause earlier death in those who eat them most days, so eat these sparingly if at all!

Should I eat more soy or whey products to get adequate protein? First of all, most people who eat balanced diets get more protein than is absolutely necessary. But if you’re vegetarian or really excited about exercise, you may need to be more conscious of how much you need and what combinations will get you the amino acids your body can’t make on its own. Old-recipe soy products are likely very healthy for you, like non-gmo organic tempeh, tofu, miso, and soy sauce. Newer highly processed formulations (like those ‘fake meat’ concoctions) are where the problems likely lie. Heating protein isolates to high temperatures for use in protein powders or processed food likely changes the structure of the proteins and may be the cause of some of the hormonal, oxidative, and digestive disturbances seen in studies of people who eat these types of foods. I suggest if you can’t buy the ingredients listed on the package of protein you’re looking at in the store it came from, leave it alone and eat something you can identify.

What diet is best for general health and which is best for weight loss? Easy answer. None of the popular diets are better than any other except this one: whole foods, plant-heavy (80% is a good start), no heavily processed foods at all, no sugary or artificially sweetened beverages, only whole-ground flours but otherwise eat entire whole grains that are high in fiber, and little to no alcohol. Exercise an hour every day or more, and make sure do something that makes you sweat seriously at least 3 times per week. Relatively simple, but not quick or easy if you’ve been doing the opposite for a long time—but this is the only way that works.
* p.s. high-protein diets have been harmful for females in some studies, leading to higher cardiovascular risk, and don’t have a better weight-loss advantage over moderate whole food diets… and also– eating whole high fiber grains decreases the risk of diabetes and intestinal cancer across the board!

Should I eat organic? I think at this time it’s a good option when your choices are only ‘regular’ vs ‘organic.’ If you have more choice, there are better options- buying from local farms and buying in-season may have more immediate environmental impact, with the added benefit that if your local farmer is nearly organic or sustainable, you can encourage them to keep going in that direction. Buying from farmers markets improves the local economy and also puts more money in the farmers’ pockets- and if they have more flexibility financially they may be able to invest in more sustainable practices and get out of the traditional hamster wheel of gmo and big-ag suppliers of petroleum fertilizers and pesticides. Permaculture is I think the only way to go at this point for the long term, but my advice is to do what you can when you can. Spend the extra to eat organic thin-skinned produce (strawberries, stone fruit, potatoes, apples, grapes, spinach, tomatoes) as much as possible, and invest in quality animal products.

What type of bottled water, juices, and sports drinks are best? None. Get a reusable bottle and a water filter you like the taste of and stick to that. Juices are highly processed, generally not fresh, and high in quickly-absorbed sugar you don’t need- eat a piece of whole fruit. Sports drinks are a huge marketing ploy and have artificial flavors and sweeteners that your body doesn’t need at all. Unless you’re running a marathon or doing something equally strenuous so you desperately need the electrolytes, don’t bother– ditch the plastic bottles, save oodles of money, stay hydrated with water when you’re thirsty, and drink tea and coffee you make yourself out of a reusable container.

How much sleep do I need? Depends on you, and depends when you sleep, but likely somewhere between 7.5-8.5 hours. If you go to sleep nightly at 10pm and allow yourself to sleep as long as necessary for a week or two, you’ll eventually catch up and know when you feel best. The body rests in approximately 90 minute cycles, so whatever iteration leaves you feeling most energetic is your best bet– some people feel genuinely great with 6 hours, some need 9. The most important thing here is keeping your circadian rhythm steady- get enough UV light in the mornings, go to bed at the same time nightly, eat regularly, and get exercise daily. This helps your body set its clock and thus its hormonal cycles. If your daily cycle is off, so will your monthly, seasonal, and yearly cycles, which will take health and years off your life. Sleeping well is the most comprehensive way to keep your brain, body, and emotional health in good shape :)

 

and of course... view more castles :)

and of course… view more castles :)

Cholesterol: the myths, the truths, the eco-info :)

Sustainable Health Nutshell: use Unrefined Local-as-possible Organic-as-possible olive oil or ghee (clarified butter) for cooking, and add water to your cooking- especially roasting or sauteeing, so the oil you use and the food itself stays below 250 degrees and is therefore less likely to become oxidized and contribute to artery damage and cholesterol plaque buildup (cooking tip: let the 1/4 c or so of water boil off and remove from heat just after to retain the good flavors from the oil and spices you used too!). Avoiding refined and non-organic oils and high temperature cooking (including most processed food) helps save your health and the planet’s at the same time! Read on for the details! :)

Here’s a quick review of the basic info western medicine has to offer. Cholesterol is necessary for life (brain cell development, hormone construction, bile acids, cell walls, etc), but in above-average amounts cholesterol is correlated with heart disease, ‘fatty liver’ disease, and more. Stiff plaques are found in arteries of patients with heart disease and angina, strokes, claudication and certain types of kidney disease. Then there’s the breakdown of ‘good’ and ‘bad’ cholesterol and triglycerides… We are taught by doctors, the government health agencies, and pharmaceutical companies that if we just lower the bad numbers and increase the good numbers with ‘lifestyle modification’ or drugs (like aspirin and simvastatin), we won’t get those diseases listed above. Well, we might not get them. Well, we might be less likely to get them. Sometimes. Depending on other risk factors. So, no, it’s not a sure thing. Not at all, actually.

Aspirin and Statins both help decrease inflammation in vessel walls that is the main cause of cholesterol plaques first sticking, then growing, then breaking off and clogging a downstream artery with blood clots that tried to repair the damage, thus killing the downstream tissue (this is what’s known as a heart attack). But what causes the inflammation in the first place? Tissue damage (from wear and tear, stress, infection, free radicals, etc) causes the blood vessel wall to send out inflammatory markers, which causes immune cells to come repair the damage. The cholesterol there gets eaten like the rest of the debris from the damage in a regulated manner by the white blood cells. However, if the cholesterol is oxidized the macrophages can’t regulate their uptake, become over-stuffed “foam cells,” and die, leaving an icky yellow streak on the wall of the damaged vessel, and releasing their insides that further break down the vessel wall, causing a thicker scar or ‘atheroma.’ The picture on the previous link gives you an idea of how this can block flow and you can imagine what happens if it gets too big or a piece breaks off and flows down to a thinner part of the artery. Yuck.

Oxidization and free radicals seem to be big keys in all kinds of inflammation (stress-induced, infection, auto-immune, etc). Free radicals are caused by many many things (including our own normally functioning cells), and are typically taken care of by our bodies and are not an issue unless the amount overwhelms our normal processes. Leaving infection and stress aside for the moment, what are our biggest sources of oxidized cholesterol we put into our bodies? Refined foods (that contain oils including trans fats, dairy, or other animal protein processed at high temperatures), charred food (yes, grilled meat… it’s burnt, and the carbohydrates turn to burnt sugar + fat = caramel= yum!= ama/toxins), and oils/fats cooked to high temperature. So what to do? The simplest thing is to stop intaking so much oxidized cholesterol- your body has enough free radicals all by itself to deal with without you overwhelming it. Then there is eating more vegetables, stress-reduction, exercise… today’s post is focusing on oil, though, so here’s the last puzzle piece for making real changes: Cook with water! Anti-climactic, I realize. But by simply adding water to cooking, for example in roasting pans, eggs (poaching), and to stir-fry cooking, you can help prevent the food and oil from overheating and oxidizing and overloading your immune system with extra free radicals.

Yay! But we’re not done. There is actually another piece. This blog is about the environment as well (and yes, you can use used cooking oil for biodiesel, but really we shouldn’t be frying often for the above reasons…), so the type of oil you choose to use, and the type of fats you eat in general are as important as how you use them. Fat is amazing stuff. It holds onto fat-soluble things- like hormones (PCOS and type 2 diabetes), and vitamins, but also things like pesticides. It also tends to concentrate and hold on to those things for a very long time.

So first, imagine a large animal (like a cow) eating a huge amount of non-organic corn, storing all that pesticide residue in its fat (which is mostly of the less healthy types Omega-6 and -9, and which it has more of than normal since cows weren’t built to eat so much carbohydrate at a time, much like people!)… and if you eat a piece of that well-marbled cow’s muscle, including the fat that’s been further oxidized and likely charred on that grill… It’s not so great for your arteries. Food for thought. But what about vegetable oils? Aren’t those “good for you?”

Imagine a field of, say, rapeseed (which originally was too toxic for human consumption until bred out to be lower in acid), even possibly “M” company’s Canadian GMO rapeseed (called ‘canola‘ which rhymes with granola, and sounds quite healthy!). Maybe the field was sprayed with pesticides. The seeds were harvested, cooked to crack the seeds, then pressed, creating more heat, to squeeze more oil out. If it was to be “refined,” then gasoline (hexane or heptane) was put on it to get the rest of the oil out of the seeds. It was then heated again to boil off the gasoline, then heated with phosphoric acid and water to ‘de-gum’ it, and then it was refined with sodium hydroxide (yep, drain cleaner!). Wow. Ok, still not done- in order to bleach it, it was passed through acid which creates peroxides, and finally to deodorize all the oxidization, it was steam distilled up to 518 degrees. Talk about high temperatures. Ew.

So, no, all vegetable oils aren’t necessarily good for you. Basically I’d like you to think about this when you’re choosing what to put in your body- think about not only the potential damage to arteries, but also the pesticides and potential GMO issues in crops used for both animal feed and cooking oil production (corn, soy, and other vegetable oils), and, of course, the petroleum used to bring that oil to you (in the fertilizer of non-organic crops, moving animals around and processing them, and flying the oil to you,… even EVOO from Italy. Jet fuel isn’t so good for the environment either and we have delicious olives right here in California! Arguably still far from, say, Maine… but I’m sure you have cows for making butter and ghee closer! :) ).

Slow down, think, and allow yourself and the planet better health with your choices.