Fork U with Dr. Terry Simpson

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Reducing Dementia with Diet Feb 15, 2024

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Three Great Diets

The Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), and the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) are all great eating patterns. Each diet focuses on different aspects of health.

Mediterranean Diet

The Mediterranean diet comes from the traditional dietary patterns of countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. High in the consumption of fruits, vegetables, whole grains, nuts, seeds, legumes, olive oil, fish, and moderate amounts of poultry, dairy, and red wine. Shown to decrease the risk of heart disease and cancer and to improve longevity.

DASH Diet

Discussed in last week's podcast (ref). DASH (Dietary approach to stop hypertension) was developed to prevent and manage hypertension (high blood pressure). Focuses on increasing intake of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while limiting sodium, saturated fats, and cholesterol.

MIND Diet

Developed by researchers at Rush University Medical Center as a hybrid of the Mediterranean and DASH diets, with a focus on brain health and reducing the risk of neurodegenerative diseases like Alzheimer's disease. It also emphasizes the consumption of fruits, vegetables, whole grains, nuts, olive oil, fish, poultry, and beans while limiting the intake of red meat, butter/margarine, cheese, pastries/sweets, and fried/fast foods.

Three Diets are Branches of the Same Tree

The Mediterranean, DASH, and MIND diets share some common elements. All focus on whole foods and plant-based sources of nutrients. The Mediterranean diet emphasizes health and longevity. While the DASH diet targets hypertension and cardiovascular health. Finally, the MIND diet specifically supports brain health to reduce the risk of neurodegenerative diseases.

1. Rush Memory and Aging Project:

A study conducted by researchers at Rush University Medical Center followed over 900 older adults for an average of 4.5 years. Findings showed that individuals who closely adhered to the MIND diet had a substantially lower risk of developing Alzheimer's disease, with a reduction in risk ranging from 21% to 53%, depending on the level of adherence. (ref )

2. Columbia University Medical Center Study:

Researchers at Columbia University Medical Center examined the dietary habits of over 1,000 participants. Individuals who closely followed the MIND diet had a 53% lower risk of developing Alzheimer's disease than those with low adherence to the diet.

3. Alzheimer's Disease Neuroimaging Initiative (ADNI):

The ADNI study found that adherence to the MIND diet was associated with better cognitive performance and a reduced rate of cognitive decline over time.

4. Systematic Reviews and Meta-Analyses:

Several systematic reviews and meta-analyses have summarized the findings of multiple studies investigating the association between the MIND diet and dementia risk. Overall, these reviews reveal that adherence to the MIND diet is associated with a significant reduction in Alzheimer's disease and dementia.

5. Mechanisms of Action:

Components of the MIND diet, such as leafy greens, berries, nuts, whole grains, fish, olive oil, and poultry, have been linked to improved cognitive function and a lower risk of dementia.

More research is needed to elucidate the mechanisms underlying the protective effects of the MIND diet. Current evidence suggests that adherence to this dietary pattern can be a valuable strategy for reducing the risk of cognitive decline and Alzheimer's disease in older adults.

Diagnosis of Alzheimer's Disease.

On TikTok, a non-physician said the only way to diagnose dementia was an autopsy. This is false. Alzheimer's disease is diagnosed based on established criteria. These are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Also can be found in the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria.

The healthcare provider will conduct a complete history and physical examination
Neuropsychological assessment may evaluate cognitive function, memory, attention, language, and executive function.
Blood tests can rule out underlying medical conditions, such as vitamin deficiencies (e.g., vitamin B12 deficiency), thyroid disorders, infections, metabolic imbalances, or kidney or liver dysfunction.
MRI or CT scans will be ordered to assess structural abnormalities in the brain or detect signs of conditions like stroke, brain tumors, or hydrocephalus. Genetic testing for mutations associated with familial Alzheimer's disease, cerebrospinal fluid analysis to assess for biomarkers associated with Alzheimer's disease (e.g., amyloid beta and tau proteins)

Genetics of Dementia

Several genetic factors are correlated, but not causative of, an increased risk of dementia, including Alzheimer's disease. Lifestyle changes can mitigate these. Hence, the MIND diet is important to those who have a genetic predisposition to dementia.

1. APOE ε4 Allele

The apolipoprotein E (APOE) gene ε4 allele is the strongest known genetic risk factor for late-onset Alzheimer's disease. Individuals who inherit one copy of the APOE ε4 allele from one parent have an increased risk of developing Alzheimer's disease. while those who inherit two copies (one from each parent) have an even higher risk. Chris Hemsworth, who plays Thor in Marvel movies, has two copies of these genes.

2. Presenilin Genes (PSEN1 and PSEN2)

Mutations in the presenilin 1 (PSEN1) and presenilin 2 (PSEN2) genes are associated with early Alzheimer's disease before 65. These mutations can cause abnormal processing of amyloid precursor protein, which leads to the accumulation of amyloid beta plaques in the brain.

3. Amyloid Precursor Protein (APP) Gene

Mutations in the amyloid precursor protein (APP) gene are also associated with rare cases of early-onset Alzheimer's disease. APP mutations can lead to the production of abnormal forms of amyloid beta protein, which contributes to the development of Alzheimer's pathology.

4. TREM2 Gene

• Variants in the triggering receptor expressed on myeloid cells 2 (TREM2) gene have been identified as risk factors for late-onset Alzheimer's disease and other neurodegenerative diseases.

• TREM2 is involved in the regulation of the immune response and microglial function in the brain, and variants in this gene may affect the brain's ability to clear amyloid beta and other toxic proteins.

5. Other Genes

• Several other genes have been implicated in the risk of developing dementia, including genes involved in inflammation, cholesterol metabolism, synaptic function, and neuronal signaling pathways.

While genetic factors can increase the risk of dementia, they do not guarantee that an individual will develop the condition. Environmental factors and lifestyle factors (such as diet, physical activity, and cognitive engagement) play significant roles in determining an individual's risk of dementia. Additionally, not all cases of dementia are attributable to genetic factors.

DASH, The Best Diet You've Never Heard Of Feb 06, 2024

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Abstract:

The Dietary Approaches to Stop Hypertension (DASH) diet is a widely recognized dietary pattern designed to lower blood pressure and promote cardiovascular health. I will attempt to provide an in-depth review of the DASH diet, its origins, key principles, health benefits, and potential limitations. It also explores the scientific evidence supporting its efficacy and applicability in various populations. Furthermore, this paper discusses practical considerations for adopting the DASH diet and its potential future developments in the field of nutrition and health.

1. Introduction

The DASH diet, or Dietary Approaches to Stop Hypertension, is a dietary plan primarily developed to combat hypertension (high blood pressure). DASH has since gained recognition for its broader health benefits. Hypertension is a major risk factor for cardiovascular diseases, including heart disease and stroke. Therefore, the DASH diet is essential to reducing these health risks.

2. Origins and Development

The National Heart Lung and Blood Institute (NHLBI) developed the DASH diet in a study known as the DASH-Sodium Study. The primary objective of the DASH-Sodium study was to investigate the effect of dietary patterns on blood pressure, in particular, the effects of sodium intake. Researchers aimed to design a diet that could effectively lower blood pressure without medication. The DASH diet emerged from this study as a dietary pattern rich in nutrients and low in sodium, saturated fat, and cholesterol.

3. Key Principles of the DASH Diet

The DASH diet emphasizes the consumption of nutrient-rich foods while limiting the intake of sodium, saturated fats, and cholesterol. Key principles of the DASH diet include:

High Consumption of Fruits and Vegetables: The diet encourages individuals to consume a variety of fruits and vegetables, providing essential vitamins, minerals, fiber, and antioxidants.
Lean Protein Sources: Lean proteins like poultry, fish, and plant-based options such as beans, lentils, and tofu are recommended to replace high-fat animal proteins.
Whole Grains: The DASH diet emphasizes whole grains like brown rice, whole wheat, oats, and quinoa, which are rich in fiber and nutrients.
Dairy: Low-fat or fat-free dairy products are included to provide calcium and protein without excess saturated fat.
Nuts, Seeds, and Legumes: These foods are encouraged as sources of healthy fats, fiber, and plant-based protein.
Limited Sweets and Sugary Beverages: The DASH diet restricts the consumption of sugary foods and beverages, reducing the intake of added sugars.
Sodium Restriction: The diet recommends limiting sodium intake to 2,300 milligrams per day (or 1,500 milligrams for individuals with hypertension, certain chronic conditions, or those at high risk).

4. Health Benefits of the DASH Diet

The DASH diet offers a range of health benefits beyond blood pressure reduction:

Lowering Blood Pressure: Numerous studies have shown that the DASH diet can effectively lower blood pressure, particularly in individuals with hypertension.
Cardiovascular Health: The diet is associated with a reduced risk of heart disease, stroke, and other cardiovascular conditions due to its focus on heart-healthy nutrients and reduced saturated fat intake.
Weight Management: The DASH diet can help weight loss and weight management due to its emphasis on nutrient-dense, low-calorie foods.
Improved Lipid Profile: The diet can lower levels of LDL cholesterol (bad cholesterol) and improve HDL cholesterol (good cholesterol), further reducing the risk of heart disease.
Diabetes Management: The DASH diet may help individuals with diabetes manage blood sugar levels, as it encourages a balanced intake of carbohydrates, fiber, and protein

5. Scientific Evidence

The effectiveness of the DASH diet has been supported by numerous clinical trials and epidemiological studies. For instance, the original DASH-Sodium trial demonstrated that the DASH diet could significantly lower blood pressure, with greater reductions observed when combined with sodium restriction. Subsequent research has reaffirmed these findings, highlighting the positive impact of the diet on cardiovascular health and well-being.

This was one of the few studies in which all the food was made for the participants.

6. Applicability and Limitations

While the DASH diet offers substantial health benefits, it may have limitations for some. Its emphasis on whole foods and fresh produce can be costlier and less convenient than processed alternatives. Cultural preferences and dietary restrictions may also pose challenges in adopting the DASH diet. Nevertheless, modifications and adaptations can be made to suit individual needs and preferences while maintaining the core principles of the diet.

7. Practical Considerations

For those interested in adopting the DASH diet, practical considerations include meal planning, grocery shopping, and monitoring sodium intake. Consulting with a healthcare professional or registered dietitian can provide personalized guidance and support.

8. Future Developments

The DASH diet continues to evolve as new research emerges in nutrition and health. Future developments may focus on tailoring the diet to specific populations, incorporating technological advancements, and exploring the impact of the DASH diet on additional health outcomes beyond hypertension.

It is America's Mediterranean Diet

DASH is a version of the Mediterranean Diet. You can see the same requirements for whole grains, vegetables, fruits, dairy, and legumes. It combines meats and fish depending on the calories and still uses primarily monounsaturated fats. There is no recommendation for or against alcohol in this diet. There is a strong recommendation to decrease sodium in the diet.

9. Conclusion

The DASH diet is a well-established dietary pattern with proven benefits for lowering blood pressure and improving cardiovascular health. Its emphasis on nutrient-rich foods, balanced nutrition, and sodium restriction makes it a valuable tool for reducing the risk of hypertension and related health conditions. While challenges may exist in adopting the DASH diet, its adaptability and potential for customization make it a practical and effective choice for individuals seeking to improve their dietary habits and well-being.

Health Benefits of Limiting Red Meat Jan 25, 2024

Show notes

Did You Try the Carnivore Diet?Did you try the carnivore in January? A month of red meat, eggs, and butter? If you did, you probably lost weight. If you lost weight, you felt better. The Carnivore crowd will point to weight loss as proof of superiority.But did you worry that this might not be the healthiest diet for you long-term? Is it healthy? In short, the answer is no.Perhaps you remember on a previous podcast, we talked about the beer and sausage diet. On that diet, Evo, the pod god who distributes this podcast, lost weight every month he was on the diet. In addition, his weekly lab work -sorry for all the jabs Evo - improved every week he was on the diet.Could you argue that drinking beer and eating sausage is a good diet? You could, and that same logic is what the carnivore crowd uses to convince people the carnivore diet has merit.Simplicity, is Thy Name Carnivore?What could be simpler than eating a diet of just red meat? Who doesn't like a good steak? If you just eat steak or red meat, you will lose weight. When you lose weight, you will feel better. And your labs might improve. You might think it is paradoxical that your cholesterol level went down - it isn't; that is just a result of giving up junk food and weight loss.Every diet has a honeymoon phase, where people think they can do the diet "forever."Then reality comes home:The diet becomes boring, and one noteThere is an undeniable increased risk of heart disease and cancerMaybe you got hemorrhoids or developed diverticulitisFinally, in social situations, you become that person - the one who could only eat red meat - the reverse veganFORK UToday, on Fork U, we will discuss the latest low-carb fad: the Carnivore diet, the denial that goes into those who make up the diet, and the risks of an all-meat diet.I'm Dr. Terry Simpson, and this is Fork U.Fork UniversityWhere we make sense of the madness, bust a few myths, and teach you a little about food as medicine.Carnivore DietThe carnivore diet, which primarily consists of animal products like meat, fish, and eggs, has become the latest low-carb fad. It is a controversial and extreme dietary approach. Proponents of the carnivore diet claim numerous health benefits. To be clear, the scientific evidence supporting these benefits is limited, and that long-term studies on the effects of the carnivore diet are lacking.Paul Saladino, Ken Berry, and Shawn Baker are a few doctors who advocate for this diet. And oddly, none of them see private patients, although Saladino and Baker love showing their abs, and spend a lot of time in the gym.The Biotruth of EvolutionSome claim the natural diet of humans is meat. This is a biotruth.When someone tells you that “man was meant to eat” this or that – it is part of a logical fallacy known as a biotruth. A biotruth is an argument presented by someone with misunderstood notions of human biology and/or evolution but uses those false arguments to justify their views. In this case, how they eat.You can extend that logical fallacy out: man was not meant to fly, so we shouldn’t be in airplanes. Primitive man did not have laboratories, so we should not have antibiotics.You will see biotruth arguments from people who practice carnivore diets, as well as those who practice vegetarian (and vegan) diets. Often with photographs of our jaws and those of our ancestors – or they will say how we have a long or short intestine, and on that basis, we “were meant” to eat in whatever their view is.As we evolved, were we better as plant eaters or meat eaters? Does it matter? It is an argument based in biotruth.Paleolithic Man and BiotruthThe carnivore diet is based on the premise that man had evolved during the Paleolithic era by eating meat. Furthermore, they state that when agriculture and domestication of animals came (10,000 years ago), man’s metabolism was unable to adapt to these new foods. They assert that the maladies of modern man come from foods such as grains and dairy products. That non-meat diets lead to heart disease, obesity, and diabetes – all from our evolutionary dysfunction.Archeology has about 6000 fossils to make these assumptions. From those 6000 fossils, we find that early man:Probably was more of a scavenger than a hunter - taking whatever meat something else killed and left behindGathering, especially roots and beans, kept humans aliveThe most common things hunted were frogs and rabbitsNeanderthals and Homo Erectus, our cousins but not direct ancestors, did organized hunting; the Neanderthals, and homo sapiens began organization until perhaps 20,000 years ago.Man ate grains even 30,000 years ago.The view of man as a large game hunter is not from the evidence unless you count comic strips and movies.Modern Hunter Gather Societies Eat MeatOften, they refer to the Inuit, whose lifespan is about 50 (excluding infant mortality). They eat mostly sea creatures but have mummified evidence of atherosclerotic disease. The Hazda eat honey, fruit, and meat, and their average age of death is 50. Over half of their people don't make the age of 15.The use of early man, or hunter societies, to state that we should be eating meat is factually incorrect.Humans evolved not by eating meat. Humans evolved by eating anything they could, mostly plants. Early man did not evolve to live into the 90's.Vegetables are poison: Lectins, Oxylates, and anti-nutrientsThe other comments go something like the "defense of vegetables against humans." This ignores the long-lived populations, who eat mostly plants and little meat.Kidney stones are found more commonly among meat eaters than vegetarians. (ref).Despite their protestations, Kale, spinach, beans, and broccoli are healthy for people.The Most Bioavailable FoodThe other argument is that meat contains the richest nutrients, and the most bioavailable food. Meat is a rich source of protein, the liver has a lot of vitamin D, and heme-iron is generally better adapted for iron deficiency. Meat is far from having all the nutrients a person requires. Red meat is rich in iron, zinc, B vitamins, and iron.There is minimal fiber in meat. The carnivore crowd waives this off, stating that fiber isn't something humans need. In spite of the clear evidence that fiber decreases colon and rectal cancer, that fiber helps regulate blood sugar and cholesterol. Fiber is important to a healthy gut microbiome, and fiber prevents hemorrhoids as well as diverticulitis. Their assertion is false and painfully so - especially if you've had hemorrhoids.Vitamin C is not abundant in meat. This lesson led to the discovery of citrus as a means of avoiding scurvy in sailors during the era of Discovery. A finding attributed to another surgeon, Dr. James Lind. Modern-day isn't without scurvy found among carnivore aficionados, such as musician James Blunt, who went on the carnivore diet.Calcium is more abundant in dairy products and some vegetables, as is Folate. and omega-3 fatty acids. They tend to forget that farm-raised salmon has ten times the amount of omega-3 fatty acids as does the cow raised on and fed with high-quality grass all their life.Weight Loss and the Carnivore DietWeight loss occurs in a calorie deficit. There is no diet that cannot produce a calorie deficit. This has been demonstrated in great studies showing the equivalent of low-carb diets, and the Mediterranean diet are equal over time.It has also been demonstrated in those showing the McDonald's diet, the cookie diet, the Twinkie diet, and our own - Beer and Sausage diet.One simply gets tired of eating red meat, and you eat less of it. So instead of eating three thousand calories of multiple foods, you eat 2200 calories of meat, and you lose weight. Nothing to see here, folks, just another diet.But there is a dark side to red meat. Just because you can lose weight and show all the physiological benefits of weight loss doesn't mean that a lot of red meat is good for a human. In fact, there is every evidence to state one should limit red meat.Is Red Meat Consumption like Smoking?There is always some headline grabber who states that eating red meat has the same risk as smoking. While red meat, as we shall see, has an increased risk of cancer, heart disease, and diabetes, it is not as risky as smoking cigarettes. As much as some anti-meat activists might like to frighten you, we assume you came here for the facts.So, where did our studies begin?Meat, the Seven Countries StudyHeart disease was an epidemic in the 1950s in the United States, primarily affecting white-collar men. However, when Ancel Keys heard that certain populations had almost no heart disease, he began a quest that resulted in the Seven Countries Study.Briefly, people in some villages in the Mediterranean region ate less red meat. Some because they couldn't afford it, and it wasn't a traditional part of their cuisine.Keys group studied 14,000 men from 16 villages in seven countries. Some of those cohorts, like in the United States and Finland, had high levels of red meat and saturated fat in their diet. Others, like those from Crevalcore and Montegiorgio, had far less saturated fat.The Seven Country Study was the first to show that serum cholesterol, blood pressure, diabetes, and smoking are universal risk factors for heart disease. Ancel Keys and colleagues were central to the modern recognition, definition, and promotion of the eating pattern they found in Italy and Greece in the 1950s and ’60s, now popularly called “The Mediterranean Diet.”They showed that dietary patterns in the Mediterranean and in Japan in the 1960s were associated with low rates of coronary heart disease and all-cause mortality. The studies on the elderly showed that a healthy diet and lifestyle (sufficient physical activity, non-smoking, and moderate alcohol consumption) is also associated with a low risk of cardiovascular disease and all-cause mortality. A healthy diet and sufficient physical activity may also postpone cognitive decline and decrease the risk of depression.While Carnivore like pointing out that Hong Kong has the highest consumption of meat and some of the longest-living people in the world, a closer look shows those who live to be well in their 80's and 90's ate a diet more like the Mediterranean and not much meat.Red Meat and DiabetesRed meat consumption has been associated with an increased risk of developing type 2 diabetes. Several studies have investigated this relationship, and here are some key findings:Particularly processed red meat, like sausages, bacon, and hot dogs, is associated with an increased risk of type 2 diabetes. Perhaps from high levels of sodium and preservatives like nitrates may contribute to the development of diabetes.The high iron content in red meat can lead to elevated iron stores in the body and may interfere with insulin action and glucose metabolism.Saturated fats, abundant in red meat, increase the accumulation of fat in the muscles and liver, leading to insulin resistance.Large-scale epidemiological studies have provided evidence of the link between red meat consumption and diabetes risk.Red Meat and Colorectal CancerThe International Agency for Research on Cancer (IARC) has classified processed meat as a Group 1 carcinogen and red meat as a Group 2A carcinogen. A significant body of research has linked red meat, especially processed meat, to an increased risk of colorectal cancer. For example, a meta-analysis by Chan et al. (2011) found that each 100g/day increase in red meat intake was associated with a 17% increased risk of colorectal cancer.Mechanisms Linking Red Meat to Colorectal CancerPotential mechanisms include the presence of heme iron in red meat, which facilitates the formation of known carcinogens, such as N-nitroso compounds.Grilling or barbecuing can lead to the production of heterocyclic amines and polycyclic aromatic hydrocarbons, also carcinogenic compounds.Red Meat and Pancreatic CancerA pooled analysis by Larsson and Wolk (2012) indicated that high red meat consumption was modestly associated with an increased risk of pancreatic cancer.Red Meat and Prostate CancerThe relationship between red meat consumption and prostate cancer is less clear. Alexander et al. (2010) meta-analysis found a weak but statistically significant association between high intake of red meat and increased risk of prostate cancer.What is the Strength of Evidence?While not all studies have found strong associations, also, the mechanisms are not fully understood. However, the evidence suggests a link between high red meat consumption and an increased risk of certain types of cancer, particularly colorectal cancer.Reduced Cancer RiskNumerous studies have established a link between red meat consumption, especially processed meat, and an increased risk of certain types of cancer, including colorectal and pancreatic cancer (International Agency for Research on Cancer, 2015).Decreasing red meat intake and incorporating various plant-based foods contribute to a lower cancer risk due to the high fiber content and presence of cancer-protective phytonutrients in plants.Better Weight ManagementReducing red meat consumption can help weight management. Red meat is often high in calories and fat, contributing to weight gain. Opting for leaner protein sources and increasing the intake of vegetables and whole grains can help maintain a healthy weight (Wang, Y., & Beydoun, M. A., 2009, Epidemiologic Reviews).Your Gut HealthReducing red meat consumption can improve gut health. Diets high in red meat are low in fiber. Fiber is essential for a healthy gut microbiome. Incorporating more fiber-rich plant-based foods promotes better digestion and a healthier gut. Especially a reduced risk of diverticulitis and hemorrhoids. Drawbacks of a carnivore diet include nutrient deficiencies (such as fiber, vitamin C, and certain phytonutrients) and the potential impact on gut health due to the lack of dietary fiber.ConclusionThe benefits of reducing red meat consumption include a lower risk of cardiovascular diseases, cancer, and type 2 diabetes, better weight management, and improved gut health. Embracing a balanced diet rich in plant-based foods and varied protein sources can lead to a healthier lifestyle and well-being.We call that lifestyle The Mediterranean Diet.Thank you for listening to this edition of FORK U. You can find the references for this podcast on my blog, yourdoctorsorders.com or forku.com. While I am a doctor, I am not your doctor. If you need a doctor, please see a board-certified western-trained physician, not a naturopath or a chiropractor or some Eastern medicine witch doctor.Fork U is distributed by our friends at Simpler Media and thanks to Allie Press and the pod god - Evo Terra.Hey Ev0 - did you know that those mummies in early Alaska had a lot of vascular disease? I wonder what my daddy had.ReferencesChan, D. S., Lau, R., Aune, D., Vieira, R., Greenwood, D. C., Kampman, E., & Norat, T. (2011). Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PloS one, 6(6), e20456.Larsson, S. C., & Wolk, A. (2012). Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. British Journal of Cancer, 106(3), 603-607.Alexander, D. D., Mink, P. J., Cushing, C. A., & Sceurman, B. (2010). A review and meta-analysis of prospective studies of red and processed meat intake and prostate cancer. Nutrition Journal, 9, 50.World Health Organization. (2015). IARC Monographs evaluate consumption of red meat and processed meat.Micha, R., et al. (2010). Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation.Pan, A., et al. (2012). Red meat consumption and mortality: results from 2 prospective cohort studies. Archives of internal medicineO'Connor LE,…

Full show notes at the publisher

Diet Disappointment 2024 Version Jan 16, 2024

Show notes

Sorry It Didn't Work

This is the time of year when everyone is excited about some change in their life. My neighbors are doing a "dry January" because they want to cut down on their alcohol. Other neighbors committed to more physical activity before a hip replacement. And there is the inevitable "what diet will I do this time?"

Now, before I go to that, long-time readers of my newsletter will realize that I am drinking my cup of Peet's coffee. Peet's is a story of disappointment, which I will use to illustrate a point:

Diet Disappointment

Diets are like that person who disappoints you again and again. The person you invite to events, but they never reciprocate. The diet starts out great. You lose a bit of weight, decide you can eat this way forever, and this is your new lifestyle. Then something happens. If you are smart, you realize you cannot live that way. Most, though, internalize and think, "It is my fault." Well, it isn't your fault.

Low Carb Disappointment

Low-carb diets can be disappointing for various reasons. Some people may find it difficult to stick to a low-carb eating plan because they miss certain high-carb foods that they enjoy. This can lead to feelings of deprivation and dissatisfaction with the diet. Additionally, some people may not experience the weight loss or health benefits they were hoping for with a low-carb diet. It's important to remember that everyone's body is different, and what works for one person may not work for another. Furthermore, it is important to focus on overall health and well-being rather than just weight loss or specific dietary restrictions.

Every year, someone starts a new version of low carb. I've done a few myself. This year's version is carnivore. Some are doing a carnivore January. The results will be the same as the previous low-carb diets - and let me go back to Peet's coffee.

Coffee and Diets

I have been a member of Peet's Coffee Club since 1995. I get it faithfully every couple of weeks. Whole beans. It costs about $36 for two bags. Then I discovered I could get it at Costco for $25, with no shipping charge, the same date of roasting. I wrote Peet's, of course. They told me my coffee is always fresh, unlike the bulk sold to Costco. Except the roasting date is on the package.

Diets are like that. You get some results, then disappointment. You don't get the return for the money. But someone in the low-carb community will tell you that you didn't do it correctly:

You were not earnest enough,
You didn't get the right kind of grass-fed beef
The beef wasn't organic
You ate a banana and ruined ketosis
If you stop eating carrots, you will maintain ketosis.
Oh, does that pasta look delicious
Stop eating vegetables and grains, and just eat beef, salt, and water

Now What?

So, some consider weight loss surgery or new drugs. Both of these are reasonable (yes, I have done a lot of weight loss surgery in my time).

But what I've advocated is that people have to take responsibility for what they eat even after weight loss surgery. Well, you don't have to - but your body is a perfect calorie counter.

Does that mean a "diet?" No, the goal of weight loss drugs or surgery isn't to put someone on a diet for weight loss. The goal is to give them good food so they can nourish themselves.

It also means I have to get rid of silly ideas they learned from things like the low-carb diet. The low-carb diet, that friend you always invite into your home, always disappoints.

My Journey to Culinary Medicine

About ten years ago, I received certification in Culinary Medicine. Part of that training was long hours reviewing the literature more about food than I could imagine. For my patients, they will remember the day I began to advocate for the Mediterranean Diet.

I made the journey from some version of a low-carbohydrate diet to a diet that had substantial proof of long-term health.

Today, the Mediterranean diet is what I recommend to everyone. It is the most well-studied diet on the planet.

The Mediterranean Diet

The Mediterranean diet is a way to eat based on the traditional foods and cooking styles of countries bordering the Mediterranean Sea. It has been associated with numerous health benefits, including a reduced risk of heart disease, stroke, and certain types of cancer. The components of the Mediterranean diet include:

Abundance of plant-based foods: The diet emphasizes the consumption of fruits, vegetables, whole grains, legumes, nuts, and seeds. These foods are rich in vitamins, minerals, fiber, and antioxidants.
Olive oil as the primary fat source: Olive oil is the main source of fat in the Mediterranean diet. It is high in healthy monounsaturated fats and has been linked to lower rates of heart disease.
Moderate consumption of fish and poultry: The Mediterranean diet encourages consuming fish and poultry in moderate amounts. Fish, especially fatty fish like salmon and sardines, are rich in omega-3 fatty acids, which have numerous health benefits.
Limited red meat intake: Red meat is limited in the Mediterranean diet, with a focus on leaner options like poultry and fish. This helps reduce saturated fat intake and lower the risk of heart disease.
Moderate consumption of dairy products: The diet includes moderate amounts of dairy products, such as yogurt and cheese.
Red wine in moderation: Moderate consumption of red wine is a common component of the Mediterranean diet. This is believed to be due to the presence of antioxidants in red wine, such as resveratrol, which may have health benefits when consumed in moderation.
Herbs and spices for flavor: The Mediterranean diet relies on herbs and spices, such as garlic, basil, oregano, and rosemary, to flavor foods instead of using excessive amounts of salt or unhealthy condiments.
Regular physical activity: In addition to the dietary components, the Mediterranean lifestyle also emphasizes regular physical activity. This can include activities like walking, cycling, or participating in sports.

It is important to note that the Mediterranean diet is not a strict set of foods but rather a flexible and adaptable way of eating. You can eat in this manner by eating food from India, the Phillippines, or Norway. The emphasis is on whole, unprocessed foods and a balanced approach to nutrition.

More To Come

Want to learn more? I have a course coming up - watch this space. For my followers on TikTok you can find the course there.

Oh, and I will be buying from Costco, although many other coffee companies have come to me and said, "Hey, try our coffee." So I am. Sorry, Peet's - I may still drink you, but I have boundaries.

Do that with your diet that will disappoint you. Consider instead a diet that will nourish your body and keep you in good shape.

Good Luck & have fun!

Salesmen of Supplements and Scams Dec 29, 2023

Show notes

The Scams and Quacks of the YearThe New Year, the point we all look for a second chance. To get healthy, lose weight, adopt a new habit. And waiting for you are the hucksters who want to sell you hydrogen in your water, expensive supplements of dubious value, and some choices that might actually harm you. If it sounds too good to be true, you might just be hearing the sound of the duck - or a quack, at least.TOP SCAMS OF THE YEARCarnivore DietMagnesium SupplementationCeltic SaltMTHFR Gene MutationCold PlungesFORK UToday, on Fork U, we will reveal the top scams of 2023 and make sense of the madness that surrounds them.I'm Dr. Terry Simpson, and this is FORK U. Fork University.Where we teach you a little bit about food as medicineBusting myths and making sense of the madness.The Liver King and Paul SaladinoChief among the shirtless salesmen of supplements and scams, 2023 saw the self-described liver king (Brian Johnson) fall from grace, and his partner, Paul Saladino, tried to say he didn't know.Liver King's five-foot-two-inch frame was filled with more steroids and growth hormones than found in a pharmacy. Purchasing somewhere between $12,000 and $20,000 of injectables a month and eating a diet far from the liver he recommended. Ultimately, Johnson admitted this, albeit the evidence was overwhelming. Finally, let us not forget that his business partner, Paul Saladino, loves to yell at spinach and kale while pushing his Heart and Soil supplements.Liver King and Saladino jointly own a supplement business, Heart and Soil. They sell supplements and pretend to tell you about health through the carnivore diet. Moreover, the company "Heart and Soil" is registered in Texas, and Brian Johnson, his wife, and Saladino are all board members.The Shirtless Salesmen of Supplements and ScamsBeing shirtless is oddly effective, especially among some men. Whether this comes from "we like alpha males with abs" or homo-erotic fantasy, shirtless sells. Countless times showing studies refuting their claims don't move these supporters. In fact, the response from some males was some version of "Show me your abdominals." My retort, "I'd love their abs, but in time they'd love my arteries," just didn't move them.I still find it odd that a grocery store would allow a shirtless person to yell at spinach. Yes, Saladino did train in psychiatry, although he does not see patients.While Saladino said, he had "an inkling" his partner was doing steroids. Johnson (Liver King) used to inject insulin and balance it with maple syrup. Isn't it odd that Saladino's refrigerator is filled with the same maple syrup that Liver King used to balance his insulin to increase glycogen in his muscles?The Carnivore Diet - or - Doctors Don't Learn Nutrition in Medical SchoolSaladino received a medical degree from The University of Arizona, and I was a faculty member (assistant professor) at the time. Saladino loves to pander to the anti-medicine crowd with the trope that doctors don't learn the root cause of disease. I pointed out that we taught him pathophysiology, and he must have forgotten that our Western medicine discovered the root cause of many diseases.In front of one audience, Saladino claims he learned nutrition in medical school. Then, a few years later, he claims he didn't learn nutrition in medical school. Do we learn nutrition in medical school?Do Doctors Learn Nutrition in Medical School?As someone who is certified in Culinary Medicine and taught nutrition, I can say yes and no. The basics of nutrition are anatomy, physiology, and biochemistry. While you can get these courses in college, in medical school, these are graduate-level courses.The basic pathology of atherosclerosis, or how cholesterol is made, transported, and absorbed, is taught in medical school. The effect of dietary saturated fats causing an increase in low-density lipoprotein is taught in medical school. Moreover, the foods with high levels of saturated fats are taught in medical school.Because of those basics, we surgeons can take the sickest patients and feed them with intravenous nutrition. Surgeons developed intravenous nutrition that has kept countless people alive. In addition, surgeons developed the ability to feed directly into the gut through a tube. But we may not learn that Popeye's chicken breast contains 1000 mg of sodium more than a regular chicken breast. We don't learn the practical side of food, but we learn a lot about the basic science, which is the foundation of nutrition. An analogy might be that an architect can design your home but may not know how to build it.The Inflammatory Process in Medical SchoolThe inflammatory process is one of the first series of lectures that medical students learn. They learn that inflammation is an essential part of healing from injury and disease. That the inflammatory process is necessary to remove bacteria, viruses, parasites, and even cancer from the human body. Further, medical students learn that if the inflammatory process is overdone, destruction remains, such as in auto-immune diseases like rheumatoid arthritis, Sjogren's, or lupus.Medical students are not taught to order C reactive protein or sed rates on everyone because that would be a waste of resources. Someone could have high inflammatory markers for various reasons, and blindly ordering tests is often a wasteful practice of doctors without a clue. Sometimes, we are clueless about a patient's condition, but oftentimes, medical students are taught that a history and physical exam will reveal more than a laboratory test.Medical students are not taught that the inflammatory process is the basis of all diseases because this isn't true. Nor are they taught that atherosclerosis is all from inflammatory disease because that isn't true.Vitamin Deficiencies and SurgeonsVitamin deficiencies are taught in medical school. The first one noted, vitamin C and scurvy, was elucidated from the great work of the Scottish Surgeon Dr. James Lind. Scurvy is a disease with multiple parts - wounds reopen, teeth fall out, blood blisters form, and seemingly many symptoms, but is treated with a source of vitamin C. The root cause of disease, indeed.The Root Cause of DiseaseOr consider this mysterious constellation of symptoms: a person progressively develops difficulty walking, strange eye movements, muscle weakness, shortness of breath, swelling of the legs and feet, and ultimately death. The disease was called kakke. Eastern-trained physicians had worked on it for 300 years, and it affected the royal household and the elite in Japan. Did they have some ancient remedy? They did not.A doctor, Kanehiro Takaki, dissatisfied with his Eastern medical education, decided to learn Western medicine. He apprenticed under a local doctor until the doctor said he couldn't teach him anymore, and the Imperial Navy sent him to St. Thomas in London to learn surgery. There, he learned "Western" medicine and even epidemiology, as was taught there by John Snow, who elucidated the cause of the cholera outbreaks.Using the tools of Western medicine, he showed that the cause of these symptoms was a dietary deficiency of what became known as vitamin B1, or thiamine. If you want to hear a podcast about it or read more, click here.What We Don't Teach in Medical SchoolWhat we are not taught in medical school is that a low-carb diet, or keto diet, or paleo diet, or carnivore diet cure diseases. We don't teach that to medical students because it is not true.We teach how the DASH diet with low sodium reduces blood pressure and how to encourage patients with hypertension to decrease their diet. Or how the Mediterranean diet decreases the risk of heart disease and cancer.While diet is the most empowering thing people can do, often it will not be enough. While physicians can influence some of the health decisions of patients, often the patient will come to us beyond where diet and exercise can help.The Carnivore DietThe carnivore diet is the latest evolution of the low-carb fad. Saladino does a fruit modification of the diet, which will prevent scurvy. In fact, the musician James Blunt suffered from scurvy. as the carnivore diet is far from a complete diet.Carnivore diet sounds great - just eat steak. Saladino will claim this is the most nutrient-dense food in the world. It isn't.Others will claim you can get all your nutrients through this - you cannot.The health problems of an all-meat diet are clear:Keto vs Mediterranean diet - same weight loss, but Med diet had fiber and lower LDL (ref)A good review of meat-based vs. plant-based show plant-based overall healthier (ref)Another review shows that dietary fiber is associated with improved metabolic health (ref)While Saladino refers to the Hadza, studies show their diet, like most hunter-gatherers, is rich in fiber (ref)The Inuit in Alaska have high rates of heart disease, stomach cancer, and colon cancer - all diet-related (ref) (ref) (ref)The carnivore diet increases the risk of diverticulitis, hemorrhoids, and stomach cancer (Sivasubramanian BP, Dave M, Panchal V, Saifa-Bonsu J, Konka S, Noei F, Nagaraj S, Terpari U, Savani P, Vekaria PH, Samala Venkata V, Manjani L. Comprehensive Review of Red Meat Consumption and the Risk of Cancer. Cureus. 2023 Sep 15;15(9):e45324. doi: 10.7759/cureus.45324. PMID: 37849565; PMCID: PMC10577092.) Although many chiropractors will dispute this. I wonder how chiropractors ever learned to do anything but cherry-pick studies?Magnesium SupplementationI recently covered this on a previous blog/podcast ( reference ). Suffice it to say that excess magnesium has become one of the more common problems seen in poison control centers. At best, excess magnesium can lead to loose bowels, but worse cases lead to depression of the carotid baroreceptor with POTS symptoms, cardio-toxicity, and severe cardiac rhythm changes.Legitimate reasons for magnesium deficiency include diarrhea, malnutrition, use of some diuretics, hyperaldosteronism, Crohn's disease, alcoholism, and advanced kidney disease. If you have any of these, you need to see a physician.If you eat a lousy diet and don't get enough magnesium, it is time to grow up.But this leads to the next scam of the year:Celtic SaltCeltic salt is simply sea salt harvested from the North Atlantic. It costs about $1.66 an ounce, compared to regular salt, which is $0.06 an ounce - six cents. Is there magic to justify this additional expense? To answer this, you can ask the naturopath, Barbara O'Neill.For those who haven't seen her, she seems like a kindly lady, a pleasant voice and an easy smile. She is usually filmed while standing next to a whiteboard, explaining her version of reality to an audience who paid thousands of dollars to listen to her.Her misinformation was considered so dangerous that she was barred from Australia's health care system. She claimed cancer could be cured with sodium bicarbonate, that cayenne pepper could reverse atherosclerosis and stop a heart attack, and that infants with strep infections didn't need antibiotics. If you didn't know, every one of those statements is dangerously incorrect.She also states that she can treat high blood pressure with Celtic salt because Celtic salt has magnesium in it. Celtic salt has 80 mg of magnesium for every 34,000 grams of salt (that is a toxic amount of salt). A serving of spinach will give you the 80 mg, as will almonds or half a serving of pumpkin seeds.O'Neill goes on to say that magnesium is a water-hungry molecule and is good for hydration. Magnesium is not useful for rehydration. In severely dehydrated children, we use a combination of water with sugar and a bit of sodium chloride, and not magnesium.Cold Plunges, MTHFR Mutations, and Gary BreckaThe last is a charismatic fellow named Gary Brecka, who is great at self-promotion. Selling people high-priced solutions to non-existent or rare problems. For legitimacy, Brecka calls himself a "human biologist." Brecka received a bachelor's degree from Frostburg State and another bachelor's degree from a chiropractic college. In summary, Brecka has no formal medical training.Often, Brecka starts his talks by making the claim he can tell a person when they will die to the month. Oddly, no one on planet Earth can tell when a person will die, let alone the month, year, day, or hour. Although there is an entire science, actuarial science, where they determine probabilities of surviving in any given year. However, Brecka claims he can tell based on labs or other issues. Yet this bold claim brought Brecka's most noted client, Dana White. Concluding that Dana White had ten years to live, White became an ardent disciple.Today, Brecka advocates hydrogen water, cold plunges, and selling overpriced genetic tests for the MTHFR mutation.Cold Plunges and The Polar Bear ClubI'm a member of the Polar Bear Club. I've swam from the waters coming from the Mendenhall glacier by Juneau, Alaska. When I did this, I had spent weeks preparing by swimming in other waters and acclimating my body to this. Growing up in Southeast Alaska, cold water swims were the only ones we had. In those days, I was young, athletic, and took many foolish chances. The last time I was in cold water was scuba diving in New Zealand at 60 degrees, and I had a 9 mm wetsuit on - even that was a bit cold for me.Acclimation occurs with athletes who competitively swim in cold water. First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.People who do cold water immersions claim this is good for their health and have a cult-like joy in this frigid experience. Such claims are as cold as the water they immerse themselves in.Cold Water Immersion Immediate EffectsIn all the advertisements I've seen on TikTok for cold water immersion tubs, I have never seen one of them warn people of the immediate consequences. Here is what we know based on laboratory studies:Increase heart rateIncreased blood pressureIncreased respiratory rateIncrease in troponin levels - indicating heart damageIncreased shiveringIncreased cardiac (heart) arrhythmiasVasoconstriction of skin vessels begins at temperatures of 37.1 (98.78 F) when immersed in cold water or 37.5 (99.5 F) post-exercise (ref). The body attempts to maintain its core temperature by shivering. However, when immersed in cold water, the body loses its ability to protect its core temperature after 36.2 C or 36.5 post-exercise. This is where the danger begins, as heat is lost. exponentially by convection from water more than a cold shower or air ( ref ).Because of the immediate effectsCold Water SwimmingAcclimation occurs with athletes who swim in cold water. First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.Sudden Disappearance SyndromePerhaps you've heard about people who have jumped in the water and never returned? This was called "sudden disappearance syndrome." Jumping into cold water will cause some people to have an involuntary gasp. The shock will cause their body to take a sudden large breath underwater, which fills their lungs, and they sink. It is a miserable death.Brown Fat and Fat Stripping Effect of the PlungeBrecka says, "Nothing strips fat off the body faster than a cold plunge." He is incorrect, as physical exercise is faster, more efficient, and safer. Shivering is faster at producing heat, but once you get below 36.2 degrees, you lose that regulation and are prone to hypothermia.What about brown fat, which generates heat from cold w…

Full show notes at the publisher

Canola Oil is Healthy and Inexpensive Dec 13, 2023

Show notes

Canola Oil is Healthy and Inexpensive

Did you ever notice there are those people who will tell you how everything is bad for you? Don't eat this and don't eat that?

They make grand assertions about the modern food system. Often claiming we should return to the age of the caveman. Assuming that health will return when we eat what our ancestors ate.

The Logical Fallacy of Ancestral Diets / and Humans

Proponents of ancestral diets are confused by the logical fallacy called a biotruth.

What is a biotruth? An argument based upon a misunderstanding of natural selection or the evolutionary process. Usually combined with the conclusion that if it was good enough for primitive man, it should be true for now. Ultimately, we forget that primitive man did not have an easy life.

Canola Oil Podcast Transcript

Canola oil is today's topic because not everyone wants to buy expensive olive oil. When I mention canola oil on TikTok, the comments go like this:

Canola oil was "meant" to be motor oil
It comes from the rapeseed plant
It is a GMO-crummy oil
Chemically extracted with hexane and it can turn rancid and create trans-fats

Are those claims valid? Should we avoid Canola oil? Must we avoid Canadians in general?

Today on Fork U

We will make sense of the madness that is Canola oil. Is it an evil plant that is only good to make oil for your car, truck, or tank? Or is it a reasonable oil for your body?

I'm Dr. Terry Simpson, and this is Fork U

Fork University

Where we make sense of the madness

Bust a few myths

And teach you a little bit about food as medicine.

What is Canola Oil?

Canola oil was invented in the 1970s in Canada and is an acronym that stands for Canadian oil's low acid.

Canola comes from the pressed seeds of rapeseed plants. Granted, that is an unfortunate name. However, not if you know its epistemology. Rapeseed comes from the Latin rapa, which translates to "turnip." Thus this flowering plant is a member of the turnip, cabbage, and mustard family.

Latin just isn't taught anymore. But if you think of Rome often, as we men do, Latin might be the new language for you.

Speaking of Mustard, did you ever wonder why we don't have mustard oil in the United States? Primarily Erucic acid.

Erucic Acid

Erucic acid is a monounsaturated fatty acid that is associated with heart disease. In some poorly done experiments in rats, they seemed to have higher levels of heart disease. Rats, not politicians. But the healthy kind of rats you find in sewers, not the vermin found in Washington, DC.

Erucic acid is why you don't find mustard seed oil in the United States. Those who travel to India will experience delicious foods cooked in mustard oil. But don't fear. It will be just fine (ref).

In fact, erucic acid decreases the rate of some progressive brain diseases and is being examined to treat cancer and other diseases.

Rapeseed Oil as a lubricant

Because of the high erucic acid content, rapeseed oil was originally used as an industrial lubricant. Some rapeseed was cold pressed, seeds gathered, pressed, and not heated, and the oil extracted. This has been used as a cooking oil for years, but there was concern regarding the erucic acid content.

Canadians Hybrids

Canadian scientists began to crossbreed the rapeseed with wild cabbage to lower erucic acid. The seeds of this new hybrid plant became the Canola oil. Later, this plant was genetically modified to withstand Round Up. Hence, it is a genetically modified plant (ref).

GMO Oh No

As someone who has published about genetic engineering, I find the fear of GMOs to be a fear of the unknown. Modifying genes is what humans have been doing for centuries. Hence, using laboratory techniques is simply faster than cross-breeding. Still, GMOs are a major cause of heartburn for the latte-sipping English major.

It is human studies that are the gold standard for how a food behaves. Not where it came from or what it has been used as.

Lyon The Gastronomic Capital of France

Let us begin in Lyon, France. The capital of fine dining in the world, home of restaurants with over twenty Michelin stars.

But Lyon? Home of butter? What happens when we take people with heart attacks from Lyon and ask them to change their diet?

There was a seventy-five percent lower incidence of cardiac deaths in patients with a first heart attack who modified their diet to a Mediterranean-style diet.

What was the main change? Well, they wanted the French to go from butter to olive oil, but alas, that was not popular. The French, other than those who reside in the Rivera, do not find olive oil attractive. But the French had no trouble adopting canola oil.

Canola oil was provided as both a cooking oil and a margarin to spread on their famous French bread.

Mediterranean Diet

Other changes they adopted included:

consume whole grains rather than refined grains,
to have fish more than beef,
and to never go a day without fruit.

In the first year, the canola group had 73% less risk of having a second heart attack or dying from heart disease. After several years, the final paper (referenced here) showed a similar risk reduction.

Implementing the Mediterranean Diet

One of the great conclusions of the Lyon heart study was that adopting the Mediterranean-style diet was not that difficult for these patients. While some doctors might give up, this one dietary change had as much influence as controlling blood pressure in patients with clinically active heart disease.

Other Human Studies?

Nine studies showed that patients consuming canola oil had lower LDL cholesterol. The higher the LDL, the more heart disease a person is likely to have, as well as strokes and peripheral vascular disease.

In spite of what the shirtless salesmen of supplements and scams want to tell you, the human trials show:

Canola oil is not toxic to humans
Canola oil improves biomarkers for the heart
Canola oil improves insulin levels.
Canola oil over butter and cream is one factor leading to less heart disease in patients with coronary artery disease.

Canola Oil is Not Toxic to Humans

Lab studies of people improve when consuming canola oil over saturated fat, butter, or beef tallow.
Insulin levels are decreased - which is good - with canola oil
And as in Lyon, while the butter is delicious, those who consume canola oil have fewer problems with their heart.

Implementing the Mediterranean Diet

If you want to implement the Mediterranean diet into your life, why not do what they did in Lyon?

If you cannot afford olive oil, use canola oil to cook with. It has fewer trans fats than tallow, lard, butter, or coconut oil and has a neutral flavor.

Make sure to have a fruit every day or two.

Use whole grains in your diet, be that for bread or just grains with your meals. Whole grains contain a lot of fiber.

New Course Coming

Thank you for listening to this edition of our series on how to adopt the Mediterranean Diet. We will have a course put together soon about adopting the Mediterranean diet, and you can find out when by listening to this podcast or signing up for my newsletter on terrysimpson.com. You can also follow me on TikTok, where I am @drterrysimpson.

Check out the blog associated with this - either yourdoctorsorders.com or forku.com.

This podcast was researched and written by me, Dr. Terry Simpson. While I am a real medical doctor, board-certified, I am not your doctor. Before making dietary changes, please check with a real, board-certified western-trained physician. Not an Eastern medicine doctor, not a witch doctor, not a chiropractor, not a naturopath.

Distribution and audio editing were done by my friends at Simpler Media - run by the pod god Evo Terra and his most able assistance. Thank you, Allie.

Hey Evo - in the interest of research, we need to go to the Mediterranean - by way of Lyon.

Nuts and Seeds, or Supplements Dec 06, 2023

Show notes

Nuts and Seeds, or Supplements

People who count calories notice nuts contain about 200 calories per ounce. Nuts are calorie-dense. However, nuts are also nutrient-dense. Moreover, nuts provide fiber, healthy oils, and essential minerals.

Nuts have been shown to decrease sudden cardiac death, decrease cholesterol, and provide satiety that helps people who wish to control their weight.

Two Brazil nuts contain enough magnesium to meet the adult daily requirement.

Food Works, Supplements May Not

The advantage of a healthy diet is that you do not need supplements in your diet. While Magnesium is an essential mineral needed in hundreds of reactions in your body, you can get all the magnesium you need by following a Mediterranean Diet.

Take Pumpkin Seeds - also known as Pepitas in the US. Kernels: 1 oz, 168 mg or pumpkin seeds in shell: 1 oz, 74 mg

Other Foods That Work:

Almonds, dry roasted: 1 oz, 80 mg

Spinach, boiled: ½ cup, 78 mg

Cashews, dry roasted: 1 oz, 74 mg

Peanuts, oil roasted: ¼ cup, 63 mg

Soymilk, plain or vanilla: 1 cup, 61 mg

Black beans, cooked: 1⁄2 cup, 60 mg

Peanut butter, smooth: 2 tablespoons, 49 mg

Bread, whole wheat: 2 slices, 46 mg

Avocado: 1 whole one is 44 mg

Potato, baked with skin: 3.5 oz, 43 mg

Rice, brown, cooked: 1⁄2 cup, 42 mg

Yogurt, plain, low fat: 8 oz, 42 mg

Oatmeal, instant: 1 packet, 36 mg

Banana: 1 medium, 32 mg

Salmon, Atlantic, farmed: 3 oz, 26 mg

Halibut, cooked: 3 oz, 24 mg

Raisins½ cup, 23 mg

Chicken breast, roasted: 3 oz, 22 mg

Beef, ground, 90% lean: 3 oz, 20 mg

Broccoli, chopped & cooked: ½ cup, 12 mg

Apple:1 medium, 9 mg

Carrot, raw: 1 medium, 7 mg

All of those are foods you get in your diet, and all of them are a part of a healthy Mediterranean Diet.

TEXT FROM PODCAST:

Which is better? Magnesium glycinate three eight citrate or oxide?

This is one of the most common questions I'm asked during my doc talk live sections on TikTok. Magnesium supplementation is a popular subject probably ever since the disgraced Naturopath published her book The Magnesium Miracle, claiming that magnesium could cure over 60 diseases. It was popular because so many people wanted one thing that they could grab hold of to explain all of their problems.

And because symptoms of magnesium deficiency are common, fatigue, weakness, insomnia, and heart palpitations, it became a natural reservoir for all of the nonsense that people want to present.

Barbara O'Neill, the naturopath banned from Australia for dangerous practices, frequently lectures that taking Celtic salt will cure hypertension, but it isn't Celtic sea salt you need.

If you need magnesium today, I will introduce you to Mediterranean magnesium. It will not only help regulate blood pressure but also improve your life and increase longevity.

Today on Fork U, we will make sense of the madness of magnesium, and we'll tell you which magnesium supplement you should buy and which you should avoid. And how to take the Mediterranean magnesium miracle and avoid the supplemental magnesium misery of Montezuma.

I'm Dr. Terry Simpson, and this is Fork Fork University.

where we make sense of the madness. Bust a few myths and teach you a little bit about food as medicine.

The Mediterranean magnesium miracle. Where do you get this? Well, first try nuts and seeds, which we include in the fruit section of the Mediterranean diet. Did you know that two Brazil nuts contain enough magnesium for a person for a day? An ounce of pumpkin seed contains about half of what you need. A banana is about 10%. Salmon about a fourth beef. Beef is about 10%. Now, I know the carnival crowd has a hard time accepting that beef, bison, or organ meat doesn't contain sufficient amounts of magnesium to meet minimum data requirements. But I digress. It's just so much fun to call them out about their quackery. No doubt, many of those proponents sell magnesium supplements on their websites. But did you know that a well-rounded diet like the Mediterranean diet, you will consume all of the magnesium you need?

And speaking of nuts, did you know that increasing walnut consumption has been shown to lead to a reduction in low-density lipoprotein cholesterol and decrease inflammatory and oxidant markers in individuals who are at high risk for coronary disease?

And do you know that other studies have shown that people who consume nuts and seeds have fewer heart attacks? For example, 40% decrease in heart disease among those people who consume four servings of nuts a week.

Let's go back to the supplementation stuff. The problem with supplementation is you're just replacing one factor when eating food provides not only that one factor but plenty of other things.

The second problem with magnesium supplementation is magnesium toxicity.

Now, oftentimes people may attribute the nausea, cramps, and diarrhea to food poisoning when actually they're getting overdosed on magnesium supplementation. They probably don't know that taking those magnesium supplements could interfere with their medicines, like their diuretics, their heart medicine, or their antibiotics. Magnesium can cause more muscle aches and sleeplessness, and extra magnesium can even stop the heart. They probably don't tell you on those magnesium bottles that it's going to compete with calcium for absorption. So taking excess magnesium will not only overdose you but also decrease calcium absorption.

Wow, it's hard to believe they actually sell that stuff when you can just take a Mediterranean diet full of nuts and seeds at one portion of it and get plenty of it in your diet. While magnesium is essential, it is far from rare in plants, nuts, and seeds in spite of supplement makers consistently making claims that our food has less magnesium because we're depleting our soil. Did you know that magnesium is the third most common element on the crust of the earth?

Because of that, one of my favorite mineral waters has 45 mg of magnesium per glass. It is called Socasani, I don't know if you can find it anywhere else, but I get it at Costco here in the Los Angeles area. This is mineral water that bubbles up from springs in the Andes. It is high in magnesium. I like it because they won some water awards and that is how I found it. But a cup of that water is about a quarter of the amount of magnesium because magnesium is the third most common element on the crust of the earth.

So when I refer to Mediterranean magnesium, it's not a supplement you're going to buy, although I'm sure someone will probably sell it now. But it does come from nuts, seeds, fruits, and vegetables.

Now let's go back to Celtic Salt. I hear people selling Celtic salt all the time, be that Barbara O'Neill, Santa Cruz Medicininals, or Gary Brecka.

But Celtic Salt has 34,000 mg of sodium to 200 mg of magnesium in three and a half ounces (100 grams). That is a tone of salt.

Now contrast Celtic Salt with one ounce of pumpkin seeds, which has 170 mg of magnesium and two milligrams of sodium. Celtic salt is just overpriced salt. It is not a source of magnesium.

And certainly, if you're going to take three and a half ounces of salt, which contains 34,000 milligrams of sodium, to get 200 milligrams of magnesium, whatever good the magnesium will do to your blood vessels will be more than outdone by the overdose of sodium you're giving to your body.

The problem with supplement makers and sellers everywhere is that they are constantly trying to sell you something that you can get in a healthy diet, like the Mediterranean diet, and in this case, from nuts and seeds. They are easy to add to a salad from nuts, which makes an incredible snack that you can carry portable with you almost anywhere, containing fiber and protein, along with magnesium, selenium, potassium, and all those things that you need.

You don't need to spend more money on magnesium supplements, what you really need is to spend more money eating a better diet. Or like I tell people when they tell me, well, I just don't like fruits and vegetables and nuts and seeds. It's time to grow up because there is more in your diet than just magnesium. There are plenty of other things that you need that you can get from a diet that you will never get from a pill.

Now to be clear, there are those people who need magnesium supplementation if required by a board-certified physician. There are people with certain conditions, kidney disease, and people who have taken certain pills that will deplete magnesium and need it.

How do you test for magnesium deficiency? Not just a blood test. Blood only contains a few percentages of the magnesium in your body. There are several other tests. One of the gold standards is that we give you a bunch of magnesium, check your urine, and see if it all came out. Another one is the red blood cell test for magnesium. There are some good magnesium tests out there, typically not available from your average chiropractic lab, which oversells you on tons of tests.

So if you overdose on magnesium, like my aunt did when she brought me the book, The Magnesium Miracle. She said, "I think this is what was giving me diarrhea." I said, absolutely. It was also one of the reasons that her anti-hypertensive wasn't working. She was getting too much hypertension. She stopped her magnesium supplement. Her bowels cleared up, and her hypertension got better. She was taking her anti-hypertensive, and it wasn't being interfered with magnesium. And she loves fruits, seeds, and nuts. I mean, she has to love nuts. I'm her nephew.

Please listen to the blog or see the blog associated with this called Your doctor's orders.com or for you.com. This was researched by me, Dr. Terry Simpson. And while I am a physician, I am not your physician. If you need a physician's help, please see a board-certified Western-trained physician, not a naturopath, not an Eastern medicine man, not a chiropractor, not a witch doctor. Our friends carried out distribution at Simpler Media, and the pod god, my good friend Evo Terra.

The Beautiful Bean Nov 29, 2023

Show notes

We Love Legumes

The legume is a powerhouse plant protein. The beautiful bean. Often the source of protein for vegetarians and vegans, and forgotten about in most modern diets today. Thus, we will campaign to bring back the legume.

In today's gym, you will find people selling protein powders, advocating all meat diets, and flexing their muscles. But in ancient times, the original Greek Gymnasiums, the source of protein for these fellows, were legumes. Their diet was cereals from whole grains, fruits, legumes, vegetables, and occasionally fish. No meat, no protein powder, no pre-workout.

What is a Legume or Pulse?

When most think about legumes, they think about the common green bean (Phaseolus vulgaris). Yet there is an entire family of Leguminosae.

The precise definition of a legume is any plant from the Fabaceae family that would include its leaves, stems, and pods. A pulse is an edible seed from a legume plant. Pulses include beans, lentils, and peas. For example, a pea pod is a legume, but the pea inside the pod is the pulse.

Rediscovering the Bean

When Ancel Keys was told there were few cardiac events in Southern Italy, he went to investigate. Legumes have less fat, and thus, a diet rich in legumes should have less fat and, thus, less heart disease.

In Naples, only 20-25 percent of the calories were from fat. In contrast, Keys noted in England that 35% of the calories were from fat, while in Minnesota, 40 percent of the calories were from fat. Legumes meant plenty of protein, less fat.

The blood cholesterol reflected some of this. Naples had cholesterol values of 165 milligrams per 100 milliliters of blood, while England had over 200 and Minnesota had over 230. Total blood cholesterol was the only measurement at the time.

What Keys also showed was the wealthy Neapolitans ate a richer diet:

"Still, a small sample of bankers and professional men in Naples, who lived on a much richer diet than the working class, had cholesterol values of about 200 in their blood serum, and some of them had coronary heart disease." (reference 1)

Beans and Lower Cholesterol

Keys then took 24 healthy men and controlled their diet for fat and protein. Keeping calories constant with equal amounts of protein but changing the fat, the cholesterol fell from 225 to 195 on the lower-fat diet. But the Neapolitan diet was not what he followed. The fat in Naples was mainly olive oil, and the fat in the low-fat metabolic ward was from fat in meat and milk.

At the time, Keys concluded it would be difficult to convince people to eat a diet rich in legumes. Americans love their meat. Today, we have better methods to decrease heart disease risk by using statins often with other drugs. While a diet of legumes replacing meat might reduce blood cholesterol by 10-20%, that is often not enough to decrease the risk of heart disease.

A combination of modern medications (such as Crestor, Zetia, Repatha) can lower LDL (apo-B levels) to where heart disease can become an "orphan" disease. You can have your steak and eat it too!

Legumes and the Mediterranean Diet

Legumes are part of the Mediterranean Diet (ref). The recommended amount includes 3-4 ounces of legumes per day. Or using legumes as a major source of protein for a meal several times a week.

Legumes: lentils, beans, peas, and peanuts. The more common ones that humans consume.

Ancient Peoples and Legumes

Until about 12,000 years ago, homo sapiens were hunter-gatherers. For almost two million years before that, our evolutionary ancestors subsisted on hunting and gathering. What was the most common protein source? Legumes. Not meat, as much as your carnivore-crazy friends would have you believe.

Remains of lentils, the tombs of the Twelfth Dynasty (2400-2200 BC). Archeologists have found peans and lentils from remains in Turkey dating to 5500 BC.

Even North America has legumes. America is best known for both the kidney bean and the haricot (and you thought it was French). Those were cultivated throughout North, Central, and South America. Dried kidney beans have been found in pre-Inca tombs.

Want Some Data?

People who ate legumes four times a week had a 22% reduction in heart disease compared to those who consumed legumes once a week or less. The U.S. Dietary Guidelines emphasize legumes (about 3 cups a week) and the DASH Eating Plan of the National Heart, Lung, and Blood Institute (4-5 half-cup servings a week). The Food and Agriculture Organization (FAO) of the United Nations declared the International Year of Pulses in 2016, focusing on the contribution of pulses to food production and nutritional diversity to help eradicate hunger and malnutrition.

Nutritional Value

Legumes are a significant source of protein, dietary fiber, carbohydrates, and dietary minerals; for example, a half cup of cooked chickpeas contains 18% of the Daily Value (DV) for protein, 30% DV for dietary fiber, 43% DV for folate and 52% DV for manganese. Not much fat and not much sodium in these.

Legumes are also an excellent source of resistant starch, one of my favorite starches. Your gut doesn't break down resistant starch but is broken down by bacteria in the large intestine to produce short-chain fatty acids used by intestinal cells for food energy. Those byproducts reduce the risk of colon and rectal cancer.

Favorite Recipes:

One of my favorite recipes is life-saving Dahl by Simon Majumdar - my co-host of FORK U. His recipe is here.

REFERENCES:

(1) Keys, Margaret.Keys, Ancel. The Benevolent Bean. United States: Farrar, Straus and Giroux, 1972.

Gofman JW, Delalla O, Glazier F, Freeman NK, Lindgren FT, Nichols AV, Strisower B, Tamplin AR. The serum lipoprotein transport system in health, metabolic disorders, atherosclerosis and coronary heart disease. J Clin Lipidol. 2007 May;1(2):104-41. doi: 10.1016/j.jacl.2007.03.001. PMID: 21291675.

LA, He J, Ogden LG, et al. Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study. Arch Intern Med 2001 Nov 26;161 (21):2573-8.

"Nutrition facts for Chickpeas (garbanzo beans, bengal gram), mature seeds, cooked, boiled, without salt, 100 g, USDA Nutrient Database, version SR-21". Conde Nast. 2014. Retrieved 15 January 2015.

Birt DF, Boylston T, Hendrich S, et al. Resistant Starch: Promise for Improving Human Health. Advances in Nutrition. 2013;4(6):587-601. doi:10.3945/an.113.004325.

Am J Hypertens. 2014 Jan;27(1):56-64. doi: 10.1093/ajh/hpt155. Epub 2013 Sep 7.

Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials.

Jayalath VH1, de Souza RJ, Sievenpiper JL, Ha V, Chiavaroli L, Mirrahimi A, Di Buono M, Bernstein AM, Leiter LA, Kris-Etherton PM, Vuksan V, Beyene J, Kendall CW, Jenkins DJ.

Naureen Z, Bonetti G, Medori MC, Aquilanti B, Velluti V, Matera G, Iaconelli A, Bertelli M. Foods of the Mediterranean diet: garlic and Mediterranean legumes. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E12-E20. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2741. PMID: 36479501; PMCID: PMC9710409.

Turmeric: It Can Kill You Nov 22, 2023

Show notes

Turmeric: It can kill you

Turmeric is from the root of a flowering plant (Curcuma longa of the ginger family Zingiberaceae), known for being anti-inflammatory. Because of its anti-inflammatory nature, turmeric is one of the most common supplements I am asked about during my TikTok live sessions. This is because people like a "natural" anti-inflammatory supplement rather than over-the-counter medications.

Supplements

Supplements are excluded from "black box warnings." Those warnings you see in the package inserts in pharmaceuticals. This article is meant to provide references for those interested in doing more research about Tumeric to realize it is not benign.

Turmeric has many potential applications for cancer, brain injury, and many other diseases. The key is knowing what dose of turmeric is toxic, what dose is effective, and what dose is ineffective. We also need to know how to mitigate potential dangers.

Contrast with Aspirin

Aspirin is a known anti-inflammatory agent with many uses. Since aspirin is regulated, we know the dose effect of aspirin. If you have a headache, the 81 mg dose of aspirin will not relieve your headache. But the 325 mg dose will decrease headache. And you know that taking two hundred tablets of aspirin is a toxic dose.

A single aspirin can cause a bleeding ulcer, which may lead to death. Some people are allergic to aspirin, and an allergic reaction can lead to death.

What we don't know is the effective dose of Turmeric or the lethal dose of it in that supplement bottle. But we know that turmeric, curcumin can lead to liver injury and death.

Turmeric and Liver Injury

Toxicity is always in the dose. High curcumin levels, the active ingredient in turmeric, have caused liver damage (Ref 1-13). To quote from one of the references:

Liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. (2)

Turmeric and Cooking

There is no danger in using turmeric as a spice in cooking. First, because your intestines do not absorb turmeric well. Unlike a supplement, which has high doses of curcumin. In addition, supplements also have black pepper, which increases absorption. Since turmeric has a mild anti-inflammatory component, this might have limited benefits as part of a healthy diet.

Tumeric belongs in the cabinet, not in a capsule.

TEXT FROM THE PODCAST

You probably have some turmeric in your herb and spice drawer.

You’ve probably heard that Turmeric’s active ingredient Curcumin has anti-inflammatory properties and has been used for centuries as an “ancient” medicine.

That yellow powder comes from the root of the Curcuma longa plant, a member of the ginger family.

Turmeric has a warm, bitter taste, and I use it in Paella, curry, and add it to salads, rice, or other starches like pearl barley.

But what you haven’t heard is that too much Turmeric can kill you.

Today we will make sense of the madness surrounding Turmeric. From its promise as an anti-cancer agent to its toxicity, and who should avoid it for daily use.

FORK U

I’m Dr. Terry Simpson, and THIS is FORK U

Fork University

Where we make sense of the madness

Bust a few myths!

And teach you a little bit about food as medicine.

Inflammation

Inflammation is a complex biochemical, physiological, and even pathological process. Inflammation is the basis of our immune system, and acute inflammation allows us to rid our bodies of cancer, viruses, bacteria, yeasts, mold, and parasites. Without the inflammatory process, we would end up being a pile of goo in twenty-four hours – dead as dead can be. Inflammation allows us to repair our body from injury, anything from burning our hand by spilling coffee to major trauma from an automobile accident.

Chronic Inflammation

Chronic inflammation can make certain illnesses much worse - from arthritis, heart disease, inflammatory bowel disease, psoriasis, and may even play a part in premature aging.

So we want some inflammation, but not too much.

You've Had Inflammation

Did you ever have the flu and have muscle aches and a fever, only to take an aspirin and feel better in 24 hours? Those muscle aches and fevers were not the result of the virus but of your body fighting it – and fighting it to where you felt poorly. So you added a bit of anti-inflammatory agent – aspirin – and felt better.

Science and Inflammation

Science is always looking for anti-inflammatory agents, and curcumin has attracted a lot of interest among legitimate scientists.

Curcumin has been examined for a potential role in cancer treatments or with inflammatory bowel disease.

Because inflammation is complex – here is an example about curcumin: “It binds to the toll-like receptors and regulates downstream nuclear factor kappa B, mitogen activate protein kinases, activator protein one and other signaling pathways.”

Hucksters, Curcumin, and Inflammation

Curcumin has also attracted the attention of the non-regulated supplement industry. Where they can bottle it up and tell you it “supports heart health, or gut health, or immune function.” All those statements are meaningless – designed to fool someone to buy something with a label of “natural” to believe it might be better than some “drug.”

Because it is complex, you can have hucksters use the word “inflammation” and sell you a product, an idea, or a supplement for hundreds of dollars. Their science is marketing, and in this case, marketing to you a product with words and extracting dollars from your wallet.

Do we even have wallets anymore?

The Most Anti-Inflammatory Diet

Do you know what the most anti-inflammatory diet is? The Mediterranean diet – the one tested to work well for people with overactive inflammatory diseases – like arthritis, Crohn’s disease, multiple sclerosis, diabetes, obesity, or heart disease.

Let's take curcumin and turmeric back to the kitchen.

A part of the Mediterranean diet is cooking with herbs and spices.

And even if you can’t cook, you can spice things up a bit.

Turmeric seems to be a worthy candidate.

Fresh Turmeric or Powder?

If you buy fresh turmeric from the store, it will look like a root. It is brown on the outside with a deep yellow inside. This turmeric is also great for cooking. But be warned, it will stain your hands a nice yellow color - not permanently. Use a micro plane to shave the root onto your dishes into your dishes. If you follow a recipe, you can substitute fresh turmeric in the ratio of 1 tablespoon fresh is equal to a teaspoon of the dried yellow in any recipe.

Start with Breakfast!

If you’ve been to coffee shops lately, you may notice they have started adding turmeric to some drinks, like a turmeric-laced latte. Which has about a quarter to half teaspoon of the powder in the drink. Turmeric will add a deeper flavor to your latte, and some liken it to other spiced drinks – such as the famous pumpkin.

Turmeric is a great addition to scrambled eggs or a tofu scramble. It provides a color and depth of flavor.

A quarter teaspoon of the spice is all you need. You can also use it with paprika on top of deviled eggs.

Moving on from Breakfast

Adding a teaspoon to your rice will give it a deep yellow color that makes the rice more visually appealing.

A teaspoon also works well with your bean dishes. That famous cowboy caviar – adding turmeric to it – makes it a bit more earthy.

Some of you have asked me about Ginger/Turmeric /honey teas or “shots” to decrease inflammation.

But if you consider other anti-inflammatory drugs, like aspirin, and ibuprofen, you know they have side effects.

So does curcumin.

In the blog, I have half a dozen references to the deaths of people with liver failure who had high doses of curcumin, some prescribed by Ayurvedic practitioners. Many of these patients died; some were saved when they went to conventional hospitals where they needed liver transplants.

The Dose is Always in the Poison.

Be warned about the supplements of curcumin, especially when it has been combined with piperine (pepper) to increase its uptake in the gut.

Curcumin should not be used if you are pregnant or going to become pregnant. This can cause a loss of pregnancy.

Nor should curcumin be used if you are breastfeeding.

Do not take curcumin if you are taking any blood thinners, like warfarin, Plavix, or Eliquis.

If you tend to bleed more or bruise easily, you should not take this supplement.

The supplement should not be taken daily if you are over 60 years old, as it can cause bleeding in the brain.

Do you have some issues with your gallbladder? Curcumin causes inflammation of your gallbladder, which requires urgent surgery.

Curcumin should not be taken if you have stomach issues – it can cause ulcers in your stomach and make any ulcer you have to bleed more.

It should not be taken if you are taking aspirin, Motrin, or any anti-inflammatory drug.

It should not be taken if you are going to undergo surgery – it should be stopped two weeks ahead of time.

The Non-Regulated Supplement Industry

The supplement industry is not regulated. Besides people getting too much and causing bleeding issues and death, there have been supplements colored with heavy metals, causing heavy metal accumulation in people who use these supplements.

If you have a headache or joint ache, we know the dose of aspirin, Naprosyn, or Motrin that is effective, the dose that won’t do anything, and the dose that is toxic. We don’t know that with turmeric or curcumin.

I love cooking with the herb turmeric. It adds a depth of flavor to almost any meal. As with all good food, it has properties that can add to the properties of other whole foods and spices.

Turmeric belongs in the kitchen, not in the capsule.

Please see the blog associated with this podcast on yourdoctorsorders dot come.

This podcast was researched and written by me, Dr Terry Simpson. And while I am a board-certified physician, I am not your physician.

If you need advice, please seek a board-certified western-trained physician n- not an Ayvurdic healer, not an Eastern medicine man, not a naturopath or chiropractor – but someone who can help you with real conditions.

Simpler Media distributes the podcast, and the transcript can be found on FORK U. Audio editing and music were inserted by my good friend and pod god – Evo Terra.

Hey Evo – I wonder if you’ve ever tried turmeric in beer?

REFERENCES:

Drug-Induced Liver Injury Secondary to Turmeric Use https://pubmed.ncbi.nlm.nih.gov/37205206/
Liver Injury Associated with Turmeric-A Growing Problem: Ten Cases from the Drug-Induced Liver Injury Network [DILIN] https://pubmed.ncbi.nlm.nih.gov/36252717/
Acute liver injury following turmeric use in Tuscany: An analysis of the Italian Phytovigilance database and systematic review of case reports https://pubmed.ncbi.nlm.nih.gov/32656820/
Turmeric-Associated Drug-Induced Liver Injury https://pubmed.ncbi.nlm.nih.gov/36600786/
Turmeric Induced Liver Injury: A Report of Two Cases
https://pubmed.ncbi.nlm.nih.gov/31214366/
Turmeric-Associated Liver Injury: A Rare Case of Drug-Induced Liver Injury
https://ncbi.nlm.nih.gov/pmc/articles/PMC10149439/
Turmeric-Induced Hepatotoxicity: Report of 2 Cases
https://ncbi.nlm.nih.gov/pmc/articles/PMC8711139/
Turmeric Induced Liver Injury: A Report of Two Cases
https://ncbi.nlm.nih.gov/pmc/articles/PMC6535872/
Turmeric-Associated Liver Injury
https://pubmed.ncbi.nlm.nih.gov/31283536/
Autoimmune Hepatitis Associated With Turmeric Consumption
https://pubmed.ncbi.nlm.nih.gov/32337301/
A rare case of turmeric-induced hepatotoxicity
https://pubmed.ncbi.nlm.nih.gov/32037709/
Turmeric supplement induced hepatotoxicity: a rare complication of a poorly regulated substance
https://pubmed.ncbi.nlm.nih.gov/31271321/
Drug Induced Liver Injury Attributed to a Curcumin Supplement https://pubmed.ncbi.nlm.nih.gov/31781418/
Peng Y, Ao M, Dong B, Jiang Y, Yu L, Chen Z, Hu C, Xu R. Anti-Inflammatory Effects of Curcumin in the Inflammatory Diseases: Status, Limitations and Countermeasures. Drug Des Devel Ther. 2021 Nov 2;15:4503-4525. doi: 10.2147/DDDT.S327378. PMID: 34754179; PMCID: PMC8572027.

Weight Loss Meds: Making Sense of Madness Jul 12, 2023

Show notes

Ozempic, Wegovy, Monjaro, and a host of other drugs – the GLP-1 agonists and near miracles weight loss drugs, and soon a more potent pill form coming.

These drugs have known side effects, and there have been increased visits to the emergency rooms. Often because people were not told foods to avoid.

As with any new drug, there are the grifters. After all, since it is a prescription, you will have supplement salesmen that promise a natural solution. What about those who claim they can "compound" the drug for you in their compound pharmacy?

Weight Watchers and Sequence

Was it a coincidence that Weight Watchers (WW) bought Sequence? Sequence is a company that prescribes these drugs through a network of physicians that you contact via telemedicine. Sequence, as it turns out, is one of the more legitimate telemedicine companies, not only trying to get you a prescription but providing a diet plan with it.

Weight Watchers purchased Sequence for over 100 million dollars. One thing missing from the frequent prescription of the new drugs is a diet plan. Weight Watchers does this.

And Weight Watchers is partially owned by Oprah Winfrey, who has been open about her weight loss struggles. Now, Oprah reports she has been on semaglutide and lost over 45 pounds.

Thus Oprah proved that the drugs, with a good diet, are a powerful tool against obesity.

It is More Than Willpower - Ask Oprah

As a weight loss surgeon, I am constantly asked about willpower and obesity. For example, Oprah Winfrey a person with more willpower than probably anyone you know. Given her resources to have people cook for her, provide her with a workout plan, and any assistance. She even bought a major portion of Weight Watchers. What made the difference? The injectable drug, semaglutide (Wegovy).

Obesity Management is more than a diet - ask Weight Watchers

The Weight Watchers diet plan has evolved over the years. Even with the Weight Watchers diet plan ranking among the best diets in the world, they purchased Sequence. Thus repositioning themselves to use their diet with the drugs to provide optimal health.

Keeping you out of the Emergency Room - Side Effects of the New Drugs

Emergency room physicians have noted an increase in patients coming to the ER after using these drugs. I was recently interviewed about this, and you can find it here.

Common side effects include nausea, vomiting, bloating, constipation, and diarrhea. Up to eighty percent of people who take these drugs have symptoms. Many of those problems can be avoided by following a few simple rules:

Avoid fatty foods. Fatty foods increase bloating and discomfort with these drugs. Fried chicken has sent many to the emergency room
Alcohol should be limited to one drink per day. Although best to avoid alcohol altogether with these medications.
Junk food with lots of sugar, like candy, cookies, and donuts, should be avoided while on these drugs.
Foods to concentrate on are fruits, vegetables, whole grains, and brothy soups like Minestrone or Dahl.

Compound Pharmacies and "generic Ozempic"

Many compound pharmacies have offered these drugs for sale. They are often at a greatly reduced price. But they are not the same drugs approved and tested by the FDA.

There is no "generic" form of Ozempic, Wegovy, or Mounjaro.

Compound pharmacies are telling their customers that, since there is a shortage of these drugs, they can compound the drug and sell it to the public.

Many of these compound pharmacies import semaglutide from overseas. It is illegal to import a drug from overseas without FDA approval. Furthermore, the drugs they import are not the same formula tested by the FDA. It is often sodium semaglutide and the FDA has warned against the use of this drug on its website (here).

In our podcast, we talk with a compound pharmacist who warns about these drugs.

In fact, the FDA has a warning for doctors:

"Healthcare professionals who are considering working with compounders to obtain semaglutide products should be aware that compounders may be using salt forms of semaglutide. FDA is not aware of any basis for compounding a drug using semaglutide salts that would meet federal requirements."

Natural Ozempic

Supplement makers are left out because now we have a drug that can treat obesity almost as well as weight loss surgery. Some claim Berberine is a "natural Ozempic." Berberine is not. Berberine is not a GLP-1 agonist; it has mild weight loss benefits. In one recent study (cited here) people lost about 4 pounds over half a year of taking it. That is nothing compared to any of the GLP-1 agonists.

But there is a natural GLP-1, and you can find it in the Gila monster.

From the saliva of the Gila Monster came the drug, Exenatide, which is a GLP-1 agonist. It was the first approved for diabetic use and was noted to have a decrease in weight. The drug is not as effective for weight loss as Ozempic.

The new weight loss medications are one step to conquer obesity. Obesity is a chronic disease. It's not about losing ten pounds. While the stars on the runway want to use it for short-term use, that is a fad.

This year, sales of Ozempic are expected to hit 17 billion dollars (ref). All of this from a drug originally developed as a medication for type 2 diabetes.

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Fork U with Dr. Terry Simpson

Three Great Diets

Mediterranean Diet

DASH Diet

MIND Diet

Three Diets are Branches of the Same Tree

1. Rush Memory and Aging Project:

2. Columbia University Medical Center Study:

3. Alzheimer's Disease Neuroimaging Initiative (ADNI):

4. Systematic Reviews and Meta-Analyses:

5. Mechanisms of Action:

Diagnosis of Alzheimer's Disease.

Genetics of Dementia

1. APOE ε4 Allele

2. Presenilin Genes (PSEN1 and PSEN2)

3. Amyloid Precursor Protein (APP) Gene

4. TREM2 Gene

5. Other Genes

Abstract:

1. Introduction

2. Origins and Development

3. Key Principles of the DASH Diet

4. Health Benefits of the DASH Diet

5. Scientific Evidence

6. Applicability and Limitations

7. Practical Considerations

8. Future Developments

It is America's Mediterranean Diet

9. Conclusion

Sorry It Didn't Work

Diet Disappointment

Low Carb Disappointment

Coffee and Diets

Now What?

My Journey to Culinary Medicine

The Mediterranean Diet

More To Come

Canola Oil is Healthy and Inexpensive

The Logical Fallacy of Ancestral Diets / and Humans

Canola Oil Podcast Transcript

Today on Fork U

What is Canola Oil?

Erucic Acid

Rapeseed Oil as a lubricant

Canadians Hybrids

GMO Oh No

Lyon The Gastronomic Capital of France

Mediterranean Diet

Implementing the Mediterranean Diet

Canola Oil is Not Toxic to Humans

Implementing the Mediterranean Diet

Nuts and Seeds, or Supplements

Food Works, Supplements May Not

Other Foods That Work:

TEXT FROM PODCAST:

We Love Legumes

What is a Legume or Pulse?

Rediscovering the Bean

Beans and Lower Cholesterol

Legumes and the Mediterranean Diet

Ancient Peoples and Legumes

Turmeric: It can kill you

Supplements

Contrast with Aspirin

Turmeric and Liver Injury

Liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. (2)

Turmeric and Cooking

TEXT FROM THE PODCAST

FORK U

Inflammation

Chronic Inflammation

You've Had Inflammation

Science and Inflammation

Hucksters, Curcumin, and Inflammation

The Most Anti-Inflammatory Diet

Fresh Turmeric or Powder?

Start with Breakfast!