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    Health & Fitness

    Fork U with Dr. Terry Simpson

    Fork U(niversity)
    Not everything you put in your mouth is good for you.

    There’s a lot of medical information thrown around out there. How are you to know what information you can trust, and what’s just plain old quackery? You can’t rely on your own “google fu”. You can’t count on quality medical advice from Facebook. You need a doctor in your corner.

    On each episode of Your Doctor’s Orders, Dr. Terry Simpson will cut through the clutter and noise that always seems to follow the latest medical news. He has the unique perspective of a surgeon who has spent years doing molecular virology research and as a skeptic with academic credentials. He’ll help you develop the critical thinking skills so you can recognize evidence-based medicine, busting myths along the way.

    The most common medical myths are often disguised as seemingly harmless “food as medicine”. By offering their own brand of medicine via foods, These hucksters are trying to practice medicine without a license. And though they’ll claim “nutrition is not taught in medical schools”, it turns out that’s a myth too. In fact, there’s an entire medical subspecialty called Culinary Medicine, and Dr. Simpson is certified as a Culinary Medicine Specialist.

    Where today’s nutritional advice is the realm of hucksters, Dr. Simpson is taking it back to the realm of science.

    Advertise

    Copyright: © Copyright 2023 Terry Simpson

    • Apple Podcasts
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    Latest Episodes:
    Fruit Fearmongering: Is Fruit Bad For You? May 14, 2025
    Show notes

    Is Fruit Bad For You?

    Have you heard the latest nonsense from the diet grift industrial complex?

    Apparently, fruit is now dangerous. Yes—fruit. The stuff that grows on trees and ends up in your kid’s lunchbox is being blamed for everything from diabetes to “metabolic collapse.”

    The same influencers who once screamed about seed oils are now coming for your bananas, blueberries, and yes, even your smoothies.

    It would be laughable if it weren’t so successful.

    I’ve Seen Real Diets That Work—They Include Fruit

    My father had a massive heart attack at 55. The kind that forces lifestyle change.

    But here’s the thing—he lived. He didn’t just live; he thrived.

    He made it to 98, living independently until the very end.

    And every single morning, he started his day with fruit: grapefruit, berries, and cantaloupe. He didn’t fear fructose. He just ate a balanced diet, and it worked.


    The Anti-Fruit Grift: A Modern Wellness Scam

    On social media, fruit is now the villain of the week. According to the keto-carnivore crowd, fruit will spike your insulin, make you fat, and destroy your health.

    But right after shaming your banana, they usually offer a discount code for their liver pills or collagen powder.

    Even Paul Saladino—the original shirtless prophet of beef liver supplements—is eating fruit now. Apparently, scurvy isn’t a great look.


    Here’s the Truth: Fruit Is One of the Healthiest Things You Can Eat

    Let’s stick to actual science. Fruit is one of the nine essential components of the Mediterranean Diet—a dietary pattern backed by decades of research, including landmark studies like PREDIMED and EPIC.

    The Mediterranean Diet recommends 250 grams of fruit per day. People who follow it experience lower rates of:

    • Cardiovascular disease
    • Type 2 diabetes
    • Cognitive decline

    And guess what? Even people with diabetes do well when they eat whole fruit.

    According to large observational studies, such as the BMJ study by Muraki et al. (2013) and Li et al. (2016) in The Journal of Nutrition, higher intake of whole fruits—especially berries, apples, and citrus—is associated with a reduced risk of type 2 diabetes, not an increased one.


    Smoothies: Not Soda. Let’s Stop the Nonsense.

    Yes, when you blend fruit, it digests faster. That’s true. But a smoothie made from whole fruit, with the fiber intact, is nothing like drinking a sugary soda.

    Want to improve it even more? Add protein, oats, chia, or yogurt. You’ve got a perfectly fine breakfast that’s far better than most boxed cereals.

    So drink your smoothie. Enjoy it. You’re not ruining your health. You’re nourishing your body.


    Cultures That Live Long... Eat Fruit

    All the world’s longest-lived populations eat fruit—daily.

    • Okinawans enjoy papaya, guava, and sweet potatoes.
    • Sardinians love figs, grapes, and citrus.
    • Loma Linda Adventists consume berries and stone fruits, and live some of the longest lives in America.

    None of these groups fear fruit. And spoiler alert: none of them are blending bacon into their coffee.


    Beware of Magical Thinking (and Tallow)

    The real problem isn’t fruit—it’s the carnival of carnivore influencers selling meat-based miracles. These aren’t scientists. They’re entertainers with no credentials who demonize fruit while pushing “ancestral eating” and supplements derived from animals that... ate fruit.

    If your diet says yes to beef tallow but no to blueberries, it’s time to reevaluate who you’re listening to.


    Final Thoughts: Let’s Use Our Brains (and Eat the Peach)

    Fruit isn’t the enemy. It’s not a metabolic poison. It’s one of the most nutrient-rich foods you can eat—and it's associated with better health outcomes across every major population study.

    So next time someone tells you to skip the apple, ask them to show you a peer-reviewed study—not a coupon code.


    References:

    1. Guan J, Liu T, Yang K, Chen H. Dried fruit intake and lower risk of type 2 diabetes: a two-sample mendelian randomization study. Nutr Metab (Lond). 2024 Jul 10;21(1):46. doi: 10.1186/s12986-024-00813-z. PMID: 38987806; PMCID: PMC11234600.
    2. Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. Rev Esp Cardiol (Engl Ed). 2024 Jul;77(7):574-582. English, Spanish. doi: 10.1016/j.rec.2024.01.006. Epub 2024 Feb 7. PMID: 38336153. - (click for reference)


    On a GLP-1 - You Should be on the Mediterranean Diet Also May 07, 2025
    Show notes

    Weight Loss Surgery and Mediterranean Diet to GLP-1 and the Mediterranean Diet

    For years, I have guided my weight loss surgery patients toward the Mediterranean diet. Why? Because it’s not only delicious and sustainable, but it’s also backed by decades of science. Now, as GLP-1 medications like Ozempic and Zepbound transform how we approach obesity, the question arises again: what should people eat while on these powerful drugs? The answer, as it turns out, remains the same.

    GLP-1 medications have undeniably revolutionized weight loss. These drugs, originally developed for diabetes, have rapidly gained fame for helping individuals shed significant amounts of weight. They work by reducing appetite, slowing stomach emptying, and altering hunger signals in the brain. Many patients simply cannot achieve sustained weight loss with diet alone, and for them, GLP-1 drugs are life-changing.

    However, while these medications help people lose weight, they do not address everything. Weight loss is only part of the equation. Nutrition still matters deeply. Without nourishing your body properly, you risk missing out on crucial benefits such as inflammation reduction, cardiovascular protection, and cognitive preservation.

    The Mediterranean Diet

    This is exactly where the Mediterranean diet shines. For decades, in fact, over 70 years, researchers have studied this dietary pattern. More than 13,000 scientific publications support its benefits. It’s not just about eating "like people in the Mediterranean." Rather, it’s about embracing a carefully studied set of foods, in specific amounts, shown to optimize health outcomes.

    For example, the diet emphasizes:

    • Around 9 ounces (250 grams) of fruits daily.
    • Plenty of vegetables and whole grains.
    • Healthy fats, especially from olive oil.
    • Lean proteins, particularly fish and legumes.
    • Limited red meat and alcohol.

    Studies Showing the Diet Works For Health

    The science is clear. The PREDIMED study demonstrated significant reductions in cardiovascular events among followers of this diet. The EPIC studies have shown lower overall mortality, reduced cancer risk, and enhanced longevity. Furthermore, other research consistently links the Mediterranean diet to better insulin sensitivity, lower diabetes incidence, and reduced Alzheimer’s risk.

    So, how does this all connect to GLP-1 medications? Simple. If you are using GLP-1 drugs, you are already taking control of your weight. Why stop there? Combining these medications with a Mediterranean diet maximizes your health benefits. While the drugs help you eat less and lose weight, the diet ensures that what you do eat is packed with nutrition, anti-inflammatory compounds, and essential nutrients.

    Examples of the Diet in Real Life

    In practical terms, adopting this diet does not have to be complicated. For breakfast, try Greek yogurt topped with fresh berries, or overnight oats with fruit and nuts. For lunch, enjoy a salad filled with leafy greens, chickpeas, avocado, and stone fruits, drizzled with olive oil and lemon. For dinner, think grilled salmon or chicken, paired with quinoa or farro and plenty of colorful vegetables.

    Ultimately, GLP-1 drugs and the Mediterranean diet are not competing solutions — they are complementary tools. Together, they support not just weight loss, but whole-body health.

    If you are on a GLP-1 medication, remember this: losing weight is important, but being healthy while losing weight is essential. The Mediterranean diet remains the gold standard, helping you do both.

    Don't forget your vitamins

    If you are on a GLP-1 medication, please take a daily multivitamin. There are plenty of them out there, but you need these daily. Especially the B-complex. I like this one from YouTheory.


    Banning Neon Cupcakes While Ignoring Real Public Health Threats: Welcome to America 2025 Apr 30, 2025
    Show notes

    Welcome to the theater of absurdity.

    While the federal government waves the flag of victory over removing petroleum-based food dyes from snacks, it is simultaneously gutting critical public health programs like food inspection, bird flu monitoring, injury prevention initiatives, and scientific research grants. The result? A dazzling case study in misplaced priorities.

    Today, let's walk through what is actually happening — not the headline-friendly soundbites — and why Americans should be far more worried about E. coli in their milk than Red Dye #3 in their Skittles.

    The Food Dye Fear Mongering: What's Actually True?

    First, let's address the food dye hysteria head-on. Many news outlets, "wellness influencers," and natural health bloggers are breathlessly claiming that we are "eating petroleum" because some food dyes are synthesized from hydrocarbon molecules derived initially from crude oil.

    Here’s the scientific truth: petroleum-derived hydrocarbons are nothing more than basic building blocks of carbon and hydrogen — the same stuff that makes up olive oil, avocado oil, and the omega-3 fatty acids you proudly add to your smoothies. [1]

    Importantly, food dyes like Red 40 and Yellow 5 are purified and rigorously tested substances. They are chemically synthesized from hydrocarbons, not "extracted gasoline." Saying Red 40 is gasoline is like saying salt is explosive because it contains sodium. It's chemophobic nonsense.

    Meanwhile, many of the same people yelling about food dyes are promoting supplements like methylene blue — another petroleum-derived chemical. Cognitive dissonance, much?

    Reference:

    1. ImmunoLogic. (2025). "No, You're Not Eating Gasoline." Retrieved from https://news.immunologic.org


    Meanwhile, in the Real World: Food Safety Programs Are Being Gutted

    Now, while we're distracted by the horror of neon cupcakes, something far more dangerous is happening. Funding for critical public health initiatives is being slashed:

    • Food inspection programs are being downgraded and shifted from federal oversight to inconsistent state programs.
    • Bird flu monitoring — crucial in an era of rising zoonotic diseases — is being slashed.
    • Injury prevention programs — those that track traumatic brain injury, car crashes, drownings, and falls — are being dismantled.

    According to reporting from Food Safety News, the Trump Administration's proposed budget would cut $128 million from the FDA’s food safety programs alone — programs that help prevent outbreaks of foodborne illness like the 2018 E. coli outbreak tied to romaine lettuce. [2]

    Reference: 2. Food Safety News. (2025). "FDA food safety funding faces big cuts." Retrieved from https://www.foodsafetynews.com


    Leadership Matters: Enter RFK Jr.

    You might ask, "Who’s steering this ship into the iceberg?" None other than Robert F. Kennedy Jr., head of Health and Human Services.

    There’s a small problem: RFK Jr. never took a single science course during his undergraduate education — at least, none we can find. Yet he is now in charge of overseeing agencies that depend on scientific literacy, from the CDC to the FDA.

    No wonder policy is being dictated by what makes Instagram wellness bloggers like "Food Babe" happy. Forget investing in scientific infrastructure to actually prevent disease. Apparently, public health is now about making sure your lettuce won't "run away with your colon."


    And the Hypocrisy Continues: Milk and Metabolic Disease

    While politicians play "Whac-a-Mole" with food dyes, real nutritional science continues to quietly reveal important risks — like the health consequences of dietary fat.

    A recent study in BMC Gastroenterology found that frequent consumption of full-fat milk is associated with a higher risk of metabolic dysfunction-associated fatty liver disease (MAFLD). [3]

    Surprisingly, this association was especially strong among people with higher education levels. So yes, your $7 artisanal organic whole-milk latte might be sneaking you toward fatty liver — one creamy sip at a time.

    Yet without adequate public health research funding, follow-up studies that could clarify mechanisms, confounders, and long-term risk could evaporate. The death of science isn't just about laboratories; it's about the slow, steady starvation of research that actually improves human health.

    Reference: 3. BMC Gastroenterology. (2025). "Non-skimmed milk and MAFLD." Retrieved from https://bmcgastroenterology.biomedcentral.com


    Transitional Moment: So, What Are We Prioritizing?

    Instead of investing in:

    • Safer food systems
    • More robust disease tracking
    • Cutting-edge nutritional science

    We are prioritizing:

    • Removing artificial colors that haven't been linked to deaths
    • Slashing foodborne illness monitoring
    • Hiring a non-scientist to oversee our nation's health apparatus

    This is a classic case of "health theater"— grand, performative actions with little substance while real threats simmer under the surface.


    Why Should You Care?

    Because someday, when the next E. coli outbreak rips across 15 states, you might wish someone had prioritized pathogen monitoring instead of neon cupcakes.

    Because someday, when another zoonotic virus jumps from animals to humans, you might wish someone had protected our bird flu surveillance systems.

    Because someday, when your "healthy" full-fat latte quietly leads you toward metabolic disease, you might wish public health research had been better funded.

    This isn’t hypothetical. It’s happening. Right now.


    Closing Thoughts: Welcome to America 2025

    In the final analysis, food dyes aren’t the enemy. Ignorance is.

    Real public health work is boring. It involves spreadsheets, bacterial cultures, inspections, and endless grant applications. It doesn't make splashy headlines or Instagram-worthy memes.

    But it saves lives. Quietly. Consistently. Effectively.

    Today, we’re watching that entire system be sacrificed on the altar of viral outrage.

    So the next time you eat a slightly less vibrant Froot Loop, take a moment to appreciate the irony: you might survive the Red Dye #3... but good luck surviving the E. coli smoothie no one inspected.

    Stay skeptical. Stay curious. Fork responsibly.


    Mission FORK U Apr 24, 2025
    Show notes

    Welcome to FORK U. Fork University. Where we make sense of the madness, bust a few myths, and teach you a little about food and medicine.

    I’m Dr. Terry Simpson—surgeon, scientist, and your chief medical explanationist. At FORK U, we’re not here to sell you supplements or tell you carbs are evil. We’re here to bring the science back to your plate—with a healthy side of sarcasm.

    Food hasn’t been medicine for 2,000 years, and despite what the smoothie bowl crowd says, it still isn’t. But we do know that eating better can help you live better. And that matters.

    Our Mission

    Here’s what we do:

    ✅ We bust nutrition myths that clog your feed and your arteries

    ✅ We decode the latest studies in easy, bite-sized episodes

    ✅ We bring the receipts—every episode is evidence-based and referenced at ForkU.com

    History

    We’ve revisited the foundational studies of nutrition, like Ancel Keys’ Seven Countries Study—which didn’t just compare nations but followed real people in real villages for decades. We’ve explored the French Paradox. We’ve even told the story of the surgeon who discovered the first vitamin.

    And we don’t just look back—we dive into current topics too: GLP-1s, gut health, ultra-processed foods, and yes—what happens when a shirtless influencer tries to sell you dehydrated buffalo hearts in the name of ancestral living. (Spoiler: you’re better off with lentils.)

    If you’re tired of pseudoscience disguised as wellness, and you want real answers—served with wit, citations, and no BS—welcome to FORK U.

    Let’s eat smarter. Let’s myth-bust louder. And let’s get cooking.


    Butter, LDL, and the Myth of Plaque Apr 15, 2025
    Show notes

    Butter, LDL, and the Myth of Harmless Plaque

    Why High Cholesterol Isn’t Just a Number—and What the Latest Science Says About Oils, Fats, and Your Risk of Death

    By Dr. Terry Simpson, MD – The Culinary Medicine Doc

    We’ve all heard the story: butter’s back, LDL doesn’t matter, and as long as you’re low-carb, your heart is safe.

    But what if I told you that the science—real, peer-reviewed science—tells a different story?

    In this post, I’ll walk you through three powerful studies that dismantle the myth of “harmless” LDL and show why swapping butter for plant-based oils could literally save your life.


    1. LDL and ApoB: The True Origins of Arterial Plaque

    Atherosclerosis—the buildup of plaque inside arteries—often starts silently. But over time, it becomes the leading cause of heart attacks, strokes, and cardiovascular disease.

    A key study from the Journal of the American College of Cardiology found that the primary trigger for plaque formation is not “existing plaque” as some influencers claim—but rather, LDL cholesterol and ApoB-containing lipoproteins that penetrate the arterial wall and kick off the inflammatory cascade that builds plaque [1].

    Once inside, these particles don’t just hang out—they lead to plaque progression and destabilization, which is what causes heart attacks. No LDL, no plaque. It’s that simple.


    2. High LDL, Worse Plaque—Even on Keto

    A 2025 study published in JACC: Advances examined people on carbohydrate-restricted diets—many of whom had very high LDL cholesterol levels [2].

    While some hoped the data would vindicate high LDL in the context of keto, that’s not what happened. The study found that the higher the LDL, the worse the atherosclerotic plaque—regardless of dietary pattern.

    Bottom line: High LDL is still atherogenic, even if you’re “metabolically healthy.” That six-pack doesn’t protect your arteries.


    3. Butter Increases Mortality. Plant-Based Oils Reduce It.

    Let’s talk fats. Specifically: butter.

    In a major pooled analysis of three large U.S. cohorts—the Nurses’ Health Studies I & II and the Health Professionals Follow-up Study—researchers found that butter consumption was associated with increased total, cancer, and cardiovascular mortality [3].

    But here’s the good news: Replacing butter with plant-based oils—like olive, soybean, and canola oil—reduced the risk of death.

    The substitution analysis showed that replacing just 15 grams of butter (about 3 small pats) with 15 grams of plant-based oil (about 1 tablespoon) led to statistically significant reductions in mortality risk.

    These plant oils are rich in polyunsaturated and monounsaturated fats, which have been shown in trials to:

    • Lower LDL cholesterol [4]
    • Reduce inflammation [5]
    • Improve lipid profiles [6]
    • Decrease overall mortality [7]


    4. Butter, Cancer, and Inflammation

    It gets worse for butter.

    The same study found a strong association between butter intake and cancer mortality, especially hormone-sensitive cancers like breast and prostate [3].

    Why? Saturated fat—found in high levels in butter—can increase inflammation in fat tissue and alter hormone activity, both of which are risk factors for these cancers [8,9].

    And no, this wasn’t confounded by white bread or pastries—the researchers adjusted for those too.


    5. Are All Plant-Based Oils the Same? Not Exactly.

    Olive oil, canola oil, and soybean oil showed consistent protective effects. Corn and safflower oil? The data were weaker—possibly due to low use or degradation during cooking [3].

    Some commercial corn oil is also more likely to be oxidized or partially hydrogenated, especially in older food systems [10]. So, while vegetable oils generally fare better than saturated animal fats, quality and cooking method still matter.


    Final Thoughts: What the Data Say

    High LDL is not “just a number.” It’s a powerful driver of atherosclerosis and death.

    Butter, despite its nostalgic appeal, increases risk of death. And plant-based oils? They reduce it—even in small amounts, even in real-world diets, and even over decades.

    So next time someone tells you to throw out your olive oil for butter, ask them to show you the data. You now have three major studies that say otherwise.


    TL;DR:

    • LDL and ApoB cause plaque — not existing plaque.
    • Higher LDL = worse plaque, even on keto.
    • Butter increases mortality — especially from cancer and heart disease.
    • Plant-based oils reduce mortality, especially olive, canola, and soybean oil.
    • Replace 3 pats of butter with 1 tablespoon of plant oil to lower your risk.


    References

    1. Libby P et al. “Plaque Progression and Rupture in Atherosclerosis.” J Am Coll Cardiol. 2020. Link
    2. Ebinger J et al. “Coronary Atherosclerosis in Individuals with Markedly Elevated LDL-C from Carbohydrate-Restricted Diets.” JACC: Advances. 2025. Link
    3. Zhang S et al. “Butter and Plant-Based Oil Intake and Risk of Mortality.” JAMA Internal Medicine. 2024. Link
    4. Mensink RP et al. “Effects of dietary fatty acids on serum lipids.” Am J Clin Nutr.
    5. Mozaffarian D. “Omega-3 Fatty Acids and Cardiovascular Disease.” N Engl J Med.
    6. Schwingshackl L et al. “PUFA and risk of CVD.” BMJ.
    7. Hu FB et al. “Types of dietary fat and risk of CHD.” Am J Clin Nutr.
    8. Rose DP. “Dietary fat and breast cancer.” Am J Clin Nutr.
    9. Parikh M et al. “Saturated fat intake and inflammation.” J Nutr Biochem.
    10. Choe E, Min DB. “Oxidative stability of oils and fats.” J Food Sci.


    Want more unfiltered nutrition science?

    Subscribe to FORK U — the podcast where we bust myths, decode headlines, and teach you how to use food as medicine. And follow me on TikTok & Instagram @drterrysimpson.


    Blue Zones: Beautiful Myth or Measured Truth? Apr 10, 2025
    Show notes

    The idea of Blue Zones—those rare places where people supposedly live longer, healthier lives—has become nutritional gospel. From best-selling books to Netflix specials, Blue Zones have been painted as longevity utopias we can mimic if we just eat more beans and nap more often.

    But here’s the thing: Blue Zones aren’t science—they’re storytelling.

    In this post, we take an unfiltered look at the Blue Zones concept, explore recent controversies, and compare it with something backed by actual peer-reviewed data: the Mediterranean Diet.

    What Are Blue Zones?

    Coined by journalist Dan Buettner and popularized through National Geographic, Blue Zones refer to five regions with high numbers of centenarians:

    • Okinawa, Japan
    • Sardinia, Italy
    • Nicoya, Costa Rica
    • Ikaria, Greece
    • Loma Linda, California

    These regions reportedly share key habits: plant-forward diets, natural movement, strong social bonds, and low stress.

    While these are certainly positive lifestyle features, the problem is how this information was collected. The Blue Zones model is observational, not scientific. It’s a patchwork of ethnographic notes, anecdotes, and assumptions—not randomized trials or controlled cohort studies.


    The Blue Zones Controversy

    In recent years, the Blue Zones concept has come under scrutiny:

    • Okinawa’s longevity claims have declined in newer data; life expectancy has dropped, and obesity and chronic diseases are on the rise.
    • Record inaccuracies in places like Okinawa and Ikaria have been found, making claims of centenarian density questionable.
    • Survivorship bias skews the picture—we hear from those who lived long, not those who didn’t.
    • Westernization has eroded the very habits that supposedly defined these zones.

    In short: Blue Zones are more about a moment in time than a repeatable formula.


    So What Does the Data Say?

    If you're looking for longevity strategies backed by evidence—not just folklore—consider the major cohort studies:

    • Nurses’ Health Study
    • Adventist Health Study
    • EPIC-Oxford

    These studies have followed hundreds of thousands of people for decades. The data consistently shows that people who live longer:

    • Eat more whole, plant-based foods
    • Limit ultra-processed foods and added sugars
    • Exercise regularly
    • Maintain strong social connections
    • Get adequate sleep
    • Manage stress
    • Don’t overeat

    No magic. Just measurable habits.


    Mediterranean Diet: The Gold Standard

    Unlike Blue Zones, the Mediterranean Diet is a defined, evidence-based dietary pattern. And it’s been rigorously studied in over 13,000 peer-reviewed publications.

    Core Features:

    • High intake of fruits, vegetables, legumes, whole grains
    • Olive oil as the main fat
    • Moderate fish and poultry
    • Minimal red meat and sugar
    • Moderate wine, usually with meals
    • Emphasis on community and shared meals

    Evidence Highlights:

    • PREDIMED Trial (2013): A randomized controlled trial of over 7,000 participants in Spain found that the Mediterranean Diet reduced the risk of cardiovascular events by 30% compared to a low-fat diet.
    • Reference: Estruch R, et al. N Engl J Med. 2013;368(14):1279-1290.
    • Link
    • Spanish Cohort Study (2022): A population-based study of 1.5 million adults found that greater adherence to the Mediterranean Diet was associated with increased longevity and lower all-cause mortality.
    • Reference: Zheng Y, et al. BMC Med. 2022;20:180.
    • Link

    Unlike Blue Zones, the Mediterranean Diet is replicable anywhere and supported by robust, controlled data.


    The Bottom Line

    The Blue Zones offer a romantic vision of a long life. But they’re built on observation—not rigor.

    If you're serious about longevity, skip the storytelling and look to the science. The Mediterranean Diet, supported by clinical trials and massive population studies, is the most proven path to better health and a longer life.

    Don’t chase myths. Follow the data.


    🎧 Want More?

    Listen to the full Fork U episode:

    “Blue Zones: Beautiful Myth or Measured Truth?”

    Available on Spotify, Apple Podcasts, and wherever you get your audio science straight.

    Follow me on TikTok and Instagram @drterrysimpson for more unfiltered medical myth-busting.


    Common Carnivore/Low-Carb Myths Apr 03, 2025
    Show notes

    Dietary Myths vs. Nutritional Science: Why the Mediterranean Diet Reigns Supreme

    As an Athabascan physician and culinary medicine expert, I'm often amused by the dietary myths perpetuated online, particularly those championed by keto and carnivore diet enthusiasts. Today, let's debunk some of these myths—Inuit diets, Hong Kong longevity, Maasai heart health, and the so-called French paradox—and explain why decades of robust nutritional science firmly support the Mediterranean diet.

    Myth 1: The Inuit Diet

    Low-carb proponents love pointing to the traditional Inuit diet as evidence of the supposed superiority of carnivorous diets. Yes, Inuit diets are traditionally high in marine mammals like whales, seals, and fish, providing ample vitamin C from sources such as muktuk (whale skin and blubber) and seal liver. Yet, archaeological evidence clearly shows ancient Inuit mummies suffered from vascular disease, challenging the claim that their diet was protective (Fodor et al., 2014). Additionally, Inuit diets historically incorporated plant-based foods such as berries, seaweed, and tubers during summer months—a fact conveniently overlooked by keto advocates.

    Myth 2: The Hong Kong Longevity Claim

    Another popular keto narrative incorrectly attributes Hong Kong's impressive longevity statistics to high meat consumption. But research shows elderly individuals in Hong Kong typically eat less meat and adhere closely to diets resembling the Mediterranean style, rich in vegetables, seafood, and whole grains (Woo et al., 2001). Again, context is key—and frequently missing from keto claims.

    Myth 3: Maasai Immunity to Heart Disease

    The Maasai, often cited as proof that diets rich in saturated fats don't cause heart disease, actually demonstrate the opposite. Recent studies confirm significant atherosclerosis and cardiovascular issues among Maasai populations, underscoring that even "warrior" genetics don't provide immunity from saturated fat-related diseases (Mann et al., 1972).

    Myth 4: The French Paradox

    Ah, the French Paradox—the idea that French populations consume diets high in saturated fats yet experience low heart disease rates. The reality is simpler: the French eat plenty of vegetables, fruits, olive oil, seafood, and emphasize portion control and mindful eating. France was initially included in the famous Seven Countries Study but was ultimately excluded due to funding constraints—not dietary irregularities (Kromhout et al., 2017). It's sensible eating, not paradoxical magic.

    Solid Science: The Mediterranean Diet

    Contrary to these dietary myths, extensive nutritional science consistently supports the Mediterranean diet. Two landmark studies illustrate this clearly:

    • Seven Countries Study: Spanning 50 years and involving over 14,000 men, this research demonstrated clearly superior cardiovascular outcomes for individuals following Mediterranean-style diets rich in vegetables, fruits, whole grains, legumes, fish, and olive oil compared to higher-fat diets (Keys et al., 1986).
    • EPIC Study: Following over half a million Europeans, the European Prospective Investigation into Cancer and Nutrition showed that diets emphasizing plant foods and limiting red and processed meats significantly reduce cancer risks (Boffetta et al., 2010).
    • Lyon Heart Study: Participants with existing heart disease significantly reduced their risk of a second heart attack by adopting Mediterranean dietary patterns—highlighting the diet's profound protective benefits (de Lorgeril et al., 1999).

    Final Thoughts

    Keto and carnivore diets might make enticing promises, but the science tells a different story. With over 70 years of rigorous research and more than 13,000 peer-reviewed publications, the Mediterranean diet remains the gold standard for long-term health and disease prevention.

    In an era where powerful obesity treatments like ZepBound emerge, it's even more crucial that we align medical innovations with proven nutritional strategies to ensure long-term health for newly fit bodies.

    Enjoy your meals, stay curious, and always leave room for dessert (occasionally)!


    References:

    • Fodor, J.G., et al. "The Inuit paradox and heart disease." Can J Cardiol. 2014.
    • Woo, J., et al. "Dietary habits of elderly Hong Kong Chinese." Age Ageing. 2001.
    • Mann, G.V., et al. "Cardiovascular disease in the Maasai." Am J Epidemiol. 1972.
    • Kromhout, D., et al. "The Seven Countries Study: Overview." Eur J Epidemiol. 2017.
    • Keys, A., et al. "The diet and 15-year death rate in the Seven Countries Study." Am J Epidemiol. 1986.
    • Boffetta, P., et al. "EPIC study: Diet and cancer." Am J Clin Nutr. 2010.
    • de Lorgeril, M., et al. "Mediterranean diet and cardiovascular health." Circulation. 1999.


    Why Bitterness is Good for You Mar 07, 2025
    Show notes

    The Bitter Truth: Why Bitterness Matters More Than You Think

    Have you ever taken a sip of black coffee and immediately regretted it? Or maybe you’ve bitten into a grapefruit and felt like your tongue was under attack? If so, you’re not alone. Bitterness is one of the most misunderstood flavors, but it plays a huge role in our health and survival. From keeping us from eating toxic foods to helping digestion, bitterness has a bigger impact on our bodies than most people realize. So, let’s dive into the bitter truth—why some people hate it, why your stomach can actually taste it, and how it has been used as medicine for centuries.


    Why Do Some Foods Taste Bitter?

    To begin with, bitterness exists for a reason. In nature, many poisonous plants contain bitter compounds. Long ago, humans who could detect bitterness had a survival advantage. In other words, their ability to taste bitterness kept them from eating something deadly. As a result, our bodies evolved to be extra sensitive to bitter flavors.

    However, not all bitter foods are dangerous. Many are incredibly healthy. Take kale, dark chocolate, and turmeric, for example. These foods may taste strong or even unpleasant to some people, but they are packed with antioxidants and nutrients that support overall health.

    So, why do some people love bitter foods while others can’t stand them? The answer lies in our genes. Scientists have discovered that a gene called TAS2R38 determines how sensitive we are to bitterness. If you are a super-taster, bitter foods might seem unbearably strong. On the other hand, if you are a non-taster, you may barely notice the bitterness at all.


    Your Stomach Can "Taste" Bitterness Too

    Interestingly, your tongue isn’t the only part of your body that detects bitterness. Your stomach can taste it as well. But how does that work? Well, your stomach has bitter taste receptors that serve a very important function.

    First, these receptors help control digestion. When bitter foods enter your stomach, the receptors slow down gastric emptying. In simpler terms, they make food stay in your stomach longer. As a result, you feel full for a longer period. This is one reason why bitter greens like arugula or dandelion leaves can help with weight management.

    Second, these bitter receptors act as bodyguards for your digestive system. If your stomach detects a bitter substance that shouldn’t be there—like a potential toxin—it delays digestion to prevent harmful substances from moving too quickly into your intestines. This process gives your body extra time to neutralize any potential threats.


    Bitters: From Medicine to Cocktails

    Because of their digestive benefits, bitter herbs have been used in medicine for centuries. In the past, people took bitters—herbal mixtures containing bitter plant extracts—to help with digestion, bloating, and nausea. Some of the most common bitter herbs include:

    • Gentian root – A powerful bitter used to stimulate digestion.
    • Dandelion – Helps with liver function and gut health.
    • Wormwood – Historically used for digestive problems and gut health.
    • Burdock – Supports digestion and has anti-inflammatory properties.

    Over time, bitters made their way from medicine cabinets to cocktail bars. During the 1800s, bitters became a key ingredient in alcoholic drinks, including the Old Fashioned and the Manhattan. In fact, some of today’s most famous bitters, like Angostura and Peychaud’s, were originally marketed as health tonics.

    But perhaps the most interesting story of all is how gin and tonic became a malaria treatment. In the 19th century, British soldiers stationed in tropical regions were at high risk of getting malaria. The best available treatment at the time was quinine, a bitter compound from the bark of the cinchona tree. However, quinine was extremely bitter and unpleasant to drink on its own. So, soldiers mixed it with sugar, lime, and soda water to make it more palatable. Eventually, someone had the genius idea to add gin, and just like that, the gin and tonic was born.

    Even though modern tonic water contains only small amounts of quinine, the drink remains popular today—not as medicine, but as a refreshing cocktail with a fascinating history.


    A Word of Caution: Who Should Avoid Bitters?

    Although bitters have many health benefits, they aren’t for everyone. Some people should avoid them, including:

    • Pregnant or breastfeeding individuals – Some bitter herbs can have harmful effects during pregnancy.
    • Children – Since bitters are often infused with alcohol, they are not suitable for kids.
    • People with digestive disorders – If you have ulcers, inflammatory bowel disease, or other stomach sensitivities, bitters could make your symptoms worse.

    In addition, taking too much of certain bitters can lead to side effects, such as:

    ✔ Nausea

    ✔ Cramping

    ✔ Diarrhea

    ✔ Gas

    ✔ Stomach pain

    As always, if you’re thinking about adding bitters to your diet, it’s a good idea to check with a doctor first.


    Conclusion: Embrace the Bitter!

    Bitterness may not be everyone’s favorite flavor, but it plays an important role in our health. It helps regulate digestion, protects against harmful substances, and has been used in medicine for centuries. Even though many people find bitter foods challenging at first, the good news is that your taste buds can adapt over time. So, if you want to develop a taste for bitter foods, start small. Add a little lemon or olive oil to bitter greens, try a piece of dark chocolate, or experiment with herbal bitters in your drinks.

    Who knows? You might just learn to love the bitter side of life!


    References

    1. Beauchamp, G. K., & Mennella, J. A. (2009). The biology of bitter taste. Scientific American, 301(2), 36-43.
    2. Meyerhof, W., Batram, C., Kuhn, C., Brockhoff, A., Chudoba, E., Bufe, B., & Appendino, G. (2010). The molecular basis of bitter taste perception. Trends in Neurosciences, 33(2), 92-101.
    3. Bartoshuk, L. M. (2000). Comparing sensory experiences across individuals: Recent psychophysical advances illuminate genetic variation in taste perception. Chemical Senses, 25(4), 447-460.
    4. Klee, H. J. (2010). Improving the flavor of fresh fruits: Genomics, biochemistry, and biotechnology. New Phytologist, 187(1), 44-56.
    5. Bisset, N. G., & Wichtl, M. (2001). Herbal Drugs and Phytopharmaceuticals. CRC Press.


    The Egg: From Villain to Victory Mar 04, 2025
    Show notes

    The Great Egg Redemption: How Science Saved Breakfast (But Not Your Wallet)

    For decades, the humble egg was treated like a ticking time bomb for your arteries. Nutrition guidelines told us to avoid them, doctors warned us about cholesterol, and many Americans swapped their morning omelet for a sad bowl of processed cereal. But here’s the kicker—those recommendations weren’t based on strong science. Instead, industry interests heavily influenced them, outdated theories, and a lot of fear-mongering.

    Now, eggs are back on the menu. Science has finally caught up, and experts agree that dietary cholesterol isn’t the villain it was made out to be. But just when we thought we could enjoy eggs guilt-free, bird flu struck, prices skyrocketed, and suddenly, eggs became the new luxury item. So, how did we get here? Let’s crack open the truth.


    The Food Pyramid: A Big Business, Not Big Science

    If you grew up in the 90s, you probably remember the Food Pyramid. It told us to eat 6-11 servings of bread, pasta, and cereal every day, while foods like eggs, meat, and fats were placed at the top—basically labeled "Eat Sparingly."

    But was this pyramid built on solid science? Not exactly.

    The grain industry played a huge role in shaping these guidelines. In the 1970s and 80s, low-fat diets became the gold standard for heart health. The idea was simple: eating fat leads to heart disease, so cutting out fat would make us healthier. Unfortunately, that’s not what happened.

    Instead, food companies removed fat from products and replaced it with sugar and processed carbs—because, let’s face it, fat-free food tastes terrible without something to make it palatable. As a result, Americans ended up eating way more refined carbs and sugar, leading to a spike in obesity and type 2 diabetes (Ludwig et al., 2018).

    Meanwhile, eggs—one of nature’s most nutrient-dense and affordable foods—were put on the naughty list.


    The War on Eggs: How a Bad Idea Became Dietary Dogma

    The real egg panic began in 1968 when the American Heart Association (AHA) declared that dietary cholesterol was a major cause of heart disease. They recommended eating no more than three eggs per week (Kritchevsky, 1999).

    But here’s the problem—this recommendation wasn’t based on strong human studies. Instead, it was based on:

    1. Animal Studies – Scientists fed cholesterol to rabbits, which are naturally herbivores, and (shocker!) their cholesterol went up. But rabbits process cholesterol differently than humans (McNamara, 2000).
    2. Epidemiological Correlations – Early studies linked high cholesterol intake to heart disease, but they didn’t separate it from other factors like saturated fat, smoking, or lack of exercise (Hu et al., 1999).
    3. Clinical Studies With Unrealistic Diets – Some studies tested cholesterol intake using six eggs per day—which is way more than most people eat (Fernandez, 2006).

    Meanwhile, many scientists already knew that dietary cholesterol had minimal impact on blood cholesterol for most people. Our bodies naturally regulate cholesterol production—when we eat more cholesterol, the liver produces less to balance it out (Griffin & Lichtenstein, 2013).

    But by the time the science caught up, the damage was done. Food companies had already flooded the market with "cholesterol-free" products like margarine and egg substitutes. And people believed the hype.


    The Egg Industry Fights Back (With Science!)

    While eggs were being villainized, the egg industry wasn’t about to sit back and let breakfast be ruined. In 1984, they established the Egg Nutrition Center (ENC) to fund research and set the record straight.

    Over the next few decades, study after study debunked the myth that eggs were bad for your heart. In fact, major research showed:

    • Eating eggs does NOT increase heart disease risk. A Harvard study of 117,000 people found no link between egg consumption and cardiovascular disease (Hu et al., 1999).
    • Eggs can even be good for you. They’re packed with protein, choline (for brain health), and lutein and zeaxanthin (for eye health) (McNamara, 2000).
    • Cholesterol guidelines were flawed. By 2015, the Dietary Guidelines for Americans finally removed cholesterol restrictions because there was no strong evidence linking dietary cholesterol to heart disease (USDA & HHS, 2015).

    After 47 years of bad press, the egg was officially redeemed. Here is a link for some science (ref)


    Just When Eggs Made a Comeback… Prices Went Through the Roof

    Now that science finally supports eating eggs, you’d think we’d be in a golden age of omelets. But no—2023 and 2024 have given us record-breaking egg prices.

    Why? One word: Bird flu.

    A massive avian flu outbreak led to the culling of millions of hens, drastically reducing egg supply and sending prices soaring (USDA, 2023). In some stores, eggs were even locked up like high-end electronics.

    So now, after decades of unnecessary restrictions, eggs are back on the menu—but they’re too expensive for many people to enjoy daily. Irony at its finest.


    The Bottom Line: Eat the Egg

    So, what’s the takeaway?

    • The demonization of eggs wasn’t based on strong science.
    • Many dietary guidelines (like the Food Pyramid) were heavily influenced by industry, not just research.
    • Science finally caught up, and now eggs are recognized as a nutrient powerhouse.
    • Just as eggs were redeemed, bird flu made them a luxury item.

    If history has taught us anything, it’s that we need to question nutrition trends—especially when big industries stand to profit. Eggs were wrongly blamed for heart disease, just like fat was wrongly blamed for obesity. But science eventually wins.

    So next time you crack open an egg, enjoy it. It took nearly five decades of bad science, industry influence, and misinformation for us to get here.


    References

    • Fernandez, M. L. (2006). Effects of eggs on plasma lipoproteins in healthy populations. Food & Function, 7(3), 156-164.
    • Griffin, B. A., & Lichtenstein, A. H. (2013). Dietary cholesterol and plasma lipoprotein profiles: Randomized controlled trials and meta-analyses. The American Journal of Clinical Nutrition, 98(6), 1465S-1470S.
    • Hu, F. B., Stampfer, M. J., Rimm, E. B., et al. (1999). A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA, 281(15), 1387-1394.
    • Kritchevsky, S. B. (1999). Dietary cholesterol, serum cholesterol, and heart disease: Are the associations valid? The American Journal of Clinical Nutrition, 69(4), 1210S-1215S.
    • Ludwig, D. S., Willett, W. C., & Volek, J. S. (2018). The low-fat diet: A failed experiment. Annual Review of Nutrition, 38, 37-57.
    • McNamara, D. J. (2000). The impact of egg limitations on coronary heart disease risk: Do the numbers add up? Journal of the American College of Nutrition, 19(5), 540-548.
    • USDA & HHS. (2015). Dietary Guidelines for Americans, 2015-2020.
    • USDA. (2023). Avian Influenza and Egg Supply Reports.


    Apple Watch vs. Oura, Whoop, and Withings Feb 22, 2025
    Show notes

    Apple Watch vs. Oura, Whoop, and Withings

    Health wearables have exploded in popularity, promising better sleep, fitness, and recovery tracking. But with so many options—Apple Watch, Whoop, Withings, Oura, and Ultrahuman Rings—which one is actually worth your money?

    More importantly, do these devices improve your health, or are they just expensive digital trophies?

    In this breakdown, we’ll compare features, accuracy, HRV (Heart Rate Variability) and “strain” tracking, battery life, hidden costs, and privacy concerns—so you can make the best choice for your lifestyle.

    We have come a long way since the pedometer - which I used to buy and give to my post op surgery patients to encourage them to walk.

    What Do These Devices Track?

    Most modern wearables track heart rate, sleep, HRV, activity levels, and even blood oxygen and temperature. More than just steps - which they all track, but each device has its strengths:

    • Apple Watch – Tracks HRV, ECG (FDA-cleared for atrial fibrillation), and fall detection. However, cellular models require a monthly subscription for full use, and it no longer tracks blood oxygen (SpO2) due to a patent dispute.
    • Whoop – Focuses on recovery, strain, and sleep—but requires a costly subscription and has no screen.
    • Oura Ring – A discreet ring tracking sleep stages, HRV, and body temperature.
    • Withings – The only one besides Apple to be FDA-cleared for atrial fibrillation detection, with a focus on medical-grade tracking (smart scales, blood pressure monitors, and sleep mats). Unlike Apple, Withings still tracks blood oxygen (SpO2). Withings also tracks heart rate continuously during sleep, and thanks to its long battery life, it can be worn at night for weeks without interruption. No subscription required.
    • Ultrahuman Ring – A newer ring with a focus on metabolic tracking and recovery.

    Scientific Insight:

    A 2020 Nature Digital Medicine study found that wrist-based devices overestimate activity but underestimate calories burned, while rings tend to be more reliable for sleep and HRV.


    HRV and Strain: What Do These Metrics Really Mean?

    What is HRV (Heart Rate Variability)?

    HRV is the variation in time between heartbeats—a measure of how well your autonomic nervous system is functioning.

    • Higher HRV = Better recovery, lower stress, and improved cardiovascular health.
    • Lower HRV = Fatigue, overtraining, stress, or even illness.

    However, HRV is highly variable based on factors like hydration, sleep, and time of day.

    How Wearables Measure HRV:

    • Apple Watch, Whoop, Oura, Withings, and Ultrahuman all track HRV, but accuracy depends on when and how it’s measured.
    • Whoop and Oura measure HRV during deep sleep, which is considered more stable than spot-checks.
    • Apple Watch and Withings measure HRV periodically throughout the day, which may be less reliable due to external factors.

    💡 Bottom Line: HRV is useful for tracking trends over time, but daily fluctuations can be misleading.

    Dr. Terry Simpson's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.


    What is “Strain” and Is It Useful?

    Strain is Whoop’s proprietary score that estimates how hard your body works based on HRV, heart rate, and activity levels.

    • High Strain = More exertion, requiring longer recovery.
    • Low Strain = Your body is well-recovered.

    🚨 The Problem?

    • Strain scores don’t account for individual fitness levels—what’s high strain for one person may be normal for another.
    • External factors like caffeine, stress, and dehydration can artificially raise strain scores.

    💡 Bottom Line: While strain tracking can help athletes fine-tune training, it’s not always meaningful for the average user.


    Accuracy & Reliability: Can You Trust the Data?

    Not all wearables are created equal.

    • Withings and Apple Watch are both FDA-cleared for atrial fibrillation detection, meaning they have been tested for medical accuracy.
    • Apple Watch’s ECG is 97% accurate for detecting AFib (JAMA Cardiology, 2023).
    • Whoop and Oura’s HRV tracking is solid, but they are not medical-grade devices.
    • Withings devices have been used in clinical research, meaning their data is considered highly reliable for medical use.
    • Withings still provides blood oxygen (SpO2) tracking, while the Apple Watch lost this feature due to a patent dispute.
    • Withings tracks heart rate continuously during sleep, while the Apple Watch requires the user to trigger measurements manually or wear the device overnight (which can be inconvenient due to short battery life).

    Bottom Line:

    • For medical-grade tracking, Withings and Apple Watch are the best choices.
    • For recovery & strain, Whoop and Oura perform well but lack medical validation.
    • For long-term health monitoring, Withings is the clear winner.


    More for our paid subscribers below - comparing battery life, hidden costs, and the overall winner.

    Battery Life & Charging: The Hidden Cost of Convenience

    Device Battery Life. Charging Time

    Apple Watch 18-24 hours 1-2 hours

    Whoop 4-5 days 1.5 hours

    Oura Ring 4-7 days 20-80 minutes

    Withings 3-4 WEEKS ~2 hours

    Ultrahuman 4-6 days 1-2 hours

    🔋 Withings wins by a landslide with up to a month of battery life. This allows users to wear it at night for continuous heart rate tracking, something that’s difficult to do with an Apple Watch.


    Costs & Hidden Fees: What’s the Real Price?

    Device Upfront Cost Subscription Hidden Costs

    Apple Watch. $250-$800. None for basic use $10-$20/month cellular charges

    Whoop Free device $30/month ($360/year) bands/sleeves

    Oura Ring. $299-$549. $6/month ($72/year) Without subscription, limited data

    Withings $250-$500 No subscription. None

    Ultrahuman $349-$499 $8/month ($96/year)

    💰 Whoop is the most expensive long-term due to its subscription model.

    💰 Apple Watch requires a monthly fee if you want cellular features.

    💰 Withings is the most cost-effective—one-time purchase, no subscriptions, no hidden fees.


    Final Verdict: Why Withings Wins

    🥇 Best for Most People: Withings – FDA-cleared, blood oxygen tracking, continuous heart rate monitoring at night, long battery life, no subscription, strong privacy protections.

    🥇 Best for Fitness & Heart Health: Apple Watch (beware of cellular fees).

    🥇 Best for Recovery Optimization: Whoop (if you can afford it).

    🥇 Best for Sleep & Metabolic Tracking: Oura, Withings, or Ultrahuman Ring.


    Final Thoughts

    Wearables are great tools, but they don’t replace healthy habits.

    I told Verizon that I don’t need the now $21 a month for cellular for the Apple Watch. The Withings Watch looks much nicer and easily stays on my wrist day and night.

    I had Whoop for over a year and a half. It has great insight, and those who have a favorite watch (Timex, Rolex, Omega, and so forth) but want tracking might like this device. You can wear a Whoop on your sleeve and still have your fancy watch on your wrist. I am a watch fan - but day in and day out, Withings is now my go-to. But even when I am going out and put on my watch that Dad gave me, I don’t need a lot of things tracked. I can be free of the digital age.

    I am not a ring fan. As a surgeon, they don’t work for me. Every surgeon loses rings to scrub laundry. Which is why many surgeons simply don’t wear rings at all.

    Withings also has an entire health system with blood pressure, a scale (where I keep track of my weight), and a sleeping pad that can diagnose and track sleep apnea (FDA-cleared).


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