Food as medicine

[Poindexter]

I want to get out from under @woodgeek 's Vegan thread. I do agree with him, he has done his homework, I bet his goo feels good inside his skinsuit.

I have come at this from having to solve for myself the problem of chronic pain that western medicine is simply not equipped to handle.

I have osteo arthritis. My great grandma used to put her right thumb firmly against the anterior aspect of her left wrist, wrap her right fingers around the back of her left hand and grimace hard while she pulled and pulled and pulled. She died when I was 9-10 years old and I never did understand that about her. Until I was about 25 years old myself and had my first bone spur in my left wrist. I remember pushing my right thumb into my left wrist as hard as I could, flashed to her in her wheelchair, so I wrapped my fingers like she used to do, and tugged my left hand away from my left wrist, it was the best I could do.

I also have psoriasis, with psoriatic arthritis from both elbows out to my fingertips. It used to only bug me when outdoor temps were -20dF or colder. That was a while ago, now I also have it in my left leg from the knee down, and it bugs me (was bugging me) at about 0dF.

When my last doc retired she sent out a thank you note to all of her patient's, with a list of providers she felt were good enough to take care of us, her old patients, going forward. On that list (I know pretty much all the medical providers in town) all the ones I would be willing to have be my doctor were not accepting new patients with chronic pain.

At the time (~ 2019) I was already off all narcotics but suffering in cold weather. Now in 2023 I am off all meds, I am not even taking turmeric or elderberry, and I feel like I am about 24.5 years old, before the first bone spur.

I am about to take dinner off the grill, so I will make the intro short.

I count everything we put into our bodies as nutrition, as food. I think of this short list as the mandatories to handle before looking for more advanced stuff.

1. Stop smoking. Full stop.
2. Limit alcohol to 2 servings per day, max. I will get back to this.
3. Media consumption and self talk. Are the TV shows you are watching congruent with the person you want to become? Are you your own worst enemy because of the things your brain says that your body will naturally try to obey? How much time are you spending playing "first person shooter" video games?
4. Limit and eventually eliminate processed carbs, processed oil and processed sugar.
5. Consume a legitimate 5 servings of vegetables every day.

Those are the big 5 to start with.

I will get back to this, probably tomorrow.

 

[Poindexter]

So to point 1, smoking is bad, mkay?

We have a ton of data about vehicle exhaust, forest fire smoke and tobacco smoke. And we got a preponderance of data about barbecue. If you eat a lot of smoked meats, your risk of colon cancer is increased.

As in all things in life, you got to weigh preparing for the future with living in the moment and find your own balance. I have personally moved out of the big city, stopped smoking tobacco and come up with a filtration system to keep the air inside my home clean during wild fire season, but every once in a while I am going to have a reverse seared ribeye or some baby back ribs or some brisket.

Or smoked salmon. I am willing to have some salmon that isn't smoked, a rather lot of salmon that isn't smoked. but I have three recipes for wild caught salmon that is smoked on alder wood. The recipe titles are "Salmon Candy" "Salmon Cocaine" and "Salmon Crack Cocaine."

If I die young from eating smoked salmon, at least I went out doing what I love. If I die young from tobacco smoke I am a dumb@55. Pick your poison.

I can typically identify regular tobacco smokers on inpatient med surg from 6-10 feet away while they are sleeping in a dark room. Heavy smokers I can usually pickup on from the hallway outside the door to the hospital room. Nobody wants to be in this demographic when this habit catches up with you. I cannot think of one single time ever any one individual experienced one minute positive health effect from smoking.

Just stop.

 

[Poindexter]

Alcohol, beverage alcohol, ethanol, is a thing to minimize or eliminate for Americans who want to have good health.

One of my life goals is to go to France, get an AirBNB with a kitchen, and spend at least two weeks cooking French food with French ingredients and try to suss out the French approach to alcohol by talking to the locals in whatever village or town my wife picks.

I read one of Jacque Cousteau's books many many years ago. He had designed and contracted out a small two man submarine, and used the sub to go explore a place a coastal French city was planning to dump untreated sewage. He found a vibrant underwater community in the proposed spot, drove around a little while, found a virtual underseas dessert a few miles away. Then he parked the sub on the seafloor and split one baguette and one bottle of wine with his co-pilot, and then drove the sub back to base and his car back home. Americans, most of us, can't do that. I am confident Jacques had some more wine with dinner later that same evening.

On the one hand the good Lord put yeast right on the skin of the grape, but in the last month or so I had a patient, ten years younger than me, who was so far gone even the whites of his eyes were jaundiced from alcoholic cirrhosis.

For most Americans most of the time playing with alcohol is paying with fire. I think of folks who admit to drinking one case of beer daily, or one fifth of whiskey daily, as professional grade. The few folks I know of putting down both a case and fifth daily are all-star grade (walk ons need not apply), but both the pros and the allstars have very low life expectancies.

If you are drinking every day, your brain chemistry will adjust to accommodate. If you stop drinking suddenly, your brain chemistry will be out of whack. If you are drinking more than 4 servings of alcohol daily I suggest professional guidance in finding a taper plan that will let you cut your consumption gently without an inpatient detox stay.

But you got to slow down. This is another area where when the habit catches up with you medically, no one wants to actually be in the demographic.

 

[Poindexter]

Imma skip over #3 tonight so I can come at it fresh in the morrow.

For #4, if you don't believe me, I suggest a challenge diet. 48 hours should be plenty.

No matter how bad or screwed up you feel today, try eating heavily processed foods only for 48 hours to see if you feel better or worse. Twinkies. Velveeta. Deep fried stuff. No vegetables other than potato and bread. Pepperoni pizza with extra cheese. Liters and liters of carbonated soda. French fries with "cheese product" squirted on with wild abandon. Potato chips, especially the ones with flavorings like sour cream and cheddar with no sour cream and no cheddar on the ingredient list. Ice cream. Breaded and deep fried candy bars. Elephant ears with loads and loads of powdered sugar. Beef jerky with "hydrolyzed protein" high on the ingredient list. No water. If you are thirsty drink a sugary carbonated product.

All the stuff that makes you feel "good." Just keep eating that stuff, only, until you feel like you got run over by a truck. Keeping eating that stuff, only, until you see the lie. Keep eating that stuff, only, until you realize that it doesn't feel good. When you get there, have some cheesecake. Or some bacon. Once you are ready to vomit from junk food, see how much bacon you can actually tolerate.

I am not going to talk anyone out of eating processed food by hammering on my keyboard. My challenge to you is to instead cut all the yucky stuff out of your diet, like water and broccoli, and eat only the stuff that makes you feel 'good' until you see the truth. You are cordially invited to eat all the stuff that makes you feel 'good' until you show up on my floor when I can ask if you want me to measure your temperature in your mouth or your butt. I will be recording an accurate temperature in your chart three times daily, and I don't give a rat's patootie how you feel about it or where I measure it.

 

[Poindexter]

There are essentially five reasons regular people end up in the hospital.

1. physical trauma like car accidents.
2. genetics like cystic fibrosis
3. infections like community acquired pneumonia
4. lifestyle choices like methamphetamine
5. psych/ ACEs

Recall by my definition (post #1, qv) anything you intentionally put in your body, even meth smoke, counts to me as nutrition.

#5 is psychiatry/ Adverse Childhood Experience(s) . Psych is an underserved population. If you have your feces well enough in sequence to understand the payback period on a new woodstove install is going to be in the 5-10 year window, and still make the plunge; your mental health is probably good enough to name your ACEs and I encourage you to seek professional help with the knarly bits in your personal rice bowl.

Certainly there is some overlap. The lifestyle choice of promiscuity can lead to the infectious process of all the STDs.

What are you choosing, and what possibilities are opened by your choices?

 

[Poindexter]

FWIW we are all traumatized.

One hour before birth we were weightless, zero G in amniotic fluid, with all of our nutritional needs met via the umbilicus. An hour (or whatever) later, we were either squeezed through the muscle tube or surgically snatched from our paradise to a new place where we had the work of breathing to carry on forever, and we have to work for our sustenance, and we have to deal with gravity.

Life is traumatic. The amount of trauma we each have faced and will face is variable, but we are all traumatized just by having been born alive.

NB: This is exactly why hospice nurses can say they work at the other 'end' of the circle of life. They are exactly the opposite, or exactly the same as, labor and delivery nurses. It is a matter of perspective.

 

[woodgeek]

Right on. On the Food as Medicine theme...

We as a society have spent a MINT on biomedical research over the last 50 years. Not health CARE, but on pure scientific research to understand the nature of disease and possible courses of treatment.

As a scientist studying (mostly) non-medical things, I get by with a couple research grants to pay for a couple students that just cover a trip or two per year to conferences to present our findings, where we stay in a fleabag motel to not run over our thin budgets. And my colleagues studying biomedical? Their grants are 2-4X larger than mine, and the agency that funds them has 2-4X the money, and so they are awash in cash, with a small army of students slaving away in the lab almost 24/7, as they all strive for the next big discovery. And they are jetting to and fro to preset their results in luxury locations, every few weeks it seems.

In pure science, we spend as much on biomedical research as all other (non-military) things combined. And it has been that way for 50 years, since Nixon announced his 'War on Cancer' in 1972. Way more than the space program. The Cancer moonshot has cost way more than the actual Moonshot!

And that doesn't even count all the private research done by the pharma industry, which is even bigger than that! That is where all those students go when they graduate.

And yet Cancer (and the other threat found in the 1960s, heart disease) still kill more of us that anything else. Has all that money and effort failed? Why don't we have a pill to make cancer go away and prevent heart attacks? Why don't we understand WHY heart attacks happen and WHY cancer happens in the first place, so we can prevent them completely?

Is it bc heart disease and cancer are a ubiquitous feature of the human condition? Nope. You can go to various 'non-Western' societies in rural Africa, Asia and South America, and find that the population of old people there basically NEVER get heart disease, and almost never get the kinds of cancers that are killing us (when our hearts last long enough to die of something else). So SOMETHING they are doing is right, and SOMETHING we are doing is wrong, and causing the major cancers and heart disease we struggle with.

And we all know this at some level, and are in denial about it. So we are paranoid about pesticides in food, or artificial sweeteners, or fluoride in water, or the vinyl in our couches, or something in our drinking water... certainly one/all of THOSE things must be the cause of our ill health. And by avoiding X Y or Z, we can avoid an early death, via a superstition like whistling past a graveyard.

Wait, didn't we just spend trillions of dollars over the last 50 years to try to figure this out? Did those guys come to any conclusions about what was causing cancer and heart disease? Turns out they DID... and the early returns in the 1970s were correct.

Early mortality in the west is mostly caused by Smoking and Diet.

If you don't smoke, and eat a healthy diet, your life expectancy goes up, at least 10 years higher than the average. And your years of feeling healthy and active go up by more than that.

That healthy diet is nearly what you were taught in school decades ago: Eat lots of vegetables, fruits and whole grains, and not too much saturated fat, sugar and salt. Moderate meat and dairy intake. That's it.

As for drinking, the recommendation is 2 or less servings/day for men, 1 or less for women. In line with @Poindexter.

For smoking: Don't.

And so if we have known about how to avoid heart disease and cancer for most of our lives, why are people still dying from those things? The answer is misinformation and marketing.

The money spent on biomedical research is dwarfed by the amount of money spent marketing unhealthy processed/junk food to us. Food that costs almost nothing to make, being made of the cheapest mass produced ingredients, and formed on high-speed industrial processes, and which is only made addictive/appetizing by loading it with salt, sugar and saturated fat. And marketing the chit out of it.

No one is marketing broccoli and lentils and quinoa like that.

And ofc the food companies are paying for a raft of scientific studies that 'muddy the waters' quite intentionally, which then say that 'eggs are fine' and 'bacon doesn't cause heart disease', which the media then duly report to get lots of clicks and eyeballs, and ofc increasing the sales of their major advertisers.

So its like the famous Irresistable Force versus the Immovable Object: which will win? The very clear decades of science that have told us how to eat, or the trillion dollar food companies with their lobbyists, paid politicians, paid scientists and advertising budgets?

Its not even close. Since the 1970s, the American diet has gotten LESS healthy, and the amount of industrial junk has gone up, up, UP. And oddly, our rate of heart disease and many cancers have gone up as well (with the exception of lung cancer which has fallen with the decline in smoking).

Healthy diets have lost the War on Cancer and Heart Disease.

But you CAN tune out the noise, ignore the ads, come to see 80% of the 'food' in the grocery store as dangerous trash, and add up to 10 hale and hearty years to your life!

And when you do, your taste buds will recalibrate in a few weeks, to the point that you love the taste of healthy real food, and you will be just as excited to tuck into dinner as you are your current less healthy diet.

 

[Poindexter]

And when you do, your taste buds will recalibrate in a few weeks, to the point that you love the taste of healthy real food, and you will be just as excited to tuck into dinner as you are your current less healthy diet.

Amen to all brother. Woodgeek has saved us all from me having to climb up onto a couple different soapboxes.

The thing about big pharma not yet explicated here. The CEO of a drug company is ultimately responsible to the share holders to produce profits to pay dividends. The most efficient way to do that is to sell you pills that you have to take over and over and over.

 

[Poindexter]

So step three on the starter list of five things "self talk."

An easy example, my current mantra is "I am running with the 20 somethings" as the distilled truth from larger idea "In my mid 50s I am working 12 hour shifts for the first time in my life, with no joint pain, and running with my 20 something year old colleagues as a physical equal."

So what mantra is in your head? Did you write it intentionally? Is it something one of your parents spoke over you, or something you heard from the media?

The thing is, without an idea, without a goal you are rudderless, adrift in life and will end up wherever the vicissitudes of life take you.

With a negative affirmation you are basically opening all the chinks in the armor you do have to the flaming arrows of the enemy. Imagine briefly the pitfalls of choosing as a mantra "I am not going to smoke cigarettes."

With a positive affirmation in your mind, which you can choose and install with minimal self discipline, your brain will come into alignment with the idea in your mind, and your body will come into alignment with your brain. Try instead "I am smoke free."

FWIW I have been running with the 20 somethings for about 5 months now. My body is not yet fully in alignment with the software I have installed, but I am winning.

 

[Poindexter]

Besides positive software into the mind, the only dietary suggestion for intake I have that I will not budge on is vegetables.

In my clinical experience, people that have 2-3 servings of dark leafy greens and 2-3 servings of colorful other veg like tomato or purple onion or orange bell pepper - the folks that get their five vegetables every day- don't get sick as often, and they get well faster than folks who don't eat their veg.

That is all. The rest of it you get to figure out your self. No smoking, no or minimal alcohol, no processed food, go crazy with what is left.

If you just love cheese and your system is tolerating it, I am not going to argue about it, just read the labels. Ingredients should me milk, salt, enzymes and possibly some Annatto extract for a little color. FDC#5 food dye, nope.

If you want to play Fred Flintstone and call yourself a carnivore, I am not going to stand in your way. I do think you should have the minimum five veg daily as above, and you are going to need to drink a fair bit of water to keep your kidneys flushed out.

If you want to go all out vegan you can do that. There are a couple possible pitfalls to that path, but they are pretty well known. @woodgeek 's thread near this one is an excellent primer.

At the end of the day, our bodies can process just about everything we can chew that occurs naturally on the planet. It is the hydrolized this and hydrogenated that where the trouble starts.

 

[PaulOinMA]

I'll have a cigar on the porch at night. Finishing one now.

Stopped alcohol last October when I was on acetaminophen with a protruding disc. Very little in five months. Much better.

Large salad, yogurt with granola, fruit, and cheese just about every day for lunch.

 

[ABMax24]

Caffeine is my nemesis. I turned 30 in December and have been consuming 1 or more caffeine laden drinks per day, coffee, energy drinks, pop you name it, for basically the last 15 years. Last year I had to take a break, it had started to cause mood swings, anxiety, brief bouts of depression, and even tremors in my hands similar to a person with stage 1 Parkinson's. Which of course led to more sleep loss, higher caffeine consumption, exaggerated symptoms, more sleep loss, a downward spiral. So I quit, stammered through a week of non-stop headaches and within 2 weeks almost all symptoms were gone, I made it a few months caffeine free and eventually got back on the 1 coffee a day program, but I think I'd like to quit again, or at least switch to decaf.

In all this I did a bit of research on caffeine content and the results were a bit shocking:
Coke has 34mg of caffeine in a can. I mostly drank one of these per day for the first 5 years of my addiction.
Rockstar Energy Drinks contain 160mg per can, (I know, gasp, the horror of drinking such a thing) I moved on to these in college, and often drank them in addition to a can or bottle of coke.
Then came coffee, I was growing up so it seemed more benign and a more socially acceptable way of getting my caffeine fix at 7:00am instead of the canned energy drink.
A large McDonald's Coffee, 180mg of caffeine, that's more than the Rockstar. But that wasn't good enough, I switched to Tim Horton's coffee, and they sell it in an XL format so have to get one of those, a whopping 330mg of caffeine.

I won't even get into the sugar or fat consumed with all that caffeine (I envy those that can drink coffee black BTW).

This was my first scare with diet, having tremors in my hands was more than an uncomfortable feeling. My diet still needs significant improvement, but I've made some other changes and at least it's now trending in the right direction, albeit slowly. Currently I'm contemplated returning to 2 meals per day, when I was younger the first time I ate in the day was noon and I seemed to feel better all the time, which would also force me to drop the morning coffee and the sugar and cream it comes with.

 

[PaulOinMA]

I make decaf coffee at home withnl only a little regular added for taste.

I will get regular coffee out. Monthly Friendship Suppers at my wife's former church is regular coffee. A lot. In bed awake well into the night. 😀

 

[woodgeek]

I was over caffienating for years when my kids were small, which gave me 'morning insomnia', where you wake up too early. For me, like 4-5 AM. Then, by noon, I had more coffee bc I was exhausted, and only half way through my work day. This hurt my quality of life and productivity for a long time.

Now I have a single cup of half-caf pod coffee in the morning, and get a trace from swilling decafs all day.

Went from sleeping 4-5 hours per night to 6-7. About 10 years ago. Which was huge.

 

[Poindexter]

Currently I'm contemplated returning to 2 meals per day, when I was younger the first time I ate in the day was noon and I seemed to feel better all the time, which would also force me to drop the morning coffee and the sugar and cream it comes with.

I have been doing intermittent fasting lately, it seems to be working for me, but there is no reason to expect it to work for everyone.

On days I am not working I limit all my food intake to between the hours of 2PM and 10 PM. I can say I feel better, but I haven't had any lab work done to objectively demonstrate why I feel better.

 

[Poindexter]

We should include some tidbit of attention for the roughly 4 trillion pets we each have in our gut.

Besides feeding your own body's cells, the food you put in your gut influences the bacteria that can survive in there and which species can thrive in there.

I intentionally set out to make my microbiome as diverse as possible, because all the infections in town that need hospitalized come to my floor. Having a wide range of bacteria in my gut gives me better resistance to invading pathenogenic bacteria that try to get in that way.

 

[PaulOinMA]

We fast during the day one day a week. Did it for Lent a while ago and decided to continue it. Very easy to fast now. Will have salad/yogurt-granola/fruit at 4 PM and a sandwich for dinner around 6 PM on Mondays.

 

[Poindexter]

I just finished working 12s in the last 6 of 9 days, with adequate time time for rumination.

The one thing I feel confident about tonight is cycle time. Looking at human history from say the end of the last ice age to the start of globalization at circa 1750 was we "used to" add fat in the autumn, and the maybe go in to ketosis over the winter, burning fats to make it through the winter.

We don't have that problem any more. Some/most/ many Alaskans will gain weight over the winter, and then burn the pounds off over the summer when we can be active outdoors. We are out of step with the seasons. In the fullness of time I expect science will show Alaskans are doing wrong, we should, probably, gain weight in autumn when the crops come in, and lose weight over the winter to be better in tune with natural cycles. For optimal health we as a species should ~probably~ be near ideal body weight for ~6 months of each year, build up 'some' body fat to carry into winter for some 3 months or so, be in ketosis to burn off fat in deep winter for three months or so...
and spend the other six months of the calendar year more or less in equilibrium with our environment.

I cannot think of a reason to expect spending year after year in fat burning ketosis is 'better' than spending year after year in fat building 'insulin resistance.' I simply cannot think of a reason to pursue either. Both are available, neither is demonstrably 'better.'

 

[woodgeek]

OK. I think I agree and disagree.

It is clear that our bodies, more than anything else, are built to keep us alive in a variety of circumstances... only starch to eat? OK. Only meat to eat? OK. No food for a couple months? OK. At a molecular level all three of these challenges are different and pretty drastic. Our muscles and brain run primarily on glucose and/or fats, but we can switch to protein when needed (ketosis). If we are starving, we have LOTS of stored energy in our bodies (in many different forms) to draw on, and when those are gone, we happily start to burn our muscles to keep the old machine going a bit longer.

Because for our bodies, surviving different 'challenges' is paramount to, um, survival!

Beyond macronutrients and energy, our bodies are able to synthesize almost all of the thousands of different molecules we are made of and run on. We only need to ingest the dozen or so vitamins and 9 essential amino acids, and one long chain lipid (ALA)... everything else we can synthesize! And weirdly, ALL of those required compounds (except B-12) are ubiquitous in plant products, and B-12 is ubiquitous in dirt, especially African dirt (and poop). This checks out, bc our ancestors for many millions of years lived exclusively (or almost so) on unwashed plant products, so a mutation that destroyed our ability to synthesize one of those few things was never a survival problem.

Fossil (poop) evidence makes it clear that early humans ate mostly plants (which are starch and protein, btw), taking in about 100g of fiber per day, and this is very similar to the diet of modern hunter gatherers in the tropics. Meat is eaten in small amounts when it is available, often for seasonal holidays and rituals.

But as we are discussing, our bodies are flexible. Let's take those early, herbivorous humans out of Africa.

Problem 1... not enough vitamin D bc the reduced solar flux and clothing to ward off the cold. Solution, ubiquitous mutations for lighter skin... DONE.

Problem 2... seasonal variations. There are seasonal variations in the tropics (wet/dry), so our diet and bodies probably had coped with that for a long time. In the agricultural period, it is clear that we have been STORING foods for as long as we have been growing them. Probably bc it is MUCH better to eat a stale plant during the dry/cold season than to starve. So while our ability to add on fat and take it off is great as a survival tactic, its not clear that humans were fattening up massively (like bears that do NOT store food and do hibernate) for the winter. We certainly put on some fat, but were probably more like squirrels than bears... getting fat AND keeping a cache of nuts.

Problem 3... the arctic = no plants. Yikes, take that tropical animal and stick him near the arctic circle with only pine needles or lichen to eat! The solution was to eat a MOSTLY meat (protein and fat) diet. Like the Inuit, who have survived doing that for thousands of years. The Inuit DO have some mutations that appear to aid survival on a meat diet. Notably, one of these is to NOT become ketotic (protein digesting). That is, their bodies will preferentially digest fat for energy over protein, to a greater extent than those without the mutation. My conclusion: while ketosis is a great trick for surviving during starvation (including digesting your own muscle proteins), it probably has some nasty side effects for health, given that evolution ditched it in the Inuit.

Question: do the Inuit have mutations/adaptations for digesting fat or handling cholesterol? Not have been discovered. Despite some anecdotal reports from 100 years ago that the Inuit do not get heart disease (which still, sigh, show up on social media), the reality is that they DO get heart disease. Apparently in much the same way that non-Inuit would on the same high saturated fat diet. And it kills them when they get older in large numbers. But apparently, evolution doesn't care too much about folks dying over 50 yo, bc it hasn't done anything about it.

Summary: I do believe that we probably have adaptations to seasonal eating, but haven't seen any science on the matter. We can also do ketosis (protein digestion) in a pinch, when the carbs we ate for millions of years are not available for some reason. Your post seems to conflate ketosis with fat burning... but carb and fat burning are the 'normal' human metabolism, ketosis is burning protein. And while the modern 'keto diet' is clearly an effective way to lose weight (compared to the standard Western diet), it is not healthy: folks on a keto diet have 50% higher mortality rates. Evolution agrees: Inuit eating high animal protein diets got mutations to PREVENT ketosis, suggesting bad health effects and reduced fitness/survival in the short term.

Insulin resistance has nothing to do with ketosis (despite keto dieters often saying it does). Insulin resistance is caused when our muscle cells are 'full' of energy and refuse to take in more. Muscle cells store both glucose AND fats inside them. When they are full of fat, they refuse to take in more fat OR glucose, ignoring insulin's commands. It is caused by eating too many calories overall, and too much fat in particular. Anything that causes significant weight loss (including the keto diet) improves insulin resistance by reducing the stores of these 'intramyocellular lipids'. IOW, diabetes is caused by extended overeating of calories with a significant fraction of fat in the diet.

 

[Poindexter]

At this juncture I publicly acknowledge @woodgeek 's current knowledge of human nutrition is superior to mine. I did tutor human nutrition in the mid 1990s, but I haven't kept up as the field has moved on.

So I am asking, what can/ should I try next? My goal is to take care of myself, to avoid preventable problems in the future. My current BMI is 26. I do weigh once every two weeks on the same calibrated scale at my work.

I do have to work around my arthritis. I am off all meds, including fish oil supplements, and pain free. I am very intentional and organized about my cold weather exposure and wardrobe so I can stay off meds. I do have one serving of oily fish daily as one of my three proteins, typically either commercial canned sardines or home canned salmon. This seems to be enough Omega fatty acids to keep my joints from squealing.

I do also consume a fair quantity of capsaicin and a little bit of homemade elderberry syrup as dietary anti-inflammatories.

3 proteins daily gives me about 60grams of dietary protein in about 600 calories. Besides one oily fish I tend towards one of sauté chicken breast and one of plant protein.

10 servings of mostly raw vegetables daily gives me about 300 calories and a wide variety of pre-biotic fiber to feed my 4 trillion pets.

I am at 900 calories daily, but need about 1900 to maintain 185-190# with light activity level.

I have seen two references (in which I do not have complete confidence) that humans can get up to 10% of calorie needs from short chain fatty acids made by the 4T pets. 900+190 puts me at 1090 cal, with 810 to go. I am definitely getting some benefit from my new improved menagerie, but I have no way to estimate how many calories I am getting from SCFAs today.

I am willing to add a fourth serving of protein, plant based, but that still leaves a 600 calorie daily deficit.

Another thing I recognize I do is I overeat while I am working. To combat this I am giving myself somewhat free rein on work days, but intermittent fasting on days off, trying to limit PO intake to the hours of 1400-2200. In the trailing two weeks I actually lost 2# which is good. As long as my BMI is under 30 I feel pretty good about avoiding the complications of obesity. I wouldn't mind being a bit less apple shaped, but fitting back into the pants I wore to my high school graduation isn't really a goal.

Where can I get my other calories from?

 

[PaulOinMA]

Jeez. I've always been over 6'. Losing some height due to age. Just under 6' now due to discs. Calculated BMI using 5' 11". Not happy. 😀

 

[woodgeek]

At this juncture I publicly acknowledge @woodgeek 's current knowledge of human nutrition is superior to mine. I did tutor human nutrition in the mid 1990s, but I haven't kept up as the field has moved on.

So I am asking, what can/ should I try next? My goal is to take care of myself, to avoid preventable problems in the future. My current BMI is 26. I do weigh once every two weeks on the same calibrated scale at my work.

I do have to work around my arthritis. I am off all meds, including fish oil supplements, and pain free. I am very intentional and organized about my cold weather exposure and wardrobe so I can stay off meds. I do have one serving of oily fish daily as one of my three proteins, typically either commercial canned sardines or home canned salmon. This seems to be enough Omega fatty acids to keep my joints from squealing.

I do also consume a fair quantity of capsaicin and a little bit of homemade elderberry syrup as dietary anti-inflammatories.

3 proteins daily gives me about 60grams of dietary protein in about 600 calories. Besides one oily fish I tend towards one of sauté chicken breast and one of plant protein.

10 servings of mostly raw vegetables daily gives me about 300 calories and a wide variety of pre-biotic fiber to feed my 4 trillion pets.

I am at 900 calories daily, but need about 1900 to maintain 185-190# with light activity level.

I have seen two references (in which I do not have complete confidence) that humans can get up to 10% of calorie needs from short chain fatty acids made by the 4T pets. 900+190 puts me at 1090 cal, with 810 to go. I am definitely getting some benefit from my new improved menagerie, but I have no way to estimate how many calories I am getting from SCFAs today.

I am willing to add a fourth serving of protein, plant based, but that still leaves a 600 calorie daily deficit.

Another thing I recognize I do is I overeat while I am working. To combat this I am giving myself somewhat free rein on work days, but intermittent fasting on days off, trying to limit PO intake to the hours of 1400-2200. In the trailing two weeks I actually lost 2# which is good. As long as my BMI is under 30 I feel pretty good about avoiding the complications of obesity. I wouldn't mind being a bit less apple shaped, but fitting back into the pants I wore to my high school graduation isn't really a goal.

Where can I get my other calories from?

First off, I am not a medical doctor, and I am not your doctor. Do what your doctor says. Have you had blood work done? Is he/she happy with the numbers?

I am really glad you are getting some pain relief by upping the leafy greens, raw veg and fiber in your diet. So keep doing that, assuming your current habits are sustainable (that is, you like them!).

If you are asking what else to eat... I would say MORE anti-inflammatories in more variety... they are synergistic. More berries (I buy frozen wild blueberries from Maine). More nuts (esp walnuts). More brightly colored veg (red onions versus yellow), red cabbage vs green.

I tell myself that if the food I"m eating wouldn't stain my clothes, its a missed opportunity.

Are you are asking about weight loss? BMI 26 and only 1100 calories per day? Since I do believe that energy is conserved, if you are expending more calories than you are taking in, you will lose weight.

Remember that a pound of fat (in our bodies) is equivalent to 3500 calories. So if you are in a 500 cal/day deficit, you only lose a pound a week. And that can easily be masked by other factors (like a couple more pounds of (hydrated) fiber in your gut), changes in lean muscle mass, water retention, etc.

The other factor is that you can be 'missing' some calories of intake. While you are working, for example (although I think you DO need to get enough calories while working). I eat out sometimes, calories unknown. I glug oil into the pan when I cook, but never measure it to be a tablespoon... being a little generous there adds up.

Most people on more than 500 calories deficit per day get pretty hungry. So I doubt you are at -900 calories. You are probably at somewhere less than 500 calories deficit overall, and losing weight at < 1 lb/wk, and haven't noticed it yet.

Do you use a fitness tracker to estimate your calorie consumption, esp when you are working. Mine tells me I need 3000 calories on days I walk a lot.

For the record, I am NOT recommending that one count calories to lose weight. I am just answering what I think was your question.

For myself, I noticed that I have a problem with portion control, and to a lesser extent with snacking. For me, what has been most useful is using more dishes. If I want potato chips, I don't eat them out of the bag... I pour a serving into a bowl. If I want (vegan) ice cream, I don't eat it out of the tub, I scoop it into a (tiny, ramekin-sized) dish. I now eat bananas and mixed nuts as snack foods (I keep both at work). The former is naturally portioned, the latter I should meter somehow (instead of eating half the can).

At dinner time, I try to limit 'seconds' and really limit thirds (of calorie dense foods). Low calorie foods, like the non-starchy veg I have at every meal I can eat in vast amounts, crowding out the more starch and protein rich foods. I can eat a whole head of cauliflower (or equivalent broccoli) steamed, or a huge amount of brussel sprouts. In the old days, stuffing myself with omnivore foods, I would feel overfed for hours afterwards. Now, if I stuffed myself JUST with low calorie veg, I would be hungry a few hours later (I don't do this). So I stuff myself with a mix of calorie dense (vegan) foods and low calorie cooked veg, maybe 30-70 ratio. And the felling of being stuffed passes quickly and I am just comfy and sated until bedtime (or my next meal).

So, except for those adjustments of portions, snack options and caloric food proportions, I otherwise eat ad libidum. The portions and mix become automagic/habitual, so I just feel like I am eating ad lib without thinking or worrying about what I eat. I am not on a diet. I am eating.

On my old 'flexitarian' diet eating ad lib with some portion control, I ran about 202 lbs. On my current vegan diet eating ad lib, I am running 192, a 5% drop, or 1 BMI point, to about 25 versus 26 before.

I am currently planning on doing a little bit more mindful portion control (for a few months) to try to drop to 185 or maybe lower. My 'college weight'.

 

[Poindexter]

@woodgeek , yes, I could possibly have been more clear.

1. Given I lost two pounds in the trailing two weeks I 'rewarded' myself today with a big heaping bowl of shrimp and grits. I used to love this dish. I mixed some cannelloni beans in with the corn grits to construct a complete plant based protein in the bottom of the bowl. I selected a cold water shrimp. I selected a Texas based beef sausage featuring only ingredients I can reasonably pronounce and buy. I used two kinds of cheese made only from milk, salt and enzymes. I had plenty of scallion and parsley for garnish.

The taste was fabulous, the satiety was surprisingly low, and I did not get the expected hit of I think serotonin that I ordinarily expect from my 4 trillion pets. I was tired, but when I lay down I couldn't sleep, so I got up, felt tired, lay down, couldn't sleep again. I seem to be in a healthy enough state that a plant based diet is becoming more and more attractive.

2. I watched the documentary "What the Health" on Netflix this afternoon, after my "not nap". It was my first returned search result when I searched on "fast food." If you have seen it, would you rate this documentary A) worse than being uninformed B) Possibly useful or C) probably pretty right on, or D) some other opinion. My first take away is I did not perceive any factual errors, but I freely admit my knowledge of human nutrition is dated.

So coming back around and trying to restate the question. I had lab work in Feb 2023 and saw my doc in Feb 2023. My doc is ecstatic with my lab work. I am cleared to continue making rational choices about my diet. I feel my fundamental nutritional needs are met with 10 servings of veg and 3 servings of protein daily, but I am short ~900 calories for energy. I tend to only one or two servings of fruit daily, but try to avoid white fleshed fruit like apple/pear/ banana and gravitate towards raspberry, blueberry and elderberry.

I am getting the other 900 daily calories. I have been at this for about 5 months. Early on I was demolishing home canned potato. I am real close to 300g of drained potato in one home canned pint jar, for about 300 cal with some flavorful sauce on there, done. My pants weren't fitting right, so I had a brief dalliance with durum wheat pasta and the fit of my clothing got even worse. What happens as the lower end of my apple shape moves south from my belly button towards my pubic bone, even with my weight not changing, my drawstring work pants ride lower and lower on my hips. Eventually the hem of my pants starts getting hooked on the heel of my shoes and irritating the living fire out of me when I am trying to concentrate.

From there I moved to whole grain (red/ purple/ black) rice and about a week after that my 4T pets hits some kind of plateau. My apple shape is currently northbound instead of southbound. My pants aren't catching on my shoes. However, I am just about bored out of my mind with whole grain rice/ lentils and a sauce with the change up diet item being whole grain rice/ chickpeas and some kind of sauce.

I am going to try soup beans and cornbread as a plant based item that might qualify as a complete protein, given corn is "a grass". Once I splash enough tabasco on there I can choke some down. I am not using soda pop or pepperoni to meet my caloric needs.

I am specifically looking for other ways to get those other 900 calories daily, without undoing the good work I have already done.

One option might be to continue to diversify my menagerie to better process wheat and potato; I also notice the glycemic index for whole grain rice, lentil and chickpea are down in the moderate range, while wheat and potato are high glycemic index fuel sources.

I do appreciate your willingness to let me pick your brain. Thank you.

 

[woodgeek]

As for 'what the health'... I think the science content is aok. And the corporate conspiracy stuff... seem plausible enough. The USDA is not guarding our health. The AHA is doing pretty ok, but seems to be toothless.

Read about the McGovern Board in the 1970s. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910043/

Bottom line: the McGovern Board was for nutrition what the Surgeon General's report was for smoking. But the Food Companies were ready (having seen what happened with tobacco a decade earlier). The Board findings were watered down, and the government recs shelved. The USDA and food industry shills were put in charge. Then the mighty misinformation wurlitzer got spun up, and our diets got worse for the last 50 years rather than better.

---------

As for 900 calories, get some more calorie-dense plant foods. Some people like sweet potato. I am a fan of wheat/legume blend pasta... like Barilla protein plus. I make my quinoa into a pilaf mixed with brown and wild rice with veggie broth and vegan butter.

The boredom is likely the bigger challenge to diet sustainability. You need to get sauces... I put together several pasta sauces (pomodoro, bolognese, tomato+butter+onion), some curry type things, etc. I also have a palette of beans: black 'refried' style (on whole wheat tortillas), vegan chili and cannelli bean soup. Then there is still middle eastern hummus and tahini, etc, which I can eat with whole wheat pita or crackers.

I can then have the sauces or beans on pasta or quinoa pilaf, combined with cooked veg in about 4.6 billion combinations.

I got bored of raw crucifers... so now I toss them with chopped onions/shallots with a little EVOO and roast them in a toaster oven.

I also eat several avocados (or a half dozen minis) per week. As a topping on the above, or on toast (with a layer of hummus on the bread too).

The whole thing is evolving towards buddha bowls. I still need to eat more greens.

One simple guideline I have read is to try to keep fiber to 20% (or more) of total carbs on 'prepared foods' like crackers, breads and pasta. IOW, the ratio of total carbs to fiber carbs on the label should be close to 5 (or lower). I still eat stuff that is a 6 or 7, figuring the piles of veg even things out. But I avoid 10 and higher products (like white bread and pasta, etc). You will absorb the starch before it gets to the colon... so you will still be adding a bit more fiber in the extra 900 cals. Ideally I would be picking based on low glycemic index (fiber content is a poor proxy for this), but I don't have that data handy.

 

[woodgeek]

1. Given I lost two pounds in the trailing two weeks I 'rewarded' myself today with a big heaping bowl of shrimp and grits. I used to love this dish. I mixed some cannelloni beans in with the corn grits to construct a complete plant based protein in the bottom of the bowl. I selected a cold water shrimp. I selected a Texas based beef sausage featuring only ingredients I can reasonably pronounce and buy. I used two kinds of cheese made only from milk, salt and enzymes. I had plenty of scallion and parsley for garnish.

The taste was fabulous, the satiety was surprisingly low, and I did not get the expected hit of I think serotonin that I ordinarily expect from my 4 trillion pets. I was tired, but when I lay down I couldn't sleep, so I got up, felt tired, lay down, couldn't sleep again. I seem to be in a healthy enough state that a plant based diet is becoming more and more attractive.

Don't want to derail the thread into vegan propaganda, but.

The diverse 'healthy' microbiome that cranks out SCFA's that runs on fiber... that is presumably giving you some good effects (with the higher anti-inflammatories you are eating)... it doesn't like meat protein or meat fat. There are different bugs that eat meat protein and fat.

To celebrate the 30th anniversary of Jurassic Park, I will label the bugs like dinosaurs.... plant-eaters and meat-eaters

Unlike dinos, the meat eaters and plant eater bugs do not live together in harmony.... they tend to displace one another. This displacement process (antagonism is the opposite of synergy) is non-linear, meaning that if you eat a mixed diet (of plants and meats) you will tend to 'switch' at some amount of meat products. Where that level is varies from person to person (bc microbiomes are different) and probably depends on fiber content.

The dynamics of switching is 1-4 weeks after a dietary change. A lot of people increasing their fiber (or beans) are uncomfortable after a few days or a week, and 'give up' saying 'didn't work with my system'. They didn't wait long enough.

It makes sense that you upping your fiber content (significantly) got you to a plant eater microbiome, without elimination (or near elimination) of meat from your diet. That is lucky. But you are probably dancing near the line. If you take your meat consumption a bit higher than currently, or fall off the fiber wagon a bit... then you might lose your happy serotonin pets and SCFAs.

We can imagine a x-y axis kind of plot, with fraction of meat consumed as the x axis from 0 to 100%, and the y axis is fiber in grams/day. The y-axis (which is a vegan diet) spans from low fiber (junk-food vegan) near the origin, to whole food vegan at the top of the y-axis (high fiber). Carnivore diets (low in fiber) would be on the lower right corner.

So, to have a diverse (plant-eater) micro-biome, you need to be towards the upper left; if you move to the lower right you will get a meat eater microbiome (also called dysbiosis).

Antagonism means that the 'line' between the two is pretty sharp, and where it lies in the plane is different for different people. You are in the middle somewhere (omnivore diet + high fiber), and appear to be above your personal line.

The flip side of this (no doubt simplistic) picture is that you are not going to get MORE of a + response by further upping your fiber or decreasing your meat. You 'flipped' your microbiome (crossed the line moving upwards by increasing fiber), and entered a 'good' state. Going higher (or to the left) might not do much more in the + direction. Conversely, if you lose your current state, the solution would be to up the fiber, cut the meat some, or both.

Ofc, there are healthy benefits of a whole food plant based diet that go beyond microbiome effects, which likely WOULD get better with a more vegan diet direction (dose dependent), but if your doctor is happy with your blood work, I will not confuse this thread with that info.