Can you believe it’s already 2019? Time sure flies when you’re having fun. When I was a child, the days seemed interminable, but now I’m a seasoned senior, I can’t seem to find enough hours to do everything I have in mind. I’m either slowing down or time is moving faster. I’m thinking it’s the former! Or there’s some weird Doppler effect that falls around our aging bodies, but doesn’t affect the younger generation among whom we live. Then again, I may have just decided to live at a slower pace because I want to and I no longer am constrained by outer forces such as schedules, paychecks, or responsibilities.
CAN WE TEACH AN OLD DOG NEW TRICKS?
A new year is always a good time to turn over a new leaf. Contrary to popular myth, a dog’s capacity for learning generally doesn’t decline during the aging process. In fact, older dogs may have a more developed attention span than puppies, which can actually make the training process a little faster. They might need extra training to unlearn bad habits, but they can acquire good ones in their place.
KUNG FU MASTERS
Since human beings are smarter than dogs, we can all change behaviors that drive us or our loved ones to distraction. As a survivor of decades of broken resolutions, I think picking one specific behavior on which to focus is better than choosing a general goal, such as “I’m going to get healthy this year.” This overgeneralized goal has too many moving parts to it. Bruce Lee, or some Kung fu master, might be able to pick a whirling ninja throwing star out of thin air in mid spin without slicing off any bodily appendages, but we ordinary mortals will be riding in a speeding ambulance, hoping for a five star surgeon at the end of the route.
SHORT TERM GOALS
When I sold insurance, I would focus each week on a specific goal. For one week only, I would be the best cold caller, and the next I’d give the best service, followed by the next week of setting the most future appointments, and the next week of closing sales. In a month, I’d hit every skill and then I’d repeat the cycle. I was always fresh, always excited, and had a short term goal to accomplish on the way to the long term goal of making a living helping people while being paid on commission.
MAKE LONG TERM GOALS INTO SHORT GOALS
Many of us work in occupations with long term goals. These are difficult to meet, but having short term goals along the way to celebrate helps us keep our attitudes positive. When we look at the long year looming ahead, we might be overwhelmed. It we take one day at a time, or a week at the most, Life is more manageable. If we want to “be healthier,” we can chop this goal into several parts:
1. Sleep 7-8 hours per night
2. Drink 8 glasses of decaf non-sugared liquids a day (half water)
3. Eat more fiber, vegetables, and whole grains
4. Eat less processed foods and more home cooked foods
5. Exercise 30 minutes to an hour daily or a minimum of 150 minutes weekly
6. Reduce our sugar intake (sweetened beverages)
7. Quit smoking or reduce our nicotine use
8. Limit our alcohol to 1 drink daily for women or 2 drinks for men
If we were to attempt this entire change all at once, we might last at most a week, unless we were under lock and key, or offered a giant reward in some “Survivor: New Year’s Resolution Island” spin-off. However, we could achieve at least one of these goals if we worked on them just one week at a time. If we make to week 8, we can feel comfortable adding in some of the other week’s behavior goals, but not all at once, when we go for months three and four. The whole purpose is to change and transform a person, not to institute a structure from the outside which they will resist or reject the moment life gets in the way.
THE ART OF PICKING A GOAL
Trust me, at some point in 2019, life will throw a monkey wrench into the best laid plans of everyone. It always does. This is when we discover if we’ve made new habits, or if we’re just play acting. By Valentine’s Day, 80% of New Years resolutions will lay beside the road of good intentions. I think this isn’t because we are failures, but because we pick the wrong resolutions. Pick a small, achievable, and measurable goal instead.
“Losing weight” is a lesser goal, since it is measurable, but it may not be achieved in a healthy manner. Drinking red pepper water isn’t healthy. Eating only 500 calories a day isn’t healthy. We have to eat enough to cover our basic metabolic needs.
“Writing an hour a day” is measurable and attainable, and it serves a purpose. We don’t have to be paid for everything we do. Our spiritual and mental health may depend on this hour well spent! Whatever goal you pick, give yourself permission to come close on most days and to try your best on all days.
GOALS AND GRACE
Some days the monkey wrench will mean 25% is all you can give as your best. Give yourself permission to celebrate achieving that much, pick yourself up, and try with God’s help for better tomorrow. We always get a fresh start at the dawn of a new day, for each sunrise is a new beginning, as if it were the first day of the rest of your life. Therefore, every day is a little new year, for there’s 365 days to follow it! Rabbit! Rabbit! Happy New Year!
Joy and Peace, Cornelia
Archaic Torso of Apollo
By RAINER MARIA RILKE, 1908
We cannot know his legendary head
with eyes like ripening fruit. And yet his torso
is still suffused with brilliance from inside,
like a lamp, in which his gaze, now turned to low,
gleams in all its power. Otherwise
the curved breast could not dazzle you so, nor could
a smile run through the placid hips and thighs
to that dark center where procreation flared.
Otherwise this stone would seem defaced
beneath the translucent cascade of the shoulders
and would not glisten like a wild beast’s fur:
would not, from all the borders of itself,
burst like a star: for here there is no place
that does not see you. You must change your life.
Rilke was secretary to the artist Henri Rodin in 1905-1906.
From Ahead of All Parting: Selected Poetry and Prose of Rainer Maria Rilke, translated by Stephen Mitchell and published by Modern Library. © 1995
This is the Japanese zodiac year of the Boar. Instead of my usual rabbits, I’m celebrating with a poem in homage to Ancient Greek art as well as Japanese art with New Year themes.
Toyohiro Utagawa: Tai no yume Ebisu no soroban or The red snapper’s dream: Ebisu using an abacus.
Cold and grey weather in December makes me want to bake in the kitchen. I must have my mother’s DNA for sure, since some of my fondest memories are of her up to her elbows into a giant mixing bowl as she stirred together the various candied fruits and nuts for the fruit cake cookies and loaves she produced in mass quantities every Christmas.
This recipe also had a significant amount of cheap whiskey in it, so when I was preaching in small towns in Arkansas, I usually let one of the ladies of the church know of my need. “Don’t you worry,” they’d tell me, “we’ll make sure this gets covered.”
A few days later I’d be invited over to this kind lady’s home for lunch. She’d have a Christmas gift for me. Inside the colorful bag would be a small flagon, double wrapped in a brown paper bag. “You don’t have to tell anyone where you got it. That’s a secret, just between you and me.”
I’d nod and smile. Christmas has always been time for secrets. My parents would hide presents up in the attic until we got big enough to pull the rope for the hidden stairs. Then they hid the gifts in the trunk of my daddy’s black Pontiac. I never knew why we weren’t able to find the keys. When we were truly old, my folks managed to keep the Christmas secrets by gift wrapping the presents at the store before we came home from school.
One of the mysteries of Christmas I discovered along the way was Santa could write as elegantly as my daddy, but I never told anyone else. After all, I had two younger siblings and I wouldn’t want to spoil his visits for them! This recipe makes a Spicy Sweet Nut and Seed Mix for snacks. You can vary it infinitely and even use it as a base for a Chocolate Bark recipe. It’s great for a share party.
4 cups unsalted, roasted whole nuts (almonds, pecans, pistachios, and walnuts)
1 cup seeds (I used pumpkin, quinoa, and sunflower)
1/4 cup agave
1 tablespoon unsalted butter
1 teaspoon red-pepper flakes
1 Tbs brandy
227 grams chocolate chips (1 cup)
1 teaspoon kosher salt (divided)
1 teaspoon turbinado sugar
Heat the oven to 325 degrees and line a large baking sheet with parchment paper. In a large bowl, combine the nuts and seeds.
In a microwave-safe bowl, combine agave, butter, red-pepper flakes and ½ teaspoon salt. Microwave until the butter has melted, about 30-40 seconds. (Alternatively, you can melt the mixture in a small saucepan on the stove.)
Pour the butter mix over the nuts and seeds, and stir until well coated. Dump onto the prepared baking sheet and spread in an even layer. You want the nut mix spread out as much as possible.
Bake, stirring occasionally, until the nuts are tacky and look and smell toasted, 20 to 25 minutes. Remove from the oven and immediately sprinkle over the remaining 1/2 teaspoon salt and all of the turbinado or dark brown sugar. Let cool on the baking sheet, then transfer to a bowl and serve (or transfer to an airtight container, where they’ll keep for up to 4 days).
As I enter yet another decade of Thanksgiving, I’m most thankful for my health. Once a person enters “senior status,” good health means “managed diseases.” My young friends often whine about the difficulty of taking a single prescription per day. I just laugh, for they don’t know what truck will hit them after age 50! Most people my age have pill minders or get theirs in daily prepared packaging ready made.
One health condition that can’t be standardized is the blood glucose reading, unless you qualify for a new 24 hour wearable monitor. Otherwise you do the stick and read at different times of the day. If you’re like me, keeping track of the blood sugar readings gives you a window into your body’s response to your food choices and your commitment to an exercise plan.
I have prediabetes, so I measure my glucose in the morning and before I go exercise. My doctor says the morning should be under 100 and the preexercise reading needs to be over 100 if I’m going for anything more vigorous than a gentle walk. I don’t yet have the high readings because for 14 years I’ve eaten a Mediterranean diet and exercised daily. I still eat around 2000 calories per day, so I’m not starving myself, since my BMR is 2060.
Would they like me to lose weight? Yes, and so would I, but my blood pressure is finally normal without medication, my arteries are clear, and my depression is in remission due to medication and lifestyle commitments. We have to pick the battles we want to fight. If our weight is fat, our bodies will metabolize food differently than if our weight is muscle. Weight bearing exercises such as walking, lifting weights, or climbing stairs, will build muscle over the long haul.
When I first started walking, I couldn’t make the whole way around a city block without stopping for breath, I was so out of shape. I set a smaller goal, mastered it, and made a bigger one. I can walk a 5K now, and even if I’m the last to finish, I still am faster than everyone who didn’t enter the race. Keep a positive attitude!
Health isn’t a number on the scale or a size of clothes into which you fit. Health is more about reclaiming your positive attitude towards food as nourishment for your body, rather than as a sedative for your emotional distress. I’ve been in this place myself. I never met a chocolate donut that wouldn’t soothe my inner angst, only to give me eater’s remorse afterwards. It was a downward, addictive spiral, for I’d eat again to feel better, only to feel icky once more.
Health is also about leaving behind the bad habits that bought on high blood pressure, high blood sugar of type 2 diabetes, and prediabetes: stress, excessive caffeine, and processed foods. These foods are the heart killer trifecta of the Standard American Diet—fat, salt, and sugars. These show up in our processed meats, dairy products, and bakery goods, not to mention our condiments and desserts.
Just as we learned negative habits, we can learn positive behaviors. We don’t have to change everything all at once, but we do need to begin somewhere, sometime. Perhaps the holidays seem to be the worst time, with all the extra cooking and treating surrounding us. If we pick one behavior each week, such as measuring our food portions this week and not eating second helpings the week of Thanksgiving, we’ll be on the way to a healthier lifestyle!
Remember the words of Paul in 1 Thessalonians 5:16-18–
“Rejoice always, pray without ceasing,
give thanks in all circumstances;
for this is the will of God in Christ Jesus for you.”
SEE SLIDES ON WHAT AFFECTS YOUR BLOOD SUGAR READINGS
Have you readied your costume for the annual Trick or Treat event? I saw folks shopping for costumes as early as mid September, for both adults and children. Most of these garbs aren’t scary at all, unlike the one worn by the ghosts and ghouls of ancient lore, by which I mean my neighborhood companions and I.
We protect children today from such horrors, but back in the 1950’s, ritual exposure under adult protection was considered part of growing up. A very small child dressed as a ghost with a pillowcase over her entire body. Only the eyes and mouth holes were cut out, plus a slit in the front for holding the basket of treats. The shifting nature of the pillowcase was part of the plan—the child couldn’t race to the next house in the dark or the eyeholes would slip and then they’d slip too. I never realized how cunning my parents were.
LET THE HARVEST FESTIVALS BEGIN
Halloween is the official beginning of the harvest festival season in America.
First is the Chocolate Candy season, also known as Trunk or Treat in the church. Then 22 days later is Thanksgiving, a day given over to cooking and eating, with leftovers for a week afterwards. For the next month until Christmas, cookies and homemade treats roll out of our kitchens as if we were our grandparents. Once the New Year arrives, even if we make a resolution to stop this madness, we get an invite to a Super Bowl party on February 3rd, 2019. This is all happening in less than one hundred days (95).
We do this in addition to our regular lives, of course, for we don’t let anything go. No, we merely pile stuff higher and the wonder why it collapses. It’s called the Western Life Style.
LIFESTYLE POSTER CHILD
The main negative features of this lifestyle include stress (long-term and continuous, psychological), positive energy balance (excessive energy intake and low physical activity), low-quality food (both high fat and energy dense, and at the same time poor in micronutrients), and disruption of chronobiology(insufficient sleep). What toe have I not stepped on yet? As my old congregations used to say, “At first you were preaching, but now you’ve done gone to meddling!”
WESTERN LIFESTYLE DEADLY
As countries around the world adopt the Western Lifestyle, rates of metabolic syndrome and diabetes are also increasing. For 2017, the International Diabetes Foundation estimated there were 451 million (age 18-99 years) people with diabetes worldwide. These figures were expected to increase to 693 million by 2045. Almost half of all people (49.7%) living with diabetes are undiagnosed. Moreover, an estimated 374 million people are likely living with impaired glucose tolerance (IGT) and almost 21.3 million live births to women were affected by some form of hyperglycaemia in pregnancy.
In 2017, approximately 5 million deaths worldwide were attributable to diabetes in the 20-99 years age range. The global healthcare expenditure on people with diabetes was estimated to be USD $850 billion in 2017.
DISTURBANCE IN THE FORCE
“An acute disturbance in any of the physiological regulatory systems evokes reactions that tend to reestablish equilibrium. When the stimuli, even of moderate magnitude, tend to be repetitive or chronic, change and allostasis in one system impact on the other, and vicious cycles are created and reinforced.” The plain language translation is our bodies tend to seek equilibrium. If we lose weight, our bodies try to regain it. The vicious cycle many of us are most familiar with is losing the same amount weight over and over again.
THE FOOD WE EAT
Does what we eat make a difference? Every day a new diet fad comes down the pike, or at least a new packaging of an old one trots out for us to ride it for a while. Then we fall off that horse and look for another, with more appeal (cookie diet, anyone?).
Our food choices interact with our genetic, metabolic, and environmental factors. In obesity and metabolic syndrome, often dietary patterns are considered of central importance. In these, attention has been focused over calories, amounts, and proportions of macronutrients, and their effects on the energetic balance by themselves, and through metabolic regulators. You recognize this in the shorthand “calories in/calories out” slogan.
However, obesity, metabolic syndrome, insulin resistance, and diabetes are way more complex operations than mere subtraction. A calorie isn’t just a calorie. That is, not all calories are created equal, although all whole foods have nutrients. Only recently have the acute effects of food ingestion, taking into consideration the type of food, and the specific effects of some nutrients, namely, fatty acids, began to be studied in relation with obesity and inflammation.
INFLAMMATORY ROLE OF FATS
Total dietary fat and saturated fat are associated with insulin resistance and high blood pressure as well as obesity-related inflammation. An immediate postprandial increase in plasma inflammatory markers after a high-fat meal had been shown in abdominally obese men. Consumption of a saturated fatty acid-rich diet resulted in a proinflammatory “obesity-linked” gene expression profile, whereas consumption of a monounsaturated fatty acid-rich diet caused a more anti-inflammatory profile. This means carnivores eating well marbled steaks every day aren’t doing their bodies long term good, but of course they’re too busy being important to have a real doctor test their blood. And they “feel fine.”
MUFA’s are foods and oils with higher amounts of monounsaturated fats, such as Nuts, Avocado, Canola oil, Olive oil, Safflower oil (high oleic), Sunflower oil, Peanut oil and butter, and Sesame oil. Everyone needs some fat in their diet, for it keeps our skin smooth, our hair lustrous, and our appetite satisfied. We don’t need fried foods or animal fats on a daily basis.
LIVER AND FAT STORAGE
The liver has two functions that directly impact the formation of excess fat: metabolism of carbohydrates (sugars) and digestion of lipids (fats). When we consume carbohydrates, our blood sugar rises, triggering a rise in insulin. That rise in insulin signals our liver to begin storing the excess glucose within its own cells. When the liver is full, it begins storing the excess carbohydrates as fat in our body fat. Sometimes that fat begins to accumulate in the liver cells, and the liver becomes fat.
Similarly, when we consume more lipids that the body can use for energy, the liver stores the excess lipids in body fat, and this excess of lipids can begin to accumulate within the liver as well. Whether the excess of food is made up of carbohydrates (sugars) or fat (lipids) —the liver stores the excess energy for future use. Often this results in excess fat accumulating in the liver itself. This is known as Fatty Liver, the first stage of NAFLD and should be viewed as a warning to change unhealthy lifestyle habits and adopt a low carbohydrate and low fat diet that is high in fresh vegetables and lean proteins.
TAKE OUT BOX
We need to eat enough quality nutrients to lose weight. Starving ourselves won’t do it, since this messes up our metabolism. Eating the good food, complex carbohydrates with fiber, for instance, and lots of vegetables full of water (spinach, zucchini, mushrooms) will help us meet our nutritional goals. Foregoing fried foods, highly processed foods, and fast foods will also improve our health. Exercise every day, if just to walk around the block. I sometimes fail on this. But I find a way to move more around the house or do big muscle chores.
Time—we all have the same amount of it. What we do with it is the important thing. If I add an event to my schedule, something else has to go away. I’m not Wonder Woman. I’m not God. I might be Batgirl. I can’t do ALL things through Christ who strengthens me, but I can do all the IMPORTANT things Christ calls me to do in his power.
Below I’ve made some notes on the role of obesity, free fatty acids, and insulin resistance if you want more information. The link below has an excellent paper if you want to dig deeper. Low grade inflammation and free fatty acids are both implicated in NAFLD, non alcoholic fatty liver disease, which occurs when fat is deposited in the liver.
OBESITY AND INSULIN RESISTANCE
The reason why obesity is associated with insulin resistance is not well understood. Obesity is a condition characterized by an increase of body weight beyond the limitation of skeletal and physical requirements, as the result of excessive accumulation of body fat.
NOT A ROCK BAND
Free fatty acids (FFA) cause both insulin resistance and inflammation in the major insulin target tissues (skeletal muscle, liver and endothelial cells) and thus are an important link between obesity, insulin resistance, inflammation and the development of T2DM, hypertension, dyslipidemia, disorders of coagulation and ASVD.
FAT TISSUE: FACTORY AND WAREHOUSE
Adipose tissue not only stores and releases fatty acids but also synthesizes and releases a large number of other active compounds. According to this concept, an expanding fat mass releases increasing amounts of compounds such as FFA, angiotensin 2, resistin, TNF-α, interleukin 6, interleukin 1-β and others. Some of these compounds, when infused in large amounts, can produce insulin resistance.
However, any substance, in order to qualify as a physiological link between obesity and insulin resistance, should meet at least the following 3 criteria:
0. the substance should be elevated in the blood of obese people;
0. raising its blood level (within physiologic limits) should increase insulin resistance and
0. lowering its blood level should decrease insulin resistance.
So far, only FFA can meet these 3 criteria in human subjects.
Plasma FFA levels are usually elevated in obesity because
0. the enlarged adipose tissue mass releases more FFA and
0. FFA clearance may be reduced
Moreover, once plasma FFA levels are elevated, they’ll inhibit insulin’s anti-lipolytic action, which will further increase the rate of FFA release into the circulation.
The liver is more insulin sensitive than skeletal muscle.
FAT PILLS ARE REAL
Nevertheless, there is convincing evidence that physiological elevations of FFA, such as seen after a fat rich meal, inhibit insulin suppression of hepatic glucose production (HGP) resulting in an increase in HGP (1).
Acutely this rise in HGP is due to FFA mediated inhibition of insulin suppression of glycogenolysis or releasing glucose from carbohydrates.
Longer lasting elevations of FFA, however, are likely to also increase gluconeogenesis, or making glucose from non carbohydrate substances.
Chronically elevated plasma FFA levels, as commonly seen in obese diabetic and non-diabetic individuals, also cause insulin resistance.
GENES AREN’T OUR DESTINY
We know there’s a genetic component linked to the UCP3_HUMAN or mitochondrial uncoupling protein 3 and 2. Healthy pancreatic β-cells are poised to respond rapidly and efficiently to acute changes in circulating nutrient availability to maintain metabolic homeostasis.
CHRONIC EXPOSURE TO OVERNUTRITION
However, it is well recognized that chronic exposure to overnutrition, such as what occurs in obesity, results in a blunting of the insulin response to an acute stimulus.
Whatever its origin, be it or not obesity the main initiator, the chronic low-grade inflammatory condition that accompanies the metabolic syndrome has been implicated as a major player in both the installation of the syndrome and its associated pathophysiological consequences.
WEIGHT LOSS HELPS INFLAMMATION
In good agreement with this interpretation of things, weight loss of obese patients is repeatedly verified to be associated with a decrease of inflammation biomarkers accompanied by improvement of metabolic parameters, namely, insulin sensitivity.
Monteiro, Rosário, and Isabel Azevedo. “Chronic Inflammation in Obesity and the Metabolic Syndrome.” Mediators of Inflammation 2010 (2010): 289645. PMC. Web. 11 Oct. 2018
Diabetes Impact on World
Why do we choose the food on our plates? Some of us eat traditional foods from our childhoods, our cultures, or our homelands to connect us with our history and our stories. Others of us may choose alternative menus, to change our story line or to rewrite a troubled or fraught past. In this way, “what we eat proclaims who we are,” even as it nourishes the person we are becoming in the flesh.
Yet the extreme carnivore fat shamers have no problem what so ever in singing the praises of a huge, fat riddled hunk of ribeye steak, preferably rare, and eagerly devoured as a testimony to their peak powers and dominance traits. They often mention bitcoin’s luster or their own wellness ventures if the conversation goes much past hello. I’ve often wondered if the inanimate aspect of the slab on the plate allows them to connect more deeply with their food than they can with an actual human being, who has feelings and might speak back. Better to devour both of these, and stay unaffected by the outer world’s complexities.
However, the world always intrudes. We find no sanctuary, for we tear down the very walls which we build about ourselves. If we choose the extreme course, we’re on a path to self destruction, unless we change our lives. The ancient Greeks were wise to say, “The middle path is safest and best.”
Our choice of menus, diets, or eating plans is also a form of tribal signaling, as we send out signs for others to recognize and to respond accordingly. Fat shaming is a negative form of signaling by those who overvalue outward appearances. Those whose bodies are overly generous in size need to disregard this crowd’s disgust. Instead, discovering their personal value and worth is more important so they can be proactive about their own health. To enjoy life, to live as well as possible, and to be a blessing to our family and the community, is important for each of us.
WHAT IS TRUTH?
With all the competing claims out in the world today, how can we know what is truly healthy for the long haul? Since anyone can get on the internet and make any claim they want, until someone gets hurt and the legal process shuts their scam down, how do we sort out these “Truth Claims?” The accepted way is a RCT, or randomized controlled trial, which enrolls a large number of persons and follows them over many years. This is the “gold standard” of science, rather than “I use it and it works for me, plus listen to these testimonials!” In between is the single paper, not published in a major journal, with only a small sample of 50 to 100 subjects studied for a brief period. (If someone still believes “all these truths are equal,” I may know a friend with a friend with seashore property in Arizona to sell you, but I’d recommend a lesson in logic first.)
The Lancet Public Health Journal, August 18, 2018, published a major prospective cohort study and meta-analysis of dietary carbohydrate intake and mortality. The study followed nearly 16,000 adults in 4 different US communities for 25 years and they added in published research results from 7 multinational prospective studies. They did some big number crunching, so if you want to read the whole paper, the link is at the bottom of the page. It is a real RCT study, and deserves space for commentary.
MORTALITY AND FAT SOURCE
As the wag says, “men live longer if they don’t mention the extra weight their sweet cake is carrying on her hips.” It must be true–Neil DeGrasse Tyson’s photo is connected to this quote (meme worthy, for sure!).
When my mother made meatloaf, it had breadcrumbs and an egg to bind it together. She laid two strips of bacon on top of the loaf in the pan so it would get extra flavoring. Today people wrap the entire meatloaf in two pounds of bacon before they grill it on the outdoor BBQ pit. That pork fat goes into the food we eat and stays in the arteries to clog those vessels. We might be able to live higher on the hog than our parents, but we won’t live longer, not even with a good medical plan.
LIFE EXPECTANCY AND INCOME
Fifty years has passed: we eat worse, exercise less, and we our life expectancy has quit increasing. Back in 1966, men and women could live on average to age 67 and 73. Now those numbers are 76 and 81 in 2016. Back in 1933, men could expect to live to age 61 and women to 65. At least we aren’t going back to those “really good old days” when life was harsh, medicine lacked modern advances, and sanitation was poor.
Today poverty often impacts life expectancy due to food deserts in neighborhoods, lack of health insurance, and low incomes. The wealthy live longer. The poor in some cities — big ones like New York and Los Angeles, and also quite a few smaller ones like Birmingham, Ala. — live nearly as long as their middle-class neighbors or have seen rising life expectancy in the 21st century. But in some other parts of the country, adults with the lowest incomes die on average as young as people in much poorer nations like Rwanda, and their life spans are getting shorter.
CHOOSE YOUR FAT WISELY
This Study of Dietary Carbohydrate Intake and Mortality explored how the source of fat affected deaths in the group. The more meat fat a person ate, the more it impacted their life span for the worse (table 2).
The low-carb group was split into two separate groups:
1. The plant-based low carbohydrate dietary score was associated with higher average intake of vegetables but lower fruit intake (appendix p 11).
2. By contrast, the animal-based low carbohydrate dietary score was associated with lower average intake of both fruit and vegetables (appendix pp 9, 10).
3. Both low carbohydrate diets were associated with higher fat intake in exchange for carbohydrate, although the plant-based low carbohydrate diet had higher average polyunsaturated fat and lower saturated fat intake compared with the animal-based low carbohydrate diet (appendix pp 9–11).
ANIMAL FATS VS. PLANT FATS
People choosing an animal-based diet had an overall, higher, total protein intake. Five foods differed most significantly between the highest and lowest quantiles of animal-based and plant-based low carbohydrate dietary score (appendix p 9):
1. The animal-based low carbohydrate diet had more servings per day than did higher carbohydrate diets of beef, pork, and lamb as the main dish; beef, pork, and lamb as a side dish; chicken with the skin on; chicken with the skin off; and cheese (appendix p 10).
2. The plant-based low carbohydrate diet had more servings per day of nuts, peanut butter, dark or grain breads, chocolate, and white bread than did higher carbohydrate diets (appendix p 11).
3. Both low carbohydrate diets were lower in average regular soft drink intake (appendix pp 10, 11)
DEATH BY GIANT RIBEYE STEAK
Exclusionary diets, unless for medically necessary reasons, are not the best choice. Just because we want to jump off a cliff doesn’t mean we should do this! Someone who wants to eat only white food, as my child did for a time, is going through a phase. An adult who won’t eat anything white is missing out on some food groups, or doesn’t want to spend the time learning about food. If we have time saving machines all around us, why don’t we have the time to care for our embodied selves in this spare time? Do we value our work more than the worker? This devaluation of people is a slippery slope to other ills, not only to self harm but to disparagement of others or outright hatefulness.
1. In the ARIC cohort and in meta-analysis, increased consumption of animal-based protein and fat instead of carbohydrate was associated with a significant increase in all-cause mortality (table 3). Eat more animal fat and die sooner.
2. Alternatively, increased consumption of plant-based protein and fat instead of carbohydrate was associated with a significant decrease in all-cause mortality (table 3). Trade animal fats for healthier plant fats from nuts and seeds, such as olive oil. Use in moderation.
3. The animal and plant-based findings were consistent for cardiovascular and non-cardiovascular mortality (appendix pp 3, 4). Both heart disease and other diseases are made worse by animal fats. Let’s eat leaner, greener, and add more plants into our menus.
4. Similarly, in the meta-analysis, mortality increased when animal-derived fat and protein were substituted for carbohydrate, and decreased when these substitutions were plant-based (table 3). Eating more plants would do us better.
THE SWEET SPOT
The model for carbohydrate caloric intake is about 50% of total calories per day. It seems to be a sweet spot for life expectancy. In the diabetes world, most of us work to control our blood glucose readings by diet, so many of us will reduce our carbohydrates until they’re minimal at best. We may get good readings on our glucose meter, but what about our heart health? We don’t have a home health test for this. Since people with diabetes also have high rates of heart disease, we need to think of our whole body as one interconnected system, and not focus only on one symptom. We are complex and wonderful, so finding a balance for our finely tuned instrument is important.
ALL CARBS ARE NOT EQUAL
What carbohydrates we choose are another factor. If we think a bag of potato chips is equal to a baked potato in calories and nutrition, we have another think coming. Learning to read nutrition labels might cure us of this delusion. In the meantime, avoiding the snack aisle at the grocery store can keep us from bringing this ersatz food product into our home.
In “Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association Clinical,” the trials that used polyunsaturated fat to replace saturated fat reduced the incidence of cardiovascular disease. In contrast, trials that used mainly carbohydrates to replace saturated fat did not reduce CVD.
CHOOSE CARBS WISELY
However, the types of carbohydrate-containing foods were often unspecified and typically included sugar and other refined carbohydrates to maintain energy balance. When carbohydrates from whole grains replace saturated fat, evidence from prospective observational studies indicates reduced CVD. The two best interventions for menu modification are DASH and the Mediterranean Diet.
The other way we can help keep our blood sugar in range is lifestyle modification. This is the most difficult of changes most of us have to make. Exercise, meditation, journaling, adjusting recipes, cooking meals, making menus, and setting a bedtime or wake up schedule all seems like too much at once. Of course it is! And if it were easy, everyone would be doing it, no one would blog about it, and there’d be no great 25 year long studies to tell us not to wrap two pounds of ground beef in two more pounds of fatback bacon.
Actually, Aristotle, the Ancient Greek philosopher, spoke about the “golden mean.” Moral behavior is the mean between two extremes: at one end is excess, and at the other deficiency. Find a moderate position between those two extremes, and you’ll be acting morally, or rationally. This was his goal in life.
If we were to pick only one of these lifestyle modifications per week to work on, then in the next, do another one the best we can, and do on in the following weeks. Soon we’d all be more comfortable with the routine, and all of us would be doing them all without even realizing it. This is how you sneak in your learning! Before you know it, you have a transformed life. No one waved a magic wand over you, but you grew into your grown up shoes slowly but surely.
Best wishes for a better life, with more exercise and more joy!
The Lancet Public Health Journal, August 18, 2018
Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association | Circulation