Within minutes of this paper’s release, my buddy, (and blog contributor) Dr. Jason Valadao texted me the link. I later replied with a thumbs up, two big hearts, gold trophy, and five eggplants emojis. This article is a big deal because The New England Journal of Medicine (NEJM) is the most highly respected medical publication in the world, just narrowly beating out JAMA, The Lancet, and DrJimmywestbrook.com. The NEJM’s recent extensive article on the many benefits of intermittent fasting (IF) marks a turning point in the study of health. It firmly puts tired statements like, “eat 6 small meals per day,” and “breakfast is the most important meal of the day,” in the same category as those old timey scientific proclamations, “smoking helps us breathe better,” “masturbation will make you go blind,” and “redheads don’t have souls.” This post is a very brief summary of the NEJM article, but not a how-to guide of IF. Here’s a link to the full NEJM article and here’s a link to my short guide to easy intermittent fasting.
Defining IF. The NEJM defines IF as, eating in a 6-8 hour window each day, with 16-18 hours of fasting (18:6 vs 16:8) or eating normally for five days per week and only eating one moderate sized meal per day on the other two non-consecutive days (5:2).
Daily Caloric Restriction (CR). Animal studies have repeatedly shown that calorie restriction extends the lifespan of animals, ranging from yeasts and worms to dogs, rats, and monkeys. The life extension can be dramatic, up to 80% in some cases and the restriction does not have to be lifelong. Even starting CR in older animals shows a huge life extending benefit.
This is the face of daily caloric restriction.
The problem is that daily CR can be miserable. These animals may live longer but they often seem to be praying for death, and there are side effects like brain shrinkage (seen in monkeys), depression, cold intolerance, decreased energy, and slow metabolism. Humans subjected to daily CR also start resembling Woody Allen, an unpleasant side effect indeed.
It seems that the benefits of CR may be a result of the restricted feeding time window and not the CR. In more recent experiments, animals were not calorie restricted, but their feeding was time restricted (IF) which showed the same life-extending benefits of CR, but is much easier for humans to follow and doesn’t have the unwanted side effects.
What Happens when we intermittently fast? IF obviously helps us lose weight, but so does Jenny Craig. So what’s the big deal? I’ll tell you. When we fast, our bodies switch fuels, from glucose to fats (in the form of ketones). This switching to ketones acts as a signal to the body to activate a host of anti-aging processes. IF allows for old, useless cells to be killed (autophagy), which doesn’t occur when we stay in a “fed” state, here’s a link to my article about it. Even better, after the old cells die, new young cells take their place. Studies show that the benefits of IF are independent of the healthy effects of weight loss and therefore IF is a good idea whether we are overweight or normal weight. Here are some more benefits of IF discussed in the NEJM article:
–Weight Loss: This seems obvious, but the type of weight we lose is also super important. Studies show that IF causes greater loss of body fat, specifically abdominal fat, resulting in a smaller waist circumference, as compared with caloric restriction.
–Maintenance of muscle mass. Keeping your muscle mass when you’re losing weight is important for metabolism, insulin sensitivity, and increasing your odds of waking up with attractive strangers. Studies show that IF is great for this as well.
–Heart Health. Decreased inflammation, blood pressure, and LDL (bad) cholesterol are all helpful for keeping your ticker healthy, and are coincidentally all documented benefits of IF. The subtle theme of this post is that IF is good for you.
–Brain Health. IF research has shown improvements in cognition, balance, coordination, and active memory, both in young people and in older folks with dementia. IF has shown promise (in animal models) to reduce the risk of stroke, Alzheimer’s, Parkinson’s, and other neurodegenerative diseases.
–Type II Diabetes. IF cures type II diabetes. That’s all I have to say about that.
–Cancer. As we age our risk of cancer increases exponentially. IF is shown to prevent cancer through many different mechanisms, but IF also shows promise in improving the survival of those with active cancer, and reducing the side effects of chemotherapy. Despite this new research, patients with cancer are often told to try to gain weight, and thus are discouraged from fasting, but I expect this will change soon.
–Other. IF has shown early evidence of benefit in rheumatoid arthritis, multiple sclerosis, asthma, traumatic brain injury, spinal cord injury, other inflammatory or autoimmune conditions, and the gum disease gingivitis. That last one may be bullshit.
Bear Avoidance is the most important
Dr. Jimmy’s Editorial Conclusion: So, why does IF help all these very different health issues? Here’s my take. Our single greatest risk factor for all of these diseases is age and IF fights the aging process. Our bodies don’t have a clock that keeps track of time in hours, days, and hockey seasons. Instead, our bodies age by detecting things like inflammation, nutrient consumption, cell divisions, and damage to our DNA.
IF reduces our body’s inflammation, strengthens our DNA, lowers insulin, and keeps things tight both at the cellular level and with regards to our midsections. Many people say that they don’t want to live to be 95 or 100. What if you feel amazing at 94, with a sharp mind, supple body, an active sex life (gross), and you just inked a sweet deal with a member of the Nigerian Royal family who needs five hundred dollars in order to access his family’s vast fortune which he will share with you? Cha-ching! Would you still want to check out at 95? I didn’t think so.
IF has shown that it can fix what ails us today and delay what is coming down the road tomorrow. Also IF is pretty easy, as well as being free. So instead of making the same doomed and clichéd New Year’s resolution to lose 30 pounds by joining a gym, counting calories, or cutting off a limb, start IF to lose the 30 pounds and in the process you may gain 30 years. Thank you for coming to my Ted Talk.
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If you answered “no” to any of the above questions, then that may be the issue, but if you answered “yes” to all and are still having trouble achieving your ideal weight, then it’s possible that chronic stress is holding you back. While this occurs in men, I see this much more commonly in my female patient population for reasons I do not fully understand.
Chronic stress activates our “fight or flight mode”, but for most of us, it never gets turned off. This is bad. Cortisol is our body’s chemical response to stress. Cortisol raises our blood sugar levels, and causes a host of other problems (see diagram below). Cortisol also causes us to hold onto our body fat when dieting or fasting, and our body’s only recourse is to slow our metabolism (fatigue) and burn protein (muscle) as fuel, both of which are bad. Chronic stress often leads to poor sleep, which leads to even higher levels of cortisol. I wrote about this here. To make matters worse, stress and lack of sleep both encourage stress eating. This makes stress a triple or even quadruple whammy (I lost track of whammies) in regards to our weight.
So why do we have chronic stress?
Our stress response evolved to help us survive when we were running from sabretooth tigers. We don’t have many sabretooth tiger encounters today, so why are we so stressed? My theory is that during ancient times the tiger encounters served to calibrate people’s internal stress meter. Stress levels were high when tigers were near, and stress levels were much lower when they weren’t. Also, before lightbulbs, we had not choice but to relax, socialize, and rest when it got dark outside. Today many of us have a 24-7 bombardment of stressors from our jobs, our kids, cable news networks, and baseless criminal investigations. None of our stressors today are as dangerous as sabretooth tigers, but today’s stressors are more constant, more numerous, and therefore overwhelming. This is the problem.Our stress response is locked in the “On” position. Add on the facts that most of us aren’t getting enough sleep, and we have access to an unlimited supply of processed foods, and it’s not surprising that America is over-stressed and overweight.
So how do we reduce chronic stress? As tempting as it sounds to quit our jobs, enroll our kids in boarding school, and move to a naked hot yoga commune, in a non-extradition country, we really just need to adjust our response to stress. A Man’s Search For Meaning, by Victor Frankl proposes that we choose our responses to stressors, but most of us react instinctively, effectively giving up the power to choose. He discovered this truth while being a prisoner at Auschwitz. While his guards had the power to hurt him, only he had the ultimate power to choose his own response to their actions. This is literally the most empowering concept I’ve learned in 25 years of self-improvement reading. That’s a little deep for this space, and I promise a meme or penis joke is forthcoming, but first here is a model of his theory I made, no big deal.
That space between stimulus and response is our opportunity to choose to not stress and to let it go, like Elsa from Frozen. Just fucking let it go. The choice is ours. I just want us to realize that it is a choice. When I hear someone say, “He made me so mad…” I want to say is, “Karen, what really happened was he did something, and you chose to get mad, and then you asked to speak to the manager.” We all choose. If Victor Frankl can choose not to hate his guards, then I can choose not to get mad at the guy who cuts me off in traffic, and therefore I choose not to stress in the first place. Also, we need to de-stress. Here’s a few things I recommend.
Get a lot of D. The catch is that the D has to be natural D, the kind of vitamin D you get from sunlight and a healthy diet and not from a pill. People with naturally normal vitamin D levels are less stressed and maintain better body weight, but studies show that this does not apply to people who are taking oral D supplements. Lab mice when deprived of sunlight will get elevated cortisol levels, and even show drug addiction withdrawal symptoms, which all stems from a lack of sufficient D.
Sauna. Not everyone enjoys 20 minutes in the sauna as much as I do. Perhaps the sweating, extreme heat, spicy odors, and naked men aren’t your thing. Try it anyway. If you do an honest self-assessment 30 minutes after, you will feel more relaxed, less stressed, and signifiantly happier. The body releases natural endorphins during and after a sauna, similar to exercise and sex. Also, don’t exercise or have sex in a sauna. I will write an article about sauna soon, but it’s my go-to stress reliever that just happens to make us live longer too. I distract myself during my sauna with crossword puzzles to get through the whole session. I bring water with electrolytes and a towel to cover my private areas, and you should too, especially if you go to my gym. Please and thank you.
Exercise. You already know this. I won’t go into details, but exercise helps stress. Thanks, Captain Obvious.
Mindfulness AKA meditation. This really works but unfortunately, it often takes 2 or 3 consecutive days to feel the results, but the results are ridiculously good. I feel so good after a few days that I often forget to do it and then rebound. I (and probably you) just need to make it a regular daily habit like flossing, manscaping, or messing with your spouse’s toothbrush. Initially, I recommend committing to two weeks of a daily practice. If you don’t feel 50% better at the end then maybe it’s not for you, but trust me, it’s for you. I’ve used and enjoy the Calm, Headspace, and Brain FM apps for my guided mindfulness. My favorite is the Calm 10 minute loving kindness practice.
Bath with Epsom’s Salts or transdermal magnesium. Baths can relax us but adding Epsom’s salt is a whole different level of relaxing. Why? The salts contain magnesium. Magnesium is a natural relaxant and is best absorbed through the skin. This allows it to go straight to our nervous system and skips some of the GI side effects. This is also great for sleep. If you don’t want to bathe, just apply transdermal magnesium in the evening.
Yoga. If mindfulness and exercise had a child, it would be called “Yoga.” And if sauna, exercise, and mindfulness had a threesome their baby would be “hot yoga.” PS I don’t do yoga in front of people. I do room temperature yoga, at home, at least once per week to prevent back pain and improve my core strength, but also as a substitute for mindfulness. Despite not being flexible at all and having very poor balance, I’m super good at yoga, because yoga isn’t a competition. It’s like soccer for six year olds, if you just get out there and try, you get orange slices and a trophy. In yoga, we’re all winners. I’m going to buy a yoga trophy for myself and display it proudly on my mantle. I use the BeachBody.com app for my yoga, but there are a lot of good apps and YouTube channels out there for home yoga. Message me with your favorite, and I’ll update this post.
Lavender or Sage oil. I add lavender or sage oil (depending on my mood) to activities #2,4,5,6,7, and 10 as a way to bombard my senses with anti-stress messages and to disengage from the flight or fight mode.
Wine*. I’m not suggesting getting drunk in order to de-stress and forget about our problems. For legal reasons, I ask that you re-read the previous sentence. Often when we are dieting, we stop our evening glass or two of wine because it’s an extra 80 calories per glass. If that’s your way of unwinding after a long day, then I think you should keep doing it*, especially if stress is an issue for you. Also, red wine has a lot of benefits, and a glass can overall help your metabolism.
The 5 Minute Journal.** I do this every day and it has significantly decreased the amount of time I spend crying in the shower. It’s amazing. I previously used the hard copy version but have switched to the app because I was misplacing the book, and the app allows me to upload pictures. Here’s a screenshot from one day’s entry. There’s also a great daily quote and a part where you recap what could have been better.
The journal is also great to do with your kids as well. The process teaches gratitude and helps ground us and reminds us that we aren’t being chased by tigers and also sets intentions for the day. The recap at night helps me relax before bed. The app is only 5 bucks. Get one for yourself and someone you care about. You’ll be glad you did.
This was supposed to be a short article, but I ramble. If you are on the path to wellness and feel that you are stalling out, consider addressing chronic stress. We don’t need to run from our stressors but instead learn to address how we respond to them and use positive tools to let go of stress once it has affected us. Also, we need lots of D. I know this is a little touchy feely, but stress is a serious medical problem that doesn’t just cause weight issues, but also cancer, chronic inflammation, depression, anxiety, and Netflix bingewatching. If you aren’t affected, you know someone who is. Forward this article to them and encourage them to sign up for my email alerts.
*Don’t start drinking if you are a non-drinker, as this is a slippery slope, moderation can be difficult, and excess alcohol is bad. This should be self-explanatory. **This was a Tim Ferris recommendation.
Maybe this title was misleading. To be clear, this is your one stop guide for getting great sleep. If you came to this article looking for something else, I apologize, for nothing. Fixing broken sleep has been transformative, in terms of my health but also my mood, attitude, and overall life satisfaction. I didn’t even know my sleep was that bad, until I fixed it, and I’m pissed I didn’t fix it sooner. To put things in perspective, here are the top three things I have done to improve my health in the past ten years.
3 Minimized/eliminated processed foods, sugar, and wheat. Here’s why.
1 Prioritized getting 8 hours of quality sleep. Here’s why.
That’s right, sleep is numero uno. If you take my advice, it can be life changing for you as well. Here are some unbelievable sleep facts followed by my best recommendations for getting great sleep.
Amazing fact #1. Did you know that when we set our clocks forward in the spring and collectively lose an hour of sleep for daylight savings time, the rates of car crashes doubles? You did? Damn. But did you know that the rates of heart attacks, suicides, strokes, hospital admissions, coffee consumption, and people being late to work all skyrocket on that day as well. All this, from just one hour of collective sleep loss. What’s even crazier is that when we turn the clocks back and get an extra hour of sleep, the heart attacks, strokes, suicides, crashes, and work tardiness collectively hit all-time lows. This daylight savings example shows the far-reaching and devastating effects of just one hour of sleep loss.
Amazing fact #2. All animals sleep, even sharks. As a kid, I loved shark week on the Discovery Channel. I was told that sharks don’t sleep because they’ll die if they stop swimming. False. In actuality, they sleep and swim at the same time. #sharkfacts.
Amazing fact #3. When scientists completely deprive rats of sleep, they die, after only 7 or 8 days. What’s most interesting is how they die. I would have guessed car crashes or drug overdose, but in actuality these rats suffer a breakdown of their immune system and get terrible intestinal infections leading to septic shock and eventually death. Our immune systems fail when we don’t get enough quality sleep as well. One study showed that cancer fighting cells (NKC’s) decreased by 70% after patients were limited to just four hours of sleep. Another study gave rats tumors and then cut their sleep by half. The sleep starved rats’ tumors grew 2-3 times faster than rested rats, and experienced metastasis (spreading to other parts of the body) whereas the normal sleeping rats had small tumors that didn’t spread. These studies show how poor sleep lowers our immune defenses, and not just for colds and flu, but also for cancer.
Amazing Fact#4. Sleeping pills can kill you. Taking sleeping pills is shown (in 24 different large studies) to greatly increase our risk of all cause mortality AKA death, which should be put on the label, but isn’t. Here are the studies, and here’s another one. Death is one of the worst side effects I can think of, right up there with hair loss, anal leakage, and the gum disease gingivitis. Exactly zero studies show any measurable health benefits from taking these meds. Even the best sleep medications don’t provide quality sleep and only beat placebo (sugar pill) by a few minutes in terms of how fast they get you to sleep, and that is using big pharma’s own data, which is likely bullshit.
So what are sleeping pills good for? Making big pharma rich. Ambien made 4 billion dollars in profits in just two years. There are 61 countries in the world who’s entire gross domestic product is less than Ambien, and that’s just one of many lucrative drugs. Here are some other big pharma stats that are ridiculous. In conclusion, sleep meds are dangerous, habit-forming, incredibly profitable, and they don’t work. Here are some things that do work and don’t require a prescription from someone like me.
Get more light in the day and more dark at night. Our bodies are continually looking for cues about whether it’s night or day, in order to set our internal clock and control the release of melatonin, our natural sleep hormone. Before Edison’s lightbulb, our bodies knew what time it was. Now, not so much. Daylight has 50 times more lux (unit of light) than even our most brightly lit cubicles, offices, and Walmart Superstores. So even in a well lit room, our bodies are very confused. At night, the blue light from our smartphones and computers tricks our brain into thinking it’s daytime, because the blue light they emit suppresses our sleep hormone melatonin. I encourage my patients to get morning sun (without sunglasses) to help establish our circadian rhythm and to get outside periodically throughout the day. In the evening, I keep my rooms dimly lit, wear blue light blocking glasses (it’s a thing), and have night shade mode on the screens of my electronic devices, to increase my natural melatonin release. Also, I use an app call F.lux that will block blue light from my computer screen.
Get Cold. Our core body temp must drop a couple degrees in order for us to go from light to deep sleep, and going to bed a little cold can also help us get to sleep faster. I use a dip in a cold pool or a cool shower to help achieve this. One study showed cooling down patients with terrible insomnia (using cooling headcaps) got them to sleep faster than people without insomnia, and no drugs were required. I also keep my AC on high most of the year in my bedroom to help me get to sleep and stay asleep. I aim for mid 60’s in my room.
Don’t sleep completely naked. This really only applies to people who spend the night on my couch. I’m looking at you Handsome Eric. So feel free to sleep in the buck at your own house, however soft gloves and socks encourages blood flow to extremities and can help lower your temp, which is a good thing.
Use your bedroom for sleeping and sex. Don’t use your bedroom for arguing, watching TV, studying, social media trolling, or blog writing. Sex can help us relax and also make us quite sleepy, even if you’re alone. If your sexual activities involve torture devices, cattle prods, or more than three people, then consider taking it to a basement, windowless van, or your local LaQuinta Inn and Suites and be sure to have a “safe word”. No judging. Did you know that “LaQuinta” literally translates to “next to Denny’s”?
No clock-watching. Take the clock faces out of your bedroom, as this can lead to increased angst regarding sleep and set your phone to “Do not disturb”, unless you get a lot of late night “you up?” texts.
Listen to an “Adult Sleep Story”. This is not porn. I hate that the porn industry has stolen the word “adult”. Not all adults are into porn, and frankly that implication is disgusting. Statistically there are literally hundreds of men in the U.S. who don’t regularly look at porn. I use the “Calm” app (not porn) for these adult sleep stories and for my mindfulness practice, which is also good for sleep. This app has hundreds of stories that are just stimulating enough to hold your attention but soothing enough to put your sweet ass to sleep. They even have celeb guest readers like Matthew McConaughey, Bob Ross, and Sam Smith. My favorite stories are “Blue Gold”, “A Magical Winter’s Night”, or anything involving trains. Once again, this isn’t porn. The app is free, but has a premium membership as well. Also, there are sleep stories for kids on the app that are good as well. Here’s the link.
Magnesium + Apple cider vinegar + Honey+Melatonin (5mg). This elixir is the go-to of Tim Ferris. I pretty much try whatever he suggests and this stuff really works. Magnesium is a natural relaxant and something your body needs anyway. Sometimes magnesium can cause you to poop too much, if this is an issue, try the more bioavailable topical magnesium, and you will be spared this side effect. I added the melatonin to this combination. It really will help, but most people are taking it incorrectly. The key is the timing. A lot of patients have told me it doesn’t work for them, but when I get them to take it earlier (like 2-4 hours before bedtime) then it works. The rest of us only need to take it 30 minutes to an hour before bed.
Sleep Mask + Ear plugs + Lavender oil. I have turned my bed area into a sleep sanctuary. It’s important to get your room quiet and dark for sleep. My room is pretty dark, but sometimes road noise, cat fights, or my oldest child’s night screaming can disrupt my slumber. I use “Mack” ear plugs and a sleep mask with adjustable eye cups (GoZheek brand) as double protection against sleep disruptions. Lavender oil helps relax me. It’s been used for thousands of years for sleep and has some data behind it*. My brain has permanently linked the scent of lavender with sleep, not unlike how Guy Fieri associates the smell of bacon with intense sexual arousal.
Alcohol. Alcohol is used by many of us to get to sleep, but drunk sleep isn’t restorative for a number of reasons. Just because we lose consciousness, doesn’t mean we are getting real sleep. A 2×4 applied with enough force to the side of our heads will induce sleep, but that isn’t quality sleep either. When I told my mother about alcohol’s negative effects on our sleep, the anger, desperation, and fear in her eyes told me that quitting Nana-juice was going to be a multi-step process, probably 12 or so. So instead of recommending abstinence to you and The Betty Ford Center to my Mom, I came up with some mitigation strategies. Here is Dr. Jimmy’s 5 point plan for boozing and still getting good sleep.
Start early. Happy hour drinks are much less likely to mess with your sleep as compared with a night cap. So start your drinking earlier and stop well before bed with a goal of being soberish, by night-night time.
Avoid beer, especially close to bedtime. Beer is mostly water and it irritates our bladder and that makes us pee a lot. Getting up to go pee in the middle of the night isn’t great for your sleep.
Get colder than cold. Alcohol raises our core body temp a bit because its a vasodilator. As I mentioned, lower body temp is needed for deep sleep. To fight the warming effects of alcohol, keep your room extra cold and consider a cold shower or bath immediately before bed.
Afrin + Nasal “Breathe Right” Strips + CPAP. Alcohol can induce snoring and worsen sleep apnea. If you have sleep apnea, be sure to wear your CPAP mask, especially when you’ve been drinking. For the rest of us, Afrin (OTC nasal spray) and the Breathe Right nasal strips can help keep our airway open and increase the oxygen to our brain. Don’t use Afrin too frequently, it can be habit forming, once a week is fine though.
Don’t over do it. Too much alcohol stops us from getting into REM (dream) sleep which over time, leads to early dementia, and a host of mental health problems. Also, you know how upset your mom gets when you get puke on your Yoda pajamas.
Make a Caffeine Adjustment. I love coffee. I wrote about why it’s good for us (here is the link) but if abused, it can screw up our sleep. I used to drink an espresso after dinner and be asleep in an hour, but I’ve stopped drinking caffeine past noon. Let me tell you why. Caffeine has a half-life of 6 hours and a quarter life of 12 hours. So if you have a Starbucks grande drip coffee (350mg) at 2PM, it’s like having a regular coffee at 8PM (175mg) or a shot of espresso at 2AM (87mg). Anyone with even a hint of insomnia really needs to consider these facts and stop the afternoon caffeine. But Dr. Jimmy you just said that you can fall asleep after an espresso, so what’s the big deal? I’ll tell you. Even if we can fall asleep with caffeine, the sleep we get is seriously degraded. That espresso ages me by 20 years, in terms of my sleep. This poor sleep makes us tired the following day, which encourages us to drink more coffee later in the day, which makes our sleep worse, and now we are in a vicious caffeine cycle.
Workout in the AM. Even just five minutes can help set your body clock. I admittedly hate morning workouts, but I begrudgingly acknowledge that this helps. Also, avoid workouts within 4 hours of bedtime.
Track your sleep. There are lots of sleep trackers out there (Fitbit, Apple Watch, Oura Ring). I suggest using one to monitor what helps your sleep and what doesn’t. I try to be in bed 8.5 hours prior to my wake up time. I don’t sweat it if I’m not asleep the whole time. I think this takes some of the pressure off, which helps me relax. My in-bed mantra is to relax and let go. When we try too hard to fall asleep, there’s increased stress and pressure which can make sleep elusive.
Have a regular bedtime and wake time. This is impossible for many of us due to our work schedules. When I get very little sleep because of a night shift in the emergency department, I try to give myself at least one 90 minute nap in the daytime. 90 minutes is the length of one sleep cycle. While this situation isn’t optimal, it helps me to be more functional in the day while still being sleepy enough to not have insomnia at night. One of the downsides is that a 90 minute nap can cause something called sleep inertia where you feel groggy for a period of time, but once that is over, you will be better off, because 90 minutes allows your body to get into both REM and deep sleep. The shorter 20-30 minute “power nap” can be refreshing, spare you any sleep inertia, and can help you function later into the evening but it’s not a replacement for your night time sleep, the way a longer 90 minute nap can be. Also, if you have trouble falling asleep at night, try not to nap in the daytime.
Thanks for checking this out. Let me know what you think or if you have any questions. Also, sign up for my email list on the right side of the screen. It will alert you when a new article, video, or recipe is posted. I’m also going to start giving away free stuff to my email subscribers. I won’t share your email address with anyone and I won’t try to sell you anything or ask for any personal information.
*Author’s rant: Many studies involving natural products are not taken seriously by the scientific community and I think that’s a mistake. They’re generally disregarded because the studies are small and often underfunded. They’re underfunded because the stuff they are testing aren’t billion dollar prescription medications or procedures. I am in favor of evidenced based medicine, however the bar for evidence should be raised and lowered based on the risk of the product being tested. If a study shows that carrots are helpful for weight loss but the study was only involving a few hundred people and only lasted a few years, this doesn’t mean we shouldn’t recommend eating carrots for weight loss because there’s not enough high quality data. We can say that there is some evidence for carrots We know carrots are good for us and the risk of the intervention (carrots) is low, so go ahead and give it a try. Instead, we disregard these small studies of benign interventions but freely prescribe sleep medications that have a high risk associated with them (and an FDA label) when in reality they need more high quality evidence showing benefit to be safely recommended.
Every year hundreds of new books are published about how to lose weight and get healthy. New gyms open. More and more research is done on the ideal diet and exercise program. Well-meaning medical doctors write life-changing, meme-filled, snarky blogs. Despite all these efforts, America’s waistline continues to increase. Why are these diets and exercise programs failing? Could it be that we are missing a huge piece of the health and weight loss equation? Yeah, we are missing something really big and I’m not just talking about fasting. America is chronically underslept. This lack of sleep is making us overweight, diabetic, and also quite sleepy. I will explain…
Below are obesity rates in the U.S. by year as compared to our average sleep amount. As we get less sleep, our weight increases. Why does this happen? There are lots of reasons, but first, a couple disclaimers. First, I don’t believe that sleep deprivation is the only cause of our obesity epidemic. Second, the graph below only shows a correlation which doesn’t prove that insufficient sleep causes obesity. In the next few paragraphs, I will make the case that sleep plays a much bigger role in our health and fitness than most of us think, in the hopes of motivating you to stay in bed longer. I know “stay in bed longer to lose weight” sounds like clickbait, but just keep reading. That also sounds like clickbait.
While the above graph shows a strong correlation between sleep and obesity, it’s still just a correlation, and better studies are needed to show if poor sleep is actually causing obesity. The fictitious lower graph shows that as pirate prevalence goes down, global population goes up. This is also a correlation, but probably mostly coincidental. So, we shouldn’t be fooled by statements solely based on a correlation, that’s bad science.
Fortunately, in recent years there have been many scientific studies showing a causal relationship between lack of sleep and obesity even after adjusting for factors like exercise, age, sex, and proximity to a Cinnabon. Here is the link. Why does insufficient sleep causes weight gain? Great question. One important and often overlooked cause is hormonal. When we don’t get the proper amount of quality sleep, a stress hormone called cortisol goes up. High cortisol causes us to lose muscle and gain fat, regardless of what we eat! Cushing’s syndrome is a disease characterized by too much cortisol and the effects (shown on the right) are devastating and very similar to persistent lack of sleep. High cortisol from lack of sleep or Cushing’s syndrome makes getting healthy as f**k impossible.
Incidentally, Addison’s disease is when cortisol levels are too low (opposite of Cushing’s syndrome). JFK had this disease. The symptoms are tan skin, thin appearance, extra confidence, and frequent, aggressive episodes of coitus.*
Sleep loss just doesn’t cause obesity, but it can also lead to type 2 diabetes. Rates of type 2 diabetes are much higher in under-slept adults, but like the pirates and global population, this was just a correlation, until one study took a group of healthy fit young people and limited half of them to just four hours of sleep per night. The researchers fed both groups the same healthful food. After just one week, the under-slept group’s blood sugar levels were so high, they qualified as “pre-diabetic”! WTF? I’ve been taking care of diabetics and pre-diabetics for years. Why am I just learning this? This has been repeated in different studies with even less severe sleep disruptions. Type 2 diabetes will take an average of 10 years off of your life, but even just having slightly high blood sugar triggers high insulin, increased body fat, and a host of other bad stuff. Here’s my article about insulin and blood sugar.
Lack of sleep makes us hungry as f**k. Pro-satiety hormones (leptin) and pro-hunger hormones (ghrelin and endocannabinoids) all go in the wrong direction after just two nights of poor sleep (6 hours or less). This is a double or even triple whammy for weight gain, because these hormones cause us to be persistently hungry but also not fully satisfied by eating. In one well controlled experiment done at a sleep study hotel, patients ate an average of 340 calories more per day when they were restricted to six hours sleep as compared to when they were allowed 8 hours sleep. Additionally, those sleep deprived subjects tended to choose more junk food (cookies, pretzels, chips, Chili Lime Cheetos, etc) and they reported excessive cravings for high carb foods. Basically, not sleeping enough gives us the munchies.
Poor sleep crushes dieting efforts and causes muscle loss. One study took a group of dieters and let half of the subjects sleep normally and sleep restricted the other half to just 5.5 hours per night. While both groups lost weight, the low sleep group lost mostly muscle while the group that got good sleep, lost mostly fat. Losing muscle while retaining fat lowers our metabolism and makes us less sexified, technically speaking. This is the opposite of bueno, I might even dare to say it’s no bueno. If you haven’t noticed, the theme of this article is that good sleep helps us lose weight.
How did one group or researchers turn a group of virile, strapping men in their 20’s (think shirtless Abercrombie and Fitch models spraying each other with water from a hose) into a bunch of middle aged dad-bods with jean shorts on riding lawnmowers? They limited their sleep to only 5.5 hours. This sleep restriction aged these young men by 15 years in terms of their testosterone levels. Testosterone is important for weight because it promotes muscle building while simultaneously decreasing body fat and low testosterone in men is linked to truncal obesity. Sufficient, restorative sleep boosts testosterone and also growth hormone which is responsible for injury repair, muscle growth, resurfacing the lining of blood vessels, and essential for healthy cardiac function and blood pressure. Growth hormone is also the number one reason NFL players visit doctors in Mexico, so you know it must be good.
While there is some evidence that exercise improves sleep, more research is needed in this area. What has been repeatedly shown is that great sleep boosts your exercise performance and poor sleep greatly decreases your ability and likelihood of exercising. Shawn Stevenson’s book, Sleep Smarter recommends morning exercise as a key for better sleep at night. Don’t worry, I’ll go into my recommendations for getting great sleep in my next post.
Many of us are trying so hard to get thin and healthy that we are waking up at 4 AM to go to the gym, spending tons of money on powders, pills, food scales, and Lululemon apparel and not getting the results we could get from simply staying in bed and getting a great night’s sleep. This should come as great news because sleep is free and it feels amazing.
In conclusion, poor sleep makes us gain weight by screwing up our hormones, spiking blood sugar, lowering our metabolism, shrinking our muscles, holding onto body fat, increasing our cravings, and sabotaging our workouts. Clearly, getting sufficient quality sleep should be a priority of anyone who is trying to get healthy as f**k or maintain their healthy as f**k status. It’s ridiculous that this is not more emphasized by the health community. It’s clear from my research that not getting enough quality sleep is the perfect activity, if your goal is to become obese, diabetic, and sleepy. I will put out my best sleep improvement tips in the next few days. Thanks for reading.
*Addison’s disease is a rare autoimmune disease that is characterized by low cortisol. Symptoms include fatigue, weight loss, low blood sugar, hyperpigmentation of the skin, and depression. JFK had this disease. I’m not kidding. I was kidding about the coitus part.
One of the primary resources for this article was the amazing book, Why We Sleep by Dr. Mathew Walker. I highly recommend it.
Fasting is the forgotten pillar of great health. Everyone talks about diet and exercise because there’s money to be made there. We don’t talk about fasting because it’s free and you can’t sell free things and expect to make money. Fasting is actually better than free because you save both time and money on food when you fast. Fasting is far more effective than any pill, health shake, or wart-removing cream and the only side effect is a little hunger and looser fitting pants. Effective at what you ask? All the things, more to come on this. I’ve written about time restricted eating, AKA short fasts of 12-24 hours. This is the why and the how of a longer fast (48-96 hours). The good news is that we don’t have to do these fasts very often (monthly or quarterly is sufficient) and the benefits of such fasts are long lasting, miraculous, and sometimes weird. Before we get to the details, here is Cliff Clavin (from the 80’s Sitcom Cheers) and his buffalo theory…
“Well ya see, Norm, it’s like this… A herd of buffalo can only move as fast as the slowest buffalo. And when the herd is hunted, it is the slowest and weakest ones at the back that are killed first. This natural selection is good for the herd as a whole, because the general speed and health of the whole group keeps improving by the regular killing of the weakest members. In much the same way, the human brain can only operate as fast as the slowest brain cells. Excessive intake of alcohol, as we know, kills brain cells. But naturally, it attacks the slowest and weakest brain cells first. In this way, regular consumption of beer eliminates the weaker brain cells, making the brain a faster and more efficient machine. That’s why you always feel smarter after a few beers“. -Cliff Claven (John Ratzenberger)
Cliff Claven’s buffalo theory is actually a metaphor for fasting and autophagy (pronounced “uh tof Oh Gee.”) Autophagy is when the body intentionally kills off its own cells that are damaged, too old, or no longer working properly. What does this have to do with fasting? I’ll tell you. Ideally we would be cleaning house at the cellular level constantly (with autophagy) but unfortunately our bodies don’t really do much autophagy in our normal fed state. So these useless cells just hang around in a state called “senescence”. They get in the way, they turn into cancer, and are a major reason why our organs don’t work as well as we get older. It’s only when our bodies sense fasting or an extreme caloric restriction, do we start to get rid of these old, useless cells, AKA the slow buffalo. This herd thinning improves our body’s function, appearance, and efficiency. But wait, here’s the best part, after getting rid of the old saggy cells, the body generates new taught, sexy cells. This happens all over the body including our liver, brain, kidneys, skin, and muscles. Fasting induced autophagy and cell regeneration literally reverses the aging process on the cellular level. Scientifically speaking, that is fucking awesome.
Our bodies were meant to fast. Our ancestors lived for 7 million years without reliable food sources. For almost all of human history; fasting was a regular occurrence. Only recently, have we had refrigerators stocked with food and drive-thru’s open 24 hours per day. And while continuous access to Crunch Wrap Supremes and Seven Layer Burritos is convenient, it’s not what nature intended. On an unrelated note, I have woken up and found a Taco Bell receipt for 90 dollars. I was in college.
The effects of fasting last a long time. One study involving diabetics showed greatly improved glucose control in the subjects who did a 72 hour fast in the days following the experiment. What fascinated researchers, was how these effects lasted more than three months after the fast, despite no other dietary changes. Dr. Jason Fung, a nephrologist and author of the Obesity Code (great book), is literally curing type 2 diabetes in a matter of weeks with these longer fasts.
Fasting is simple. I have written over 70 thousand words about what to eat. Clearly, the ideal diet is kind of complicated, nuanced, and controversial. Fasting is simple. Just don’t fucking eat. That’s it. I will give some more details in a bit. I used to get frustrated after explaining my dietary theories to a patient only for them to come back two weeks later and happily report that they switched to whole grain pasta and margarine because that’s what they thought I recommended. To be clear, whole grain pasta and margarine go against everything I believe in. Just seeing it in the store hurts my soul, but my communication skills weren’t strong enough to overcome my patient’s 65 years of whole grain/saturated fat brainwashing. So, I tried the new approach of recommending fasting to my patient, and I was totally understood. Of course, there were the obligatory questions like, Can I have tea? Yes. Can I drink diet coke? No. Can I have fat free fig Newtons? Fuck No.
Weird benefits from fasting. If you’ve lost weight in the past, you may have some extra loose skin and connective tissue hanging about causing such conditions as “Lunch Lady Arms” or in my case “Old man Butt”. When we fast, these conditions improve, not just because we lose weight, but the process of autophagy, takes in those useless cells that are just hurting our self-esteem, slowing our buffalo herd, and not serving any other purpose. When morbidly obese people lose massive amounts of weight using conventional means, they usually have to get surgery to get rid of that extra skin, but those who fast to lose massive amounts of weight have no such issues, because of autophagy.
Another weird thing that happens when you do a long fast, is that you keep pooping. You can be two days since your last meal, but still having poops! Who knew? This can be very beneficial for cleaning out your digestive plumbing and will help your digestive health for months after your fast.
Fasting can lower total body inflammation and is a tool used in combating autoimmune diseases like rheumatoid arthritis and many others. Fasting has shown to improve the effectiveness of chemotherapy and greatly reduce its terrible side effects, specifically fatigue, hair loss, and nausea. Finally and most notably, fasting induced autophagy can help get rid of some of the pre-cancerous cells that could lead to tumors down the road. Fasting is free, simple, natural, and an amazing tool for living longer and better. So now that you’re onboard, here are some tips for completing a long fast.
The first rule of fasting is that we don’t talk about fasting.
The second rule of fasting is that we don’t talk about fasting. It’s annoying when people go into great detail about their diets (I’m looking at you vegans), their pets, or their bowel movements. Refer them to my website and be done.
Eat a high fat, low carb meal in the evening prior to starting a fast. This will help keep your insulin low and allow you to go immediately into ketosis (fat burning) and avoid a metabolic slowdown. If you ignore this advice and binge on pizza and cookies, you will have elevated insulin (from eating carbs) and are therefore unable to access your fat stores for several hours. Your body’s only option is to slow down it’s burn rate, plus you will get crazy hungry. All of this is bad.
Avoid strenuous workouts during a long fast, but brisk walking, yoga, and aggressive hanky-panks are all encouraged.
Stay hydrated and replace electrolytes. Eating normally covers your electrolyte needs, but since you aren’t doing that, replacing your sodium, magnesium, and potassium are important for keeping you feeling good. If you get a headache, it’s probably because your electrolytes are off. Drink some tea with salt and lemon added.
Prioritize Sleep. If you are sleep deprived, fasting is not a good idea. We will actually hold onto fat and burn muscle in a fasted and sleep deprived state. This is obviously bad. Get sleep. Sometimes, fasting can make sleep more difficult. If this is the case for you, add more magnesium (400mg) and melatonin (5-10mg) at bedtime.
Avoid Temptation. Try not to schedule barbecues, parties, or fancy dinners whilst fasting. I even avoid cooking for my kids because just being around food can be difficult. Instead, I reheat some frozen food for them. Don’t judge. They love it. Getting buy-in from your partner and friends can be a big help as well.
Have Some Rescue Foods. I allow myself up to 5 tablespoons of MCT oil or coconut oil (per day) that I mix with coffee or tea if I’m getting hangry. Sometimes I also have a cup or two of bone broth to keep me happy if I have to see patients during my fasts. Coffee and tea can be satiating, and I add a little salt in my tea and coffee when fasting. While the MCT oil and bone broth are technically not allowed on a strict fast, for my purposes it still counts as a fast. I try to keep this type of thing to the minimum, however. Lemon water, sparkling water, pickle juice, apple cider vinegar, plain tea, and coffee can all help, and are fasting approved beverages.
Schedule Non-Eating Activities, especially during meal times. A Netflix marathon, video games, extra naps, or other distractions can help get you through a long fast. Be self-indulgent. You’ve earned it.
Break your Fast. Weigh yourself later. As long as it’s not an excessively long fast (more than five days), it’s not dangerous to eat whatever. I recommend eating a smallish meal at first to avoid having an upset tum-tum and/or bum-bum. You will probably notice a pretty substantial weight loss after allowing for a day to normalize. I find that this weight stays off too. I often do a long fast following a weeklong vacation of overeating and debauchery to lose whatever weight I gained whilst being bad.
I use the free app “Zero” to keep track and to help me stay motivated during my long fasts, that I do once or twice a quarter. I get hungry initially during the fast but after the first 14 hours or so, I generally feel good. I feel a lot better in the days and weeks following the fast. It’s actually very empowering to know that you can go without food whenever you choose. My patients are super proud of themselves after finishing their first long fast and I bet you will be too.
In conclusion, the occasional long fast can be an empowering tool for weight loss, longevity, and to keep your buffalo herd moving at healthy pace.
Patients, friends, and guys I meet online often ask me how they can lower their cholesterol levels. Most the time they say that they’ve been watching their cholesterol intake, or cutting back on their saturated fat, or they send me an inappropriate picture of themselves. In all cases, they are wrong to do so. I will now take a minute to explain how cholesterol works. As a side note, I encourage all my patients to get their cholesterol levels checked before starting a high fat diet, so that they can see for themselves that their numbers really do get better. Also, if possible get a “particle size” included in your cholesterol test. Also, get a hemoglobin A1c, testosterone (for males), chemistry panel, CBC, vitamin D, and an iron level while you are at it.
Just to show you that I’m not that far out on a limb here, as of 2015, even the U.S. Dietary Guideline association (DGAC) agrees with me in the belief that the cholesterol that is in your bacon and eggs does not affect the cholesterol levels in your blood. In their most recent recommendations The DGAC said that cholesterol “is not a nutrient of concern for overconsumption” and eliminated their 2010 guideline recommending less than 300 mg daily. When the Federal Government reverses its dietary stance on something, it’s usually 10 years too late and after there is way more evidence than needed to support it, and this U turn on cholesterol is no exception. I predict that fats and even saturated fats will be officially exonerated in the near future, the way that cholesterol was in 2015.
How Cholesterol Works
Our body’s cholesterol is made by our liver. Our liver makes cholesterol when it senses high blood glucose levels, and not as a result of how much fat or cholesterol we eat. Some cholesterol is good which is called HDL(high density lipoprotein) and some cholesterol is not good like LDL (low density lipoprotein).
Essentially, all cholesterol is the combination of a protein (which are dense and hard) and a lipid (fat), which is light, think fat floating to the top of gravy, which is why it is called a “lipo-protein”. The role of cholesterol is to take fats to the parts of your body that need them. Where is fat needed you ask. All sorts of things in your body require fats to function correctly, and cholesterol are the Uber drivers who take the fats to and from their intended destinations. LDL or bad cholesterol Ubers have a passenger (fat) and HDL’s are empty Ubers looking for fat particles to pick up.
Fat is needed almost everywhere in your body, but there are some places it shouldn’t be like our bellies and stuck to the walls of our arteries. Almost all of our cells need fats to coat their outer shells. Our hormones like testosterone, estrogen and the nerves and neurotransmitters responsible for our happy thoughts and feelings require fats. When there is an overproduction of bad LDL cholesterol because of persistently elevated blood glucose, and all of the body’s fat needs have been met, these Uber drivers don’t have any place useful to bring the fats and end up taking them to your body’s version of a dirty Tijuana strip club*. When deposited at these inappropriate places, your body pays the price, and not just for the cover charge and the watered down drinks, but for some really shady stuff. I think this analogy has run its course, but one of the shadiest places LDL cholesterol gets dropped off is into the tiny coronary arteries, which are tasked with providing the muscles of the heart with proper blood flow. To make matters worse, the LDL cholesterol are also dropped off in the even smaller arteries responsible for the blood flow to your favorite male reproductive organ. If my innuendo wasn’t clear enough, I’m talking about the penis. These deposits can result in decreased flow and eventually no flow at all #frownyface emoji, and when all blood flow is suddenly stopped to an area of the heart, this is called a heart attack or in medical speak, a myocardial infarction (MI).
Recently, we are starting to learn that a myocardial infarction seems to be also related to inflammation that can make cholesterol deposits, (cardiologists call them plaques) unstable. These unstable plaques leave the walls of your larger arteries and travel downstream to smaller arteries where they create a blockage or a myocardial infarction (MI), AKA heart attack.
How do we positively affect the plaques characteristics, so they don’t cause MI’s? The answer is two-fold and leads us to the definition of High Density Lipoprotein or good cholesterol. Good cholesterol (HDL) is almost all protein and no fat, which is why it is very dense, hence the name “high density lipoprotein”. Think of this guy as the Uber driver, riding around in an empty Prius, looking to pick up fats from places they shouldn’t be, like the Tijuana Strip club (coronary arteries) and take them to be recycled in the liver. Obviously, the more of these good Samaritans you have driving around in your blood the better, because they are cleaning up the streets, AKA your arteries. Now what does that have to do with plaques? It seems that if you have a plaque that is soft and fluffy and full of squishy soft fats AKA LDL (bad cholesterol) it is more likely for part of that plaque to fall off and end up causing a heart attack than if it is a hard “stable” plaque. The way plaques get hard (I’m skipping the obligatory erection joke here) is by HDL Uber drivers showing up and pulling some of those fluffy fats out of the plaques, thus firming up and shrinking that plaque and making that plaque unlikely to break off and cause any troubles.
In the light of this information, it is no wonder that, recent research has shown that HDL (Good Uber drivers) to be a much more important predictor of heart health than LDL. A recent study involving 135K patients who had recently had a heart attack showed that over 75% of these heart attack patients had normal LDL (bad cholesterol) but less than 5% of them had achieved a recommended level of good HDL cholesterol. So why do we care so much about bad cholesterol and talk so little about good cholesterol? I’ll get there but first I’ll give you another example.
Case Study I had a patient a few years ago, 52 year old male let’s call him Max Powers. Using my diet he lost 20 pounds in 10 months and was able to go off of his blood pressure meds but was disappointed that his cholesterol went up. Here are his numbers before and after starting his journey to get Healthy As F**k.
Before Total Cholesterol 192 HDL 38 LDL 146 **
After Total Cholesterol 195 HDL 60 LDL 148 **
When Max told me his cholesterol numbers went up, I was disappointed too, and my initial reaction was to blame him, I certainly can’t blame myself, but I had him come to the office and take a closer look anyway. First of all, he looked great. He had a fun summer cut and was wearing a tasteful cardigan with sassy lobster print pants. When I put his numbers into the ASCVD risk calculator (a tool doctors use to determine your risk of a heart attack or stroke) he was looking even better. I found that his 10 year risk went from 9.2% to 3%! This was an incredible improvement. I had to check my math and as always, it was correct. Part of the reason his risk went down so much was because he had better control of his blood pressure, so I put the numbers in again, but this time not accounting for his blood pressure improvements and his risk still went down by more than 50% from 9.2% to 4.5%. He was shocked that even though his bad cholesterol and total cholesterol went up, he was way less likely to suffer a heart attack or stroke.
So why do we always focus on lowering cholesterol? Because the things that raise HDL effectively are not drugs but lifestyle stuff. A colleague recently reminded me that niacin helped HDL a little but didn’t change heart attacks significantly, so that’s out. We have many expensive drugs that can lower your LDL. Drug companies make billions of dollars per year lowering your LDL without a huge impact on your overall health. While I on the other hand, am trying to get you to raise your HDL, and I am doing it for free, so would it kill you to sign up for email updates?
In conclusion, bad cholesterol is predominantly made as a result of too much sugar and not too much fat. So, never order an egg white omelet, eat the yolks too. They are full of healthy fats, nutrients, and according to my daughters are home to the “dippy part” of the egg. Keep your blood sugar low, by avoiding most fast and processed carbohydrates and your cholesterol will get better without medications and your risk of MI will go down, but please also listen to your doctor.
Good cholesterol (HDL) can be increased with exercise, healthy saturated fats like coconut oil and grass fed beef, and some alcohol consumption, specifically red wine. I recommend all of these things, especially exercise. The complicated part is that sometimes the bad LDL is raised a little by healthy saturated fats as well, but the good HDL is raised more, creating a net positive effect, just like we saw in Mr. Max Powers. My cholesterol numbers were poor in my 20’s but have been exceptional since starting this diet and have gotten better every year. Many patients are afraid of all the butter, eggs, bacon, and butter that I recommend, but are elated when their cholesterol improves dramatically. When you get your numbers back, feel free to share them with me on the site. Mine will be measured next month and I will be sure to post them as well.
*Also, you should know that there are no clean or classy Tijuana strip clubs, I checked. Some references are listed below.
** There is a third cholesterol component known as VLDL that wasn’t mentioned in Mr. Max Powers’ lipid report but it can be calculated by subtracting the LDL and HLD from the total.
REFERENCES: Our findings suggest that reduction in serum cholesterol does not prevent the risk of AMI. There was a significant increase in systemic inflammation in AMI patients, inversely correlated with HDL levels, suggesting an important role of inflammatory mediators in AMI. Thus, a decrease in serum HDL and increase in hs-CRP strongly predispose the risky individuals to the event of AMI. We emphasize the importance of HDL and hs-CRP measurements in the assessment of a combined lipido-inflammatory risk factor for the screening of high risk individuals and the prognosis of AMI. Lipid Profile of Patients with Acute Myocardial Infarction and its Correlation with Systemic Inflammation Haseeb A. Khan,1Abdullah S. Alhomida,1 and Samia H. Sobki2
The well-known “HDL hypothesis” suggests that therapies aimed at raising HDL-C concentrations will lower the risk of CAD and MI. In a widely cited meta-analysis of four large studies (total number of individuals studied: 15,252), a 1 mg/dL increase of HDL-C levels was reported to be associated with a 2%–3% decreased CVD risk
These aren’t all “health foods” in the traditional sense. The point of this article is that these foods are better than most people think, and that’s really good news because all of the foods on the list are delicious. These write ups ran a bit long, so I will only post the first five now and then another five in a few days. I hope you like it.
1. Bacon. I love bacon and it’s statistically likely that you do too. I know there’s been some bad bacon press recently, and a lot of people, namely my unpaid editor/website designer/mom are concerned about the reports of increased cancer risk associated with smoked and/or processed meats. As a side note, I recommend and eat organic and/or humanely raised and sustainable pork because it’s healthier, tastier, and better for the environment. I like Niman Ranch or small locally farmed pork products for this reason https://www.nimanranch.com/. I also avoid turkey bacon because it doesn’t taste as good as regular bacon, also it looks weird, like cartoon bacon but in real life.
While there are a lot of high quality studies that show that eating meat is not harmful to your health, there are two recent studies that show increased risk of stomach cancer and colon cancer associated with eating smoked and processed meats like bacon. These recent reports regarding bacon are reasonably well done but the media reporting of these studies are examples of how easily we are misled by scientific data, special interest groups, and the media.
I am not a big fan of hot dogs, corndogs, bologna, and other processed commercialized cold cuts and mass produced meats, partially because almost all of these animals came from CAFO’s (concentrated animal feeding operations) which pose many health and environmental risks to America. I could go on and on. But high quality bacon, yeah I like that. So these studies concerned me. https://www.sciencealert.com/yes-bacon-has-been-linked-to-cancer-again-here-s-how-bad-processed-meats-really-are-for-you So I looked a little deeper and applied some of the principles I learned in medical school with a little bit of 5th grade math. Here’s the truth. First off, even if these studies are completely true and these meats really do cause an 18% increase in stomach and colon cancer, as they claim, what does that really mean? I know 18% increase sounds like a lot. Also, I’m a doctor and I know stomach cancer is very bad.
Uhh, Dr. Jimmy, I thought this article was going to be good news. WTF?… I’m getting there. Also you are coming off a bit aggressive. In the U.S. you have a 0.8% lifetime risk of getting stomach cancer. If you’re math challenged, that’s less than one in 100. This study finds that eating bacon raises your risk by 18%. What’s confusing is that this study doesn’t mean your new risk is 18.8% (that would be bad) because an 18% increase on 0.8% is 18.8%. Actually, your lifetime risk becomes 0.94% (0.8 X 1.18= 0.94). So
your risk was less than one in 100 with no bacon in your life, add some bacon, and it’s still less than 1 in 100, in fact it barely goes up at all, less than two tenths of one percent. Uh, I can live with that if it means I get bacon too. The longer you live, the higher your risk of stomach cancer, perhaps the reason bacon eaters stomach cancer risk is slightly higher is because bacon is healthy and making them live longer, thus increasing their risk for stomach cancer. I think I just broke the matrix. Actually, this is not how statistics work, but I almost had you buying that circular logic. “Your risk of cancer goes up less than two tenths of one percent” is not an exciting headline, so the media and special interest groups try to fool us with statistical terms like relative risk and tell us that our cancer risk goes up 18%. If you were single in the 90’s and early 2000’s, every sexual encounter put you at risk for HIV/AIDS which was a death sentence back then (unless you played point guard for the Lakers). What’s worse, those encounters, unlike real bacon, were probably devoid of any smoky baconey goodness, unless you were having sex with Emeril Lagasse.
Incidentally, I found a way to increase your chances of winning the lottery by 100%! All you have to do is buy 1 more ticket. Unfortunately, your odds remain low at 0.000000006% but it’s up from 0.000000003%! This is an example of how deceiving relative risk statistics can be.
One thing that people lose sight of, is that when we decide not to eat a food for health reasons we have to eat something in its place. So you don’t eat bacon because of the 0.14% absolute increase in risk of stomach cancer. What do you eat in it’s place? If your choice is kale or low carb pancakes/ fine, you right, good choice. If the answer is cereal, pop-tarts, waffles, or bagels you just spiked your glucose, increased insulin, worsened your cholesterol profile, and gained weight. These foods can lead to heart disease, stroke, diabetes, and obesity, all of which are much more likely to cause harm than that statistically insignificant bump in your stomach cancer risk, also all of those foods aren’t nearly as tasting or filling as bacon.
So, when your publicist/unpaid editor/website designer/Mom tells you to stop eating bacon because it’s bad for you, you should stop eating bacon in front of her because she’s your mother, but then later you can enjoy some secret bacon, because it’s actually fine for you health-wise. I think “Secret Bacon” would be a great name for a band. So go forth and enjoy your bacon without guilt or regret, just don’t go nuts.
2. Nuts. Many people read food labels, or listen to incorrect diet advice and conclude that things like chips, crackers, and pretzels are healthier than nuts because they contain less fat and calories and they are all found in the junk food aisles of the grocery store. Nothing could be further from the truth. Nuts have healthy fats, fiber, vitamins, minerals, and protein. They help promote healthy gut bacteria and help fight diabetes, heart disease, obesity, and even breast cancer. While many of you know of the virtue of eating almonds and walnuts, you probably don’t know that there are a pair of even tastier, healthier, and sometimes saltier nuts. The amazing pair of nuts I’m referring to are pistachio andmacadamia nuts. These two tasty nuts have more healthy fat, less carbs, and a lot more nutty flavor for your mouth.
I know macadamia nuts are pricey but if you get them from the bulk bin at the supermarket or from Costco, you get more nut for your buck. Did I mention how good these nuts taste in your mouth? So good.
In Sicily, pistachios are sacred like potatoes in Idaho, vodka in Russia, or meth in Reno. They’re not just delicious, but they contain a magical compound called nitric oxide that helps improve blood flow to our nether regions making for better and more robust erections which is probably why the Sicilians put pistachios on everything.
Interestingly, French men note a significant but temporary increase in height when they eat pistachios, other foods containing nitric oxide and Viagra. This allows them to look even farther down their noses on us Americans when we struggle with their ridiculous language on vacation in France. If you make it to France, be sure to include a visit to the graves of our fallen soldiers who died liberating their overrated country. I propose that if we have to go in there again, we keep the Southern half of their country and turn it into a redneck vacation paradise, just to piss them off. I apologize for this rant. I’m a little cranky. I need some coffee.
3. Coffee. You may have heard that you shouldn’t drink too much coffee but the overwhelming majority of new evidence supports coffee as a health drink. The Finnish people drink more coffee than anyone else on earth. The average adult male in Finland averages a ridiculous nine cups of coffee per day (their cups are a little smaller than ours, but still). They are also a super healthy group of people.
I know what you are thinking. You are going to say that it’s because of their cross country skiing, their saunas, their fatty fish intake, polar bear plunging and their rampant inbreeding. You may be right, but one of the things you can do when you are measuring the effect of a variable is to measure the “dose dependent response” by that I mean, you can ascertain if people who drink 12 cups are healthier than those who drink 8. You can then find out if those people are healthier than those who drink 4, all the way down to the one Finnish guy who only drinks Monster Energy Drink and Blue Mountain Dew. P.S. He’s super unhealthy. It turns out, that in the Finnish study there is a dose dependent response and the heavier coffee drinkers were the on average the healthier people. So assuming you don’t have any negative side effects, coffee can be considered very healthy.
Because of a sub-par national diet, coffee is the major source of anti-oxidants for a lot of Americans but studying coffee in the U.S. population is tough because we don’t drink that much when compared to those cousin loving Fins. Also, we mix in all sorts of unhealthy shit like sweetened creamers, caramel syrup, and whiskey. Whiskey being the most healthful of the three unless you fly commercial airliners for a living. Also, our serving sizes are so variable, a serving of coffee to some Americans is a 72 ounce trucker sized plastic mug and to others it’s a tall latte, which is Starbuckian for small. Incidentally, if you go to Italy and order a “latte”, they will give you milk. If you order a cappuccino, you will get a Starbucksesque latte, and if you order a machiatto, you will get a Starbucks-like cappuccino, but I digress. Lucky for us, the Finnish people have pretty much standardized their coffee cup serving size, thus making studying them a lot easier.
The bottom line is that as long as you don’t put a bunch of unhealthy crap in your coffee, you can expect to experience better glucose control, more energy, better mood, better athletic performance, lower risk of parkinson’s, alzheimer’s, many forms of cancer especially colon cancer, stroke, heart disease, also it really helps your poop come out smooth and easy like butter.
4.Butter. I’ve been told that butter makes you fat. Butter gives you heart disease. Butter should be replaced with vegetable oils and unsaturated fats like margarine. Butter doesn’t taste good. False, false, false, and sofa king false. Sofa King Healthy was one of the proposed titles of our book, by the way. I thought it was funny but misleading, and by that I mean perfect. Back to butter, it is obviously delicious and if you read my previous posts, you know that margarine and most refined vegetable oils are processed poison https://drjimmywestbrook.com/2019/01/08/food-rants-the-10-health-foods-that-are-making-us-fat-and-memes/.
A recent study showed that people with higher butter fat levels in their blood had huge reductions in their risk of type 2 diabetes (30-40% which is a real difference because type 2 diabetes is super common these days) and there has never been a well documented link between butter and heart disease. In fact, the countries that consume the most butter seem to have some of the lowest rates of heart disease, France being first on the list, despite high rates of smoking and the fact that French gyms are reserved for tourists use only.
Organic grass fed butter has almost no carbs and is environmentally sustainable. It’s delicious, and high in very healthy omega-3’s, and rich in buttery goodness. If that’s wrong I don’t want to be right. So start finding ways to get more healthy butter into your meals and get rid of the processed vegetable oils. I’ve mentioned how much I love vegetables and how healthy they are for us. This isn’t news but you should still check out my top ten reasons to eat more veggies for more information. One thing I left out is how there are a lot of vegetable eaters who don’t absorb many of the healthy vitamins that are in their veggies. Vegetables contain fat soluble vitamins and if you are eating your veggies without fat then you are likely just pooping out those important nutrients. If we cook veggies with fats like clarified butter, our bodies are more able to absorb the fat soluble vitamins the veggies contain and we are also much more likely to go back for seconds. Please stop steaming your veggies.
Bonus cooking tip: You can make clarified butter by melting and filtering butter, thus removing any milk protein that can burn and smoke. Clarified butter has a very high smoke point, around 460 degrees, which means you can use it to cook vegetables, seafood, and meats at high temps. When you use oils with lower smoke points like olive oil, high temperatures can cause the oil to break down and create unhealthy byproducts that can cause increased inflammation. To be clear, it’s OK to cook vegetables with olive oil, just not at those high temperatures. Clarified butter is also safe for people with lactose intolerance, and dairy sensitivity because the lactose and problematic proteins have been removed. You can make clarified butter in advance and keep it in the refrigerator in a jar. If you don’t have a jar, just use whatever you have lying around the house.
I average eating a little less than a stick of butter per day, usually I cook with it but if I am hungry and lazy I will salt it a bit and eat it straight like cheese. Don’t judge me until you try it. It goes great with red wine.
5. Red Wine. Red wine has been one of the most controversial topics in nutrition for many years. There are many reasons for this controversy. First, doctors and nutritionists are really scared to recommend any alcohol because of all the potential hazards associated with it’s use. I don’t blame them. Second, there is a strong association between red wine and other healthy lifestyles like eating vegetables, yoga, and McDonald’s avoidance which can make the data less conclusive whereas things like Busch Light, Sailor’s Choice Vodka, and Four Loko are associated with unhealthy lifestyles, specifically high rates of sexually transmitted Diseases, truck related accidents, and truck related Sexually transmitted diseases. So, many experts dismiss red wine health claims as hype and association bias. I respectfully think these experts have their heads up their asses because there’s a mountain of evidence to support red wine’s many health claims. Longevity data shows that moderate drinkers live longer than non-drinkers, and alcoholics don’t live that long at all. Of all the alcoholic drinks, red wine shows the most benefit by a wide margin.
If you don’t drink, good for you. I’m not trying to get anyone to start drinking, but if you already drink alcohol, then you owe it to your health to make sure that you are drinking some red wine. Red wine or “Mommy Juice” as it was known in my house as a child has been associated with preventing diabetes, Alzheimer’s disease, certain cancers, inflammatory diseases, and gut health. The most important benefit is seen in your heart. Red wine seems to be one of the few things that will raise your good cholesterol HDL and lower your bad LDL. Red Wine also lowers blood pressure and lowers total body inflammation which is important for heart health and preventing myocardial infarction AKA heart attacks.
Red wine may help us achieve a healthy weight if we switch from a different higher carb drink like Rum and Coke, Gin and Tonic, or Red Bull Vodka Slushy’s. As a side note, many people do not know these fun facts about tonic water: It has as much sugar and calories as a Coke. It was invented as a way to get British Soldiers to take their malaria prevention medication (quinine) by mixing it with gin. It glows very bright when exposed to black light, like the remote controls at a Motel 6.
All alcohol is high in calories but red wine is fairly low in carbs (usually between 2-3 carbs per serving). Red wine has been shown to help your good gut bacteria flourish which is helpful for your metabolism. It has also shown to help convert your white fat cells into brown fat. White fat is the stuff we are all trying to get rid of while brown fat is the kind we all want, or at least we will want after reading this paragraph. Brown fat was previously thought to be only found in babies and functioned to help them keep their body temperature stable in cold because babies can’t shiver and are too lazy to clothe themselves. We recently found that adults have brown fat and it serves as a little furnace where we can burn excess calories without working out or storing them. More research is needed in this area but if scientists could get better at isolating this brown fat thing, we would all have a much easier time maintaining our ideal weight.
So if you’re drinking beer, Jaeger bombs, Vegas Bombs, Irish Car Bombs, or anything thing that has booze and comes out of a slurpy machine, do your heart, waistline and self-respect a favor and switch to a nice oaky cabernet or jammy zinfandel.
I’ll post five more Unhealthy Foods that aren’t, in the next week or so.
The processed foods we eat in this country are killing Americans, literally, and killing me, but only figuratively. The issue has cost me a lot of sleep, literally. The manifesto below is a call to arms, figuratively.
Definition of Processed foods: Mass produced, homogenous, foods that have been refined or broken down into various isolated substances and then reconstituted to make other “foods” using chemical, industrial, or demonic processes. These foods are generally low in nutrients, shelf stable, cheap, unhealthy, and are the cash cow of the American food industry. -Dr. Jimmy Westbrook
Did I just quote myself? Anywho, big food companies have been getting rich off of processed foods for decades. Like Kaiser Soze from “The Usual Suspects” these products are protected from up on high by the prince of darkness himself.
Corporations, politicians, and lobbyists, use food pyramids, heart healthy labels, nutrition misinformation, and biased scientific studies to protect their processed food profits. They’ve got teams of scientists, doctors, and nutritionists in their pockets and on their payrolls. They don’t need to get everyone to buy into their lies, instead they can pump out bad information, and leave the public unsure about what to believe, then they win. Useless nutritional claims like “no sugar added*”, “fortified”, “low sodium”, and “fat free” confuse an already lost pubic into buying their poison. Do you know what else is low in sodium, fat free, fortified, and has no sugar added? My couch, and it smells like Febreeze and dog farts. By “fortified” I mean we use it for making forts.
Various civilizations have thrived on a multitude of diets throughout human history without developing the epidemic obesity, diabetes, and heart disease we have in our society since the advent of processed foods. People have maintained high levels of health on plant based diets, hunter gatherer diets, and meat based diets (like the Inuits of Alaska). When these groups start to eat a processed Western diet, collective health is utterly destroyed. One could argue that it doesn’t matter what diet we eat, as long as we avoid processed foods. Unfortunately, today processed foods are so engrained (do you see what I did there?) in our society that they are very difficult to avoid. 100 years ago, a loaf of bread wasn’t a processed food, but sadly it is today. Even if you make your own bread at home, the wheat you are using is far from bueno. I’d even say it’s no bueno.
It is the processing, refining, and genetic modification of the grains that cause them to have such an undesirable inflammatory and pro insulin response in our bodies. Dr. William Davis author of “Wheat Belly” calls wheat the perfect obesogenic food because wheat spikes your blood sugar and make you hungry very quickly after eating it. The other grains (corn, rice, etc) aren’t much better and completely different from the grains of 70 years ago. Can you picture a field of wheat in your mind? Is the wheat waist high and beautifully amber with a child running through it? If that is the case, you are not picturing wheat in its current form. Wheat today is 13 inches tall at maturity (see above) and children would likely be choked by pesticides fumes or the petroleum based fertilizers used on the crops.
100 years ago if you picked corn and then planted the corn kernels in the soil, corn would grow. Today, not so much. Companies like Monsanto have altered industrial corn to be almost incapable of reproduction. That’s weird. What’s even more ridiculous, is the fact that it takes years to get a lifesaving cancer drug approved for a small group of people who are literally doomed without it, but food corporations can make a new plant and feed it to every human being in America without even testing the food out on prisoners, lab rats, or college students. Back in the good ol’ days, grains like wheat and corn were not genetically modified or processed and did not cause the obesity, allergy, diabetes, and inflammation that corn and wheat cause today. This is probably why there were so few obese people 70 years ago and yet there was no such thing as cross fit, 24 hour fitness, gastric bypass surgery, GNC, or gluten sensitivity.
Many processed foods also use shelf stable vegetable fats like: partially hydrogenated soybean oil, partially hydrogenated vegetable oil, and other very pro-inflammatory processed cheap fats. To be clear, these are “trans fats” which are the only fats that are truly harmful. They cause heart disease and have also been linked to stroke, diabetes, and other things you don’t want. Fats like these should be avoided at all costs. To be clear, I am pro-fat with the exception of trans fats. **
Processed foods, like most poisons, have a dose dependent response and therefor the more processed foods we eat; the sicker, the fatter, and more reliant on doctors and the pharmaceutical industry we become. Furthermore, the more processed foods we consume, the more addicted we become to their artificial flavors, chemical additives, convenience, and the hilarious catch phrases of their animated mascots. Even worse, when we allow corporations to do the cooking for us, in the form of fast and easy processed foods, we collectively forget our traditional recipes, the joys of cooking, and where we stored our Dutch oven. This is just what the food industry wants to happen, and spoiler alert, it is happening, all of it. And it is not about to stop anytime soon.
*”No sugar added” or “naturally sweetened” are labels make moms and dads feel good about the food choices they are making, but in reality these labels hide the fact that the manufacturer has figured out a sneaky way to sweeten the food without using plain sugar. Usually they add a sweet juice like pear or peach that has been refined to the point that the only thing left in it is fructose (a potent sugar), which turns out to be worse than table sugar and if people knew what fructose did to their bodies, they would be begging for the sugar to be added back into their foods. My high fructose corn syrup manifesto is coming soon.
** The US government banned trans fats in 2018 but many products have been granted extensions until July 2019 and are still prevalent in many processed foods.
Derek Zoolander said, “Water is the essence of moisture.” The 10 keys discussed below are the essence of how to get Healthy as F%$#!
These are the most fundamental points. I have included a lot of links to articles that expand on these topics. This isn’t the why. This isn’t the how. This isn’t the who. You are the who. This is the 10,000 foot view of what are the most important things for your health.
1. Eat lots of fats. Fats are the best fuel your body can use. Fats will keep you full, keep your blood sugar low, taste good in your mouth, and help you look and feel your best. Eat more fats, and then eat some more. If you want ten good reasons why, click here: Top Ten Reasons to Eat More Fat
2. Eat lots of vegetables. They are full of micronutrients, low in calories, and high in fiber. Vegetables are healthy as F%$#! Here is why… Top Ten Reasons to eat More Veggies
3. Don’t eat sugar. Don’t eat fake sugar, high fructose corn syrup, grains, whole grains, or starches. These foods create blood sugar spikes, insulin release, inflammation, obesity, and diabetes. For more information on this, here you go. Cut the BS*!
5. Don’t eat processed foods. These foods are loaded in anti-nutrients, chemicals, and toxic mass-produced grains, sugar, and soy. My processed foods manifesto is complete. Here it is.
6. Get sufficient quality sleep. Good sleep is the secret foundation for great health and without it, all of this other stuff becomes a waste of time. Prioritize getting amazing sleep and everything else will improve. Here’s why. And here’s how.
8. Exercise regularly but not to lose weight. Exercise is amazing for your body but don’t try and out-exercise a shitty diet. Working out is most effective when it’s done using weights and with short periods of intense unpleasant activity. * The Stoops easy, no jogging, workout plan
10. Don’t stress over perfection. Follow the 80/20 rule that states, what you do 80% of the time is what really counts. So, have some pizza, tacos, wine, and tequila every now and then. Here’s your cheat day guide. F*** Moderation. How to overdo it.
*Stop jogging. Consult your doctor before starting an exercise program, but don’t tell him or her about the above rules, as they will likely disagree.
You up for getting healthier, losing weight, and silently chuckling to yourself while reading? Then you may like my website. I’ve been doing research on health, wellness, and weight loss for a long time. I know what works. If you are checking out my site, it’s likely that you want to improve an area of your health. Martin Hall, a famous golf instructor says, “If you keep doing what you’re doing, you’ll keep getting what you are getting”. The same is true with your health, except worse because as we age, maintaining great health can get more and more difficult, but not impossible. Americans keep trying the same things like jogging and low fat starvation diets to get healthy and Americans keep getting fatter, sicker, and less sexually appealing. I am asking you to try something different. Give it three months, it’s a third of an NBA season, and if it doesn’t work, I’ll give you your money back. Except, there is no money. It’s free, so even better. You already know what doesn’t work, it’s what you have been doing. Put your health in my hands and I promise to get you looking, feeling, and looking better than you thought possible. Did I mention “looking” twice? That was a typo.
Every night before I tuck my daughters into their sleep treadmills, I say the same thing, “Kim and Khloe, remember girls, it’s what’s on the outside that counts”. We have a strict “no smiling” policy in my house, as it only leads to premature wrinkles, and ice chips are considered an entrée and a dessert. But seriously, sometimes what we see on the outside is a reflection of what’s going on inside, so we endeavor to improve both. As a disclaimer, if you have been offended by this article or anything you have ever seen on cable television, it’s best you stop reading now, because it’s only going to get worse, and my writing style is not for everyone, specifically you. I’m sure there’s a vegan website or a Jenny Craig somewhere near you that would be more your speed, in fact, here’s a link https://www.jennycraig.com/. They’ve got plans starting as low as 29 dollars and the first week of food is free. You can’t beat that.
Back to me. I am an active Dad who’s over 40 and balancing raising two daughters, a busy career as a physician, a wife who thinks a bottle of wine is a single serving, and a bookie who is best described as “leg breaky”. Despite my hectic schedule, I am feeling and looking better than I have in 15 years. I have lost over 30 pounds, improved all aspects of my well being, and stopped needing medications for my high blood pressure, knee pain, psoriasis, acid reflux, and for occasionally feeling not so fresh, you know, down there. The changes I recommend are simple, life-saving, but totally free. This is the link to my bio A Bit About Me…More content is coming to the site soon. I am also in the process of writing a book with professional author and physician Dr. Jason Valadao. Check him out and get your copy of his new book at Jasonvaladao.com. Some of this website’s content will be featured in our book. Above all else, we believe that food is the world’s most powerful medicine. It should nourish the body and soul, and it should be shared with the most important people in our lives. It shouldn’t be ordered from a clown’s mouth, purchased at a gas station, or worst of all, eaten at The Olive Garden.
The book and website are funny and sometimes ridiculous reads that just happens to contain life-changing new information based on the most up to date nutritional science. That’s what we call a teaser in the publishing game. I hope you keep reading. This is the best place to start. You Should Start Here… START HERE: The Basics. 10 Keys to Getting Healthy as F**k!
While the prospective graduates of my medical school class were in the midst of selecting a specialty to pursue, a professor gave us a piece of advice. She said, “Select the area of medicine where you see the greatest injustice, and focus your efforts there.” For some members of my class this was pediatrics because of the number of children without access to healthcare and to give a voice to those who can’t yet speak. Others selected psychiatry because of the often forgotten plight of the mentally ill. Still others chose plastic surgery because of the unfair disparity in breast size in America and because they yearned to own a yacht that is much larger than their father’s very large yacht. I have my own ideas about what the greatest injustice in health care is. Mine is rooted in the belief that the most important factor in your overall health is what you choose to eat. Most people don’t know that food is this important, but it truly is. Also, most people (and this probably includes you) do not know which foods are good and which foods are bad. This speaks to the injustice we see. Americans are fat, chronically ill, and dying because of wrong information and lies. Who is putting out this wrong information, and what are the right and wrong foods to eat? I think you will be surprised by the answers. We will get there, just keep reading.
Me and med school friends at our white coat ceremony
Thanks for taking the time to read this. I’m Jimmy Westbrook, a board certified family medicine physician. I attended medical school at Florida State University College of Medicine, but originally I am from Seattle. Before getting my M.D., I spent 9 years as a pilot in the U.S. Navy. I have been writing recreationally all of my life to include serving as a film critic to a small newspaper in Key West, researching and writing an article on the Mediterranean Diet published in a semi-prestigious medical journal, and the primary author of my family’s R rated Christmas letter. Most notably, I am in the throws of writing a book on my style of healthy eating. It is co-authored by my good friend Dr. Jason Valadao. Jason also has a new book out and you can read up about him at his website, https://jasonvaladao.com/. I give medical talks in the arena of health, nutrition, longevity, diabetes, physician leadership, and various other medical subjects. I have a comedic, down to earth, and snarky tone to my writing that is not often found in the world of medicine, nutrition, and health. I have a dirty sailor’s mouth and sometimes this spills into my writing on this webpage. If you are offended by this, I apologize…for nothing.
My last flight in the mighty SH60
Because I wasn’t always in medicine (did I mention that I spent the first 9 years of my post-college life as a Navy Pilot, see the above picture), I am able to better gauge what an intelligent but non-medical audience needs or wants to know about these subjects. I try to explain things in a way that makes people laugh, is easily understandable, and believable. On a personal level, I enjoy red wine, scotch, golf, watching football, cooking, and gambling. I love pop music, fantasy football, and am terrified of rats and clowns, also I overshare. Because I came to medicine later in life, I have the perspective of being able to speak in a relatable way without being condescending to the reader and without using a bunch of words that require a textbook to decipher. In medical school, I was frustrated by unnecessary medical terminology. For instance, why do doctors have to use the word “epistaxis” for nosebleed or “hematochezia” for bleeding from your butt? Why can’t we just call it a nosebleed or rectal bleeding? Then patients and doctors could be on the same page about what substance is coming out of which of the patient’s holes. I think doctors use this terminology to help us sound smarter than non-doctors. I will try to avoid using these types of words and explain things as if we are talking to very smart people who did not attend medical school, that’s you. This site does not have a political or ideological slant. And I promise that I won’t try to get you to go vegan, get a food scale, or buy any meal replacement shakes. I will try and get you to purchase my upcoming book for all of your friends, family, work related acquaintances, and Tinder hookups. Thanks again for visiting my site. Read More
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