Although metabolism is generally used as a term to describe the utilization of food for energy production, particularly in regard to weight loss, it actually has a much broader meaning. Metabolism also includes all other reactions that support life, which implies that changes in metabolism can influence health, for better or worse, in ways unrelated to energy production. Therefore, having a basic understanding of metabolism is not only important for maximizing the effectiveness of your fat loss efforts, but also for doing so in a healthful manner.

Is Calorie Intake All that Matters?

When food intake is considered from the perspective of nutritional quality and health promotion, the sentiment of all calories being equal is absurd. Despite the probability that most people realize this, those looking to lose weight often put more emphasis on calories than nutrients. This is unfortunate because any dietary approach to weight loss that neglects nutritional quality is much more likely to result in poorer health and a subsequently reduced quality of life regardless of how much weight is lost. Nonetheless, weight loss is indeed mostly a matter of energy expenditure exceeding intake.

Despite the obvious role of energy balance, it’s important to realize that both energy intake and expenditure are influenced by a variety of factors. For example, a higher intake of protein tends to reduce overall calorie intake,¹ but prolonged calorie restriction tends to reduce energy expenditure.^2-4 Furthermore, estimations of calorie intake are generally inaccurate,⁵ and formulas commonly used for estimating resting metabolic rate are inherently error prone.⁶ In other words, counting calories is like aiming for a moving target while trying to balance on one leg. For many people, it’s nothing more than a frustrating waste of will power that could be better used elsewhere.

Low carbohydrate diets are sometimes said to have a “metabolic advantage” because of their tendency to produce more weight loss than low fat diets with the same caloric content. This has been proposed to be a result of increased energy expenditure, partly through the digestion and metabolism of a higher protein intake, and partly due to a greater dependency on gluconeogenesis for energy production.^7,8 The reduction of glycemic index in conjunction with reduced carbohydrate intake, but with the same caloric content, has also been shown to result in a higher resting energy expenditure.⁹ In agreement with the existence of a metabolic advantage, compared to people who consume 20% less fat than average, individuals with a lower carbohydrate and higher fat intake have been found to have a higher rate of resting energy expenditure and a similar body composition despite also having a much greater caloric intake.¹⁰ Although, in this case, protein intake was similar between groups suggesting that protein digestion was not related to the difference in metabolic rate. Furthermore, since this was a retrospective study with food intake having been determined through a food frequency questionnaire, it provides only weak support for the existence of a metabolic advantage.

While a metabolic advantage may exist to some extent, the proof of its existence remains elusive, and it may not be the primary reason why carbohydrate restriction tends to result in more weight loss than calorie restriction alone. For example, in a 6 month comparison of a low carbohydrate and low fat diet, although the low carbohydrate group lost more weight, there was no difference in resting energy expenditure.¹¹ Besides, such a metabolic advantage implies inefficiency which could conceivably be more of a hindrance than a benefit to overall health by promoting a small but persistent increase in metabolic burden.

Regardless of the supposed metabolic advantage, both low carbohohydrate^12,13 and Paleolithic type^14,15 diets have been shown to reduce uninhibited caloric intake. Given that these diets tend to have a higher protein content, and that an increase in protein intake is known to reduce overall calorie intake,¹ this is likely to be a contributing factor to improved weight loss. Likewise, the tendency for these diets to be based primarily on whole foods implies a reduction of glycemic index which has also been associated with lower calorie intake.¹⁶ This is consistent with the conclusion that it is carbohydrate restriction more so than protein content that results in reduced intake,¹⁵ although the association between glycemic index and calorie intake has not been consistently supported.^17,18 Either way, even in the absence of proof for the existence of a metabolic advantage, it’s obvious that effective weight loss involves considerations that go well beyond calorie intake.

Fat Loss versus Weight Loss

In general, as much as a third of the weight lost through calorie restriction can be accounted for by a loss of muscle mass.¹⁹ This is where the influence of lifestyle choices on macronutrient metabolism becomes especially important. Although such choices may not have much influence on the quantity of weight lost, they can have a significant impact on the ratio of fat and muscle loss. In addition to the obvious implications relating to appearance, this is associated with important health implications as well.

It’s possible to be thin with a relatively high percentage of body fat. This is sometimes referred to as being “skinny-fat” and is characterized by a mild to moderate accumulation of body fat in conjunction with a reduced amount of muscle mass. Aside from being associated with a number of markers indicative of metabolic dysfunction and disease risk,²⁰ this is an obvious indication, regardless of whether your goals are based on appearance, health, or both, that it’s important to minimize muscle degradation during weight loss. As such, there’s clearly more to consider in regard to losing weight than simply reducing the number on the scale.

Coincidentally, in addition to a higher protein intake possibly being associated with a higher energy expenditure, it’s also known to reduce muscle loss during calorie restriction.¹⁹

The Importance of Utilizing Fat for Energy

At rest, skeletal muscle is estimated to account for 20% to 30% of total energy expenditure,²¹ and fat is the primary source of this energy.²² This is good news for anyone looking to lose body fat. However, following a meal, carbohydrate is preferentially used for energy production prior to fat.²³ Furthermore, the increase in circulating glucose and insulin that results from carbohydrate intake is likely to inhibit the utilization of fat for energy production,^24-26 especially when caloric intake exceeds demand.^27,28 Because this inhibition can last as long as 6 hours,²⁹ a consistent intake of moderate to high carbohydrate meals can result in fat utilization being impaired for the entire day.

Obviously, maximizing the utilization of fat for energy will have a significant influence on how body composition is influenced during weight loss. However, fat utilization is also an important consideration for health. Impaired utilization of fat during fasting conditions is believed to play a primary role in promoting insulin resistance^30-32 which is a foundational component of metabolic syndrome,³³ and in turn, is associated with a number of chronic health conditions including cardiovascular disease,^34,35 cancer,^36,37 and neurological disorders such as depression,³⁸ cognitive decline,³⁹ dementia,^40,41 and Alzheimer’s disease.^42-45 Clearly, more is at stake than how you look in a swimsuit. In addition, insulin resistance facilitates muscle degradation⁴⁶ which, in conjunction with reducing the capacity for fat utilization, further increases the chances of becoming “skinny-fat.”

Why You Should Care More About Glycogen Storage than Calories

Dietary carbohydrate not immediately used for energy is primarily stored as glycogen in either the liver or in muscle.^47,48 However, this storage capacity is limited to a total of about 15 grams of glycogen per kilogram of body weight.⁴⁹ Dietary carbohydrate will generally be used to replenish glycogen storage before being used for energy production.^48,50,51 Since the remainder of carbohydrate not used for glycogen repletion will be preferentially utilized for energy production before fat, an increased need for glycogen repletion will reduce immediate carbohydrate availability and therefore increase the potential for fat utilization. As such, the extent of glycogen depletion will dictate how much dietary carbohydrate is used for glycogen repletion instead of energy production, and in turn, how much fat will be utilized to meet the remaining energy demand. Therefore, as glycogen storage increases, the potential for losing body fat decreases.

After reducing carbohydrate intake and increasing fat intake as part of a weight maintaining diet, it has been shown to take between 3 and 7 days for the utilization of fat to increase to the point where utilization equals intake.^52,53 However, further supporting the role of glycogen in the regulation of fat utilization, when such a change in intake is preceded by glycogen depleting exercise, fat utilization has been shown to equal intake during the first day.⁵⁴

As illustrated above, glycogen content is primarily dictated by carbohydrate intake and activity level. Therefore, assuming that you’re eating mostly whole foods, which should greatly reduce the likeliness of overeating, focusing on your carbohydrate intake and activity level should have a much more favorable influence on your body composition than counting calories. Either way, you still need to expend more energy than you consume in order to lose weight, but by maximizing the utilization of fat for energy production, more of your weight loss should come from body fat and less of it from muscle. In support of this, a reduced carbohydrate intake has been shown to promote more favorable changes in body composition than a reduced fat intake.^55,56 Furthermore, in contrast to the increase in fat utilization generally observed with carbohydrate restriction, calorie restriction alone has been generally shown to not have this effect.^32,57-59

Why Exercise Alone is Not Enough

A well balanced exercise program is clearly beneficial for maintaining a high level of health and quality of life in addition to its potential to facilitate weight loss. Plus, resistance training in particular can help to minimize the amount of muscle lost while maintaining a reduced caloric intake.⁵⁶ However, the common approach of exercising more frequently and intensely to compensate for poor dietary choices can severely compromise quality of life. Among athletes, it’s well documented that excessive exercise can result in persistent fatigue, mood disturbances, increased injury risk, sleep disturbances, and impairing immune activity,^60-66 all of which are likely to be compounded by the continuation of a lower quality diet.⁶⁷ As such, it should be obvious that the benefits of exercise do not reduce the importance of a healthful diet, and this is the case for both health and weight loss.

In regard to weight loss specifically, exercise alone has been shown to be significantly less effective for weight loss than dietary intervention.^68,69 What’s important to realize about the weight loss benefits of exercise is that when combined with dietary intervention, not surprisingly, the combination is more effective than either intervention alone,^68,70 particularly in regard to long term maintenance.^69,70

Exercise has been shown to increase fat utilization both during exercise and at rest^71-74 which is obviously important for fat loss. As previously described, exercise also depletes glycogen storage which can promote an increase in fat utilization. Despite these benefits, it has been shown that exercise fails to increase the total amount of fat utilized throughout the entire day.^73,75 A likely reason for this is a carbohydrate intake that repletes glycogen enough to offset the increased capacity for fat utilization. If this is the case, it further illustrates the interdependency between exercise and diet in regard to health and weight loss.

Lifestyle Considerations

This article is not necessarily an endorsement for a low carbohydrate diet. In contrast, the point is that the flexibility to alternate between fat and carbohydrate metabolism, which is an important factor for both health and fat loss, is best supported by a carbohydrate intake that allows for periodic or partial glycogen depletion. Because this is highly dependent on activity level, the appropriate amount of carbohydrate intake can vary by person as well as by day.

Despite the metabolic benefits of carbohydrate restriction, it’s important to consider that it’s been associated with adverse side effects and is speculated to increase the risk of certain disease conditions.⁷⁶ Much of this potential for disease risk is based on the assumption that food restrictions associated with a low carbohydrate diet will lead to nutrient deficiencies. However, a diet based solely on the most commonly available fish, meat, vegetables, and fruit, in conjunction with a low carbohydrate intake, has been shown to readily meet the RDA for all essential nutrients except calcium.⁷⁷ In this case, the reduced intake of calcium was primarily a result of dairy exclusion. Either way, the RDA for calcium has been suggested to be excessive,⁷⁷ and even though dairy can be included as part of a carbohydrate restricted diet, a significant amount of dietary calcium can be obtained through vegetable consumption.

In regard to adverse side effects, the obvious solution is to experiment and determine an amount of carbohydrate restriction that strikes a balance between maintaining a strong sense of wellness and supporting your activity level and fat loss efforts. After all, long term maintenance of a desirable body composition depends on transforming short term behavior changes into lifelong habits, and side effects that detract from quality of life are clearly not supportive of this. In my opinion, for someone who’s not extremely active, limiting carbohydrate intake to 150 grams per day is a good place to start. If and when this becomes comfortable, carbohydrate intake can be further limited to 100 grams per day. For maximum effect, carbohydrate intake can be maintained below 50 grams per day, but anyone doing so should be comfortable with any concerns associated with ketosis. Finally, keep in mind that some adverse side effects may simply be a result of metabolic adaptation to changes in dietary intake. Providing that such side effects are tolerable, a week or two should be an adequate amount of time to determine whether or not they’re temporary.

A whole food diet based primarily on meat, seafood, vegetables, and fruit will, by default, be relatively low in carbohydrate and practically devoid of sugar. Given that these are arguably the most healthful food choices anyway, the concern of carbohydrate restriction causing nutrient deficiency is irrelevant. Furthermore, such a diet can be used to promote both health and fat loss at the same time, which in my opinion is the only reasonable approach for most people. If you consider that such a diet is typical for hunter-gatherer and other traditional populations, all of which are relatively free of obesity and metabolic disorders,⁷⁸ this shouldn’t be much of a surprise. In most cases, a significant part of regaining or maintaining a lean body composition in conjunction with good health is simply a matter of undoing some of the bad habits that the conveniences of modern society has facilitated.

Optimizing Your Metabolism for Fat Loss is an article by Vin Miller from RageWellness.com

Another Case of Epidemiology

The study is based on a population of over 100,000 people who’s diets have been tracked since the 1980s. In other words, it’s an epidemiological study which means that no intervention was applied and the population of participants was merely observed. As useful as this type of research is for identifying associations, it’s important to realize that it can’t prove causation. For example, if red meat is associated with an increase in death, this doesn’t necessarily mean red meat is the cause of the increase. Gray hair could very easily be associated with an increased risk of death, but it obviously isn’t the cause.

Although criticisms of epidemiological evidence often rely heavily on this weakness, epidemiology is valuable because it’s the most practical way to discover potential relationships between lifestyle and health. However, the strength of such evidence rarely justifies the bold statements that are sometimes made based on it.

A Closer Look at the Numbers

The authors of the study concluded that for each additional serving of red meat per day, death is 12% more likely. An admirable aspect of this study is that in addition to total red meat consumption, processed and unprocessed red meat were each considered individually. Each additional serving of unprocessed red meat was associated with a 13% increase in mortality while processed red meat was associated with a 20% increase.

These numbers seem scary, but when evaluated from a more direct perspective, they’re much less intimidating. Throughout the duration that data was collected for, in the group consuming the least amount of total red meat, approximately 20 out of every 100 participants died. The proposed 12% increase in risk would imply an additional 2.4 deaths. In other words, if you added 1 serving of red meat per day to your diet, the results of this study suggest that you might have a 2.4% chance of a premature death.

In case you’re wondering, I didn’t choose the percentage for total red meat because it’s the lowest, but rather because the published data doesn’t include the breakdown of participants by type of red meat. Besides, as you can easily figure out for yourself, using 13% or even 20% for the example above doesn’t make much of a difference. Either way, the risk doesn’t seem nearly as large when considered directly instead of as a relative increase. For example, the difference between 1 in 100 and 2 in 100 only implies 1% of additional risk, but it’s a 100% increase in risk.

Appreciating the Smallest of Risks

If you were to argue that even just a 2.4% chance of premature death is worthy of consideration, I’d completely agree. In fact, in an article I wrote about gluten sensitivity, I regarded the estimated 1% prevalence of celiac disease as a worthwhile consideration. However, I think there’s more than enough uncertainty associated with the methods used in this study to cast serious doubt on whether or not the small amount of risk proposed should be taken seriously.

The first and most important problem is confounding variables. On average, the people in this study who ate more red meat also smoked more, drank more alcohol, consumed less fruit, vegetables, and seafood, were less active and more likely to be overweight, and were less likely to use a multivitamin. Although each of these variables was “controlled for” by statistical analysis, the potential for inaccuracy in doing so could arguably bring the already small 2.4% risk closer to zero.

Without even considering how effectively statistical analysis can differentiate the influence of one lifestyle habit from another, the negative connotation surrounding red meat is deeply embedded in conventional health wisdom. Based on this, people who eat more red meat are also more likely to disregard health advice, take poorer care of themselves, and engage in risky behavior. Obviously, it’s not possible for a study like this to consider every one of these potential influences. If it was, the amount of risk suggested by the study would most likely be even smaller than it already is.

A common criticism of epidemiological nutrition research is how the dietary intake data is collected. In most cases, it’s collected through the use of a food frequency questionnaire. This is generally the most practical way to identify the eating tendencies of a large population, but it has two major drawbacks. The first is that it can only provide a rough estimate of intake, and the second is that it’s only as effective as the memory of the person answering it.

The questionnaires used to collect the data analyzed by this study required participants to recall their food consumption for the past year. How accurately do you think you could recall what you ate a couple of months ago let alone a year ago? Furthermore, the questionnaires were only used every 4 years which means that 75% of the dietary intake data was extrapolated. If you’d like, you can take a look at the actual food frequency questionnaires and decide on their efficacy for yourself. The first is for the Nurse’s Health Study, and the second is for the Health Professionals Follow-Up Study. These two studies are the original sources of the data used to assess the influence of red meat consumption on mortality.

In my opinion, the vagueness of these questionnaires could easily offset the mere 2.4% of proposed risk. In fact, the efficacy of one these food frequency questionnaires used was evaluated by some of the same authors who published this study. In comparison to a detailed food record, which is regarded as the gold standard for assessment of dietary intake, they found that many foods, including processed meat, were reported with significant inaccuracy.² On average, people reported only about half of the processed meat they actually consumed. However, this difference was “corrected” with the use of a statistical coefficient. Once again, we’re faced with the question of whether or not statistical manipulation is accurate enough to justify the legitimacy of small differences.

Quality of Life versus Longevity

An interesting question is if red meat really does increase the risk of premature death, what’s the extent of prematurity? This is an important consideration because it’s unlikely that many people would be willing to spend a lifetime foregoing their enjoyment of red meat just to potentially extend their lives by a couple of months. Despite being more passionate about healthy living than most people, even I can appreciate this. Unfortunately, the study doesn’t provide any information directly relating to longevity, but the percentages presented in the conclusion are based on person-years which implies that longevity was accounted for. Therefore, based on the small amount of risk identified by the study, the difference in longevity is probably small as well.

Although longevity is an interesting and worthwhile consideration, I think quality of life is more important. Even considering the claims that red meat consumption promotes heart disease and cancer, I have yet to come across any evidence strong enough to convince me that this is true or that eating red meat will negatively influence quality of life in any other way for the average person. One might say that I’m biased because I eat it myself, but my dedication to living a healthful life is a lot stronger than my appetite for red meat.

Not All Red Meat is Equal, Even if Unprocessed

While it’s commendable that this study differentiated between processed and unprocessed red meat, further differentiation is needed for several reasons. The first is that the hamburger meat in fast food, the meat in frozen meals, and lunch meat were all classified as unprocessed. The preservatives and other additives in the majority of these meats makes this questionable. Furthermore, the quality of most fast food hamburger meat is highly suspect.

The second reason is that even for fresh cuts of meat, those from conventionally raised livestock, which is typically what’s sold in most grocery stores, can differ significantly from the meat of livestock raised on pasture. If you’re unfamiliar with these differences, I suggest you read my article about basic principles of healthy eating. As discussed in the article, conventionally produced beef can have considerable nutritional differences including an abnormally high ratio of omega-6 to omega-3 fatty acids, increased susceptibility to lipid oxidation, and contamination from unnatural agricultural chemicals. Each of these characteristics are independently recognized as important factors in the development of chronic disease.

Another consideration that I think could be important is cooking methods. Cooking meat at unnecessarily high temperatures promotes the formation of advanced glycation end products which are believed to accelerate the aging process and cause many of the complications associated with diabetes, including heart disease. ^3-5 In fact, this latest red meat study mentions heterocyclic amines as a possible reason why red meat consumption might increase mortality risk, and like advanced glycation end products, heterocyclic amines are also produced from high temperature cooking.⁶ The authors even acknowledge this despite it not being accounted for in their statistical analysis.

A Few More Inconsistencies

In my opinion, the limitations of statistical analysis, the inherent inaccuracies of food frequency questionnaires, and the failure to fully consider meat quality are collectively more than enough to challenge the legitimacy of the small amount of risk proposed. However, there are a few other aspects of this study that invite further skepticism.

Given that processed meat had a stronger association with mortality than unprocessed meat, which isn’t surprising, it would be logical to expect the risk associated with both types combined to fall somewhere in between. However, this isn’t the case. Unless there’s a strange scenario in which a certain amount of processed red meat eaten in addition to unprocessed red meat is beneficial, this is yet another example of how statistical analysis isn’t perfect.

Whether justified or not, much of the negativity surrounding red meat is based on the belief that its content of saturated fat and cholesterol will elevate serum cholesterol and promote heart disease. In this study, however, people who consumed more red meat were found to have a lower prevalence of high cholesterol.

The Conclusion Translated

In short, here’s what I think the conclusion of this study really tells us. For each additional serving per day of red meat in one’s diet, much of which is likely to have an abnormal nutritional profile and contain potentially harmful residues, even if unprocessed, there’s a 2% to 4% chance of premature death. However, the cause of death may have no direct relationship to red meat, and a number of other lifestyle choices are likely to have an influence. Stated in this way, which I think is more objective, it seems to be nothing more than a small amount of risk based on a lot of uncertainty.

The Latest Study on Red Meat and Mortality is an article by Vin Miller from RageWellness.com

Wellness is a combination of both mental and physical health, and these two aspects of wellness are clearly dependent upon each other. But in regard to happiness, which is generally the ultimate goal of achieving wellness, physical health cannot compensate for the displeasure and pain caused by poorly managed thoughts. Therefore, learning how to effectively manage your thoughts is the most fundamental aspect of achieving a high level of wellness.

How Stress Influences Your Health

The concept of mental thought having direct influence on physiological function was once considered nonsense and still is by some people. However, decades of research has proven it to be true. A significant basis for this influence is the “stress response” which a set of well established physiological changes that occur in response to physical or mental strain.^1,2 This response is more commonly known as the “fight or flight” response and is the reason why your heart rate and blood pressure increase when under stress. In short, poorly managed thoughts can unnecessarily invoke this response and cause your body to prepare for a battle that may not even exist.

Although the physiological responses invoked by emotions like anger or fear may help you avoid harm in some cases, modern life has the tendency to provoke these responses when they’re not needed. The stress response is ultimately a survival mechanism, but a great majority of today’s common sources of stress are far from being a threat to survival. How many people die as a direct and immediate result of a bad hair day or because their kids don’t listen? Nonetheless, when the negative thoughts surrounding such trivial circumstances are poorly managed, they subject the body to the burden of the stress response even though they pose no threat whatsoever to survival.

In some regards, the stress response triggers adaptations that make you more resilient to external sources of stress. Exercise is an obvious example. However, excessive activation of the stress response, referred to as allostatic overload, is similar in concept to wear and tear in that it can accumulate to the point of causing physiological dysfunction. Eventually, such overload can lead to chronic fatigue, inflammatory disorders including heart disease and autoimmunity, impaired immunity, weight gain and related metabolic disorders, impaired cognitive function, psychiatric disorders, and insomnia.^1,3 And this is in addition to the rotten moods that poorly managed thoughts usually lead to.

The following are 4 of the most effective ways I am aware of to develop a perspective that reduces unnecessary activation of the stress response and promotes a happier, healthier, and more peaceful state of mind.

1. Finding Value in Unpleasant Situations

As painful as it may seem, stress is only a perception. Many people will disagree with this or have trouble accepting it, but it’s true. How else could one person experience happiness and another despair or frustration from the same set of circumstances?

The fact of the matter is that your circumstances are your reality. While you can choose to let them persist as is or do something to change them, there’s no value in maintaining any of the negative emotions that may surround them. Doing so will only make your worries seem more unbearable and unavoidable. However, diffusing these emotions with a more rational and positive outlook will promote relaxation and allow you to respond in a more productive and effective manner.

The basis of this approach is to identify the benefits of a situation that you find to be causing you grief. By focusing on the benefits you identify, your grief will eventually be replaced with appreciation, or at least acceptance, and these emotions are much more satisfying and enjoyable than any of the emotions associated with stress. As a result, you’ll be in a much better position to either tolerate the situation in a peaceful manner or calmly do something to improve it.

Here’s a simple example. I enjoy listening to audio books while I drive, and when I’m stuck in traffic, I look at it as an opportunity to do more of something I enjoy. Even if the traffic will make me late, unless I have the choice of taking an alternate route, I might as well sit back and enjoy the opportunity. This is much more enjoyable than letting anger accumulate by the minute. The traffic is not my choice, but how I respond to it is.

Another personal example is my experience with chronic fatigue syndrome. As my poor health pushed me to learn how to take better care of myself, I knew the process would make me healthier, more resilient, and happier, all of which turned out to be true to an even greater extent than I initially hoped. I could have absorbed myself in self pity, which is exactly what some people do in response to health limitations, but I instead made the choice to have a positive outlook and do something to improve my situation. Even if I merely chose to accept my limitations, that would have left me in a much more peaceful state than resisting reality with anger and self pity.

You may question the effectiveness of this approach for more serious matters, and if you do, I refer you to Man’s Search for Meaning by Viktor Frankl. If this man was able to find value in being a Holocaust prisoner, is there really any misfortune in your life that you can’t find value in? This question isn’t meant to be judgmental, but rather to encourage you to challenge your own beliefs. Ultimately, the only person you must genuinely obey is yourself, and if you’re maintaining beliefs that are untrue or unproductive, then you’re being a difficult boss.

2. Calming Your Nervous System

The stress response discussed earlier is regulated by the sympathetic and parasympathetic branches of the autonomic nervous system.⁴ The sympathetic branch is responsible for much of the stress response as well as most conscious activity. In contrast, the parasympathetic branch can inhibit the stress response while also promoting recovery and other restorative functions. Although the activity of these two branches is constantly shifting back and forth, the problems typically associated with stress tend to surface when the activity of the sympathetic branch becomes dominant.

Deep breathing exercises are a simple and well established method for countering the effects of the stress response. They work by promoting an increase in restorative parasympathetic activity.^5,6 Other relaxing practices such as meditation, Tai Chi, and Qigong are believed to have similar effects.^7-10 Although there are a variety of specific protocols for deep breathing, many of which are derived from yoga, my experience is that it can still be very effective when practiced in a less formal manner. The following is the simple approach that I prefer to use: inhale slowly and deeply through the nose, hold for a moment, exhale slowly through the nose or mouth, hold until the urge to inhale is present, and repeat for as long as desired.

Although these methods of calming the nervous system can be used to relieve acute stress, they’re best used as part of a regular practice with the intention of improving your ability to maintain a relaxed and worry free state of mind. It’s also important to realize that while these methods may relieve your stress, they won’t address the cause of it, so you may still find it necessary to focus on managing your thoughts more effectively.

Heart Rate Variability and HeartMath

Heart rate constantly fluctuates, and the measure of this fluctuation is referred to as heart rate variability. The fluctuation is caused by the continuous shifting of activity between the sympathetic and parasympathetic branches of the nervous system.¹¹ As such, heart rate variability is a valuable indicator of stress and nervous system balance that can effectively be used to promote wellness.¹² For example, the feeling of appreciation has been shown to promote a smooth and distinct pattern of heart rate variability that’s indicative of reduced sympathetic activity while anger causes a much more jagged pattern associated with increased sympathetic activity.¹³

By combining the use of heart rate variability with a variety of thought management techniques, the Institute of HeartMath has produced a powerful way to promote a more healthful, peaceful, and grateful state of mind. The most basic HeartMath technique is called Freeze-Frame and involves catching yourself in a state of stress, calming yourself with breathing techniques, invoking thoughts that generate a sense of appreciation, and then thinking of a more sensible and beneficial way to react to the original source of stress. In addition to improving heart rate variability,¹⁴ this approach has been shown to increase levels of secretory IgA¹⁵ which is an indication of enhanced immune function.

Another HeartMath technique called Cut-Thru expands on the Freeze-Frame technique to promote an even deeper understanding of stressful thoughts. There’s also the Heart Lock-In technique which is intended to be used on a regular basis to promote a more frequent sense of appreciation and a more healthful heart rate variability pattern. The use of these two techniques has been shown to improve psychological state, reduce levels of cortisol, and increase levels of DHEA,¹⁶ all of which are indications of a reduced perception of stress and a higher level of wellness.

Further supporting the role of stress in the progression of disease, a number of studies have shown the HearthMath techniques to improve a number of health conditions. These studies are described in the Institute of HeartMath’s Science of the Heart publication. For more information on the HeartMath techniques and how to use them, I highly recommend reading The HeartMath Solution by Doc Childre, Howard Martin, and Donna Beech. The Institute also offers a software package called emWave Desktop which displays your heart rate variability pattern on your computer screen. It’s a great biofeedback tool, and although it’s meant to be used with the HeartMath techniques, I often use it while practicing deep breathing.

3. Embracing the Present Moment

Life is ultimately nothing more than one present moment after another. Past and future only exist in our minds. Although much easier said than done, the ability to appreciate each and every present moment as genuinely and deeply as possible is really all that’s needed to experience happiness. Yet, many of us deprive ourselves of this opportunity by obsessing over perceptions of the past or expectations for the future. In the process, we literally become oblivious to reality.

This may sound like an argument against thinking, but it’s not. The point is that when thoughts are poorly managed, the mind can become a detrimental distraction instead of being an asset. We need thinking to learn from our mistakes and to make choices that will enable us to get the most value out of each present moment. However, when thinking becomes negative and unproductive, it’s a wasteful distraction from the reality of life. At this critical moment, which all of us are prone to experiencing, we can choose to redirect our focus to the present moment, or we can subject ourselves to a spiral of negative and unfounded thoughts that will ultimately make us feel miserable. Consider the cumulative effect of either choice being repeated many times day after day. Such simple choices can indeed be the difference between happiness and despair.

Being able to embrace the present moment partially depends on finding value in misfortune. Obviously, some of the moments you experience are going to be much less pleasant than others. However, as I mentioned earlier, there are really only two productive things you can do. You can choose to accept the moment for what it is, or you can calmly choose to do something that will promote a future change. Anything else is a futile attempt to resist reality and will most likely worsen your negative perception of the situation. The present moment is the only reality that exists, and cooperating with it is the only possibly way to live an enjoyable and peaceful life.

Happiness truly is a choice, and if you don’t agree, it’s an indication that you’re resisting reality. Happiness is seeing each moment as perfect, not because the moment is what you might imagine to be ideal, but because it’s reality and nothing else is possible. Provoking change may make the present moments you might experience in the future more favorable, but nothing can change the moment that exists right now, so what value is there in associating negative emotions with it? And contrary to what you may think, negative emotions are not needed as motivation to provoke favorable change.

For quite some time, Viktor Frankl’s reality was being a Holocaust prisoner. As long as he was unable to change this reality, it was in his best interest to appreciate each moment as much as he could manage. Maintaining the anger he must have experienced would have certainly been justifiable, but it would have only made his misfortune seem more unbearable, and it wouldn’t have done anything to help resolve the injustice he was forced to endure.

This perspective clearly takes a lot of work, and I certainly don’t claim to be an expert at it, but I will say that simply trying to adopt it has helped me a lot. And contrary to what some people seem to think, this perspective certainly doesn’t imply becoming passive and letting life have its way with you. In fact, the improved clarity that it promotes should help you navigate the difficulties of life more easily and effectively.

For an excellent explanation of embracing the present moment and how it applies to a variety of circumstances, I highly recommend reading The Power of Now by Eckhart Tolle. Although it’s very philosophical and seems somewhat like a “spiritual teaching,” if you interpret it with an open mind, it will likely help you come to realizations that are both significant and practical. I had to go through it twice to fully embrace some of the concepts.

In conjunction with this perspective, the more mechanical practices used to calm the nervous system can be used to distract yourself from your unproductive thoughts and regain your focus on the present moment.

4. Investigating Your Thoughts

Investigating the validity and value of your thoughts is in my opinion the most powerful way to promote happiness. The process has a natural tendency to make you let go of unproductive thoughts, and in turn, be free of the negative emotions that accompany them. We can’t control the thoughts that enter our minds, but we can choose how we respond to them. Repeatedly trying to respond to negative thoughts as objectively as possible seems to be the most direct way to replace resistance to reality with an appreciation for it.

In her book, Loving What Is, Byron Katie presents four simple questions that can be used to investigate stressful thoughts. The point of these questions is not to come up with specific answers, but rather to evaluate your thoughts through different perspectives. As such, the power of the questions comes from how they’re put to use. To fully understand their application, I highly recommend reading the book. The premise is very similar in nature to The Power of Now, but it’s presented in a much more practical manner.

The four questions encourage you to investigate a single thought by evaluating its validity, considering the influence it has on you, envisioning how you’d feel and act without it, and identifying if there are any stress free reasons to maintain it. In many cases, you’ll find that you’re causing yourself unnecessary pain by maintaining unjustified beliefs or expectations. Consistently working towards such realizations progressively makes it easier to resolve a wide variety of negative emotions in a calm and productive manner.

Being Happy without Reason

Learning how to effectively manage your thoughts and maintain a peaceful state of mind will likely lead you to a new understanding of happiness. It seems to me that the most common perception of happiness is the temporary thrill associated with something good happening. The problem is that this happiness is dependent on an external event, and it usually doesn’t last long. In fact, this type of happiness is probably more accurately defined as excitement because it’s like an intense emotional high that depletes energy and will inevitably be followed by a low.

In my experience, when I’m able to consistently stay grounded in the present moment and appreciate it for what it is, I unexpectedly find myself in an effortless and worry free state that’s more enjoyable than any other mood I’ve experienced. In contrast to the excitement described above, this state of mind is relaxed. It’s also sustainable and will persist for as long as I let it. That is, until I allow stressful thoughts to corrupt my perspective. What’s significant about this state of mind is that it develops internally. It’s not dependent on anything other than my appreciation for reality. Ultimately, life is pretty simple, and so is happiness. It’s our own thoughts, and the beliefs we base on them, that tend to make life difficult.

Unhappiness arises when you develop a belief that something is wrong with your life. But is your life really the problem, or is it your perception? As Byron Katie explains, a piece of dust on a projector lens results in a flawed picture, but it doesn’t mean the picture itself is flawed. How you see your life is nothing more than a projection, and the quality of that projection depends on the clarity of the lens you choose to view it through. And yes, it is indeed a choice.

Wellness Begins in the Mind is an article by Vin Miller from RageWellness.com

I fully respect the right of any individual to choose what they eat and I have no interest in denouncing veganism or vegetarianism. In fact, if I believed one of these approaches would improve my health and quality of life, I’d switch in a heartbeat. While I do believe that some people can indeed thrive on a vegan or vegetarian diet, I also believe that this is not the case for everyone. Either way, the primary purpose of this article is to provide support for the role of animal food in a healthful diet. Ultimately, you’ll have to come to your own conclusion, and I hope I can provide you with enough valuable information to help you do so.

With the exception of one small paragraph, this article is strictly about the nutritional aspects of animal food as they relate to health and wellness. Although I find the environmental and moral arguments behind veganism and vegetarianism to be both compelling and interesting, I have no intention of debating them here. If you’re curious to know where I stand, reading The Omnivore’s Dilemma by Michael Pollan will give you a pretty good idea.

By necessity, this is a very long article that touches on many aspects of nutrition, so be prepared!

What The China Study Claims

Based on the name of this book, as well as its publicity, I had high expectations of it being a thorough analysis of a well documented and convincing study supporting the superiority of a vegan diet. It’s not, and it’s even stated in the book that only an overview of the evidence is provided. Nonetheless, some very strong claims are made.

In case you haven’t read the book, the overall message is that the consumption of animal food is the cause of most modern disease and consuming it in any amount whatsoever is harmful. Let’s see if the existing evidence supports the strength of this claim.

Nature and the “Western” Diet

It’s no secret that the modern diet, often referred to as the Western diet, is associated with many of today’s most common and serious health problems. Although it’s emphasized in The China Study that a vegan diet should exclude refined foods, even of plant origin, the book gives the impression that this unhealthy Western diet is any diet containing animal food. To say the Western diet is unhealthy is one thing, but in my opinion, neglecting to consider animal food independently of other aspects of the Western diet is a huge oversight. Doing so comes at the risk of associating poor health with animal food when it may really be caused by other unrelated aspects of the Western diet such as excessive intake of refined foods, exposure to food additives, or suboptimal intake of essential nutrients. As you’ll soon see, this calls into question much of the evidence supposedly implicating animal food as a cause of poor health.

Although many vegans and vegetarians will disagree, it’s well established that the digestive anatomy and physiology of humans is that of an omnivore. This means we’re well adapted to eat both plants and meat. Based on a variety of archaeological evidence, it’s practically undeniable that humans have been eating meat for a very long time.^1-4 In fact, a compelling theory called the Expensive Tissue Hypothesis has been proposed to explain how meat eating is likely to have been the driving force behind the significant advancement of the human brain.^5,6 Even though limitations of archaeological evidence make it difficult to know the extent to which meat was a part of the early human diet, even researchers who argue against the significance of meat in human development acknowledge that the evidence of meat consumption can’t be denied.^7,8

As I describe in my article about the basic principles of healthy eating, traditional cultures isolated from modern technology have given us the best and most recent opportunity to look at what a natural human diet is and what kind of influence it has on health. Many researchers have documented the striking absence of chronic disease in these populations. Even more telling is that many of these populations have been observed to succumb to modern diseases once introduced to modern foods. This has led to the classification of many modern illnesses as “diseases of civilization,” or as described in The China Study, “diseases of affluence.”

One of the prominent themes in The China Study that I really appreciate is the emphasis on the intelligence of nature, and in turn, an emphasis on whole foods. Part of this theme is based on the robustness of the traditional cultures described above. However, on several occasions, The China Study gives the impression that the diets of these cultures were primarily plant based. This is far from true.

Although there’s a variety of documentation on the diets and health of traditional cultures, arguably the most compelling and comprehensive source is Nutrition and Physical Degeneration by Weston Price. Contrary to what’s suggested in The China Study, Dr. Price found that these cultures tended to favor animal food, and the cultures with limited access to animal food tended to be less healthy. In agreement with Price’s observations, an evaluation of ethnographic data on 229 hunter-gatherer societies indicated that for 73% of them, more than half of the food consumed was from animal sources.⁹ In fact, according to Price’s observations, cultures such as the Inuit, North American Indians, and Nilotic tribes of Africa thrived on a diet consisting almost exclusively of animal food.

Modern medicine, and even today’s excessive emphasis on natural supplements, are rightfully criticized in The China Study as a misguided attempt at “mastering nature.” However, based on the information above, it seems to me as if the claim that animal food promotes poor health is also in disagreement with nature.

And while on the topic of nature, if you read The Omnivore’s Dilemma, you might come to realize why monocrop agriculture is not sustainable, that it destroys entire ecosystems, and that it’s one of the most prominent examples of humans manipulating nature for the worse. Yet, The China Study makes no mention of how difficult it would be to follow its recommended vegan diet without relying on this destructive system of farming.

One Size Doesn’t Fit All

Many of the diets of the isolated cultures described above are radically different. While this can be interpreted to mean that humans can thrive despite significant variations in nutritional intake, a more thoughtful explanation suggests that as humans spread across the globe, each culture underwent genetic adaptation in response to the sources of food that were locally available. In support of this, Roger William’s book, Biochemical Individuality, thoroughly illustrates how much anatomical, physiological, and biochemical variation exists among humans, all of which can have a significant influence on nutritional requirements.

Modern knowledge of genetics has confirmed this individuality as well as its significant relation to nutrition.¹⁰ In fact, two relatively new fields of nutrition science called nutrigenomics and nutrigenetics are entirely based on this relationship and are believed to have tremendous potential for preventing and treating disease.^11-13

Despite the abundant evidence of individuality, The China Study claims that all people should entirely avoid a very broad range of nutritious food that’s deeply rooted in human history.

Does Protein Really Kill Rats?

In The China Study, a series of studies on rats is presented in a way that seems to clearly suggest protein promotes the initiation and progression of cancer. In these studies, rats were provoked to develop cancer through exposure to a toxin called aflatoxin. According to the book, all of the rats consuming a 20% protein diet died while all of the rats consuming 5% protein survived. In addition, the advancement of cancer on a 20% protein intake is said to have been reversed with a 5% protein intake.

A closer look at this research, however, reveals that the results aren’t nearly as compelling or clear cut as the book suggests. In one of the earlier studies done to identify the influence of protein intake on enzyme activity, the 5% protein intake was regarded as a blatant deficiency that severely restricted the physical development of the rats and caused them to have fatty livers.¹⁴ In a later study done to assess the influence of protein intake on aflatoxin induced cancer development, the dose of aflatoxin given to the rats on the 5% protein diet had to be reduced by half in order to prevent them from dying. The rats fed the 20% protein diet, however, were still given the full dose.¹⁵ Also not disclosed is the observation in another study that rats first fed 20% protein and then 5% protein were much more protected from cancer than rats fed 5% protein all along.¹⁶

In The China Study, concerns that the nitrites added to processed meat products may cause cancer are belittled. In regard to the animal studies these concerns are based on, the book states that the dosages of nitrites used would be the equivalent of a human eating a ridiculously large number of bologna sandwiches. Ironically, the dosages of aflatoxin used in the protein studies mentioned above appear to be equally ridiculous. For example, the study that evaluated the variation of protein intake on the carcinogenic effects of aflatoxin used a daily dosage of 250 micrograms per kilogram of rat body weight.¹⁶ Based on the FDA’s limit for aflatoxin in food, which is 20 parts per billion,¹⁷ you’d need to eat more than 1,000 pounds of maximally contaminated food per day to get the same dosage.

Chris Masterjohn, a PhD student at the University of Connecticut, has provided a more in depth review of this research providing even more reason to be skeptical of it.

Cutting Off Your Nose to Spite Your Face

Detoxification primarily occurs in the liver through two stages of reactions. As described in The China Study, some of the first stage reactions can ironically make a compound more toxic than it was originally, and in turn, cause the DNA damage that leads to cancer. As with most reactions in the body, these detoxification reactions are made possible by enzymes, and enzymes happen to be proteins. As such, the supposed benefit of the low protein intake in the rat studies above is most likely the result of a reduction in enzyme production due to deficient protein intake. Reduced production of detoxification enzymes leads to reduced detoxification of aflatoxin, and in turn, reduced conversion of aflatoxin into a more toxic substance.

Not all detoxification enzymes have the undesirable potential to increase the toxicity of the substances they act on. More importantly, human life is dependent on the actions of thousands of enzymes, and only a portion of them are involved in detoxification. In addition, enzymes aren’t the only important substances in the body that require protein for synthesis. Protein is also required for the synthesis of hormones, neurotransmitters, antibodies, cell membrane receptors and transporters, and is also needed for the maintenance of connective tissue and muscle.¹⁸ Therefore, when protein intake doesn’t satisfy the body’s demands, overall health can be negatively affected in many ways. This leads to the question of how much protein is needed to support optimal function.

A variety of genetic, lifestyle, and physiological factors, as well as factors relating to the source of protein itself, can influence intake requirements, all of which further illustrates the significance of individuality. The best method currently available for assessing protein requirements is nitrogen balance, but it has limitations. The basic idea is that if you’re excreting more nitrogen than you consume, then it’s likely that you’re not consuming enough protein to support optimal function. Research has shown that 0.65 grams of protein per kilogram of body weight is sufficient to achieve even nitrogen balance in half the population while 0.83 grams per kilogram of body weight should achieve even balance in the majority of the population.¹⁹

It’s stated in The China Study that 5% to 8% of total calories as protein should be adequate to meet the body’s needs. However, even the lower rate of 0.65 grams per kilogram of body weight, which is estimated to only be adequate for half of the population, can easily exceed this amount. And this doesn’t even take into account the increased protein requirements associated with aging physical activity.²⁰

It’s currently not possible to precisely identify human protein requirements, especially on an individual level, and even if it was, manipulating consumption to match a precise amount would be extremely difficult. Therefore, the question that becomes important is if it’s better to error on the side of consuming too much protein or too little.

The body is very efficient at processing and eliminating any protein consumed in excess and can even use it for energy production. However, unlike carbohydrate and fat, unneeded protein can’t be stored for future use and must be excreted instead. Since there’s no reserve to draw from, other than the breakdown of functional body tissue, insufficient protein intake will likely impair physiological function to at least some extent. Based on this, I think the more conservative and healthful approach is to error on the side of consuming more protein rather than less. However, based on how the results of the aflatoxin research are presented in The China Study, you might think you’d be better off risking some impairment of function to protect yourself from cancer just in case you happen to eat 1,000 pounds of contaminated food each day.

Protein and Cancer Growth

The above discussion of enzymes only applies to the initiation of cancer. The China Study also claims that protein fuels cancer growth after it’s been initiated.

For the most part, cancer results from a combination of genetic mutation, reduced capacity for the repair of these mutations, and reduced capacity of the immune system to detect and eliminate affected cells.²¹ It’s important to realize that many aspects of lifestyle unrelated to protein intake have a significant influence on the presence of these factors. Despite this, The China Study isolates animal protein as if it were the only concern.

In the book, the tendency for protein to increase circulating levels of insulin like growth factor (IGF) is said to be the mechanism through which protein facilitates cancer growth. And, of course, this is said to apply primarily to animal protein. However, regardless of the source of protein, the evidence associating IGF with cancer is far from concrete, and there are many additional factors involved.²²

Like animal protein, plant protein has also been shown to increase IGF, ²³ especially soy.^24-26 But the evidence lacks consistency. For example, one study found protein intake to have no significant effect on IGF, even when animal protein was considered separately from plant protein.²⁷ In fact, some researchers claim that protein deficiency decreases IGF as opposed to an excessive intake increasing it.²³ Therefore, increases in IGF may simply be the result of reducing protein deficiency.

Some research has specifically isolated dairy protein as having the most influence on IGF.²⁸ Dairy also happened to be the sole source of protein in the rat studies used in The China Study to implicate all animal protein. But this is merely a distraction from the fact that IGF levels are a weak indicator of cancer risk. As I’ll explain later, there are also some other important considerations that need to be made prior to blaming dairy for all of the diseases The China Study claims it to be associated with.

Regardless of whether protein comes from animal or plant sources, the role of IGF in the development of cancer is much more complicated than described in The China Study. While it’s true that IGF promotes cell growth and proliferation and inhibits cell death, all of which facilitate the progression of cancer, there are multiple types of IGF to consider, and their interaction with binding proteins and receptors must be considered as well. In fact, the amount and type of IGF binding proteins and receptors may be equally as important, or even more so, than levels of IGF itself.^29,30

An important fact not mentioned in The China Study is that insulin can bind to some of the same receptors as IGF, and in turn, have the same effect of initiating cell growth and proliferation.^31,32 Insulin is also associated with the development of cancer independently of IGF, although to a weaker extent.³³ In addition, insulin is believed to reduce production of several IGF binding proteins which increases the availability of IGF.^32,34 Based on these roles of insulin, carbohydrate intake may also play an important role in facilitating cancer development. Yet, according to The China Study, you can eat all the insulin stimulating potatoes and brown rice you’d like. In fact, a high carbohydrate intake is even recommended as the ideal without any mention of this association between insulin and cancer.

Finally, although this is briefly acknowledged in The China Study, it’s important to realize that IGF is critical to health, particularly in regard to the development and maintenance of bone and muscle.³⁵ In fact, low levels of IGF have even been associated with increased mortality and increased heart disease risk.³⁶ As such, the decline in IGF associated with age has led to the recommendation for older people to increase protein intake to more than twice the amount recommended in The China Study.^35,37

Animal Food and Human Health Outcomes

It’s generally understood that vegans and vegetarians tend to follow healthier lifestyle habits than most of the population. When considering findings of reduced mortality in vegetarians and vegans, such as with The Oxford Vegetarian Study,³⁸ this makes it difficult to determine if the reduced mortality is a result of avoiding animal food or if it’s a result of other lifestyle habits. Furthermore, such results aren’t consistent. For example, a combined analysis of 5 different vegetarian studies, totaling to over 70,000 people, found no statistically significant difference in overall mortality or mortality from a variety of cancers and other diseases, but did find that vegetarians had a lower mortality from ischemic heart disease.³⁹ However, contrary to the claims made in The China Study, vegans had a higher rate of mortality from ischemic heart disease than fish eating vegetarians and lacto-ovo vegetarians.⁴⁰

A German study that followed more than 1,700 people for 21 years attempted to reduce the influence of lifestyle habits by comparing vegetarians and vegans to health conscious non-vegetarians.⁴¹ Despite this effort, the non-vegetarian group still had a smoking rate twice that of the vegetarian and vegan group which shows how difficult it is to eliminate the influence of other lifestyle factors. Nonetheless, no differences were found for overall mortality or for mortality from any specific conditions. Vegans and vegetarians did have reduced mortality from ischemic heart disease, but the difference wasn’t statistically significant. Again, in contrast to the claims made in The China Study, vegans were found to have a higher mortality than lacto-ovo vegetarians, but in this study, vegans only represented a small percentage of the study group.

Providing further illustration of how difficult it is to isolate the impact of animal food on health, the same study found exercise to have a more significant impact on reduced mortality than any other factor, including consumption of animal food. Yet, the Oxford Vegetarian Study mentioned above didn’t take exercise into account at all, and the combined analysis on more than 70,000 people didn’t include enough data to make a fair assessment of the influence that exercise may have had.

Despite this influence of exercise, another study including more than 64,000 people found no statistically significant differences in mortality between vegetarians and non-vegetarians without considering any other lifestyle influences besides smoking and alcohol consumption. Although non-vegetarians had a non-significant increase in mortality from heart disease, vegetarians had a non-significant increase in mortality from stroke.⁴² Unfortunately, this study didn’t consider vegans separately from vegetarians, and the authors interestingly noted that even a study population of this size is inadequate to draw solid conclusions from.

As you can see, much of this research is focused on the supposed association between meat eating and heart disease. However, the evidence supporting this association is not nearly as strong as conventional wisdom may lead you to believe. In his book, Good Calories, Bad Calories, Gary Taubes has provided an excellent and extremely thorough critical review of the evidence.

Many lifestyle factors are likely to contribute to the development of heart disease and all other “diseases of affluence.” The German study mentioned above demonstrates that a lack of exercise is a significant one, which most people already realize. Stress is a major factor as well, but in regard to diet, consumption of refined foods is arguably the greatest risk factor. And even when whole foods are eaten, nutritional quality, contamination, and cooking methods are additional factors that can still have a significant impact. For example, cooking meat at unnecessarily high temperatures promotes the formation of advanced glycation end products (AGEs) which are implicated in aging as well as the complications of diabetes.^43,44 In regard to the associations between meat eating and ischemic heart disease, it’s important to consider that heart disease is one of the most prominent and serious complications of diabetes, and that AGEs play an important role.⁴⁵

Most of the evidence above is based on mortality which doesn’t always give an accurate representation of quality of life. Unfortunately, it appears that there isn’t much evidence available to determine if this is the case when comparing vegans and vegetarians to non-vegetarians. A study on Seventh-day Adventists found vegetarians to have less chronic disease, a lower reliance on medication, and less need for health care services than non-vegitarians, but they were also found to have a greater prevalence of allergy, and the only other lifestyle factors taken into consideration were smoking, age, and education.⁴⁶ In contrast, data from the Stanford Five-City Project showed no differences between vegetarians and non-vegetarians for physician visits, sick days, or days spent in the hospital.⁴⁷

In my opinion, this research comparing the health of vegans and vegetarians to that of non-vegetarians provides, at best, only inconsistent support for the claim that animal food promotes poor health, and even this limited amount of support is likely to be influenced by the tendency for vegans and vegetarians to live healthier lifestyles in general.

The China Study Itself

Expecting The China Study to be a dedicated in depth review of the study itself, I was sorely disappointed. All that’s provided is a brief overview of the study’s conclusions and a couple of pages about its design.

The book makes the study appear to be of grand proportion. For example, a quote from the New York Times referring to the study as the “grand prix of epidemiology” is recited several times, and the subtitle on the front cover refers to it as “the most comprehensive study of nutrition ever conducted.” The Framingham Heart Study, the results of which are in my opinion overemphasized in the book, is a true example of a major study. It’s very easy to find hundreds, if not thousands, of peer reviewed journal publications based on this study. In contrast, I was only able to find a handful of such publications relating to The China Study. Apparently, this “grand prix of epidemiology” didn’t draw much interest from the scientific community.

In the book, there’s a major emphasis on the importance of peer reviewed evidence. However, very little information about the results of The China Study is published in peer reviewed journals. Many of the claims made in the book cite the full publication of the study’s data as a reference, but the data was published in a book rather than in a peer reviewed journal, and the book is now out of print. Although regression analysis wasn’t used, Denise Minger has done an extremely thorough analysis of this data that failed to support many of the claims made in The China Study.

I only found two published articles from The China Study that discussed the potential harm of consuming animal food.^48,49 Despite the claim that more than 8,000 statistically significant correlations were made, the entire premise of these articles is based on the questionable notion that animal food promotes disease through elevations in total cholesterol.

There are also three other published articles I found relating to The China Study, but they’re only indirectly related to the general message of the book. The first compares sex hormones in Chinese women to British women and shows Chinese women to have lower estrogen levels.⁵⁰ This finding is used in the book to support the idea that animal food promotes breast cancer, but very little is mentioned in the article about diet. The second identifies a reduction in esophageal cancer with increased fruit intake and increased blood levels of vitamin C,⁵¹ none of which has much relevance to animal food. The third study is almost amusing. Increased intake of salted vegetables and eggs were found to have a statistically significant association with an increase in stomach cancer while increased intake of green vegetables and increased blood levels of selenium and beta-carotene were associated with a reduction.⁵² However, the study also showed an increased intake of meat to be associated with a reduction in stomach cancer, and to a greater extent than blood levels of beta-carotene!

Does Cholesterol Really Cause Disease?

The generally low cholesterol levels of the Chinese are routinely mentioned in The China Study and are the primary focus of the two primary journal articles mentioned earlier. However, low cholesterol isn’t as favorable as these these articles and the book might lead you to believe.

Stroke is the most common cause of death in China, and about a third of the strokes are caused by hemorrhage. This type of stroke is associated with low cholesterol, and when you consider only rural areas of China, cholesterol tends to decrease while hemorrhagic stroke tends to increase.⁵³ In addition, low cholesterol levels have been associated with violent behaivor^54,55 which isn’t surprising when you consider the importance of cholesterol in brain function.⁵⁶ Also associated with low cholesterol is an increased susceptibility to infection.⁵⁷ In addition, a study on 12 rural areas of Japan found low cholesterol levels to be associated with increased mortality from cancer, hemorrhagic stroke, and heart failure not associated with heart attack.⁵⁸ In regard to cancer, however, whether the association with low cholesterol is a cause or an effect is still being debated.⁵⁹

Over the past couple of decades, a lot of important information regarding cholesterol has surfaced. We now know that the LDL to HDL ratio of cholesterol is a much more important measure of risk than total cholesterol or even LDL cholesterol alone.⁶⁰ It’s also been established that inflammation plays an important role in the development of atherosclerosis^61,62 and that LDL may only be a concern when the lipids it contains are oxidized.⁶³ Finally, it’s becoming clear that LDL particle size and count may be more important than the measure of LDL cholesterol. Small LDL particle size is the primary concern and is closely associated with elevated triglycerides levels.^64,65

With the exception of extremely low or high values, the information above strongly suggests that total cholesterol values are of limited use in predicting health risk, especially beyond the scope of heart disease. Furthermore, a certain dietary pattern has been found to promote the high risk profile of elevated triglycerides and small LDL particle size. And it’s not consumption of animal food. In fact, it’s a high carbohydrate and low fat diet^66,67 very similar in macronutrient ratios to the recommendations in The China Study. The unfavorable response to this diet was especially noted in individuals with genetic predisposition which further supports the significance of individuality.

A low carbohydrate diet containing a significant amount of animal food, the opposite of what’s recommended in The China Study, has been repeatedly shown to effectively reverse this pattern of elevated triglycerides and small LDL particle size, and it also tends to promote a desirable increase in HDL cholesterol.^68-70 Although total cholesterol usually increases as well, this is typically in conjunction with an improvement in the overall lipid profile that’s indicative of reduced risk.

Finally, like protein, cholesterol is absolutely necessary for optimal physiological function. In addition to its previously mentioned role in brain function, it’s also the precursor for vitamin D, bile, and a number of hormones, and it’s both a structural and functional component of cell membranes.⁷¹ More information about cholesterol, as well as a thorough critical review of the evidence supposedly implicating it in the development of disease, can be found in Uffe Ravnskov’s book, The Cholesterol Myths.

Diseases of Affluence

Although cancer is the primary focal point of The China Study’s claim that animal food promotes disease, many other conditions are considered as well. As previously mentioned, these conditions represent most of the chronic health problems that are prominent today, and because of their strong association with lifestyle factors, the book refers to them as “diseases of affluence.”

One factor believed to play a foundational role in chronic disease is oxidative stress. Without going into detail, oxidative stress is counteracted by antioxidants which is why they’ve become such a popular nutrition topic.

In The China Study, it’s stated that the body doesn’t produce its own antioxidants and that we must therefore obtain them from plant food in order to protect ourselves from disease. Although plant foods certainly do provide a wide variety of valuable nutrients, including antioxidants, the body does indeed produce its own. In fact, effective antioxidant defense is dependent on the synergistic outcome of the body’s innate antioxidant defense system interacting with dietary antioxidants.⁷² And because much of the body’s innate defense system is dependent on the actions of proteins, many of which are enzymes, protection against disease is dependent on protein intake.

Glutathione is an example of such a protein and is one of the most important antioxidants in regard to health and human function. In addition to its pivotal role as an antioxodant, it’s also of critical importance to detoxification. The synthesis and subsequent effectiveness of glutathione is clearly dependent on protein intake, and more specifically, on the intake of the sulfur containing amino acids methionine and cysteine.⁷³

Dairy and Disease

Although The China Study is strongly biased against all animal food, there’s a particular emphasis on dairy and its association with chronic disease. However, evidence indicates that this association may be the result of a specific protein component that exists in some, but not all, sources of dairy.

Certain breeds of cattle are known to produce a unique milk protein called A1 beta-casein which breaks down into a peptide capable of promoting disease and acting as an opioid. A1 beta-casein is associated with heart disease and type 1 diabetes,⁷⁴ both of which are discussed in The China Study, and it’s even associated with neurological disorders including autism and schizophrenia.⁷⁵ In his book, Devil in the Milk, Keith Woodford provides a thorough explanation of the concerns surrounding A1 beta-casein.

Pasteurization and the quality of care for dairy cattle are two other important considerations. However, despite the challenges associated with dairy, the point is that it can still be part of a healthful diet for people willing to make the effort to get it from a quality source. Support for dairy as a component of a healthful diet has been clearly demonstrated by the isolated Swiss cultures and Nilotic tribes of Africa observed by Weston Price.

Type 2 Diabetes

Most chronic disease is associated at some level with poorly regulated blood sugar and insulin levels. With no other disease is this association as critical as it is with type 2 diabetes. As I mentioned earlier, the progression of this disease is very much based on dietary glycemic load.^76,77 While the vegan diet recommended in The China Study may provide enough fiber to offset the high carbohydrate load, it’s debatable. And regardless of how much fiber is consumed, it’s likely that the high carbohydrate load will be too much for some people. For example, Australian Aborigines have been shown to have a glucose and insulin response to the common potato that’s 2.5 times greater than that of Caucasians, and this helps to explain why the prevalence of type 2 diabetes in Aborigines is up to 10 times higher.⁷⁸

It’s well known that ethnicity can be a risk factor for type 2 diabetes. For many ethnicities, the disease is much more prominent in the United States, and some ethnicities are much more prone to this susceptibility than others.⁷⁹ Like the Australian Aborigines, the ethnicities most prone to type 2 diabetes are likely to have a genetic tendency for a more pronounced glucose and insulin response to carbohydrates. These people probably won’t do well on the high carbohydrate diet recommended in The China Study, even if it’s based on whole food, and even if it’s high in fiber. In contrast, a low carbohydrate diet containing significant amounts of animal food has been shown to be very effective for the treatment and even reversal of type 2 diabetes.^80,81

Autoimmune Diseases

One aspect of autoimmune disease that aligns well with the diet promoted by The China Study is that protein is the primary component of food capable of provoking immune activity. However, with the exception of a few intestinal diseases, this won’t happen unless protein passes into circulation prior to being fully digested. For this to occur, the integrity of the intestinal lining must be compromised.

Vegans and vegetarians tend to rely heavily on grain based foods, and as I described in my article about gluten sensitivity, gluten containing grains such as wheat, barley, and rye are notorious for not only increasing intestinal permeability, but also for triggering autoimmune disease.^82,83 In fact, gluten is even capable of increasing intestinal permeability in people who aren’t sensitive to it, although to a lesser extent.⁸⁴ Legumes, which vegans and vegetarians also tend to rely heavily on, contain lectins that can also increase intestinal permeability and promote autoimmune disease.^85-87

Finally, there’s the fascinating case of Terry Wahls, MD. After succumbing to a slow decline from multiple sclerosis and eventually being reduced to a wheelchair, she miraculously reversed her disease through a nutritionally dense diet including wild fish and meat from pasture raised animals.^88,89 If the claims in The China Study against animal food were correct, Dr. Wahls’ diet should have worsened her condition.

Breast Cancer and Fat

In The China Study, the supposed association between fat intake and breast cancer is used to support the books promotion of a low fat diet. Although two major studies in the United States have failed to show an association between fat intake and breast cancer,^90,91 the book regards them as being irrelevant due to the high protein intake in America. However, similar results have been produced in Europe as well.⁹²

As discussed earlier, insulin is an important consideration in regard to cancer, and it’s been shown to promote the growth of cultured breast cancer cells.⁹³ In addition, elevated levels of fasting insulin have been found to be associated with poor prognosis for breast cancer.⁹⁴ Given the information on insulin and cancer discussed earlier, this is not a surprise, but it’s a reminder that if macronutrient ratios play a role in the development of cancer, a high carbohydrate intake could easily be just as much of a concern, if not more so, than a high intake of protein or fat.

Food Acidity and Bone Health

A common claim made about animal foods is that they promote acidity, and in turn, promote a number of health concerns including bone loss. However, it’s been estimated that our hunter-gatherer ancestors consumed more animal food than plant food⁹ while, on average, also having an alkaline acid-base status.⁹⁵ Archaeological evidence indicates they had strong and healthy bones as well.⁹⁶

When projected food intake was considered for each individual hunter-gatherer society, however, up to half of the societies were suggested to have an acidic acid-base status.⁹⁷ But African societies, believed to provide the truest representation of a natural human diet, have been estimated to maintain an alkaline acid-base status.⁹⁸ Either way, the influence of diet on acidity and bone health is controversial and has been seriously questioned. Evidence exists indicating that protein intake promotes bone growth rather than bone loss, that the kidneys are more than capable of buffering protein acid load before it can promote bone loss, that animal proteins don’t promote acidity any more so than plant proteins, and that calcium excretion is more a function of calcium absorption than protein intake.⁹⁹

Despite the claims made against animal food, some studies have shown vegetarians and especially vegans to have a higher occurrence of bone fractures.^100-102 Although the increased rate of osteoporosis in the Inuit can be used to counter this evidence, reduced levels of calcium in the Inuit, as indicated by elevated levels of calcitriol, are more likely to promote bone loss than a high intake of animal food.¹⁰³

Even if dietary acid load does contribute to bone loss, an alternate explanation indicates that it has more to do with sodium, chloride, and potassium than protein.¹⁰⁴ Sodium and chloride are the constituents of salt, and a large majority of the salt in the modern diet comes from processed foods.^105,106 In contrast, animal foods are naturally low in sodium and chloride. Potassium is abundant in both animal and plant foods, but the reduction of plant food in the modern diet has led to a reduction in potassium intake. The increase in sodium intake increases calcium excretion while the increase in chloride and decrease in potassium reduce the body’s capacity to buffer acidity,¹⁰⁴ all of which indicates that processed foods promote acidity much more so than whole animal foods. In addition, plant foods can promote acidity as well. This is especially the case with grains,⁹⁹ and many vegans and vegetarians rely on grain based foods as a dietary staple.

Animal protein is often argued to promote acidity because of its sulfur containing amino acids methionine and cysteine. However, plant protein can contain just as much, if not more, sulfur.⁹⁹ And as I mentioned previously, sulfur containing amino acids are needed to support the body’s capacity for detoxification and antioxidant defense.

Another related claim is that increased protein intake increases the risk of kidney stones, but it appears that this only applies to people with pre-existing metabolic disorders predisposing them to stone formation.¹⁰⁷ In fact, protein restriction has been shown to be ineffective for reducing stone formation in such people.¹⁰⁸

Carbohydrates and Weight Gain

Throughout The China Study, it’s suggested that the high carbohydrate content of the vegan diet is the reason why vegans tend to be lean. However, the book also clearly states that vegans and vegetarians can just as easily be overweight if they consume a lot of refined plant foods. This leaves a major hole in the argument that animal food is the cause of weight gain. If this argument were true, it would be very difficult to explain the excellent weight loss results associated with low carbohydrate diets that include significant amounts of animal food.^109-114

The China Study basically claims that a low carbohydrate diet is nothing more than an unhealthy weight loss fad. However, the nutrient dense animal and plant foods that the isolated cultures discussed earlier are known to have thrived on are mostly low in carbohydrates. These cultures obviously weren’t following a fad, but simply consuming the best food available to them. For many of them, a low carbohydrate diet was the norm rather than a fad, but compared to the modern diet, it’s extreme. It’s really the modern diet, however, that’s extreme. We’ve just become accustomed to it. All of this is supported by the estimation that carbohydrate intake among 229 hunter-gatherer societies was within the range of 22% to 40%.⁹ For cultures that relied almost exclusively on animal food, the reliance on carbohydrate was obviously even lower.

Based on the premise of eating the foods our genome is most likely to have adapted to, a hunter-gatherer type of diet is steadily gaining support as a logical way to improve health.^115-119 As indicated above, this way of eating tends to be low in carbohydrates compared to the modern diet. However, this is a result of emphasizing nutrient dense whole foods rather than a deliberate attempt to restrict carbohydrate intake. As such, I consider the weight loss often associated with this type of diet to be nothing more than a secondary benefit that indicates the return of healthy metabolic function.

In The China Study, it’s stated that a high carbohydrate diet promotes weight loss because excess carbohydrate is burned as heat rather than stored as fat. This may be true for some of the excess, but certainly not all of it, especially when the excess is significant. For vegans and vegetarians who primarily consume whole foods, a more likely explanation for their leanness is the fact that a significant amount of the carbohydrate in low starch plant food is undigestible and also impairs the digestion and absorption of other carbohydrates.¹⁸ In other words, a significant proportion of the carbohydrates a vegan or vegetarian consumes will simply pass right through the gastrointestinal tract, but this isn’t as harmless as it may seem.

For the carbohydrate that does make its way into circulation, there’s no doubt that once muscle and liver glycogen stores are full, which is likely for sedentary or mildly active people, the liver will convert excess carbohydrate into fat through a process called de novo lipogenesis.^120-124 This is precisely why a high carbohydrate diet often leads to elevated triglyceride levels.^{120,121,123,125} Because fat storage is regulated by insulin, the levels of which are increased by carbohydrate consumption, the fat produced from carbohydrate by the liver is very likely to be stored as body fat. In conjunction with this, insulin also inhibits subsequent usage of fat for energy production.^126-128 In short, a meal high in digestible carbohydrate promotes fat storage and inhibits its use for energy production. This is why carbohydrate restricted diets, even if very high in fat, are so effective for weight loss and reducing triglyceride levels. They allow the body to more consistently rely on fat for energy production. This may seem paradoxical, but when you consider how these nutrients are metabolized at the biochemical level, it makes perfect sense.

This is not to say that everyone should go out of their way to moderate their intake of sugary fruits and starchy vegetables. As I’ve now mentioned numerous times, individuality is important, and I’ve already noted the variation that exists in glucose, insulin, and triglyceride response as well as in the predisposition to type 2 diabetes. The point is that while a high carbohydrate diet may be appropriate for some people, it’s clearly not appropriate for everyone, and contrary to what’s suggested in The China Study, it’s certainly not a universal solution for weight loss.

Nutrient Insufficiencies

One of the most challenging aspects of following a vegan or vegetarian diet is avoiding nutrient insufficiencies. As is the case for anyone, I think it’s prudent for vegans and vegetarians to complete a basic dietary analysis to identify what nutrients they may need to consume more of. In contrast, The China Study recommends the very loose approach of simply taking a B12 supplement once in a while after three years of avoiding meat. In general, I think the importance of B12 and other important vitamins and minerals is understated. Even though it can be obtained from plant food, riboflavin is another B vitamin that can easily be deficient in the diet of a vegan,¹²⁹ and this is just one of several examples.

Vegans in particular are prone to insufficient intake of the essential minerals calcium, zinc, and iron.¹²⁹ Like riboflavin, these nutrients are all available from plant foods, but extra attention is needed to ensure adequate intake. The potential for deficiency is increased by the fact that the grains and legumes so heavily relied on by many vegans and vegetarians contain antinutrients such as phytate and oxalate which bind to and inhibit the absorption of these minerals.^130-132

The iron in plant foods is the non-heme form which is absorbed less efficiently than the heme iron in animal foods. Although non-heme iron can be absorbed almost as effectively as heme iron when body stores are low, this can be offset by the amount of phytate common in the vegan and vegetarian diet. Based on this, the USDA recommends that vegans and vegetarians increase their iron intake by 80%.¹³⁰

In The China Study, measures of hemoglobin levels are used to suggest that the reduced absorption of non-heme iron isn’t a real concern for vegans. However, hemoglobin levels are only affected in late stage iron deficiency and fail to identify a large portion of people who are deficient.^133,134 Unfortunately, the book doesn’t provide any information about the other measures that were supposedly made to support its claim, nor is any information provided about dietary factors such as intake of grain and legumes that may have influenced iron status.

Fiber is another dietary factor that can impair absorption of essential nutrients.¹³¹ In fact, this is the primary reason why iron status is discussed in The China Study. The potential for fiber to impair absorption is trivialized in the book based on the hemoglobin measures described above. Ironically, this is the same mechanism through which fiber can reduce cholesterol levels and keep blood sugar regulated, both of which are touted in the book as benefits of high fiber intake.

Fortunately, if you’re set on following a vegan or vegetarian diet, these absorption issues can be reduced by soaking or fermenting whole grains, legumes, nuts, and seeds prior to eating them. Although far from being a pro-vegan resource, Nourishing Traditions by Sally Fallon provides great information on how and why to do this.

Omega-3 Fatty Acids

Along with vitamin B12, long chain omega-3 fatty acids are easily one of the most significant nutrient concerns for vegans and vegetarians. However, in The China Study, this concern is trivialized. Although there has been a lot of hype surrounding omega-3 fatty acids, there’s no doubt that they’re needed for optimal physiological function, particularly in regard to vision, brain function, and the regulation of inflammation.^135-137

Alpha-linolenic acid (ALA), which is the essential omega-3 fatty acid that must be obtained through diet, can be obtained from plant foods. However, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the physiologically important omega-3 fatty acids, and they can only be obtained from animal food or through conversion from ALA. But in humans, the conversion from ALA is inefficient, especially in men.^137-139 Furthermore, this conversion relies on zinc^135,140 which vegans and vegetarians tend to not consume or absorb enough of. As such, they’re often found to have reduced levels of EPA and DHA, and the reduction tends to be more pronounced in vegans.^140-143

Based on the higher omega-6 content of common vegetarian and vegan foods such as vegetable oils, grains, legumes, nuts, and seeds, vegans and vegetarians are also commonly found to have an unfavorably high ratio of omega-6 to omega-3 fatty acids. A growing body of evidence is continuing to implicate this imbalance in the progression of the many chronic diseases associated with inflammation and neurological dysfunction. Even in the absence disease, there’s good reason to believe that an adequate intake of EPA and DHA can help promote optimal cognitive function¹⁴⁴ and reduce common mood disturbances such as depression and anxiety.¹⁴⁵

Because of the role of the omega-3 fatty acid DHA in visual and brain development, adequate levels are especially important during pregnancy and lactation. The breast milk of vegan and vegetarian mothers has been found to have low levels of DHA, and infants of vegan mothers have been found to have low levels as well.¹⁴⁶

The tendency for vegans and vegetarians to be healthier has been used as an argument against the importance of the long chain omega-3 fatty acid DHA.¹⁴⁷ However, this tendency for better health certainly isn’t universal, especially when other aspects of a healthy lifestyle are considered. Obviously, vegans and vegetarians still succumb to all of the health issues associated with reduced and imbalanced levels of omega-3 fatty acids. Even if this is the case to a lesser extent, it doesn’t mean that an improvement in omega-3 status couldn’t still promote an improvement in overall health.

Seafood is the best source of EPA and DHA. For the vegan or vegetarian concerned about omega-3 fatty acid intake, the best option would be to make an exception for seafood. If this is unfavorable, which I assume it will be for some people, these omega-3 fatty acids can also be obtained from marine algaes in whole or supplement form.¹⁴⁰

Nutritional Reductionism

A common theme throughout The China Study, and one I appreciate, is the problematic nature of placing too much emphasis on individual nutrients. This is also a major theme in Michael Pollan’s great book, In Defense of Food. One common but misguided tendency that results from this perspective is the attempt to resolve health complaints with supplements while neglecting to address fundamental inadequacies in the diet. Another is the belief that fortifying or enhancing processed foods with essential nutrients makes them part of a healthful diet.

These problems, however, don’t necessarily mean that a narrow focus on individual nutrients is always bad. In fact, it’s often necessary in research to prevent additional variables from having an influence. It also helps us to understand the roles and importance of certain nutrients which ultimately helps us make more informed dietary choices.

One could easily use reductionism as an argument against many of the points I made in this article. In fact, this is the approach used in The China Study to trivialize the importance of essential fatty acids as well as a number of other concerns relating to vegan and vegetarian diets. Such concerns are disregarded as nothing more than excessive details that cause confusion. As confusing as the science of nutrition can be, we’re obviously much better off when we consider it than when we don’t. It may require you to think and to come to your own conclusions, but in my opinion, this is something many of us should be doing more of anyway, and not just in regard to nutrition and health.

While the criticism of reductionism provides great insight into many of the major problems associated with the modern diet, it can also be counterproductive when taken too far. To argue for or against any claim, we must consider details, but if we disregard these details to avoid reductionism, we’ll never be able to come to an informed conclusion. For example, the entire premise of The China Study can be disregarded based on the simple fact that the isolated focus on animal food is a case of reductionism that fails to consider diet as a whole, but what would this accomplish?

Conclusion

It was never my intention to criticize vegan or vegetarian diets or the people who follow them. Although I do believe these diets pose a number of challenges, there’s no question that we each have the right to choose how we eat, and I also believe that with dedication, a vegan or vegetarian diet can adequately support excellent health for many people.

There are really only two points I wanted to make with this article. The first is that animal food can indeed be part of a diet that promotes excellent health. The overall message of The China Study is that consumption of animal food, even in the smallest amounts, is nothing but bad. I think the information I’ve presented in this article makes it abundantly clear that this claim is not supported nearly as well as the book suggests. In fact, it’s debatable if such a strong claim is even supported at all.

The second point is the significance of individuality. Whether it be a low carbohydrate diet including plenty of animal food, a vegan diet excluding all animal food, or any variation in between, there are cases of both success and failure associated with all of them. While some dietary choices may present more concern than others, it’s undeniable that we each respond to food in a different manner and have unique requirements. In fact, even the DRI system established by the USDA, which is the foundation of nutritional evaluation, is based on this principle. The Recommended Dietary Allowance (RDA) is calculated based on the Estimated Average Requirement (EAR) which is the amount of a particular nutrient believed to meet the needs of 50% of the population. Even the RDA, which is projected to meet the needs of 98% of the population, is not adequate for everyone.¹³³ Similarly, the fact that some people can thrive on a vegan or vegetarian diet certainly doesn’t mean that everyone can.

The China Study: Is Animal Food Really Unhealthy? is an article by Vin Miller from RageWellness.com

Serotonin is a neurotransmitter that’s commonly cited as a cause of depression, and the most prominent class of antidepressants is believed to work by increasing its availability. However, the involvement of serotonin in depression is not universally accepted, and even if it was, the fact that serotonin activity can be influenced by basic dietary factors is often overlooked. This serves as a good example of the many opportunities to treat depression in a manner that promotes optimal health instead of detracting from it. And while it’s easy to place blame on our medical system for not making such opportunities more available, it would be much more productive to embrace the perspective that it’s your own responsibility to guide the direction of your treatment.

The Common Approach to Treating Depression

Based on data from 2007, it’s estimated that nearly 9 million Americans recieve treatment for depression.¹ For a large majority of these people, the form of treatment is either a class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs), or a similar class called serotonin-norepinephrine reuptake inhibitors (SNRIs), both of which inhibit the reuptake of serotonin by nerve cells. All of these medications are prescribed based on the hypothesis that reduced serotonin availability causes depression. However, this hypothesis has not been proven, and as with most hypotheses, it’s surrounded by disagreement and controversy.²

Depression comes in a variety of forms, is characterized by a variety of symptoms, and can be caused by a number of different factors. As many of us already know, depression can even be a natural and expected reaction to difficult life circumstances.³ In addition, depression has been associated with a number of abnormalities in neurological function that are unrelated to serotonin.⁴ Despite this, the prescription statistics mentioned earlier indicate that most patients are being treated with medication based on a questionable assumption that their depression is caused by serotonin abnormalities.

Serious Risks Associated with SSRIs

Most people understand that medications can have dangerous side effects, and many of these people appreciate the potential risk for other unknown effects. SSRIs are reported to have very serious side effects including increased risk of heart attack⁵ as well as a controversial association with an increased tendency towards suicide.⁶ In addition, they can cause a potentially fatal collection of symptoms known as “serotonin syndrome.”^7,8 And these are just a few of the potential side effects. For example, the U. S. National Library of Medicine lists the following side effects for Prozac which is one of the more popular SSRIs: nervousness, nausea, dry mouth, sore throat, drowsiness, weakness, uncontrollable shaking, loss of appetite, weight loss, changes in sex drive, excessive sweating, rash, hives, fever, joint pain, swelling, difficulty breathing, irregular heartbeat, severe muscle stiffness, hallucinations, and seizures. Also listed is a suicide warning for children, teenagers, and young adults up to the age of 24.⁹

Clearly, there’s plenty of incentive to use alternative treatment methods that don’t impose as much risk. Such alternatives are indeed available and have proven to be effective.

Surprisingly Simple Alternatives to SSRIs

Even for people who’s depression is indeed associated with serotonin abnormalities, there are safer and more logical treatments that can be used before prescribing an SSRI. Tryptophan, a precursor to serotonin, is an amino acid that’s readily available from most dietary sources of protein. Therefore, simply increasing protein intake can promote an increase in serotonin synthesis and potentially alleviate depression as a result. In addition, identifying and addressing digestive issues can help by increasing the availability of the tryptophan already in the diet.

If improvements in protein intake and digestion fail to have the desired effect, the use of supplementation is another option that can be considered. Because tryptophan competes with other amino acids for transport into the brain,¹⁰ supplementation of tryptophan by itself may be more effective than simply increasing overall protein intake. Although some might remember that tryptophan supplements were once banned by the FDA in the 1990s, the underlying concern was eventually attributed to contaminants from a single manufacturer rather than tryptophan itself.¹¹ If you’d still prefer to avoid tryptophan or have found it to be ineffective, there is yet another option. Tryptophan is converted to 5-hydroxytryptophan (5-HTP) prior to being converted to serotonin.¹² Supplementation with 5-HTP may therefore be more effective because it’s the direct precursor to serotonin, and it’s widely available in supplement form.

Although critics say that more thorough research is needed, supplementation with tryptophan and 5-HTP has been shown to be as effective as SSRIs.¹³ A Cochrane review, which is a standardized review of intervention trials that’s generally regarded as highly reliable and unbiased, identified 108 trials that used tryptophan and 5-HTP to treat depression.¹⁴ Although only 2 of the trials met the Cochrane inclusion criteria, they both found tryptophan and 5-HTP to be more effective than a placebo for the alleviation of depression.

Even if the quality of the supporting research doesn’t meet the standards of critics, I hope most people would agree that the risk of ineffectiveness is certainly a lot more appealing than the risk of heart attack, suicide, and other side effects, even if these risks are unlikely.

Supplements Aren’t Always Better than Drugs

Even though supplements are generally safer and more natural than medications, their use still imposes some unnecessary risk. For example, as with SSRI use, supplementation with the natural serotonin precursors tryptophan and 5-HTP can potentially cause serotonin syndrome.^7,8 In conjunction with several points I’m about to discuss, I consider this a good reason to emphasize a diet and lifestyle based approach prior to considering supplementation.

First, because tryptophan is an essential amino acid, meaning that it can’t be produced by the body and must therefore be obtained from diet, it would be logical to evaluate protein intake prior to recommending supplementation.

Second, supplementation doesn’t account for the vitamin and mineral cofactors that are involved in the conversion of tryptophan and 5-HTP into serotonin. For example, iron is needed by the enzyme that converts tryptophan into 5-HTP, and vitamin B6 is needed by the enzyme that converts 5-HTP into serotonin.¹⁵ As such, supplementation with 5-HTP won’t have much of an effect if intake of vitamin B6 is insufficient.

Third, a patient’s depression may be caused by dietary factors that are unrelated to serotonin. For example, a group of neurotransmitters called the catecholamines, which consists of epinephrine (adrenaline), norepinephrine, and dopamine, have also been associated with depression.¹³ These neurotransmitters are derived from the amino acid tyrosine which is in turn derived from the amino acid phenylalanine.¹⁵ Obviously, supplementation with tryptophan or 5-HTP is not going to alleviate depression caused by a insufficiency of these amino acids and the neurotransmitters derived from them. In addition, the previous two points apply to phenylalanine just as much as they apply to tryptophan. Phenylalanine is an essential amino acid, and its conversion into neurotransmitters requires a variety of vitamin and mineral cofactors.

Fourth, depression may be caused by factors that need to be eliminated from the diet rather than added. For example, sugar consumption has been highly associated with major depression.¹⁶ Although this doesn’t prove causation, it’s certainly plausible that an excessive intake of refined foods may promote depression, and supplementation is highly unlikely to correct such a problem.

Finally, because it’s not always practical to test for all of the known nutritional factors relating to depression, and because there may even be factors that we don’t know of yet, the information needed to use supplements accurately and safely isn’t always available. When used in such circumstances, supplementation can result in excessive intake and be counterproductive, as is the case with tryptophan and 5-HTP supplementation causing serotonin syndrome. As such, a well balanced diet that provides an adequate intake of as many essential nutrients as possible is a safer approach and is also likely to address a much wider variety of factors relating to depression. In my opinion, the only time supplementation is a smart choice is after all reasonable opportunities to improve food selection have been exhausted. Even then, supplementation should still be guided by a thorough dietary analysis.

As Hippocrates is well known for saying, “let food be thy medicine.”

A Paradoxical Side Effect of SSRIs

One potential side effect of SSRIs not yet discussed provides an excellent illustration of the irony behind their high rate of use. Understanding this example requires a somewhat more detailed explanation of how SSRIs are believed to work and how serotonin is metabolized.

Neurons (nerve cells) release neurotransmitters, including serotonin, to transmit an instructional impulse to another cell, which in some cases may be another neuron. This is a fundamental aspect of how the brain and nervous system work. Neurotransmitters are released from an ending of a neuron into a space called the synaptic cleft where they can bind to receptors on the cell located at the other end. The neurotransmitters that don’t bind with the target cell may be reabsorbed by the neuron that released them. In regard to the treatment of depression, SSRIs appear to work by blocking the reabsorption of serotonin¹⁷ which provides more opportunity for it to bind with the target cell. However, this also creates additional opportunity for serotonin to be broken down and excreted in urine as 5-hydroxyindoleacetate (5-HIAA).

Urinary elevations of 5-HIAA have been associated with SSRI use which indicates that SSRIs reduce the amount of serotonin recycled and therefore also increase the amount lost from the body. As previously mentioned, the amino acid tryptophan is a precursor to serotonin. Therefore, the depletion of serotonin by SSRIs can also deplete the body’s supply of tryptophan and create an increased need for intake.¹⁵ Wouldn’t it make a lot more sense to avoid the risks associated with SSRIs and start with a dietary increase of tryptophan in the first place?

Other Alternate Approaches

Even when serotonin abnormalities aren’t an issue, there are still other alternatives to pharmaceuticals, and as with dietary approaches, they’re much more conducive to promoting optimal health.

A negative outlook on life has been associated with depression¹⁸ and theorized as a cause of it.^19,20 This suggests that depression can be alleviated by developing the ability to perceive daily events and circumstances in a more positive manner. Although not easy, perception is something that can certainly be changed, and the benefits can extend well beyond depression. If this approach interests you, I highly recommend The Heart Math Solution or The Power of Now. The former is a practical approach to changing your perception of negative events while the latter is more philosophical and addresses perspective at a much deeper level.

Aerobic exercise has been shown to be just as effective as SSRIs as a treatment for depression,^21,22 and a follow-up to one of these studies found that the medicated group had a higher rate of relapse after 10 months.²³

Take Responsibility

Based on the variety of safe and health promoting treatment options that exist for depression, you may wonder why they’re not recommended more frequently. If you currently use antidepressants, you may even feel some anger and resentment in association with this question.

The most likely reason, in my opinion, why these treatments aren’t widely recommended is that the structure of our medical system doesn’t allow for it. The dependency of the medical system on the insurance industry dictates that visits with health care providers be kept brief, and it takes a lot more time to assess a patient’s diet and lifestyle than it does to write a prescription. In addition, because nutrition and lifestyle aren’t a significant aspect of medical training, except for nutritionists, not all health care providers will have the background to even offer such options. And seeking out an alternative health care provider may not be any more helpful because they may still follow the same conventional model of addressing symptoms rather than causes, but with the use of supplements instead of drugs. As I mentioned earlier, there are many cases in which supplements are probably not the best choice.

Despite the flaws in our medical system, it’s excellent in a number of other ways, and it’s not my intent to criticize it. Instead, I hope for you to understand its limitations and have the motivation (rage) to become more informed so that you can have more of an influence on the direction of your treatment. Ultimately, the only person truly responsible for your health and wellbeing is you!

Although self sufficiency is a great value and I’m a big believer in being proactive, it would be irresponsible to write an article like this without mentioning the following concern. If you’re already taking an SSRI, it’s important to know that there are serious concerns associated with discontinuing usage or even just reducing the dosage. In fact, this concern is prominent enough to be the basis for a named syndrome: SSRI discontinuation syndrome.²⁴ If you do decide that you’d like to transition off of your medication in favor of a more healthful approach, please do so with the help of a physician who appreciates your intent. While it’s an admirable goal, it’s not advisable for everyone and can be dangerous to attempt without professional help.

Healthful Alternatives for Treatment of Depression is an article by Vin Miller from RageWellness.com

Photo by Mark Howard

Novak Djokovic

It was somewhat of a shock to most of the tennis world when Rafael Nadal took the top ranking from Roger Federer, but these two guys have been so dominant for such a long time that it seemed far fetched to think anyone else could catch up with them. The closest contender, relatively speaking, has been Novak Djokovic.

Djokovic has always been regarded as a very talented player. In fact, I watched him play his first US Open match in 2005. The match was played on an a small outer court, and the only reason I wanted to watch it was because Djokovic was playing a hot new prospect named Gael Monfils. Having no idea that I was watching a future top player, I was surprised by Djokovic’s abilities. Since then, he’s done quite well and eventually reached the number 3 ranking, but he’s always been plagued by breathing problems and was well known for struggling in hot conditions. Late in 2010, however, things began to change.

In the semifinals of the 2010 US Open, Djokovic hit some very courageous shots to fight off 2 match points against Roger Federer and went on to win the match. Shortly after the US Open, Djokovic and his Serbian teammates won the Davis Cup, which for tennis is the equivalent of soccer’s World Cup. He started 2011 full of confidence and surprised everyone by not losing a single match for 5 months. In addition to only losing 5 more times during the remainder of the year, he won 3 of the 4 most important tournaments and finished the season with one of tennis’ most prestigious accomplishments; the year end number 1 ranking. And he did so with a substantial lead. This will undoubtedly earn a place in the tennis record books as one of the greatest seasons ever.

There are clearly many things that went into Djokovic having such a spectacular season, but he has openly attributed at least part of his success to his gluten free diet. He says it’s given him more energy, and it’s obvious from watching him play that he’s not as affected by the breathing problems that used to trouble him.

Andy Murray

Like Djokovic, Andy Murray is another player who’s been regarded for a long time as having tremendous potential. In fact, the same year I watched Djokovic play at the US Open, I also caught some of Murray’s notable match against Andrei Pavel during which he vomited on court and still managed to win. Although the same young age as Djokovic, I actually knew who Murray was at the time because he was already being regarded as a top prospect. But unlike Djokovic, he still hasn’t fully lived up to the expectations of tennis critics.

Possibly inspired by Djokovic, Murray has been avoiding gluten since the conclusion of Wimbledon this past July. He claims to have more energy and an easier time getting out of bed in the morning. With his added energy, he recently won 3 tournaments in a row which was enough to temporarily take the number 3 ranking from Roger Federer.

Why is Gluten a Concern?

Gluten is a type of protein found in grains such as wheat, barley, and rye. In genetically susceptible individuals, estimated to be about 1% of the population, the consumption of gluten provokes a destructive autoimmune reaction within the lining of the intestines.¹ This condition, formally referred to as celiac disease, is the most widely recognized form of gluten sensitivity. Continued consumption of gluten by people with this disease leads to intestinal damage that impairs nutrient absorption and increases intestinal permeability. These alterations increase the risk of vitamin and mineral deficiencies, anemia, osteoporosis, and lactose intolerance and are associated with an increased incidence of secondary autoimmune disorders including type 1 diabetes and thyroiditis.^2,3

Although the definition and diagnosis of celiac disease is primarily based on alterations of the intestinal lining, gluten sensitivity can exist in the absence of such damage.^4,5 For example, gluten sensitivity has been associated with neurological damage that occurs without any trace of gastrointestinal symptoms.^6,7 Similarly, an “asymptomatic” or “silent” form of gluten sensitivity has also been identified and is associated with low level illness that can cause more subtle symptoms such as fatigue, depression, irritability, and impaired mental performance.⁸ These atypical cases are usually identified by the presence of antibodies intended for a component of gluten called gliadin. Some researchers refer to these varieties of gluten sensitivity as a form of celiac disease even though not all people with the disease test positive for the antibodies. Making matters even more confusing, adverse reactions to gluten are known to occur in the absence of both anti-gliadin antibodies and gastrointestinal symptoms.⁹ These variations have led many authors to believe that gluten sensitivity is much more prevalent than typically suggested.

Increased intestinal permeability is a key component of gluten sensitivity and allows undigested gluten to enter circulation and invoke immune responses. This is believed to be the reason why gluten sensitivity can be systemic in nature and why celiac disease is associated with the development of other autoimmune diseases.^10,3 A variety of lifestyle factors such as poor diet, stress, and alcohol consumption can increase intestinal permeability^11-14 and therefore facilitate adverse reactions to gluten. However, as part of the autoimmune response characteristic of celiac disease, gluten itself can also increase intestinal permeability.¹⁵ In addition, gluten has been found to increase permeability in cultures of intestinal cells from people without celiac disease, although to a lesser extent than in the cells of celiac patients.¹⁶ Despite the significant role of intestinal permeability in gluten sensitivity, apparently not all gluten sensitive individuals have increased permeability. A study involving gluten sensitive individuals free of celiac disease found that they had no statistically significant difference in intestinal permeability compared to controls.⁹ However, based on the prevalence of the previously mentioned lifestyle habits, it’s arguable that the general population, represented by the controls in this case, may also have a tendency towards altered permeability and therefore be a poor basis for comparison. Either way, what’s obvious is the complex nature of gluten sensitivity and its potential to affect a broad range of people.

Another potential problem is that some products of gluten digestion can act as opioid agonists.^17,18 However, little evidence is available to determine the extent to which this might be a concern. Based on the premise that opioids downregulate natural killer cell activity, it’s been proposed by at least one author that the opioid agonists derived from gluten can have a similar immunosuppressant effect and contribute to the development of cancer as a result. This has been suggested as an explanation for the increased prevalence of lymphoma in people with celiac disease.¹⁹

Universal Benefits of a Gluten Free Diet

Relief from the detrimental effects of gluten sensitivity may very well explain the perceived improvements in wellbeing experienced by Djokovic and Murray. However, I think other factors may be involved as well, and this applies to anyone following a gluten free diet, not just elite athletes.

As I explained in my overview of basic principles for healthy eating, consuming processed foods on a regular basis can have a detrimental effect on wellbeing. A major basis for this is the significant amount of refined carbohydrates in most processed foods, much of which are derived from grains that contain gluten. Wheat flour is an extremely common example. Because it’s mostly processed foods that contain gluten, the need to follow a gluten free diet makes it much easier, almost by necessity, to embrace healthier eating habits based primarily on whole foods. However, the increasing availability of gluten free varieties of processed foods is making this benefit less inherent.

Anyone who replaces processed foods with nutrient dense whole foods is bound to experience significant improvements in wellbeing. For those who are sensitive to gluten and use this approach to eliminate it from their diet, the benefits they experience from doing so will likely be much greater than if they were to simply replace processed foods with their gluten free counterparts. In other words, the improvements that many people attribute to a gluten free diet, assuming it’s based primarily on whole foods, are in many cases also attributable to the general benefits of a more nutritious and well rounded diet. I have no idea what Djokovic or Murray eat on a regular basis, but unless they’re gorging on gluten free varieties of refined foods, I suspect this added benefit of improved food quality applies to them as well.

How to Determine if You’re Sensitive to Gluten

The awareness of gluten sensitivity has been rapidly increasing, and the success of Djokovic and Murray will likely help to increase it further. However, because of the different forms of gluten sensitivity, testing can be inconclusive. As such, simply trying a gluten free diet can sometimes be the most reliable indicator. Although subjective, this method of testing is also less invasive, more understandable, and can be easily done by anyone. In addition, it may relieve symptoms that you never even realized were abnormal. As long as you stay focused on nutritional quality, you have a lot to gain and little to lose.

To accurately assess any potential effects of gluten, it’s best to completely eliminate it for at least 2 – 4 weeks and then intentionally consume a significant amount of it in a single day. Reintroducing gluten after the trial period will make any adverse reactions to it much more obvious, and if you improved the nutritional quality of your diet as part of the trial, the reintroduction will also help you differentiate between the effects of gluten and the benefits a more nutritious diet. For example, if you experience benefits that persist after the reintroduction of gluten, they’re most likely a result of other changes that you made to your diet. However, if you can attribute significant improvements directly to the avoidance of gluten but continue to suffer from symptoms of compromised health, it would be a good idea to seek the help of a physician or nutritionist who can determine if these symptoms are secondary progressions of celiac disease. This is important because such progressions may require additional intervention beyond a gluten free diet.

If you’d like more information on celiac disease, gluten sensitivity, or following a gluten free diet, I suggest starting with Dangerous Grains by Dr. James Braly and Ron Hoggan.

Top Athletes Attribute Success to their Gluten Free Diets is an article by Vin Miller from RageWellness.com

1. Eat Food, not Nutrients

“The whole is more than the sum of its parts” is a phrase commonly used to signify the added value that can only result from the cooperative interaction of individual parts. This concept is generally referred to as synergy. It has powerful implications in modern medicine,¹ and in regard to nutrition, implies that whole foods offer greater nutritional value than processed foods.

Despite the myriad of health claims found on the packaging of processed foods, whether it be for vitamins, antioxidants, essential fatty acids, or whatever else, the bottom line is that these foods are nothing more than a sum of isolated nutrients, some of which don’t exist in nature and are potentially harmful. In fact, prior to a change in legislation in the 1970s, such products were required by the FDA to be labeled as food immitations.² Not only do these manufactured foods lack the synergy of whole foods, they create an entirely new synergy that is clearly not serving us well.

Infant formula is an excellent example of this concept. Early use of formula was catastrophic with death being a frequent outcome, and even though we now have a much better understanding of essential nutrients, concerns over infant formulas still exist.^3-6 Fruits and vegetables are another great example. There’s a lot of evidence supporting their role in the prevention of many diseases, and this protection is often attributed to antioxidant content. However, most research on antioxidant supplementation has produced disappointing results. The difference is most likely a result of the synergy between the thousands of phytochemicals that exist in whole fruits and vegetables.⁷ Processed foods and supplements are much less likely to have this health promoting synergy.

In the book In Defense of Food, Michael Pollan describes a philosophy called nutritionism which is the current standard of thinking and focuses on individual nutrients more so than the foods that they constitute. For the most part, this narrow perspective makes it difficult to appreciate the value of synergy and has the effect of making processed foods seem a lot more healthful than they really are. For example, a list of vitamins fortified into a breakfast cereal may make it easier to misjudge the overall quality of the product. We clearly haven’t reached the level of scientific understanding needed to effectively reinvent foods, and we may never, but food manufacturers are doing it anyway. The artifical food that they create now constitutes the majority of our diet.

In short, eating whole foods in place of processed foods as often as possible is probably the most effective thing you can do to avoid the health risks associated with the modern diet. A few characteristics of whole foods that make them easier to identify are that they spoil relatively quickly, come directly from an animal, tree, or plant, and are generally not sold in packaging.

2. Emphasize Quality

There’s a lot of truth to the saying that you are what you eat. This is because many of the compounds from the food you ingest literally become part of your body tissues. Since this is the case for plants and animals as well, it’s also accurate to say that you are what your food eats. For the most part, the nutrients eaten by animals or absorbed by plants is what dictates their quality as food.

Beef is perhaps the most obvious example. It’s one of the most common sources of meat in the American diet, and the majority of it comes from Concentrated Animal Feeding Operations (CAFOs) which are more commonly known as factory farms. The cattle on these farms are given hormones to accelerate their growth, are fed grains instead of their natural grass diet, and are forced to live in small areas overfilled with feces. To compensate for the health concerns presented by this type of environment, the cattle are also treated with antibiotics on a regular basis.⁸ The beef from these cattle is significantly different from the beef of cattle raised on a strictly natural diet of organic grains, and even this organically produced beef is different from the beef of cattle raised on grass pastures. For example, beef from grass fed cattle has been shown to have a more favorable ratio of essential fatty acids^9-12 and a lower susceptibility to lipid oxidation which is likely a result of higher vitamin E content.^11,13 Another important difference is the likeliness of conventionally produced beef to contain residues of hormones and anitbiotics.^14-17

Similar differences exist with plants as well. Most of the produce sold at American grocery stores is from industrial farmers who rely exclusively on synthetic fertilizer to replenish their soil. This results in a smaller subset of nutrients being made available to crops and increases the need for pesticides and other agricultural chemicals.⁸ As a result, conventionally grown produce is different than organically grown produce, and even organic produce is different than produce grown in rich soil maintained by sustainable farming methods. For example, both organically and sustainably produced corn, marionberries, and strawberries have been shown to have a greater content of vitamin C and total phenols than their conventionally grown counterparts.^18,19 Phenols are natural plant substances that include a variety of antioxidants and are thought to contribute to the health benefits associated with fruits and vegetables. In addition, although the concentrations of chemical residues found in conventional produce are usually small,²⁰ they’re still there, and it doesn’t make much sense to expose yourself to them if you don’t have to.

Choosing organic meat and produce is generally better than choosing their conventional counterparts, and getting meat and produce directly from a sustainable and pasture based farm is even better. However, if neither of these options are possible, choosing conventionally produced whole food over any type of processed food, including organic, can still greatly improve the nutritional quality of your diet.

3. Be Inspired

You may feel disappointed by the simplicity and perhaps obviousness of the previous two principles. I don’t disagree that they can be regarded as a matter of common sense, but given that the majority of the American population is overweight and that the prevalence of obesity, type 2 diabetes, and other diet related health concerns is alarmingly high, it appears that most people have trouble putting this common sense into practice.

Just because something is easy to understand doesn’t mean it’s easy to do, and this is certainly the case with healthy eating. Processed foods, which in my opinion are often the basis of an unhealthy diet, tend to taste good and provide maximum convenience. Overcoming these temptations requires a level of dedication and effort that many people simply don’t want to bother with.

Although there are ways to significantly reduce the amount of time and effort required to prepare whole food meals, this isn’t always enough to compensate for low motivation. In my opinion, staying committed to healthy eating habits, or any other type of health related habits for that matter, requires intrinsic motivation. This type of motivation, which I like to refer to as rage, is driven by meaningful personal values and is usually very strong as a result. Without this type of motivation, the comfort and convenience of old habits will probably be too enticing to overcome.

Basically, you need to make sure that your reasons for wanting to eat healthier are connected to one or more of your deep personal values. For example, you might want to improve your quality of life, be a role model for your children, or live long enough and well enough to enjoy the experience of watching your grandchildren grow into adults. In contrast, simply wanting to eat healthier to lose weight and look better probably won’t provide a strong enough sense of urgency.

Time Tested Simplicity

The primary value of the three principles summarized above is that they address the most important aspects of healthy eating and do so in the simplest way possible. While I encourage everyone to look beyond them, doing so is not required. These principles can have a significant impact on one’s wellness without any further consideration. Either way, it’s important to not let them be diluted by overemphasizing other less significant aspects of nutrition.

A very long history of natural selection is very likely to have been the most significant determinant of what types of diets humans can thrive on. For this reason, some scientists have embraced the concept of paleolithic nutrition which is based on reproducing the diet of our preagricultural ancestors as closely as possible. Our departure from this type of diet is believed to have played a significant role in the high prevalence of modern disease.^21,22 Although there are obviously some limitations to this approach, it’s a simple and effective way to establish an emphasis on whole foods. In fact, research is beginning to show health improvements in people who follow it.^23,24 A much more extensive explanation of paleolithic nutrition can be found in The Paleo Diet by Loren Cordain as well as its accompanying cookbook.

For those who are skeptical of an evolution based approach to nutrition, the much more recent observation of isolated indigenous cultures within the past century provides even stronger evidence for the superiority of whole foods. Some of the most convincing evidence, which is thoroughly documented in Nutrition and Physical Degeneration, comes from Weston Price’s observations of isolated cultures transitioning from their traditional whole food diets to processed foods. Time after time, Price witnessed a dramatic decline in their health. Similar investigations have been carried out by a number of other researchers. The strikingly consistent observation made by most of them is that modern diseases such as cancer, heart disease, diabetes, and obesity were practically non existent in these populations prior to the introduction of processed foods.²⁵

Our ancestors had no choice but to follow the “big 3″ basic principles. Whole foods were the only type of food available, their quality was dictated by nature, and since death was the only alternative to whole foods, there was plenty of motivation to eat them. This once necessary and unquestioned way of life has now been reduced to a choice; one that most people pass up for the convenience of processed food. It’s not as if we have to hunt and gather our food as our ancestors did, we just have to prepare it and perhaps be willing to spend a little more money for it. Considering the possible implications to health and quality of life, it’s a relatively minimal commitment.

The 3 Most Powerful Principles of Healthy Eating is an article by Vin Miller from RageWellness.com

The Alphabet of Movement

Dr. Eric Cobb of Z-Health Performance has come up with a great analogy relating the alphabet to the fundamental importance of basic movement ability. Communication is incredibly important to our daily lives and it depends on the knowledge of a vast number of words as well as the ability to combine them in a way that conveys meaning. At an even more basic level, words depend on letters. Without them, words and language wouldn’t exist, but with just the 26 letters comprising the English alphabet, a seemingly infinite number of thoughts, emotions, and directives can be communicated. If just a single letter were taken away, communication could be significantly compromised.

Movement is no different. If the ability to effectively perform a simple but fundamental movement pattern is lost, the more complex movement patterns that rely on it will be impaired. This leads to compensations that can increase the risk of injury and limit physical ability, all of which can reduce quality of life.

A gradual approach to fitness that focuses on the basics first is usually the most effective and certainly the safest, but in this age of instant gratification, it’s no surprise that many people are eager to jump right into more advanced exercises and training methods. I have to admit that I’m sometimes guilty of this myself, but it’s usually counterproductive, often to a significant extent. In effect, it’s like trying to develop an advanced vocabulary without first learning the alphabet. Ensuring proficiency at basic movement patterns should come before other type of fitness endeavors, or at least be done in conjunction with them.

How Impaired Movement Leads to Injury

The science of biomechanics is based in part on the application of forces to the structures of the body and gives us a relatively good idea of how our limbs and joints should and shouldn’t move. Throughout the course of daily life, and especially during more strenuous physical activity, our ability to control the actions of our muscles dictates how such forces are applied and ultimately determines whether or not the movements we make are causing more strain than necessary.

The body is able to compensate for limitations in movement and is amazingly resilient at tolerating the unfavorable movement patterns that result. It’s something that was probably necessary for survival throughout the course of our evolution. However, continuing to move in this compromised manner is bound to eventually lead to pain or injury. The compensations that occur put more stress on muscles, tendons, ligaments, bones, and cartilage than what they’re able to readily handle on a consistent basis. When this leads to pain or injury, it’s usually a result of the accumulation of many instances of excessive strain rather than a single occasion. In other words, if you’re grinding through workout after workout with imperfect movement, you may be promoting the accumulation of tissue damage while also increasing your potential for injury.

Consider a runner. With each stride, various structures of the body are exposed to the significant forces generated by muscular contraction and impact with the ground. Limitations in the runner’s movement can leave joints in compromised positions making them and their surrounding tissues more vulnerable to these forces. In addition, flawed movement can increase the amount of force distributed to malpositioned joints making them even more vulnerable. With this in mind, consider the thousands of times it may happen during a single run and the millions of times over the course of a year. The thought makes me cringe, and I hope it makes you cringe too, at least enough to help you appreciate the importance of movement quality.

At the opposite end of the fitness spectrum, strength training doesn’t involve nearly as much repetition as running, but when done with movement limitations, it can cause damage just as easily by exposing malpositioned joints and their surrounding tissues to much greater amounts of force. Furthermore, as strength improves and heavier weights are used, the resulting increase in force further increases the potential for damage.

Clearly, it makes good sense to ensure proficiency at basic movement patterns prior to engaging in demanding or repetitive physical activity, especially if you hope to be active, or at least self sufficient, in your old age.

How Exercise can Reinforce Dysfunction

Although muscle has an obvious influence on movement, the nervous system has an even greater influence because its impulses are what stimulate muscular contraction. Without nerve impulses, there’s no muscle contraction, and without contraction, there’s no movement. Even the simplest of movements involve a very large and complex network of nerve cells that must stimulate many muscle fibers in a specific sequence and within a very small window of time. If just a portion of this complex sequence is altered, the resulting movement will be altered as well. For this reason, the nervous system is often at the root of movement limitations.

The axon of a nerve cell, which is what nerve impulses travel through, is coated with a fatty form of insulation called myelin. It improves the accuracy and reliability of nerve impulses and makes muscle activation patterns easier to execute and more automatic. Science is beginning to show that when you practice a specific skill or movement many times, it becomes easier, more natural, and more precise primarily because of the increased accumulation of myelin around the path of nerve cells responsible for the movement’s execution.^1-3 Based on this mechanism of facilitation, the more frequently a faulty movement pattern is utilized, the more established it becomes, and the more difficult it will be to effectively replace it with a better pattern. In other words, exercising with imperfect movement trains your body to promote inefficiency and injury.

A Lesson From the World’s Best Movers

For anyone who pays a lot of attention to the fitness industry, particularly in relation to athletic performance, it’s fairly common to hear some of the most highly respected physical therapists and strength coaches talk about professional athletes they’ve worked with who had surprisingly significant limitations with one or more basic movement patterns. If these athletes are able to perform at such a high level despite such limitations, it may lead you to question their importance. Well, the reason why athletes like this find their way to renowned therapists and strength coaches is usually because of chronic pain and injury that’s hindering their careers. They’re able to perform at a high level despite the limitations because their bodies are able to compensate, but this typically leads to trouble and may prevent their already high level of performance from becoming even better.

Similarly, it’s not uncommon to hear cases of highly sought after high school or college athletes who have lost their chance to make it big because of a serious injury. Some of these injuries are traced back to basic movement limitations that were never properly addressed.

In short, if elite athletes who spend many hours training their bodies to function at a high level are prone to the impaired function and increased risk for injury that result from limitations in basic movement patterns, then you certainly are too! Sure, you may not be a professional athlete, and you may not even be an athlete at all, but this doesn’t make it any less important for you to be able to effectively meet the physical demands of daily life without pain or difficulty.

Regaining Your Natural Ability

Movement quality is different from other aspects of fitness in that it’s not something you start without and have to work long and hard to develop. In fact, it’s quite the opposite. Basic movement skills are developed very early in life, but the problem is that many of us lose them as a result of either abusing our bodies or neglecting them.

For anyone who appreciates human movement, watching a baby rise from the floor into a standing position is a thing of beauty. For the most part, it’s the perfect squat. They start at full depth and shoot straight up with a neutral spine and perfectly synchronized hip and knee extension. If you watch the squats being performed in most gyms, you’ll likely see something much different.

It’s not uncommon to find people in their 20s or 30s who can no longer do a full depth body weight squat, and it only gets worse with age. This is a loss of a movement pattern that is so basic and fundamental that it develops before the ability to walk. And if you think this is a natural result of aging, then you’re selling yourself short. In less westernized cultures, the full squat position is often used for resting as well as for using the toilet, and the ability to get into this position is usually maintained well into old age. The only thing that the loss of this ability is a natural result of in westernized societies is neglect and inactivity.

Don’t overestimate your ability to do the “simple” stuff. Even if you think you have a strong command of basic movement patterns, the results of a screening may leave you surprised at what you’ve lost, and this would obviously be a lot better than being surprised by an injury. The key is not necessarily to develop excellent movement quality, but rather to regain it and then to keep it, all of which can be accomplished through a single well designed training program.

For a more thorough and textbook like understanding of basic movement, including it’s importance in injury prevention and performance as well as how to screen for it and address identified limitations, check out Movement by Gray Cook.

Movement Quality: The Foundation of Physical Wellness is an article by Vin Miller from RageWellness.com