Finding Nutrition

Adi was suffering.  The chemotherapy inflicted heavy damage on her body, and looming, unspoken, was the threat of recurrence.  I had no way to help.  Seeking answers, I dove into the Sea of Nutrition Science.  The sea was murky and its treasures were hard to find.  I emerged after four months, not with shiny pearls, but with nutritious oysters, rich with food for thought.  The sea is murky because nutrition science is vague.  Experiments are mostly conducted on animals, and human studies are largely observational.  They can demonstrate correlation but do not prove causation.  The few randomized, controlled experiments are small, and leave a lot of room for doubt.  Despite, and perhaps because of, this vagueness, there are many nutrition philosophies patrolling these depths, all claiming to be king of the sea.  Hence this oyster, which took me a long time to find and gather.
  • Be a skeptic.  A nutritional philosophy is an opinion, not science.
In Oncology Bay, I learned that cancer cells can utilize only glucose for their energy and growth.  In contrast, normal cells have many metabolic alternatives.  This weakness can be exploited to combat the disease.  To do so, Dr. Valter Longo, recommends periodic five-day fasts.  To ease the long fast, he designed a Fast Mimicking Diet (FMD), and founded Prolon, which sells the appropriate meals.  The FMD, when taken prior to a chemo cycle, alleviates the side-effects.  Unfortunately for Adi, this information came too late to be useful.  If fasting works by temporarily lowering glucose, then a short swim away, I found the Ketogenic Diet (KD), which lowers it continuously.  This diet, taken up by ultra-distance athletes and bodybuilders, offers to improve athletic performance and enhance clarity of mind.  KD strictly limits carbohydrates (the glucose-producing nutrient) to less than 10% of total calories,   The majority of the needed calories come from eating fat, which metabolizes into ketones rather than glucose.  A snack on this diet, could be butter wrapped in bacon.  Sounds horrible?   I felt the same way until I read Dr.  Peter Attia's blog. There, I learned all about cholesterol, and after being convinced that fat is not harmful, I converted to the KD, which I followed... for a while.  Although both Adi and I realized that such a drastic diet may not be right for us, we noticed that fasting was a weapon utilized by both KD and FMD.  Conveniently floating by, was the Time Restricted Diet (TRD), which formalized various fasting schedules.  The most popular scheme seemed to be a sixteen-hour fast (skip breakfast).  Another denizen of the deep, pointed to the fact that eating at night violates the body's Circadian Clock and disrupts metabolism.  We decided that although we will attempt the longer fast, we are committed to the less-demanding oyster
  • Do not eat between sunset and sunrise (12 hours)
While roaming the seas, I kept in mind that diabetes could be lurking in my genes.  Diabetes is usually lumped with  other chronic diseases such as obesity, high blood pressure, cardio-vascular disease, cancer and more.  Often, a precursor to these nasties is Insulin Resistance, a condition in which both glucose and insulin levels are elevated.  If I wish to reduce my risk of diabetes, I will need to remain insulin-sensitive.  One way to do so, is to avoid  excess glucose, or in nutrition terms
  • Control carbohydrate consumption
BTW, fasting also, serves this purpose.  'Control' means that the calories derived from carbohydrates should fall somewhere between 15% to 30% of the total.  This is a wide range, which I will eventually narrow.  I learned not to worry about protein, since it is regulated by our body (probably at 10% to 20%).  Fat will fill the rest of my caloric needs.  If this sounds too vague or too complicated, I have good news.  The nutritional sea is subject to changing fashions (like any science). High carb, low carb, Atkins, Paleo, and so on.  The latest fashion is that there is not one solution that fits all.  You should choose a nutrition regime that fits your genes, condition, and goals.  This is what Ofer has been trying to tell me all along, and I now accept as truth.  Not surprisingly,  there is an Israeli research group that is building a computer model to provide your individualized menu.
  • Correct nutrition is a personalized nutrition.
Out of curiosity, rather than necessity, I wanted to learn about the causes of the "Obesity Epidemic"
Among the more notorious villains I found Fructose, Insulin, and Food addiction.  Heated debates are raging between the proponents of the different theories.  Stephan Guyenet's calmer blog, helped me navigate the issues.  Out of the churning waters I plucked two oysters that were not a large departure from my previous habits, and conform with my new understanding
  • Do not drink any sweetened beverages
  • Do not eat any processed products
We all want to optimize our nutrition, and we tend to exaggerate its impact on health.  I observed, that good nutritional habits, reduce the risk of chronic illness by only ten, or twenty, percent.  Yet exercise, appears to be as beneficial as correct nutrition, if not more so.  Across many studies, exercise erases the effect of other high risk factors.  For example, obese people who exercise, have the same risk of heart disease as normal-weight persons.  Vigorous exercise also improves insulin sensitivity by depleting the muscle's energy stores.  For the "vigorous" portion, I augmented swimming with high intensity resistance workout, described by Dr. Doug McGuff's.
  • Exercise regularly and vigorously
In homage to Pareto,  I will present the last oyster
  • Don't stress.  Follow the rules 80% of the time.
 Adhering to the rules for 80% of the time, will require only 20% of the will power, and leave the rest for more important tasks.  If you sin, it's OK.  Our body is anti-fragile, it can take it, and thrive.  I eat a small mountain of ice cream every Saturday.


Non-scientific References
A talk against fructose here.  A classic.
The case against insulin here
I like the way he talks, and he is also an ultra-distance swimmer.  Peter Attia on TED
Somewhat wonkish, yet interesting interviews by Dr. Rhonda Patrick