Nat Arem's Blog

Okay fine it isn’t really a break. I saw this awesome comic on xkcd:

xkcd is definitely my favorite webcomic. I am entertained by, approximately, 80% of the strips and I probably let out a real laugh at like 30-40% of them. Really good stuff.

I thought this one really rang true to the health stuff also. You see all sorts of labels which are totally irrelevant. I bought a thing of oregano the other day and it says “All Natural” all over it. In terms of meaningfulness, I rank “all natural” just behind a stripper telling me that I look cute.

All of this gave me an idea for helping to improve nutrition and health. What if the FDA put in rules saying that products had to list the three WORST things about it? They could pretty easily come up with a ranking system to determine, approximately, what is worse. For instance, obviously the presence of something is almost always worse than the lack of something. So the presence of a certain chemical is worse than the lack of a certain vitamin. While I don’t know how you’d rank things like trans fats, saturated fats, sodium, processed grains, etc, I have to believe that some combination of substance and % of content could be established in a rough formula.

Then you put a three-item list on every product. Instead of simply seeing “Vitamin C” all over orange juice people would also be able to look and see the bad list of 30g of sugar per serving, among other things. At the very least, marketers would be less in control over the system and people would have some help making their choices.

This is Part 2 of a series of blogs that I am writing. It won’t make total sense without reading Part 1. More parts are going to be published after this one.

The really important thing, for me at least, was that this four to five week episode woke me up to the dangers of the so-called Western diet. Remember all those “Milk” ads you used to see everywhere? Saying it does a body good? Well, that’s a lie. There’s no doubt in my mind that a regular cow milk drinker is damaging their body and has a significantly higher likelihood of all sorts of problems. To use an analogy, milk has a lot of smoke around it when it comes to things like cancer, osteoporosis (yes, I know, most think it helps build strong bones) and even diabetes. And, as you know, where there’s smoke there’s fire. Books like The China Study show you just how damaging milk and any dairy product is for you. Milk, cheese, butter, cream, etc. I’m not even talking about the well-known problems that butter or other fattening dairy products cause for your heart. I’m even talking about the organic grass-fed free-range hormone-free skim milk that you buy at Whole Foods or Trader Joe’s. It’s all bad for you. No, it won’t make you fat. But that doesn’t mean it doesn’t promote disease. If you don’t believe me, read this book.

I’m not totally convinced that gluten is as bad for humans as dairy products are but there’s no doubt in my mind that it isn’t good for you. Even the whole grain super healthy cardboard-like stuff that you get at premium supermarkets is not good for you. It isn’t as bad as processed grains but it is not a good food for ideal long-term health. And the crappy “fake” whole wheat bread you can buy in some bread aisles is actually highly processed junk food. There’s no doubt that stuff is poison. Anything that says “enriched” on it, almost by definition, is awful for you. That means they processed the vitamins, minerals and nutrients right out of the grain (the only redeemable characteristics of the grain) and added a few back in. If they have to do that, don’t buy it.

And, of course, the old meat issue. Obviously the low-carb crowd thinks they’re doing great because they lose some weight on their bacon, eggs, cheese, sausage, burger meat and whatnot. Yes, they will lose weight in the short term but they’re destroying their heart along with raising their risk for other disease. The China Study actually lays out a fairly convincing argument that any decent amount of meat or other animal products (eggs, cheese, mayo, etc) will lead to serious long-term issues including the obvious ones such as heart disease and less obvious ones such as cancer. Other diseases are also affected by so-called “animal proteins”. I remain unconvinced that occasional (read, once a month or so) meals centered around healthy poultry (chicken breast or something like that) and fish are going to cause long-term complications. There are numerous documented health benefits thought to derive from fish so I can’t get behind a recommendation to cut out all meat and fish but I do think it makes sense to eliminate red meat and keep other animal consumption low. Don’t make meat a centerpiece of your diet or else you’re asking for long-term problems.

My issue with all of this is that people simply don’t know how bad certain foods are for you. So many people claim to want to be healthy but they don’t know how to be healthy. They buy granola instead of Frosted Flakes because they think anything that says “granola” on the front of the box is healthy. And, to be fair, it is better for you than Frosted Flakes. But most granola still has an absurd amount of sugar in it. And even the people who know to check out things like sugar content on granola don’t realize how bad almost all salad dressing is for you. Okay, so they avoid the white colored ones because they’re usually creamy and bad for you. A lot of people know that putting ranch dressing all over your salad is one way to turn a good meal into a bad one. So they pick up an Organic All-Natural Balsamic Vinaigrette. Little do they know that it’s packed with high fructose corn syrup. Or they make their salad with nutrient-free (basically) iceberg lettuce and croutons. Some argue that no one wants to hear the full truth about their damaging diets. Or that their family member who died from cancer or heart disease could have avoided a large part of the risk if they’d changed their diet. But I feel like it’s necessary for people to at least know the full, whole and accurate truth so they can make a decision for themselves.

The education of the American public as a whole on the issue of nutrition is absurd. Newspapers and other media make health way too confusing. You see headlines like “Eggs not as bad for you as nutritionists once thought” and then you see an article titled “New study shows strong direct link between blood cholesterol levels and heart disease”. You think to yourself, wait, if eggs tend to raise my blood cholesterol then how are they not bad for me? Isn’t a heart attack a bad thing? There are constant conflicts. No one seems to know how much of a certain vitamin you should get or what % of your diet should be protein or whatever. Nutrition is a world of fads. One day it’s how bad trans fat is, the next day it’s how antioxidants will save you from cancer. Years ago it was simply how bad fats were (oddly enough, transfats arose partially out of the desire to lower intake of saturated fat) and how good grains were. That logic has since been flipped by the Atkins diet and the like. What do you believe? Do you believe the latest thing (Acai berries!) just because it is the latest thing and hasn’t been discredited yet? There’s no doubt it’s confusing even for the best-informed.

A journalist named Michael Pollan (60 min talk on YouTube here) has written a few books that have made him a bit of an icon to the health food movement. Although he isn’t a scientist or nutritionist by trade, he brings some great real-world insight to the table. He likes to come up with more general “principles” as opposed to giving people a handbook with detailed figures on how much Vitamin C to get on a daily, weekly and monthly basis. He says things like “shop only on the perimeter of the supermarket” or “don’t buy food where you fuel your car” or simple things like that. He also says to forget trying to control your intake of specific nutrients, especially in supplement form. Forget about getting enough beta carotene, lycopene or the antioxidant content of your food. Just eat carrots, tomatoes, blueberries and lots of other whole foods in a balanced manner. Don’t take supplements for nutrients. Just eat real whole food. According to him, if your grandmother and great-grandmother would recognize it as food then it’s not all that bad. Of course, he isn’t totally correct. Things like dairy are awful for you and your ancestors would definitely recognize it. But the beauty of his rules is that they’re VERY simple and, actually, almost anyone can understand them and, more importantly, follow them. No, the person who follow’s Pollan’s rules won’t be eating the “ideal” diet but at least it will get a large chunk of the bad food out of someone’s diet. That’s more than can be said for the myriad of other nutrition recommendations that just confuse people with mg-level nutrient recommendations, daily calorie % levels, etc.

The same issue of confusion exists with health care, drugs and doctors. There’s always a promise of a new drug to treat such and such cancer. Or some new therapy. Even one week ago I saw a segment on 60 Minutes about a new method to reduce/eliminate certain cancers using radiowaves. It’s currently getting ready to undergo human trials in the next few years. Do I know whether it’s going to work or not? Of course not, I have no idea. It’s way out of my league technically. But the issue is, things like that have been on the horizon for years and years. Outside of surgery, chemo, radiation and a few select drugs for certain specific cancers, there are few options for dealing with cancer. Those treatments are either highly risky, highly toxic or simply not all that effective. Very few cancer treatments are low risk (relatively speaking, all cancer is high risk to the person who gets it) except for certain cancers that are caught early. But that doesn’t stop TV shows and newspapers from hyping the latest possible drug or treatment option which is “only a few years away”. There’s always a new hope or promise on the horizon. Yet, progress on cancer has been turtle-like at best. Certain cancers have made progress, some haven’t made any progress worth noting. Of course, every disease has some new supposedly promising treatment or early detection test being worked on but the reality is that most of them don’t pan out.

And big pharmaceutical doesn’t really have a high bar set for itself on issues like cancer. They’re able to sell “life extending” drugs to patients for many thousands of dollars because usually insurance covers it and patients in a desperate situation are usually willing to try almost anything. Extending the life of a struggling patient by two months on average really isn’t anything to write home about. And that’s what a lot of cancer drugs actually do. There’s no incentive for these companies to educate the public on issues like diet and lifestyle changes because they make incredible amounts of money from drugs for things like blood pressure and high cholesterol. They RELY on people having these problems. I’ve read some articles about how Pfizer is basically in a panic about what to do once Lipitor loses patent protection in 2011. This is a drug that has produce billions and billions of dollars every year for Pfizer and is, by most accounts, the best selling drug of all time. The general drug class of statins (which Lipitor is) includes a number of other immensely popular drugs such as Crestor. And there is overwhelming evidence that plant-based diets would come close to completely eliminating any need for cholesterol medication. While it isn’t a “sure thing” I would be willing to bet that over 99% of the population in the US could achieve the same effect (over the long-haul — the drug probably works better in the short term) as Lipitor by changing their diet.

Doctors are partially to blame as well. What percent of doctors do you think alert patients to the dangers of dairy? I can’t imagine it’s even above 5%. I’d be shocked if it was that high. Of course, I would hope that pediatricians would explain that feeding cow milk to a baby is asking for Type 1 diabetes but I really don’t know how many forget to mention that “little” detail which will affect a child for the rest of their life. Also, Celiac is one of the most undiagnosed diseases because doctors are generally unaware of it in detail. Sure, most doctors have heard of it but they don’t look for it or consider it most of the time. I had an endoscopy done when I was having tons of Celiac symptoms and the gastroenterologist never even suggested Celiac to me or even considered the idea of taking a tissue sample for testing. It’s estimated that millions of people are living with Celiac completely unaware of what’s happening to them and also unaware that they’re at much higher risk for colorectal cancer because of their disease. Why don’t doctors diagnose Celiac? It’s sad to say but it’s because there’s no pill for it. The only known treatment for Celiac is a life-long avoidance of gluten. No pills. No prescription to write or surgery to recommend. The pharmaceutical companies spend their in-office visits with doctors promoting drugs like Lipitor and beta blockers for high blood pressure. And why would they promote anything else when they have limited time to sell doctors on the benefits of their drugs? The natural outcome is that those doctors focus on the diseases and drugs which are marketed to them in their regular meetings with drug companies. And diseases like Celiac and prevention techniques (ie, diet, lifestyle) falls by the wayside. I don’t blame the companies for operating within the system but I do blame the doctors for not taking a more proactive approach in warning patients and explaining a proper diet. But, doctors get paid more when they see more people so I don’t foresee any speeches, discussions and question/answer sessions in the future when I visit my doctor.

Part 3.

I want to start by saying that this is going to be a long multi-part blog. At least three parts and possibly as many as five parts. I’m going to publish them consecutively over the next few days. I almost never type out, edit, proofread, edit again, etc any of my blogs. Almost all of them consist of me thinking of a subject or two, sitting down, writing, quick proofread and posting. This entry is, in my opinion, too important to screw up or leave to chance. I’ve been writing it and editing it for a few weeks now and I think I’m finally ready to get it out there.

So, you might be asking, what’s so important? In my opinion, the single greatest controllable threat facing the Western world is our diet. Obviously there are all sorts of potential dangers lurking out there but most of them aren’t something you can really control. If Yellowstone decides it’s going to blow up (it’s overdue) and launch the world into a devastating volcanic winter then, well, so be it. We can’t control a supervolcano. But we can control our diet. Most people either don’t realize it or they simply don’t care but they are poisoning themselves. I’m no exception. For years I’ve eaten in an unhealthy manner and let my weight get out of control. It took a wake up call this past spring with a Celiac scare to snap me out of it. It isn’t that I didn’t know that eating lots of plant-based foods was better for me. It’s that I didn’t realize HOW much better it was for me. I also know a lot more details about diet, nutrition and health than I did six months ago. The more I learn, the more I realize how much I don’t know yet. It’s an incredibly complicated world and I’m pretty convinced no one will ever solve human nutrition better than nature already has.

As you may recall if you read my blog back in May, I had some extreme stomach problems for a few weeks and basically couldn’t eat for seven days in a row. I was so lightheaded by the end of that period that I was having trouble walking. I almost passed out a few times. Oddly enough, I saw Elizabeth Hasslebeck (of all people) on her TV book tour to promote her gluten-free living book and she spoke about her personal experiences with Celiac disease and some of the symptoms. All of the symptoms I was having lined up with Celiac and I had increased my gluten intake before the stomach problems. So I figured, what the hell… I haven’t eaten more than 500 calories in a day for a week and I can’t even walk around without feeling like I might fall over so I might as well give the gluten-free thing a shot. I had an endoscopy done in Costa Rica on Monday, May 4th. I didn’t eat any gluten that day because I had to fast before the morning endoscopy and after the endoscopy was when I made up my mind to try the gluten-free thing. I felt a bit better on Tuesday, May 5th but I still didn’t feel all that good. I was able to eat a bit more and I managed to put down some Gatorade which made me feel better. I flew home to Grand Cayman on Wednesday, May 6th and I remember when I got on the plane the stewardess brought me a bowl of nuts before we took off. The dilemma was, should I eat then and potentially feel better? Or was it too big a risk that I would feel horrible and spend the flight in the bathroom? I decided to take it slow and see how it went. I probably ate one almond every two minutes until we took off. I didn’t feel worse. So I kept eating and about an hour later I had polished off the bowl and actually felt pretty good. For the meal on the plane the only thing that was gluten-free was a salad so I ate that and felt better still.

I changed planes in Miami and had some time to kill in between flights so I grabbed a salad at Au Bon Pain and I can’t even begin to describe how good it tasted. Just being able to put food down was a great feeling. But my stomach was feeling infinitely better even just 60 hours after my last bite of gluten-containing food. I thought to myself, wow, is this really the problem? Maybe gluten was the problem, maybe it wasn’t. It’s really hard to say because there were a host of factors in play but I really didn’t care. I obviously kicked myself for the PB&J sandwiches I’d eaten in Costa Rica but more so than anything I was incredibly relieved. I decided I had to get tested and read up on gluten. Obviously I hoped I didn’t have Celiac disease just because of the difficulty involved in follow such a diet when eating out but I was so happy to feel better I actually would have opted for Celiac disease in a second over feeling awful in the long run.

After returning to Cayman on May 6th I immediately jumped into the Celiac reading material. I also made a doctor appointment to get the Celiac blood test which, admittedly, is not all that accurate. But since I didn’t want to get another endoscopy done at the time and no one in Cayman is capable of doing a celiac biopsy, I figured the blood test was the best I could do at that time. In addition to all of that, obviously, I was eating a gluten-free diet. And it was probably the healthiest I’d eaten over the course of a few weeks in years. First, I couldn’t get dessert whenever I was out somewhere just because everything except for sorbet had gluten — and I don’t really like sorbet. Second, I was eating a lot of salads with oil/vinegar dressing because basically everything at restaurants has gluten in it. Even if you order something like chicken with vegetables, if there’s any sauce on the chicken you can safely bet that it has gluten in it. So I was eating healthier than ever and feeling better than ever. I never really realized that you could actually subsist on salads, fruit, nuts, beans, etc. It wasn’t so much that I didn’t realize it as much as I never really comprehended why in the world anyone would eat like that. Little did I know what I was about to find out.

The first book I read was a book about eating with Celiac disease. It was about 50-100 pages of actual information followed by another 100 pages of recipes. It made me feel better about my prospects by teaching me about which flours have gluten and a whole host of other stuff about eating with Celiac. Helpful for sure but nothing life changing. A high school friend of mine recommended I read a book called The Paleo Diet so I bought a version of it meant for athletes and off I went. The book’s premise is that humans evolved to eat fruit, vegetables, meat, seafood, certain nuts and relatively few other things. The crux of his argument is that grain and dairy were introduced to the human diet within the last 10,000 years or so which is only 300-something generations. In his opinion, that wasn’t enough time for our digestive system to evolve and it has led to widespread problems with milk products. This made sense to me on a basic level even before I read some of the science behind it. I’m sure everyone knows someone who is either lactose intolerant or gets an upset stomach from milk. Also, while grains were introduced thousands of years ago, processed grains have really only been introduced in the last generation or two. He makes a very convincing argument against grains (even more so against processed grains which have been stripped of all nutrients) and dairy and explains their role in disease and early death. The Paleo Diet left me convinced that dairy and processed grains had to go from my diet. I also decided that, although whole grains arguably have some health benefits, I wasn’t going to eat them either for the time being because I was still unsure about whether I had Celiac or not.

A few weeks after the blood test I got the results back (Cayman doctors have to ship the blood to labs in the US to get it tested so it takes forever) and the test indicated that it was possible I had Celiac. My antibodies or whatever gets produced in the autoimmune response found in Celiac sufferers happened to out of normal range. But it also wasn’t as high as the typical Celiac sufferer so it really didn’t give me a good answer. I decided, well, I guess I can try eating some gluten here and there to see how I react. But the thing was, I’d been forced to eating really healthy for the rest of May and I was losing so much weight and feeling so much better I really didn’t even want to go back to gluten. I basically just stopped caring about things like gluten in sauces but I still didn’t eat bread, pasta, cake, etc. Anything with larger quantities of gluten was out. While I know Celiac is triggered by even a tiny amount of gluten, my theory was that if I had some sort of intolerance or allergy then volume might make a difference. And I didn’t want to overdo it if that was the case. So I ate smaller amounts of gluten here and there and I felt fine. I’m pretty sure I don’t have Celiac. I should probably get the endoscopy done at some point but I haven’t done it yet.

My next few months were basically filled with daily reading of books and online material related to diet, health, disease, medications, etc. I learned a lot about death rates, ailments and tons of other things relevant to diet. My next part will start to focus on what I read and what I managed to take away from it all. Later parts will talk about the sources of the problem with our diets and also what we can do about it.

View Part 2 and Part 3.

My weekend started in an interesting manner when I hung out with some new friends — one of whom co-owns the only rum distillery in the Cayman Islands. It’s a pretty small operation and it isn’t sold outside of Cayman so far. It’s called Seven Fathoms Rum if you’re ever in Cayman. We spent a little while helping him out with the bottling process. I operated the “bottle rinsing” station which consisted of taking empty bottles out of the cardboard box and rinsing them out using a rubber attachment that was on the end of a sink faucet. I then put the bottles in a drying rack. I also helped stack up boxes after they were filled up with sealed bottles of rum. Overall it was a fun experience and I wouldn’t mind doing it again. The distillery is right in downtown George Town above Hammerheads (a local bar) so check it out if you come by Cayman on a cruise. It’s right next to where the ships come in.

Earlier on Friday (ie, before the rum bottling) I went to the gym and ran for awhile on the treadmill. It was the first major exercise I’d gotten since last Tuesday when I ran about five miles and played two hours of flag football. I was totally worn out on Wednesday and Thursday I didn’t have time to go so Friday was my first chance. I felt fine at the gym but late Friday night after I got back to my apartment I noticed my left foot was hurting me. I did a quick visual check and noticed a bruise on the inside of my foot. I took a picture of them to email to my mom (a doctor) so I could ask her if it was anything I should get checked out. I’ve never had a big bruise in that area so I was a little concerned about making it worse by continuing to exercise on it. In the end she basically said I should let pain dictate what I do on the foot.

Here is a link to the picture… for obvious reasons I am not embedding a picture of my feet on the blog. I know no one here signed up to load up a webpage and see my feet so I’m giving you fair warning about that link. Click at your own risk. If you do look at it, you can see a darker small bruise towards the bottom of my left foot but the discoloration actually extends up into the ankle area. The lighting doesn’t really show what it looked like in real life.

The bruise and pain have gotten better after a Saturday and Sunday of basically zero activity. I’ve spent as much time as possible on the couch doing nothing and, when I do walk around the apartment, I have been doing it in socks and with shoes. The heel still feels sore but I think it’s recovering. The tough thing is going to be deciding when to come back and how hard to come back. I might just do some indoor biking this week to get my heart rate up and try to minimize my conditioning losses. It’s another frustrating setback for the half marathon training but I would rather play it safe and not develop a chronic condition or put myself out of commission for a few months by turning a minor injury into a major one.

I’m also working on getting some pictures and video from some tubing from last Thursday. I bought a 100″ tube (ie, huge) and it was a ton of fun at high speeds.

Okay I’m wondering about that whole half marathon plan. I did a five mile outdoor run and I was definitely struggling. The combination of the heat, humidity, surface (gravelly) and weight of my water belt really did me in. I had to stop to walk before the end of it because my heart rate was just going through the roof even when I slowed down a bunch. I grabbed a Gatorade from a place I was walking by and just felt the blood pumping through my legs like I haven’t felt before. Really weird feeling. The kicker on all of this is that I was running to play flag football with some guys here on the island. Smart, right? Anyway, we played a few hours of touch football and now I’m back home, showered and feeling pretty tired. I am going to either not work out tomorrow or just take it light.

So anyway, I think I need to do more outdoor training if I want to do this half marathon. Five miles shouldn’t crush me like that. I know that running on a treadmill in an air conditioned gym is much easier than running outdoors but it still shocked me how badly I was feeling it even just three miles in. I’d gotten used to doing three miles no problem on the treadmill. And I’ve done a number of runs over five miles in the gym. This was bar none the toughest run I’ve done in my memory and there’s just no way I could have done 13.1 miles in the shape I’m in right now. I’ll keep at it and see how it goes. I’m sure I’ll see improvement it’s just a matter of how fast.

On another note, I’ve written on here about my bad sinus problems over the last few years. I get frontal sinus cavity headaches on airplane descents and I just get way more than my fair share of runny noses and congestion. It usually goes through good periods where I have very little congestion and then I’ll hit a bad period for a few weeks where I’m going through tissues like crazy. I’ve finally gotten fed up with it to the point that I booked a doctor visit a few weeks back and he prescribed Nasonex and some other stuff to try to help out. I’ve been doing great ever since I started on the Nasonex. I think the other stuff helped too but the Nasonex has been huge.

I had an appointment today with an ear, nose and throat doctor from a few weeks back because I wanted to actually find out what was wrong with me. Do I have standard allergies? Do I have a chronic sinus infection? Basically, the other doctor is a general practitioner and while he did a good job prescribing me the right stuff to help me get better, I don’t think I would ever get any real answers out of him. So the ENT told me to continue on the Nasonex and a strong decongestant and he also said that I should get a CT scan of my nasal passages. So I am going to get that done in the next few days hopefully and we’ll be able to try to figure out what’s going on. Also, once I’ve been off of Claritin for two weeks we’re going to do some allergy testing to see if that pops up anything. He said that he doesn’t think it’s an allergy problem but more along the lines of a chronic sinus infection that needs to be treated. Either way, I’m fine with whatever I have to do as long as it fixes the problem. I’m just fed up with it and I look forward to getting more answers.