For close to a year and a half now, the majority of my reading has shifted away from game and toward health and poker. Not to say that I’m not interested in game and won’t continue writing about it, but I wanted to put together my thoughts on health as they currently stand (they’ve evolved a lot since I first started forming opinions on the subject).

High level Understanding:

Health, as I define it, is the absence of disease. The implication here is that we are all born with perfect health, and if we live within our evolutionary experience, we will stay that way. Our health is relatively robust, so acute deviations from our evolutionary experience are generally well tolerated, but for the vast majority of people, chronic deviations from this template cause problems, and the longer they chronically deviate without correcting and letting things heal, the more likely they are to develop problems.

With very few exceptions, nearly all health problems are caused by a poor diet. Our resistance to a poor diet can be improved by improving our sleep length and quality, getting adequate direct sunlight, and exercising, but with a perfect diet these areas are substantially less important for maintaining perfect health.

There’s No Such Thing as a Macronutrient

Dr. Kurt Harris was the first one I saw state this in his posts here and here, and man how true it is. We need to stop thinking about fats, and start thinking about healthy, natural fats as compared to hydrogenated seed oils. We need to stop thinking about carbohydrates, and start thinking about glucose and fructose, and what baddies the whole food source you’re getting them from come with, i.e. grain lectins, phytoestrogens, etc.

Drilling Down: Cancer

During any cell replication, there is a non-zero probability that a genetic mutation will occur, and a subset of these genetic mutations will be cancerous.

In a healthy person, there is a normal amount of cell turnover, and thus a moderate amount of genetic mutation, but for each of these mutations there is a near 1 probability that apoptosis will cause any mutated cells to self destruct preventing any cancerous ones from spreading.

In an unhealthy person, the elevated level of inflammation causes an increase in cell turnover and thus cell replication, increasing the total number of mutations and thus cancerous mutations in the body. An increased number of mutations increases the likelihood of that .00000001 chance that one slips through the cracks. It also has the effect of potentially taking apoptosis offline to some degree, particularly in the case of hyperinsulinemia (one mechanism by which this may occur is through suppression of retinoic acid production). So an inflamed person is both producing more cancerous cells and inhibiting his ability to deal with those cancerous cells, thus massively increasing the likelihood of cancer occuring.

Smoking causes cancer by the same above mechanism. It damages cells in the body, particularly the lungs and throat, increasing cell turnover. However, since it doesn’t do anything on the back end that would inhibit apoptosis, if you eat a healthy diet and smoke it is very unlikely that you will get cancer. This is why a traditional culture like the Kitavans don’t get cancer despite smoking like chimneys.

Many if not most modern cancers can be treated effectively with a ketogenic diet. While some cancers are able to convert glutamine into glutamate and use it for energy by running it through the TCA cycle, most modern cancers require glucose. Starving them of glucose will cause them to stop spreading and start dying. It will also help bring apoptosis in the body back online, accelerating this process.

Drilling Down: Autoimmunity, Psychiatric Problems and Allergies

Autoimmune disease and allergies start with a leaky gut and psych problems start with a leaky brain. If the gut is healthy, large plant proteins (see: toxins evolved by the plants to prevent their seeds from being eaten) are not making it through the intestinal barrier without first being broken up into their free amino acids. Same goes for the blood-brain barrier.

A leaky gut/brain is caused by a disregulation of the protein zonulin. Zonulin is responsible for regulating the tight junctions between cells in the intestinal barrier and the blood-brain barrier, and when zonulin is overproduced, these tight junctions let large particles in. I don’t know the mechanism by which this occurs, but it is pretty clear that grain lectins in particular cause this disregulation of zonulin and thus permeable barriers.

Once in the bloodstream, many of these plant proteins get attacked by the immune system as foreign invaders. However, some of them have very similar amino acid profiles to proteins in our body, and so in many cases as a result of producing antibodies to the plant proteins our own tissues will get attacked. For example, WGA (wheat germ agglutinin) looks very similar to pancreatic beta cells, and in someone with Type I Diabetes, if it is caught early enough and the appropriate dietary intervention is implemented, the disease process can be reversed and pancreatic function can be restored.

The proper dietary intervention for autoimmunity, allergies and psych problems is a strict removal of all grains, legumes, dairy (mostly casein containing dairy, milk fats are fine) and nightshades for a certain period of time. This time period will vary from person to person, and can be as short as a few weeks or as long as a couple of years before the gut is healed and the disease process is reversed. Once the disease is reversed, most tissues will go back to normal, but some may be permanently damaged.

Drilling Down: Obesity

Fat tissue in the body is very tightly regulated. This regulation occurs primarily in the hypothalamus, not in the fat tissue as Gary Taubes has suggested. We can call this regulating mechanism the adipostat, similar to a thermostat except for adipose tissue instead of temperature. Insulin resistance does not cause obesity, leptin resistance does. In the cases where insulin resistance occurs, it occurs downstream of leptin resistance. However, there are some cases in which a person can be overweight but not insulin resistant. Further, injecting leptin into the brain of an overweight or obese person would almost assuredly cause them to seemingly spontaneously lose weight (has only been tested in animal models) despite insulin resistance.

For a given leptin sensitivity, there is a tight range that the body will keep fat and thus weight in. It’s like a house that has a heater and an air conditioner, and regardless of what the conditions are outside the temperature inside will stay within a tight range of the temperature set on the thermostat. This is why people who are lean will stay lean in trials where they are forced to overeat to a disgusting degree. This is also why overweight individuals can maintain basically the same weight under short term overfeeding conditions as well, despite already having leptin sensitivity issues.

The adipostat breaks when leptin resistance occurs. I don’t totally understand the biochemical mechanism by which leptin resistance occurs, but it probably starts with inflammation, and likely particularly inflammation in the liver. It is most closely associated with fructose, hydrogenated seed oils and grain lectins. Leptin is secreted by the fat mass, and when a person is leptin resistant, they have a very high level of blood leptin but very little of it is getting into the hypothalamus.

The most effective way to lose weight will vary from person to person, but it will invariably involve a resetting of this adipostat. In someone who is insulin resistant, they probably are going to have the best results on ketogenic diet. For someone who is not insulin resistant, they will probably lose weight equally as fast independent of macronutrient ratios and calories as long as they are getting all of their calories from safe foods that do not cause and perpetuate leptin resistance. “Safe” carb sources can include root vegetables and tubers, and for many people white rice.

Drilling Down: Heart Disease

Not too much to explain on this one, since heart disease is so closely associated with obesity. Heart disease is caused by systemic inflammation, and in particular vascular inflammation. Dietary causes are the same as those for obesity, which is why they are so closely linked.

Dietary saturated fat does not cause heart disease. Saturated fat is in no way nefarious. Same for cholesterol. There is no reason to believe that for a healthy person, any substance that the body produces is problematic in the diet. This includes all fats that the body can produce via lipolysis, as well as glucose, among other things. Still, that is not to say that a person who is inflamed and insulin resistant is not going to have problems tolerating dietary glucose.

Aging

At this point, I have very little reason to believe that most of the disease processes associated with aging are actually caused by aging. Rather, the vast majority of them, including balding, vision loss, fattening, muscle loss, heart disease, cancer, etc. are all product of lifestyle choices catching up to you. If you keep poisoning your body, it will eventually catch up to you. For some people this happens in the womb, for others it happens in their 30s, but the causal mechanisms are the same and are not due to the aging process itself. There *may* be a point where your body’s telomeres become too short after a certain number of replications that will vary from person to person, and in these cases health will deteriorate rapidly. This is speculative because the research is still pretty fuzzy, and also it’s not something that I’ve focused in on much myself. If this is true, the best way to push that point out is to keep systemic inflammation at a minimum throughout your life. Alternatively, there may be an age beyond which if a human is still alive and in good health, the probability of death in any given year is flat. So while for most of us, after the age of 30 or so, the probability of dying increases every year, but there may be a point where it flattens out, i.e. The probability of dying within the next 365 days is the same if you’re 96,  107 or 115.

The J-Curve

When you read about nutrition, a concept you will often come across is the concept of essential nutrients. By definition, these are the nutrients that must be in your diet because your body cannot create them, but does need them for proper functioning. For example, palmitic acid, a saturated fatty acid, is not an essential nutrient despite the fact that the body needs it, because your body can make it, but omega-6 and omega-3 fatty acids are essential nutrients, because the body cannot make them. Same goes for vitamin c, all minerals, and many other dietary substances.

One characteristic that all essential nutrients share, that non-essential nutrients do not, is that you can plot what is known as a J-Curve with them. In this curve, you have mortality/disease on the y-axis and the nutrient on the x-axis, and what you see is that up to a point, mortality goes down as the amount of this nutrient in the diet goes up, but after a point there are usually negative effects of that nutrient in the diet. This is why linoleic acid is an essential nutrient, without which we’d die, but excess linoleic acid causes all kinds of problems, particularly if it throws off the ratio of omega-6/omega-3 fatty acids in the diet.

Perfect Health

For someone who is healthy and has an intact gut lining, the best way to stay that way is to eat a diet that does not cause any of the above issues. I believe the templates provided by the Perfect Health Diet or the Weston A. Price Foundation are the least restrictive templates that a healthy person can use and stay that way indefinitely. An unhealthy individual may require more restrictive intervention to reverse disease processes, but these diets are a good place to start. Certain deviations from those plans can be tolerated by healthy individuals as long as they are not chronic, but if any problems do pop up in these meanderings, strict adherence for a certain amount of time is recommended to correct them.

If you are interested in eating this way, these recipe links are a good place to start:

Perfect Health Diet Recipes

Free the Animal Recipes

Mark’s Daily Apple Recipes