Wednesday, November 28, 2012

What is N=1 and what does it have to do with diet?

When I start a new client out on their health and wellness journey, I like to make it a point to emphasize that what is best for them is best for them.  In other words, there is no best path to health and wellness, you have to do what works for you and that will be different than what works well for me.  Since no 2 people are living under the same conditions, it’s impossible to generalize a program that will work for everyone.  In scientific studies, N is the number of subjects in the experiment.  When I refer to N=1, I am referring to an experiment that involves only 1 participant…You.

So why is N=1 so important?  Some people have large appetites, some people’ don’t.  Some people work day shift, some work nights.  Some people work laborious jobs while some sit at a desk all day.  Some people genetically put weight on easily, others not so much.  Some people have kids and they can’t get away to a gym most days and others have no family and can go every day.  The point is, we are all different and need to find out what works for us in order to live healthy lives.  One person may spend 4 days a week at the gym while another exercises by playing with their kids.  The mode isn’t necessarily the important factor, only that you achieve certain parameters within the mode of exercise you choose.

As far as diet goes, your N=1 experiment begins with an elimination Paleo Diet for 4 weeks followed by adding in potentially problematic foods like dairy one at a time and measuring the way you feel.  Having a device like the Fitbit to track sleep and measuring blood glucose are valuable ways of determining how your body responds to food.  Of course, you could just go by how you feel and any sort of allergic responses you may have.

Once you have collected all of the data of your N=1 experiment, you know exactly what to do to feel good, look good, and live a long and healthy life.  Of course, it’s important to realize that there are going to be times when you don’t stick to the plan 100%.  The point of the N=1 experiment isn’t to restrict everything you eat, just to give you a framework or template to work with going forward.  If you stick to it 80% of the time and were only sticking to it 60% of the time before you would expect to see progress.  When progress stops you can decide if it’s worth going to 85-90%, but at least you have the option f knowing what you need to do.  The best part is, you don’t need to worry about how much food or exercise any more.  When you eat a diet that is congruent with your genes you don’t really overeat and your appetite stays low provided your exercise is appropriate as well.

Monday, November 26, 2012

What should you eat?

What to eat seems to be the most difficult concept for most people to grasp when it comes to health and wellness, and for good reason.  If you were to ask 10 people that simple question you would probably get 10 different answers and every day it seems a new study comes out refuting the last study you read.  One of the primary issues with just regurgitating what a study says is that in a lot of instances, what a study shows is not what you think or are being told.  Towards the end of this blog we will go over that, but first, what to eat?

In my opinion, the healthiest way to figure out what you should be eating is to follow an elimination Paleo Diet for 4 weeks and then add in things to see how you tolerate them.  The Paleo Diet includes fruits, vegetables, meats, and nuts and removes grains, legumes and dairy.  Processed foods or foods with added sugars shouldn’t be eaten at all.  The reason you are removing grains, legumes, and dairy is that these foods contain proteins that are hard for us to digest.  Not everyone has a problem with these foods, but to determine if you are one of them you need to completely remove them for 4 weeks and add foods that contain them 1 at a time after that.  What you are looking for is changes in energy levels, headaches, skin irritation, or anything out of the ordinary.  If a food gives you a reaction, you know that food isn’t right for you.

You may be thinking, “I have always heard that whole grains are a healthy part of a diet, what gives?”  The evidence that this pseudo-fact is based on is very shaky.  The studies showing whole grains to be healthy don’t actually show this, they show them to be healthier than consuming refined grains such as white bread, which we know to be unhealthy.  Using the same logic, we could assume that either crack or heroin is healthy because one is healthier than the other.  Not buying that?  Neither am I.

So what about carbs, protein, and fat?  For the most part, the number of carbs you eat is in relation to the amount of intense physical activity you get and how lean you are.  If you strength train, play sports, or work a labor intensive job your carbohydrate needs will be greater than someone who sits at a desk all day.  In addition, a low carbohydrate diet is very effective for losing weight if you are large, but as you become leaner you will need to add in more carbohydrates, especially if you fit in to the labor intensive group above.  Just realize that if you do cut your carbohydrate intake you need to increase your fat intake.  Fat and carbohydrates are your fuel choices, protein is only used as fuel if it is converted to carbohydrate first.  The easiest way to remember which you should be eating more of is that fat functions more as diesel fuel while carbohydrates are jet fuel.  Your lifestyle dictates which is most appropriate for you.

Outside of avoiding trans-fatty acids or seed oils (Canola oil or most vegetable oils except for olive) you don’t really need to worry about your fat intake.  This means that you don’t need to worry about saturated fats as much as you have in the past.  This is primarily due to recent studies which have shown no relationship between saturated fat intake and health outcomes.  How do you decide which study to believe and which to ignore? 

First off, you have to realize that most of these studies they use to tell you what to eat are not capable of doing that.  These studies are called epidemiological studies and involve questionnaires given to people asking them what they have eaten/done over the past 6 months, year, or multiple years.  As you could imagine, it’s pretty difficult to recall what you’ve eaten over the last couple of weeks accurately, let alone months or years.  Furthermore, if you tell people that eating saturated fat is unhealthy, healthy people are going to avoid it.  These people are also more likely to exercise, not smoke, moderate their drinking, and follow other healthy lifestyle factors that will skew the data in that direction.  Because these studies lack the control or statistical power of better studies, they can’t tell you A causes B, just that there is some sort of relationship between the 2.  That relationship may be direct or indirect such as the relationship between ice cream consumption and drowning deaths.  This relationship is strong, but is indirect in that both increase during the summer, not because one causes the other.

Another sort of fact check I like to use is to think of the study in relation to what evolutionary science shows.  For example, we know that cancer, diabetes, and heart disease was relatively rare up until the agricultural revolution.  We also know that hunter-gatherer societies that are still around today have little to no cancer, diabetes, or heart disease unless they adopt a western diet.  They don’t consume seed oils because they don’t have the technology to extract oil from seeds, but they do have the technology to obtain animal fat, which was certainly not thrown away as it is a good source of calories and they aren’t getting their food from the local Pizza Hut.

Finally, your protein needs will be dictated by your muscle mass and whether you are trying to add muscle mass through strength training.  You will want to eat more protein if you are strength training or doing labor intensive work because protein is used to make muscle.  Even if you are not actively trying to increase muscle mass, you still need a baseline level of protein to maintain your current muscle mass as well as making enzymes your body needs to function properly.  If you are sticking to a Paleo diet and consuming animal protein regularly you probably don’t need to focus on protein intake unless you are trying to add bulk.

As you could probably tell by this post, the proper diet is really dependent on a number of factors and there really is no single “Best Diet”.  This is because we are all different genetically and choose to do different things with our lives.  At this point I am certain that the foods contained within the Paleo Diet should be what most people eat most of the time.  You may stray from time to time to kick up your heels and that’s fine.  What you don’t want to do is base your diet around the garbage that most people eat, and I will be using this blog to tell you why.

Welcome to the Synergy Health and Wellness Blog!

Hello, and welcome to the Synergy Wellness Blog!  In this inaugural blog post, I’ll lay out the narrative of this blog.  The primary theme of discussion is health and wellness, specifically lifestyle choices we can make to optimize our health.  The content within this blog is data driven and based on good scientific principles and practices.  You may notice that some of what I write appears at odds with what you’ve read or heard from other sources.  My plan is to lay out my thoughts and provide the scientific rational behind those thoughts in every post.  Where my ideas diverge from conventional thinking, I will describe why I believe the conventional thinking is flawed and how the science may not be saying what you think it says.

Before we go on I would like to lay out what I believe to be the best health model and compare it to the current model we use in the US.  First and foremost, optimal health requires the proper nutrition, very little sedentary time, daily activity, 8 hours of quality sleep, and the proper ratio of stress to recovery.  Within the stress:recovery category we look at things like strength training, work stress, family stress, and stress management modalities such as yoga, meditation, beach time, or just plain laughing.  When you take care of all of these things the vast majority of people achieve optimal health.  Pharmaceuticals provide help when infections occur, genetic defects are present, or a person leading an otherwise healthy life encounters a health problem.  Contrast this model with the current US model where people make terrible lifestyle choices and use pharmaceuticals in attempt to make up for those poor decisions.

As our understanding of human biology increases, the foundation that the current US health model is based upon crumbles.  Through advancements in the field of epigenetics, we now understand how nutrition, stress, and physical activity impact our health.  Epigenetics is the science of how our genes interact with the environment, referred to as genetic expression.  When we get regular physical activity and eat the proper foods, we affect thousands of genes in a way that improves health, immune function, brain function, stress management, physical performance, and any other way you can measure human health.  It appears that the primary flaw in using pharmaceuticals to compensate for not doing what is built in to our genes is that while the proper lifestyle choices affect thousands of genes, taking a drug to alleviate symptoms from poor choices may only affect as few as 10-20 genes, leaving many other avenues for things to go wrong.  It also could help explain why the average person takes as many pills per day as decades they have lived.  For a 60 year old person that’s 6 different pills per day!

I hope you enjoy this blog and pick up some good habits on the way.  If you have any questions or would like to discuss opposing ideas I welcome you to post in the comments section.  My only rule is that comments and discussions remain productive and don’t devolve in to flame wars or pissing contests.