The 7 Mega Principles of Diet and Exercise for Fat Loss

Yes, I am somewhat proud of the fact that if you do a Google search (at the main google.com site), an article of mine still comes up number 1 for the term fat burning. It’s an article I wrote for About.com Weight Training over 12 months ago. I am surprised at this because Google records about 3.1 million records for the search term ’fat burning’. And when you see all the goony, loony web sites and weight loss schemes and supplements and silly diets and downright ripoffs that plague the internet, it does seem unlikely that a truthful and accurate article still has a chance of getting to the top. Three cheers for Google.

In any case,  for Christmas I’ll do the KISS thing and “keep it simple, stupid” by summarising the no-fail approach to weight loss that emphasizes fat loss and muscle maintenance. If it fails for you, then you are either eating too much, moving too little or have a genuine pathology or genetic disorder — and mostly this is rare as a cause of obesity.

7 Rules to Rule Them All

1. Don’t sweat the small stuff. The number 1 rule is not to get hung up on the trivia. This is the 90/10 rule or whatever you want to call it. The idea is that you must concentrate on putting most effort into doing the things that bring you most return and success. It’s okay to  follow up on the small stuff after you get the big picture correct. Don’t get distracted by “insider secrets” or any of that web marketing hype. There are no insider secrets to achieving and maintaining normal weight. But that doesn’t mean there are not serious challenges.
2. It’s the calories stupid! Even though I saw Tom Venuto use this phrase recently, I first used it in 2001 in a book I wrote called The Organic Factor. Even so, I’m sure quite a few people  have come up with this independently, it’s so very obvious. This is one of the pieces of “big stuff” that I refer to in the rule above. You need to get into negative energy balance territory (but not too negative) to lose weight and that means eating less and exercising more. And the best way to cut calories? Limit animal fats, added fats, added sugars, alcohol, and reduce  excessive portion sizes.
3. Adopt a lifestyle. Most diets will work for a short while – low-carb, low-fat, meal replacement shakes, you name it. If you take in less than you expend in energy, you will lose weight. However, you need to find an eating and exercise pattern that suits you, that works, and that you can adopt more or less every day of your life.
4. Do Regular Aerobic Exercise. Aerobic exercise is walking, running, treadmill, cycling, swimming, class aerobics and  rowing. You need to put some effort in so that you puff and sweat to some extent. Do this at least 5 times a week, for at least 30-40 minutes, even if it’s walking fast around the block.
5. Do Regular Weight Training. Get to a gym or buy some dumbbells and a bench for home and do at least 2 sessions of weight training each week. It helps maintain muscle and bone while you lose fat and builds strength, flexibility and mobility for the future.
6. Move more at home and work. Under-rated and misunderstood, this is the science of NEAT or “non-exercise activity thermogenesis.” Moving more at home or work builds a feedback system that upregulates your metabolism. Get a pedometer and try to rack up 5,000 steps each day. It can be gardening, housework, playing with kids, lunchtime walks at work, stair walking, anything in addition to programmed exercise. Upper-body movement counts as well.
7. Get a brain plan. Tackle weight loss as a personal project. Keep a diary, set goals, review your progress each week, do lots of internal head talk, adjust your approach when necessary, be patient, stick to a lifestyle you can tolerate, and get encouragement from friends or a group.

That’s the nub of it. No secrets, no surprises. Good luck.

What You Don’t Know About Saturated Fat That Could Harm You

What you probably do know is that most dietary recommendations say that you should keep your consumption of saturated fat and cholesterol in food low in order to lower your blood cholesterol and consequently your risk of heart disease.

The usual recommendations are that saturated fat should be no more than 10% of total calories and cholesterol less than 300 milligrams each day – and for people with existing signs of heart disease, less than 7% saturated fat and under 200 milligrams of cholesterol each day.

If you read widely of internet health and nutrition sites, you may also be aware that fringe movements exist that say this is not true; that it’s a government conspiracy and so on, and that saturated fat and cholesterol are as harmless as soft fruit. You can read one of my responses to that. It’s surprising how many otherwise knowledgeable pundits get taken in by this stuff.

What you may not know is that too much saturated fat in the diet has other adverse effects beyond how it raises blood cholesterol. Here is a short summary.

Saturated Fats Cause Dementia

Here is what one research team has to say about saturated (and trans) fat and cognitive function.

“Diets high in fat, especially trans and saturated fats, adversely affect cognition, while those high in fruits, vegetables, cereals, and fish are associated with better cognitive function and lower risk of dementia. While the precise physiologic mechanisms underlying these dietary influences are not completely understood, modulation of brain insulin activity and neuroinflammation likely contribute.” (Ann N Y Acad Sci. 2007 Oct;1114:389-97.)

And another:

“Moderate intake of unsaturated fats at midlife is protective, whereas a moderate intake of saturated fats may increase the risk of dementia and AD, especially among ApoE epsilon4 carriers. “ (Dement Geriatr Cogn Disord. 2006;22(1):99-107. )

Saturated Fats Cause Insulin Resistance

This conclusion provides a pointer to findings from several similar studies:

“A change of the proportions of dietary fatty acids, decreasing saturated fatty acid and increasing monounsaturated fatty acid, improves insulin sensitivity . . . ” (Diabetologia. 2001 Mar;44(3):312-9.)

And:

“Therefore, prevention of the metabolic syndrome has to be targeted . . . and . . . to improve insulin sensitivity and associated metabolic abnormalities through a reduction of dietary saturated fat, partially replaced, when appropriate, by monounsaturated and polyunsaturated fats.” (Clin Nutr. 2004 Aug;23(4):447-56.)

 Saturated Fat Slows Blood Flow in the Arteries

Here is what recent studies found about how saturated fat essentially clogs the arteries. (The endothelium is the layer of cells lining the inside of blood vessels and arteries. It is important in regulating blood flow.)

“High SFA (saturated fat) caused deterioration in FMD (flow-mediated dilation) compared with high PUFA, MUFA, or CARB diets. Inflammatory responses may also be increased on this diet.” (Arterioscler Thromb Vasc Biol. 2005 Jun;25(6):1274-9.)

And:

 ”Consumption of saturated fat reduces the anti-inflammatory potential of HDL and impairs arterial endothelial function. In contrast, the anti-inflammatory activity of HDL improves after consumption of polyunsaturated fat.” (J Am Coll Cardiol. 2006 Aug 15;48(4):715-20.)

And:

“Consumption of an SAFA-rich meal is harmful for the endothelium, while a MUFA-rich meal does not impair endothelial function in subjects with type 2 diabetes.” (Diabetes Care. 2008 Dec;31(12):2276-8.)

Overall, you should be able to see that the case against too much saturated fat in the diet is convincing – one way or another — and it’s not just about cholesterol. Bear in mind that vegetable sources of saturated fat are not inconsequential. Olive and soy oil are about 15%, corn and sunflower about 12% and peanut oil around 20%. However, consuming saturated fat and cholesterol together in animal foods may present the greatest combined risk, and whole nuts or seeds, even with some saturated fat, the least risk.

- Parrott MD, Greenwood CE. Dietary influences on cognitive function with aging: from high-fat diets to
healthful eating. Ann N Y Acad Sci. 2007 Oct;1114:389-97. Review.
- Laitinen MH, Ngandu T, Rovio S, et al. Fat intake at midlife and risk of dementia and Alzheimer’s disease: a
population-based study. Dement Geriatr Cogn Disord. 2006;22(1):99-107.
- Morris MC, Evans DA, Bienias JL, et al. Dietary fats and the risk of incident Alzheimer disease. Arch Neurol. 2003 Feb;60(2):194-200. Erratum in: Arch Neurol. 2003
- Vessby B, Unsitupa M, Hermansen K, et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetologia. 2001 Mar;44(3):312-9.
- Riccardi G, Giacco R, Rivellese AA. Dietary fat, insulin sensitivity and the metabolic syndrome. Clin Nutr. 2004 Aug;23(4):447-56. Review.
- Keogh JB, Grieger JA, Noakes M, Clifton PM. Flow-mediated dilatation is impaired by a high-saturated fat diet but not by a high-carbohydrate diet. Arterioscler Thromb Vasc Biol. 2005 Jun;25(6):1274-9.
- Tentolouris N, Arapostathi C, Perrea D, et al. Differential effects of two isoenergetic meals rich in saturated or monounsaturated fat on endothelial function in subjects with type 2 diabetes. Diabetes Care. 2008 Dec;31(12):2276-8.
- Nicholls SJ, Lundman P, Harmer JA, et al. Consumption of saturated fat impairs the anti-inflammatory properties of high-density lipoproteins and endothelial function.J Am Coll Cardiol. 2006 Aug 15;48(4):715-20.

The Fitness Wars Are Futile

I’ve put up a permanent page called Fitness Wars because I thought it should be a little “sticky.” It discusses the very strange culture of strength trainers who seem to react to cardio and aerobics with a crucifix held at arms length.

It’s a very odd response to a very important component of health and fitness conditioning and wellbeing programming.

Anyway, I’ve explored some of the origins of this antagonism and I take a look at aerobic conditioning in this context.

Dioxins in Food and Water Could Cause Diabetes

I’ve been aware of an increasing number of recent studies that seem to show that the chemical pollutants called POPs – dioxins and similar compounds – could be at least partly responsible for the current epidemic of type 2 diabetes. Now it’s not conclusive, but some aspects of these investigations are certainly interesting. Like the fact that when controlled for dioxin content of tissue, even obese people were at no higher risk of type 2 diabetes if their dioxin levels were low. This could be a chance occurrence, or other factors could cause this to occur, but overall there are some compelling aspects to this research.

Here is what one author had to say:

“The strong associations seen in quite different studies suggest the possibility that exposure to POPs could cause diabetes. One striking observation is that obese persons that do not have elevated POPs are not at elevated risk of diabetes, suggesting that the POPs rather than the obesity per se is responsible for the association. ” [Rev Environ Health. 2008 Jan-Mar;23(1):59-74. Review.]

POPs are “persistent organic pollutants.” This class of pollutants includes dioxins, PCBs, DDT, DDE and many chlorinated organic pesticides. They accumulate in your body and in the fat of the animals we eat.

History of Dioxins and Diabetes

Some years ago I worked in occupational and environmental health and safety, advising on toxic chemicals and health. As well as working to establish the first chemical list for Australia’s National Pollutant Inventory, I also helped out the local Vietnam vets with their Agent Orange herbicide case. Much of the finer detail of the toxic risk assessments involved dioxins — exotic chemical contaminants that result from chemical manufacture and combustion. Levels of dioxin were very high in Agent Orange. There are over 200 varieties of dioxins, furans and polychlorinated biphenyls (PCBs) – chemicals with somewhat similar structure and varying toxicities to humans. Sometimes the toxicity of these dioxin-like chemicals are referred to collectively with ‘toxic equivalents’ or TEQ.

Studies of manufacturing workers exposed to dioxins and similar compounds had already revealed a higher incidence of diabetes, and animal tests had confirmed this possibility to some degree.

The early emphasis of dioxin toxicity research was on birth defects and cancer. However, it took some time for the US Veterans Affairs Department to acknowledge limited evidence in support of a connection of Agent Orange exposure with type 2 diabetes, to the extent that disability pensions are now paid on this basis.

Other pieces of research seem to fit the puzzle. It seems that endocrine disrupting chemicals in general, especially ones that persist in the environment, are associated with diabetes. And a most recent research study suggests that the much-publicized plastics residue bisphenol-A is also possibly involved.

POPs and Diabetes: What You Can Do

While these contaminants are everywhere – from the Antarctic to the purest looking lake water – they also contaminate food by accumulating in animal fats – and which we consume in meat, chicken, dairy and fish products and fats.

If you want to reduce  your intake, you really need to either find wild or organic and lean products from pristine places, or reduce your intake of animal foods, especially fat, or perhaps do a combination of both. This issue is also another reason why high-meat and fat diets like Atkins low-carb can be a recipe for disaster. And as for those so-called diet gurus who say we should eat more saturated fat . . . here’s a very good reason not to.

- Rignell-Hydbom A, Rylander L, Hagmar L. Exposure to persistent organochlorine pollutants and type 2 diabetes mellitus. Hum Exp Toxicol. 2007 May;26(5):447-52.
- Rylander L, Rignell-Hydbom A, Hagmar L. A cross-sectional study of the association between persistent organochlorine pollutants and diabetes. Environ Health. 2005 Nov 29;4:28.
- Ropero AB, Alonso-Magdalena P, García-García E, Ripoll C, Fuentes E, Nadal A. Bisphenol-A disruption of the endocrine pancreas and blood glucose homeostasis. Int J Androl. 2008 Apr;31(2):194-200. Epub 2007 Oct 31. Review.
- Wang SL, Tsai PC, Yang CY, Leon Guo Y. Increased risk of diabetes and polychlorinated biphenyls and dioxins: a 24-year follow-up study of the Yucheng cohort. Diabetes Care. 2008 Aug;31(8):1574-9. 2008 May 16.
- Michalek JE, Pavuk M.  Diabetes and cancer in veterans of Operation Ranch Hand after adjustment for calendar period, days of spraying, and time spent in Southeast Asia. J Occup Environ Med. 2008 Mar;50(3):330-40.

Burn That Belly Fat With High-Intensity Training?

A recent study by researchers at the University of Virginia found that high-intensity exercise training disposed of more belly fat in obese middle-aged women than lower-intensity training of the same energy expenditure.

The idea that doing high-intensity interval training burns off stubborn fat and visceral belly fat has been around for quite a few years. The premise has always lacked strong evidence in my opinion — or at least reasonable qualification. Any number of internet training and fat-loss gurus are promoting this idea.

What is High-Intensity Training?

First up, we need to get the concept straight. What exactly is the ’interval training’ or ‘high-intensity training’ or ’high-intensity interval training (HIIT)’ that we hear so much about?

Interval training is intermittent training, often near your maximum, in which you do a lap of an oval, or a spin on a bike, or 60 seconds on a treadmill very fast, then you recover, and do it again several times. That’s simple enough.

For example, I’m a masters sprinter and in training I might do 10 x 100 metres at 95% capacity, or 10 x 40 metres at 100% capacity. This is high-intensity interval training in real life. But I’ve been a marathoner and triathlete as well (don’t ask), and high-intensity training for those disciplines is mostly entirely different; say, 2km fast, 2km slow, 2km fast; or 6 x 400 metres at 90% capacity, or even, I might add, 5km at race pace, which is still high-intensity training, even if not interval training. And further, I know that if you run 40 to 60 miles a week in marathon or triathlon training you’ll burn fat . . . lots of it. So what’s this HIT stuff all about?

Early Investigations Were Not Adequate

One problem with some of the earlier studies was that they did not set a rule for what constitutes ‘high intensity’. The study I quoted above used lactate threshold to determine this, an excellent idea. And few earlier studies actually compared the different intensities for the same energy expenditure, which is what needs to be done to get a reasonable comparison.

You can’t just do 6 spins on a stationary bike for 30 seconds flat out and expect to burn the same amount of calories and fat as someone who does 30 minutes on the treadmill at 85% capacity, or even a 90-minute run at slow pace for that matter. Energy expenditure, which just about always includes some fat and glucose burning, is going to be a product of intensity X time for any physical activity. 

In that event, the best approach for fat loss and fitness goals is likely to be a combination of interval training, weight training and cardio at different intensities. Big surprise eh? No, that’s right, it’s not. It almost reflects the recent exercise guidelines issued by the US government for general health and fitness.

Persistent Abdominal Fat and How to Shed It

What the study above suggests is that high-intensity training just might be superior to to lower-intensity training, for equal energy expended, in removing belly fat, especially the visceral fat wrapped around the internal organs that has been shown to increase your risk of heart disease and type 2 diabetes. Naturally, you have to include a nutrition program with some calorie restriction as well.

Even though the study involved a small number of women, 27, it seemed to be well designed. And yet men might respond differently, as might the young or post-menopausal women. It’s an idea that has promise for designing exercise programs for the overweight and people with metabolic syndrome and diabetes and is well worth watching in the future. The main problem is one that is not going to be easily solved: that unfit, obese people are unlikely to take on high-intensity training by themselves and stick to it, despite what you see on The Biggest Loser.

Having said that, there is plenty of evidence that aerobic, cardio type programs help people lose fat in general — even some visceral fat — and aerobic exercise has additional benefits for cardiovascular protection. A combination of weights, cardio and HIT is likely to be the superior program if it can be tolerated.

The Best Type of High-Intensity Training for Obesity?

Heavy people exert quite a shock to the knees when they run long or hard. It’s a real injury concern. Running is often out of the question for obese people, let alone high-intensity running. For this reason, I favour cycle spin classes on a stationary bike. Doing this exercise in a group has advantages. The instructor will encourage hard work, but it’s possible to set your own pace by adjusting resistance and peddle cadence if you get overwhelmed. You’ll get some high-intensity work threaded with lower-intensity cardio — an excellent workout combo. A medical checkup is highly recommended for anyone moving from a sedentary lifestyle to high-intensity training.

The Diet Wars Really Are Over

John Tierney over at TierneyLab recently had a bit to say about the New England Journal of Medicine study that compared an American Heart Association low-fat diet with Atkins and Mediterranean diets.

I’ve discussed the details and the implications in a longer page post called Diet Wars, but the upshot of this and many other bits and pieces of nutrition research from recent times pretty much suggests that we stop wasting time debating low-fat or low-carb or in between and get on with recommending a healthy eating pattern that spans a wider macronutrient range for fat, protein and carbohydrate.

Let’s get the faddists, fanatics and false prophets on the run.

The Truth About Organic Food

I’ve been a keen gardener most of my life, following a strong family tradition. We’ve grown everything from flowers and ornamentals to fruit trees and vegetables — with varying measures of success. Organic growing in a home garden, and wherever feasible commercially, just seems like sensible environmental management to me . . . and it’s especially applicable to home gardening. I’ve also written about organic growing and been a member of a growers group for decades.

Organics may not be the only solution

Even so, I’m not an absolutist, and I am a pragmatist . . . I accept that there may be other farming and cultivation systems that could indeed be regarded as “sustainable and healthy” even though they may not pass organic certification. But that’s not my argument here. I’m going to look critically at the notion of why you should buy organic food and whether the advantages stack up — give or take a few generalisations.

Here are the usual reasons for supporting organic food production:

• It’s healthier because few, and low-toxic pesticides are used and residues on crops are not a problem
• It’s healthier because organic food is higher in dietary nutrients
• It’s more sustainable because soil is managed better without chemical fertilizers
• It’s safer and sustainable because beneficial organisms like bees and predatory organisms and wildlife are not poisoned by pesticides
• It’s safer because humans are not poisoned by pesticides as they use them.

Pesticide residues

Even allowing for cheating, it is clear from testing that organic food has fewer residues of detectable pesticides than non-organic food. The issue is whether the presence of residues in non-organic food is a health hazard. Clearly, in some cases it is. The cases of aldicarb pesticide poisoning from melons in California is a classic case. This was only detected because of the severe symptoms. Many other cases are likely in which the victim has less acute symptoms and the cause remains unidentified. And, the effect of long-term exposure to small quantities of residues is unknown, but could be significant.

Testing for safe food. With the world food supply increasingly traded across borders, ensuring “clean” food by monitoring it for contaminants has become increasingly difficult. Recent issues in food safety in relation to food products imported from China make this all too clear.

Organic food has more nutrients

This is the one the professional agriculture, health and nutrition communities have resisted so strongly for so many years. In essence, it is a complex issue. To measure this accurately, you really need to set up controlled growing conditions for a reasonable comparison, and even though quite a few early studies showed advantages for organics in some nutrients like vitamin C, iron, omega-3s and a few other minerals, the design was often somewhat amateurish — until the European Union Newcastle University study came along. Read the results here: “Organic produce better for you”.

Variability abounds. The authors caution that variations in qualities exist across the organic and non-organic spectrum. What this might mean for you, as a purchaser, is that a badly grown organic apple could very well be inferior to a well-grown non-organic apple. One might expect that across a continuum of organic produce, the nutrient value may be higher, but don’t expect that any one purchase will give you that guarantee.

Phytonutrients finally. Over the years of this organic nutrient debate, the one thing that has mostly been absent is an evaluation of the non-vitamin and mineral nutrients. These are the antioxidants, the polyphenolics, carotenes, sulphur compounds, the omega-3s and many more that are known to be health-giving principles in foods. Finally, this also seems to have been answered. In the Newcastle University study:

They found levels of antioxidants in milk from organic cattle were between 50% and 80% higher than normal milk.

This is not surprising, overall, because Alyson Mitchell, associate professor and food chemist at the University of California, Davis, found exactly the same thing in her work analysing tomatoes. Soluble fertilisers, especially nitrogen, and strong pesticides may inhibit the plant production of phenolic compounds. See Mitchell again for a discussion.

One would have to say that early professional bias against the idea of organics having higher overall nutrient values, in a dietary sense, seems to have been ill-founded and perhaps influenced by various vested interests. However, this should not suggest that eating organic foods, even with a premium supply of antioxidants, results in superior health outcomes: that is yet to be proven.

Organic growing is more sustainable

As a general rule this is probably true, and is likely to be more so for smallholdings rather than large commercial enterprises. The definition and evaluation of “sustainability” is variable, but one issue is the recycling of inputs to the system versus importing inputs like organic fertilizers from elsewhere. Sustainability is about being able to make systems last without degrading the system.

Nevertheless, several recent studies — University of Michigan, the USDA and the FAO and others, have found that organics actually outperform conventional agriculture in measures of soil sustainability and biological sustainability — and may even approach the production efficiency of non-organic farms in some cases.

Safer for wildlife and diversity

New Scientist reports: “Organic farming boosts diversity”.

Organic farming increases biodiversity at every level of the food chain – all the way from lowly bacteria to mammals. This is the conclusion of the largest review ever done of studies from around the world comparing organic and conventional agriculture.

Enough said about that one.

Occupational health and safety

This is the sleeper issue in organic production. It receives less attention than other aspects. The human health legacy of toxic pesticides in developing nations has been monumental. And even in the developed nations, the misuse and overuse of pesticides has resulted in substantial impacts on human health. The US Agricultural Health Study has reported on some such results.

Here is what esteemed toxicologists Levine and Doull said about pesticide poisoning worldwide in 1992:

Global estimates of acute pesticide morbidity and mortality. Levine RS, Doull J. Rev Environ Contam Toxicol. 1992;129:29-50.

Mathematical models have projected increasing numbers of pesticide poisoning throughout the world, rising from 500,000 cases/yr in 1972 to 25,000,000 cases/yr in a 1990 estimate.

Summing up

Organic food is more expensive; you have to decide if it’s worth it. In addition, the science of organics is a bit fuzzy at times. Some modern pesticides actually have lower toxicity than approved organic pesticides. The more popular and affordable organic food becomes, the more we will see mainstream food manufacturers taking advantage of it. No folks, the organic pop tart is not a health food. Overall, though, organics is a neat package of environmental health and safety practice. I support it strongly.

Food for Life, Fit for Life - Lifestyle Training Course Released

Food for Life, Fit for Life - Prevent Diabetes, Heart Disease and Cancer is a set of training modules in lifestyle preventive health.  It took me 12 months to write and it’s now available for licensing. You can download a free ebook version that describes the content. Here’s what’s included:

• Training and evaluation manual for course presenters
• 120 PowerPoint slides with notes and contemporary references
• Sample learner assessment questions for each module
• Fact sheets that can be used as handouts to clients/students
• Risk evaluation self-assessment handouts for nutrition, physical activity, diabetes, cardiovascular disease, and cancer
• Case studies for workgroups and workshops
• Glossary of terms
• Regular newsletter
• US and UK/Australia versions (spelling and units)
• Evidence based information, fully referenced
• Flexible licence conditions and regular, free updates for one year
• Access to a membership web site for support, updates and extra resources.

Background

I started writing this over 12 months ago as a tool to use for talks to clients and groups in fitness and personal training. Rather than the limited training course I had in mind at that time, it has now morphed into something more like a training ‘environment’ with support tools like handout risk assessments and case study tasks. I have plans to add more of these tools and content within the context of the course. For example, a basic ’sports nutrition’ module is near completion.

As a trainer-presenter, your options are varied. You could select various slides or modules for presentations ranging from 2 hours to 2 days to groups or even individual clients. The target audience could include lay people or professionals in various support roles in preventive health. Presenters could include dietitians, nutritionists, fitness trainers, practice nurses, physios, diabetes educators and any support professionals working in preventive and lifestyle health. Some skill in delivering an appropriate language and idiom to audiences with variable knowledge bases would be required by the presenter.

I’ve summarised the essential elements of lifestyle disease, meaning the risks with which we burden ourselves because of our behaviour in relation to food, nutrition and physical activity. Although I mention the roles of environment and genetics, this is not the focus of the program at this time, but I do have plans to add modules that address basic issues in environmental safety in relation to food quality. Any additional modules added are included in the updates available in the licence for one year.

The core elements are:

• Type 2 Diabetes
• Cardiovascular disease
• Cancer
• Obesity
• Motivational and behavioural change
• Nutrition
• Physical activity and exercise

For example, I’ve summarised the complete content of the WCRF/AICR Expert Report: Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective so that the essential points are clear.

Licences

At present, only one licence option is available. This locks the headers and footers and PowerPoint attributions to me and no changes are permissible. I will probably also offer a ‘professional licence’ under which the licensee has the right to modify the content and replace attribution and headers etc with their identity. This would allow the licensee, with some restrictions, to modify the content and to adjust any particular aspect that did not suit their purpose or premise.

Availability

I’ve created a free ebook (pdf) version of the course, featuring the PowerPoint slide headings with content from the notes of each slide. This delivers a summary version and illustrates the content quite successfully. Not everything is fleshed out of course.

The best way to get this is to fill out the email form on the front page of the web site — or on this blog at the top right. This will redirect to a download page after confirmation. You will then get an email advising when content is updated or added, including new web and blog articles. This would be no more frequent than once each week.

I hope you take a look at the free ebook and let me know what you think. Suggestions, comments and admonitions are, of course, welcome.

How the Cholesterol Skeptics Can Harm You

Do a search for ‘cholesterol and heart disease’ in Google and you will see that many of the results in the first few pages are from sites that dispute the current medical view that cholesterol is a major factor in causing heart disease.

Some of the advocates of this position are well known ‘alternative’, or at least fringe movements that have a particular dietary barrow to push. Many belong to the low-carb brigade, indigenous diets advocacy, Paleo nutritionists, and sadly, some bodybuilders and weight trainers and men’s health advocates. And, of course, it should be said that many reputable people within these movements do not accept the ‘cholesterol myth’ line.

Cholesterol is a factor in heart disease and these people are dangerously wrong. They rely on dumbing down a complex scientific issue to impress a gullible audience. I could write a long review of this issue, fully supported by references, but I won’t waste my time, or yours. Here are a few crucial points to consider.

It’s the Cholesterol, Stupid!

1. In the condition familial hypercholesterolemia (FH), individuals have naturally very high cholesterol levels as a result of a genetic abnormality. If undiagnosed, or without treatment, such people can die of heart attacks in childhood or in early adulthood depending on the severity of the condition. Brown and Goldstein won the Nobel Prize for their work on cholesterol, HF, and how cholesterol causes cardiovascular disease. The science of HF alone, should be enough to send the cholesterol skeptics packing — but still they persist.
2. Although I am no promoter of pharmaceutical company interests per se, there is little doubt that statin medications improve heart disease conditions and fatal outcomes in people with high cholesterol by a combination of lowering LDL cholesterol and probably raising HDL cholesterol. The evidence is just too overwhelming. In fact, in recent years, the cholesterol skeptics have subtly shifted their attacks from “cholesterol does not cause heart disease” to, “saturated fat does not cause heart disease”, which is a softer target for them considering the complexities of different chain length saturated fats and the interactions of mixed diets.
3. The skeptics like to juggle the medical literature to try to show that there is no valid evidence linking high cholesterol to heart disease. However, it’s not in dispute that heart disease is dramatically low in healthy populations with total cholesterol levels under 150 mg/dL or 3.9 mmol/L. Cardiovascular disease rises with increasing total cholesterol, and especially LDL cholesterol, in most populations.
4. Even so, some populations in some countries seem to defy this trend, and these are the people the skeptics concentrate on when delivering their message. The thing to remember is that heart disease is multifactorial — that is, cholesterol may only be one factor among several, even though it is a major factor. Some populations will, through genetics or lifestyle, defy the atherogenic effects of higher cholesterol to some extent. This seems to be the case with the ‘French paradox’, in which French populations have much lower heart disease than other country groups with similar cholesterol levels. That does not mean that cholesterol is not a major factor in heart disease for most populations.

Overall, considering the established science of familial hypercholesterolemia, and the evidence from statin drug trials, including regression of plaque with cholesterol lowering, the evidence is so overwhelming for a dominant role of blood cholesterol in heart disease, and the influence of poor nutrition in raising blood cholesterol, that one can only assume the cholesterol skeptics have another agenda. I don’t know what it is, but it doesn’t take too much thought to come up with a list of industrial food interests that might benefit from this hogwash. Believe them at your peril.

What if You Could Prevent Prostate Cancer with Diet and Exercise?

Preventing prostate cancer with lifestyle behaviours may not be that extreme a proposition considering the latest research from a group studying gene and prostate cancer interactions.

I should make it perfectly clear that this research is promising and profoundly interesting, but it is NOT a sure-fire cure for prostate cancer and you should not disregard advice from your treatment specialist if you have existing prostate cancer.

The prostate is a gland that sits at the neck of the urethra and bladder in men and the cancer usually occurs in men older than 40 and with increasing incidence as men age.

The study emphasized a diet high in plant foods and exercise

The pilot study, which involved well-known lifestyle researcher and nutritionist, Dr Dean Ornish, evaluated changes in prostate gene expression in men with low-risk prostate cancer who declined conventional treatments like surgery, hormone therapy or radiation and who trialled an intensive nutrition and exercise lifestyle program while undergoing evaluation for tumor progression.

The patients at a diet high in plant foods including soy, fish oil, the mineral selenium and vitamins C and E and very little of red meat and fats. They walked or did gym for at least 30 minutes, 6 days a week; did an hour of daily yoga and meditation type relaxation; and attended 1-hour weekly support sessions.

The authors emphasize that it is too early to know if this kept the cancer in check. Yet, to the surprise of the researchers, what they found was that at the gene level, genes that protect against cancer seemed to be turned on (tumor-suppressor genes) and genes that promote cancer (oncogenes) were turned off in substantial quantities.

University of California, San Francisco geneticist Christopher Haqq said”

“It is absolutely intriguing this lifestyle change can have as much effect as the most powerful drugs available to us now. We medical oncologists are always looking for drugs that can do this. It is delightful to find that diet and lifestyle can have profound effects and be complementary to drug therapies—with fewer side effects.”

What you need to know

While this looks like a valuable line of research, don’t get too carried away and reject all standard treatments if your doc advises it is too dangerous to do so. Remember that the experimental group had “low-risk” prostate cancer to start with.

Second, what this research does suggest is that this sort of lifestyle approach could be a really useful preventive approach to prostate cancer. You need to get that exercise and eat lots of nuts, beans, seeds like sunflower and pumpkin green vegetables, fruits and whole grains. Avoid the red meat and saturated fat as much as possible; chicken and fish is better. A few Brazil nuts each day will give you a good dose of natural selenium — about 100 micrograms or thereabout.

Read the complete study at Proceedings of the National Academy of Sciences, USA, 2008.

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