Issue #7. June 2014
First things first, Garrett and I had a great conversation for this month’s 180D podcast. For more about Dr. G’s crazy world of mineral co-relationships and some giggles about our days of urine testing, listen in HERE. Definitely some interesting stuff in there. You may be making a big mistake by taking calcium! Also, since tooth decay and tooth remineralization seemed to be the primary topic of interest from readers submitting questions last month, I think you’ll find many of the answers to your questions without having to resort to some disgusting liver and cod liver oil diet in yet another great book by Sir-Writes-a-Lott. Check it out HERE. Now, on with the newsletter.
This section features new content from 180 founder Matt Stone.
Involuntary Mechanisms
Ladies and gents, I’m happy to report that I’ve got the itch! No, not that kind of itch you pervert. I’m talking about the good kind of itch that makes the first day of your month more enjoyable (if you are spending that day reading this that is)–the itch to write.
Yesterday I was clawing at the screen at some typical ridiculousness. Be glad that you aren’t a semi-notable figure in the health and nutrition scene, or you too might draw the attention of the abrasive Lyle McDonald. Lyle is a polite gentleman, known for his hard-headed certainty regarding all health matters, particularly regarding bodyweight regulation. You can see a warm sample of some of the politeness Lyle shares whenever he comes over for a friendly discussion on Facebook.
Isn’t that fun! Best friends forever!
But today we’re not going to talk about diabetes. Today I want to talk about the involuntary mechanisms of the body that regulate body composition. These mechanisms are the primary focus of all, real obesity researchers and scholars, which are a far cry from the voices on the internet that speak about such matters as obesity and weight regulation with 100% confidence and conviction in their conclusions.
“How does reducing calorie intake not work?”
I claimed that controlling a kid’s portions wasn’t an effective solution to childhood obesity, and I was condescendingly asked this question. Aside from the obvious hilarity of that simple-minded belief (I know you guys know the answer… because it reduces your metabolic rate and makes you effing hungry!) let’s take this one step at a time as if I’m explaining this to a child who didn’t make the honor roll.
It’s really quite simple why calorie manipulation cannot, is not, has not been, never has been shown to be, nor ever will be a reasonable, permanent solution to a serious weight problem–especially in kids. It’s because of the response that the involuntary mechanisms of the body that factor into weight control and body composition have.
Calorie intake goes down, body fat levels decrease, metabolic rate decreases in proportion to the fat lost, as does desire for physical activity and the calorie-burners NEPA (fidgeting) and NEAT (calorie burn from light movement). Meanwhile, appetite increases, cortisol increases (favoring fat storage over lean mass preservation), binge-proneness increases, cravings increase, etc.
All of these involuntary mechanisms are sending strong biological signals to our bodies that ensure eventual weight regain, often exceeding and surpassing prior body fat levels before the period of conscious calorie reduction began. What percentage of people regain their lost weight depends on how long you study them for. 6 months? It works! A lot of people keep that weight off! A year. Eesh, not so good. 2 years, uh oh. 5 years: oh crap.
Even those who do manage to starve a significant amount of weight off and keep it off for several years–many of those registered with the National Weight Control Registry, are found to be eating an abnormally low number of calories for their age, height, weight, gender, and physical activity levels. Guarantee you that there are an abnormal amount of socks, mittens, lotion, laxatives, Preparation H, caffeine, and pharmaceutical drugs at the households of these people. And no damn cookies anywhere. No way I’m going over there to find out, if there are no cookies involved.
In all seriousness, it’s not just appalling that people still really think that watching portion size and counting calories is a reasonable solution to obesity, particularly in children. It’s surprising! But then again, I’m almost always shocked at what virtually everyone I encounter believes about just about everything. This curious mind of mine sucks. I have to think about everything instead of jump to a conclusion and get busy defending it no matter what contradictory evidence or viewpoints I encounter.
In the end, saying that conscious reduction of food intake or increase of physical activity levels to create an intentional, voluntary calorie deficit is effective for weight loss, is about as strong as an argument for abstinence as a birth control method. Technically, and sure, even scientifically, it’s impossible for abstinence not to work as a birth control method. But you know, the thing is, it doesn’t work. Why? Because of the physiological and psychological reaction to abstinence.
It’s the same with the tiring sermon about eating less and exercising more. It works 100% of the time. The only problem is, it fails nearly 100% of the time. Those who do succeed long-term and preach the gospel of it are extreme outliers. It’s not a real solution to anything. It’s just blah, blah, blah from bullheaded internet trolls with serious personality disorders.
If a viable solution to obesity is ever confidently identified and confirmed and found to have minimal side effects, it will be effective because, and only because, it works by altering the involuntary mechanisms that affect metabolism, appetite, fat storage, and body composition. I think progress has been made in this arena here and a handful of places like it, but there are a lot more questions than answers remaining. Anyone who is sure of the answer and takes on an arrogant tone you can be sure is full of it–especially if they constantly tell you how “scientific” they are in between expletives. 
This section features the latest thoughts, research, anecdotes, and findings of the Official 180DegreeHealth Doctor: Dr. Garrett Smith. (drsmith@180degreehealth.com)
Dr. G Bites
Matt Stone here. Gangsta G was super busy travelling around snipping hair like a scene from a Jackass movie, doing book signings and putting on seminars at Crossfit gyms and other strange places I wouldn’t feel safe wandering into without a body guard. So for this month I’m going to highlight some of the Doc’s little sayings that he likes to post on Facebook. I give you, Dr. G’s Bites…
This section features one of the greatest hits from 180D’s seven year blog and its 666 published posts.
How We Get Fat
No this is not a book review of Gary Taubes’s Why We Get Fat. Rather, this is a post about the reality of how people pack on extra weight minus Taubes’s incorrect and shortsighted assessment of biochemistry.
A question I get as often, or more often than any other, is ?Well then, what does cause people to become fat?? Believe it or not, this question involves more than just a one-word response, such as ?carbs? or ?fat? or ?junk? or ‘stress? or ?calories.
I’m finding it difficult to coax some people who really need a dense calorie supply in order to normalize their metabolic rate into eating common foods. It seems that many people who gravitate towards strange diets find a lot of comfort in the strangeness of their diet because there are a lot of people that eat ?normal? and are obese and sick. Eating abnormally provides a feeling of security that, because you don’t eat like Uncle Diabetes, you therefore cannot ever have diabetes ? as if food is the only factor, or even the primary factor, in diabetes? and it probably isn’t.
Hence the frequency of hearing the ?How do we get fat?? question when I recommend stocking the freezer with Haagen-Dazs. For starters, there is no one macronutrient ? be it carbohydrates, fat, or protein that causes us to become fat. One is not really better than the other. Although there are a few errors, Lyle McDonald lays out a pretty fair summary of the equality among macronutrients when it comes to fat storage in his very own article entitled How We Get Fat.
I thought I would share some common ways that people gain fat in the first place. Like anything intelligent, it won’t pin it all on one villain, but will take an honest look at what is a multifactorial process. Here are 10 of the biggest contributors to an increase in body fat?
1) Binge Eating ? Eating a ton of food doesn’t always cause fat gain. I have some followers that report eating in excess of 8,000 calories per day without following a structured exercise program that have been in fat balance (storing and burning the same amount of fat, and thus not increasing total body fat levels) for a year or longer. My girlfriend’s daughter who I mention a lot, is just finishing up the equivalent of a 5,000 calorie meal for a full-sized adult. Eating a ton doesn’t cause fat to accumulate outright. Binge eating only seems to be particularly fattening when done in a reduced metabolic state, frequently, and/or done while on a restricted diet.
For example, if you are on a low-fat diet that suppresses fat oxidation, and binge on ice cream, you’ll probably store a lot more fat than you burn until that becomes your normal way of eating and your metabolism adjusts to the higher fat and higher calorie intake. Of course, the gaining of weight and increase in metabolic rate that accompanies the fat gain is your body’s way of healing itself from a suppressed metabolism. For many, some short-term fat gain is necessarily to achieve peak function.
I think this is why dieting is so fattening long-term, as dieting increases the tendency to binge eat, particularly on foods you have restricted. This is particularly problematic, as eating a low-carb diet for a long time can make carbs additionally fattening. Likewise, eating a low-fat diet for a long time can make fatty foods additionally fattening. You could further break this down to say that eating in any way that reduces the tastiness of the food will cause a return to better food to be fattening in the short-term. So be careful about eating a diet that you can’t continue. You can imagine the redundancy with which I am told that ?adding ?x? food back to my diet makes me gain weight.
Dietary restriction causes self-fulfilling prophecy. If you believe that ?x? food is making you fat, taking it out of your diet and then putting it back in later will often make you gain weight ? one of the reasons I look at dietary restriction as a last resort unlike most nutrition gurus. But you have to ask yourself a question. Is it the binge eating or the restriction that actually causes the fat gain? Without prior restriction, eating a ton of food isn’t nearly as fattening, nor is the desire to binge present. A gun must be loaded for it to actually kill someone when you pull the trigger. I’ll let you answer that one for yourself, as it is obvious that I view the restriction, not the calories one consumes, as the primer for fat gain.
2) Chronic Stress ? Acute stress doesn’t seem to have a fattening effect. Stress of any kind often has a short-term fat lowering effect. But there’s something about chronic stress, day after day, month after month, that has a fat accumulating property for many people. My mom, for example, has gained 20 pounds in the last 10 years. She gained 10 pounds in a month when switching to a new job without noticing any other changes to her diet and lifestyle. A few years later she switched to a new job again and put on another 10 in a month. Thus, she gained 20 pounds in 10 years, despite remaining perfectly weight stable for 118 out of the last 120 months.
This is how most people accumulate fat ? in quick bursts followed by a stabilization of weight at a slightly higher set point. This weight comes during stress, or immediately after stress ? similarly to what would happen to people if they cycled on and off of amphetamines. This is because immediate stress decreases appetite and stimulates metabolism, but it does damage to the thyroid gland so that when the stress is finally removed, or the body adjusts to the stress, the metabolic rate is lower and appetite is higher. Stress can be psychological or physiological due to inflammation, injury, or otherwise. Humans will probably always have the worst obesity problems because of our complex psychology and complex interaction with food.
3) Lack of sleep ? For similar reasons as stress, the declining amount of time of the average night’s sleep over the past couple of centuries is a big factor in weight problems. Lack of sleep, like any stress, decreases metabolic rate and often increases appetite along with it. It only takes a few nights with little sleep to trigger pretty severe insulin resistance, a metabolic state typically seen with obesity.
4) Television ? Television, as well as the use of computers, video games, etc. causes a large reduction in brain wave activity and non-exercise physical activity (NEPA). Television in particular, which the average American watches 4 hours of daily, puts the brain into a low-alpha wave, high serotonin state ? putting the body into a fattening state similar to a bear right before hibernation. The sort of iconic portrait of obesity would be mindless eating in front of a television, and this is probably somewhat accurate ? as engulfing lots of food in a metabolically-suppressed state can certainly add body fat.
5) Erratic exercise patterns ? In my own personal history, I have found erratic exercise patterns to be the single biggest source of cumulative fat gain. Going from exercising a lot to exercising very little often triggers some short-term weight gain before the body acclimates to the change. And this weight doesn’t spontaneously come off in any hurry.
6) Pregnancy ? Men and women during pregnancy gain over 10 pounds on average. Many women eventually have a surge of weight gain with pregnancy that doesn’t resolve itself afterward, especially in the mid to late 30’s and beyond.
7) Age ? Age is of course the greatest stimulus for fat gain, related primarily to the decrease in metabolic rate that occurs with aging. It certainly isn’t related to increased fat, carbohydrate, or calorie consumption ? as consumption of all three of those decreases with advancing age.
8) Food ? The food we eat does have an impact on long-term metabolic rate and thus proneness to store excess fat. Of all the foods I’ve investigated, the most likely to cause a long-term worsening of metabolic rate are foods containing a large quantity of unsaturated fats. So our modern junk foods like potato chips, French fries, doughnuts, fried foods, mayonnaise, salad dressings, margarine, and most commercial packaged foods ? as well as a high consumption of pork and poultry, certainly appear to contribute.
9) Heredity ? Many of the above factors impact the metabolic programming of a young child during pregnancy and during the early developmental period. Heredity is obviously the biggest of all factors when it comes to the propensity for storing excess fat in the modern environment. Obesity researchers estimate that heredity is more than half of the contribution to any individual’s weight. Studies of identical twins make this the most abundantly clear, as most twins will gain the same amount of fat, stored in the same parts of the body in the same proportions, and gain the fat at the same age even if they are reared in different households. Certain ethnic groups are a lot more prone to fat gain as well. Generally-speaking the whiter you are the less obesity prone you will be, which is even true when controlled for socioeconomic status (another well-known fattening factor).
10) Medication ? Medications like anti-depressants, corticosteroids, and birth control pills, just to name a few, are very fattening. Many gain a great deal of excess fat while taking these medications. Remember that this is just a list of contributing factors looked at in isolation, and there are dozens of others. The bigger picture that I want people to see is more the interaction with several factors at once, creating sort of a perfect storm for fat gain. And even when there is a perfect storm for fat gain, in my experience most people still gain their fat in brief periods of a month or two, while spending most of their lives perfectly weight stable whether retreating to some harsh diet or not. Hope it helps some to better understand their own personal fat fluctuation history. YOU can become weight stable. And you can probably do it eating just about whatever the hell you want. In other words, you don’t have to drink 1 percent milk. You could drink whole if you wanted to.
And here is the recent Slideshare for those of you who might have missed it. You can see all my slideshares at: http://slideshare.net/180degreehealth
This section features recipes, cooking tips, and food discussion by Matt Stone.
Low-Pufa Caesar
My girlfriend is nuts about Caesar salad. But as a former chef with the skills and cooking repertoire that rivals many upscale restaurant chefs in the world’s culinary capitals, I’m often appalled by what is served when she orders one of these things. To wear out a crude and oft-used play on words, some taste more like I’m tossing Caesar’s salad. I’m talking about you Bonefish Grill. I’ve wrung out better-tasting dressings from socks after long hikes on a hot day.
Truth be told, I don’t care what you put in a salad. It could be solid gold or completely covered in foie gras, but it still can’t touch a properly made Caesar. First off, make your own croutons. It’s like 5 minutes of work, takes a little baking while you’re making weeks-worth of dressing, and can be stored away in Ziploc bags for quite a while. A crouton MUST, and I mean must, be small. The smaller the better almost. Cut white bread in cubes (sliced sourdough loaves from the bakery at the supermarket are the perfect thinness). If it’s too soft and squishy and gets too mashed when you cut it, you can try partially freezing the loaf. That stiffens it up a bit. Stiffens, lol.
Toss it around in a big bowl with plenty of olive oil, or, perhaps even better–melted butter–and season heavily with salt and pepper. Before you bake them, it should taste divine and require restraint not to gobble it all up right there on the spot. Spread those puppies out on a wide baking sheet and bake in the oven at around 400 F or so until they are lightly brown and crunchy–but not chip a tooth crunchy. The texture should be nice enough that you once again have to use restraint not to gobble them all up. Now for the dressing. Ingredients (huge ass batch):
- 3 pints (1.5 liters) sour cream
- 2 cans anchovy filets packed in olive oil (drain the oil)
- Juice of two big lemons
- 4 cloves of raw garlic
- Freshly-ground black pepper until your forearms reach failure
- 2 cups of freshly-grated REAL Parmigiano Reggiano or Grana Padano (if the price tag at the store doesn’t scare you, you’re using the wrong kind of cheese… It’s impossible to make a truly good Caesar dressing without the right cheese)
- Salt to taste
Directions:
Blend it well. If you have a Vitamix, blend it for a full 20 seconds at least. If you don’t have a Vitamix, take whatever blender you have and stick your hand in it while it’s on high. The pain you feel is a close approximation to what it feels like to use any other blender on earth once you’ve owned a Vitamix for a substantial period of time. Taste here is everything. If your eyes don’t immediately roll back in your head, adjust the flavors around until you feel it’s right (more pepper, more lemon, more salt, etc.). If you still can’t get it, just keep adding cheese. There is a point where everything tastes good if you keep adding enough cheese. Seriously though, you should be able to stick a crisp Romaine leaf into that blender full of dressing, take a bite, and start laughing at how absurdly good it is.
Okay, you’re coming down the home stretch here. From here all you have to do is:
- Cut up one Romaine heart (that’s a head of Romaine with the leathery, floppy, green exterior removed–leaving the inner half of the head of lettuce more or less). A rough chop is good. Get plenty of crunchy stuff close to the root.
- Hopefully the lettuce is clean. Washing lettuce, even if you dry it well, does damage to the finished product. So hopefully you can just throw it straight into a bowl.
- Dump in a big handful of croutons. Too many will ruin it, so don’t get silly.
- Add a half cup of dressing or so. You should be lightly dressed. You know, metabolism n’ all. But salads should be heavily dressed if the dressing is actually GOOD (extremely rare).
- Toss briefly and put on a plate.
- Top it with more fresh-grated cheese and black pepper.
And that’s the secret. Like most things when it comes to cooking, it’s not about secret or exotic ingredients, it’s about not f$%&ing it up. 
This section highlights one of the best health-related videos on the web each month.
The Quest to Understand the Biology of Weight Loss
Going with the theme of this month’s newsletter, you can see I’m not the only person on earth talking about these kinds of issues. In fact, I’m in company with the world’s leading obesity researchers in disagreeing with personality-disordered know-it-alls in the internet health shitsphere… 
This section features an article by one of the leading minds in health each month.
Don’t Resist It
By Caroline Haagen
www.thefuckitdiet.com
So, you’re crazy about food?
You would give anything to just be normal and not obsessed around food and mostly to stop bingeing. It sometimes can seem like if you could just stop bingeing, everything would be fine! It’s easy to feel like bingeing is the problem. But here comes paradox-time…
You cannot stop bingeing by trying to stop bingeing.
Trying to ‘stop bingeing’ just makes bingeing worse, because bingeing is the symptom of a bigger problem.
The only thing that genuinely will heal you from your ragged bingeing state: is to stop dieting and stop restricting. And the hardest part is that once you do, and when you begin testing your freedom and are allowed to eat all this food… you will binge. And when that happens… (as it most likely will) don’t resist it.
Because when eating isn’t tied up in all of these intense emotional triggers and high stakes, when there is no guilt, or need to “get it all in before the next diet” the bingeing just becomes… eating-a-lot. And then… when you aren’t resisting eating-a-lot, eating-a-lot just becomes… eating. Neutral, life affirming eating.
So, YOU dear reader, are probably following and listening to Matt (as you should be!) and have left diets behind. And are now allowing yourself to just eat the food. Finally. Thankfully. Woooooo. Good first step.
But you may be freaked out about how much you are eating now.
On one level you know that eating-a-lot is a normal and important reaction, and essential to heal your metabolism, but you’re still hoping that someday soon… you will stop. That somebody you’ll be normal.
And here I am to tell you:
1. You will.
2. But not very quickly with that attitude.
3. Eating-a-lot can be neutral, too
The physical and mental pendulum swing from restriction to overeating (when in a diet recovery) is freaky, and it can sometimes feel anything but normal. And when all you want is normalcy, that can be an incredibly difficult time period. But the hardest part, is that you cannot white knuckle it.
You have to find it in yourself to accept the process, trust where you are, and to trust that in diet recovery, “normal” is eating-a-lot.
You are allowed to want to be normal around food. Being crazy around food is the worst. It is awful, and nobody deserves to live that way! That is why you are here, after all. But don’t resist the process, don’t go for perfection like before. This is a new journey.
Lots of important life lessons turn out to be tied up in paradoxes. And this eating thing is no exception…
The sooner you totally accept where you are, the sooner it’ll be as it should, (and most likely be allowed to pass).
Do I sound like f**king Yoda?! Yep. That’s because, for lots of people, realizing that their old super-control-over-food didn’t actually help things the way they hoped it would (and actually messed things up), turns this whole shebang into a spiritual journey.
(Which is jusssst how I like it.)
The more you resist it all, the harder it will be and longer it will take.
You got this.