An Attitude of Gratitude

We in America are good at wanting things. We are a consumer culture. Advertisements on TV show us things to buy. Everyone is concerned with having the latest, greatest, and newest. From the time we are kids, until we are adults, we seem to want, want, want.

Today, however, is a day for giving thanks for what we have. When I was young, I saw a motivational speaker. That speaker's topic was the importance of having an attitude of gratitude. At first blush, I did not really agree with what he said. Why was it important to have gratitude for the things I already had. I always thought my focus should be on my goals, and what I wanted. How on earth are you supposed to reach your goals by focusing on what you already possess.

I have grown and changed much in the intervening years since I saw this motivational speaker. As those of you who follow my blog know, I have had many trials and life experiences which have taught me the importance of being thankful. As it turns out, being thankful is critically important to any goal you might want to achieve in the future, for several reasons:

1. It reminds you of how blessed you already are- No matter how difficult your life is, there are some important things you possess. You possess life, the most precious gift imaginable. In addition, you likely have at least one or two people who love you. When you realize how important the things you have are, the things you want aren't quite so pressing.

2. It relieves stress- Part of the stress that we experience comes from the American rat race. The rat race is an endless pursuit. You run in circles pursuing a career, a higher rung on the corporate ladder, a bigger house, a nicer car, and more money. Ceaselessly pursuing the next big thing creates a feeling of pressure. This pressure turns to anxiety, which leads to stress. People who are under significant negative stress are at higher risk for obesity, heart attack, stroke, and sudden death. Gratitude is like a flood gate which releases the stress when opened. Someone who is grateful on a daily basis is far less likely to hold on to stress.

3. It makes you more likely to get what you want- I don't have a good explanation for this based upon science and nature, but it works. I attribute it to God. If you don't believe in God, you can call it the universe, karma, or whatever you want. Reason would suggest that there is no connection between being grateful for what you have, and getting what you want, but I can tell you from my own life that it works! If you spend time daily focusing on being grateful, many of the things you want will come to you, and you will be less concerned about the things that don't.

As you sit down with your family members to your (hopefully healthy) dinner, spend a minute being thankful for all the blessings in your life. In the end, you will have much more to be grateful for!

M. Jacob Ott, M.D.

Eat the Whole Food

Better living through chemistry. DuPont used this slogan back in the 80's. The intent of the phrase is obvious: DuPont (and by extension, mankind) can top nature by producing artificial products to meet all of our needs. Better materials, better drugs, better foods, all of these things are implied by the slogan. Back in the 80's, most people really believed in it. Not DuPont, necessarily, but the idea that we could create products out of virtually nothing which could supplant similar (inferior) versions made by nature.

These days, much of the public and virtually all of the healthcare industry believe the same thing. We have synthetic medications, clothing fibers, building materials, and synthetic foods.

Synthetic foods, you ask. OK, so you might be thinking "I don't see any polyester apples out there," and you are right. We don't have completely synthetic foods, but we have something very close to it. Food companies are able to chemically separate parts of foods, and combine those parts into various other types of "food." I put food in quotes, because these products have little or no value as food. Mostly they are clever combinations of corn and soy molecules. Not the good parts, mostly the fat and sugar.

Yet these convenience foods flood our grocery stores and vending machines, and many people eat a diet which consists of almost all processed convenience foods. Often times, these foods are even marketed as being good for you. The manufacturer will note one or two of the nutrients contained in the product, and tout it as being good for you. For example, I am currently looking at a cereal box that touts "heart healthy grains," and "14 vitamins and minerals." Of course, they fail to mention that the "heart healthy grains" are combined with high fructose corn syrup, and that the "14 vitamins and minerals" were added in artificially, and do not actually belong in the food in question.

What is the problem with synthetic foods, you might ask? If we get all of the nutrients we need from them, why is that not an OK way to eat? They are easy and taste good. Well, there are really two major problems, and a host of minor problems. I will discuss the major problems here:


1. The foods are too energy dense. Processed foods concentrate the parts of food that we humans find appealing based upon our sense of taste, namely the fat, salt, and sugar. They leave out the fiber, starch, and all the "filler" which is in whole foods. This amps up the calorie density, and makes the foods far richer than they should be. Thus, you eat far more calories before your brain knows that you are full.

2. All that "filler" is pretty important. We are pretty arrogant as a species. Because we now believe in the omniscience of science, we study foods, and try and isolate the parts of food that are "good for us." We hone in on these nutrients, and study them. When we find one that shows some benefit in our studies, we start adding it to all kinds of processed goodies. We feel good about ourselves, because we think that this makes the otherwise unhealthy food healthy. Unfortunately, this is very far from the truth. In our arrogance, we forget that there might be other chemicals in the whole foods that we can't detect which contribute to the benefit we see. A classic example of this phenomenon is fiber. I'm sure you have heard that fiber prevents colon cancer. Shortly after this was discovered, synthetic fiber products appeared in large numbers on grocery shelves. Fiber was added to cereal, doughnuts, bread, and scores of other foods. People feel better, because they are able to get their 35 grams of fiber without changing their habitual diet at all. Wonderful, right?

Not so much. The colon cancer rates did not fall with this influx of fiber. In fact, they got higher! When the scientists did research as to why, they got quite a shock. Where the fiber in whole foods did lower the risk of colon cancer, the "fake fiber" in the other products did not. The same is true of most of the nutrients the USDA recommends. While vitamins are crucially important, and deficiencies of vitamins cause diseases, taking vitamins in pill form does not improve lifespan or mortality. In fact, some recent studies have shown that taking a vitamin may actually INCREASE your risk of death!

The bottom line is that we were meant to consume the whole foods, not their chemically rearranged counterparts. There are probably thousands of nutrients in the whole foods that we are unable to detect that work together to produce health benefits. That is why the Devolve eating rule #1 is:

Eat foods like they grow in nature

Wherever possible, eat the whole, unprocessed food. The closer you get to plucking it off the tree or pulling it out of the earth, the more nutritional value you will get out of it. In general, if your food was created in a lab, you will probably need to take a lot of lab created medicines to treat the diseases your created foods caused.

M. Jacob Ott, M.D.

The not so Incredible Edible (but Don't Eat it) Egg

The egg. Throughout my life, I have watched the egg swing like a pendulum in the court of public opinion. There is no food that goes from good guy to bad guy quite like these little guys.

In the 50's and 60's, athletes used to drink raw eggs to build strength. In the 70's, there was a backlash against the egg, and people were told to stop eating eggs, or cut back due to the spike in heart disease. Cholesterol in the eggs was blamed for this spike. In the 80's, eggs got a reprieve (I pulled the little slogan that I modified for this post's title from the 80's, although it has recurred in egg advertising throughout the years).

And so it goes. Every decade it seems, the egg switches from one extreme to the other. Eat it, don't eat it... Right now, it happens to be enjoying another good period. I recall Dr. Oz telling millions of unsuspecting people to eat an egg a day. I shudder to think of the devastation his advice on this point will cause.

As the court of public opinion with regards to nutrition is generally based upon expert opinion, let me explain why experts can't figure out where exactly to place the egg.

To the left is the nutrition label for the egg. One egg contains a relatively modest number of calories (around 70), and no carbohydrates. The numbers that the experts go back and forth on are the cholesterol and protein. As you can see, the egg has a lot of cholesterol (70% of what the USDA says that you need), and 6 g of protein (a pretty large amount for the small number of calories in the egg). So what is the problem?

The problem is, that in the opinion of most experts, protein is good, but is the amount of protein in the egg worth the amount of cholesterol that it contains? So experts with differing views argue back and forth.

Now for the problem with the problem: the experts are completely ignoring some very important facts. Many of them are aware of these facts, but because of various interests (financial is one, trying to appear mainstream is another), they choose not to tell the public. This puts you at some risk.

I am going to tell you the truth as I see it based upon research that has been done. I believe in this so much that I choose to follow my own advice in my diet, to tremendous result. You can choose to believe what I write, or not, but at least please read it and give it a chance. I just want to improve your health. I have no financial interest in this situation, and I don't care what the mainstream thinks about what I have to say.

Let's start with cholesterol. The USDA sets a limit of 300 milligrams of dietary cholesterol as what you should consume daily. As I already said, the egg has about 70% of that. What is this number based upon? Nothing at all. It is the consensus of a group of experts. Since all animal fat contains cholesterol, they had to pick a number that allowed for what they considered adequate amounts of animal foods in the diet. As you can imagine, this was heavily influenced by the egg, dairy, and meat industries.

Jake, you might ask, how much cholesterol does your body actually need? Great question. The answer is none. Zero. Zip. Cholesterol is a very important fat, and is found in virtually every cell of your body. Here's the rub: your body can easily make all the cholesterol you need, from other nutrients you intake. There is absolutely no need to take any in at all. On the other hand, cholesterol intake does have some other significant consequences. In multiple studies, a blood cholesterol level of greater than 200 was associated with double the heart attack risk of a level under 200. In medicine, we set the "normal" value for cholesterol at 200. This is incomplete data, however. In other studies, a cholesterol level of less than 150 was associated with a 5 times smaller risk of heart attack than a level of over 150. The cholesterol level of your average meat eater? 150-200. Your average vegetarian? 150-175. Your average vegan? 136.

Faced with these numbers, you might be wondering if all that protein is worth the risk that the cholesterol brings. Now we will deal with the protein issue.

Based upon multiple sources, including The China Study, animal protein intake has been linked to the following diseases:

Heart disease
Stroke
High Blood Pressure
Diabetes
Peripheral Vascular Disease
Colon Cancer
Prostate Cancer
Breast Cancer
Esophageal Cancer
Obesity
Osteoporosis

This list is not all inclusive, but is a good sampling. It should be enough to give you the gist. It is becoming more apparent that the protein is just as bad as the cholesterol, if not worse. To top it off, you don't really need the protein anyway. The USDA recommends that protein make up about 20% of your daily calories. That is double the 10% of daily calories recommended by the World Health Organization, and four times the 5% that multiple studies have shown are necessary for survival and muscle growth. The USDA's number is heavily influenced by experts who were taught the same fiction that you have been taught (and that I was taught in medical school), and by lobbyists for various groups who farm the animals that produce the protein.

The bottom line: the experts who tell you to eat or not eat eggs were trying to balance what they considered to be the good (protein) vs the bad (cholesterol). What they didn't tell you is that both nutrients go on the same side of the balance scale. They are both bad. Eggs are edible, but unless you happen to be a snake or a mongoose, you probably shouldn't eat them, unless you want the diseases on the list above.

M. Jacob Ott, M. D.

Another SIde Effect of the Standard American Diet

In this blog, I spend a lot of time talking about the major health problems that go along with the standard American diet. There is no doubt that a western diet leads to multiple chronic health problems, obesity, and early death. I have seen it with my own eyes, both in myself and in my patients, many of whom suffer from hypertension, diabetes, obesity, heart disease, and various forms of cancer.

Today I was thinking about some of the other side effects of the western diet, mostly due to my daughter. Yesterday, she went to a small carnival at her elementary school, with a friend of hers. Christy and I were not there with her. She was with the parent of her friend.

Although our children are not completely vegan, only a tiny percent of their daily calories come from animal products. In general, they eat a diet of whole, unprocessed fruits and vegetables. At the little carnival, as you might imagine, the foods available were not the kinds we would usually feed her. She ate a couple of hot dogs, as well as several dessert foods made with processed sugar and flour.

Later that night, my daughter complained of abdominal pain. She had crampy abdominal pain, as well as several episodes of diarrhea. This lasted most of the night, and went away after about 12 hours or so. By morning she was all better.

I know what you are thinking: little kid ate too much and got a tummy ache. I was thinking the same thing, until I remembered that I used to get the same symptoms. Before I switched to a vegan diet, when I was very overweight, I used to get abdominal cramps and diarrhea so frequently that I had diagnosed myself with Irritable Bowel Syndrome. Until today I had never thought about it, but those symptoms stopped immediately after I switched to a whole foods vegan diet.

Apparently Irritable Bowel Syndrome is yet another side dish served with the standard american diet. If you have IBS, and don't believe what I am writing, I challenge you to switch to a whole foods vegan diet, and prove me wrong.

M. Jacob Ott

Milk: It Does(n't Do) a Body Good

Milk. I can think of no food or beverage that is more aggressively marketed. There are milk commercials on TV, celebrities sporting milk moustaches in magazines, and everyone knows the old slogan: "milk: it does a body good."

Milk is almost universally admired, and holds almost sacred status as a health food. Kids are told by their health teachers and parents to drink lots of milk, to build strong bones. Athletes are told to drink milk to help build muscle and give them energy. There is even a glass of milk on the picture beside the government's new plate graphic, which replaced the food pyramid. It would seem to indicate that milk should be a part of everybody's daily diet.

It's true that milk is the best thing for you and contains everything you need to grow and be healthy... if you happen to be an infant cow. That is the point most of us miss. Milk comes out of the mammary glands of adult cows, and is meant to be consumed by infant cows. Cows themselves even stop drinking milk within months of birth. In fact, humans are the only mammals who continue to consume milk past the stage of infancy.

In adults, milk can cause many problems. First and foremost, almost 30% of people are lactose intolerant. They lack the enzyme that breaks down the sugar. This leads to bloating, abdominal pain, and gas after eating or drinking dairy products. Why, you ask, would we lack this enzyme? Probably because we are not meant to eat lactose. It is basically only found in milk, which we are not meant to drink after we reach about 12 months of age.

As if that isn't enough, milk proteins can cause allergic reactions. Behind nuts, milk is one of the most allergenic substances in adults. In addition, those same milk proteins in experimental models can lead to the development and promotion of cancer. Animals fed milk proteins developed cancer at much higher rates than those fed only vegetable proteins.

Finally, people suffer from their own misconceptions about milk. If you ask almost anyone what food has the most calcium, they will say milk. Kale and bell peppers have approximately 100 times as much calcium as milk. Ask anyone what the most important thing they can do to prevent bone loss is, and they will say "drink milk." In reality, milk has little to do with bone formation, and load bearing exercise is the most important factor leading to strong bone development. Even if milk isn't actually bad for you, the misinformation which is sold about milk can be.

The last nail in the milk coffin is this simple fact: if the claims are true, and milk is important in preventing osteoporosis, then the countries that drink the most milk should be the ones who also have the lowest osteoporosis rates. Below is a graph of hip fractures (which are mostly caused by osteoporosis) vs milk consumption:

As you can see, the United States, which has by far the highest rate of hip fractures, also has one of the highest rates of milk consumption. Why does Hong Kong, who consumes less than half of the milk of the US have half the rate of hip fractures? Quite simply, because milk does not prevent bone loss.

I have nothing against milk. It just shouldn't be consumed by anyone except infant cows.

M. Jacob Ott

The Role of Hunger

Hunger. It is one of the earliest sensations we feel. Very little in the world has the power to drive us like hunger does. It is something that we can temporarily defer, but will always come back before too long. In fact, it is one of the few things in life that we can truly count on. Hunger will always come back.

How we are able to manage hunger plays a large role in determining our health. If we eat every time we get hungry, and eat typical modern processed foods until we are full, then the result is that we will be obese and unhealthy.

Why is it that this natural sensation leads us astray?

Just like with our sense of taste, the feeling of hunger was made to serve us in a primitive world where food was hard to come by, and getting it was hard work. Animals by and large are hard to catch, and plants while plentiful, often require quite a bit of work to expose or collect the edible parts. Our sense of hunger was designed to be a strong motivator, as a survival aide. We need strong motivation to make the difficult and time consuming search for food seem worthwhile. If we didn't have this, we would eventually have starved to death. For cavemen, hunger was a constant companion, which impelled them to spend much of their time searching for their next meal.

Fast forward to today. We live in a society where food is offered in nearly every building, and where high calorie, processed foods are as close as the next drive through. Animals are no longer hard to catch. They are factory farmed in ridiculous numbers and pre butchered for us. No work or preparation is needed on our part, other than tearing open a plastic wrapper.

Unfortunately, our sense of hunger has not changed at all. We still feel that consuming sensation that we must eat whenever our stomach empties. The problem is that we are no longer filling it up with low calorie veggies. We now eat pastries, meats, and candy as "snacks" to fill us up between our high calorie, processed, and unhealthy meals. Additionally, we now sit at desks all day, instead of working our bodies to catch and prepare our food. Is it any wonder we are obese?

We were made with this hunger sense as standard equipment, and we cannot get rid of it. There is a silver lining, however. We were also given a powerful brain as standard equipment, and it has the ability to override our basic instincts, such as hunger. In order to be healthy in a world full of poor quality calories, we must engage our rational brain.

The first step is to realize a basic truth. This truth is simple. In fact, it is so simple, that I did not realize it, because we are taught the opposite so routinely that I never questioned it. Here is the simple truth

IT IS OK TO BE HUNGRY!

Growing up, I was taught that you ate whenever you were hungry. From as early as I can remember to age 29, whenever the feeling of hunger struck, I ate something. I never bothered to question whether or not I needed to eat. I figured that the sensation of hunger meant that I needed to eat. Based on the above discussion, you can see that this is not the case.

In order to be free of the control of hunger, you need to become comfortable with being hungry. Practice not eating when you feel hungry. At first, it will be very hard, and you may not be able to hold off eating for more than 15 minutes. With practice, you will eventually be able to ignore the sensation of hunger for hours. Then it is time to put your rational brain to work. Now that the feeling of hunger does not consume you, when you feel hungry, ask yourself when you last ate, and if you need to eat, or if you merely need to live with the hunger for awhile.

Knowing that it is OK to be hungry, and that you can always eat later (unlike your primal ancestor, your food will not run away), you will be able to consume less per day, and only eat the amount of food that your body actually needs.

If it's so Easy, Then Why is it so Hard?

In my job in a physician, as well as my job as a health counsellor, I try to get people to change. Those people who are uninitiated in the medical world think that the Emergency Department is mainly a place of gunshot wounds, car accidents, and other major life threatening illnesses. In reality, these make up a minority of people who come through the doors of virtually any ED. These days, most of the patients we see are victims of what I like to call "diseases of lifestyle." These diseases are malfunctions of the brain and body caused by various voluntary activities that are not healthful. These diseases include:

Diabetes
High Blood Pressure
Obesity
Heart attack
Stroke
Gallstones (some cases)
Depression/ Anxiety (some cases)
Fibromyalgia or chronic pain syndrome
Cancer (some types and many cases)
Trauma (many types)

The activities that cause these diseases are as follows, in order of importance
Poor diet and lack of exercise
Poor diet and lack of exercise
Poor diet and lack of exercise (this is not a misprint. It is just that important)
Smoking
Excessive alcohol intake
Drug abuse

As such, I spend a lot of time speaking with people about how and what to change. The things that I am asking them to do seem so simple when I say them or write them out: Quit smoking, eat better, exercise a few times a week, pay attention to their health and follow through with routine medical exams. Despite how easy these changes seem, a surprisingly low percentage of people are able to change, even temporarily. Why?

As my wife reminded me yesterday when we were talking about this subject: "change is hard, even if it is from something you don't like." She is correct. Even if I can get someone to recognize that there is a problem with the choices they are making, and that they are responsible to change it (a very difficult proposition), habit is powerful. Even a habit that you don't want, and know is bad, like smoking or poor eating is difficult to change. We as human beings resist change, whether good or bad.

In order to create change once and for all, we must overcome that resistence. Fortunately, we were given one weapon to help us change. It is not our intellect. I can reason with a patient all day long about how smoking is going to kill them, and they will nod, say they understand, and light up the minute they leave the ER. The weapon that we have to aid us is our emotion. Strong emotions, like fear and guilt, can push us to act when we are faced with the necessity of change. Fear can be supplied by a medical scare, like a heart attack or a tumor, or by social consequences. That is why you often hear of people quitting smoking or beginning a diet and exercise plan after being diagnosed with cancer or a heart attack. Similarly, the alcoholic quits drinking when they experience enough pain or fear that they don't want things to get worse (rock bottom). The power of our rational mind is that we can create the fear without the bad consequences. Visualization in the brain is as real to us as reality is. If you explore your uncomfortable emotions and visualize the negative consequences of the decisions you make, it will be far easier to overcome them.

This is how I finally managed to change. I was forced by my circumstances to visualize the fact that my children would have to grow up without their father, and that I would not be around to see the important events in their lives if I did not change. In the span of a second, the change that had eluded me my entire life became simple. So to Christy and everyone else, I submit my version of her quote:

"Change is easy if you have the right reason." Find your reason.