Tuesday, March 27, 2007

Out of Town and Out of Sorts

For about a week, my sister and I operated as satellites. We were two small masses revolving around Dartmouth Hitchcock Hospital at the whim of forces greater than our own. We survived on the Turkey Jerky I stocked up on from the Health food Store and grossly inappropriate doses of bad coffee. I even used a dash of the Stevia she keeps in her purse just to make the coffee feel like a different food group - something with nutritional value. Every now and then on the long drive back and forth to the hospital, my sister and I would glance at each other and share a look that said, "I feel really yucky," but as my mother struggled, we were hesitant to say it out loud because it sounded selfish.

My sister Stacey, a yoga instructor who teaches two-hour classes sometimes twice a day, and me, a personal trainer accustomed to 1.5 hours of grappling each day followed by a CrossFit class, were thrown into an unavoidable space of ill-health that consumed my mother and both of us. My mother died on Sunday and my sister and I began to tentatively reassemble our lives.

First, just to cap off the stress, the grief, and the overall yuckiness, we all had Ice Cream Sundaes topped with one indestructible, bawdy marshmallow peep. My mom loved those little buggers, stale. She was stoic and severe about her nutrition most of the time which led to these little explosions of naughtiness that manifested in what felt like food field trips which included things like peeps, and pound cake in the toaster. Come to think of it, she also managed to eat more fake cheese than anyone I know.

Then I finally started noticing the two young men running about the house in a perpetual MMA bout that included plastic swords and a Lacrosse stick. 'I'm in!', I thought. Which led to a rather impressive goose egg on my head from my sister's dresser when I engineered an ill-advised but exciting take-down in the middle of her bedroom. Seriously, hauling down a 12 year old can take some work but trying to figure the geometry in your head simultaneously is too much for my middle-aged brain. And, as Dustin, the 12-year old in question points out, the Gibbons' family may be damn near bullet proof but our grey matter goes first. As my head made an impressive thwack, I didn't hear the running play-by-play that usually accompanies Gunnar's finer moves but I bet it went something like, "aunt Heather rocks." It was worth the goose egg.

I have noticed, and not for the first time, that the 'trainer' conflicts with the aunt and I find myself trading mass doses of sugar for my 'cool aunt' title. The cost is not mine. I've dosed the two of them so heavily with sugar and caffeine that I thought one of them was going to blow a spark plug as they whirred through the house swinging blunt weapons and chattering nonsensically and nonstop. I tried to stuff chicken in Dustin after I unwisely bought him something called a 'Strawberry Colada' at Dunkin Donuts in town which happens to be the only place I get cell phone reception (thanks tons, Cingular).

I forget how hard it is to avoid crap especially if you're a teenager and things like 'Nutrition' mean nothing to you other than a boring science 'elective'. And establishing your dominance where adults are concerned can be as simple as slurping down a 'Strawberry Colada' and calling it dinner. I did however manage to make what I think is a positive impact. Yesterday, with a little prodding from Michael, I did three rounds of 21 Lunges, 21 push-ups and 21 Double-unders in the melting snow and mud of the cul-de-sac. My nephews took part. Well, if 'taking part' means pelting me with tennis balls using the lacrosse stick. Isn't 'accuracy' one of the lesser-applied measures of fitness?

Saturday, March 24, 2007

Is the Atkins Diet Healthier Than Previously Thought?

The Atkins diet, a low-carb, high-fat plan named after the doctor who created it, received high marks in one of the largest comparative studies of popular weight-loss plans.
It did better than the low-carb Zone diet, the low-fat, high-carb Ornish diet. and U.S. federal guidelines.
The study involved over 300 women; they attended weekly diet classes for eight weeks, and then were left to their own devices for the following 10 months.
Overweight women on Atkins lost more weight (10 pounds on average) over the course of the year than those on the other diet plans (between 3.5 and 6 pounds). Women on Atkins also had somewhat better blood pressure and cholesterol readings than those on other plans. This could mean that Atkins is healthier than its critics allege.However, it should be noted that by the end of the study, few participants were following any of the diets very strictly. Zone diet creator Barry Sears said that the study "had a good concept and incredibly pathetic execution."
Journal of the American Medical Association March 7, 2007

Wednesday, March 21, 2007

What matters

When your life is in crisis, at what point are you allowed to pull the rip cord on your own downward spiral? Is it selfish to consider your own health in the face of your mother's life threatening illness? As you can imagine, it's become a point to ponder with me. Am I self-centered or self-aware?

It's clear I won't be sleeping so it's outside of my consideration. Between the stress of hospital days and seeing my mother's vulnerability for the first time in my life, I must also contend with my sister's couch that is just a few inches too short, the heater that's just a few degrees too cold and the three cat's that are three cats too many for uninterrupted slumber.
So in the triad of health - rest, exercise, nutrition - I'm already handicapped. But then, does my sleep really matter?

Then of course, my nutrition is McGyver style complete with tons and tons of Jerky. None of which I prepared myself with primitive tools and roadkill.
No, I went to 'Grainful', the only 'health food' store in town which, given my aversion to grains, was suspect from the start. But I did find jerky, bless their small town hearts. My urge, of course, is to overmedicate with comfort food but that serves no purpose so I've done the best I can to stay on track. But then, does my nutrition really matter?

If standing upright on occasion counts as exercise, I'm golden. Given the look I'd give a client if they answered any question that way, I'm assuming it doesn't. I brought my jump rope and I try to look for opportunities but until the biopsy results, I think I'll give myself a pass even though my body desperately misses it. But then, does my exercise really matter?

In truth, all of those things matter to my mother. She woke up and her big brown eyes focused on me. "You look pale. You haven't been sleeping," she said before she tucked her head back down and was pulled back into restless sleep by painkillers and fatigue. Eventually I'll remember that all of those things matter to me too, but right now it's one of the few things I can do for my mother.

Today she asked my sister and me if she's going to die. She seemed surprised by the idea and so did I. In truth she was going to die the day she was diagnosed with Diabetes but I'm grateful that in her lifetime she slept well, ate well, and exercised otherwise I would have lost her long ago. For the people who want me around, it's the least I can do for them and my mother, who loves me, and who taught me how.

Tuesday, March 20, 2007

Tell me what we need to do to get you out of here

I told my frail, thin mother as I bent to hug her in her hospital bed. She's been in the ICU of Cottage Hospital in Woodsville, NH for a couple of days suffering from complications of diabetes and tumors on her lungs.

My mother, who I often refer to as the Warrior Queen, has fought a long and brave battle with an illness that's poorly understood in spite of all we think we know. She's refused insulin for almost forty years because the science never made sense to her. When I first learned about her illness and understood what she was trying to do, I thought she was crazy. So did most everyone else.

She refused because she has a working pancreas that produces insulin. When she was told that she didn't absorb insulin on a cellular level - insulin resistance - which was why they were going to give her insulin she didn't think it made much sense. When she was told she'd die without it, she said, "No. And you're going to tell me how not to." Dr. Rowe, looked surprised but he knew my mother. He gave her some guidelines to follow, wished her luck and offered support.

She started controlling her diet long before anyone really even knew much about high glycemic and low glycemic carbohydrates and when Peanut M&M's were still on the 'low Glycemic / Diabetic Approved' list.

I was awed by her effort and I tried to help mainly because I couldn't sit idle if she was in jeopardy. I learned things about diabetes that contradicted everything books and doctors tried to teach me. When all her insulin dependent diabetic friends first endured the amputations before dying a slow death, she remained active and frankly, angry. I still worried though when she refused to use the glucometer I bought her.

Whenever she made mistakes with her sugar - too much carbohydrate - she walked up and down the stairs until her blood sugar came down. She ate regular meals and kept moving and she prepared all her food at home. Yes, there were still bad habits. The stale marshmallow peeps at Easter and the slices of pound cake in the toaster with butter. I looked the other way because for the most part, she was tenacious and diligent. Plus, as I might of mentioned, the woman is fierce.

This trip to the hospital scared us all. Including the one woman who always looked unshakeable. In her thin little gown, you can see the impact of a battle long fought. Though she was stoic on the phone, convincing my sister and I to stay away, she had lost control and she knew it. She had fallen months back, bruised her hip and was inactive. While she tried to wait out a recovery, her blood sugar went awry and she wasted away.

As she lay there, 77 pounds and all big scared brown eyes, she looked fragile for the first time. Still I don't doubt her. Even at 77 pounds, there's a woman who can kick my ass with nothing but that will of steel. I can't even see how she'll get better from here but if she chooses, she'll defy this too.

I'm frustrated though, because people look at what she's done and see neglect and superstition without seeing the courage of a forty year battle that no doctor ever expected her to win. They don't see how well she educated herself and what close attention she paid. No matter how she leaves, they will blame her and maybe even me, her daughter. But the system blames all diabetics. I've seen it because at PRO Club, I've been around it for so many years. Usually they just blame them for obesity and for creating the disease themselves. They couldn't do that with my mom because she is a 'Diabetic Anomaly', that's what they call Type II patients that aren't obese.

An anomaly, she's not. Many people walk around with bad eating habits poised to overtake them. The way Greg Glassman explains it, wellness isn't close enough. If you're not thriving, there are only a few quick steps from your grip on wellness to that of illness. I was over 2,000 miles away from the ER where my mother's steps took her.

As you can imagine, I'm here in New Hampshire for awhile commandeering my nephews computer and with little or no cell phone coverage. I'll keep you posted though, I suspect not often, until I can go home to Seattle.

Wednesday, March 14, 2007

Cheese Enzymocide

I've more than once mentioned that unpasteurized dairy products are a good source of healthy enzymes that may keep your tendons healthy. I wish I could give you firsthand evidence but, since my one and only experiment with goats milk made my stomach expand to three times its normal size, I elected to abort further study. Lactose intolerance or demonic possession - wasn't pretty either way.

Since I mentioned it, I'm sure you've been yearning to have an answer to the question, "what about unpasteurized cheese?" Honestly, my nights were sleepless and I've saved you from having to make that crazy dash to the cheese counter. I did it for you.

It turns out that making cheese requires the heating of milk to a temperature above that of pasteurization. Since it's the heat that kills enzymes, it's safe to assume that the process of making cheese causes a similar enzymocide. Next question: why pay extra for unpasteurized cheese unless it has something to do with flavor? Feel free to pester the cheese counter folks with that one. My job is done on the subject but say hello to the cheddar for me . . . sigh.

Monday, March 12, 2007

Maybe You Should Eat Real Food

If I didn't make it clear in the last post why supplementation is confusing, check out this excerpt from T-Nation:

Nutritional Crime of the Century
by TC

There are a few people or groups you just don't screw with. You don't want to piss off the mob, the Klan, or the Crips, and you sure as hell don't want to make fun of Kim Jong Il's haircut.

But the aforementioned pale in comparison when it comes to the vindictive nature of most nutritional scientists and certified dietitians. Okay, okay, I'm exaggerating, but these last two groups — and I guess, at least peripherally, I'm one of them — have screwed you up. Maybe it wasn't intentional, but you were screwed nonetheless.

I bet you can't even look at a piece of food without consciously or subconsciously agonizing over its alleged nutritional value, judging whether it contains the correct amount of fiber, the correct macronutrient ratio, life-giving vitamins, antioxidants, and fatty acids.
Oh, you poor sap.

We puff out our chests and tell you what foods to eat, which vitamins to consume and which antioxidants (chortle) you should eat to fight cancer.

Then, then, when some study comes out, as it did last week in JAMA, that high doses of certain antioxidants (Vitamins A and E) could actually cause cancer, we cough nervously, clear our throats, and mutter something about the vagaries of science.

Take a look at the following list of chemicals, all anti-oxidants:
4-Terpineol, alanine, anethole, apigenin, ascorbic acid, beta carotene, caffeic acid, camphene, carvacrol, chlorogenic acid, chrysoeriol, eriodictyol, eugenol, ferulic acid, gallic acid, gamma-terpinene isocholorgenic acid, isoeugenol, isothymonin, kaempferol, labiatic acid, lauric acid, linalyl acetate, luteolin, methionine, myrcene, myristic acid, naringenin, oleanolic acid, p-coumoric acid, p-hydroxy-benzoic acid, palmitic acid, rosmarinic acid, selenium, tannin, thymol, tryptophan, ursolic acid, vanillic acid

Must be the label of the latest vitamin from the Centrum people, right? Nope, they're the antioxidants contained in a simple piece of thyme. (Thyme is the green crap your mother sprinkles on the rib roast to add flavor.)

And don't think for a second that thyme is some wonder food. I just used it as an example of how antioxidants are everywhere and how their number is legion.

Yet garden-variety nutritionists deem to study a handful of them here and there and make blanket recommendations. They ignore the possible complex interactions between them and other chemicals; they don't take into consideration that maybe the alleged healthful benefits of any one antioxidant might be dependent on being ingested simultaneously with one, two, or a dozen other antioxidants or phytochemicals. They ignore what I've publicly worried about for years, that taking large amounts might actually turn antioxidants into pro-oxidants — chemicals that actually cause free radicals to be formed.

What balls. What hubris.

Supplemental Education

I just had a friend ask me to give him some advice about vitamins. I believe my answer went something like, "ask somebody smarter." Vitamins are the technological gadgetry of nutrition. If you check out for a bit, you get passed by and before you know it you're standing in the vitamin isle as if you've just upgraded technology and encountered a new operating system. I imagine there's some low-tech equivalent to the frantic mouse-clicking panic that happens when you suddenly realize you have no idea what you're doing. I gave him a mouse-clicking response and threw a lateral to PCC or Whole Foods nutrition (excuse me, Whole Body) department.

The following article from PT on the Net illustrates the point. Though I agree with some of the following, I disagree with parts of it. And there will continue to be contradictions and voodoo magic that accompanies this murky science. I still say, go visit the wizards of this dark art at PCC or Whole Foods and bring with you a healthy scepticism, common sense and a healing crystal. Oh, and eat better food.

Top 10 Supplement Facts You Probably Didn't Know
By Joe Cannon

Fact #1. Natural vitamins are not better than synthetic vitamins.

A common mistake made not only by the general public but also by many fitness professionals as well is that vitamins made in nature are superior to synthetically-made vitamins. The fact is that the chemical structure of synthetic and natural vitamins is basically identical. In other words, synthetic vitamin C looks the same as natural vitamin C. This means that your body cannot tell the difference between them. In some instances, the absorption of vitamins can differ between natural and synthetic, but this does not always favor natural vitamins. For example, folic acid, common among prenatal vitamins, is actually the synthetic version of the B vitamin, folate. Folic acid is used in prenatal vitamins because it is better absorbed.

Fact #2. - Censored for your safety

Please do not believe what you read about soy or cholesterol. There's more information on this to come, in the meantime, the above advice is an industry standard that should be ignored. Please remember that Soy is the #2 crop produced in this country and that the food industry is compelled to find markets for it. Link to the article if you want to read what the author had to say. I felt compelled to delete it because those of you who 'ticker' read, would have missed my objection.

Fact #3. Vitamins do not give us energy.

Some people may take massive amounts of vitamins (especially B vitamins) in the hopes that they will provide more pep to get through hectic days. This is why you often see a lot of B vitamins in energy drinks. However, a problem arises when it becomes known that vitamins do not contain any usable energy (calories). Vitamins do help us extract energy from food and process it. In a malnourished person, such vitamins may indeed help, but for those who eat an even halfway decent diet, vitamins alone are unlikely to improve energy levels. Remember, vitamins and food work in concert with each other to keep us healthy and provide us with the energy we need.

For those of you who missed it the first couple of hundred times I said it, eat better food.

Fact #4. Glucosamine may help arthritis.

Many studies over the last several years found that glucosamine may help reduce arthritis-related pain. For glucosamine to work, you must have osteoarthritis. Of the over 100 types of arthritis known to exist, osteoarthritis is the most common and results when the cartilage between bones wears away. This is the type of arthritis that responds to glucosamine. While the degree of osteoarthritis and length of time you have it may impact success with this nutrient, studies tend show that four to eight weeks of glucosamine supplementation may be needed before results are observed. For best results, look for glucosamine sulfate as this form has the most evidence that it might help.

Fact #5. Natural does not always mean safe.

A common mantra repeated on many web sites today is that because supplements are natural, they are automatically safe for everyone. On the contrary, some supplements, if used by the wrong people may have significant side effects. For example, St. John’s wort, which is typically used for depression, may interact with not only antidepressant drugs but also those used to treat cancer and AIDS. Vitamin E might reduce the blood’s ability to clot. This is the reason why doctors typically tell their patients to stop using vitamin E before surgery. While many supplements are indeed safe, it is also true that people should know what they put in their bodies.

Fact #6. To build the most muscle, eat your protein after working out.

Frequently, I am asked the question, “When is the best time to eat protein, before or after exercise?” While your body will absorb protein no matter when you eat it, new research suggests that after exercise may be better than before exercise. In a study of older individuals who lifted weights, researchers found that people who ate protein immediately after exercise built more muscle than seniors who ate protein two hours later. While this study investigated the effects of protein and strength training in seniors, there is little reason to doubt that the same effect would not be seen in younger persons. If you like to eat protein before exercise, that’s fine. Just remember to also eat some protein (and carbs) preferably within 30 to 60 minutes after exercise to get the best results.

In fact, many sources recommend a 4/1 ratio of protein to carbohydrates post workout. I've had people tell me this works fabulously, however, I've found that if your nutrition is sound most of the time, this formula isn't necessary. There are studies that show great results with chocolate milk since the ratio is about right. I say, whenever chocolate milk becomes 'health food' you should be skeptical.

Fact #7. The government does regulate supplements.

It’s often stated that the US government doesn’t regulate supplements. In reality, it does, but the regulations are different than those used for medications. The government has a very lengthy definition to describe what can and cannot be called a “supplement.” While this does allow for a wide range of products to be sold, the definition does have limits. For example, some hormones are not permitted to be sold as supplements. Another stipulation is that supplement companies cannot make specific claims that a product can treat or cure any diseases or conditions. Doing so might confuse people and make the product appear to be like a drug.

In contrast, supplement labels can list what are called structure/function claims. These claims make reference to how a supplement is involved in helping the body. For example, the claim that a supplement helps keep bones strong is a structure/function claim. Structure/function claims are pretty easy to identify because they usually contain words like supports, aids or maintains.

Fact #8. You CAN absorb more than 40 grams of protein at a time.

There is an urban legend circulating through some fitness circles that maintains that people can only absorb a certain amount of protein per meal. Usually, people say this amount is about 40 grams. This may be why some protein bars and shakes usually do not contain much more than this amount. Regardless, while we can indeed utilize more than 40 grams of protein per meal, the real question is whether or not all of that protein is going to build and maintain muscle. This is a much harder question to answer and depends on your exercise routine, how often you work out and how much rest you get, to name a few.

I've read this in a variety of forms. I believe the first place I saw it was in 'Natural Hormonal Enhancement' by Rob Faigin. I'm not sure which way I'm leaning but if you consume protein in the form of real food, you may find it's self limiting based on how much chewing you can tolerate in one sitting and how full you get.

Fact #9. Extra vitamins will not make you a better athlete.

While a good quality multivitamin is probably something to consider, many studies have found that extra vitamins do not make people stronger, faster or improve any exercise-related activity. As a rule, people who exercise regularly tend to eat more food and make healthier food choices overall. Food is also a very good source of vitamins. So the more food people are eating, the more vitamins they tend to eat as well.

Fact #10. Even if you eat a healthy diet, you might still benefit from supplements.

Sometimes people email me and ask, “Do I need supplements if I eat well”? It turns out that the answer appears to depend on who you are. Research shows that some supplements may benefit certain groups of people when used above what is normally consumed in a typical diet. For example, it is well known that as people grow older, they tend to eat less. This can have disastrous consequences by leading to muscle and strength loss and a reduced quality of life. Some new research is finding that the branch chain amino acids (leucine, isoleucine and valine) can stimulate appetite in older adults. Potentially, if you can stimulate appetite, this might lead to stronger muscles and a better chance of remaining independent to a ripe old age. Another example is the amino acid glutamine. Studies tend to show that when consumed at higher amounts than is normally eaten, glutamine may lead to shorter hospital stays and increased body weight in some cancer patients.

Sunday, March 11, 2007

Thin Mint Meltdown

Whenever I get up on my high horse, there seems to be a cell phone strapped to the saddle. Luckily for the unfortunate souls on speed dial, my cell phone generally drops my call in mid sentence which causes the necessary break for introspection. I like to think my cell phone comes with an added feature I call 'rant guard'. My Blog has no such feature and I can occasionally rant without interruption which makes this the perfect occasion to bring up Girl Scout Cookies.

First; Blasphemy. Thin mints aren't that good and neither are tag-a-longs. They're one shoddy glaze or waxy peanut butter filling away from Danish Butter Cookies, Walker's Shortbread, Lorna Doone's or a random single-serving "gourmet" box lunch cookie pack. None of those are ever truly savored, except the Lorna Doone's by my mother who also enjoys stale Easter Peeps and 'Circus Peanuts'. We'd brush them aside like a garnish if we weren't deprived of them 11 months out of the year.

Girl Scout cookies really are just a guiltless excuse to eat empty calories for a cause. The option exists to write the check with no exchange of cookies for cash. Just write the check. Then there's no chance you'll walk in the door from the office, drop your armload of stuff, slip off your shoes and demolish an entire box of Somoa's over the sink.

Girl Scout Cookies are designed to be one of those mindless eating moments. You can identify it by the fact that you often can't swallow fast enough before the next cookie disappears behind your teeth. I've seen it, I've heard about it, and I've done it. I got over it because I couldn't afford to toss my nutrition under the bus and because I remind myself that it's meant to be a fundraiser not just a cookie sale. Even if you only eat one or two a day, there are 3,500 calories in a pound whether you ate them over the sink or sneaked them here and there after dinner. And good Samaritan calories count.

There are better cookies to be had out there. Don't trick yourself into thinking that Girl Scout Cookies are all that and a glass of milk. Write the check if you have to but turn your back on the boxes.

Monday, March 5, 2007

Ratios Revisited

In my post on inflammation I made quick mention of Omega-3/Omega-6 ratio without elaborating. It's a topic I've covered before. It's possible, however, that you don't read everything I write - hard to fathom. My mom always does. Here's an abstract that sums things up without having to reread one of those incredibly long posts that I'm sure you enjoyed.

Long Slow Heart Attack

I'm always a little cautious about printing anything that comes from ACE. That's in part because I don't always trust their motives and also because their studies usually consist of control groups of under 100. I do think it's significant when they can't ignore something many of us have been talking about for a long time. Because when the data trickles down so far that even conservative organizations have to poke at it a little, it's a sign that things might be changing.

Prolonged exercise may NOT be good for be good for your heart

The cardio-respiratory benefits of moderate to vigorous aerobic exercise are well documented. It is not as common, however, to hear that exercise may actually cause excessive cardiac damage. Past research has found that an acute bout of vigorous exercise may impair contractility, elevate of blood markers of cardiac stress, and promote excessive increases in arterial pressures.

Researchers in Great Britain now report that impairment to heart function may occur as a consequence of high frequency endurance training specifically in highly-trained endurance athletes. Ten (10) very highly-trained male long distance runners who had been training at least 5 days per week completed a 15.3 mile run over mountainous terrain each day for 3 consecutive days. Markers of cardiac damage in blood were assessed immediately post-exercise, at 1 hour, and 20 hours post-exercise, and researchers measured Ejection Fraction (EF) via echocardiogram to determine Left Ventricular Function (LVF) at equivalent intervals.

The most significant outcome of this experiment was the reduction in LVF after the third exercise bout. Impairment persisted through the final echocardiogramat 20 hours, however, researchers could not conclude the duration of the dysfunction. An assumption was made based on prior research, which had indicated a return to normal function between 24 and 48 hours. At no point were any of the participants in danger as EF did not drop below clinical values,which are less than 50%.

The value of this study was implied to rest with the Endurance/Ultra-endurance athlete and military personnel who are exposed to long-duration training on a daily basis. There should also be concern for the deconditioned individual whois experiencing cardiac stress from exercise volume and intensity relative to that of the endurance athletes in this study. To prevent excessive cardiac stress, intensity and duration should be varied regularly to promote adequate recovery. Heart rate and blood pressure should be assessed frequently and may help to estimate proper recovery time between sessions. Middleton, N. et al (2007) Impact of Repeated Prolonged Exercise Bouts on Cardiac Function and Biomarkers. Medicine and Science in Sports and Exercise.39 (1): 83-90.

Friday, March 2, 2007

Nothing Nice About Chronic Swell

When I go to parties, I sometimes tell people I'm a landscaper. It guarantees nobody will ask me questions like they do when I say I'm a trainer. But it's not the questions that are hard, it's the answers. Most people don't like them, few people listen to them and many spend the rest of the night telling me in painstaking detail the multitude of reasons they can't follow any of my advice. Besides, it's the wrong angle to take because if I could explain foods impact beyond the tedium of spare tires it would light sparks. If instead I could get everyone to educate themselves about inflammation, without sounding like Cassandra of course, diets would change, waistlines would shrink and doctors would have enough time to frequent parties where they could field questions about random medical research posed by landscapers.

When I say inflammation, I'm not talking about a reaction to blunt force trauma - it makes for more compelling party chatter but it's not relevant to any of the guests other than those in the room who tend towards tipsy. I'm talking about chronic inflammation in reaction to food, in response to imbalanced polyunsaturated fats and as a byproduct of stress.

Systemic inflammation in it's most obvious form, contributes to heart disease. At it's most diabolical, however, it manifests itself as insulin resistance. It's a sneaky hemorrhaging of health and vitality and nobody seems to be talking about it at social gatherings.

In matters of the heart, cholesterol's role continues to be misunderstood while C-reactive protein (CPR), an acute phase protein that increases during systemic inflammation, remains a greater mystery to most in spite of the fact that it's a far better marker of cardiovascular disease risk. According to 'Inflammation, Heart Disease and Stroke: The Role of C-Reactive Protein' from the American Heart Assoc., "The American Association and the Centers for Disease Control and Prevention recently published a joint scientific statement about using inflammatory markers in clinical and public health practice. This statement was developed after systematically reviewing the evidence of association between inflammatory markers (mainly CRP) and coronary heart disease and stroke." Though this is obviously known well enough to be discussed in mainstream arenas, doctors still don't appear to be incorporating regular testing.

Notably not a topic for a casual chat with strangers especially over communal Hors d'Ĺ“uvres, infectious disease may also be a contributor. Also mentioned by the American Heart Assoc., "Possible infectious bacteria include Chlamydia pneumoniae and Helicobacter pylori. Possible viral agents include herpes simplex virus and cytomegalovirus. Thus, it may be that antimicrobial or antiviral therapies will someday join other therapies used to prevent heart attacks." Fabulous - talk of chlamydia and herpes - a guarantee that by the end of your dinner party repartee you won't contract either one of them.

Talk of antimicrobials should have been an a-ha moment for those of you who regularly read my blog. I've talked about the antimicrobial properties of saturated fats and enzymes in raw dairy. I feel the vibe of all my regular folks, leaning out of their seats and thrusting hands in the air. "Ooh, ooh, I know this one. . . ."

For me, the link between insulin resistance and inflammation is far more compelling. If hipster jeans did anything other than make the dressing room experience even more horrifying, they exposed the telltale Syndrome-X bellies of the walking wounded. So many of us are suffering from mild symptoms of a snowballing problem that could and should be addressed now. The cruel part is that even the stress of growing bellies could be growing your belly since stress has proven to be a big part of the equation.

This link is discussed in research done by the Department of Microbiology, Boston University School of Medicine. "Evidence is presented that the liver, the endothelium, and fat cell depots are the primary sources of cytokines, particularly IL-6, and that IL-6 and the acute phase protein (APP), C-reactive protein (CRP), are strongly associated with, and likely play a dominant role in, the development of this inflammatory process which leads to insulin resistance, non-insulin dependent diabetes mellitus type II, and Metabolic syndrome X. The possible role of psychological stress and the major stress-related hormones as etiologic factors in the pathogenesis of these metabolic diseases, as well as atherosclerosis, is discussed. The fact that stress can activate an APR, which is part of the innate immune inflammatory response, is evidence that the inflammatory response is contained within the stress response or that stress can induce an inflammatory response. The evidence that the stress, inflammatory, and immune systems all evolved from a single cell, the phagocyte, is further evidence for their intimate relationship which almost certainly was maintained throughout evolution."

And while we're on the subject, what is WAT and what does it have to do with anything? I'll let the research explain it:

It now appears that, in most obese patients, obesity is associated with a low-grade inflammation of white adipose tissue (WAT) resulting from chronic activation of the innate immune system and which can subsequently lead to insulin resistance, impaired glucose tolerance and even diabetes. WAT is the physiological site of energy storage as lipids. In addition, it has been more recently recognized as an active participant in numerous physiological and pathophysiological processes. In obesity, WAT is characterized by an increased production and secretion of a wide range of inflammatory molecules including TNF-alpha and interleukin-6 (IL-6), which may have local effects on WAT physiology but also systemic effects on other organs. Recent data indicate that obese WAT is infiltrated by macrophages, which may be a major source of locally-produced pro-inflammatory cytokines. Interestingly, weight loss is associated with a reduction in the macrophage infiltration of WAT and an improvement of the inflammatory profile of gene expression.

Several factors derived not only from adipocytes but also from infiltrated macrophages probably contribute to the pathogenesis of insulin resistance. Most of them are overproduced during obesity, including leptin, TNF-alpha, IL-6 and resistin. Conversely, expression and plasma levels of adiponectin, an insulin-sensitising effector, are down-regulated during obesity. Leptin could modulate TNF-alpha production and macrophage activation. TNF-alpha is overproduced in adipose tissue of several rodent models of obesity and has an important role in the pathogenesis of insulin resistance in these species. However, its actual involvement in glucose metabolism disorders in humans remains controversial. IL-6 production by human adipose tissue increases during obesity. It may induce hepatic CRP synthesis and may promote the onset of cardiovascular complications. Both TNF-alpha and IL-6 can alter insulin sensitivity by triggering different key steps in the insulin signalling pathway.

In rodents, resistin can induce insulin resistance, while its implication in the control of insulin sensitivity is still a matter of debate in humans. Adiponectin is highly expressed in WAT, and circulating adiponectin levels are decreased in subjects with obesity-related insulin resistance, type 2 diabetes and coronary heart disease. Adiponectin inhibits liver neoglucogenesis and promotes fatty acid oxidation in skeletal muscle. In addition, adiponectin counteracts the pro-inflammatory effects of TNF-alpha on the arterial wall and probably protects against the development of arteriosclerosis. In obesity, the pro-inflammatory effects of cytokines through intracellular signalling pathways involve the NF-kappaB and JNK systems.

Scary, yes? So next time, can we talk about your job?