Is The Mediterranean Diet Really All That?

This study about supposed benefits of a Mediterranean diet is making news:

Primary Prevention of Cardiovascular Disease with a Mediterranean Diet, New England Journal of Medicine, 25 February 2013

7447 people "with no cardiovascular disease at enrollment" were randomly assigned to one of 3 diets. After ~4.8 years into the study:

• 96 people assigned to the Mediterranean diet plus olive oil (about 4 tablespoons/day) group experienced a major cardiovascular event.
• 83 people assigned to the Mediterranean diet plus nuts (about 1 ounce/day mixed - 15 g walnuts, 7.5 g almonds, 7.5 g hazelnuts) group experienced a major cardiovascular event.
• 109 people assigned to the control diet (advised to reduce fat but didn't) experienced a major cardiovascular event.

Why did 179 people who had no cardiovascular disease (CVD) prior to entry into this study experience heart attacks or strokes after eating a Mediterranean diet supplemented with olive oil or nuts? It sounds like what they were doing before they started supplementing their diets with olive oil and nuts protected them more from CVD, since they apparently developed it only after partaking in the study.

Dr. Esselstyn had much better success with his plant-based, oil-free diet and his patients did have CVD:

"The patients in Dr. Esselstyn’s initial study came to him with advanced coronary artery disease. Despite the aggressive treatment they received, among them bypasses and angioplasties, 5 of the original group were told by their cardiologists they had less than a year to live. Within months on Dr. Esselstyn’s program, their cholesterol levels, angina symptoms, and blood flow improved dramatically. Twelve years later 17 compliant patients had no further cardiac events. Adherent patients survived beyond twenty years free of symptoms."

Back to the present study ... There was a 30% reduction in risk (of a "major cardiovascular event" but only stroke reached significance) for eating the Mediterranean diet, but this article from the New York Times said:

"Those assigned to a low-fat diet did not lower their fat intake very much. So the study wound up comparing the usual modern diet, with its regular consumption of red meat, sodas and commercial baked goods, with a diet that shunned all that."

The authors said so much:

"We acknowledge that, even though participants in the control group received advice to reduce fat intake, changes in total fat were small."

Perhaps the benefit was due to eliminating red meat, soda, commercial baked goods, and dairy (the control group was advised to consume 3 or more servings of dairy a day, the Mediterranean diet groups were not) and not due to eating olive oil or nuts. It's hard to say since the authors did not divulge what participants in each group ended up eating. (Update: I was wrong about this. I just reviewed the supplemental materials. Here are some additional facts:

• The control group, which had been advised to eat a low-fat diet, was eating 37% of their calories from fat. The low-fat diet community says a low-fat diet gets 10-12% of its calories from fat. The American Heart Association says a low-fat diet is <30% fat. By any standard, this was not a low-fat diet.
• Both Mediterranean diet groups ate more vegetables, fruits, legumes, wine, and seafood than the control group. (Table S5, p<0.05).
• The Mediterranean diet groups did not reduce risk for heart attack, death from cardiovascular causes, or death from any cause. "Only the comparisons of stroke risk reached statistical significance."

Given Esselstyn's scorecard, people eating the Mediterranean diets in this study could have reduced their CVD risk further by reducing intake of processed fats (including olive oil) and nuts.

This study was conceived and conducted in Spain. The olive oil and nuts given to participants were supplied by producers in Spain, who were probably very happy to see the results lauding oil and nuts' benefits published in a prestigious journal. Also, the authors of this study report the following conflicts of interest:

• Research Foundation on Wine and Nutrition
• Beer and Health Foundation
• European Foundation for Alcohol Research
• California Walnut Commission
• International Nut and Dried Fruit Council
• Mediterranean Diet Foundation
• OmegaForte

________That's a photo of my olive oil and walnut. I like both, but I don't eat anything near the amounts in this study.

Egrets Fishing

"The black egret (or heron) must be one of nature's most creative hunters. Watch as it displays its clever "umbrella" hunting tactic while it stalks fish in the shallows of Botswana's Okavango Delta."
- EarthTouch




________

The Label Game

Labels lie - whether it's meat labeled beef which is actually horse, pig, and donkey, or whether it's salmon labeled "wild" which is actually farmed. This last example was revealed today in a survey conducted by the international ocean conservation group Oceana:

Oceana Study Reveals Seafood Fraud Nationwide

Oceana found that about one-third of the 1,215 fish samples it purchased from 2010 to 2012 were mislabeled. Also:

• In the 120 samples labeled red snapper, 28 different species of fish were found, including 17 that were not even in the snapper family. Only 7 of the 120 samples of red snapper were actually red snapper.
• In New York, fish that was not really tuna was being passed off as tuna in 94 percent of the samples taken.
• Almost two-thirds of “wild” salmon samples were found actually to be farmed Atlantic salmon, which is considered less healthy and less environmentally sustainable.
• Tilefish — known for its mercury content and on federal advisory lists for sensitive populations to avoid — was sold as red snapper and halibut.

While consumers are wringing their hands over whether to believe the labels on beef and fish, the FDA has been wringing its hands over whether to approve, with or without a label, genetically engineered (GE) salmon. In a possibly unprecedented move last week, the FDA extended its comment period by 60 days in order to invite further feedback and process the deluge of public comments on the production of AquaAdvantage's GE salmon.

It makes me wonder how much it matters - the label. If farmed salmon is today getting passed off as wild, why would it not be conceivable that GE salmon would get passed off as non-GE? California's Proposition 37 in last November's election - which mandated that food containing GE ingredients be labeled as such (it didn't pass) - also seems like a moot move. Most corn and soy in this country is already GE. The label doesn't buy you much. Probably an opt-out label (like non-GMO or USDA Organic) would be more telling. Even then, the USDA Organic label is only 95% organic, and may degrade further if thoughts to allow GMOs in the definition come to fruition.

What might improve the integrity of a label would be regulations and enforcement, e.g. more inspections. It looks like we're going in the opposite direction:

USDA to Let Industry Self-Inspect Chicken

"The USDA hopes to save $85 million over three years by laying off 1,000 government inspectors and turning over their duties to company monitors who will staff the poultry processing lines in plants across the country."

Does that sound like a good idea? I can't imagine that the private sector cares as much about public health as the public sector. But if reducing federal spending and downsizing government were the objective, this may be a good idea.

Speaking of downsizing government ... I think the austerity measures across Europe will impact our food supply. We import 80% of our seafood and inspect only 1%. That 80% will likely see fewer inspections. Food producers and distributors will take more shortcuts and not be found out, which is already happening, e.g. cheaper meat from horses and pigs were sold as beef for a profit, and not many people noticed. (Does anyone know why Ireland's Food Standards Agency decided to test beef DNA in the first place?) The confluence of globalization of our food supply with austerity measures won't bode well for the quality and safety of food.
________

Goats Yelling Like Humans

________Thanks, BL.

Vitamin C Supplements Increase Risk For Kidney Stones

In a new study, taking vitamin C supplements (~1000 mg) led to a 2-fold increased risk for kidney stones in men.

Ascorbic Acid Supplements and Kidney Stone Incidence Among Men: A Prospective Study, JAMA Internal Medicine, February 2013.

"Ascorbic acid use was associated with a statistically significant 2-fold increased risk [of kidney stones]."

It was a large, prospective study involving 23,355 participants from the Cohort of Swedish Men.

The risk remained at 2-fold even after adjustment for possible confounders (e.g. age, education, BMI, alcohol, other nutrients including dietary intake of vitamin C, tea and coffee consumption, smoking, diabetes, high blood pressure). The risk was even higher if men took more than 7 vitamin C tablets per week. Vitamin C in food, and interestingly vitamin C in multivitamins did not increase risk.

The mechanism? Vitamin C or ascorbic acid can contribute to the development of kidney stones when some of it is metabolized to oxalate and excreted in urine via kidneys. The authors: "urinary oxalate is an important determinant of calcium oxalate kidney stone formation."

In a commentary that accompanied the study (The Risk of Taking Ascorbic Acid), Robert H. Fletcher, MD, of Harvard Medical School said:

"Randomized controlled trials have established that ascorbic acid does not prevent mortality; that is, there is strong, consistent evidence against its effectiveness, not just the absence of evidence supporting it. Similarly, there is consistent evidence from randomized trials that ascorbic acid does not prevent the onset of or death from cardiovascular disease or cancer — nor occurrence of the common cold, for that matter."

"This [2-fold increase] is not an insignificant risk. But more to the point, is any additional risk worthwhile if high-dose ascorbic acid is not effective?"

The RDA for vitamin C is ~90 mg/day.

The passing of a kidney stone is an acute condition. I can imagine that lower doses of vitamin C could lead to less overt chronic kidney problems, especially since there was a dose-response effect seen in this study.
________

Artwork By People Diagnosed With Autism

The book, Drawing Autism, is a collection of drawings and paintings by people diagnosed with autism.

The site 50 Watts, Drawing Autism posted a small selection of images from the book. The images sometimes include a brief statement from the artist. I've posted three; you can visit 50 Watts for more.

Below by Jessica Park: The Mark Twain House with the Diamond Eclipse and Venus, 1999.



Below by Felix at age 12: Imaginary City Map.

What was the inspiration for this piece? "Generally I start drawing one street on different spots on the edge of my paper. I make the streets grow toward one another."

Who are some artists that you like? "None. I study road maps and atlases in detail and generally I scroll the full track of our trips on Google Earth."

Below by David Barth at age 10: Vogels ("Birds" in Dutch), 2008.

From an email from David's mother to Jill Mullen: "His drawings often represent his current obsessions. In the attachment I send you, it's not hard to guess what's keeping him busy right now. There are almost 400 birds on it and he knows the names and Latin names of most of them."

There's a certain quality to these images. A sense of intense focus or devotion to a topic, and the repetition of the object of focus. But they are also quite distinct from one another. Just fascinating.

The CDC says:

• About 1 in 88 children has been identified with an autism spectrum disorder (ASD).
• ASDs are reported to occur in all racial, ethnic, and socioeconomic groups.
• ASDs are almost 5 times more common among boys (1 in 54) than among girls (1 in 252).

1 in 88 ... for a disorder that was relatively rare in my childhood. There's something going on.
________

90 Seconds, And Then It's Gone

"Dr. Jill Bolte Taylor is a Harvard-trained and published neuroanatomist who experienced a severe hemorrhage in the left hemisphere of her brain in 1996. On the afternoon of this rare form of stroke (AVM), she could not walk, talk, read, write, or recall any of her life. It took eight years for Dr. Jill to completely recover all of her functions and thinking ability. In 2008, Dr. Jill gave a presentation at the TED Conference in Monterey, CA, which has become the second most viewed TED Talk of all time."
- Dr. Jill Bolte Taylor

Here's her talk. She describes the particulars of her 4-hour, left-brain stroke, the experience of a right brain functioning without a left brain, and the lessons she learned during her 8-year recovery:
TED: Jill Bolte Taylor's Powerful Stroke Of Insight

Below is an excerpt of an interview she gave to Bleeping Herald (BH) in 2008. I posted this originally in 2008, but the interview looks to have since been removed. (Thanks to Dave Lull, the link now works).
Interview with Jill Bolte Taylor, Ph.D.
"Stroke of Insight"

Bleeping Herald: I love the part in your book where you discuss that when a person has a reaction to something in their environment, there's a 90 second chemical process that happens in the body and then after that, any remaining emotional response is just the person choosing to stay in that emotional loop.

Dr. Jill: The 90 second rule and then it's gone. It's predictable circuitry, so by paying attention to what circuits you are triggering and what that feels like inside of your body, you can recognize when it has happened. We all know what it feels like when we suddenly move into fear. Something happens in the external world and all of a sudden we experience a physiological response by our body that our mind would define as fear. So in my brain some circuit is saying something isn't safe and I need to go on full alert, those chemicals flush through my body to put my body on full alert, and for that to totally flush out of my body, it takes less than 90 seconds.

So, whether it's my fear circuitry or my anger circuitry or even my joy circuitry - it's really hard to hold a good belly laugh for more than 90 seconds naturally. The 90 second rule is totally empowering. That means for 90 seconds, I can watch this happen, I can feel this happen and I can watch it go away. After that, if I continue to feel that fear or feel that anger, I need to look at the thoughts I'm thinking that are re-stimulating that circuitry that is resulting in me having this physiology over and over again.

When you stay stuck in an emotional response, you're choosing it by choosing to continue thinking the same thoughts that retrigger it. We have this incredible ability in our minds to replay but as soon as you replay, you're not here, you're not in the present moment. You're still back in something else and if you continue to replay the exact same line and loop, then you have a predictable result. You can continue to make yourself mad all day and the more you obsess over whatever it is, the more you run that loop, then the more that loop gets energy of it's own to manifest itself with minimal amounts of thought, so it will then start on automatic. And it keeps reminding you, "Oh yeah, I was mad, I have to rethink that thought."

________

Raccoon Paw Prints

This is why it's so hard to have a garden. One night, it was pitch dark, I saw 4 raccoons partaking of the water I leave for the birds. They sit next to it, dip their weirdly-human hands into it and cup it up to their mouth. I rarely see them except in the middle of the night. But this tells me they're around more often than I think.



Close-up.



Here they crawl up to the planter I use to grow potatoes or beans.



They move slowly, not at all like a squirrel or a fox, more like a human. And they can climb! Boy can they. Just a fascinating creature.
________

Ice Form

Does anyone know what this is? I took the photo at 6:30 a.m. this morning. It was around 28 degrees F. There's nothing in the water underneath it. It just formed on its own overnight.





This is about an hour later, after the sun came up. It's still 28 degrees but it's starting to melt in the sunlight.




________

Culture Of Personality Vs. Culture Of Character

In her book, Quiet: The Power of Introverts In A World That Can't Stop Talking, Susan Cain describes a cultural shift that took place at the turn of the twentieth century. It coincided with the movement of people from isolated, rural communities to cities, a move spurred by industrialization and the increase in factories.

"Americans had shifted from what the influential historian Warren Susman called a Culture of Character to a Culture of Personality.

In the Culture of Character, the ideal self was serious, disciplined, and honorable. What counted was not so much the impression one made in public as how one behaved in private.

The word personality didn't exist in English until the eighteenth century, and the idea of "having a good personality" was not widespread until the twentieth."

"The social role demanded of all in the new Culture of Personality was that of performer," Susman famously wrote."

Performance and appearances came to be valued over character when Americans found themselves working alongside strangers and "employees."

Susman counted the words that appeared most frequently in the personality-driven advice manuals of the early twentieth century and compared them to the character guides of the nineteenth century.

From 19th century guides, representing a Culture of Character:

• Citizenship
• Duty
• Work
• Golden deeds
• Honor
• Reputation
• Morals
• Manners
• Integrity

From 20th century guides, representing a Culture of Personality:

• Magnetic
• Fascinating
• Stunning
• Attractive
• Glowing
• Dominant
• Forceful
• Energetic

________Photo is from a British sitcom which to me epitomizes the Culture of Personality. The main character is a woman (Hyacinth Bucket, who insisted her name be pronounced "Bouquet") obsessed with image. She's "a social-climbing snob who passes her time visiting stately homes, hosting "executive-style" candlelight suppers, bragging of her "white slimline telephone with automatic redial", and name-dropping at any hint of an opportunity."

Music: Van Morrison's "Into The Mystic," Studio Vs. Live

Morrison (from Belfast) wrote "Into The Mystic" in 1969. It was included in his "Moondance" album. Allmusic described it as "a song of such elemental beauty and grace as to stand as arguably the quintessential Morrison moment." It is one of Rolling Stone Magazine's 500 Greatest Songs of All Time.

Here's the studio version:



Live version:


________

Letter Of Condolence

Last December, shortly after his wife passed away, a man was sent a letter of condolence by the doctor who had treated her in the emergency room.



Transcript:

12/7/12

Dear Mr. [redacted],

I am the Emergency Medicine physician who treated your wife Mrs. [redacted] last Sunday in the Emergency Department at the New York Presbyterian Hospital. I learned only yesterday about her passing away and wanted to write to you to express my sadness. In my twenty years as a doctor in the Emergency Room, I have never written to a patient or a family member, as our encounters are typically hurried and do not always allow for more personal interaction. However, in your case, I felt a special connection to your wife [redacted] who was so engaging and cheerful in spite of her illness and trouble breathing. I was also touched by the fact that you seemed to be a very loving couple. You were highly supportive of her, asking the right questions with calm, care and concern. From my experience as a physician, I find that the love and support of a spouse or a family member is the most soothing gift, bringing peace and serenity to those critically ill.

I am sorry for your loss and I hope you can find comfort in the memory of your wife's great spirit and of your loving bond. My heartfelt condolences go out to you and your family.

(Signed)
________ From Letters of Note.

Attenborough Crawls To A Baby Rhino

David Attenborough Admits Crying Over Animals, The Telegraph, 5 February 2013

"At the end of the final episode, to be shown on Wednesday night, Sir David is shown in perhaps some of the most personal and moving moments of his career. The closing credits show the 86-year-old presenter on his hands and knees exchanging "squeaks" with a blind baby rhino.

Asked if he had ever cried after seeing an animal suffer, he replied: “Oh of course. I’ve been deeply moved and upset and worried. How can you not be?”

But he said it was not appropriate for a presenter to show emotion: "That’s making an exhibition of myself and that’s not what it’s all about.” "

Here's the video (or at least the link to the video, I can't embed it) of Attenborough engaging the baby rhino. I love his curiosity and his tenderness.


________

The Risk Of Supplementing With Folic Acid

In 1998, the FDA required certain foods to be fortified with folic acid, e.g. flour (breads, pasta, cookies, crackers, cakes), cereals, cornmeal, and rice. A slice of fortified bread might now contain between 50-200 mcg folic acid, breakfast cereals between 100-400 mcg per serving. The RDA is 400 mcg.

Is there anything risky about getting more than 400 mcg? Yes. Folic acid can mask a vitamin B12 deficiency that can lead to nerve damage.

There's also damage to the colon from too much folate:

Altered Folate Availability Modifies The Molecular Environment Of The Human Colorectum: Implications For Colorectal Carcinogenesis, Cancer Prevention Research, April, 2011

"Excessive folate supplementation [1000 mcg] might promote colorectal carcinogenesis by enhancing proinflammatory and immune response pathways."

Cancer Incidence And Mortality After Treatment With Folic Acid And Vitamin B12, JAMA, 2009

"Conclusion: Treatment with folic acid [800 mcg] plus vitamin B12 [400 mcg] was associated with increased cancer outcomes and all-cause mortality in patients with ischemic heart disease in Norway, where there is no folic acid fortification of foods."

A basic multivitamin usually contains at least 400 mcg, but so does a bowl of fortified breakfast cereal. Add some pasta and a piece or two of bread, which are now fortified, and you're well over 800 mcg. Let alone all the other foods that naturally contain folate, like spinach (1/2 cup cooked: 130 mcg), black-eyes peas (1/2 cup: 105 mcg), or beef liver (3 oz: 215 mcg).

Is it any wonder so many people have irritable bowel syndrome? Maybe it's not the wheat or the gluten. Maybe it's what's been added to the wheat. Or maybe it's the vitamin pill. Maybe doctors should stop recommending so many supplements.
________Thanks, RB, for getting me started.

Advertisement Or Health Advice?

Saw this article in the Healthy Living section of the Huffington Post today:
Savvy Supplement Shopping, Mark Hyman, MD, 6 February 2013

Hyman warns of "large-scale nutritional deficiencies in our population" and recommends taking the following supplements "to help overcome diabesity":

• A high-quality multi-vitamin and mineral.
• 1,000 to 2,000 IU of Vitamin D3 a day with breakfast.
• 500-1,000 mg of omega-3 fats (should contain a ratio of approximately 300/200 EPA/DHA), once with breakfast and once with dinner.
• 100-200 mg of magnesium, once with breakfast and once with dinner.
• 300 to 600 mg alpha lipoic acid a day, once with breakfast and once with dinner.
• 200 to 600 mcg chromium polynicotinate a day (up to 1,200 mcg a day can be helpful).
• 0.5-1 mg biotin, once with breakfast and once with dinner.
• 125-250 mg cinnamon, once with breakfast and once with dinner.
• 25-50 mg green tea catechins, once with breakfast and once with dinner.
• 2 to 5 grams of PGX fiber in powder or capsules, 15 minutes before each meal with 8 ounces of water.

To learn more about specific products and brands he recommends? Visit his website. Buy his book. You can even get online help in selecting supplements from his "nutrition coaching team." A $100/hour value but for you ... $19.99/month.

This is an advertisement masquerading as health advice.

Update:: At least when it comes to heart disease, supplements don't buy you much. In this brand new meta-analysis of 50 randomized control trials, "supplementation with vitamins and antioxidants was not associated with reductions in the risk of major cardiovascular events."

Efficacy Of Vitamin And Antioxidant Supplements In Prevention Of Cardiovascular Disease: Systematic Review And Meta-analysis Of Randomised Controlled Trials, British Medical Journal, January 2013

"Conclusion: There is no evidence to support the use of vitamin and antioxidant supplements for prevention of cardiovascular diseases."

________

Steve Jobs’ Fruitarian Diet Lands Ashton Kutcher in the Hospital

From Time Magazine:
Steve Jobs’ Fruitarian Diet Lands Ashton Kutcher in the Hospital

Ashton Kutcher spent time in the hospital after going on one of Steve Jobs’ infamous fruitarian diets to prepare for a new role in a biopic featuring the late Apple CEO.

“First of all, the fruitarian diet can lead to, like, some severe issues. I ended up in the hospital like two days before we started shooting the movie. I was, like, doubled over in pain,” Kutcher said. ... “My pancreas levels were completely out of whack, which was really terrifying … considering everything.” (Jobs died after a long battle with pancreatic cancer in October 2011.)

Jobs had a lifelong fascination with fruitarianism, a diet consisting entirely of fruits, nuts and seeds.

At one point, the practice also helped inspire one of Jobs’ first great strokes of genius. According to ABC News and Issacson’s biography:

"[Fruits] even served as inspiration for his company’s name. “I was on one of my fruitarian diets,” Jobs reportedly told Isaacson of his decision to name the computer company Apple."

Steve Jobs on the left, Aston Kutcher on the right.  - CNET

It's hard to know what Kutcher was actually eating. For that matter, it's hard to know what Jobs was eating. People aren't always up front with what they put in their mouth, especially when they have the kind of relationship with food that Jobs had.

When it comes to what Jobs ate ... Below is an excerpt from an article written by Kaayla Daniel for Psychology Today, iVegetarian: The High Fructose Diet of Steve Jobs. The bullets, she says, are "either quotes or close paraphrases of Isaacson's words." Walter Isaacson wrote Jobs' biography, Steve Jobs, released in 2011 shortly after Jobs' death. Kaayla Daniel, PhD, is vice president of the Weston A. Price Foundation, a group that does not endorse vegetarian diets.

It's a fascinating account of Jobs' dietary history:

• Jobs came to appreciate organic fruits and vegetables as a teenager when a neighbor taught him how to be a good organic gardener and to compost. (14)
• Between his sophomore and junior hear of high school, he began smoking marijuana regularly and by his senior year was dabbling in LSD as well as exploring the mind bending effect of sleep deprivation. (18-19)
• Toward the end of his senior year in high school, Jobs began his "lifelong experiments with compulsive diets, eating only fruits and vegetables so he was as lean and tight as a whippet." (31)
• He attended the love festivals at the local Hare Krishna temple, and went to the Zen center for free vegetarian meals. (35)
• During his freshman year at college he went to the Zen center for free vegetarian meals and was greatly influenced by the book Diet for a Small Planet by Frances Moore Lappe. At that point, he swore off meat for good and began embracing extreme diets, which included purges, fasts or eating only one or two foods, such as carrots or apples for weeks on end. (36)
• For awhile at college, Jobs lived on Roman Meal cereal. He would buy a box, which would last a week, then flats of dates, almonds and a lot of carrots. He made carrot juice with a Champion juicer, and at one point turned "a sunset-like orange hue." (36)
• His dietary habits became more obsessive when he read The Mucusless Diet Healing System by Arnold Ehret. Jobs then favored eating nothing but fruits and starchless vegetables, which he said prevented the body from forming harmful mucus, and determined to regularly cleanse his body through prolonged fasts. That meant the end of his consumption of Roman Meal cereal - or any bread, grains, or milk. At one point, he spent an entire week eating only apples, and then began to try even purer fasts. He started with two-day fasts and eventually stretched them out to a week or more, breaking them with large amounts of water and leafy vegetables. "After a week, you start to feel fantastic," he said. "You get a ton of vitality from not having to digest all this food. I was in great shape. I felt I could get up and walk to San Francisco anytime I wanted." (36)
• As a $5 an hour technician at Atari, he was known as "a hippie with b.o." and "impossible to deal with." He clung to the belief that his fruit-heavy vegetarian diet would prevent not just mucus but also body odor. As Isaacson writes "It was a flawed theory." (43)
• "He was doing a lot of soul-searching about being adopted ... (with) the primal scream and the mucusless diets, he was trying to cleanse himself and get deeper into his frustration about his birth." (51)
• He was a fan of the Whole Earth Catalog and particularly taken by the final issue, which came out in 1971 when he was still in high school. On the back cover it said, "Stay Hungry. Stay Foolish." (59)
• The name Apple Computers came to him when he was on one of his fruitarian diets. "I had just come back from the apple farm. It sounded fun, spirited and not intimidating. Apple took the edge off the word ‘computer.'" (63)
• His mother Clara Jobs didn't mind losing most of her house to piles of computer parts and house guests, but she was frustrated by her son's increasingly quirky diets. She would roll her eyes at his latest eating obsessions. She just wanted him to be healthy, and he would be making weird pronouncements like, "I'm a fruitarian and I will only eat leaves picked by virgins in the moonlight." (68)
• He was still convinced against all evidence that his vegan diet meant that he didn't need to use a deodorant or take regular showers. ... At meetings people had to look at his dirty feet. Sometimes to relieve stress, he would soak his feet in the toilet. (82)
• A colleague who recommended he bathe more often was told that "in exchange" he would have to read fruitarian diet books. "Steve was adamant that he bathed once a week, and that was adequate as long as he was eating a fruitarian diet." (82-83)
• In 1979 or so he "put aside drugs, eased away from being a strict vegan, and cut back the time he spent on Zen retreats." (91)
• He decreed that the sodas in the office refrigerator be replaced by Odwalla organic orange and carrot juices." (118)
• The kitchen was stocked daily with Odwalla juices. (142)
• At the launch of the Lisa computer in 1983, he ate a special vegan meal at the Four Seasons restaurant. (152)
• He had edged away from his strict vegan diet for the time being and ate vegetarian omelets. (155)
• In 1984 in Italy, Jobs demanded a vegan meal and became extremely angry when the waiter very elaborately proceeded to dish out a sauce filled with sour cream. (185)
• The menu for his 30th birthday day celebration included goat cheese and salmon mousse. (189)
• He had a lot of mannerisms. He bit his nails. His hands were "slightly and inexplicably yellow" and in constant motion. (223)
• At a meal with Mitch Kapor, the chairman of Lotus software, Jobs was horrified to see Kapor slathering butter on his bread," and asked, "Have you ever heard of serum cholesterol?" Kapor responded, "I'll make you a deal. You stay away from commenting on my dietary habits, and I will stay away from the subject of your personality." (224)
• At a 1988 NeXT product launch, the lunch menu included mineral water, croissants, cream cheese, bean sprouts. (233)
• Jobs was a vegetarian and so was Chrisann, the mother of his daughter Lisa. Lisa was not vegetarian, but Jobs was fine with that. "Eating chicken became her little indulgence as she shuttled between two parents who were vegetarians with a spiritual regard for natural foods." Jobs's "dietary fixations came in fanatic waves," and he was "fastidious" about what he ate. Lisa watched him "spit out a mouthful of soup one day after learning that it contained butter." (259-260)
• "Even at a young age Lisa began to realize his diet obsessions reflected a life philosophy, one in which asceticism and minimalism could heighten subsequent sensations. "He believed that great harvests came from arid sources, pleasure from restraint. He knew the equations that most people didn't know: Things led to their opposites." (259-260)
• Once he took Lisa on a business trip to Tokyo and they stayed at the Okura Hotel. At the elegant downstairs sushi bar, Jobs ordered large trays of unagi sushi, a dish he loved so much that he allowed the warm cooked eel to pass muster as vegetarian. Lisa later wrote, "It was the first time, I'd felt with him, so relaxed and content, over those trays of meat; the excess, the permission and warmth after the cold salads, meant a once inaccessible space had opened. He was less rigid with himself, even human under the great ceilings with the little chairs with the meat and me." (260-261)
• Jobs had hired a hip young couple who had once worked at Chez Panisse as housekeepers and vegetarian cooks. (264)
• At his wedding to Laurene Powell, the cake was in the shape of Yosemite's Half Dome. It was strictly vegan and more than a few of the guest found it inedible. (274)
• "Since his early teens, he had indulged his weird obsession with extremely restrictive diets and fasts. Even after he married and had children, he retained his dubious eating habits. He would spend weeks eating the same thing - carrot salad with lemon, or just apples - and then suddenly spurn that food and declare that he had stopped eating it. He would go on fasts, just as he did as a teenager and he became sanctimonious as he lectured others at the table on the virtues of whatever eating regimen he was following." (477)
• Jobs's wife, Laurene Powell, had been a vegan when they first married, but after her husband's first cancer operation, the partial Whipple procedure, she began to diversify the family meals with fish and other proteins. Their son, Reed, who had been a vegetarian, became a "hearty omnivore." They knew it was important for Steve to get diverse sources of protein. (477)
• In early 2008, Jobs's eating disorders got worse. On some nights he would stare at the floor and ignore all of the dishes set out on the long kitchen table. He lost 40 pounds during the spring of 2008. Dr James Eason "would even stop at the convenience store to get the energy drinks Jobs liked." (485)
• He remained a finicky eater, which was more of a problem than ever. He would eat only fruit smoothies and he would demand that seven or eight of them be lined up so he could find an option that might satisfy him. He would touch the spoon to his mouth for a tiny taste and pronounce ‘That's no good. That one's no good either.'" His doctor lectured him: "You know this isn't a matter of taste. Stop thinking of this as food. Start thinking of it as medicine." (486)
• Early in 2010, Jobs went to dinner and ordered a mango smoothie and plain vegan pasta. (505)
• At the launch of the iPad2, Isaacson reported "For a change he was eating, though still with some pickiness. He ordered fresh squeezed juice, which he sent back three times, declaring that each new offering was from a bottle, and a pasta primavera which he shoved away as inedible after one taste. But then he ate half of my crab Louise salad and ordered a full one for himself followed by a bowl of ice cream." (527)
• Jobs's eating problems were exacerbated over the years by his psychological attitude toward food. When he was young, he learned that he could induce euphoria and ecstasy by fasting. So even though he knew that he should eat - his doctors were begging him to consume high-quality protein - lingering in the back of his subconscious, he admitted was his instinct for fasting and for diets like Arnold Ehret's fruit regimen that he had embraced as a teenager. Powell kept telling him it was crazy. ‘I wanted him to force himself to eat,' she said ‘and it was incredibly tense at home.'" (548-549)
• Bryar Brown, their part-time cook would produce an array of healthy dishes, but Jobs would touch his tongue to one or two and then dismiss them all as inedible. One evening he announced, "I could probably eat a little pumpkin pie," and the even-tempered Brown created a beautiful pie from scratch in an hour. Jobs ate only one bite, but Brown was thrilled." (549)
• During the final years of his life, Powell talked to eating disorder specialists and psychiatrists to try to get help, but her husband shunned them. (549)

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David Attenborough Retiring?

David Attenborough is 86. He's thinking about retiring. "I'm not going to be doing this when I'm 92," he's quoted as saying late last year.

I adore Attenborough. Adoration is not too strong a word. There really isn't his kind of raw enthusiasm and absence of self-focus out there in presenterland.

Here he is talking about the bowerbird. Dear God.


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It's The Fat In The Diet, Not The Carbohydrate, That Drives Diabetes

This is a fantastic video. It's a TED talk by Dr. Neal Barnard on how a very low fat diet, one that essentially excludes animal food, can in effect "cure" type 2 diabetes. What I love about it is his description of how insulin works to clear the blood of glucose, and how it is not so much the glucose in blood (or the sugar and starch we eat that gets converted to blood glucose) that drives diabetes, but the inability of insulin to assist entry of glucose into the cell, that is, insulin resistance:



The study to which he refers:

A Low-Fat Vegan Diet Improves Glycemic Control And Cardiovascular Risk Factors In A Randomized Clinical Trial In Individuals With Type 2 Diabetes, Diabetes Care, August 2006

Here's a discussion of this study from a few years ago: High-Carb, Low-Fat Diet For Diabetes.

Barnard compared his low-fat, vegan diet to the American Diabetes Association's diet. What happened when people with diabetes ate a high-carb, low-fat diet - consuming 70% of their calories as minimally-processed carbohydrates? They lowered their blood glucose. Here's how each group fared (all of the following were statistically significant):

Among participants whose diabetes medications remained unchanged: (A1C is short for hemoglobin A1c or HbA1c, a measure of blood glucose over the last 3 months.)

• A1C fell 1.23 points in the Vegan group
• A1C fell 0.38 points in the ADA group

Reduction in diabetes medications:

• 43% of the Vegan group
• 26% of the ADA group

Body weight decreased:

• 6.5 kg [14.3 lbs] in the Vegan group
• 3.1 kg [6.8 lbs] in the ADA group

Among those who did not change lipid-lowering medications:

• LDL cholesterol fell 21.2% in the Vegan group
• LDL cholesterol fell 10.7% in the ADA group

Reductions in urinary albumin:¹

• 15.9 mg/24h in the Vegan group
• 10.9 mg/24 h in the ADA group

Those on a low-fat, vegan diet had lower blood glucose, lower LDL cholesterol, improved kidney function, and over double the weight loss. There were also significantly greater reductions in BMI, waist circumference, and total cholesterol in the low-fat group compared to the ADA group.

Notably, there was no significant difference in exercise between groups, so these changes weren't because vegans were overtly spending more calories. ("Overtly" is key, since, as previously discussed, some diets lead to greater expenditure of calories from digestion and thermogenesis.)

Participants in the low-fat, vegan group were allowed unrestricted consumption. They could eat as many calories and as much carbohydrate as they wanted, as long as they didn't eat from certain food groups. Participants in the conventional diet group had to limit their caloric intake, count calories, and control portion sizes. Even with unrestricted food intake and a higher calorie consumption, the high-carb group lost more than twice as much weight.

It is frustrating for me to hear people say their doctor instructed them to eat fewer carbohydrates since their blood glucose is inching up. I've researched this for years and I can see it's more the fat in the diet, not the carbohydrate, that is a problem. Also, fat is the ideal solvent for many industrial pollutants, chemicals which have been implicated in the development of diabetes, obesity, and other metabolic disorders. And these chemicals bioaccumulate, making the fat of animals - cheese, butter, lard, marbled steak - likely to contain the highest amounts. ________ ¹ People with diabetes suffer microvascular complications involving the kidneys which allow passage of protein into urine. The lower the amount of the protein albumin that leaks into the urine, the healthier the kidneys.

Low-Fat, High-Fiber Diet Plus Exercise Caused Women's Blood To Significantly Slow Down And Stop Breast Cancer Growth

And it did so in a mere 13 days.

Here's the study:
Effect of a Low-Fat, High-Fiber Diet and Exercise Intervention on Breast Cancer Risk Factors and Tumor Cell Growth & Apoptosis, Nutrition and Cancer, 2006

"The subjects of this study were postmenopausal women attending the Pritikin Longevity Center Residential Program where they were given a low-fat (10-15% Kcal.), high-fiber (>40 gm/d) diet along with one hour of daily supervised exercise, primarily treadmill walking. The diet consisted of natural whole grains, fruits and vegetables with limited amounts (<3.5 oz) of fish, fowl or lean meat and nonfat milk."

It wasn't a diet devoid of animal food, although animal food was substantially scaled back.

Estrogens, insulin, and insulin-like growth factor-I (IGF-I) all stimulate the growth of breast cancer cells. In this study, women experienced marked reductions in all of these markers. Not only that, the blood of women who underwent the diet-plus-exercise for 13 days slowed the growth of plated cancer cells and caused an increase in cancer cell suicide (apoptosis), compared to their blood at the beginning of the study.

Dr. Michael Greger describes the results of this and another similar study involving prostate cancer that I discussed on this blog several years ago. In that study, the blood of men in the treatment group inhibited the growth of prostate cancer cells 8 times more than blood of men in the control group.


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