"I saw few die of hunger; of eating, a hundred thousand." -Ben Franklin

Monday, August 13, 2012

AHS: Day 2

For days 2 and 3 of AHS, there were always two talks going on at the same time.  As much as I would've loved to see (and report on) all of them, my next two entries will only be covering the talks I went to; for full coverage, definitely check out the blogosphere for reports on the other talks going on simultaneously.

The first presentation I went to on Day 2 was Esther Gokhale's "Restoring Our Primal Architecture", which was primarily a demonstration on proper posture.
-"It's so great to be with people like-minded.  It's like being with your tribe."  -Gokhale's opening remarks
-Spine should be J-shaped, not S-shaped!  "Your behind is out behind, down low in the back."  Babies, statues, and hunter-gatherers all have J-shaped spines.
-To achieve better posture, roll one shoulder back, then the other.
-"One of the reasons you want your behind behind is that it lets the rest stack easily."
-We should use better furniture in order to have better posture.
-"When you have good posture, the people around you are influenced."
-The Gokhale Pain Free Chair is an option for better posture and much less back pain.

I then went to Keith Norris's "Health vs. Performance: Two Distinct and Oftentimes Conflicting Wellness Goals", which discussed how the two words are not synonymous and how people need to break their scale addictions.
-By 2030, more than 1/3 of the entire federal budget will be spent on Medicare and Medicaid alone.
-There is a profound difference between training an athlete and training a person who wants to be healthy.
-"If you're training for health, and training more than a few hours a week, you're doing it wrong."
-Blood work is a means to show someone that something's wrong internally.
-A DEXA scan shows body composition in not only the full body, but separately in the arms, legs, etc.
-"It's not about the weight: it's about body mass... and how you perform."
-"If you don't have the DEXA scan, it's hard to get rid of the scale problem."

There were a lot of presentations on Day 2 about food policy, politics, and advertising-- the first one I went to was Matthew Metzgar's "Simulating a Ban on Food Advertising", which was really fascinating. He showed how the overweight and normal weight children in his research were exposed to the same amount of food advertisements on TV and both consumed the advertised foods; however, the normal weight children compensated by eating less later on that day, whereas the overweight children did not.
-Food advertising increases consumption of advertised foods.  However, normal weight and overweight/obese children watch similar amounts of TV.
-After eating fast food, the lean children ate less later in that day.
-Assumption: overweight children have lost the ability to self-regulate energy intake over time.
-When overweight/obese adults were told to eat more fruit and vegetables, they actually gained weight because they failed to eat eat less of other foods.
-Given the above, more exposure to food advertising should lead to more weight gain, but only in overweight/obese children.
-Food advertising: trying to get everyone to eat more of those foods!
-Higher levels of TV viewing lead to a positive relationship with BMI in overweight children.
-49% of ads during Saturday morning children's programs were for food.
-There has been a huge jump in obesity in African American girls.  Further, the closer one is to poverty, the higher his/her BMI.
-If food advertising is banned, then watching TV should have the same effect as any other sedentary activity (video games, reading, etc.) in overweight children.
-Results:  in this sample, banning food advertisements would shift 5.8% of individuals (children 2-11) from overweight/obese to normal weight (4.4% for boys, and 6.2% for girls).

Next up was Danielle Purifoy's "How Food Policy Councils Can Support Urban Agriculture."  I didn't really know much about urban agriculture, so I thought this talk was really quite informative.
-Why urban agriculture?  Local/healthy/Paleo foods.
-One objective is to get zoning for urban agriculture:  expand agricultural land use in all zoning districts, create urban agricultural districts, create overly districts to support sustained urban agriculture.
-Another objective is to get zoning for animal husbandry!
-Land inventory and preservation is another object, but one of the major challenges is receiving fiscal support.
-Water, besides land, is the #1 most important resource for urban agriculture.
-Training and public outreach is an absolute must in order for urban agriculture to succeed.
-Ecological sustainability is another major issue.  We need to get involved in food policy councils in order to further these goals and allow for urban agriculture to grow.

I then went to a panel of Nate Rosenberg (moderator), Peter Ballerstedt, Dr. Lynda Frassetto, Adele Hite, and Anna Kelles called "Fix Our Food Initiative: A Comprehensive Approach to Food and Nutrition Reform".  This was one of my favorite panels of the AHS-- not only was it really informative, but I could really relate to it due to how messed up food policy at all levels.
-Research and money = a catch-22.  You need money to do research, but you need to do research in order to receive money.
-"Most Americans believe that obesity is caused by eating too much, not exercising enough, and watching too much TV."
-Change will come about by "a whole social network of people doing this at a grassroots level."  Us!
-Ballerstedt:  "'Agriculture' is people."  After WWI, the US was cut off from the principal supply of wheat (Russia), which lead to the Dust Bowl-- people plowed up the ground that shouldn't have been plowed up.
-Kelles:  "Be a devil's advocate with yourself: the more we question our own thoughts, the more successful we'll be."
-The nutrition community is extremely diverse!  (Sorry the quality's not that great, but the picture shows all of the different nutrition practitioners in the US.)
-We need to push for a monopoly in nutrition therapy!
-All nutrition laws have been initiated by the Academy of Nutrition and Dietetics (AND).  47 states, Washington, D.C., and Puerto Rico all have some law governing nutrition; however, laws vary!
-The AND corporate sponsors include General Mills, Coke, Pepsi, Kelloggs, etc.  The AND also believes that organic is unnecessary and that "biotechnology techniques" (a.k.a. genetically modifying foods) is better, because they're pro-industry.
-92% of registered dietitians work in industrial settings, and therefore only focus on acute care treatment.  They work with the people who need care the most, which is a major issue!!
-We need to increase the access to quality nutrition practitioners and increase transparency of the role of industry and government on nutritional care in the US.
-Why should we get involved?  A million reasons!  "Nothing will work, but everything might."
-We need individualized nutrition ("One Diet Does Not Fit All"), nutritional literacy, and sustainable food-health systems.

The last talk before lunch was Dr. Peter Attia's "The Straight Dope on Cholesterol", which, as promised in the abstract, taught me "more about cholesterol than 99% of the physicians in this country."  Although some of the science went a bit over my head (I'm really not a science person...), I feel like I now have a pretty good understanding of the topic.
-What causes atherosclerosis?  The presence of a sterol in the artery wall-- nothing more, nothing less.
-Cholesterol is the sterol from the animal kingdom.
-ALL cholesterol is good cholesterol.  Cholesterol is essential for life.  No cholesterol = no life.
-Exogenous cholesterol (from what we eat) vs. endogenous cholesterol (from the body).
-The liver plays a huge role in cholesterol; the gut regulates how much gets reabsorbed.  The total body store is 40-50 grams.
-People either synthesize or absorb cholesterol (the former is more common).
-Think of lipoprotein vs. cholesterol/triglycerides as "boats" and their "cargo."
-People with a mutation in PCSK9 are immune to atherosclerosis because of really low LDL.
-Atherosclerosis is not a lipid-mediated disease; it's a lipoprotein-mediated disease.
-Does the size of an LDL particle matter?  Are the small ones bad because they're small, or because there are more of them?
-Discordance:  2 variables not predicting the same thing.  The greater the metabolic derangement, the greater discordance between LDL-C and LDL-P.  There is a discordance from having too many triglycerides, which crowd out cholesterol.
-The A to Z trial (Gardner, 2007)-- after comparing people on many different types of diets, the Atkins dieters had the biggest reduction in triglycerides.  The Workplace Diet Trial (2008) had the same result.
-What role does sugar play in triglycerides?  Pure fructose and High Fructose Corn Syrup worsen your lipoproteins and lead to the build up of more LDL and less HDL.
-The cholesterol we eat has little to do with the cholesterol in the body.

After a wonderful lunch of chicken, ribs, greens, and mashed sweet potatoes (thanks, AHS!), the next talk I attended was by the amazing Gary Taubes, whose talk "Calories vs. Carbohydrates: Clearing Up the Confusion Over Competing Obesity Paradigms" cleared up a lot of the issues surrounding calories and carbs-- pretty much, his signature topic!
-Obesity is a fat accumulation disorder.
-Refined sugar/grains/starches lead to insulin issues, which lead to obesity.
-The first law of thermodynamics is always true.
-If obesity is an energy balance disorder, then carb-restricted diets work because they increase satiety, and therefore we eat less.  They may also provide a metabolic advantage by increasing dietary-induced thermogenesis.  
-The brain regulates body fat mass through Energy-in and Energy-out.
-Insulin is "the principal regulator of fat metabolism" (quote from 1965).
-The primary problem with calorie-restricted diets is that the total calories include total carbohydrate calories.
-"One explanation for the poor long-term outcome of weight loss diets relates to behavior!"
-The greater the carb restriction, the greater the energy expenditure, and the greater the weight loss.
-Why do a ketogenic diet?  Insulin regulation!
-Calorie restriction in monkeys wasn't an accurate experiment, because look what they were restricting:
-Leptin reverses weight loss-- it induces changes to regional neural activity responses to food stimuli.

Next up was a panel including Jimmy Moore (moderator), Paul Jaminet, Dr. Ron Rosedale, Dr. Catherine Shanahan, and Chris Kresser-- "Safe Starches: Are They Essential to an Ancestral Diet?".  This is such a huge topic in the ancestral community, so it was really interesting to hear so many differing opinions from this group.
-Jaminet:  the Perfect Health Diet is low-carb.  "If we don't ask these hard questions [about starches], no one's going to listen to us."  "Safe starches" are starchy plants whose toxins are destroyed when you cook them, and they are therefore toxin-free.  Examples include white rice, white and sweet potatoes, and taro.
-Kresser:  Some problems occur for people who don't have starches, such as low energy, cold hands/feet, depression and anxiety, and thyroid issues.  Not everyone thrives eating very low carb (VLC) long-term;  people on VLC don't convert as much T4 to thyroid hormone.  There is no "one size fits all" approach-- there are genetic and epigenetic factors to take into consideration.
-Shanahan:  People who low-carb gradually might not run into trouble.  It's important to be in ketosis many days, but it's important to burn sugar some days too.
-Rosedale:  The thyroid goes down with low-carbing, but not THC.  People on low carb dies do not go into hypothyroidism!  Carbs that are not a fiber will turn to sugar and cause harm (though what harm, we're not sure).
-Jaminet:  Is "safe" just semantic?  No!  Glucose is a nutrient-- not necessarily a toxin.  We're supposed to have a certain blood sugar, insulin levels, etc.  Breast milk is 50-60% fat, then carbs, then protein.   The body will adapt to different diets-- T3 goes down in low carb diets, but that doesn't mean you have a thyroid problem.  If you add in starches, some problems (dry eyes, dry mouth, etc.) will go away.  Energy excess causes faster aging.
-Kresser:  There's a lot we still don't understand.  Cultures that are healthy with a lot of starch include the Kitavans (75% carb) and Okinawans (85% carb, and they have the most centenarians).  There were starches in human evolution as an alternative to fruit, and this may have increased brain size.  Starch consumption may not affect longevity.  However, people with insulin resistance may not be able to process starch well.
-Shanahan:  Sugar is sugar!  She also doesn't believe Kresser's statistics about the starch-heavy cultures due to how Westerners interpret data.  "The Paleo diet is one type of traditional diet."
-Rosedale:  If you eat something that contains sugar, it will turn to glucose and raise insulin levels.  You can burn sugar or fat; fat furnishes ketones.  The brain doesn't need to burn any sugar under certain adapted situations.  Kitavans are small people (have IGF1) and therefore have increased longevity.  "I do not understand this obsession with the Kitavans."
-Jaminet:  There is a ketogenic version of the Perfect Health Diet, and patients have helped many major conditions by following it.  However, it still contains some safe starches!  The higher the carb intake, the shorter the life span.

I then went to Dr. Lynda Frassetto's "Paleolithic Diets and Diabetes Control: How Do We Think It Works?", which was really spot-on-- the current diabetes recommendations are so far from ancestral!
-The way to prevent type 2 diabetes is NOT through a low-fat diet and exercising!
-Grain/dairy-free diets in clinical practices show decreased insulin secretion and improved insulin resistance in healthy, sedentary volunteers.
-Diabetes is the #1 cause of kidney disease in the US.
-Apple vs. pear shaped bodies and genetics do make a difference!
-Just eating a lot of salt can increase more insulin.
-Obese people have higher free fatty acid levels, which leads to hyperglycemia, which results in glucose toxicity, altered insulin signaling, higher levels of AGEs, and inflammation.
-Sleep is important!  The activation of circadian rhythm ligands lead to increased energy expenditure and weight loss, which lead to lower insulin and glucose levels in obese mice.
-Leptin blocks the hunger chemicals and turns on the satiety levels in your brain.

I was so excited for the next presentation, "What Not to Eat for Good Mental Health" by Dr. Emily Deans, who was a really great speaker.  I love her blog, and her presentation certainly did not disappoint!
-Trans fats are formed primarily from the partial hydrogenation of vegetable and seed oils.  They should be avoided!
-Heart disease deaths have decreased in Denmark since 2003, when the country banned trans fats.
-However, natural ruminant trans fats are thought to be safe.
-Trans fats displace essential n-6 and n-3 fatty acids, which can lead to ADHD, depression, psychosis, and dementia.
-Carbs:  There is a link between hypoglycemia and irritability and violence!  Caffeine and alcohol will exacerbate the blood sugar drop.
-Women with PCOS are more likely to have reactive hypoglycemia symptoms and more likely to engage in binge eating.
-Carbs lead to an increase in insulin.
-Soda consumption has correlated with poor mental health, increased aggression, and violence.
-What to eat?  Real food.

The last presentation of the day-- "What is Hunger, and Why Are We Hungry?" was by J. Stanton, whose quirky, brilliant, and hilarious talk was one of my favorites of the conference.  Definitely check out his blog and book for just a little taste of how great his presentation was!
-Diets fail because our levels of hunger override our motivation.
-Food palatability and reward are objective-- they are based on past experiences and our current state.
-"Palatability is a lot like pornography-- we all know it when we see it."
-Hunger is the interaction of 4 processes:  satiety, satiation, hedonic impacts ("likes"), and incentive salience ("wants").  Availability and will power are also major factors.
-Junk foods are not hyper-palatable:  they're hyper-available.
-Obesity is primarily a failure of satiety.
-Taste receptors are located throughout our bodies, not just on our tongues.
-More micronutrients lead to more satiety.

-I met Mark Sisson!  He is such a nice guy, and I am so glad I finally got to talk to him.
-I'm not exactly the most social person, yet everyone at the AHS was so nice, and I felt really comfortable approaching/talking to people.  The ancestral community really is a big family, and I'm so thankful to be a part of it!
-Cambridge restaurant recommendation:  EVOO.  It doesn't get much better than farm-to-table!

Quote of Day 2 (not previously mentioned):
"I challenge each one of you to follow the path of science, and not the path of politics."  -J. Stanton


  1. For those of us that couldn't make it to AHS, thank you! I think I will eat a sweet potato now.

  2. Leigh:

    Hunger is a strangely neglected subject in the greater nutrition world as well as the ancestral nutrition world, and I'm glad you found my presentation interesting and informative.

    Thank you for the detailed reporting!


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