Dr. Kevin Patterson on Western Diets and Health

A few readers have pointed me to an interesting NPR interview with the Canadian physician Kevin Patterson (link). He describes his medical work in Afghanistan and the Canadian arctic treating cultures with various degrees of industrialization. He discusses the "epidemiological transition", the idea that cultures experience predictable changes in their health as they go from hunter-gatherer, to agricultural, to industrial. I think he has an uncommonly good perspective on the effects of industrialization on human health, which tends to be true of people who have witnessed the effects of the industrial diet and lifestyle on diverse cultures.

A central concept behind my thinking is that it's possible to benefit simultaneously from both:

• The sanitation, medical technology, safety technology, law enforcement and lower warfare-related mortality that have increased our life expectancy dramatically relative to our distant ancestors.


• The very low incidence of obesity, diabetes, coronary heart disease and other non-infectious chronic diseases afforded by a diet and lifestyle roughly consistent with our non-industrial heritage.

But it requires discipline, because going with the flow means becoming unhealthy.

Spiced Lentils with Mushrooms and Greens

I'm always on the lookout for a way to incorporate lentils into my diet as well as more greens. So this recipe for Spiced Lentils with Mushrooms and Greens from the February, 2011 issue of Food and Wine magazine is perfect, especially since I think nothing with mushrooms can ever be bad. And there is nothing I love better than when foods that seem somewhat boring on their own (i.e. dry lentils and Swiss chard) get tossed together with some spices and end up super tasty as a result! And this is exactly what I got with this one. In fact, it was so good I didn't eat it as a side-dish as suggested in the recipe, I ate it stand alone as a light meal.

Spiced Lentils with Mushrooms and Greens 4 side-dish servings 1/2 cup brown or green lentils 3 Tbsp extra-virgin olive oil 1/2 pound shiitake mushrooms, stems discarded and caps sliced 1/4-inch thick Salt 1 garlic clove, minced 1/4 tsp ground cumin 1/4 tsp ground coriander 1/4 tsp freshly ground black pepper 1/8 tsp turmeric 1/2 pound Swiss chard or other tender greens, large stems discarded and leaves coarsely chopped 1 Tbsp chopped parsley

In a small saucepan, cover the lentils with 2 1/2 cups of water and bring to a boil. Cover and cook over low heat until the lentils are tender, about 30 minutes.

Meanwhile, in a medium saucepan, heat 2 tablespoons of the olive oil. Add the shiitake and season with salt. Cover and cook over moderate heat, stiffing, until the mushrooms are tender and starting to brown, 5 minutes. Add the remaining 1 tablespoon of olive oil along with the garlic, cumin, coriander, pepper and turmeric and cook, stirring, until fragrant, 1 minute. Add the greens and cook, stirring, until wilted, 2 minutes.

Add the lentils and their cooking liquid to the mushrooms and simmer for 3 minutes. Add up to 1/4 cup water if the lentils are too dry. Season with salt. Ladle the lentils into bowls, garnish with parsley and serve.

My Legume Love Affair (MLLA) was originally started by Susan of The Well-Seasoned Cook. This month's MLLA #33 is being hosted by Ammalus Kitchen

Scarlet Barley with Mushroom & Cannellini Paprikas

I admit that the main reason I made this recipe is so that I could shred a beet. I have had a thing with beets this past fall but so far I have only tackled roasting them. I found the concept of peeling the raw beet and then shredding it and using it as an ingredient intriguing. And when I learned this month's Monthly Mingle theme is "Think Pink" I decided this recipe for Scarlet Barley from Isa Chandra Moskowitz's "Appetite for Reduction" would be a fun contribution.

The Scarlet Barley along with the Mushroom & Cannelini Paprikas came together in about an hour. Shredding the beet for the Scarlet Barley was harder than I thought. I used the shredder on my mandolin and since the beet is naturally hard it was a bit difficult to get a good position for the shredder to shred it. And of course my hands turned all red. But once that was done the rest was simple. And it wasn't too difficult that I wouldn't do it again to use for other recipes if the ingredient is called for.

I prepared this dish prior to an evening appointment and let it sit on the stove for at least two hours before I ate it. Unfortunately I think it lost some flavor. The end result was somewhat bland to me. I think if I would have tried the barley after letting the fresh lemon sit for about 10 minutes it would have been much better.

The next day I sauteed some Swiss chard with green onions and garlic (like the way it is done for the Miso Udon Stir-fry with Greens and Beans recipe) and then threw the leftovers into the pan to reheat. I mixed it all together and after it was plated I squirted on a bit of sriracha. It was a really great combo to be eaten this way!

Scarlet Barley Serves 6 1 tsp olive oil 2 cloves garlic, minced Freshly ground black pepper 1 bay leaf 1 cup pearl barley, rinsed 2 1/2 cups vegetable broth 1/4 tsp salt 1 beet (about 3/4 pound), grated Juice of 1/2 lemon Fresh dill, for garnish (optional)

Preheat a 2-quart pot over medium heat. Saute the garlic in the olive oil for about 30 seconds. Add several pinches of pepper and the bay leaf. Add the barley, broth, and salt; cover and bring to a boil. Once boiling stir and lower the heat to low. Cover and cook for about 20 minutes, stirring occasionally.

When most of the water has absorbed, mix in the grated beet. Cook for about 20 more minutes, stirring occasionally. Turn off the heat, mix in the lemon juice, and taste for salt. Cover and let sit for about 10 mire minutes. Remove bay leaf and serve topped with fresh dill.


Mushroom & Cannellini Paprikas
Serves 4

1 1/2 tsp olive oil
4 cloves garlic, minced
1 pound cremini mushrooms, sliced
Several pinches of freshly ground black pepper
1/4 tsp salt
1/2 cup dry red cooking wine
1/4 cup vegetable broth
2 tsp smoked paprika
2 Tbsp fresh chopped thyme
1 (16-ounce) can cannellini beans, drained and rinsed
1/4 cup chopped fresh dill
1 recipe Scarlet Barley

Preheat a 4-quart pot over medium-high heat. Saute the onions in the oil until lightly browned, about 7 minutes. Add the garlic and saute for about 30 seconds. Add the mushrooms, pepper, and salt; cook until lots of the moisture has been released, stirring occasionally, for about 5 minutes.

Add the wine, broth, smoked paprika, and thyme. Turn up the heat and bring the mixture to a low boil. Boil for about 3 minutes. Lower the heat and add the beans. Cook to heat through, about 4 more minutes. Use a strong fork to lightly mash some of the beans, to thicken the sauce. Just mash a few against the side of the post and then mix 'em back in. Taste for salt and serve.

Serve over Scarlet Barley with plenty of fresh dill.

This month's Monthly Mingle theme is Think Pink and is being hosted by Sarah at Maison Cupcake.

Randy Tobler Show: Welcome

This morning, I had a conversation with Dr. Randy Tobler on his radio show "Vital Signs", on 97.1 FM News Talk in St Louis. Dr. Tobler is an obstetrician-gynecologist with an interest in nutrition, fitness and reproductive endocrinology from a holistic perspective. He asked me to appear on his show after he discovered my blog and found that we have some things in common, including an interest in evolutionary/ancestral health. We talked about the history of the American diet, the health of non-industrial cultures, what fats are healthiest, and the difference between pastured and conventional meat/dairy-- we took a few questions from listeners-- it was fun.

The show is available as a podcast here (3/26 show), although as far as I can tell, you need iTunes to listen to it. My section of the show starts around 8:20.

To everyone who arrived here after hearing me on the air this morning: welcome! Here are a few posts to give you a feel for what I do here at Whole Health Source:

The Coronary Heart Disease Epidemic
US Weight, Lifestyle and Diet Trends, 1970-2007
Butter vs. Margarine Showdown
Preventing and Reversing Tooth Decay
The Kitavans: Wisdom from the Pacific Islands
Potatoes and Human Health, Part I, Part II and Part III
Traditional Preparation Methods Improve Grains' Nutritional Value
Real Food XI: Sourdough Buckwheat Crepes
Glucose Tolerance in Non-industrial Cultures
Tropical Plant Fats: Palm Oil
It's Time to Let Go of the Glycemic Index

Safflower Oil Study

A few people have sent me a new study claiming to demonstrate that half a tablespoon of safflower oil a day improves insulin sensitivity, increases HDL and decreases inflammation in diabetics (1). Let me explain why this study does not show what it claims.

It all comes down to a little thing called a control group, which is the basis for comparison that you use to determine if your intervention had an effect. This study didn't have one for the safflower group. What it had was two intervention groups, one given 6.4g conjugated linoleic acid (CLA; 50% c9t11 and 50% t10c12-CLA) per day, and one given 8g safflower oil. I have to guess that this study was originally designed to test the effects of the CLA, with the safflower oil group as the control group, and that the interpretation of the data changed after the results came in. Otherwise, I don't understand why they would conduct a study like this without a control group.

Anyway, they found that the safflower oil group did better than the CLA group over 16 weeks, showing a higher insulin sensitivity, higher HDL, lower HbA1c (a marker of average blood glucose levels) and lower CRP (a marker of inflammation). But they also found that the safflower group improved slightly compared to baseline, therefore they decided to attribute the difference to a beneficial effect of safflower oil. The problem is that without a control (placebo) group for comparison, there's no way to know if the improvement would have occurred regardless of treatment, due to the season changing, more regular check-ups at the doctor's office due to participating in a study, or countless other unforeseen factors. A control group is essential for the accurate interpretation of results, which is why drug studies always have placebo groups.

What we can say is that the safflower oil group fared better than the CLA group, because there was a difference between the two. However, what I think really happened is that the CLA supplement was harmful and the small dose of safflower oil had no effect. Why? Because the t10c12 isomer of CLA, which was half their pill, has already been shown by previous well-controlled studies to reduce insulin sensitivity, decrease HDL and increase inflammatory markers at a similar dose and for a similar duration (2, 3). The safflower oil group only looked good by comparison. We can add this study to the "research bloopers" file.

It's worth noting that naturally occurring CLA mixtures, similar to those found in pastured dairy and ruminant fat, have not been shown to cause metabolic problems such as those caused by isolated t10c12 CLA.

Miso Udon Stir-fry with Greens & Beans

Wow! This dish tastes about 10 times better than it looks. With a little Sriracha and salt on top, it's creamy and salty and spicy... perfect!

I bought a few kinds of different kinds of beans the other week just to have on hand. One of those was a bean I hadn't heard of before: azuki beans. So when I was flipping through my new cookbook, Appetite for Reduction, I flagged this recipe as the first one to make because of it's use of this fun new ingredient.

I couldn't find brown rice udon noodles as suggested in the recipe so I bought some brown rice spaghetti. But I had some regular pre-cooked udon packages in my refrigerator so when it came time to put this together I decided to use those.

I realize now that I forgot to add the sesame seeds. Oh well, I do bet they would have been great on this but it was really tasty all the same.

Miso Udon Stir-fry with Greens and Beans Serves 4 1 pound broccoli, stems sliced thinly, tops cut into florets 8 ounces brown rice udon noodles 1 teaspoon olive oil 6 cloves of garlic, minced 1 bunch Swiss chard (about ½ pound), coarse stems removed, chopped roughly 1 cup thinly sliced green onions, plus extra for garnish 1/2 teaspoon salt 1 (16-ounce) can azuki beans, drained and rinsed 1/3 cup miso 1/2 cup hot water 4 teaspoons toasted sesame seeds Sriracha hot sauce, to serve

Prepare a pot of salted water for cooking the noodles.

Preheat a large skillet over medium-high heat. First saute the broccoli with a bit of nonstick cooking spray and a pinch of salt for about 5 minutes. Cover the pan and flip once or twice. The broccoli should be browned in some spots. Add a splash of water at the end, then cover for another minute. The pan should be steaming. Remove broccoli from the pan and set aside.

At this point, the water should be boiling. Use a mug to remove ½ cup of water; you can use that to mix into your miso in a few steps. Then cook the noodles according to the package directions. Drain when ready.

Now we'll put everything together. Preheat the large pan again, over medium heat. Saute the garlic in the oil for about a minute, until fragrant. Add the chard, green onion, and salt, and saute for about 5 minutes, until wilted. Add the beans and let heat through.

In the meantime, in a mug or measuring cup, mix together the miso and warm pasta water until relatively smooth.

Add the drained noodles to the pan, along with the miso mixture and broccoli. Saute for about 2 minutes, using a pasta spoon, making sure everythin is nice and coated. Taste for salt. To serve, to with sesame seeds and green onions and keep the Sriracha close at hand.

No Croutons Required March bogging event theme is "aduki beans or mung beans" and it is being hosted by Lisa's Kitchen. View the roundup here.

New Ancestral Diet Review Paper

Pedro Carrera-Bastos and his colleagues Maelan Fontes-Villalba, James H. O'Keefe, Staffan Lindeberg and Loren Cordain have published an excellent new review article titled "The Western Diet and Lifestyle and Diseases of Civilization" (1). The paper reviews the health consequences of transitioning from a traditional to a modern Western diet and lifestyle. Pedro is a knowledgeable and tireless advocate of ancestral, primarily paleolithic-style nutrition, and it has been my privilege to correspond with him regularly. His new paper is the best review of the underlying causes of the "diseases of civilization" that I've encountered. Here's the abstract:

It is increasingly recognized that certain fundamental changes in diet and lifestyle that occurred after the Neolithic Revolution, and especially after the Industrial Revolution and the Modern Age, are too recent, on an evolutionary time scale, for the human genome to have completely adapted. This mismatch between our ancient physiology and the western diet and lifestyle underlies many so-called diseases of civilization, including coronary heart disease, obesity, hypertension, type 2 diabetes, epithelial cell cancers, autoimmune disease, and osteoporosis, which are rare or virtually absent in hunter–gatherers and other non-westernized populations. It is therefore proposed that the adoption of diet and lifestyle that mimic the beneficial characteristics of the preagricultural environment is an effective strategy to reduce the risk of chronic degenerative diseases.

At 343 references, the paper is an excellent resource for anyone with an academic interest in ancestral health, and in that sense it reminds me of Staffan Lindeberg's book Food and Western Disease. One of the things I like most about the paper is that it acknowledges the significant genetic adaptation to agriculture and pastoralism that has occurred in populations that have been practicing it for thousands of years. It hypothesizes that the main detrimental change was not the adoption of agriculture, but the more recent industrialization of the food system. I agree.

I gave Pedro my comments on the manuscript as he was editing it, and he was kind enough to include me in the acknowledgments.

Hearty Irish Lager Stew

You probably don't think "vegetarian" when you think of Irish food, but this dish is not only vegetarian, it's vegan. This recipe for Hearty Irish Lager Stew from the March, 2011 issue of Vegetarian Times magazine is made with no animal products at all so it's super healthy. That might not have you smackin' your lips, but this stew is very tasty and since it's made of mostly veggies, you can eat a huge amount and it won't go to your hips. And, it's made with beer! So that's kinda fun.

Make sure you cut your veggies on the small side. Ours were a bit large and with the cooking times listed in the recipe we found that the potatoes were still hard. We cooked it an extra 15-20 minutes and some of it was still al dente. It was good anyways; I don't mind chewing my vegetables. I'd rather that than have them be too mushy. And we munched on some Salt and Vinegar Potato Bites while we were waiting for the stew to finish so we had no complaints.

Hearty Irish Lager Stew Serves 8 1 Tbsp. vegetable oil 8 oz. button or shittake mushrooms, halved 2 cloves garlic, minced (2 tsp.) 1 medium leek, white part only, diced (1 cup) 2 medium carrots, peeled and sliced (2 cups) 2 small parsnips, peeled and sliced (1½ cups) 1½ tsp. tomato paste 1 15-oz. can crushed tomatoes 1½ cups low-sodium vegetable broth 2 sprigs fresh thyme, tied in bundle, plus 1 tsp. chopped fresh thyme, divided ½ lager beer 1½ Tbsp. quick-cooking tapioca 1 cup shredded cabbage 1 Tbsp. white miso 2 Tbsp. chopped parsley

Heat ½ Tbsp. oil in large pot over medium heat. Add mushrooms and garlic; saute 8 minutes, or until mushrooms are browned. Remove from pan. Add remaining ½ Tbsp. oil to pot. Add leek, and cook 5 minutes. Add potatoes, carrots, parsnips, and tomato paste. Cook 2 minutes. Add tomatoes, broth, and thyme sprigs; bring to a boil. Reduct heat to medium-low, cover, and simmer 40 minutes, stirring occasionally.

Add lager, tapioca, and mushrooms. Simmer 10 to 15 minutes, or until thickened, stirring often. Remove thyme sprigs, stir in cabbage and miso, and simmer 4 to 5 minutes, or until cabbage softens. Stir in chopped thyme and parsley, and season with salt and pepper, if desired.

Nutritional Information as provided in magazine:
Per 1-cup serving: 118 CAL; 4 G PROT; 2 G TOTAL FAT (<1 G SAT FAT); 23 G CARB; 0 MG CHOL; 204 MG SOD; 5 G FIBER; 5 G SUGARS

Salt and Vinegar Potato Bites

We love these potatoes! Way better then french fries, roasted potatoes are much healthier. Found in the March, 2011 issue of Vegetarian Times magazine I made these tonight as a snack.

The recipe says you can drizzle the sauce over the potatoes, but I think that would have made them soggy. We liked dipping them and that way we could each control the amount of vinegar that absorbed into to potato.

Salt and Vinegar Potato Bites Serves 8 6 medium red or yello potatoes, cut into 1-inch cubes (3 cups) 2 Tbsp. vegetable oil 1 cup malt vinegar 3 Tbsp. sugar Soak potatoes in large bowl of cold water 30 minutes. Drain, and pat dry. Preheat oven to 425°F. Toss potatoes with oil on baking sheet, and spread in single layer. Roast 45 minutes, or until golden and crisp, turning 2 or 3 times. Season with salt and pepper, if desired. Meanwhile, bring vinegar and sugar to a simmer in saucepan over medium heat. Cook 15 to 20 minutes, or until liquid is reduced by half, stirring occasionally. Serve malt sauce on side for dipping, or drizzle over potatoes.

Nutritional Information as provided in magazine:
Per ½-cup serving: 89 CAL; 1 G PROT; 4 G TOTAL FAT (<1 G SAT FAT); 14 G CARB; 0 MG CHOL; 3 MG SOD; <1 G FIBER; 5 G SUGARS

Gluten-Free January Survey Data, Part II: Health Effects of a Gluten-Free Diet

GFJ participants chose between three diet styles: a simple gluten-free diet; a "paleo light" diet diet that eliminated sugar and industrial seed (vegetable) oils in addition to gluten; and a "paleo full monty" diet that only included categories of food that would have been available to our pre-agricultural ancestors. The data in this post represent the simple gluten-free diet group, and do not represent the other two, which I'll analyze separately.

To get the data I'll be presenting below, first I excluded participants who stated on the survey that they did not adhere to the diet. Next, I excluded participants who were gluten-free before January, because they would presumably not have experienced a change from continuing to avoid gluten. That left us with 53 participants.

For each of these graphs, the vertical axis represents the number of participants in each category. They won't necessarily add up to 53, for several reasons. The most common reason is that for the questions asking about changes in health conditions, I didn't include responses from people who didn't have the condition in question at baseline because there was nothing to change.

Question #1: What is your overall opinion of the effect of gluten free January on you?

Participants had a very positive experience with the gluten-free diet. Not one person reported a negative overall experience.

Question #2: Did you note a weight change at the end of gluten free January?

And here are the data for people who described themselves as overweight at baseline:

Two-thirds of people who were overweight at baseline lost weight, and only one person out of 37 gained weight. That is striking. A number of people didn't weigh themselves, which is why the numbers only add up to 37.

Question #3: Before January 2011, did you have a problem with intestinal transit (frequent constipation or diarrhea)? If so, did your symptoms change during the month of January?


Responses are heavily weighted toward improvement, although there were a few instances where transit worsened. Transit problems are one of the most common manifestations of gluten sensitivity.

Question #4: Before January 2011, did you have frequent digestive discomfort (pain, bloating, etc.)? If so, did your symptoms change during the month of January?


Digestive discomfort was common, and the gluten-free diet improved it in nearly everyone who had it at baseline. I find this really impressive.

Question #5: Before January 2011, did you have acid reflux? If so, did your symptoms change during the month of January?

Acid reflux responded well to a gluten-free diet.

Question #6: Before January 2011, did you have a problem with tiredness/lethargy? If so, did your symptoms change during the month of January?
Lethargy was common and generally improved in people who avoided gluten. This doesn't surprise me at all. The recent controlled gluten study in irritable bowel syndrome patients found that lethargy was the most reliable consequence of eating gluten that they measured (1, 2). That has also been my personal experience.

Question #7: Before January 2011, did you have a problem with anxiety? If so, did your symptoms change during the month of January?

Anxiety tended to improve in most participants who started with it.

Question #8: Before January 2011, did you have a problem with an autoimmune or inflammatory condition? If so, did your symptoms change during the month of January?

Autoimmune and inflammatory conditions tended to improve in the gluten-free group, although one person experienced a worsening of symptoms.

Question #9: If you ate gluten again or did a gluten challenge after gluten free January, what was the effect?

Just under half of participants experienced moderate or significant negative symptoms when they re-introduced gluten at the end of the month. Two people felt better after re-introducing gluten.


Conclusion

I find these results striking. Participants overwhelmingly improved in every health category we measured. Although the data may have been somewhat biased due to the 53% response rate, it's indisputable that a large number of participants, probably the majority, benefited from avoiding gluten for a month. At some point, we're going to compile some of the comments people left in the survey, which were overwhelmingly positive. Here's a typical comment in response to the question " In your own words, how would you describe your January 2011 experience" (used with permission):

Amazing! I would recommend the experiment to anyone. I felt completely more alert, and less bloated. When I ate some gluten at the close of the experiment, I felt gross, bloated, and lethargic.

I think it's worth mentioning that some participants also eliminated other starches, particularly refined starches. Judging by the comments, the diet was probably lower in carbohydrate for a number of participants. We may try to assess that next year.

Gluten-Free January Survey Data, Part I: Demographics and Limitations

Thanks to Matt Lentzner for organizing Gluten-Free January, and everyone who participated and completed the survey, we have a nice data set illustrating what happens when a group of people stop eating gluten for a month. Janine Jagger, Matt and I have been busy analyzing the data, and I'm ready to begin sharing our findings.

GFJ had over 500 participants, 527 of which received the survey and 279 of which completed the survey at the end of the month. Of those who received the survey, 53 percent completed it. I think these are respectable numbers for a survey of this nature, and it reflects the conscientious nature of the people who participated in GFJ.

Demographics

Although respondents were primarily from the United States, I'm happy to say that the data represent 18 different nationalities:

Respondents represented a diversity of ages, the largest group being 30-39 years old, with similar numbers in the 20-29 and 40-49 year groups.
Respondents were just under 2/3 women.

Respondents represented a variety of weights, but the sample was biased toward lean people, in comparison with the general population. There were not many obese participants.
Overall, I was pleased to see that the demographics were quite diverse, particularly in the age and gender categories.

Limitations

There are a few caveats to keep in mind when interpreting the survey results:

1. GFJ participants do not represent a random cross-section of the population at large. They represent primarily health-conscious individuals who were motivated enough to make a substantial dietary change. In addition, many of the people who participated probably did so because they already suspected they had a problem with gluten.
   
2. The survey response rate was 53%. Although I think that's a reasonable number considering the circumstances, it leaves open the possibility that survey responders differ from non-responders. It's conceivable that participants with better adherence and better outcomes were more likely to complete the survey than those who did not adhere to the diet or had neutral or unfavorable outcomes, despite our efforts to encourage everyone to complete the survey regardless of adherence or outcome. So the results could be biased toward positive outcomes, meaning that we will need to see a strong effect for it to be believable.
   
3. This was a non-blinded diet trial without a control group. There's no way to know how much of the effect was due to avoiding gluten per se, how much was due to overall changes in diet patterns, and how much was a placebo effect.
   

With that in mind, what can we take from the survey data? I feel that we can use it to answer the following question: "what is likely to happen when a motivated, health-conscious person decides to avoid gluten for a month?" And I think we can also use it to generate (but not test) hypotheses about the effects of eating gluten on the general population.

Flu Season is Here

I've noticed everyone around me getting sick lately (I seem to have become mostly immune to colds and the flu in the last couple of years), so I took a look at Google Flu Trends. Lo and behold, the United States is currently near peak flu incidence for the 2010-2011 season. Here's a graph from Flu Trends. This year's trend is in dark blue:


Flu Trends also has data for individual US states and a number of other countries.

It's time to tighten up your diet and lifestyle if you want to avoid the flu this year. Personally, I feel that eating well, managing stress effectively, and taking 2,000 IU of vitamin D3 per day in winter have helped me avoid colds and the flu.

Gluten-Free January Raffle Winners Selected!

Raffle winners have been selected and shirts are on their way. You know who you are. Thanks to everyone who participated and filled out the survey! For those who didn't, there's always next year.

Janine Jagger, Matt Lentzner and I are busy crunching the mountain of data we collected from the GFJ survey. We got 279 responses, which is remarkable for a survey of this nature.

Stay tuned for data!

Oltipraz

Oltipraz is a drug that was originally used to treat intestinal worms. It was later found to prevent a broad variety of cancers (1). This was attributed to its ability to upregulate cellular detoxification and repair mechanisms.

Researchers eventually discovered that oltipraz acts by activating Nrf2, the same transcription factor activated by ionizing radiation and polyphenols (2, 3, 4). Nrf2 activation mounts a broad cellular protective response that appears to reduce the risk of multiple health problems.

A recent paper in Diabetologia illustrates this (5). Investigators put mice on a long-term refined high-fat diet, with or without oltipraz. These carefully crafted diets are very unhealthy indeed, and when fed to rodents they rapidly induce fat gain and something that looks similar to human metabolic syndrome (insulin resistance, abdominal adiposity, blood lipid disturbances). Adding oltipraz to the diet prevented the fat gain, insulin resistance and inflammatory changes that occurred in the refined high-fat diet group.

The difference in fasting insulin was remarkable. The mice taking oltipraz had 1/7 the fasting insulin of the refined high-fat diet comparison group, and 1/3 the fasting insulin of the low-fat comparison group! Yet their glucose tolerance was normal, indicating that they were not low on insulin due to pancreatic damage. The low-fat diet they used in this study was also refined, which is why the two control groups (high-fat and low-fat) didn't diverge more in body fatness and other parameters. If they had used a group fed unrefined rodent chow as the comparator, the differences between groups would have been larger.

This shows that in addition to preventing cancer, Nrf2 activation can attenuate the metabolic damage caused by an unhealthy diet in rodents. Oltipraz illustrates the power of the cellular hormesis response. We can exploit this pathway naturally using polyphenols and other chemicals found in whole plant foods.