Back from vacation and cramming for my 2nd TEDx (I'll share the link when it's ready in a few weeks), I decided to make up for lost blogging time with an extra long post for you to chew on. I included a bonus section dedicated to my former dinosaur loving twin sons….they claim they're not into them any more, but I'm in denial since I refuse to let them grow up. It is a somewhat graphic, but memorable way to explain the food chain to kids, but don't blame me if they get nightmares. So here we go!
I frequently get readers who like to send me the latest study on red meat, eggs, coconut oil, saturated fat, etc. since the results may be contrary to what I preached in my book or in lectures. I sympathize completely since nutrition news headlines swing back and forth like a pendulum, leaving lay folks and educated folks with their heads spinning about what they should be eating on a daily basis. In this post I'm going to ask you to stop reading headlines about specific nutrients and foods and start understanding the more complex and eloquent interplay of nutrients in a given meal or snack that can completely counteract superficial headlines like “Red Meat Causes Cancer” or “Saturated Fat Causes Heart Disease.” Just like we say don't judge a book by its cover, I ask you to stop judging a nutrient or food based on a news headline. There is tremendous disagreement in the world of nutrition research, but through my own discussions with some of the world's experts on nutrition, there is one thing they do agree on…the fact that nutrition research is highly inaccurate with unlimited confounders that just cannot all be controlled for. Even in the world of pharmaceutical research where there is the ability to tightly randomize and control studies to measure the impact of a single drug on a particular condition, we are finding conclusions being reversed constantly. I have lost track of the number of drugs I started prescribing earlier in my career which were supposed to be beneficial, but now have been either pulled off the shelf or are no longer considered safe for the conditions they were intended to treat.
Nutrient Quality and Diversity: Deconstructing A Burger
I decided to focus on the ever controversial topic of red meat to make my point about the importance of understanding nutrient quality and diversity. So I ask you for a moment to put aside your political, religious, and moral beliefs about red meat and just look at this objectively from a scientific perspective. In order to do this, I want us to use the example of a burger and ask 2 primary questions which can be applied to any food:
1. What's in your burger? (the meat itself)
2. What's on and around your burger? (burger toppings and sides)
Now let's dig into this a little deeper
What's In Your Burger? A Look at Meat Quality
The vast majority of studies done on red meat and saturated fat do not differentiate meat quality. Whether you ate a fast food burger from a CAFO cow (I'll explain CAFO in a minute) or a high quality grass-fed, organic burger, you were labeled a red meat eater. So let's differentiate these scenarios to see how ludicrous it is to categorize CAFO cows and grass-fed cows together and just call them red meat.
1. Fast Food Burger: This is red meat that comes from a CAFO cow. CAFO stands for Concentrated Animal Feeding Operation. These are cows that are removed from their natural, rustic environments where they freely roamed, chewing on grass and bathing in sunlight without a care in the world and shoved into a dark shed, bunched together with other inmates and fed an unnatural diet composed solely of grains. I'm not going to discuss in this post the dangers of a diet that is predominantly grains, but in my book and my practice I constantly see the ill effects of my Indian patients who consume excessive grains, little to no plants, and hardly any high quality proteins and fats.
2. Grass Fed Cows: These cows live like they were meant to live. By roaming pastures and feeding on grass, they are getting more nutrients not just from the grass but also the bugs that land on the grass which supply additional Omega-3s. Here's a summary from NPR of grass-fed benefits including double the amount of anti-inflammatory Omega-3s compared to grain-fed cows. Grass-fed cows are also exposed to direct sunlight, which means they are getting healthy doses of vitamin D, which will end up in the meat you eat. Their overall lives are care-free and stress-free which means until the point of slaughter, they are physically and emotionally healthier. Yes, stress does not just adversely affect the lives of humans, but can do the same to animals.
We all know the saying, “you are what you eat.” Remember that there is a longer food chain that starts from the soil and works its way up to the sun. I understand that high quality grass-fed meat is costly, but you are getting more nutrients per dollar spent. Considering the billions spent annually worldwide on supplement pills, why not pay the extra amount and get the more bioavailable nutrients from natural food rather than synthetic pills? Nutrient rich soil feeds the grass that feeds the cow along with whatever bugs land on that grass, and the sunshine overhead bathes that cow and triggers vitamin D production and together the interplay of nutrients from the ground below and the sun overhead eventually end up on your plate. I know that's a terrible run on sentence but its deliberate so you understand the rhythm of the food chain from above and below. You can apply this same concept to organic produce grown on high quality soil.
What's On and Around Your Burger? Nutrient Interactions
1. Green Veggies and Anti-cancer Effect: Let’s say you're stuck on a freeway and all you have access to are fast food restaurants that serve nothing but CAFO meats. Is there some way you can mitigate the inflammatory effects of this lower quality meat? This is where nutrient interactions come to play. Studies that show a link between red meat and colon cancer point to the role of dietary heme, which is the type of iron found in meat, fish and poultry. In animal studies, dietary heme is metabolized to a chemical that kills colon cells and may promote tumor growth. Interestingly,this study showed that the cytotoxic (aka “cell-killing”) effects of dietary heme were counteracted by adding green vegetables. Green vegetables contain chlorophyll (pigment that gives veggies their green color), which has a structure similar to heme and may block heme from attacking your colon cells. Darker, leafy green vegetables like spinach are especially rich in chlorophyll. So top that burger with dark green leafy veggies or have a spinach salad on the side. Apply this principle to meat you consume in any form (kebabs, curries, etc.)….maximize the dark greens. This is another reason I push leaf-wrapped burgers so strongly in my book. Not only are you removing the excess carbohydrates from the bun/bread, but you are replacing it with anti-cancer nutrients that may counteract the effects of heme iron.
2.Avocados and Anti-inflammatory, Heart Protective Effects: How about topping your burger with another powerfully protective green powerhouse, the avocado. When you eat a lower quality CAFO burger, there is an instant measurable surge of inflammatory chemicals in your body like IL-6. The blood flow in your peripheral arteries actually goes down. It’s astonishing how a single meal can have such immediate detrimental effects on your health by compromising your blood circulation and triggering inflammation. Here’s where the avocado comes to the rescue. This UCLA study showed that adding an avocado to a burger in study subjects actually counteracted the surge in inflammatory IL-6, prevented the the blood flow restriction, and even lessened the surge in triglycerides that occurred when the burger was eaten without the avocado. Ok, to be fully transparent I must add that this study was supported by Hass Avocados. Does that make the information less reputable? If we apply that rationale then many of the drugs I prescribe as a physician should be taken off the market due to direct and indirect drug sponsorship of supporting studies.
“What’s around your burger?” is another key question. Is it a side of french fries and a diet coke? If you ordered a high quality steak, then “what’s around it” includes what you ate before (bread basket and appetizer), what sides you ordered, what you ordered for dessert and what beverage. A basket of bread followed by a CAFO steak with a side of baked potato, coke and a dessert is an entirely different meal than an opening salad, grass fed steak with a side of vegetables, a glass of red wine or sparkling water and fruit or a small serving of dark chocolate for dessert. Most studies done on red meat don't distinguish between these scenarios. Regardless of whether you are a carnivore or an herbivore, plants (especially green plants) need to be the center point of any eating plan, and for meat eaters, instead of having high quality meat with a side of veggies, start thinking about having lots of veggies with a side of high quality meat. An ideal burger is grass-fed, and at the very least topped with avocado/guacamole (and whatever other veggies you can squeeze in: tomatoes, herbs, etc.), and wrapped in green leaves instead of a bun.
Now armed with this background you can see why nutrition headlines are so misleading. When a headline says “Red meat found to increase heart disease or cancer risk,” most likely the meat consumers were not eating red meat the way I prescribed. Although these studies do try to remove confounding effects like activity levels, smoking, socioeconomic background, etc., they don't account for what's in your meat, on your meat or around your meat. The vast majority of these studies are looking at a grain-fed cow contaminated by CAFO processing and surrounding by toxic amounts of fructose (soda), carbohydrates (buns), and trans fats (fries). These are not grass-fed lettuce wrap burgers topped with guacamole that they are studying. Two completely different animals with vastly disparate effects on insulin and inflammation.
In my office, I am directly measuring the impact of eating these healthier versions of red meat based meals on inflammation and insulin and seeing dramatic reversals in health risks. The other point that these studies often make is that eating red meat increases cholesterol. In my office I see that effect, but it's entirely due to an elevation in healthy HDL cholesterol and a beneficial particle shift from small, dense LDL to larger LDL subfractions which I often measure. If you're saying “what is he talking about?,” you can read my book which has a whole chapter on cholesterol that explains this stuff in more detail.
Now that grass-fed meat is making more of a mainstream entry into markets other than Whole Foods and as people are becoming conscious about the dire impact of sugar, excess carbohydrates and grains in the diet, we need an entirely new class of studies measuring the impact of red meat consumed in a healthier context than in the past. So next time the inevitable headline comes out disparaging red meat , think about the population studied and what's in their meat, on their meat and around their meat. You can apply this reasoning to any animal product you eat, including eggs which I discuss here. Again, most studies do not differentiate eating CAFO eggs in the form of a breakfast sandwich or burrito with a glass of OJ on the side versus eating the healthier alternative of having organic, cage-free eggs wrapped around veggies in the form of an omelette with a side of berries and a glass of kefir. You get the picture.
Dinobesity and CHOWs (Confined Human Office Workers)
Here's the bonus section as I promised. What if Jurassic Park really came to life and we had a hybrid T-rex with an intelligent brain trying to decide who to eat for optimal health? Based on everything you’ve learned so far about the nutrient food chain, T-rex would have a hard time finding a nutrient-dense human to eat. Today's modern human is not much different than a CAFO animal. In fact, I have a new term for these humans which is “CHOW” (Concentrated Human Office Workers) which I'm talking about below at TEDx.
Most of the humans I come across in my Silicon Valley clinic are confined to sun-deprived indoor work spaces depleting their vitamin D levels. They are eating sugar, excess carbohydrates and far too many of the nutrient deficient, pesticide-laden grains used to fatten up CAFO cows. As animals get pumped up with hormones and antibiotics, today’s average human is pumping in a growing list of prescription drugs, in addition to endocrine hormone mimickers from the environment like BPA and produce laden with pesticides . While CAFO animals experience the chronic stress of slaughter, which results in increased stress hormones, humans are experiencing chronic stress from overburdened work and personal lives resulting from our digital addiction.
If T-rex were to primarily “chow on CHOWs,” he would likely become obese and develop chronic illnesses like diabetes, heart disease and cancer. An epidemic of “Dinobesity” would spread among carnivorous predators who prey upon indoor office workers. Ideally, T-rex would seek out humans who consumed predominantly plants, some high quality meat and healthy fats, and lived a physically active life with intermittent sun exposure and stress moderation. Although this breed of humans is becoming increasingly endangered by modern lifestyle habits, it is absolutely possible to reclaim our health by reconnecting with some of these ancestral habits.
Unlike the CAFO animals, we humans have the choice and freedom to change our food supply and environment. The cow is force-fed, but we can choose to eat higher quality, nutrient-dense foods. Our confinement is also mostly self-inflicted. Even if you work inside a cubicle, you have the choice to step away and walk outdoors and get healthy doses of sunlight and fresh air. Many of my patients spend a good part of their work days and even weekends chained to their devices, inside their homes. Although we cannot be 100% free-range and grass fed, we can be intermittently free-range and mostly grass-fed. By grass-fed I don’t necessarily mean vegetarian. I mean meals and snacks that are predominantly plant-based, with some meat (if your diet allows it) from animals who lead more optimal lifestyles, similar to the ones we should all strive for.