What is “science”? Ever since the COVID-19 outbreak, the term has been thrown around by almost everyone. It’s used as a way to make it seem like your opinion is validated or that the opinion of others is not legitimate. I started writing this a few weeks ago and it seems like there have been two or three more announcements or major news stories made that reference science since then.

The actual definition of science, per the Oxford Dictionary (remember those?), is

Even the definition of science is vague at first glance, but if look carefully at the last few words, it becomes clear that you must test your theory against evidence before coming to a conclusion.

How one might go about the testing portion of the study is the most critical part. Getting science wrong has very real consequences. From vaccines, to climate change, to causes of autism, to alternative medicine and GMOs, the “science” is what we all must lean on to determine the truth. And to make decisions on how to live and what’s best for those that we care about.

Before I dig into how the scientific method is used, it’s important to distinguish where information on a topic comes from. Journal articles, the primary way science is communicated in higher education, are a different format than online news articles, social media posts or blogs and require a level of skill and are put under much more scrutiny.

A journal article is written by experts and published in an academic journal to share new research, theories, or findings with other professionals in a specific field. These articles are often reviewed by other experts before publication (peer review) and are considered a high-quality source of information.

The danger is that now that the world has search engines and AI, it’s not that difficult find a ”study” that shows the results that you believe or want to be true. For most people, that one study is enough proof for them. What constitutes enough proof? Unfortunately, spending hours in the research is the only way to truly get enough information to determine if the study you are referencing is legitimate.  

You might have tried to read scientific papers before and been frustrated by the dense, boring writing style and the unfamiliar words and terms. I felt this way years ago when I started digging deep into studies on fitness, nutrition and training techniques.  Reading and understanding research papers is a skill which every single doctor and scientist has had to learn during graduate school – my wife is in the middle of her clinical psychology doctoral program and can attest to this as well.  You can learn it too, but like any skill it takes patience and practice. Which most people are not willing to take on.

Reading a journal article or research paper is a completely different process than reading a summary on social media or in an article on a website from your trusted news source. It’s even different than reading a book. You will have to read the sections (Abstract, Introduction, Methods, Results, and Conclusions/Interpretations/Discussion) of the research in a different order than listed. You will likely have to read portions of it multiple times and even take notes like you are back in school studying for mid-term. I often go down rabbit holes looking up other papers that are referenced for some of the details. Does this sound like fun yet?

If you are still interested in learning how I suggest going about this, here are some things to consider before you read a journal article or research study:

• Who are the authors and what are their institutional affiliations.
• Some institutions (most universities) are well-respected. Others (The Discovery Institute or Center for American Progress for example) may sound like legitimate research institutions, but are actually agenda or financially-driven.
• Take note of the journal in which it’s published. Reputable (biomedical) journals will be found in Pubmed or on clarivate.com
• Note the date when the study was done. Knowing when the research was published helps you have an understanding of whether these are the most recent findings and how likely it is that further studies have taken place since.
• Determine who funded the study. Check the acknowledgments section of the paper for a specific funding statement. You can also look for grant numbers and use databases like NIH RePORTER to search for the funding agency. The biggest example was when the sugar industry paid scientists in the 1960s to publish research that downplayed the link between sugar and heart disease, shifting the focus to saturated fat instead, a narrative that influenced dietary guidelines for decades. Tobacco companies also funded many studies concluding that second hand smoke was not harmful.

INTRODUCTION

Once you feel convinced that research is from a credible source, start by reading the Introduction. The abstract is listed first but won’t tell you the whole story and if you just read this, you could misinterpret what the actual findings were (I’ve been guilty of this). Abstracts are a summary and interpretation of the entire study. I’m not saying to ignore the abstract but read it after you have dug into the research.
The introduction will also describe what the purpose of the study was. Using the scientific method, this would be the exact question the researchers were trying to solve and should be very specific. Sometimes you will see a headline about “research finds…”, but if you read deeper, that might not be the answer to their question and should give you a pause.

METHODS

Next read the methods section. This will tell you exactly what the authors did as part of this experiment. An experiment is designed to test the hypothesis in a reproducible way, collecting relevant data and observations. The methods should be directly aligned with the question they set out to answer. If they or other researchers can’t reproduce the exact method that was used, the results should not be valid.
A randomized controlled trial (RCT) is thought of as the “gold-standard” method of research. It is a scientific study where participants are randomly assigned to either an intervention group or a control group to test the effectiveness of an intervention. A RCT cannot always be used due to ethical concerns, logistical limitations, or when the intervention affects a whole population rather than individuals. Ethical issues arise when withholding an effective treatment from the control group is dangerous or when it's impossible to conduct a study without affecting the participants' lives. Logistical problems include situations where interventions target entire communities, and the control group can be contaminated by the intervention's effects.

Implementing and managing a full RCT can be very costly and time-consuming, especially for interventions that are intended to be implemented over a long period. They may not be feasible for all research projects.

RESULTS

Next is the most important part in my opinion. The Results.
This is one or more paragraphs to summarize the results for each experiment. Usually, the results are summarized in the figures and tables (you know I love charts and graphs). Pay careful attention to these. 

The results can be hard to read. Especially if statistics are involved. They are usually way more complicated than that high school Statistics class we took. Even for those of us that took higher-level Stats in college, that was likely a long time ago and interpreting statistical results can be confusing.  Below are some things to pay attention to in the results section:

• Any time the words “significant” or “non-significant” are used. These have precise statistical meanings.
• A result is "statistically significant" when the observation is unlikely to have occurred by random chance, leading researchers to reject the null hypothesis (no relationship or effect) and accept the alternative hypothesis.
• A “non-significant” result does not mean there is no effect. It means the study failed to prove one with sufficient confidence. This could be due to a small sample size, for instance, which makes it difficult to detect a true effect.
• The sample size. Was the study conducted on 10, or 100,000 people? This is a big one for me. Depending on the subject of the study, a large sample size may be difficult, but if it’s something that is more common in society or has been around a while, I usually discredit small sample size studies.
• What do YOU think the results show? If you are still reading this post, you are likely a pretty smart person. Use your logical mind to interpret the results on your own. What conclusion do you think they show? Maybe once you read the researcher’s interpretation and conclusion, you will change your mind, but it’s a really good habit to start forming your own interpretations before you read those held by others – even the authors of the study.

CONCLUSION

Now read the Conclusion/Discussion/Interpretation section.

Do you agree with the conclusion the authors made? Do they call out any weaknesses in their own study? If not, that’s a red flag. You can always think of ways to do it better if you had the chance to start over. The researchers should tell you what they missed.

This is where it is important to remember the phrase “causation does not equal correlation”. Observing that two things change together (correlation) doesn't automatically mean one causes the other; a third, unobserved factor, random chance, or reverse causation could be responsible for the relationship. Mistaking correlation for causation can lead to incorrect conclusions and misguided decisions.

Some examples that help this make sense:

• Ice cream sales and drowning: Both increase in the summer, but a third factor (hot weather) causes people to buy more ice cream and go swimming more, leading to both increases.
• Firemen and damage: More firemen at a fire correlate with more damage, but the fire itself is the cause of both the damage and the larger number of firemen needed.
• Lighters and lung cancer: The number of people with lighters correlates with the number of people with lung cancer, but the real cause is smoking, which is correlated with both phenomena.

A research study could do everything correct, but draw a conclusion based incorrectly on ignoring or not exploring a possible third factor. Even top Scientists struggle with the difference between correlation and causation. And a few years back, a professor of epidemiology and biostatistics at Drexel University collaborated with researchers in Sweden to study Autism. In the first part of a study, they compared children who had been exposed to Tylenol - which is a trade name for the drug acetaminophen - with children who had not been exposed while in the womb. And they did see a small statistical association linking Tylenol use to autism. But autism is a very hereditary condition, and association is not causation. So they tried to drill down on this question by comparing siblings. Specifically, they looked at cases where one child had been exposed to acetaminophen during pregnancy and the other had not.

When they did the sibling analysis, the association completely disappeared. In other words, the association was not a causal one, and it was most likely due to other factors like genetics, infections, fevers, or something else.  

So yes, there is a connection between autism and Tylenol use by the mother, but it appears to be a correlation and not the cause. At least in this particular study. This is an example of how it is easy to prioritize studies showing a correlation while giving insufficient weight to the more scientifically robust sibling-controlled analysis that demonstrated no causation. If you go into the research with the expectation of a certain result, you can easily convince yourself that you see that result.

As mentioned previously, the gold standard for science is the randomized controlled trial, and you can't exactly do this with pregnant women due to ethical concerns around the health of the mother and fetus.

This is not meant to be a political post, but I wanted to use a relevant and timely example of causation does not equal correlation.

ABSTRACT

Finally, go read the Abstract. Does it read like you thought it would based on the Methods, Results, and Conclusions?

Another good practice is to type the exact title of the Journal Article or Research Study title into a search engine to see what comes up. Sometimes you will come across someone (an expert in the field) else’s interpretation of the results or something that was missed in the methods that you may not have realized but someone else did.

I also like to search for a systematic review or meta-analysis on the subject or specific question being researched.
A systematic review provides a comprehensive overview of all available studies on a specific research question, while a meta-analysis is the combination of results from multiple studies to produce a more precise, combined estimate of an effect.

All meta-analyses are part of a systematic review, but not all systematic reviews include a meta-analysis. If there is a conclusion reached through the meta-analysis, I have a lot more confidence in the results than if it’s just one or even two studies reaching that conclusion.

Reading and interpreting a journal article is challenging because these papers are written for experts in the field, not the general public. If you want to put in the time and energy to become an expert in any field of study, the rewards are endless. However, I know that most people do not have the time or energy to do this, so I recommend you find a subject matter expert you can trust.

Someone can become a subject matter expert (SME) through a combination of specialized knowledge, experience, formal education, and establishing themselves as the go-to authority in a specific field. They demonstrate expertise by having a deep understanding of complex topics, providing actionable insights, and possessing strong problem-solving skills within their niche. Usually it someone that is very passionate about a subject and you can see that they have devoted a good portion of their life to it.

Before we dig into it's safety, let's go back in time. Why is fluoride in our water anyway?

It all goes back over 120 years to 1901, when a young dental school graduate named Frederick McKay left the East Coast to open a dental practice in Colorado Springs, Colorado. When he arrived, he found the people of Colorado Springs with brown stains on their teeth. To his surprise, the teeth afflicted by brown stains were somehow more resistant to decay than those he had seen back home.

Years later, while studying this brown stains, McKay and Dr. Grover Kempf of the United States Public Health Service (PHS) traveled to Bauxite, Arkansas. This small town was home to Aluminum Company of America (ALCOA), which mined the ore found in the ground there and built plants and mills to process this bauxite ore that is a key component in aluminum. In this town, the two men discovered that the same brown enamel disorder was prevalent among the children of Bauxite, but nonexistent in another town only five miles away.

McKay and Kempf published a report on their findings that reached the desk of ALCOA's chief chemist, H. V. Churchill. He then decided to conduct a test of the water in Bauxite, which found that the town's water had high levels of fluoride.

In January 1931, Churchill wrote a letter to McKay regarding his findings. In the letter, he advised McKay to collect water samples from other towns "where the peculiar dental trouble has been experienced. We trust that we have awakened your interest in this subject and that we may cooperate in an attempt to discover what part 'fluorine' may play in the matter."

McKay collected the samples. And, within months, he had the answer to his 30-year quest. High levels of water-borne fluoride indeed caused the discoloration of tooth enamel. It just so happened that fluoride was naturally present in the groundwater in all of these locations. It occurs due to the dissolution of fluoride-rich minerals in rocks and soil.

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Add it to the tap water.

Fourteen years later, in 1945, Grand Rapids, Michigan became the first city in the world to purposely fluoridate its drinking water, at an amount high enough to reduce decay, but low enough to prevent the brown stains. The Grand Rapids water fluoridation study was originally sponsored by the U.S. Surgeon General but was taken over by the NIDR (National Institute of Dental and Craniofacial Research) shortly after the Institute's inception in 1948. During the 15-year project, researchers monitored the rate of tooth decay among Grand Rapids' almost 30,000 schoolchildren. After just 11 years, the caries rate (tooth decay) among Grand Rapids children born after fluoride was added to the water supply dropped more than 60%. This finding, considering the thousands of participants in the study, amounted to a giant scientific breakthrough.

Today, just about every toothpaste on the market contains fluoride as its active ingredient and approximately 73% of the U.S. population on community water systems receives fluoridated water.
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But is it safe?

Robert F. Kennedy Jr. is now the Secretary of Human and Health Services in the United States. He is outspoken about the potential harms of fluoride. Earlier this year, he stated “Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.” These statements are getting a lot of press and so I wanted to dive into the issue.

There is a recent history of research leading to a universal change in fluoride in drinking water. In 2015, the U.S. Public Health Service (PHS) updated its recommendations for fluoride levels in community water systems.

The decision was based on several factors, including the widespread availability of fluoride in oral care products and other sources and the observation that children were experiencing dental fluorosis (white splotches on teeth) due to excessive fluoride exposure.

The new recommendation set a uniform concentration of 0.7 mg/L (or 0.7 ppm) of fluoride in drinking water. This change aimed to ensure that while cavity prevention benefits were maintained, the risk of dental fluorosis in children was also minimized.
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But even if it protects your teeth, can fluoride be doing damage to other parts of your body?

There have been several studies over the last 30 years that found fluoride could cause brain damage, but only at extreme levels – much higher than we find in water. There was also a study just last year showing that higher levels of fluoride in pregnant women’s urine showed double the odds that their children have neuro-behavioral problems by age three. There were eight other studies that looked into this same phenomena and six of them found similar results. Other studies show that those that grew up with fluorinated water showed no significant differences in IQ from those that did not. The data is all over the place.

There is also a little evidence that fluorine can cause hyperthyroidism and increase risks of bone fractures, but nothing conclusive.

Based on what I can find, there is no strong evidence or Meta Analysis that definitively says that there are dangers to drinking water with fluoride.
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But it’s still good for dental health, right?

There have been several cities that have removed fluoride from their drinking water and it is documented that kids that have grown up without fluorinated water will have around 10% more cavities. If you are already an adult, the benefits don’t appear to be as great. Permanent teeth have a thicker enamel and adults also tend to be better at brushing and flossing.

Outside of drinking water there are other sources of fluoride that we encounter. Black tea and coffee can be significant sources of fluoride. As well as seafood like crab, shrimp, and fish. Unfortunately, pesticides contain fluoride, so non-organic fruits and vegetables may also contain it. Could some of these other sources be contributing to the findings of the studies showing a link to neurological issues, hyperthyroidism and increased risks of bone fractures? Possibly.

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So what's the conclusion? There is none.

Research on this topic needs to be continued and if someone is telling you the results are conclusive in one way or the other, they likely have an agenda.

As for me and my family, we stopped buying fluoride toothpaste for our home years ago, but I still drink tap water – which here in Louisville, typically contains an average of 0.6-0.7 ppm of fluoride according to the Louisville Water Company’s website. My rational is that we are exposed to enough fluoride already and we all visit the dentist regularly. If there is a link to any dangers around fluoride consumption, taking this one source away seemed to be worth it to me.

Tomorrow is Earth Day, so I thought I would use this opportunity to talk about “Earthing” or “Grounding” as it is also known. Earthing (or grounding) refers to the connecting your skin, usually your feet directly to the ground to realize possible benefits from conductive systems that transfer the Earth's electrons from the ground into the body.

This topic came up recently during a meeting I attend monthly with professional peers (not a group directly in the health and wellness space). One of the other members asked me if I had heard of grounding and wanted to know what I thought about it. To those withing earshot, it definitely sounded strange as I described taking off your shoes and socks and allowing your feet to make direct contact with the dirt, grass, or sand. But it’s something I’ve been doing for over a decade and there’s plenty of evidence that this simple practice of getting your feet dirty can be greatly beneficial for health by lowering free radical damage, reducing stress, inflammation and pain.

If you think back to prehistoric man, or even Indigenous cultures, they were naturally earthing.  But since the invention of the rubber soled shoe in 1882, most humans in first-world countries have been purposely keeping their feet from making direct contact with the ground. Foot coverings before this were made from materials such as leather and other animal skins. These materials serve as a conduit, enabling the flow of electrons to one's body from the ground up. Rubber and plastic are insulators, materials in which an electrical charge can't flow through, so once we started wearing rubber and plastic-soled shoes, the connection with the earth stopped.

The idea of earthing or grounding is that the Earth is a source of negative energy (which is good in this case) that we can connect with to offset the positive charge we build up from our typical modern lifestyle that usually does not include our skin being in direct contact with the earth.

You can find lots of information out there on the how behind earthing. To simplify it, like any other electrically conductive object, a human body can store electric charge if insulated. The body prefers to be neutral, but the build up of free radicals - produced either from normal cell metabolisms or from external sources (pollution, cigarette smoke, radiation, medications), lead to a positive charge in the body. The human body requires a constant source of negatively charged electrons in order to get back to neutral and prevent an excessive build-up of these positively charged free radicals. Without a regular supply of electrons, the cells in our body are unable to balance the positive charge. Too much positive charge starts to create free radical damage, oxidative stress and inflammation. Free radicals damage contributes to the etiology of many chronic health problems such as cardiovascular and inflammatory disease, cataracts, and cancer.

Fortunately, the Earth is continuously being charged with electrons, which mainly occurs through the hundreds of thousands of lightning strikes that take place around the world every hour. Your body is naturally able to absorb the Earth’s negative electrical charges since your skin acts like a “conductor.” Your feet, specifically certain points in the balls of your feet, are believed to be especially good at receiving the earth’s electricity.

Although direct contact with the ground outside is the best source, you can also practice grounding/earthing indoors. Indoor earthing can be realized with earthing mats, sheets, or bands. These products have a grounding wire designed to plug in to the ground port of your wall outlet or a grounding rod, which is meant to connect you to the earth through your home or building’s grounding wire. A grounding wire is a safety measure used to prevent a house fire or an electric shock if there is excess electricity in the wiring system. Ground wires run parallel to other wires in order to safely discharge excess electricity into the ground. So by plugging in a grounding mat or band, you are able to connect directly with the earth through this wire.

The conclusion of this study states that emerging evidence shows that contact with the Earth—whether being outside barefoot or indoors connected to grounded conductive systems—may be a simple, natural, and yet profoundly effective environmental strategy against chronic stress, ANS dysfunction, inflammation, pain, poor sleep, disturbed HRV, hypercoagulable blood, and many common health disorders, including cardiovascular disease. The research done to date supports the concept that grounding or earthing the human body may be an essential element in the health equation along with sunshine, clean air and water, nutritious food, and physical activity.

Bottom line is that earthing or grounding is free and with no side effects other than getting dirt on your feet, the potential benefits make it a no brainer. So take off your shoes and socks and get outside!

The FDA has now approved multiple medicines for weight loss.

The drug company Novo Nordisk, headquartered in Denmark has created two injection-type drugs. The first is known as Wegovy. It is given as a once-weekly injection. The other is known as Ozempic and contains the same key ingredient as Wegovy, called semaglutide.

Eli Lilly’s injectable drug named Mounjaro has also been approved for Type 2 diabetes but is being used off-label for general weight loss.

Another Lilly drug, Orforglipron, is part of a new group of experimental medicines that goes after the same target, GLP-1, but in a daily pill form.

Novo Nordisk reported results last month showing that a pill version of semaglutide yielded 15% weight loss over 68 weeks, similar to the injectable Wegovy’s results.

But that drug, which is approved as Rybelsus for Type 2 diabetes, can be complicated to take, doctors say, with strict requirements about not eating or drinking within 30 minutes of taking it.

Pfizer has joined the race for the “magic weight loss pill” as well with two oral GLP-1 drugs in development, publishing data last month on one of them in people with type 2 diabetes; it also led to weight loss over 16 weeks that researchers said was comparable to other drugs in the class. The experimental medicines from Pfizer and Lilly are designed to be able to be taken with or without food.

The medicines still need to complete larger-scale testing in phase 3 trials, which means they are months to years from reaching the market.

So is this it? Have the drug companies finally created the “easy button” for weight loss? No more having to eat healthy? No more counting calories or macros? No more exercising needed to try and stay lean?

You know better than that, right?

Right out of the gate, there are several reason why you should be cautious about taking these weight loss medications.

• If you lose weight with new drugs, you likely will need to keep taking the medications forever to keep the weight off. People who stop taking Wegovy and Ozempic often gain weight back relatively quickly. Some have experienced addition gain from where they started.

• The drugs are expensive, and in general, insurance plans don’t cover them for weight loss (although they often do for people with diabetes). You could be looking at $15,000 to $17,000 a year for these drugs.

• The popularity of the new drugs has led to some shortages. So you could start taking it and then not be able to get it, leading to weight gain.

• The drugs can cause unpleasant gastrointestinal side effects (see below for details).

• A small percentage of people who take the drugs can suffer from a diabetes eye complication called retinopathy. Along with consulting with your primary care provider or endocrinologist, you should also see your eye doctor.

• The drugs tend to suppress a person’s appetite but to lose weight, you’ll still need to reduce your intake of desserts, sugar-sweetened beverages, and fatty foods. And, of course, exercise is important to keep your body healthy.

• Some people have complained about looking older due to “Wegovy or Ozempic face.” While many people taking weight loss drugs are pleased to shed some pounds, some say they’re dropping weight in the wrong place: their face. Some have complained of looking old and gaunt due to fat loss in the face.

While a sedentary lifestyle and increased consumption of empty-calorie, processed foods most certainly have boosted obesity rates in the U.S. and around the world, researchers have learned much more in recent years about genetic causes for weight gain. Some people’s bodies may, in fact, want them to pack on fat.

That being understood, there may be a small portion of the population that could benefit from a drug that reduces appetite and helps people lose significant pounds, leading to better overall health.

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How do they work?

Wegovy and Ozempic mimic a hormone called glucagon-like peptide-1, which targets areas of the brain that regulate appetite, according to the FDA authorization.

The drugs decrease appetite and slow down emptying of the stomach, so people feel less hungry and eat less. They can cause some unpleasant gastrointestinal side effects.

What the pharmaceutical companies have done is taken this hormone that is naturally occurring and restructured it into a drug. So, it's not a surprise that when people stop taking the medicine, they start to feel hungrier.

Normal hormone balance can be hard to get back. Some patients that stopped taking the drug reported that their appetite had increased. They no longer feels satisfied with small meals, struggle maintaining energy and gain weight.

Who is eligible? 

Under the FDA authorization, Wegovy is supposed to be used for people who are obese or overweight. Those who have a body mass index (or BMI) of 30 or greater are eligible along with those who have a BMI of 27 or greater who also have other health problems such as high blood pressure, diabetes or high cholesterol that make weight loss important. For reference, for a woman that is 5’4”, a weight of 175 pounds puts you at a BMI of 30. A 5’9” male has a BMI of 30 if he is 203 pounds.

They are also approved for people with Type 2 Diabetes.

If you don’t meet those criteria, you would be using the medications “off-label,” or not as the FDA has approved them. Your healthcare provider may or may not be ok prescribing a drug to you off-label.

What are the most common side effects?

Gastrointestinal problems are the most common side effects since Wegovy can slow down people’s digestive systems. During clinical trials, some participants experienced nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, bloating and gas.

People who have uncontrolled diabetes can get retinopathy, a complication that involves damage to blood vessels in the eyes, and can result in vision loss or blindness.

During the clinical trials for Ozempic, there was an almost three-fold increase in the rate of people getting retinopathy when they were placed on Ozempic as compared to those who were not receiving Ozempic.  

People may be at increased risk for pancreatitis, which is inflammation of the pancreas often caused by gall stones, alcohol use or high triglycerides.

The drug does carry a black box warning because in rodent studies it caused thyroid tumors. Because of this, Doctors may screen patients to find out if they have a family history of a specific kind of thyroid carcinoma, or another rare condition called multiple endocrine neoplasia syndrome type 2 (MEN 2).

If you take Wegovy or Ozempic to lose weight, will you need to keep taking the drugs indefinitely?

Yes. As with many chronic conditions, most people who use the drugs for diabetes or weight loss will need to keep taking them to keep benefiting from them.

You have to inject yourself with these drugs. As in stick yourself with a needle once a week.

These medications currently come as injectables, although as mention in the opening, there are pill forms being tested.

So what is the bottom line? Are they safe?

Just like any prescription or over the counter drugs, you always have to weigh the benefits and risks. In general, I’m not in favor of anything that seems to be the easy way out and involves messing with your body’s hormones for the rest of your life. However, if you are currently obese and are struggling with losing weight through a controlled diet, you are already at increased risk for many diseases. Heart disease is the leading cause of death in the U.S., and obesity and weight-related conditions are top risk factors.

As you would expect me to say, a clean diet (reduce sugar, grains and vegetable oils) and exercise should always be the first strategies to try and lose weight. But given that about 70% of Americans are overweight or obese, nearly half of adults in the U.S. have hypertension and more than 1 in 3 have pre-diabetes, these drugs may have their place.

You should learn the facts, talk to a trusted medical professional and make an informed decision.

A new study came out last week in Science magazine. These researchers have precisely measured life’s metabolic highs and lows, from birth to old age, and the findings will surprise you.

The findings suggests that your metabolism (the rate at which you burn calories) actually peaks much earlier in life, and starts its inevitable decline later than we thought.

According to the abstract, the scientists analyzed the average calories burned by more than 6,600 people ranging from one week old to age 95 as they went about their daily lives in 29 countries worldwide.

Most previous studies on metabolism only accounted for the calories we burn for things that are critical to life (breathing, digesting, pumping blood).  Requirements of the heart, liver, kidney and brain account for 65% of the resting metabolic rate although they constitute only 5% of body weight. Previous studies did not take into account the energy we spend doing literally anything else. Even sitting burns calories.

Pooling and analyzing energy expenditures from data gathered over the last 40 years from multiple labs across the entire lifespan revealed some surprises. Some people think of their teens and 20s as the age when their calorie-burning potential hits its peak. But the researchers found that, pound for pound, infants had the highest metabolic rates of all.

Energy needs shoot up during the first 12 months of life, such that by their first birthday, a one-year-old burns calories 50% faster for their body size than an adult.

After this initial surge in infancy, the data show that metabolism slows by about 3% each year until we reach our 20s, when it levels off into a new normal. Despite the teen years being a time of growth spurts, the researchers didn’t see any uptick in daily calorie needs in adolescence after they took body size into account.

I remember being told that “once I turned 30, my metabolism slowed dramatically”.  Turns out that it’s not a changing metabolic rate that causes weight gain in our 30’s and 40’s. So why do most people put on the extra pounds at this stage in life? Aside from people just eating more calories than they are burning, other lifestyle changes including stress, a busier schedule and less exercise are also contributing factors.

Researchers discovered that energy expenditures during these middle decades – our 20s, 30s, 40s and 50s -- were the most stable. Even during pregnancy, a woman’s calorie needs were no more or less than expected given her added bulk as the baby grows.

The findings show that our metabolisms don’t really start to decline again until after age 60, and then at a rate of only 0.7% a year. But a person in their 90s needs 26% fewer calories each day than someone in midlife.

As might be expected, while the metabolic rate patterns hold for the population, individuals vary. Some have metabolic rates 25 percent below the average for their age and others have rates 25 percent higher than expected. But these outliers do not change the general pattern, said the researchers. So don’t assume they you are different. You likely are not

This research is going to reshape the science of human physiology and may even have doctors and pharmacists rethinking appropriate drug doses for children and older people.

You can find the details on the study here: https://pubmed.ncbi.nlm.nih.gov/34385400/

#2. Eat Real Foods

Avoid stuff that comes wrapped in plastic. “Foods that undergo ultra-processing tend to see much of their nutritional bounty stripped from them,” says Yoni Freedhoff, an Ottawa-based obesity doctor and author of The Diet Fix. Another reason to avoid processed foods is related to energy density, or calories per gram of food. “Generally speaking, ultra-processed foods are much higher in energy density than foods made from fresh, whole ingredients,” says Freedhoff, “which isn’t great for maintaining a healthy weight.”

Freedhoff’s ideal diet for health and longevity? “One that is rich in whole foods that in turn are especially filling. You can keep calories at bay while maximizing nutrition,” he says. ​

#3. Call Your Friends

While it's difficult to do during a global pandemic, a mounting body of evidence is revealing that hanging out with friends and family doesn’t just make you feel good in the moment—it’s also good for long-term health. Social connections are associated with reduced levels of the stress hormone cortisol, improved sleep quality, reduced risk of heart disease and stroke, slowed cognitive decline, lessened systemic inflammation, and improved immune function.

In a 2010 study published in PLOS Medicine, researchers from Brigham Young University followed more than 300,000 people for an average of 7.5 years. They found that the mortality risks associated with loneliness exceeded those associated with obesity and physical inactivity and were similar to those associated with smoking.

#4. Avoid (Nearly) All Supplements

Americans spend more than $30 billion every year on dietary supplements, yet the vast majority don’t work and may even cause harm. A 2016 article published in the Journal of the American Medical Association cited more than 20 years of research and concluded that “studies evaluating dietary supplements have yielded predominantly disappointing results about the potential health benefits, whereas evidence of harm has continued to accumulate.”

Though supplements are often pristinely packaged in alluring promises, ​but most are garbage. There simply aren’t many supplements with sufficient evidence behind them to support their use in a person who doesn’t have a particular proven deficiency or need. I take supplements (Garden of Life brand) because I am often asking my body to do extreme things (such as triathlons, obstacle course racing and lifting heavy weights), but if you are eating a healthy diet and your exercise is moderate, you likely don't need supplements. 

#5. Sleep 8 Hours at Night

Regardless of what the biohackers may tell you, you simply cannot nap or intermittently sleep your way to optimal health and functioning. It’s only after you’ve been sleeping for at least an hour that anabolic hormones like testosterone and human growth hormone—both of which are critical to health and physical function—are released. What’s more, a 2007 study published in the journal Sleep showed that with each additional 90-minute cycle of deep sleep, you receive even more of these hormones. In other words, there are increasing marginal benefits to sleep, and hours seven through nine—the hours most people don’t get—are actually the most powerful.

Deep sleep is also beneficial to mental health. Researchers from Harvard found that it’s only during deep sleep when your brain combs through, consolidates, and stores all the information you came across during the day. “There’s a reason all the bodybuilders and super-intellectual people I know are obsessed with sleep,” says Joyner. “Sleep works wonders.”

#6. Enjoy Nature

In Cheryl Strayed’s bestselling memoir, Wild, her mom tells her that the cure for much of what ails her is to “put [herself] in the way of beauty.” Turns out she was right, at least according to the latest science. Time in nature is an antidote to the ill effects of stress, prevents and in some cases even helps cure anxiety and depression, and enhances creativity. Though the exact causal mechanisms are not yet known, researchers speculate there is something unique about nature—perhaps related to the fact that we evolved to be in it—that puts both our bodies and minds at ease, promoting physical and psychological restoration and subsequent functioning.

#7. Don’t Smoke

New flash! Smoking is associated with dozens of types of cancer, as well as heart disease, dementia, and chronic obstructive pulmonary disease. According to the American Cancer Association, smoking causes one out of every five deaths in the United States, killing more people than alcohol, car accidents, HIV, guns, and illegal drugs combined. According to the Centers for Disease Control and Prevention, your body literally starts repairing the damage caused by smoking within days of stopping. So you are not doomed after years or even a lifetime of smoking. Stop today.

#8. Don’t Drink Too Much

Like smoking, excessive alcohol use is associated with a number of chronic diseases, such as liver cirrhosis, throat cancer, and cardiovascular disease. Drinking too much also impairs sleep and daily function. The good news is that if you enjoy alcohol, drinking reasonably—one drink per day ​—carries minimal risk. “Moderation is key,” says Joyner.

Parts of this post originally appeared in Outside Magazine published April 18, 2017.

I’m not going to waste your time or mine giving you the history of the COVID-19 virus and the ensuing pandemic. Everyone has lived through the last 5-6 months and has their own opinions on where and how it originated and spread throughout the world. I see your posts on social media, I know all the theories.

Early on in the outbreak, evidence out of China showed that there was a connection between the virus and pre-existing conditions.

The Center for Disease Control (CDC) website even states that some people are at higher risk than others when it comes to COVID-19. It specifically lists people over 65 and people of all ages with underlying medical conditions, particularly if not well controlled, including:

• People with chronic lung disease or moderate to severe asthma
• People who have serious heart conditions
• People who are immunocompromised
• Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
• People with severe obesity (body mass index [BMI] of 40 or higher)
• People with diabetes
• People with chronic kidney disease undergoing dialysis
• People with liver disease

Many of these conditions are caused by excess body fat; or a term that is starting to be more widely used, called overfat. The overfat condition itself is a significant yet little discussed risk factor in infectious viral diseases, with overfat negatively affecting immune function.

In addition to food, you can help your immune system function as designed by flushing your system regularly with lots of water and getting plenty of rest. Just as important, the strength of your immune system is also directly linked to how you manage stress, how you manage your relationships and past traumas.

If you make sacrifices and focus on improving your diet, sleep and stress, you may be astonished with the positive results - both those that you can see and those that you can’t (your immune system).

As we move into the summer and fall, we will discover a lot more about COVID-19. But as we sit here today unsure of how and when life should start to return to normal and the consequences of public interaction, I suggest that you focus on what you can control. Despite the way it seem, you have control over a lot more than you realize. Protect yourself, your family and those you come in contact with by using masks, social distancing and washing hands, but also take it one giant step forward by giving your immune system what it needs!

On January 31, 2020, Health and Human Services Secretary Alex M. Azar II declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19. The virus that causes COVID-19 is infecting people and spreading easily from person-to-person. Cases have been detected in most countries worldwide and community spread is being detected in a growing number of countries. On March 11, the COVID-19 outbreak was characterized as a pandemic by the World Health Organization (WHO).

As I write this, the world and local communities here in the United State are in various states of prevention and panic. Schools are closing, large gatherings of people are being cancelled and businesses are requiring people to work from home.

I thought it would be a good time for me to give some of my recommendations to try and combat this and other viruses.

First of all, I want to cover the basics.

- When you cough or sneeze, do it into your elbow. Doing it into a tissue is not good enough and just covering your mouth with your hands is even worse!

- Wash hands frequently.

- Do not touch your eyes, nose or mouth.

- Stay away from others who are sick.

- Do not share glasses, cups or utensils.

- Scrub your desk at work and tables at home with disinfecting wipes. Spray your keypad and cell phone with disinfecting spray.

- Maintain your best overall health to ward off germs by getting enough sleep, eating nutritiously and exercising.

- Consume plenty of water.

There are plenty of things that nature offers to help ward off viruses. I’m doing several of these already and will start doing others immediately. The list below is in order based on what I think is most important but do as many as you can.

Elderberry - The common black elderberry (Sambucus nigra) has long been used to fight off viruses and reduce the length and severity of flu symptoms. Elderberry extract binds to the tiny spikes on a virus protein that are used to pierce and invade healthy cells and destroys them so that the virus is ineffective. I take the liquid Elderberry syrup from Garden of Life.

Vitamin C – 5,000-20,000 IU daily in divided doses. Strengthens immune system by increasing the number and quantity of white blood cells.

Apple Cider Vinegar - There’s reason to believe that the acid in apple cider vinegar can work to kill pathogens that are making you sick. Apple cider vinegar is rich in the same nutrients that you would find in apples. Potassium, vitamin C, antioxidants, and vitamin E. ACV is a source to better lung function, which is especially important with COVID-19.

Chaga mushrooms have been used for centuries in Siberia and other parts of Asia as a medicine to boost immunity and improve overall health. I buy a chaga powder from Four Sigmatic and mix it with hot water first thing in the morning.

Cordyceps is another mushroom extract that can help support the lungs. I also get this from Four Sigmatic and consume the same way as Chaga.

N-acetylcysteine (NAC) — This supplement encourages glutathione production, thins mucus, lowers your chances of viral infection and reduces your risk of developing severe bronchitis. I take a 600mg supplement daily.

Garlic has been prized for its medicinal properties for thousands of years. The compounds allicin and alliion are responsible for this common plant’s reputation as a triple threat. Garlic is anti-viral, anti-bacterial and anti-fungal and it is especially effective against viruses if chewed raw.

Spirulina — Reduces severity of influenza infection and lowers influenza mortality in animal studies. In a human trial, spirulina significantly lowered the viral load in patients with HIV infection.

Zinc — Supports "effective function and proliferation of various immune cells," lowering mortality in the elderly by 27%. 80mg daily, 15mg every 2 hours if you have symptoms

Vitamin D supplementation lowers the risk of respiratory illnesses and lung infections in the elderly by 40%. It can improve the immune system's ability to fight infections because it bolsters the first line of defense of the immune system. The best way to get vitamin D is through direct sun exposure – about 10 minutes a day. There are two types of vitamin D you can take orally: synthetic or plant-based vitamin D2, which most doctors advise taking. I recommend taking 1000 IUs of vitamin D3, which your body makes after being exposed to UVB rays. Ideally, it should be taken daily with 150 mcg of vitamin K.

Vitamin A – 15,000 IU daily. Powerful antioxidants and immunity booster.

Maitake, Shitake and reishi extract help to boosts immunity and fight viral infection.

Get your body temperature up above 103F. Viruses do not survive well in warmer environment.

The herb Echinacea (Echinacea purpurea) is supportive of the immune system and has a direct anti-viral action against colds and viral bronchitis. Preparations that include both the roots and the flowering tops are the most effective at helping the body resist the viruses. Other herbs to consider are Astragalus, black cherry, goldenseal, pau d-carco and yarrow tea.

Green tea (Camellia sinensis) contains a group of flavonoids called catechins, which appear to inhibit viral infections by blocking the enzymes that allow it to reproduce. Green tea has been known to be effective in inhibiting HIV, herpes simples and the hepatitis B virus.

Finally, go out and buy a new toothbrush along with all that toilet paper everyone is hording! They can harbor viruses.

With any of the above mentioned tactics, please do your own research and consult with trusted health professionals before trying. I am not a medical doctor and do not know anyone's individual health history or current state.

Good luck!

This will be the fourth year that I have led The Holistic Hundred Challenge. Each year, the 100-Day Challenge changes the lives of dozens of people. But before you decide to join me this time around, let me first tell you more about the “why” behind the challenge.

If you are a regular reader of this blog, you know that I disagree with conventional wisdom that fat and cholesterol are the cause of the many health and overweight issues that currently plague our society. It’s been 50 years since we were told to stop eating eggs, butter and red meat and replace them with low-fat foods or artificial chemicals (aka margarine). Guess what has happened to our health in the last 50 years? You already know that despite all the advancements in modern medicine, people are sicker and move overweight than at any time in human history! So, what’s really the cause behind this health epidemic? Vegetable oils and sugar.

While limiting grains is important as I still think that people eat too many grains. After reading lots of studies, I’m convinced that vegetable oils are more dangerous to consume than most grains.

I’ve known of the dangers of vegetable oil for years. In fact, they were #1 on my list of The 5 Worst Things You Can Eat.  Vegetable oils are toxic to our arteries because they contain delicate polyunsaturated fatty acids (PUFAs) that are particularly prone to oxidative damage, especially when exposed to heat and when separated from the antioxidants that would otherwise help protect them from that oxidating damage. The historically resent rise in heart disease is the result of the recent invention of refined, bleached, and deodorized vegetable oils (see chart below). The food industry has been adding these oils to our foods without much fanfare and we are suffering because of it.

In order to make things simple, here’s a short list of good oils and bad oils:

BAD (these are industrial fats that cannot handle the heat involved in processing and cooking)

• Canola Oil
• Soy Oil
• Sunflower Oil
• Cottonseed Oil
• Corn Oil
• Grapeseed Oil
• Safflower Oil
• Non-butter spreads (Margarine)

GOOD (these traditional fats can handle the heat involved in processing or cooking)

• Olive Oil
• Avocado Oil
• Peanut Oil
• Butter (the real stuff)
• Macadamia Nut Oil
• Coconut Oil
• Animal Fats (Lard, Tallow)
• Palm Oil

You may notice that the bad oil list is mostly seeds. These oils are particularly temperature sensitive because seeds stay dormant over the cold winter. But come the spring thaw, the heat-sensitive PUFAs wake up in response to warming, facilitating germination. In order to protect the seed and allow it to grow in nature, the seeds are loaded with antioxidants. Unfortunately, refining these oils ultimately converts these antioxidants into distorted, unhealthy molecules that the human body cannot handle. If you are cooking with any oil, be sure and look up the smoke point. Even some of the good oils have low smoke points, so they should not be used for high temp cooking.

So what are some common foods that are typically loaded with bad vegetable oils? Salad dressing, rice milk, soy milk, soy cheese, soy-based meat products, breakfast cereals, roasted nuts (only eat seeds and nuts raw), any fried food, crackers and chips, granola, breads, buns, frozen pizza, cakes, pies, cookies, frosting, coffee creamers, muffins, I even found it in organic baby food! Basically, anything that can sit on a shelf for a long time allowing manufacturers to keep food around longer before it must be sold, will likely contain a form of vegetable oil.

If you need more reasons to cut out vegetable oils, consider that they destroy your brain. They do this both directly and indirectly by impacting the gut, your arteries, your white blood cells, the cellular architecture of your nerves and your gene replication. If you have heartburn, gastritis or other digestive symptoms, try eliminating vegetable oils. By inciting chaos, vegetable oil confuses the immune system and ultimately gets the body to turn on itself in ways that can lead to auto-immune brain disorders like multiple sclerosis, Lou Gehrig’s disease, Parkinson’s and all the other neurodegenerative processes we now understand result at least in part from auto-immune attacks. In addition, if you suffer from migraines or Alzheimer’s, vegetable oils are likely making things worse.

I’ve been anti-sugar for many years now and there are numerous blog posts on the subject if you would like to search and learn more about the dangers of sugar and added sweeteners. Here are a couple that I would recommend:

No Sugar November

No Sugar November 2.0

No Sugar November 2016​

I’m not going to go through that all again in detail, but I just want to point out a few things about sugar that you may not know.

The first is that sugar weakens bones and muscles. We all know that sugar is sticky. Simply lick a lollipop (or a ring pop is you prefer) and then feel how sticky it gets. Sugar gets sticky because it reacts with the proteins on the surface of your skin to form a chemical bond. This bond is called glycation. The same thing happens when sugar is inside your body. The sugar sticks to your cells and tissues, making them stiff and brittle. It clogs nutrient channels, slowing communication. It stiffens the collagen in your tendons, joints, and skin, causing arthritis and premature wrinkling, while interfering with the production of new collagen.

The more sugar people tend to consume, the less they are able to taste it. Sugar literally will dull your senses. I’ve mentioned before that after doing “No Sugar November” and cutting out added sugar for over three weeks, things like carrots and beets taste very sweet. So the good news is that if you require three packets of sugar in your coffee, with time, you can reduce the amount that is required to achieve the same taste.

Cutting both vegetable oils (unnatural fats) and sugar from your diet will not only protect your heart, but it will protect you from all other chronic diseases. The are multiple athletes who have made incredible performance gains in strength simply from by cutting out vegetable oils. This athletic improvement is likely possible thanks to an improved blood flow and maybe even some improved mental focus.

Before you start to panic and think that you will starve to death once you eliminate foods that contain these dangerous oils and sweeteners, keep in mind that most processed foods that contain vegetable oils are typically also loaded with sugar. So, you will be killing two birds with one stone. If you stick with whole foods like vegetables, organic meats and fish, free grange eggs and some fruit…you will likely not have to worry vegetable oils or sugars at all.

Just like ever other time I've done this, the goal is not to never eat vegetable oils, grains or sugar again for rest of my life. The goal is to go without it for 100 days to bring attention to how many “foods” contain these dangerous substances and to see how much better I feel and perform once I go 100 days without them. With this knowledge, I will be able to make better choices about what I eat going forward.

So if you want to join me and try to eliminate all unhealthy vegetable oils and added sugars from your diet for 100 days, comment on this post or on social media. We have a group page set up on Facebook where I can answer questions and we can offer each other encouragement!

If you are up for The Challenge, I recommend you download and print the guide (see link below). It contains handy "cheat sheets" so that you don't have to memorize all the hidden names for sugars, what constitutes a grain and what oils and good and what are bad.

THE HOLISTIC HUNDRED CHALLENGE GUIDE

October is coming to an end. So you know what that means? It’s time for “No Sugar November”! Can you go from November 1^st until Thanksgiving (that’s only 21 days this year) with no sugar? It might seem like a monumental task, but take a few minutes to read the rest of this post and I’ll guide you through the three weeks that will hopefully change your life.

Before getting into the details of the challenge, I feel like I should take a minute to remind everyone why sugar needs to be eliminated from your diet. Here are some of the things that sugar/sweeteners do:

• Promotes fat storage and weight gain
• Decreases your body’s production of leptin, a hormone critical for appetite regulation (i.e., it makes you not realize that you are full).
• It thickens the blood
• Compromises your immune system
• Fuels cancer cells (cancer LOVES sugar)
• Disrupts transfer of amino acids to muscles
• Triggers inflammation
• Causes Type 2 diabetes
• Causes nerve damage
• Causes Cardiovascular Disease
• Has addictive properties
• Causes tooth decay

If you want to know more about all of the horrible things that happen to your body when you consume sugar and/or artificial sweeteners, do a simple Google search.

So if you want to join me in the challenge, here’s what you do:

Starting now, look at the labels of everything that you eat. If the word “sugar” (in any form) is listed in the ingredients, don’t eat it. But it’s not that simple. Sugar can come in many forms. It can be very tricky to find hidden sugar in foods that you don’t even think of as being sweet. It’s obvious that candy bars and donuts are off limits, but would you ever think that pasta sauce, peanut butter and yogurt have added sugar? Even simply drinking a glass of sweet tea can trigger the release of huge amounts of dopamine into the brain. It’s the same chemical that causes people to become addicted to gambling, alcohol, drugs, sex, etc.. So when your brain gets this release from even a small amount of sugar, it makes you want it more. The only way to keep from getting cravings is to cut it out completely.

Hidden Forms of Sugar to Look For:

So what should you look for on labels other than just the word “sugar”? Check for sucrose, fructose, glucose, dextrose, galactose, lactose, maltose, dextrin, corn syrup, HFCS (high fructose corn syrup), fruit juice concentrate, cane crystals, and evaporated cane juice.

​All of these are off limits. Even though the artificial sweeteners don’t have the calories of their natural counterparts, they are toxic to your body and send mixed signals to your brain. Artificial sweeteners cause you to actually eat more because they break the connection between a sweet sensation and a high-calorie food, thereby changing your body’s ability to regulate calorie intake naturally.

What about eating at a restaurant?

So what about when you are not buying your food from the grocery and you are out to eat at a restaurant? When you are not preparing the food, it’s a little more difficult to find the hidden sugars. I usually try and order a salad with oil and vinegar instead of the dressings listed on the menu. Nearly every salad dressing out there has added sugar. Many salads also have caramelized nuts, so look to avoid those or just pick them off. Ketchup and BBQ sauces will always contain sugar. Often, sandwich meats at fast food restaurants are treated or injected with a sugar solution to add to the flavor. It’s not easy, but it can be done if you take the time to look at the menu and ask the server questions. Things can be left off or put on the side very easily if you just ask.

• Motivation – Once you start reading labels and being mindful of sugar intake, you will find yourself making better choices in other areas of health and fitness. You will be motivated to eat the salad at lunch instead of the sandwich. You will want to exercise as you get more energy and see the pounds coming off!
• Better Sleep – Sugar triggers the release of the hormone cortisol, which interferes with sleep. By giving up sugar, you should be more awake and alert during the day, and also better prepared to fall asleep at bedtime.
• Clearer Thinking – Keep forgetting things? Sugar could be the culprit. A study at UCLA found that a diet high in sugar hinders learning and memory. Over time, eating sugar may actually damage communication among your brain’s cells, the study showed.

I hope you will give No Sugar November a try this year. Get your spouse or partner on board and make it a challenge. If you slip up, start again. Let’s take this journey together and see how much better it makes you feel. And you can still enjoy that pumpkin pie and sweet potato casserole on Thanksgiving!