Food and diets

Once again nutritional supplements are headline news. This time the benefits of vitamin D and calcium are questioned. What I find shocking is that this so-called revelation is nothing more than a rehash of what we have known to be true for more than 50 years.

Waste of money

When I went to medical school more than three decades ago I learned that osteoporosis is a bone disease affecting the bone matrix proper and that calcium supplements are of no benefit in this condition. If anything excess calcium -remember the bone is also loosing calcium here- put a burden on the kidney and increase the risk for kidney stones.

This mantra was repeated over and over again and finally ended up on a test as well. Someone was clearly concerned that we get the message. And for good reason, because then as now doctors were busily prescribing calcium supplements to anyone with evidence of bone loss. Unfortunately, such bad behavior -akin to prescribing antibiotics for viral infections- only got worse as time went by. By the 1990's doctors had moved ahead and were now recommending calcium supplements for healthy young women with no evidence of bone loss whatsoever.

It would be easy to point a finger at the pharmaceutical industry, which undoubtedly played a major role in all this. But that would be to ignore the urge of doctors to do something, even if they full well knew it was useless. Doctors and patients hate to feel helpless and nothing is more problematic in the practice of medicine than the urge to do something.

Let me be very clear on this: there is no need for any nutritional supplement whatsoever. There are no proven benefits of any supplement but there are potentially serious side-effects. Taking supplements is at best a waste of money, but more often dangerous for your health.

There is also no need for special diets. Humans can thrive on nearly any diet that includes some variety. There is no evidence that any diet is better than any other. Adults can tolerate anything, from complete carnivore to complete vegan and stay healthy. The key health issue relating to food has to do with quantity of food consumed.

The culprit in the obesity epidemic is the ubiquitous availability of cheap calorie dense food. All weight gain is due to excessive intake and all weight loss is due to reduced calorie intake. No diet offers any advantage over any other diet when it comes to weight loss. What matters is calories, pure and simple.

Athletes should eat normal food whenever possible. When offered a choice, always choose regular food  over any packaged, prepared, and especially "scientifically designed" offering. If you doubt the latter, please note that many nutrients were discovered because deficiencies were seen in people who were fed scientifically designed diets.

Endurance athletes are especially likely to obsess about food. Lack of success in many endurance events is often attributed to nutrition. The reason is simple: failure often comes with gastro-intestinal symptoms. Upset stomachs, abdominal pain, diarrhea and vomiting often go hand in hand with poor performance. But are they to blame?

Athletes are not the only ones who are quick to blame food intake. No doubt when you felt ill as a child your parents first asked if you ate something that did not agree with you. When it comes to abdominal pain, humans first think of bad food. So it is not surprising athletes blame nutrition for lack of success. Like many others, I am certainly guilty as charged. Although I have made significant errors that can be attributed to nutrition, more often than not the real issue was training.

Lake Placid 09-

When I ran my first San Francisco marathon, I was forced to stop at mile 7 with a badly upset stomach. I was quick to blame the waffles I had for breakfast. My legs felt fine! Heck I could run like this forever. It took a while to figure this out but I now know the real issue was starting out too fast. I was running 7 minute miles at the time, and although that may not impress many of you, it was way too fast for me. But the excitement of the race got to me. And it wasn't the only time that happened.

I also learned that nearly all food related issues in Ironman have one of two causes: lack of adequate training and-or excessive food or drink intake. Believe  me, you are much more likely to eat and drink too much, or go out too fast than do the opposite.

I will discuss dehydration and drinks tomorrow so stay tuned.

Science III

If you took the time and read the previous posts, you may wonder why the science bar is set so high. You may also wonder how many "scientists" really practice science as defined here. To wit, I used to joke that any discipline with "science" in its name was not scientific at all. Like political science, social science, computer science, brain science, etc. I stopped telling that joke because I found people tend to react rather violently and fail to see the point. Given the status (and money involved) of science in our society, people do not like to be told their work is not "scientific." Add to that that the majority of the population equates science and truth and you can see why this joke is like saying "I have a bomb" in the airport.

Fine, but what about having the bar set high? Why is that necessary? It is because people are very easily fooled. I say people, because it is a characteristic of all people, regardless of their intelligence, upbringing, social status, etc. All people are easily fooled and they are experts at fooling themselves. Everyone has ideas, things they learned or experienced, prejudices, opinions, fears, that are based on spurious associations, hearsay, peer pressure, personal experience (often misinterpreted) etc. Scientists are no different from any other person in this respect. They are just as likely to be religious, believe in the afterlife, be afraid of ghosts, as anyone else.

Second, many people have an agenda. Some have a very active and explicit agenda, but even those who don't often have to prove something to the world. They are motivated to prove something to themselves and to others. They are driven to make a point or simply to be right about something. Such biases are even more explicit when it comes to behavior, nutrition, health, performance, etc. The more it affects people's daily lives, the stronger the biases are. Most people can be pretty neutral about gravity, but when it comes to what food is good for you, hardly anyone is without a preset opinion.

Third, there is a lot of money at stake, and money has an agenda. Once again this is more applicable to health, medicine, and nutrition than to abstract things in the physical world. Modern science is especially dependent on money and money does not come free. It exerts a noticeable influence at all levels. From the types of research that is "fundable," i.e. a couple of decades ago you could not propose any research that would imply or might find differences between the genders, to the findings of such research, i.e. many people tried to suppress the work on helicobacter and stomach ulcers; to the endless ongoing research into side-effects of birth control pills, circumcision and sexually transmitted disease, etc. that is doubtlessly motivated to prove and support a certain point of view.

Fourth, science is based on and requires open communication and free exchange of information. That does not sit well with those who aim to gain an advantage, as is true from the military all the way down to the sports competitor. One might even argue the lay person looking for health info is trying to get an edge. But conducting science in secrecy is not really possible. I know you will quickly point out all the secret government research, including the Manhattan project. When doing so it is easy to forget that the Manhattan project was mostly about engineering, not science. Once again, many will quickly take issue with this claim, not because they know it to be true or not, but because they view science as more prestigious than engineering. Or because they don't want to be known as engineers (yes folks there is a pecking order here).

Much of what goes under the label science is nothing but engineering, or empirical discovery. Guess what, there is nothing wrong with that. Science is not the only way to discover truths about nature. If anything, science is definitely the slowest (and from a practical perspective) the most inefficient way to discover new things. Many, taking a serious look at the "war on cancer" have come to that conclusion. And they are right. There is not really a scientific way to find a cure for a disease. You can do a lot of science about organisms, diseases, etc. but that is a very round-about and long process. Penicillin for example was not discovered in a scientific experiment. It was confirmed in a scientific experiment, but it was discovered by accident. And that is the way most discoveries are made.

If you want to find something new, better not do science. Better poke around, look around, and do so without any prejudice or forethought. Better think crazy thoughts and do things people wouldn't do. That is how discoveries are made. By pushing the envelope and questioning the obvious.

Nutrition and science

There is very little science in nutrition science. Unfortunately, this is one area where we know very little but make very big claims. Nearly all rules and prescriptions regarding food are based on culture, custom, religion, hearsay, prejudice, or other unsubstantiated data. Things like the famous food pyramid are driven by commercial interests only. The food pyramid urges you to eat what farmers want to sell. It is as simple as that.

Fortunately, we are largely independent of what we eat. Humans are true omnivores and nearly any diet that is unforced will do. Especially for adults. Adult humans are remarkably insensitive to food types as long as the quality is good. Quality in this case means free of toxins, infectious agents, or contaminants. By and large, food in the Western world is of very high quality and unintentional food poisoning is quite rare.

Unforced is another key term. In this context it means the person can pick and choose from a variety of items. The more freedom people have the better. The more a specific diet is forced on them, the more likely they are to get sick. Nearly all vitamins and essential elements have been discovered by forcing people to eat "scientifically" designed diets.

Contrary to what most parents seem to think, kids naturally know what is good for them. If left to their own devices and kept away from artificially sweetened items, they will eat a healthy diet, even though their day to day intake will be far more erratic than that of an adult. It is true that kids will binge on certain foods, but after a short while they will have enough of it and develop a taste for something they lack.

Humans have one great weakness and that is sugar. Pure sugar is rare in nature and it is difficult to find. But sugar is an essential food item and so people are very attuned to finding it and liking it. Craving it is the better word. Marketers of all stripes discovered this rather quickly and in rich cultures without a solid tradition and footing in cuisine -such as America- sweets quickly took over. Coupled with a sedentary life-style, sugar is wreaking havoc and causing illness everywhere.

The result is an epidemic of obesity. Due to advertising and global trade, other cultures that did have a solid tradition -such as France, the mediterranean, and others- are quickly falling prey to the sugar menace. Armed with a small amount of technology, it is easy and cheap to make highly refined sugar products. Furthermore, these items sell so well that the temptation to sell them is equally hard to resist.

Although many texts recommend a carbohydrate rich diet for athletes, I think it is a mistake. Carbohydrates are important before, during, and after hard workouts, but to switch to a year-round high carb diet is asking for trouble. Many athletes have trouble with their diet and weight as is, and suggesting more sugar is making things worse. It has gone so far that many avoid fats, a key ingredient, and the best substance to induce satiety and remove the constant hunger many carb-rich athletes feel.

Whatever you do, please try to eat a normal diet. It doesn't really matter what diet you choose as long as you pick one that has been tried and tested for a few decades at the minimum. No diet has any advantage over another and all the claims to the contrary, whether made in the popular press or in "scientific papers," are downright wrong.

The worst thing you can do is try an artificial diet, or one concocted by a "scientist" or "nutritionist" a short time ago. These diets are nearly always trouble and should be avoided at all costs.

Remember to always eat normal food, and avoid sugary drinks.

Micronutrients

Here is some food for thought. According to recent ad-publication I received I should not trust my regular diet. Entitled, "The balanced diet myth--shattered!" the publication goes on to warn me about inadequate micro-nutrients.

Wow! Now here is something to worry about? What if we can't get a balanced diet? And what is a balanced diet anyways? Where is the balance in all this?

To give credit where credit is due, there are a few truths here. For example, we read: "Did you know that there has never been a single clinical study that documents what comprises a balanced diet, nor one that has demonstrated one's ability to meet basic nutrient requirements through whole foods alone?" 

That is true as far as the "single study" goes. It would be hard to design a study like that. How do you measure balanced in any case? Most of what we know about diets comes from inadequacies and deficiencies. Ironically enough, most of those were uncovered when people tried to "engineer" artificial diets in order to improve performance. Deficits are rarely seen in common diets, and only when caloric intake is inadequate. The reason is simple: no diet could survive if it caused illness.

The second part is completely nonsensical. Clearly one is able to meet one's basic nutrient requirements through whole foods alone. That is what people have been doing for tens of thousands of years. More than that, they met their basic requirements and those of their offspring as well. If they hadn't we simply would not be here. The very fact that we are alive proves that our parents ate adequate diets that supported their daily needs for several decades and provided enough extras to produce and raise healthy offspring. Since mammals have long pregnancies that is not a trivial matter.

People in the past also did more physical work and hence put more demands on their diets than we do. No time to sit around on the couch watching TV. No chips to munch on. Nothing but whole foods alone. Real hard labor and long hours were the rule. No pushing paper in the office. No driving kids to school. Survival in past generations demanded a high level of physical fitness.

Studies on Greek triremes, a kind of warship driven by rowers, have shown that the men rowing the ship were every bit as fit as today's Olympic athletes. Given that these were ordinary citizens of Athens, chances are the real Greek athletes were even fitter. All without special nutritional supplements.

Warfare using swords and shields was a physically demanding and exhausting activity. It is widely believed that not too long ago, people walked the equivalent of a marathon each and every day. Pheidipides, the man of marathon fame, ran from Athens to Sparta, a distance of 147 miles through rough terrain, a few days before joining the Athenians at the battle of Marathon. (It is unlikely he ran the 40kms to Athens to bring the news of victory-after which he supposedly dropped dead, but that is another story. He did run the 147 though.)

In any case, my ad-publication tells me "Regular diets simply can't cover the entire range of vitamins, minerals, phytochemicals, antioxidants, and other micronutrients necessary to maintain optimal health and peak athletic performance."

There is every indication that the "regular" American diet, "unhealthy" as it is, does that and more. Clearly it contains ample supplies and lets people grow in all three dimensions. Furthermore, what makes the diet unhealthy is not a lack of items, but rather too much of them. The "regular" American diet is too high in carbohydrates for anyone's needs. But no American eating such diet suffers from lack of vitamins or minerals. 

If anything, Americans tend to suffer from hypervitaminoses due to all the vitamin pills they take. They eat too many minerals (esp. salt) and often suffer from mineral deposits instead. They do not lack phytochemicals or antioxidants either.

There is no reason to believe that "daily supplementation is a necessity, not an option," as my publication indicates. Furthermore, the daily supplementation I supposedly need consists of nothing but a cocktail of vitamins and unproven supplements and extracts whose consistency and quality is likely in doubt. Plant extracts are notoriously inconsistent in quality. The levels and types of ingredients vary from batch to batch and from season to season even under the strictest QA provisions. It is one reason FDA shies away from plant extracts.

And when it comes to clinical studies, the news is not good. Not a single study has ever shown the benefit of such extracts. Each and every time people have studied "promising" supplements in prospective studies, the results have been negative or detrimental. Promising cases include those where micro-nutrients were found to be correlated to health benefits in retrospective studies. You heard it all, vitamin E, vitamin C, lycopene, quercetin, etc. etc.

In prospective studies many of these ingredients caused or made worse the very diseases they were supposed to prevent or cure. I would advise you to stay away from such preparations. The benefit is not there and you run a very real risk of ingesting a banned substance without your knowledge. Unfortunately, when that happens you will be totally on your own. Not even a grain of sympathy will come your way. 

Nutrition and supplements

There is no shortage of nutritional information. And yet most people in our society suffer from eating induced disorders such as obesity, type II diabetes, hyperlipidemias, etc. That in itself should tell you something.

Unfortunately, most nutrition information is downright wrong and nearly all of it is unscientific. Even government guidelines are highly suspect and the government is powerfully influenced by many food- and farm-lobbies that stand to gain or lose enormous amounts of money from endorsements or lack thereof. There are simply too many people with too much money at stake to enable objectivity. Even if everyone was held to high ethical standards -and they are not- the field would be heavily biased and unsuitable for scientific discovery.

For example, the Washington Post reported recently that a campaign by Health and Human Sciences Department to advocate breast feeding was very successfully toned down at the request of infant nutrition companies. Such things can and do happen and they happen a lot.

Government officials are beleaguered by diary farmers that want you to drink milk and eat cheese, by cattle ranchers who want you to eat beef, and by the poultry industry advocating eggs and chicken. Not to mention the fishermen who want to sell fish and the corn farmers who want to douse everything and everyone in high fructose corn syrup. The list of constituents with something at stake is just endless. Unfortunately, no science can be done in this type of climate.

Athletic food intake is, if anything, even more problematic. The specialty food industry is one of the most rapidly growing market segments and that means lots of interest from business and politico's alike. Everyone loves a growing market and nobody wants to spoil the party. Nobody would even dare to attempt to, and doing so would mean a certain DOA.

Food also has important cultural and religious overtones. Nearly all religions regulate food intake, often prescribing what people can eat and when. Against such forces, no objectivity can prevail. Science practitioners are human too, with their own ideas, cultural baggage, religious beliefs, and prejudices. As Michael Pollan pointed out, nutritionism, as the ending "ism" suggest is not a scientific subject but an ideology. And "ideologies are ways of organizing large swaths of life and experience under a set of shared but unexamined assumptions."

Fortunately, humans have an elaborate digestive system, and one function or benefit of such a system is that it makes one largely independent of what and when you eat. That is especially true now that a veritable treasure trove of clean, high-calorie food is readily available. If anything, we have too much good food that is too easily accessible. 

It is therefore a total irony that people think they need supplements, vitamins, and other "magic" potions. It is safe to say that any such items are totally unnecessary and a waste of money. If anything, these useless items can only lead to disease, and hypervitaminoses are more of a problem in the West than lack of vitamins.

There is absolutely no reason whatsoever to take any vitamin or nutritional supplement. Once again I never have and I never will. It is a total waste of money and can only harm you. Yet nobody has the guts to admit to it. Most coaches will tell you to take a multi-vitamin. It is baloney and serves no purpose. 

You don't need vitamins, mineral supplements, protein supplements, lycopene or quercetin or any other supplements to perform or stay healthy. These things do not work and the "scientific evidence" backing them up is not there.

The golden rule for food is, eat but don't eat too much so you stay lean. Weight is the great enemy of most endurance athletes. Always eat a variety of foods and be careful with carbohydrates. Carbohydrates, or sugars, provide a quick energy boost but it is easy to eat too much as carbs do not signal satiety as protein and fats do. A diet based most only carbs will leave you perpetually hungry and presents a great risk of overeating.

Unlike what you may think, fats do not make you fat. Carbs do. Ask any cattle-farmer what they use to fatten the cows. Ever heard of corn-fed beef?

Nutrition is the one area where you will do better the less you listen to the "experts" and the more you stick to nature. Never eat prepackaged and prepared foods unless you have no other option and are in danger of acute starvation. A candy bar is great while cycling, but it is not nutrition and should not be treated as such.