February 2006

Hello,
It’s a new year, a new season since we last communicated. I hope you’ll take a few minutes to look through this latest newsletter. In this edition, we discuss from several angles obesity and weight control, with a very powerful personal story from Richard Morris, author and food activist.

Did you know that Vitamin D is not a vitamin at all? In this edition I debunk some myths about Vitamin D, but more than that I talk about how to make sure we get enough of this substance that is crucial to health and to life.

On the food front, the winter season calls for warming, nutritious meals, and Jessica Prentice brings us a hearty dish that is sure to please — sausage with cabbage and potatoes.

Finally, I want to be sure you’re aware of the upcoming Fourfold Healing Conference in Vancover, BC. Once again, Sally Fallon, Jaimen McMillan and I will present a series of lectures, workshops and presentations centered around this fourfold path to healing. I hope to see many of you there.

Warmly,
Tom Cowan

Focus: The Metabolic Syndrome

In the early 1980s, as the epidemic of obesity, hypertension, heart disease, arthritis, and diabetes was in full swing, it began to be clear that these and other conditions were fellow travelers. That is, they would often show up in the same person at approximately the same time. Researchers started looking at the possibility that they were not separate conditions that just happened to arise in the same person, but rather manifestations of a single underlying cause. A researcher at Stanford Hospital was able to determine that, in each of these diseases, many of the patients had abnormally high levels of insulin in their blood. He named this complex of illnesses, hyperinsulinemia (high insulin in the blood), or the metabolic syndrome.

The explanation of this phenomenon is actually fairly straightforward. There are three types of macro (large-quantity) nutrients that make up our diets: fats, proteins, and carbohydrates. Fats and proteins are used by our bodies to build our structure, make hormones, make immune proteins, provide raw material for enzymes synthesis, and on and on. Generally speaking, fats and proteins are needed by everyone to maintain the structure and function of our physical bodies. Carbohydrates, in contrast, are eaten to provide energy, and that’s all. What this means is that the protein/fat requirements are relatively fixed for a particular person and are based on body size (actually, lean body size). Another way to say this is that, without adequate dietary intake of complete proteins and healthy fats, our bodies cannot maintain their basic structure or function properly. Carbohydrates, in contrast, need to be eaten according to how much energy we are using in a given period of time.

If we run a marathon every day, we need to eat about 300 grams of carbohydrate food (about 12 bowls of pasta). If we sit on the couch all day, we need about 60 grams of carbohydrate food (one bowl of rice and an apple). The protein/fat requirement doesn’t change no matter how much or little activity we do. We still need adequate protein/fat, even if we do nothing. The problem of obesity comes when we sit on the couch and eat like a marathon runner. If we take in 300 grams of carbohydrate, what actually happens to the extra 240 grams of carbohydrates not used for energy? Our body has a system for taking care of this, which is called insulin.

Insulin is the hormone produced by our pancreas when we are “overfed” carbohydrates. It is the hormonal signal to store fat, which is what the body does with these extra carbohydrates under the influence of insulin. Without insulin, you can’t store fat. Without extra carbohydrates, you won’t make extra insulin. In theory, controlling weight is a simple process of lowering carbohydrate intake while continuing to nourish the real needs of the body, which are adequate protein/fat/vitamin/mineral intake.

Early researchers of the metabolic syndrome were shocked to find that insulin is an important player in all the illnesses mentioned above. Excess insulin is the hallmark of type II diabetes (older-onset, weight-related diabetes, as opposed to the childhood type). Excess insulin causes fluid retention and, hence, high blood pressure. It causes lowered gastro-esophageal sphincter pressure, hence reflux and heartburn (or GERD as we now call it). It cause stress on the heart, etc, etc. In fact, elevated insulin levels are the linchpin of many of the diseases we associate with aging. And elevated insulin is a result of a diet that is overly skewed towards carbohydrates as opposed to fats, proteins, vitamins, and minerals.

When we look at the diet outlined in Nourishing Traditions (or that Richard Morris discusses in his article later in this edition), we see in action this principle of getting adequate fats and proteins. We see a diet that truly nourishes, a traditional human diet, a diet that has nourished the healthiest people for millennia. It is a diet that eschews empty carbohydrates, that focuses on meeting our daily needs for adequate proteins and fats. Perhaps most importantly, the Nourishing Traditions diet focuses on the quality of our food. For when we are nourished from both a biochemical and a soul point of view, through the aroma and flavor as well as the nutrients of our food, then we are on the path of regaining the health and vitality that is our true birthright.

Therapeutics: Vitamin D

When I was growing up, my parents and grandparents were always telling me: “Go outside and play. Get some sunshine for heaven’s sake!” As is often the case, there was profound wisdom in that childhood command, and much of it comes down to vitamin D. This crucial substance plays an important role in the healthy functioning of our bodies.

Vitamin D, also known as vitamin D3 or cholecalciferol, is a complex substance, and the story behind it is likewise a complex one. Let’s start with some of the facts. First, vitamin D is actually not a vitamin at all. A vitamin was originally defined as a “vital” substance, one that was needed in the diet for optimal health, as, for example, vitamin C. Vitamin D, however, is not a necessary part of the diet and, in fact, there is some question as to whether we need to get any vitamin D through the diet at all. Second, the structure of vitamin D and how it is made in our bodies clearly puts it in the category of being a steroid hormone. That is, vitamin D is made from cholesterol, as are the other steroid hormones such as cortisone, estrogen, progesterone, testosterone, etc. It has the same biochemical steroidal ring structure as these other steroid compounds, and it shares the same general function as other steroid hormones. As such, vitamin D, like estrogen, interacts with the cell membrane via cell membrane receptors to bring about a particular effect within our cells. The general effect that steroids produce is the turning on of specific protein synthesis, which is the case with estrogen, testosterone, and vitamin D. Thus, vitamin D is a steroid hormone that affects protein synthesis by acting as a messenger chemical in the body. That much is clear, although I’ll continue to refer to it as “vitamin D” for simplicity’s sake.

The proteins that each of the steroid hormones stimulate to be produced are relatively well known. For example, testosterone stimulates the production of the proteins associated with “maleness”, and so on. With vitamin D, these functions are also fairly well known. Vitamin D catalyzes the production of proteins involved with the regulation of calcium and the regulation of cell growth. We’re all aware of vitamin D’s role in calcium regulation from stories of children in Great Britain with little or no sun exposure who developed rickets, a softening of the bones from deficient calcium uptake from the intestines. The incidence of this disease led to the finding that vitamin D synthesis in our bodies is dependent on sun exposure.

In fact, vitamin D synthesis goes something like this. In our kidneys, we make the precursor to vitamin D from cholesterol. This precursor substance, which is fat soluble (ie dissolved in fat or oil) travels to the skin, where it is found in the oily layer coating our skin. This precursor substance then interacts with sunlight (actually the UV-B component of sunlight) to form the active molecule cholecalciferol or active vitamin D. This vitamin D goes to the intestines to catalyze the absorption of calcium, participates in the deposition of calcium in the bones, and goes to all the cells of the body to help regulate cell growth. If there is inadequate active vitamin D, then calcium deficiency occurs, the bones become soft (rickets in childhood, osteoporosis in adults), and the cells undergo excessive growth (otherwise known as cancer). Because the calcium in our blood is the main regulator of our acid-base balance, we can see that calcium and hence vitamin D balance are integral to our overall health, just as the pH balance is critical to the functioning of our enzymes which function optimally at a narrow range of pH. Vitamin D is therefore crucial to human life.

It should be no surprise to anyone that vitamin D is crucial to our health. Vitamin D is a primary physiological response to sunlight. People cannot live without adequate sunlight. It is as simple and profound as that. When people get inadequate exposure to sunlight, they become sad ( SAD, seasonal affective disorder), irritable, weak in their bones (rickets and osteoporosis), and have rank, unhealthy growth (just as a plant does that is deprived of the sun). We are sun beings, and we have developed a mechanism, through vitamin D, to absorb the sun into our beings. There is nothing more profound in human physiology than that.

What do we need to do to be sure we have enough vitamin D? We need adequate levels of cholesterol, from which we make that vitamin. Cholesterol is a waxy substance found only in our diets in animal fats (no plants have cholesterol). Eating animal fats, particularly from animals that eat green grass and spend their lives outside in the sun, is one way to get adequate vitamin D in the diet. Second, we need to maintain the oily coating on our skin, which contains the substances that interact with the sun to create the active form of vitamin D. And, finally, we need sun exposure, at least 20 minutes per day with as much of our skin exposed as possible. Thus, adequate vitamin D strategy is a high animal fat diet, from animals that live outside and graze green grass, limited bathing (bathing or showering washes the skin oils off, which is perhaps why traditional people rarely bathed), and adequate sun exposure. Oddly, the American way of life as prescribed by the “experts” is to eat a low-fat diet, bathe every day, and avoid the sun because it is going to kill you. Americans are severely vitamin D deficient.

How do we measure vitamin D levels? Based on the classic paper by researcher Reinhold Veith, we now know what optimal levels of vitamin D are in the blood and the adverse health effects of not having this optimal amount. As a measure, optimal levels of 25(OH)D, the only vitamin D test that should ever be used, are 50-80. Anything below this is associated with adverse health consequences. A normally nourished person with 20 minutes of sun exposure makes about 20,000 IU of vitamin D in that time, the daily requirement for vitamin D is about that from sun exposure and dietary sources. It takes most Americans between 2,000 and 4,000 IU per day to bring their vitamin D to the optimal levels, but this is very dependent on the diet, sun exposure and any supplements that contain vitamin D (such as cod liver oil). I would encourage everyone to check out the vitamin D council website (www.cholecalciferol-council.com) for a compendium of research articles on the relationship of vitamin D to human health.

I currently test most of my patients with any significant health issue for vitamin D adequacy and correct it if it is low. In addition to the Nourishing Traditions diet, sun exposure, and usually 1 tsp of cod liver oil, I use plain vitamin D3 to make up the rest, with some adjustment in the summer. Many health conditions are improved if we have optimal vitamin D levels in our bodies. There is profound meaning in a human being’s relationship with the sun, and in many ways, the whole vitamin D story confirms the old saw: “Get out and get some sunshine!”

Guest Column:

A Personal Perspective on Diet, Weight and Health
by Richard Morris

Early in the evolutionary arc of the human diet, the mechanics of finding and eating food were simple. People harvested locally available plant and animal foods, then prepared and consumed those foods according to their cultural tradition. Under the most favorable circumstances, there was an optimal balance between the body’s dietary needs and the day-to-day demands of living.

But then some of our enterprising ancestors got smart and invented agriculture, industrialization and the drive-thru window. Food was suddenly very complicated. We started counting calories and exorcising our guilty desire for full-fat foods, by exercising at the gym. Dietary piety notwithstanding, we usually found ourselves at the end of each year, overweight, undernourished and determined to do better next year. From this post-holiday season of despair, the modern New Year’s resolution was born.

According to a 2002 study in the Journal of Clinical Psychology (2002, Volume 58, Issue 4), by the end of January, more than 36 percent of Americans who make New Year’s resolutions will have abandoned all hope of success. The six-month study revealed that as the year progressed, rates of non-compliance increased virally, climbing to 54 percent by mid-year. Other sources suggest that by December, an epidemic of failure prevails with up to 80 percent of us deciding to give it another try next year.

Quite possibly our most popular resolution is to improve personal health through weight loss, diet and exercise. The fact that so many of us adhere to this timeworn tradition, despite a near guarantee of failure, speaks to the level of commitment many people have toward improving their health. Why, then, is it so difficult for us to eat right and exercise?

One possible answer to this question may have been revealed, thanks to a recent study reported in the Journal of the American Medical Association (2006, Volume 295, Issue 1). This randomized intervention trial included over 48,000 post-menopausal women and was designed to look at the long-term correlation between body weight and a low-fat diet. The results revealed that older women on a reduced fat diet that emphasizes carbohydrates saw a weight reduction of about two pounds over an average of 7.5 years.

This study has been touted as proof that a low-fat diet does not lead to weight gain. However, when we consider that the average long-term weight loss for the participants can be measured in mere fractions of a pound over the course of a year, the study seems to have inadvertently proven that low-fat dieting doesn’t lead to weight loss either. For doctors and their obese patients looking for validation of the low-fat strategy, these results must be discouraging.

The most recent statistics from the CDC leave little doubt that obesity is a growing problem. Even more frightening is the specter of Type II diabetes, which often occurs in tandem with obesity. Could it be that our collective difficulty in managing our weight is due to the possibility that the most favored solution for reaching a healthy weight is no solution at all? Objective research, as well as anecdotal evidence, suggests that the answer is “yes”.

I speak from experience. Two and a half years ago I weighed over 400 pounds. That I gained so much weight is less astounding than the fact that while in college, I was the very model of athleticism. Conventional wisdom posits that an active lifestyle is a bulwark against obesity, but my love of sports provided little protection.

I exercised, became a vegetarian and succumbed to the promise of the low-fat lifestyle, but despite my efforts, the years of dieting and deprivation yielded nothing but modest weight loss followed by significant weight gain.

What can we make of this Jekyll and Hyde transformation that far too many people experience in their middle years? Given the dire reality of the average American’s health, it is tempting to believe that obesity and diabetes represent the “normal” outcome of modern living. But to reach such a conclusion is to set in motion the machinery of a self-fulfilling prophecy that sanctions the consumption of super-sized sodas and aggressively marketed prescription drugs. What then, are we to do?

Ultimately, we must choose between either conventional dietary dogma or take the road less traveled and seek a more holistic approach to better health. Turning our attention to what we eat is a good place to start.

Along with air and water, our connection with food can best be defined as an intimate relationship and yet, there are few things more impersonal than what we eat. Many people don’t know where their food comes from, what it is made of or how it was produced. Where children are concerned, some foods like ready-to-eat cereals are nearly indistinguishable from toys.

For decades our obsession with quantitative analysis, manifested by our need to count calories, has encouraged the belief that the quantity of the food we eat is more important than its quality. This deteriorating connection with our food is undoubtedly a contributing factor to the serious health consequences we face today.

Considering the JAMA study, some of the reasons we fail to meet our health goals should be apparent now. They include a lack of basic knowledge of nutrition, the incessant hunger and cravings that come from dieting, dissatisfying meals, persistent fatigue, and the de-motivation that comes from the diminishing returns of exercise. These were the very same issues I faced year after year–issues which up until 2.5 years ago, consistently thwarted my efforts.

To begin with, one of the most important steps we can take when seeking to improve the body is to first enrich the mind by learning more about our bodies and what we put into them. We must also look beyond the paradigm of conventional medicine in search of healthcare partners who are as skilled in the art of health maintenance as they are in the science of sick care. In time, we may come to understand that our goals are better served by setting our focus on gaining health rather than on simply losing weight.

Once I started down this path, the reasons for my past failures became readily apparent. I learned, for example, that my persistent hunger stemmed from the fact that my meals rarely left me satisfied. This was true at both the sensorial level (involving taste, smell and texture) and at the nutritional level. The foods I typically ate while dieting were low-fat, soy-based and artificially enhanced with preservatives and additives–in short, fake foods. The nutritional deficit from a diet unbalanced toward artificial foods left me with a persistent desire to eat, even after I had reached or exceeded the reasonable carrying capacity of my expanding stomach.

I was further beset by intense cravings for foods that readily converted to glucose–these were primarily foods that contained sugar or were grain-based. I found that the more of these foods I consumed, the more I craved them and contrary to their energy-boosting reputation, these foods left me perpetually fatigued and emotionally distressed. Most disturbing, my consumption threshold for these foods increased in parallel with my expanding waistline.

Through the Weston A. Price Foundation, I discovered that high quality sources of fat from coconut oil or butter, eggs and lard from pastured animals, were highly satisfying on all levels. Once satisfied, I was finally able to regulate my intake of insulin spiking foods.

Beyond food, one of the biggest issues we face in following conventional dietary advice is the counterintuitive effect of exercise. For many, exercise fueled on bland salads, low-fat energy bars and meal replacement shakes often disappoints and, at best, yields only short-term benefits.

With a proper diet of pastured meats, fresh produce and whole raw dairy as my foundation, daily exercise became a cause for celebration rather than a source of despair. Fatigue was replaced by a surplus of high-octane energy, which was enthusiastically invested in the gym.

In the end, I found myself divested of a minimum of 160 pounds along with sleep apnea, asthma, hypertension and a host of other maladies. I discovered that a healthy lifestyle is not solely dependent on exercise, counting calories or industry sanctioned solutions that don’t work. I learned that the quality of the food I ate really was more important, in the long run, than the quantity of calories consumed. Most important, with my newfound health, I’ve given up on New Year’s resolutions in exchange for resolving each new day to improve on the day before. Set free of the burden of ill health, we can all do the same.

About Richard Morris:
Richard Morris is an author, health researcher, real food activist and speaker. He is the creator of www.breadandmoney.com, an Internet destination that extols the virtues of traditional foods and the restoration of the family. His recently published book, A life Unburdened: Getting Over Weight and Getting on with My Life is a hard-hitting memoir and survival guide that details his recovery from morbid obesity. An ardent supporter of fair trade for the family farm, Richard plans to spend time in 2006 on a working farm “Reconnecting with my food at the source”.

Book Review: by Tom Cowan

A Life Unburdened: Getting Over Weight and Getting On With My Life
by Richard Morris

Obesity is a major American issue. For years every major American institution has had their say on the subject of obesity. The government has weighed in; most of the major physicians’ groups have weighed in; industry, particularly the food industry, has weighed in; and yet the problem seems to be getting worse and worse with more and more Americans being labeled as obese every year. According to reports, the dire consequences of obesity are threatening to ruin everything from our personal health to the nation’s economy. Theory after theory is tossed around and tossed aside as to the cause of obesity. Into this cacophonous mix comes the clear voice of Richard Morris, who has the one credential that most of the experts lack. He has actually overcome obesity, overcome it on his own, seemingly without the good counsel of doctors, nutrition authorities, or anyone really. He followed the advice contained in Sally Fallon’s book, Nourishing Traditions. For me, what makes Richard’s voice believable and even poignant in this debate is his personal, simple approach.

Richard’s message is at the same time radical, simple and straightforward. Simply stated, the true cause of the obesity epidemic in our country is that Americans have stopped eating real foods, foods that truly nourish our bodies and our souls. As a result, we walk around in a state, as described in other contexts, of being “hungry ghosts”. A hungry ghost is full of unmet needs. In this case, the need is for nourishment. The ghost is agitated, even angry, often compelled to look for more, insatiable in its need to get its needs met. Unfortunately, the hungry ghost lacks the wisdom to know where to look to get its needs met. It devours nearly everything in sight, but nothing that really nourishes. As time goes on, it wants more and more, but its strategy for getting fulfillment leads to less and less. It becomes frantic, even irrational in its quest. Finally, exhausted, it breaks down, beaten, ill, defeated.

This image tells the story of many overweight people, people who, as Richard points out, are given advice by doctors and experts that only serves to deepen their frustration and their failure. They are told to exercise: however, at 400 pounds it is hard to walk across the street, let alone go to a jazzercise class. They are told to eat a low fat diet or even a low food (calorie) diet: this just worsens their feelings of starvation, of their unmet need for nourishment. None of this gets them anywhere. As Richard points out, the only place to start is to eat nourishing foods, every day, three times per day and NOTHING else. In fairly short order, the game is up, the years-long quest for fulfillment on a nutritional level begins to be met, one,s whole being can finally begin to relax. More energy starts to appear, exercise becomes easier, thinking becomes clearer, one’s enthusiasm for life grows stronger. The food that nourishes on the physical level also, with its taste, freshness, aroma and economic benefits, begins to enliven one’s soul. The whole world begins to look, taste, and even smell differently. This puts them on the path, not just to less obesity, but more robust health on every level.

Richard’s book will be an inspirational guide to everyone who wants to take the lifelong journey towards health. Most especially it will be helpful for those struggling with their weight, but for everyone Richard’s story serves as a helpful guide to improving our personal health and the health of the world around us.

We’re fortunate to be able to include Richard’s own words in this edition, and we thank him for his contribution.

Recipe:  Sausage with Cabbage & Potatoes

A Recipe from Jessica Prentice -

This is one of my favorite wintertime meals.
I consider it an eintopf–the German word for a one pot meal.

Ingredients:

2 tablespoons bacon drippings, olive oil, lard, or other fat
2 whole fresh sausages in casings
2 leeks, sliced thin, including much of the green part–or 1 large
onion, sliced thin
2 cups shredded cabbage
1/2 teaspoon caraway seeds (optional)
1/2 bunch greens (chard, kale, collards; or mustard, radish, or turnip
greens), sliced into ribbons
3 medium potatoes (such as Yukon gold), diced
1/2 – 1 cup chicken, beef or pork stock, as needed
Sea salt and freshly ground pepper to taste
1/2 – 1 cup sauerkraut
Sour cream or creme fraiche

1. Heat the bacon drippings, oil, or fat in a large skillet over medium heat. Add the whole sausages and brown on both sides.
2. Add the leeks (or onions) to the pan around the sausage and sautee. When the sausage is cooked through, remove it from the pan and let it cool.
3. Add the shredded cabbage to the pan along with a pinch of salt and the optional caraway seeds. Continue to sautee a few minutes, until the cabbage begins to wilt.
4. Add the greens and stir gently.
5. Add the diced potatoes, another pinch of salt, and about 1/2 cup of stock. Cover, reduce the heat somewhat, and steam until potatoes are just tender. Add more water or stock if the pan starts to get dry.
6. Slice the sausage and add it back to the pan, stirring to incorporate and heat through.
7. Add plenty of salt and freshly ground pepper. Taste and adjust.
8. Remove from the heat and stir in the sauerkraut to warm it through–or add the sauerkraut to the bowls.
9. Serve in a shallow bowl with a big dollop of sour cream or creme fraiche

Bon appetit!

Jessica Prentice is both a professional chef and a passionate home cook. She currently conducts cooking classes, writes a monthly New Moon Newsletter on her Wise Food Ways website, and offers monthly Full Moon Feasts in the Bay Area. She is a Bay Area chapter head for the Weston A. Price Foundation for wise traditions in food, farming, and the healing arts. Her new book, Full Moon Feast, is about food and culture and will be available this spring from Chelsea Green Publishing. © 2006 Jessica Prentice