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4 years ago

Thoughts on Chronic Lyme Disease

First off, let’s get some terminology out of the way.

Lyme disease – also known as borreliosis, is an infectious disease thought to be caused by a microscopic organism called borrelia. Lyme disease is notoriously difficult to diagnose. However, classic symptoms include sudden-onset fever following a tick bite, the tell-tale “bulls-eye” rash, and migrating joint pain.

chronic Lyme disease – also known as post-treatment Lyme disease syndrome, is the presentation of lingering symptoms (or appearance of new symptoms) following the resolution of a case of Lyme disease.

IDSA – The Infectious Diseases Society of America is a medical association with a focus on infectious diseases. IDSA makes clinical practice guidelines for the treatment of infectious diseases, including Lyme disease.

CDC – The Centers for Disease Control and Prevention is a federal agency of the United States responsible for “protecting public health.”

ILADS – The International Lyme and Associated Diseases Society is a medical association that advocates for a wider recognition of chronic Lyme disease. Furthermore, ILADS makes its own treatment guidelines for chronic Lyme disease.

LLMD – A Lyme literate medical doctor is an unofficial self-designated title that some medical professionals choose to describe themselves. LLMDs typically follow the ILADS guidelines to some extent, and they are known to diagnose chronic Lyme disease.

So imagine for a moment that you are sick. Very sick. You are extraordinarily fatigued all the time. Not just “I’m tired” fatigued, but the sort of fatigue where you literally spend hours trying to talk yourself into standing up to go to the bathroom because you have to pee but you’re so exhausted that it seems better to hold it in rather than expend the precious energy needed to walk 20 feet. You’re tired all the time, but you cannot sleep. In addition to the extreme fatigue, you also cannot seem to think straight and you experience mood swings that leave your few remaining friends walking on eggshells around you. Working a job is next to impossible, so chances are you lost yours a while back. And when you go to your doctor you’re told that there’s nothing wrong with you and it must all be in your head. This is a taste of the experience of chronic Lyme disease. Of course, the symptoms are widely varied, and there is no official, standard definition for chronic Lyme disease, and so many who have this affliction may experience vastly different symptoms.

Lyme disease can be difficult to diagnose. Although there are other vectors, ticks are one of the most common. So sudden-onset fever following a tick bite is a good indicator. Add to that a “bull’s eye” rash, and you’ve got a pretty clear case of Lyme disease. However, reportedly, not all cases of Lyme disease ever present these tell-tale symptoms. Without a clear route of infection and a bull’s eye rash, Lyme disease is difficult to differentiate from many other mysterious diseases such as chronic fatigue, fibromyalgia, and multiple sclerosis. In fact, many of the symptoms are overlapping with these other conditions  So the next step is to use medical tests to determine if Lyme disease is likely. The problems here are many. For one thing, apparently few doctors will order these tests or even suggest the possibility to patients, particularly in areas with low incidences of confirmed Lyme disease. But then there is the issue of the accuracy of the tests for Lyme disease. While the CDC maintains that the tests are accurate by at least 65% (a number that seems very low to begin with,) other organizations state that the tests are next to useless because of their inaccuracy.

Now, if a doctor has clinical evidence and/or test results suggesting Lyme disease, and if the doctor is reasonably Lyme literate (which seems to be a big “if” in many areas,) then in most cases such a doctor would follow the IDSA treatment guidelines.  According to the IDSA guidelines the recommended treatment is a three-week course of antibiotics. In many cases this seems to work. But sometimes it doesn’t. And that’s where it gets even more complicated.

The tests for Lyme disease test for the presence of antibodies. In a person who has been infected it is expected that the antibodies will continue to be present even after the infecting bacteria have been successfully killed. Put two and two together and you quickly realize that there is no way to test to determine if a treatment has been successful other than the absence of symptoms. The trouble is that after a three week course of antibiotics most doctors will consider that the disease has been successfully treated regardless of presenting symptoms.

According to the CDC reports, there have been an average of 24,000 confirmed new cases of Lyme disease every year in recent years, and the numbers have been trending upward since 1977 when the disease was first identified. (Incidentally, since I wrote this, the CDC has issued press release that they are going to modify their number of confirmed cases to 300,000 a year! I’m not even going to publicly speculate about what could have motivated this extreme change in numbers.) The CDC further reports that as many as 20% of those treated for Lyme disease will continue to have symptoms, something that the CDC calls post-treatment Lyme disease syndrome. Add to that all the unconfirmed and unreported cases, and you’ve got a whole lot of chronically sick people who are receiving little to no support from any official channels.

With so many sick people and with the obviously short-sighted IDSA guidelines it should come as no surprise that there would be all sorts of angry responses. The responses range from lobbying groups to conspiracy theories suggesting that Lyme disease is a bioterrorism agent leaked from the government laboratory on Plum Island.

And then there is ILADS. ILADS challenges the CDC’s claim that there is no such thing as chronic Lyme disease. ILADS encourages sick people to get a second (or third or fourth) opinion and to ignore negative test results. ILADS also advocates for long-term uses of antibiotics, a highly-controversial practice that the CDC expressly advises against. The National Institutes of Health (NIH) has sponsored four studies examining the efficacy of long-term antibiotic use for Lyme disease. Two of the studies found no discernable difference in outcomes between short-term and long-term antibiotic use. The other two studies found that long-term antibiotic use offered no greater outcomes in terms of Lyme disease but did create other problems such as drug-resistant infections and even death in some cases. And so it is that the CDC and ILADS are two sides in what has come to be known as the Lyme wars, with lots of sick people as casualties.

LLMDs typically have waiting lists many months long. Insurance companies usually cover little to nothing of the expenses of visiting with LLMDs or following their treatment protocols. So visiting LLMDs turns out to be very expensive. But many people turn to this option because all other medical professionals have failed them. The trouble, aside from the expense, is that there is no way to have confidence in the diagnosis of an LLMD. By definition there is no real definition for chronic Lyme disease. ILADS suggests ignoring test results. And just about any symptoms can be chalked up to chronic Lyme. LLMDs are in the business of diagnosing Lyme. So from my perspective a diagnosis from an LLMD is largely worthless.

Truth be told, a good number of LLMDs do seem to help some people get well again. However, there are no studies to demonstrate the efficacy of their treatments. So we are left to “take their word for it.” But the LLMDs’ words don’t mean much because the truth is that even they don’t have good information unless they are following up long-term with every one of their patients – which they are not. And it isn’t hard to find patients who have taken the six months (or more) of various antibiotics, antifungals, and all the other “anti-”s only to find themselves sicker and poorer to boot. So while I’m not questioning the intentions of many LLMDs, I do question the efficacy of what they do.

Like many things, I suspect that the truth of this whole thing is found somewhere in the middle rather than at the extremes. It seems rather obvious that the IDSA and CDC are dropping the ball and failing to provide real help to people. They are leaving a lot of people in the lurch. At the same time, ILADS and LLMDs are capitalizing on this situation. Because IDSA and CDC have failed to provide any sort of practical definitions that have applicability to the real world, ILADS and LLMDs can get away with diagnosing a disease (chronic Lyme disease) for which they provide no real definition and for which they offer no tests whatsoever.

In the spring of 2010 I lived in the woods in New England. I slept on the forest floor. I pulled tens of ticks off of myself daily. And then I had a sudden-onset fever followed by a bull’s eye rash. Then I had several months of migrating joint swelling and pain. The next two years I couldn’t sleep, I was extremely fatigued, my digestion failed, and I had extreme mood swings. I was angry and irritable for no reason. I was depressed. I lost 40 pounds after already being slightly underweight. Due to a distrust in the medical system and an aversion to pharmaceuticals coupled with extreme anxiety, I never went to see a doctor. But I did try every “alternative” approach I could. I tried various dietary modifications. I tried many different herbal protocols. I fasted. I sweat. I even sank so low as to try and “zap” myself healthy with a small electronic device. But I remained sick. I was convinced that I had chronic Lyme disease.

Then I started eating 5000 calories a day, including plenty of protein, fat, and carbohydrates. And miraculously, I felt well. Not all of my symptoms disappeared overnight. But most of them did. I put on 50 pounds. I had energy enough that I built two cabins. I could carry my kids around and toss them up in the air. I found myself sprinting spontaneously on occasion!

For reasons that are too complex to describe, I stopped eating as much after some months. I switched to an ideological diet that most closely resembled a low-carb paleo diet. And I started feeling terrible again. I lost weight. I lost energy. No matter what I tried, I just felt sick.

After far too long sticking with that restrictive diet, I finally had sense enough to re-evaluate. I measured my resting pulse, and found that it was 50 bpm. My basal temperature was 96 F. I had problems with frequent urination. My hands and feet were cold. I had food sensitivities. I had all the signs of low metabolism. And so I decided to do the only sensible thing, and start eating large amounts of food in an unrestricted fashion once again. Unsurprisingly, once again I felt better and better as I continued to eat enough.

So what am I suggesting here? Am I suggesting that all people with “chronic Lyme disease” are really suffering from nothing more than low metabolism – that they can all heal completely by eating lots of food, including all macronutrients? No. Of course not. That would be naive and insulting. But I am suggesting this: that improving metabolism is a sensible first step and is likely to help no matter what, even if it does not prove to be the solution to all the problems. Certainly individuals should do whatever they believe is best – be that seeing a doctor or not, using pharmaceuticals or not, using herbs or not, etc. But improving metabolic function is compatible with just about anything else that a person may or may not do. As such, it makes a lot of sense to take some steps to improve metabolic function. Plus, it’s relatively cheap and easy!

You can find plenty of advice for improving metabolism elsewhere on this site, and so I won’t attempt to summarize it all here. But I will offer you my own personal top recommendations for improving metabolism and feeling better overall.

  • Relax your body. Stress of any kind, typically built upon anxious thoughts, starts a chain reaction of stress responses in the body, eventually adversely affecting metabolic function. When you notice that you have anxious thoughts or feel any stress, focus on relaxing your body. What I’ve noticed is that it is darn near impossible to relax thinking by focusing on it. But it is amazing how relaxing muscles in the body seems to relieve anxious thoughts. My suggestion is to just notice where you hold tension in your body, and consciously relax those muscles over and over for as long as necessary until you can relax without trying. Do you hold your jaw tight? Is your tongue relaxed? What about your shoulders? Is your forehead furrowed? What are you doing with your belly? Are your feet tensed? Just notice, and relax one muscle at a time.

  • Question your thoughts. If you notice that you are feeling stressed about something, question whether you can truly be certain about your beliefs regarding whatever it is. The truth is that we can never be certain. And so be willing to perceive other, less stressful, possibilities.

  • Pay attention to your breathing habits. If you are a mouth breather then work on breathing through your nose. Nasal breathing not only filters and warms air, but it also provides the benefit of creating nitrous oxide (NO.) NO is a vasodilator, which means it is a relaxant. In other words, nasal breathing is a natural stress reliever. Also, notice if your breathing is relaxed or if it is forced. The anatomy of breathing dictates that natural breathing uses a muscular contraction (of the thoracic diaphragm) on inhale and is completely relaxed and passive on the exhale. If you force the exhale then relax instead. And if you notice that you rely on auxiliary breathing muscles such as shoulders, chest, or neck, then relax those muscles. The more relaxed your breathing, the easier it is to relax more fully.

  • Eat food. Lots of it. If you’re sick it logically follows that you need extra energy to heal. Food provides that energy. If you don’t eat enough you make it impossible to heal. I expect that an average adult needs probably 3000+ calories a day. Obviously that number will vary depending on size, sex, age, etc. But if you’re eating significantly less than 3000 calories then chances are you need to eat more. And more is better in this case.

  • Give up the restrictions. Low carb? Gluten free? Sugar free? Low salt? Vegan? Casein free? Guess what? Unless you have a genuine allergy to a food, you are probably hurting your ability to heal by cutting out foods. Especially if you are starting from a place of compromised digestion function, you need to get calories from easy-to-digest sources. In my own personal experience carbohydrates, particularly sugars, have been extremely important. Salt is also important for me. And many other people report similar experiences. Adequate protein also seems to be helpful when healing. So while I don’t advocate for a high protein diet, I believe that including quality protein sources such as dairy, egg, and various other animal foods is helpful. The bottom line is, eat according to your desires, and give up the ideologies. If you desire starch or sugar then eat starch or sugar. If you desire cheese then eat cheese. And make sure you are eating enough. Often times eating enough is the real challenge, and so you may need to keep track of your calories and find ways to increase calories if you are eating too little. It is extremely unlikely that you will eat “too much.” If you are hungry enough to eat 10,000 calories (or more) in a day then that is not too much. When healing plenty of people do eat that much. So there is no real upper limit. Just make sure you are eating a reasonable minimum, which is likely to be at least 3000 calories if you are healing. (Note that most people will – at least initially – gain weight when they start eating enough after having eaten too little and lowered metabolic rate. Gaining weight in such an instance seems to be mostly inevitable. I understand that many people have a strong psychological aversion to gaining weight. That is a topic for another post.)

  • Lay off the polyunsaturated fats. I know that I just said to give up the restrictions. And I mean that. So if you truly crave soy oil or canola oil, then I guess you should eat them. But otherwise, ditch them – especially if you were eating them for ideological reasons (i.e. because the experts told you to.) I believe that high levels of dietary polyunsaturated fat suppresses metabolic function. And, frankly, who wants to eat spoonfuls of that stuff? On the other hand, most people genuinely enjoy butter! So consider eating saturated fats in place of polyunsaturated fats if you enjoy them (the saturated fats, that is.)

Those are my recommendations. It’s not a cure-all. Nor is this a comprehensive list of every consideration for metabolic healing. But this ought to provide a good foundation.

The experience of chronic Lyme disease is a real one. But the causes are uncertain. My hypothesis is that some people with chronic Lyme disease (so-called) are really suffering from little more than low metabolism that may itself be the result of a previous Lyme disease infection or from some other (non-Lyme) infection. In other words, Lyme disease (or other infections) may lower metabolism so that even after the infecting bacteria are killed, the person will continue to experience a great many unpleasant symptoms. On the other hand, in some cases it is likely that there may be lingering infections – whether from borrelia or from so-called co-infecting pathogens. It is possible that raising metabolism will resolve some of those infections by itself. In other people the infections may persist after improving metabolism. But in either case, raising metabolism seems like a logical first step. Or, at a minimum, it is sensible to do in conjunction with other treatments.

To be clear, my recommendations are for so-called chronic Lyme disease. If you have reason to believe that you have recently been infected with Lyme disease then that is another issue, and one for which I do not wish to make any recommendations at this time. As I have already stated, I had a very clear case of Lyme disease, and I never chose to use antibiotics. On the other hand, there is a good deal of evidence to suggest that antibiotics often do clear up Lyme disease if caught early enough. I don’t wish to argue for any course of action in terms of recent infections. However, if you have reason to believe that you have or may have so-called chronic Lyme disease, then my suggestion is that as a foundation for any other course of treatment you could hardly go wrong by improving metabolic function with my aforementioned recommendations. It is possible that in some cases this alone will restore health. In other cases it may not, but it may make some improvements. If nothing else, my recommendations are relatively inexpensive and quite unlikely to cause major medical complications whereas long-term use of antibiotics is both expensive and risky. In some cases long-term antibiotics may be necessary. Personally, I would want to rule out other possibilities first.

4 years ago

Are You As Unhealthy As You Think You Are?

Recently someone called my attention to a blog post titled “Are You As Healthy As You Think You Are?” over at Mark Sisson’s site. Here’s a quote from the post:

And, by and large, we get it totally wrong when we try to estimate our own health. We think we’re healthier than we actually are, have less weight to lose than we actually should, and are more physically fit than the previous generations.

Really?! I don’t know many people who overestimate their health. And I don’t know hardly anyone who isn’t hypercritical of his or her weight! So I would actually argue that most people are suffering from exactly the opposite problem from what is suggested in the post (hence the title of this post.) But what I find disturbing is that this sort of talk about how people are fat and lazy (and that this is a problem) is ubiquitous and seemingly accepted without question among most groups. Reading that post reinforced for me some of what I’ve been thinking about a fair amount lately: we’ve all had more than enough of this rubbish. There is no good that comes from this near-constant baratement. We get it from every angle. We’ve got health gurus of every persuasion – mainstream, alternative, paleo, primal, vegan, raw vegan, low-carb, whole food, etc. – telling us that we’re doing everything wrong. They tell us that we should eat less meat or less grain or less sugar (or just less of everything), and that our flagrant indulgences are causing our own personal (and collective) demise. Hollywood and the entire entertainment industry certainly seems hell-bent on promoting starvation and the anorexic ideal as something glamorous. Not only are we inundated with severely underweight stars, but on top of it these stars use their celebrity to promote diets, fasts, and cleanses. And then the government sees to it that we receive a hefty dose of shame from official channels insisting that we’re all too fat and lazy, and that we’re creating an “obesity epidemic” that is poised to create an absolute health and FINANCIAL disaster across the globe.

But what if they’re all wrong? Or what if they’re deceiving us? What if the problem isn’t that people think they are healthier than they are? Instead, what if the problem is that people are constantly bombarded with messages insisting that they are less healthy than they really are? What if the problem is that we’re under tremendous stress to make “healthy” changes that are completely unnecessary? What if “overweight” is a lie? What if we don’t need to “detox”? What if our health problems are less about what all the “experts” say they are all about and more about trying to follow all the absolutely insane recommendations the “experts” sell us?

There are so many contradictory views on the subject of health, how can you know who is right anyway? Vegans argue that humans were never intended to eat meat while paleo diet fanatics insist that meat (including animal fat) is at the heart of the natural human diet. The American Heart Association states that saturated fat and dietary cholesterol are bad for health while the Weston A Price Foundation (and others) have substantial studies backing up its view that saturated fat and dietary cholesterol are essential for human health. Fruititarians are determined that fruit is the most suitable food for humans while there are plenty who claim that fruit (due to its fructose content) is a poison! Many doctors tell people to limit salt consumption because they claim that it causes a whole host of problems (including high blood pressure) while it’s not difficult to find those who claim that salt is essential for resolving all the problems that salt is purported to cause!

My view is that all the “health” propaganda does more harm than good. Most of what passes for sound advice is harmful and chock-full of holes. Some of it is better than others, of course. But ultimately, all of it ends up having religious overtones and pretexts. And we end up with situations that look a lot like religious wars. None of this serves to improve the health of anyone. What it does, as best I can tell, is further entrench people into dogmatic worldviews, alienate people from their own bodies and intuitions, and line the pockets of the hucksters selling diets and superfoods and supplements (as well as drugs and policies.)

So I want to burst a few bubbles. Fundamentally, I think it is worth taking a look at a few questions:

  • Do you love your body? Do you really love everything about your body exactly as it is? The shape? The size? If not, then why not? What is the basis of your opinion about your body?
  • Why do you believe what you believe about diet and nutrition? Are you certain that you are correct?

It seems to me that there are two primary ways in which the hucksters cast doubt in the minds of the people, fostering mass low self-esteem:

  1. They create unobtainable and unhealthy ideals for how bodies “should” look. The specifics of this approach have changed (dramatically) over time. At present the most popular ideal seems to be an anorexic appearance. We are taught that thin is attractive and fat is unattractive. I cannot find the link at the moment, but I recently read of a poll that found that a significant percentage of people would rather die or be severely injured than be fat. And, alarmingly, “fat” is an entirely arbitrary concept (BMI ranges are entirely arbitrary) and one that is being redefined to correspond to lower and lower fat composition. In other words, many people have a very distorted view of what it would even mean to be “fat”.
  2. They create the false impression that most people are far more unhealthy than they really are. I can’t even begin to tell you how many people I talk to who experience vicious cycles of stress symptoms that they mistakenly blame on “toxicity” or “food intolerance” or “emf sensitivity”. I was one of those people too!. But the problem isn’t that we’re so unhealthy. The problem is that we’re obsessed with the idea that there is something wrong with us – which then sets the stage for something to be wrong with us!

Here are the ways in which I see people trying to deal with these (false) problems:

  • Restrict food – going on a “diet”, limiting food types, cutting out sugar or salt, etc.
  • Exercising – usually in some compulsive way and usually in some sort of stressful way
  • Fasting
  • “Detoxing”
  • Generally being obsessive and stressed

But all of these “solutions” tend to turn out to be problematic in that they mess up metabolism, upset hormone balance, and create vicious cycles of stress. Moreover, these things tend to make life unpleasant. So the bottom line is that these supposed solutions are largely ineffective and stressful.

The real problem is that by and large I don’t think there is usually nearly as much of a problem to begin with as we’re led to believe. In fact, the real problems seem to be the result of trying to fix the false problems. Let me explain what I mean. We’re told that we’re all in the middle of an obesity epidemic – that fatness is on the rise and that this is a major health problem. And the solution that we’re offered is to have all the fat people lose weight. The problem is that there is no proof that “excess” fat contributes to health problems in all but the most extreme cases, and in practice it isn’t useful or even practical for most “overweight” or “obese” people (as defined by BMI values) to lose weight! What is more (and this is very important) it turns out that there is a more direct link between health problems and being underweight. The irony here is that the current cultural obsession (fueled at least in part by the notion that there is such a thing as an obesity epidemic) with thin is probably causing far more health problems than obesity does. It turns out that losing weight is often actually undesirable in terms of health. The only way in which losing weight offers benefits statistically is when it is achieved through moderate, sustainable movement accompanied by adequate calories and nutrition to support a healthy metabolism and growth. In other words, keeping metabolic function high (by eating enough) and moving moderately can improve overall health. And one side effect of this may be some weight loss for people. But the weight loss is incidental and not the cause of the improvements in health.

We’re nearly all obsessed with losing weight (or not gaining weight) and with modifying superficial appearances. Much of it gets couched in terms of “health”, but it has little to nothing to do with health, and everything to do with commercial and political interests manipulating our thinking and our self-images. Put this in perspective: anorexia nervosa is far more lethal than obesity. So if the real issue of concern was health then we would see great media attention on the dangers of anorexia nervosa rather than obesity. But it’s not about health – it’s about money and power. The diet industry and the pharmaceutical industry see numbers in obesity, not in anorexia nervosa or other restrictive eating disorders. But the misinformation and distorted values are ubiquitous. I even came across an entire page on the March of Dimes website dedicated to the problems of a pregnant woman carrying “excess” weight! But when I searched the site I couldn’t find anything about the dangers of restrictive eating disorders for mothers and babies. And I only found one single reference to a mother being underweight – and at that it was only suggesting that being underweight prior to conception could potentially increase risk for some problems for the baby. So the message is that a pregnant woman should be very concerned about any excess weight, but there is no warning whatsoever about being underweight during pregnancy. This is so distorted that it is deeply troubling. We’ve been brainwashed. It’s time to take back our minds.

We have a culture that promotes low self-esteem and poor body image. We believe the lies that promote “ideal” bodies as though there was such a thing. Every body and every person is unique. There is no such thing as an ideal body or an ideal person. There are just bodies and people – all different and all perfect. The standards are completely arbitrary. There are cultures that value large bodies. In fact, the cultures from which our modern North American culture evolved once upon a time valued large bodies. This is important to remember because it points out that the standard could just as easily be redefined at any point. Why should anorexic model bodies be the standard for beauty? How about redefining the standard of beauty as your own body? And do it right now. Discover what that experience is like.

I know it isn’t easy to dismiss the cultural values even though they may be obviously unhealthy. We are social creatures. We want others to approve of us and like us. None of us wants people to dislike us, especially for superficial reasons such as our appearance. But is it worth it to stress over it and live our lives according to the arbitrary rules set by a culture that clearly doesn’t value health and well-being? I say no. I, for one, prefer the experience of loving myself and my body exactly as I am to the experience of constantly failing to live up to the standards set by the culture.

It is absolutely insulting that anyone would suggest that they could know better than I do about my state of health. Think about that for a second! On what grounds could anyone possibly know better than me about my health? It is ludicrous! And yet it is what happens day in and day out. And as if that wasn’t already insane enough, to add insult to injury we’re told that our appearance is not only somehow offensive or unacceptable from an aesthetic standpoint, but it also is an indicator of our state of health – thus the presumption that other people have right to judge us and interfere with our lives. But the truth still remains that no one else can know better than I do about the state of my health and regardless of the state of my health no one else has the right to interfere or impose their values on me and my body.

Next time you find yourself feeling bad about yourself, stop for a moment and consider whether it is really worth it. I know it isn’t always the easiest thing to do, but at least consider accepting yourself exactly as you are. At least consider valuing yourself exactly as you are. Sure, we all have room for improvement. That’s okay. But the ways in which most of us could stand to improve the most have nothing to do with weight or shape or BMI or cholesterol levels or blood pressure or any of those sorts of things. Rather, most of us could stand to improve by being nicer to ourselves and others both in thought and deed.

4 years ago

Good and Evil

381px-Devils-from-Rila-monasterySomehow the cultural views of food have taken on strangely religious tones. We’re given all sorts of messages along these lines from both media outlets and from governmental and non-governmental organizations promoting “health” (such as the National Institutes of Health and the American Heart Association):

  • “Limit bad fats such as saturated and trans fats”
  • “Eat more antioxidant-rich fruits and vegetables to protect from the risk of cancer”
  • “Sugar is evil”
  • “The evil king of all refined grains is high fructose corn syrup”
  • “Refined grains are dangerous”
  • “Grain consumption wreaks havoc in the human body”

But for every argument there is a counter-argument. The American Heart Association still claims that saturated fat causes heart disease. Meanwhile, organizations such as the Weston A Price Foundation publish plenty of evidence in support of the notion that saturated fat is healthy. And then there are those such as Mark Sisson or Ray Peat (to give but two polar examples of those who share this viewpoint) that polyunsaturated fat is the real evil. The same goes for every so-called “health” claim you can think of. There are those who argue, quite convincingly, with studies to back them up, that green vegetables are dangerous, that vitamin C is dangerous, that refined grains are healthier than whole grains, and on and on. So given all the conflicting views, who are we to believe? Who are we to trust?

I suggest that it’s all a distraction. Food is neither good nor evil. Why turn something so wonderful into a religious conflict? Food provides nourishment and, dare I say, enjoyment to us humans. Why turn it into yet another reason to stress, something over which to worry if you’re on the right side or the wrong side?

I lived for decades in absolute terror of food. I was terrified that touching or even looking at or thinking about “forbidden” foods such as sugar or meat or refined carbohydrates or dairy would result in some sort of punishment of a vaguely religious or at least supernatural or magical nature. And then I finally decided, once and for all, to stop the madness. I decided to stop listening to the dietary pundits – the high priests of nutrition. I decided that I had had enough of the suffering, the agonizing over food choices. I was thoroughly exhausted from the years of debating. And I decided to just eat the food.

Eating sugar is neither heavenly nor hellish. White rice is simply white rice. Beef is the flesh of a cow, nothing less and nothing more. Fruit juice is merely the juice of fruit. Food is neither good nor evil in a moralistic sense. Though I have to say that food tastes quite good, amazingly good, when it’s exactly what I want to eat and when I eat it with pleasure and enjoyment rather than stress and anxiety.

What I am coming to realize more and more deeply with every day is that food is rarely the problem. Focusing on food as the problem is a huge distraction at best, and at worst it is devastating to the person who falls victim to obsessing over food. Stress, anxiety, and obsessive worry are the real killers. These are the things that lead people to disordered eating habits that undermine their health and happiness. And all the religiosity about food only serves to perpetuate and worsen the real problem. While I don’t doubt but what many (though certainly not all) of the dietary preachers are well-intended (much as many religious preachers are probably well-intended,) it is clear that they as they ascend in status and influence we cannot discount the power that their success has over them, blinding them to all points of view other than the one they promote. For example, Dean Ornish, M.D. having made such a huge name for himself in association with a plant-based diet (that occasionally allows for some animal products) is unlikely to start promoting a low-carb “Paleo” diet any time soon. Likewise, Robb Wolf, author of “The Paleo Solution” is unlikely to start advocating for a vegan diet any time soon.

But despite the fact that these nutritional giants have lots and lots of studies and science to back their claims, and despite the fact that there are those who obtain health benefits from the prescribed diets, the fact is that there are so many exceptions that it is impossible to make any rules. There are plenty of humans who live long, healthy, happy lives regardless of their diet or lifestyle. There are plenty of long-lived, healthy people who eat refined grain, meat, fruit, sugar, coffee, chocolate cake, ice cream, nightshades, etc. So it’s about time that we start telling the truth: those who are selling us dietary protocols aren’t omniscient, infallible gods who can steer us from evil toward good. They don’t know what your body needs. Only you do. There is no good or evil when it comes to food. There is only the food that you need versus the food you don’t need in this moment. And you can differentiate fairly easily: what food do you want? The food you want is the food you need.

In a religious view of the dietary landscape we’re led to believe that the food we desire is evil and sinful. I’ve read claims that if a person craves chocolate it is due to a magnesium deficiency and sugar cravings indicate a chromium deficiency. Really? This sounds suspiciously like the religious claims that sexual desire is sinful. We’re not such stupid creatures! Our bodies are amazingly intelligent. Perhaps a chocolate craving indicates that chocolate is the perfect food in that moment. Same with sugar. It only makes sense to suggest otherwise if there is an ideological bias against chocolate or sugar…perhaps because they are thought to be evil. But again, there is no such thing as good or evil when it comes to food. Food is food.

4 years ago

Buteyko Breathing

ProfbuteykoI’m a fan of Buteyko Breathing. It’s a bit strange, to be sure. But then, most things are strange…especially professional sports. And personally, I enjoy Buteyko breathing much more than, say, American football.

If you’ve never heard of Buteyko breathing, then here’s a brief bit of background on the subject. In the second half of the 20th Century a Ukranian doctor named Konstantin Buteyko (pictured left) developed a system of breath retraining that he believed was nothing short of a panacea for all sorts of health problems, including asthma, heart disease, anxiety conditions, and probably even cancer. The breathing exercises and lifestyle recommendations that he developed now have somewhat of a cult following across the globe. There are Buteyko professionals all across the U.S. who will teach you, for a fee, to do Buteyko reduced breathing exercises. Personally, I learned from a book. I learned from Patrick McKeown’s Close Your Mouth book. And on this page I’ll give you a brief introduction.

The basic idea underlying the Buteyko breathing method is that many (or perhaps all) sick people hyperventilate. I cannot personally verify that this is true, and so I will not make any such claims myself. But this is what Buteyko breathing aims to correct in theory. Whether or not this is the mechanism by which Buteyko breathing is effective in helping people heal I do not know, but however it does work, it has helped me tremendously. The theory is that sick people hyperventilate, thus exhaling too much carbon dioxide, which then reduces body’s ability to utilize oxygen. Therefore, the theory states that by reducing breathing volume it is possible to retain greater amounts of carbon dioxide and improve oxygen utilization. Again, I don’t know if this is exactly what happens. But I do know that modifying my habitual breathing has been very helpful for me.

The first thing to note about the Buteyko method is that all breathing is done through the nose. The reasoning for this is that the nose provides important filtering functions and it naturally limits the volume of air exchange with every breath. So anyone beginning the Buteyko breathing method who is in the habit of breathing through the mouth is first encouraged to breathe only through the nose. This extends to night-time breathing as well, and so those who breathe through the mouth at night are encouraged to find ways to breathe only through the nose while sleeping. One way to achieve this is to tape the mouth shut at night. There are also chin straps that could serve this purpose.

The foundation of the Buteyko method is a diagnostic exercise called the Control Pause, or CP. This is meant to be the measurement, in seconds, of oxygen reserves in the body. (If you happen to have extreme anxiety or other severe condition then Buteyko tradition cautions against any breath holding such as with the CP test. Therefore, use your own judgment as to whether or not it is appropriate for you to do this test. If not, you can still do the reduced breathing exercise without measuring your CP until your symptoms reduce.) The way to measure the CP is to do the following:

  1. Breathe normally through your nose for several rounds if inhalation and exhalation, relaxing your breathing.
  2. After an exhalation take a small inhalation through your nose.
  3. Exhale, and then hold the breath by closing your mouth and pinching the nose closed so that no air can enter.
  4. Watch a clock or watch that indicates seconds, and continue to hold your breath for only so long as it is reasonably comfortable. Do not strain to hold your breath for as long as possible.
  5. At the first sign of air hunger, note the time, and inhale through your nose. The inhalation should be smooth and controlled, no larger than a typical inhalation. If it is larger or gasping then you have held your breath too long.

The number of seconds that you can hold your breath at the bottom of an exhalation until the first signs of air hunger is your CP.

Buteyko found that CP correlates with state of health. <20 CP indicates poor health (<10 is often very severe.) 20-30 CP usually indicates some minor health problems. 30-40 CP usually indicates good health with some health problems brought on by certain stimuli such as specific allergens. And 40+ CP is meant to correlate to good health without qualifications. Again, I cannot confirm that this is true for everyone. I can say that as my own CP has increased I have noticed improvements in my health.

For all the breathing exercises in the Buteyko method the inhalations are active and the exhalations are passive. Furthermore, all inhalations are done using the thoracic diaphragm as the primary inspiration muscle. This is all in line with the basic anatomy of breathing in the human body, and so it makes a  lot of sense. The way to measure progress in this is to place one hand on the belly and one hand on the chest. The belly should move outward on inhalation and should relax and move slightly back inward on a passive exhalation. Meanwhile, the chest should not move. If you notice that your chest moves during breathing then stay with this as an exercise until the only movement is in your abdomen and not in your chest.

The fundamental breathing exercise in the Buteyko breathing method is basic reduced breathing whereby you strive to reduce the inhalation volume. The way to do this is to start out breathing as usual for several rounds, and then on the next inhalation only inhale about 3/4 of the usual volume. Continue breathing in this fashion, inhaling only 3/4 of the usual volume. The idea is to reduce the volume enough that you feel a very mild air hunger, but not so much that it is stressful. It is important that you maintain a mild sense of air hunger by keeping the inhalation volume below what is usual for you. The key is to make it sustainable for about 20 minutes. If you reduce the volume too much then you will feel air hunger that is too strong and you will not be able to maintain it for long enough. Patrick McKeown suggests that the air hunger should be similar to what you might feel if going for a walk. Over the course of a 20 minute session you may find that the 3/4 volume becomes easier and the air hunger reduces. If so, then reduce the volume a bit more in order to maintain the same level of air hunger.

That is the basic exercise of Buteyko breathing. There are other exercises that one can do after becoming proficient at the basic exercise. The intermediate and advanced exercises involve breath holds at the bottom of exhalation and physical exercise such as walking combined with reduced breathing. I may write about these at another time.

I want to add another note here to state that I don’t necessarily believe that Buteyko breathing is the be-all-end-all of health and wellness. I believe that it can be a great adjunct to other practices and lifestyle modifications. I believe that it has helped me tremendously, but it isn’t the sole thing that turned my health around in a positive direction. For me I have found Buteyko breathing to be very complementary for reducing anxiety and improving metabolism. However, I attribute the positive changes in anxiety primarily to other practices and exercises that I have practiced and developed, and I attribute metabolic improvements mostly to eating and resting. There is a big overlapping effect between all of these things in my own experience: by reducing anxiety I was able to eat more and by eating more I was able to reduce my anxiety. So all of these practices and changes in my lifestyle worked together in a positive feedback loop to build health and reveal happiness and peace in my life.

UPDATE: I received an email asking about how I reconcile the traditional Buteyko dietary teachings with my own views regarding the importance of eating more to improve metabolic health. Here is the reply I sent in email:

I am an advocate for doing what works and being honest about your own needs versus following the dictates of some system. I personally have found tremendous benefit from Buteyko breathing as a guideline but not as a rule. Frankly, I find a good deal of Buteyko breathing teachings to be a bit obsessive and even borderline cultish. I should probably add a note about this in the blog post to make this clear. In the Buteyko obsessive community upping the CP is the most important thing above all else. Some recommend no talking no laughing no coughing no sneezing and sleeping only on the left side in addition to dietary recommendations. I just don’t agree. I think the breathing exercises, done with a light attitude and a smile can be tremendously helpful. I completely understand the deep desire to regain health, and so I understand how a practice that can be helpful can be turned into an obsession, but I don’t think it is healthy to do so. I think it is best to do it with an inquisitive and curious attitude, but don’t take it too seriously. Above all, relax, smile, and enjoy life. That is my view of it. You have to understand that I am, perhaps ironically, a bit obsessive about NOT being obsessive simply because of my history of being so obsessive with negative consequences. So I try not to take any practices too seriously.

If a person needs to eat more (i.e. low metabolism or history of starvation) then this person should eat more. Breathing exercises don’t change that or make an excuse for not eating more when it is appropriate and necessary to do so. I don’t know what your story is, and so I don’t know if you need to eat more or not. But if you do then my advice would be to try the reduced breathing exercise if you are inspired to do so AND eat more. Also, I don’t personally find that eating more or less makes such a difference in breathing exercises as the obsessives would have us believe. Same as I don’t find that sleeping on my back is a problem. Same as I don’t find that laughing is a problem. In fact, I enjoy sleeping on my back and I enjoy laughing. I also enjoy eating because I feel better. So my advise is to do what you know to be right for you. You probably know, at heart, what is best for your own health and happiness. Since you’ve asked this question, I’m guessing that you know that eating enough is important for you. So if I’m right about that, then I’d advise eating enough.

4 years ago

Obsession vs. Happiness in Eating Disorders

What does it mean to be truly happy? In my opinion true happiness is unconditional happiness. True happiness doesn’t depend on what I see in the mirror or how my clothes fit me. True happiness doesn’t depend on what I’ve eaten or how pure and perfect that food is. True happiness doesn’t depend on how morally and spiritually perfect I am (according to my own ideas of what that even means.) I’m not suggesting that this (true happiness) is the easiest thing to achieve, but I am suggesting that it is a worthy thing…much more so than happiness that depends on what the scale says or how my body matches some ideal that I’ve formulated in my mind based on media images and what I’ve read in books and my idea that people would like me more if I was more [insert your own idea of a desirable physical attribute] Much more than happiness that depends on being perfect and worthy.

I spent 20 years hating my body, being at war with my body, and determined to make my body fit my ideal image. Incidentally, those were 20 years of anxiety, obsession, and compulsion that eventually led to extreme sickness. If only my body would just admit defeat and finally shape itself according to my will I knew that all would be well. Except that it just doesn’t work that way. Hate doesn’t seem to yield happiness. It breeds misery and suffering. It took a long time, but eventually I realized that I am not separate from my body. This is the elusively obvious truth that was staring me in the face all the while. And so as I warred with my body I was really warring with myself. I was hurting myself. All the anxiety and sickness was the result of my war.

The crazy thing about this type of obsessive way of being that I lived is that it became a self-reinforcing loop. It started out as an obsession over my body, which led to an obsession over food and exercise. But the consequences of starvation and over-exercise and chronic stress are things like more stress, anxiety, fear, paranoia, and generalized obsessions with compulsions to boot. And for me all of that started to take on moral and spiritual overtones. I started to seek answers in philosophy and spirituality – things which I would then distort to serve my sick perceptions. I would meditate for hours followed by chanting and prayer. I would view insomnia and digestive problems as spiritual problems to be solved by greater purity and moral uprightness.

But for 20 years I was starving myself. I was denying myself basic necessities – nutrients and energy. My problems weren’t spiritual. My problems were dietary. I just needed to eat. Well, to be fair, I needed to eat and I also needed to relax. Mostly I needed to do both at the same time.

I feared so many foods at different times over the years. I feared sugar, refined grain, grain in general, meat, dairy, starches, vegetables, beans, fat, polyunsaturated fat, and probably even more if I cared to think about it any longer. I would obsess for hours and days over things that I had eaten or even things I hadn’t eaten. But what is amazing to me is that when my rules would change then I could eat something without any worry even though it had previously been a cause for stress. For example, I was fearful of meat for well over a decade, during which time I couldn’t even think about touching meat without being stressed. But once I gave myself permission it was no problem. I swore off all forms of concentrated sugar for many, many years, but then once I gave myself permission to eat it again it wasn’t a problem at all. So my realization with regard to all this was that the foods themselves were not a problem. It was only my attitude that was the problem. I was making myself miserable with my attitude.

So I started eating. I made a choice to acknowledge that my strategies had not only failed, but they were the very problem itself. So I decided to stop using the same old strategies or variations on them. Instead, I decided to listen to my body and my real needs. I ate what I wanted, and I ate often and a lot. I threw out the rules. My only guideline was to eat as much as I could using my desires as a way to determine what to eat. I did have goals to keep me honest – aiming to eat 3500 calories a day at least. But I didn’t stress about it. I didn’t look at the situation as one to win or lose. Rather, I chose to see it as life, a process, an adventure. And I started to feel better.

Therefore, in any restrictive eating situation I believe that one of the most important things a person can do is to eat. Eating enough (which is WAY more than you think) helps with so much – energy, mood, sleep, and more. But just eating is a difficult thing to do without also addressing the coincident obsessive tendencies that have gotten hardwired after living with an eating disorder.

So what I have come to believe is that true happiness is the natural result of a conscious choice to disregard obsession. True happiness is not something to attain as much as it is what is already present – what becomes clearer the more one chooses to ignore obsession. By following this advice – to turn away from obsession and instead discover true happiness – I found that I was able to eat more, experience faster recovery, and enjoy life for the first time in years. I stopped worrying about perfection, purity, and spiritual enlightenment because I was actually nourished and naturally felt good!

I have written about this elsewhere on this site, but it is worth mentioning again because I find it to be so powerful: I have found (and others have reported to me that they also find this to be true) that mental tension and anxiety are secondary to physical tension, and it is impossible to be anxious or obsessive when physically relaxed. My own experience of all those years of obsessiveness and anxiety is that I was usually struggling with my thoughts and obsessions…unsuccessfully. What I finally realized was that no amount of struggling with obsession will lead to a way out of the obsession. It is like a Gordian knot – the more you struggle with it the worse it becomes. So I started looking for a different approach.

What I asked myself was this: how did I know I was anxious? How did I know I had a problem? The answer? I knew it because I felt it. I felt it physically. I felt tense. So instead of obsessing and getting tangled up in thought and worry, I decided to ignore that and focus instead on the physical sensation. I noticed that I could find all the places in my body where I was tense and I could physically relax those areas, one at a time. At first, because I was in the habit of being tense, I could only relax a muscle for a split-second. So I’d have to consciously relax it again. But eventually I started to notice that I just started to be more relaxed. This practice, simple as it is, has been the most powerful force for healing in my life. It has helped me to effortlessly integrate all the wisdom I have learned throughout my life. This simple practice has helped me to rediscover happiness, peace, and laughter! I am so much more easy going now than when I was super uptight and focused on obsessions. Eating is easy and pleasurable. And things just keep getting better. Sure, I still get upset. Sure, I have my problems. But this simple practice has dramatically improved my life like nothing else.

4 years ago

Interview with Matt Stone

I’ve just published an interview with Matt Stone in the Interviews section. Check it out! I am very pleased with how the interview turned out. Matt was very gracious to agree to the interview, and his responses really far exceeded my expectations. I have a great deal of respect for Matt’s transparency, honesty, and humility…not to mention the wisdom he has gained with regard to metabolism and health.

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