What To Leave Off Your Table (To Stay Off This Surgeon’s)
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Why we eat too much (and how we can fix that)
This is Dr. Andrew Jenkinson. He’s a Consultant Surgeon specializing in the treatment of obesity, gallstones, hernias, heartburn and abdominal pain. He runs regular clinics in both London and Dubai. What he has to offer us today, though, is insight as to what’s on our table that puts us on his table, and how we can quite easily change that up.
So, why do we eat too much?
First things first: some metabolic calculations. No, we’re not going to require you to grab a calculator here… Your body does it for you!
Our body’s amazing homeostatic system (the system that does its best to keep us in the “Goldilocks Zone” of all our bodily systems; not too hot or too cold, not dehydrated or overhydrated, not hyperglycemic or hypoglycemic, blood pressure not too high or too low, etc, etc) keeps track of our metabolic input and output.
What this means: if we increase or decrease our caloric consumption, our body will do its best to increase or decrease our metabolism accordingly:
- If we don’t give it enough energy, it will try to conserve energy (first by slowing our activities; eventually by shutting down organs in a last-ditch attempt to save the rest of us)
- If we give it too much energy, it will try to burn it off, and what it can’t burn, it will store
In short: if we eat 10% or 20% more or less than usual, our body will try to use 10% to 20% more or less than usual, accordingly.
So… How does this get out of balance?
The problem is in how our system does that, and how we inadvertently trick it, to our detriment.
For a system to function, it needs at its most base level two things—a sensor and a switch:
- A sensor: to know what’s going on
- A switch: to change what it’s doing accordingly
Now, if we eat the way we’re evolved to—as hunter-gatherers, eating mostly fruit and vegetables, supplemented by animal products when we can get them—then our body knows exactly what it’s eating, and how to respond accordingly.
Furthermore, that kind of food takes some eating! Most fruit these days is mostly water and fiber; in those days it often had denser fiber (before agricultural science made things easier to eat), but either way, our body knows when we are eating fruit and how to handle that. Vegetables, similarly. Unprocessed animal products, again, the gut goes “we know what this is” and responds accordingly.
But modern ultra-processed foods with trans-fatty acids, processed sugar and flour?
These foods zip calories straight into our bloodstream like greased lightning. We get them so quickly so easily and in such great caloric density, that our body doesn’t have the chance to count them on the way in!
What this means is: the body has no idea what it’s just consumed or how much or what to do with it, and doesn’t adjust our metabolism accordingly.
Bottom line:
Evolutionarily speaking, your body has no idea what ultra-processed food is. If you skip it and go for whole foods, you can, within the bounds of reason, eat what you like and your body will handle it by adjusting your metabolism accordingly.
Now, advising you “avoid ultra-processed foods and eat whole foods” was probably not a revelation in and of itself.
But: sometimes knowing a little more about the “why” makes the difference when it comes to motivation.
Want to know more about Dr. Jenkinson’s expert insights on this topic?
If you like, you can check out his website here—he has a book too
Why We Eat (Too Much) – Dr. Andrew Jenkinson on the Science of Appetite
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Why Lung Cancer Is On The Rise In Women Who’ve Never Smoked
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It’s easy to assume that if you’ve never smoked, lung cancer is just not a risk for you, unless you got very unlucky with an asbestos-laden environment or such.
And yes, smoking is indeed the most overwhelmingly strong risk factor:
❝It is estimated that cigarette smoking explains almost 90% of lung cancer risk in men and 70 to 80% in women❞
Which is a lot (and we’ll address that discrepancy by sex shortly), but meanwhile first let’s mention:
❝Compared with non-smokers, smokers have as much as a 30-fold increased risk of developing cancer.
31% and 26% of all cancer deaths in men and women, respectively, result from lung cancer in the United States.
Overall 5-year survival is only 15%, and 1-year survival is approximately 42%.
In total, lung cancer is responsible for more deaths than prostate, colon, pancreas, and breast cancers combined❞
Source: Smoking and Lung Cancer
Sobering statistics for any smoker, certainly.
But, “smoking is bad for the health” is not the breaking news of the century, so we’ll look now at the other risk factors.
Before we do though, let’s just drop this previous main feature of ours for anyone who does smoke or perhaps who has a loved one who smokes:
Which Addiction-Quitting Methods Work Best? ← it’s not specific just to smoking, but it does cover such also
So, Why the extra risk for women, even if we don’t smoke?
Let’s reframe that first statistic we gave, now presenting the same information differently:
Women who do not smoke are 2–3x more likely to get lung cancer than men who do not smoke.
So… why?
There are three main reasons:
Genetic risks
Cancer often arises from genetic mutations. In the case of lung cancer, genes such as ALK, ROS1, TP53, KRAS, and EGFR are implicated, and some of those are much more likely to mutate in women than in men.
In some cases, it’s because if you have XX chromosomes (as most women do), there are genes you have redundant copies of that people with XY chromosomes don’t. Other less common karyotypes, such as XXY, probably carry higher risks, but that’s just a hypothesis we’re making based on “more copies of a gene = more chances for it to mutate”.
See also: Frequency and Distinctive Spectrum of KRAS Mutations in Never Smokers with Lung Adenocarcinoma
In other cases, it’s because estrogen interacts with the gene mutations, making lung cancer more likely to develop in women over time:
Hormonal risks (but not what you might think)
When something affects women more, it’s easy to blame hormones, but, as researchers have concluded…
❝A reduced lung cancer risk was found for OC and HRT ever users. Both oestrogen only and oestrogen+progestin HRT were associated with decreased risk. No dose-response relationship was observed with years of OC/HRT use. The greatest risk reduction was seen for squamous cell carcinoma in OC users and in both adenocarcinoma and small cell carcinoma in HRT users.❞
OC = oral contraceptive
HRT = hormone replacement therapyNote: we snipped out the statistical calculations for readability and brevity, so if you are interested in those, check out the paper below:
Meanwhile, another research review of 22 studies with nearly a million participants found:
❝Current or ever HRT use is partly correlated with the decreased incidence of lung cancer in women.
Concerns about the incidence of lung cancer can be reduced when perimenopausal and postmenopausal women use current HRT to reduce menopausal symptoms.❞
So, the problem seems to at least a lot of the time be not estrogen (notwithstanding what we mentioned previously about mutations—sometimes a thing can have both pros and cons), but rather, untreated menopause being the higher risk factor.
This is very reminiscent of what we talked about in one of our main features about Alzheimer’s disease:
Alzheimer’s Sex Differences May Not Be What They Appear ← Women get Alzheimer’s at nearly 2x the rate than men do, and deteriorate more rapidly after onset, too.
Chronic inflammation
For reasons that have not been tied to genetics or hormones*, women suffer from autoimmune diseases at much higher rates than men.
*presumably it is at least one or the other, because there aren’t a lot of other options that seem plausible, but (as with many “this thing mainly affects women” maladies), science hasn’t yet determined the cause.
Because cancer is in part a disease of immune dysfunction (cells fail to kill cells they should be killing), having an autoimmune disease, or indeed chronic inflammation in general, will result in a higher risk of cancer.
For general theory, see: Cancer and Autoimmune Diseases: A Tale of Two Immunological Opposites?
For specifics, see: Non–Small Cell Lung Cancer: Role of the Immune System and Potential for Immunotherapy
And this one is the most likely explanation of why lung cancer in women who’ve never smoked is on the rise—it’s because chronic inflammation in women is on the rise. While people regardless of gender are getting chronic inflammation at increased rates nowadays (probably due in large part to the rise of ultra-processed food, as well as the higher stress of modern life, but again, we’re hypothesizing), if all other factors are equal, women will still get it more than men.
However!
Like the consideration of HRT’s protective effects (and unlike the genetic factors), this is one we can do something about.
For how, check out: How to Prevent (or Reduce) Inflammation
Want to know more?
For lung health in general, see:
Seven Things To Do For Good Lung Health!
Take care!
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What’s the difference between period pain and endometriosis pain?
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Menstruation, or a period, is the bleeding that occurs about monthly in healthy people born with a uterus, from puberty to menopause. This happens when the endometrium, the tissue that lines the inside of the uterus, is shed.
Endometriosis is a condition that occurs when endometrium-like tissue is found outside the uterus, usually within the pelvic cavity. It is often considered a major cause of pelvic pain.
Pelvic pain significantly impacts quality of life. But how can you tell the difference between period pain and endometriosis?
Polina Zimmerman/Pexels Periods and period pain
Periods involve shedding the 4-6 millimetre-thick endometrial lining from the inside of the uterus.
As the lining detaches from the wall of the uterus, the blood vessels which previously supplied the lining bleed. The uterine muscles contract, expelling the blood and crumbled endometrium.
The crumbled endometrium and blood mostly pass through the cervix and vagina. But almost everyone back-bleeds via their fallopian tubes into their pelvic cavity. This is known as “retrograde menstruation”.
Most of the lining is shed through the vagina. Andrey_Popov/Shutterstock The process of menstrual shedding is caused by inflammatory substances, which also cause nausea, vomiting, diarrhoea, headaches, aches, pains, dizziness, feeling faint, as well as stimulating pain receptors.
These inflammatory substances are responsible for the pain and symptoms in the week before a period and the first few days.
For women with heavy periods, their worst days of pain are usually the heaviest days of their period, coinciding with more cramps to expel clots and more retrograde bleeding.
Many women also have pain when they are releasing an egg from their ovary at the time of ovulation. Ovulation or mid-cycle pain can be worse in those who bleed more, as those women are more likely to bleed into the ovulation follicle.
Around 90% of adolescents experience period pain. Among these adolescents, 20% will experience such severe period pain they need time off from school and miss activities. These symptoms are too often normalised, without validation or acknowledgement.
What about endometriosis?
Many symptoms have been attributed to endometriosis, including painful periods, pain with sex, bladder and bowel-related pain, low back pain and thigh pain.
Other pain-related conditions such migraines and chronic fatigue have also been linked to endometriosis. But these other pain-related symptoms occur equally often in people with pelvic pain who don’t have endometriosis.
One in five adolescents who menstrate experience severe symptoms. CGN089/Shutterstock Repeated, significant period and ovulation pain can eventually lead some people to develop persistent or chronic pelvic pain, which lasts longer than six months. This appears to occur through a process known as central sensitisation, where the brain becomes more sensitive to pain and other sensory stimuli.
Central sensitisation can occur in people with persistent pain, independent of the presence or absence of endometriosis.
Eventually, many people with period and/or persistent pelvic pain will have an operation called a laparoscopy, which allows surgeons to examine organs in the pelvis and abdomen, and diagnose and treat endometriosis.
Yet only 50% of those with identical pain symptoms who undergo a laparoscopy will end up having endometriosis.
Endometriosis is also found in pain-free women. So we cannot predict who does and doesn’t have endometriosis from symptoms alone.
How is this pain managed?
Endometriosis surgery usually involves removing lesions and adhesions. But at least 30% of people return to pre-surgery pain levels within six months or have more pain than before.
After surgery, emergency department presentations for pain are unchanged and 50% have repeat surgery within a few years.
Suppressing periods using hormonal therapies (such as continuous oral contraceptive pills or progesterone-only approaches) can suppress endometriosis and reduce or eliminate pain, independent of the presence or absence of endometriosis.
Not every type or dose of hormonal medications suits everyone, so medications need to be individualised.
The current gold-standard approach to manage persistent pelvic pain involves a multidisciplinary team approach, with the aim of achieving sustained remission and improving quality of life. This may include:
- physiotherapy for pelvic floor and other musculoskeletal problems
- management of bladder and bowel symptoms
- support for self-managing pain
- lifestyle changes including diet and exercise
- psychological or group therapy, as our moods, stress levels and childhood events can affect how we feel and experience pain.
Whether you have period pain, chronic pelvic pain or pain you think is associated with endometriosis, if you feel pain, it’s real. If it’s disrupting your life, you deserve to be taken seriously and treated as the whole person you are.
Sonia R. Grover, Senior Research Fellow, Murdoch Children’s Research Institute; Clinical Professor of Gynaecology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healthy Living in a Contaminated World – by Dr. Donald Hoernschemeyer
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There’s a lot going on here, as this book tackles very many kinds of common contaminants, from waste products and industrial chemicals (such as from fracking), pesticides that are banned in most places but not the US, smog and soot from coal and oil power, mercury and other heavy metals, dioxins, Teflon and its close relatives, phthalates, BPA, and other things again regulated out of use in many countries but not entirely in the US (which bans them only in some things, like baby bottles), drinking water issues of various kinds, and much more.
Indeed, there’s a whole chapter on the US and international regulation of toxic substances; the problem is often that on a political level, the same people who are against nebulous “chemicals” are also against environmentalist regulations that would ban them. This is mostly not a political book though, and rather is chiefly a book of chemistry (the author’s field).
It does also cover the medical maladies associated with various contaminants, while the bulk of the data is on the chemistry side of such things as “elimination times for toxic chemicals”, “amounts of pesticides in fruit and vegetables”, “antibiotics and hormones used in animal agriculture”, and so forth.
The style is dense, and/but it is clear the author has made an effort to not be too dry. Still, this is not a fun read; it’s depressing in content and the style is more suited to academia. There are appendices containing glossaries and acronym tables, but reading front-to-back, there’s a lot that’s not explained so unless you also are a PhD chemist, chances are you’ll be needing to leaf forwards and backwards a lot.
Bottom line: this book is not thrilling, but what you don’t know, can kill you.
Click here to check out Healthy Living In A Contaminated World, and improve your odds!
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The Magic of L-theanine
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All The Benefits Of Caffeine And More, Without The Drawbacks? What’s The Catch?
It just takes one extra supplement.
For many of us, our morning brew is practically a ritual, but caffeine can also cause all kinds of problems ranging from caffeine jitters to caffeine crashes to caffeine addiction and withdrawal. Surely, something could be better?
Well, yes it could! You doubtlessly know about green tea’s antioxidant properties, but its amino acid, l-theanine (which can be taken as a supplement with coffee, if you don’t enjoy green tea) has so much more to offer:
- L-theanine has been found to reduce stress responses—and let’s face it, when we most want/need a coffee is often when facing stress
- It also reduces anxiety, making it a very safe “downer” without the problems of, for example, alcohol—or other potentially addictive substances
- It’s far more than just that, though! Paradoxically, l-theanine also improves alertness (what other calming things promote alertness? Not so many)
- Part of its trick is that it also improves accuracy—whereas stimulants like caffeine may produce a twitchy, jumpy, responsiveness, l-theanine’s signature effect is a calm state of sharp readiness. Caffeine works by stimulating the adrenal gland and increasing blood pressure, while simultaneously blocking adenosine receptors so that your body doesn’t notice its own tiredness—which is why you’re likely to crash later, when the tiredness that had been masked, all hits at once. Instead, l-theanine taken with caffeine acts as a moderator of that, making for a longer, gentler curve. In terms of subjective experience, what this can mean for many people is: no more caffeine jitters!
- All this means that while l-theanine can boost all kinds of cognitive function, including alertness and accuracy, many like to take in the evening as it can also promote a good night’s sleep, ready to be at your best the next day.
- How much to take? 200mg is a commonly used dosage, which in supplement terms is usually a single capsule. A lot easier to take than the 40 cups of green tea that this dosage would otherwise be!
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10,000 Steps, 30 Days, 4 Changes
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Ariel wasn’t the most active person, and took on a “30 day challenge” to do the commonly-prescribed 10,000 steps per day—without adjusting her diet or doing any other exercise. How much of a difference does it make, really?
Stepping onwards
The 4 main things that she found changed for her weren’t all what she expected:
- Weight loss yes, but only marginally: she lost 3 lbs in a month, which did nevertheless make a visible difference. We might hypothesize that part of the reason for the small weight loss and yet visible difference is that she gained a little muscle, and the weight loss was specifically shifting away from a cortisol-based fat distribution, to a more healthy fat distribution.
- Different eating habits: she felt less hungry and craved less sugar. This likely has less to do with calorie consumption, and more to do with better insulin signalling.
- Increased energy and improved mood: these are going together in one item, because she said “4 things”, but really they are two related things. So, consider one of them a bonus item! In any case, she felt more energized and productive, and less reliant on caffeine.
- Improved sleep: or rather, at first, disrupted sleep, and then slept better and stayed better. A good reminder that changes for the better don’t always feel better in the first instance!
To hear about it in her own words, and see the before and after pictures, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Life Lessons From A Brain Surgeon – by Dr. Rahul Jandial
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In the category of surgeons with a “what to put on your table to stay off mine” angle, this book packs an extra punch. As well as being an experienced brain surgeon, Dr. Jandial also does a lot of cutting edge lab research too. What does this mean for us?
This book gives, as the subtitle promises, “practical strategies for peak health and performance”—with a brain-centric bias, of course.
From diet and nootropic supplements, to exercise and brain-training, we get a good science-based view of which ones actually work, and which don’t. The style is also very readable; Dr. Jandial is a great educator, presenting genuine scientific content with very accessible language.
Bottom line: if you’d indeed like to look after your most important organ optimally, this book gives a lot of key pointers, without unnecessary fluff.
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