"Yes, it's good for you! No, it's bad for you!" said about so many things

Exactly. Vitamins may be the worst example of this. Years ago, megadosing of vitamin C was touted as 'the cure all', and many people flushed many dollars worth of Vitamin C down their collective toilets. Why? because Vit. C is water soluble, so our bodies maintain the correct level of vitamin C in our systems by excreting the excess via the kidneys. Intake doesn't matter a whole lot. What you body doesn't use, you literally piss away. Other vitamins (notably E) are fat soluble, so your body stores it. Take too much and there is a real risk.

My takeaway is to try to do the moderation thing. Eat a healthy and balanced diet, and I'll live out my life span.

I don't think that the "saturated fats are bad" wisdom is correct or makes sense. So, maybe there is absolutely nothing that we can all agree on.

Most of the fat in my diet comes from grass-raised meat, wild fish, coconut oil, butter, olive oil and avocados, and much of it is saturated.

tommyc said...
Medications also, I was on Lipitor for a short time, it has a scary list of side effects. I stepped on a stick in the back yard and my leg muscles locked up and I almost couldn't make it back to the house.
Vioxx was a great medication, right up until it was found responsible for many deaths. Some say as many as 30,000, some say more, and of course some dont.

Absolutely. I have pointed this out previously. How is it that with the much sought after(and mega-expensive) FDA approval and blessing as "safe and effective" that such things can happen? It can also happen in the supplement world also, most especially because we never really know what we are getting. We only have the word of the manufacturer. Even something like consumerlab which tests contents of various brands of supplements, and which I used to count on to point me to the most trustworthy companies, is suspect. Due to money being paid by companies to them. (But at least Consumer Reports checks occasionally, no payoffs likely there. But all that tells you is that, at the time CU tested, all was good with this company. Or sometimes not)

So it can go both ways, but seems to me major harms show up much more frequently on the drug end- with drugs being pulled from the market or black box warnings added. And why should this ever happen when we have the FDAs approval? It's bad enough that we have to judge if the "benefits exceed the risk" as there are almost always SEs, sometimes severe. But then these significant new harms show up after the drug comes to market. Frustrating.

It's mind numbing with all the conflicting information out there.

There are studies that suggest Vitamin D raises testosterone, there are other studies suggest it doesn't. Some men might not want to raise their testosterone, in fact the opposite.

PCM prescribed 1000 IU of Vitamin D3 daily. It's taken daily but not without hmmm, what's this doing for/to me

"stop eating eggs, they will eventually kill you"

^ That has to be the number 1 oops of all time.

dmlvt said...
I don't think that the "saturated fats are bad" wisdom is correct or makes sense. So, maybe there is absolutely nothing that we can all agree on.

Most of the fat in my diet comes from grass-raised meat, wild fish, coconut oil, butter, olive oil and avocados, and much of it is saturated.

My diet is very similar to that, except I don't eat fish much. A little pastured meat, loads of olive oil, coconut oil, and avocados every day! Flaxseed, too, very high in fat and Omega 3s. And lots of veggies, of course!

Good post.

I always come back to the "Levels of Medical Evidence." The quality of the "proof" is almost always poor. Nothing is proven until a large scale randomized clinical trial (RCT) proves it, and preferably confirmed by another RCT. We have seen numerous supplements disproved or shown to be harmful when subjected to rigorous RCTs (e.g., pomegranate juice, lycopene, Vitamin E, selenium, green tea catechins, omega-3s, etc.).

Most published studies on food and supplements are epidemiological, tracking studies, or, at best, pilot efficacy studies (Phase 2). The professional research community means them to provide hypotheses for further testing or to demonstrate lack of harm, and that is all. Unfortunately, the media, the internet, and even some of us, read them as if they proved something and go off half-cocked recommending things that were never meant to be recommended. Biochemistry and feedback mechanisms are highly complex and don't lend themselves to the kinds of simplistic explanations that the media and internet feed on.

Let me lay out a few rules that I've noticed:

1. Moderation & Variety - I agree with Halbert that moderation is important. It's almost always a bad idea to overwhelm our bodies' natural control mechanisms by taking too much of anything. We are omnivores at the top of the food chain and have evolved to extract and live by nutrients from almost everything. I respect that by eating all kinds of foods I've evolved to live by. Vegetarianism is unnatural to humans. We've modified the nutrient density of all our foods. The solution is to increase our fiber intake - it helps dilute the effect of hyper-doses of any substance. We need a variety of proteins, a variety of fatty acids and a variety of complex carbs, as well as all kinds of, perhaps surprising, micronutrients. The only way to get everything we've evolved to live by is by eating a rich variety of foods (and remember, there is a reason we are attracted to color in our foods - it has survival benefit).

2. Food, not supplements - Our bodies were designed to extract what we need from the foods we eat. There are all kinds of natural filters in place (e.g., gut, liver, kidneys, blood/brain barrier, enzymes, receptors, vesicles, etc.). Those filters can be overwhelmed by taking supplements (see "Moderation").

3. Bioavailability will often negate any benefit seen in lab studies. Lots of substances look good in test tubes and mice. In real-life human studies, they usually fail to demonstrate any benefit because the substance never make it to the cells we hope to target. Curcumin is a good example of this. All the filters mentioned above are there to prevent those substances from getting into cells - we may think of them as therapeutic, but our bodies think of them as toxins. The prostate, with its dense cellular structure and poor blood supply is particular impervious. Many tumors are similarly impervious. There are enzymes in natural foods that may increase bioavailability.

4. Each of us is a complex of interacting species - and not a single species. The bacteria in our bodies outnumber the human cells in our bodies by about 10 to 1. We have co-evolved in a symbiotic relationship with them. We need the bacteria in our guts to extract vital nutrients (many of which are unknown), and likewise, those gut bacteria need us to supply them with vital nutrients (many of which are unknown). We live together under one roof in ecological balance. Supplements and drugs can disrupt that balance and may lead to illness. Some bacteria, viruses and fungi that are naturally healthful while in ecological balance, can cause illness if we disrupt that balance.

5. Inter-cellular and intra-cellular signaling can be disrupted in complex ways by our intake of substances. We are just beginning to understand the ways that outside (epigenetic) influences can change the ways our genes are expressed. Cells communicate with other cells and influence one another's behavior in complex ways. Healthy cells and cancerous cells interact, and a substance that keeps one cell healthy, may activate an oncogene in another cell, or provide a co-factor necessary for carcinogenesis in another cell.

6. The immune system and apoptosis are more complex than anyone imagines, and can be compromised by what we intake. We are just learning about the ways that intake of high levels of antioxidants can prevent damaged cells from self-destruction (apoptosis) or interfere with the immune system's killing of cancerous cells. Likewise, maintaining good oxygenation (as with exercise) appears to be important in keeping healthy cells healthy. Our bodies can balance the constructive and destructive potential of reactive oxygen species (ROS) without our interference.

7. Negative feedback will most likely prevent your accomplishing anything with supplements. Almost every biochemical system in our bodies has a negative feedback/homeostasis system in place to keep things at a normal level. If we take Zytiga without prednisone, we will produce more steroids, not less. If we take testosterone, Sex Hormone Binding Globulin (SHBH) amps up to get rid of the excess, metabolism into estrogen and DHT increases, cellular receptor sites decrease, and our natural production shuts down. Vitamin D, a steroidal hormone, seems to have similar feedback mechanisms - supplementing it may wind up reducing its net cellular availability.

8. It has taken a lifetime of eating habits to get to this point - it is unlikely that changing those habits will have an immediate affect on any cancer.

9. The same substance may often be healthful and provoke illness, and may affect different people differently. Concentration, timing, co-factors, the current state of our systems, cell cycles and probably many other factors help determine whether a substance can help us or hurt us. Also, individual differences may mean that something that helps one person may harm another.

10. All cancers are different, and they change over time. "Cancer" is not one disease. Every kind of cancer is different and is affected by different substances. A substance that prevents one kind of cancer may promote another kind of cancer. There never will be a single cure for cancer. Cancer cells are our own cells genetically, so a supplement that we take to kill the cancer may also kill us. Finding substances that have differential impact is hard - which is why there are so few kinds of chemo. Because cancer cells mutate, often very quickly, more virulent strains may be promoted by the selective pressure of substances we intake. And because they change, a substance we take to be helpful when the cancer is at one phase of its evolution, may promote the cancer at the next phase of its evolution.

11. It feels good to feel like one is doing something. I know the out-of-control feeling we've all experienced. We want to do something, anything, to get a sense of regaining control, even when evidence is lacking. I've done it myself, and I actually think there may be an important psychological benefit to doing so.

12. There is no vast conspiracy. Big Pharma is not trying to quash the simple, everyday substance that will cure us. They know we will pay through the nose for the next medicine that shows efficacy. Doctors would love to be able to tell us to just, say, take an aspirin a day- in fact, they do! Research dollars from private industry flow to medicines that will make a profit. Food and supplement manufacturers sometimes finance studies (e.g., POM Wonderful - although I bet they wish they hadn't now). NIH and NGOs do spend many millions on non-profitable substances (e.g., SELECT financed by NCI). It is extremely difficult and expensive to do an RCT on a food or supplement where its effect is not expected to show up for a very long time.

13. There is nothing particularly beneficent about nature. "Natural" does not mean good or wholesome. Nature produces toxins as well as healthful substances. We have to figure out which is which.

14. Everything has side effects. We only have about 20,000 genes that handle everything our bodies do. That's actually amazingly few when you understand our complex biochemical machinery that produces millions of proteins and enzymes. It surprised everyone when the Human Genome Project discovered that. This means that the same genetic machinery is used for multiple purposes. A substance designed to affect, say, an enzyme produced by one gene will always have multiple effects in various body systems.

I don't mean this to be a comprehensive list - there are probably lots of other reasons to think twice about putting any substance in our bodies. I'm not saying not to do it - just that it's not as simple as the media and the internet would have us believe.

- Allen

Great Thread/Rant. TA, great response. But after all is said, I love chunky peanut butter and eggs. I also pop a few supplements recommended by my MO. I also have a wonderful bowl of ice cream on Sunday night. Not worrying about all the other stuff gives me less stress and will probably increase my life span more than anything else. Cheers! -JR

Allen,
Really enjoyed reading your post. Especially surprised by the Vitamin D comment, since that's been the new "health concern" as of late for people who are low, and I believe the bar of what was considered "low" was raised. I wasn't thrilled about adding it to my list, but the GP insisted. Gary's medonc is a "just enjoy eating everything" kinda guy, and "skip the probiotics, Pom and broccoli, if you don't like it". I make sure he gets lots of carbs, protein and fruit. I don't feed him broccoli or any other cooked green, for that matter.

Yummy - Sika Deer Velvet Antler Extract.. I will take mine with a side of bacon please.

One of my favorites is the baked potato, once a plain baked potato was one of the healthiest things you could eat.
then...
We learned to scoop out the empty calories and only eat the skins because thats where all the nutrients are.
then...
We learned that there really aren't that many nutrients in the skin and thats where the toxins are so no more skins.
then... after a few more iterations of that
Brings us to today where we bring the organic potato home from the grocery, toss it in the trash because its probably gmo anyway, and just eat the grass fed butter, sour cream and bacon for its healthy fat.
We can explore distant galaxies but we just cant figure out the darn mysterious baked potato.

Post Edited (tommyc) : 2/10/2016 4:43:24 PM (GMT-7)

Allen,
I will get the sulphoraphane. That's quite a word. Will I be able to get it over the counter? Gary refuses to put anything green in his mouth, unless it's on fire. ;) Jalapenos count.
I am also going to quit the vitamin D. I get my blood monitored every three months because I'm on methotrexate and prednisone, so I can keep an eye on the D levels. Sun sounds good. We are going to HI next week ! PSA results tomorrow.
I appreciate all the information TA!
Beth
S