Unit 5 Assignment

1. Food as CAM
Course Syllabus
General Information
Instructor: Kindra Davison
Course Meetings: Online, TBD
Credit Hours: TBD
Course Description
This course will serve as an introduction to nutrition as medicine and preventative
medicine. We will spend time understanding the basic concepts of nutrition, including
hormone regulation, the mechanisms of both inflammation and fat accumulation, and
their implications for chronic diseases. We will also look into other ways that hormones
can be disrupted, such as stress.
Course Prerequisites
None
Course Objectives
1. To understand the basics of the body's nutrition needs
2. To understand the way the food we eat effects proper body functions
3. To learn specific mechanisms of fat accumulation and loss
4. To understand how to eat and live in order to support the body's inherent ability to
regulate itself
Required Materials
Fung, J. 2016. Obesity Code. Vancouver: Greystone Books.
Additional Helpful Resources
http://www.yourhormones.info/ - The Society for Endocrinology's official site offering
detailed information about each hormone in the human body.
http://www.who.int/chp/chronic_disease_report/media/Factsheet1.pdf - The World Health
Organization's overview of facts regarding the worldwide incidence and causes of
chronic disease.
Grading
Scale: TBD
Grading will be based upon a cumulative score of tests, quizzes, and essays.

2. Food as CAM
Lesson 1 Lecture
Lesson Summary: Our first lesson will address the issue of why nutrition is so
complicated, and why recommendations seem to change so often. We will review the
history of nutrition as a science and discuss ways to determine the reliability of studies.
Next, we will learn what the body requires in terms of nutrition order to function. Finally,
we will spend some time discussing micro-nutrients and dietary supplements.
Lesson Content:
History of Nutrition: Why everything we've learned is probably wrong
In the past, dietary illnesses were diseases of lack (scurvy, goiters, etc.). These
diseases appeared quickly and once the lack was addresses, were cured quickly. Early
nutrition scientists could easily solve these problems with relatively small and short
clinical trials. Nowadays, diseases that are related to diet are caused by excess. These
diseases, such as diabetes, heart disease, and even some cancers, occur over the long term
and cannot be cured by one quick dietary addition in a clinical trial. The sheer length and
breadth of trials to investigate these illnesses are not only cost prohibitive, but they leave
so many things open to interpretation.
For example, heart disease was linked to dietary fat in the 1950s by Ancel Keys.
The resulting propaganda against fat, especially saturated fat, resulted in the first
government dietary recommendations, suggesting that everyone avoid dietary fat at all
costs. It wasn't until fifty years later that Keys' bias came to light and it was revealed that
he cherry picked data from his study in order to fit his hypothesis. Many more recent
studies have shown that in fact, dietary fats do not correlate with heart disease at all, not
even saturated fat, but rather sugar intake is very closely linked to heart disease.
Nevertheless, we still often hear the advice to avoid dietary fats. Human nutrition
trials have so many variables that it is difficult to make very clear connections, and nearly
impossible to determine causality. Too often “experts” only pay attention to studies that
support their beliefs and disregard all those that show anything else. As a result, the
public is left in sickness and confusion.
The three macro-nutrients AKA Real Food
There are three basic nutrients in the food we eat: Protein, Fat, and
Carbohydrate. We call these macro-nutrients because the most common nutrients in
food, and we eat them in much larger quantities than we eat other nutrients. We generally
classify foods as one of these three nutrients based on which makes up the greatest part of
the food. For example, a steak is mostly protein, although it does contain some fat as
well, while bread is a carbohydrate even though it often contains some protein and fat.
Protein and fat are both essential nutrients. We must eat them in order for healthy
body functioning. Despite what we often hear, we do not need to eat carbohydrates to be
healthy. There are essential fatty acids and essential proteins, but there is no such thing as
an essential carbohydrate. The confusion here is caused by the fact that many of the cells
in our body run on glucose, which is energy that comes from carbohydrates. Most cells
can run on either glucose or ketones, energy from fat, but there are indeed some cells that
require glucose in order to function. This is often interpreted as a requirement for eating

3. carbohydrates, but that is a false assumption. In fact, the body will create glucose from
dietary protein if carbohydrates are not eaten. This is a normal process. It's very hard to
eat no carbohydrates at all since even green vegetables are technically mostly
carbohydrates, but most of us are eating far too many carbohydrates in proportion to the
more important proteins and fats. The bottom line is that glucose is vital to the body, not
necessarily the dietary carbohydrates themselves.
Vitamins & Minerals
Vitamins and minerals are micro-nutrients. We need a large variety of these to
function normally, but we only need them in trace amounts. It was a lack of these micro-
nutrients that generally caused the nutritional diseases of the past. We now have
supplements to make sure we are getting what we need, but supplements are not an
excuse to eat low quality food. Studies have shown that the nutrients in supplements are
not as easily acquired by the body as those in foods. Another important factor is fat.
Many micro-nutrients are fat-soluble, which means they need to taken with some fat in
order to be absorbed. Taking a supplement with meals can help with this, but eating
whole foods is a much more efficient method. If you eat a variety of whole foods in your
diet, you can be sure to be receiving a good amount of micro-nutrients as well.
There are some vitamins that are harder than others to come by in food, such as
Vitamin D. Our bodies can synthesize this from sunlight, but the only food sources are
certain types of fish. There is certainly nothing wrong with supplementing a daily
multivitamin, just do not use it as a reason to not monitor your diet.
How can I know what to believe?
With so much conflicting nutritional information coming from every news outlet,
how can we decide what's truly best for our bodies? Here are some tips for determining
the validity of a nutritional claim:
1. What is the evidence they are basing this recommendation on? Is it a clinical
study or an observational study? Observational studies can be interesting and can
lead to connections between things, but absolutely cannot be used to determine
causality. Do not trust observational conclusions that assume causality.
2. If the basis is a clinical trial, the first thing to determine is who funded the trial. A
study that finds no connection between obesity and sugar intake that was funded
by Coca-Cola is likely to have been spun in some way. That is not to say that
trials funded by interested parties are automatically not reliable, but do not take
them at face value. Look at the methods and data for yourself before trusting the
purported results.
3. Is the recommendation based on “common knowledge” or “conventional
wisdom”? If so, ignore it completely. There are many things in nutrition that are
considered so obvious that they don't need to be tested, when in fact they are
simply not true when they finally are tested. An example of this is that all calories
are equal, which is a false assumption we will address next class. This accepted
“fact” leads to trials that don't even ask the right questions, let alone lead to the
right answers.

4. Food as CAM
Lesson 2 Lecture
Lesson Summary: This lesson we will learn about the so called “Western” diseases,
from their history, to their causes, to their cures. We will focus on the roles of
inflammation in causing and exacerbating these illnesses. Since the disease cluster known
as Metabolic Syndrome is a huge epidemic in the United States, we will spend the second
half of this lesson learning about the mechanisms of fat accumulation and how hormones
can have everything to do with this.
Lesson Content:
The history of “Western” diseases
Chronic diseases are diseases that occur slowly, through a gradual and continuing
process of cell damage. Diabetes, coronary heart disease, inflammatory bowel diseases,
some types of arthritis including gout and rheumatoid, and some types of cancer such as
breast, prostate, and colon, are some of the most common of these types of diseases. For
most of human history, chronic diseases were rare. Some people contend that shorter
lifespans are the main reason for this, but even through the mid 1900s, when many people
were living long enough for these diseases to occur, they rarely did. Historically, they
were known as “diseases of affluence” because they occurred most often in the rich.
Now, they occur more often in the poor, but they occur so often in everyone that a class
distinction is no longer appropriate. Interestingly, the first historical record of diabetes
dates back to around 300BC in India. It's not a coincidence that India is where sugar cane
originated, and in fact the physicians there had already made the connection between
sugar and diabetes.
What causes chronic diseases?
There are many contributing causes to chronic diseases, such as genetic
predispositions, environmental contaminants, drug, alcohol, or tobacco use, and lack of
proper exercise, but the most important factor is diet. Genetics are often cited as a huge
factor, but in fact a group of scientists in 2016, lead by Stephen M. Rappaport,
determined that genetics can only be linked to about 16% of all chronic illnesses in the
United States. The real main cause is the change in the quality of food we are eating. Our
bodies evolved over millions of years of eating the same whole foods. In the past half
century, we have removed fiber and fats, added artificial chemical tastes and textures, and
ingested more sugar than our ancestors could ever have imagined. Yet we somehow
expect that our bodies will continue to run normally when we don't fuel them with the
food they were designed to run on.
Inflammation 101
Chronic inflammation leads directly to many of the chronic diseases we
discussed. Inflammation can be a very important healing mechanism in our body if we
have an acute infection or cut. However, systemic inflammation that persists damages
cells and leads to many diseases. This process can even effect organs, such as in heart
disease. Inflammation has been shown to be the cause of most heart disease. Eating low
quality food contributes greatly to this chronic inflammation. When you eat foods that are

5. not in their natural form, or have been somehow processed or altered, your body does not
recognize that as a healthy source of energy, it recognizes it as a dangerous mystery
substance. In this way, eating low quality (processed) foods is exactly like giving yourself
an autoimmune disease on a daily basis. Foreign substances enter your body and the
immune system works nonstop to try to eliminate the threat. The result is chronic
inflammation throughout the entire body, and eventually cell damage and real diseases
ensue.
Metabolic Syndrome
Metabolic Syndrome is the clinical name for a group of closely related chronic
diseases: obesity, high blood pressure, insulin resistance (pre-diabetes), and bad
cholesterol levels. The instances of these problems occurring at the same time in the same
individual is now so consistent and common that they are considered one syndrome. In
the U.S., 35% of adults have Metabolic Syndrome. Also very highly associated with this
syndrome are both Type 2 Diabetes and heart disease. What causes Metabolic Syndrome?
Insulin resistance and chronic inflammation seem to be the most likely culprits. Both of
these factors can be significantly reduced or even eliminated with changes in diet.
Fat Regulation: It's more than just calories
Obesity is a big factor in Metabolic Syndrome, and obesity increases the
likelihood of all chronic illnesses. So how do we avoid obesity? We've always been told
that the only factor in weight gain or loss is calories. Unfortunately, fifty years of failure
and countless studies have shown us that this fact that we so often take for granted is
simply not true at all.
A calorie is simply a measure of energy that the body can and does use in many
different ways to function. Calories are used for organ functioning, heating the body,
repairing muscles and other cells, growing, and moving, among other things. The biggest
problem with the calorie restriction method of fat loss is that we can only control the
calories we take in. We have very little control over how they are used once we ingest
them. Exercise makes up about 5% of the overall calories our body uses in a day. The rest
are used in body processes, which we cannot control.
Calories are measures of energy, but they can be made up of different things.
Remember the macro-nutrients? A calorie of fat and a calorie of carbohydrate are not
going to be used the same way in your body. Carbohydrates, particularly sugar, encourage
the creation of the hormone insulin. Insulin is important here because it is what transports
nutrients into cells. We need functioning insulin or too much sugar and other nutrients
will build up in our blood, making us sick. However, when we are trying to lose weight,
our goal is to remove things from cells, not put more into them. When insulin is present
in the body, it is constantly pushing things into cells. That makes it very hard to remove
the fat that we want to remove, regardless of how few calories we are taking in. Dietary
fat does not increase insulin at all, protein does to some extent, but carbohydrates raise it
more than anything else. Far from all calories being equal, a calorie of carbohydrate is
very likely to end up in a fat cell while a calorie of fat is very unlikely to do so. For fat
loss, the quality of calories is much more important than the overall quantity.
One final point about calories and insulin: Confusion often occurs because people
assume that no matter what, if we eat less calories than we need to function, our energy

6. has got to come from somewhere, right? It must come from the fat cells, right? Sadly, it
doesn't have to be so. Insulin is the deciding factor again. Suppose that we eat 1500
calories per day when we normally require 2200 to function. If we continue getting those
calories from foods that promote insulin, then the body does not have access to the
energy from fat cells. It's too busy sending energy into the fat to take any out. Instead, the
body reduces energy expenditure in other ways to make up for the lack of energy taken
in. Reducing overall caloric intake without taking into account the hormone insulin leads
to a reduced metabolism over time, not fat loss.

7. Food as CAM
Lesson 3 Lecture
Lesson Summary: In our final lesson, we will address what we can do to prevent and
even reverse these chronic diseases. We will learn what we should eat, how to exercise
and sleep, and a few other tips for reducing stress and balancing hormones.
Lesson Content:
So what can I do?
The chronic diseases that now plague so many of us can be prevented, greatly
improved, and even cured in some cases, by the adoption of an anti-inflammatory diet.
The severity of your diet needs depends on your personal health goals. Someone with
Metabolic Syndrome or some other chronic disease will need to be more severe in their
choices than someone who is merely trying to prevent the disease. In this lesson we will
learn the diet that is likely to have the best effect on health, recommended for everyone,
but most important for those who are working to reverse a chronic disease that they
already have.
How to eat
1. Eliminate sugar in all forms. This includes fruit. Fructose is that actual main cause
of insulin resistance because unlike glucose, which can be used in cells throughout the
body, fructose must all be processed into glucose the liver before being useable by cells.
The liver is a relatively small organ, and too much fructose at once, or over a long period
of time, can overwhelm it and it will begin to store the excess as fat inside the liver. Fatty
livers have a harder time processing normally, which leads to a vicious cycle, eventually
causing insulin resistance throughout the body.
Many people have a hard time accepting that fruits should be limited. It may help
to consider that fruit in itself is not “bad”. It would be hard to obtain enough fructose
from fruits alone to cause insulin resistance, but with the addition of a western diet and
all the added table sugar and high fructose corn syrup, it becomes easy to do. If your
body is healthy, then fruits will not cause a problem, but once the problem has begun,
fruits can add to the burden.
2. Eat foods in their natural form. If anything had to happen to the food besides
chopping and cooking before it was ready for you to eat it, you probably shouldn't be
eating it at all. This is not about a trendy “Paleo” diet, it's about working with our
biology. Ingest something that hasn't been a food source for thousands of years, and your
body will respond by assuming that you are trying to poison it. Chronic inflammation
will be the result.
3. Limit carbohydrates as much as possible. Note that this doesn't say limit refined
carbohydrates, but all carbohydrates. Carbohydrates of all kinds elevate insulin more than
fats and proteins, so in order to reduce insulin levels and access our fat cells for energy,
we need to be eating less carbohydrates and more proteins and fats. Green vegetables are
technically carbohydrates, but overall they provide so few calories that the overall
carbohydrates will still not be very high. It's important to eat green vegetable for their
micro-nutrients.

8. 4. Eat less often. This recommendation is also based on the importance of reducing
insulin in the body. Foods increase insulin, so the very best way to reduce it is to spend
more time not eating at all. This is not another way of saying “eat less calories”. When
you do eat, eat heartily, as much as you want of the foods that your body can use in a
healthy way. The amount that you eat is not important here, the amount of time you spend
eating is important. An easy way to increase fasting time each day without much struggle
is to cut out snacking. If you tend to get hungry simply eat more at your mealtime. Many
people also find that it's easy for them to skip breakfast in order to extend their time
without insulin in a day. If you are hungry, go ahead and eat, but if you're not hungry,
there is no legitimate reason to force-feed yourself. Without excess insulin, if you don't
take in enough calories, your body can simply use the stored energy from your fat.
Without excess insulin, there is no slowed metabolism to worry about.
Other Recommendations
1. Take time for yourself and relax. There are some non-food related factors that can
effect insulin. The most common is the stress hormone cortisol. Cortisol is not a food and
contains no calories, but it has been proven to increase fat storage through its effect on
insulin. Increasing the time and quality of your sleep can be a major factor in reducing
cortisol. Studies have shown that after five nights of four hours of sleep, cortisol
increases by 20% and insulin resistance increases by 65%. The food that you eat on a day
that you haven't slept well or are stressed out at work is much more likely to end up as fat
than the food you ate while you were well rested and calm. Active stress-reduction
techniques such as yoga and meditation can also be helpful in preventing this
cortisol/insulin response.
2. Exercise when you feel like exercising. Exercise is obviously great for your
muscles and overall well-being, but forcing your already ill and overwhelmed body to
exercise is counter productive to health and weight loss. If you feel up to it, definitely do
safe weight training and low-impact exercises such as walking or swimming. Over time,
exercise has been shown to increase insulin sensitivity. Do not exercise with the intention
of “burning calories”. That is useless for weight loss because it causes the exact same
response in your body as eating fewer calories. If you don't combine exercise with a
reduction in insulin, you are doing your body more harm than good, reducing your
metabolism. A healthy body will have extra energy to expend. A healthy body will want
to exercise, it won't need to be forced to do so.

9. Food as CAM
General Course Outline Handout
• Lesson One:
Nutrition Basics
o Everything we've been taught might be wrong
o The three macro-nutrients AKA Real Food
o Vitamins & Minerals
o How can I know what to believe?
• Lesson Two:
• Chronic Diseases
o The history of “Western” diseases
o What causes them?
o Inflammation 101
• Hormones & Metabolic Syndrome
o Hormone basics
o Fat regulation
• Lesson Three:
• So what should we do?
o How to eat
o Other Recommendations

10. Food as CAM
General Course Outline Handout
• Lesson One:
Nutrition Basics
o Everything we've been taught might be wrong
o The three macro-nutrients AKA Real Food
o Vitamins & Minerals
o How can I know what to believe?
• Lesson Two:
• Chronic Diseases
o The history of “Western” diseases
o What causes them?
o Inflammation 101
• Hormones & Metabolic Syndrome
o Hormone basics
o Fat regulation
• Lesson Three:
• So what should we do?
o How to eat
o Other Recommendations