Happy Thanksgiving

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Paula, Riley, Jamie, and I would like to wish every one of you a Happy Thanksgiving. Normally, we would send these good wishes next week, but after a battle with brain cancer, Jamie’s sister passed away on Thursday leaving behind two young children. With the activities associated with passings, it seemed fitting to take care of family needs next week.

At times like these it can be hard to feel thankful, but we’ll always remember the time we had with Nicki and all the love she shared with Jamie and Riley. I know that many of you will remember Nicki and her family in your prayers, and we’re grateful for that as well.

While you spend time with family and friends, remember that life is short no matter how long you live. Take the time to appreciate all those people in your life, family or not, and let them know it.

One of the things that you can do is to begin or continue to work on being the best version of yourself. You may or may not live one second longer, but you will be able to live every day you’re alive. That means the time you spend with those you love and who love you may be even better.

I’ll see you in the next Memo on the 30th. Insiders, I’m still available when you need me.

What are you prepared to do today?

        Dr. Chet

Cancelled!

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Thank you all for the prayers, good thoughts, and well wishes. I’m going to hang on to them for a while. My surgery was cancelled for this morning; Paula and I didn’t find out until we arrived at the hospital at 7:30 to check in. I was not alone. My surgeon had three surgeries cancelled for today; multiply that by many surgeons times several days, and you get an idea of how many people were disappointed. The surgery will be rescheduled for a date to be determined.

Why was it cancelled on such short notice? Because the hospital was overrun with COVID hospitalizations over the weekend. They have sufficient staff but no beds, even for an outpatient knee replacement surgery such as mine. I don’t know what it’s like where you live, but there’s a significant COVID resurgence in Michigan with no end in sight.

I’ll keep doing the prehab and be even better prepared when the knee replacement is rescheduled. I hope the reader who has had her aortic aneurism surgery postponed for the third time lives until her rescheduled surgery.

I looked at the data again since we got home: over 80% of those hospitalized haven’t been vaccinated. Take it from someone who understands the science—get vaccinated. It’s not a guarantee, but it puts the odds in your favor and helps all the people who need hospital beds.

What are you prepared to do today?

        Dr. Chet

Prehab Is Over

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One of the tests I took in preparation for surgery was to measure my levels of Staphylococcus aureus. In this case, they tested the nasal area, a common area for this serious pathogen. The test came back at zero. I was pleased because for the past three years I’ve been taking a Bacillus probiotic called Bacillus coagulans. You can check out the research by reading this Memo from 2018. It doesn’t mean I couldn’t get an infection, but zero is a good starting point.


Now on to Surgery

I’ve stretched and strengthened my legs about as much as I can in preparation for my knee replacement. My core is as strong as it ever has been. I’ve gotten as fit as I can within the limitations my knee has given me. As I said a while ago, the more pain you put in before the surgery, the less you’ll have after the surgery.

We’ll put that to the test beginning Monday afternoon. Many, many surgeries have been cancelled here in Grand Rapids because the hospitals are overrun with COVID patients; if I had not prepared by being a regular exerciser and doing the prehab, I might have had to spend the night rather than having outpatient surgery, and then my surgery might have been cancelled, too, but we got confirmation Friday that it’s on.

I’m really eager to get this done and get on with life; I’m ready for rehabilitation. My goal is to walk into the hospital and then to walk out. The medical staff probably won’t allow that but as long as I know I could, that’s fine with me.

Thanks for all the prayers and good wishes—keep them coming. I won’t write Tuesday’s Memo until I’ve recovered from the anesthesia and taken the first steps. I still plan on doing the Insider Conference call on Wednesday night so all Insiders will get the first-hand Dr. Chet version of the knee replacement experience.

What are you prepared to do today?

        Dr. Chet

Building a Healthy Microbiome

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After last week’s Memos on the importance of a healthy microbiome and immune health, let’s review how to have a healthy microbiome to protect your brain and boost your immune system.

First, eat a mostly plant-based diet: some raw, some cooked, some fermented. The raw will give you probiotics and fiber. The cooked, especially whole grains and beans, will give you fiber. The fermented such as sauerkraut and yogurt will give you even more probiotics.

Second, fast once in a while. I covered this in Memos from June, so you can re-read the Memos on fasting and microbiome health.

Third, reduce your refined carbohydrate and sugar intake. Simply put, they provide the bad microbes with the food they need to overtake the good bacteria. Good bacteria need fiber from foods or supplements, so make sure you’re getting 25–30 grams per day.

My knee replacement surgery is scheduled in six days, so I’ve been working on preparing my body to defend against staph infections. I’ll talk about that in Saturday’s Memo.

What are you prepared to do today?

        Dr. Chet

Science at Work

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The challenge this week was to watch two video podcasts, think about what you heard, and then provide comments and questions. For those of you who did it, thank you. For those that didn’t, I recommend that you take some time this weekend and listen to them. I’m going to share my thoughts but there’s so much information, I’ll hit only the highlights. Suffice it to say, based on the questions, there are many subjects that will need to be explained. That will take months to research and present in Memos and Insider conference calls in a way that’s understandable.

The point of the interviews with Dr. Jay Lombard was to find out the relationship between the microbiome and pathogenic bacteria and neurodegenerative disorders (NDD). That includes everything from Alzheimer’s disease to depression to Parkinson’s disease. Here are the three things that stood out to me out of the many concepts presented.


Three Things I Learned

Leaky Brain Theory
The prevailing thought is that the blood-brain barrier prevents almost everything from entering the brain via a series of tightly packed blood vessels and cells. Nutrients are let through along with some medications, but bacteria are thought to be barred.

But evidently the toxins of some pathogenic bacteria are able to cross this barrier and affect the production of the proteome, an organism’s complete set of proteins. Remember the tau mice from last week’s Memos? The bacterial toxins impact the way the tau and other proteins are folded, which renders them unusable, thus resulting in misshapen structures that can contribute to NDD depending on which proteins are affected.

Antibiotic-induced Reduction in Fevers
In the treatment of patients with NDD, one characteristic that most seemed to share is the inability to get significant fevers with infections. The cause appears to be chronic use of antibiotics over a lifetime which somehow reduces the ability of the immune system to create high fevers. The rise in temperature is a natural part of the immune system when dealing with infections; without it, the immune system will not be as effective at combating viruses or bacteria.

Heat-Shock Proteins
Think of heat-shock proteins as the “cleaners” of the body. One of their functions is to collect the misshapen proteins and take them to the organelles inside a cell; that’s where they’re taken apart and the amino acids reused. If you can’t generate a fever that’s high enough, they can’t do that job as well.

There were several other items on my list, but those were the most profound. The first question in your mind is most likely “What can I do about these?”


How Science Works

The reason I chose to focus on Dr. Lombard with the purpose of showing how science works was two-fold. First, he asked good questions. Many physicians would think “How can I fix this?” and stop there. What Lombard and Hyman asked was “What caused this?” or “How did this happen?” You find that out only by asking the right questions of patients.

The second is that Lombard went to the current research to find out if there were any answers, and he discovered where he might have been incorrect because someone had tested it. Remember that in the first interview he was sure that the bacteria C diff was related to ALS; two years later he found that there was more than a single pathogen that could be related to ALS and other NDDs. He learned and adapted his hypothesis: that’s how science is supposed to work. Instead of spending time heading in the wrong direction, science guides the research he’s currently doing so that eventually he may discover effective treatments for these neurological conditions.


The Bottom Line

If you haven’t watched the video podcasts, I urge you to do that; you’ll learn much more than by reading my review. More than that, you’ll have more questions. One of the things both Drs. Lombard and Hyman agreed on is that “we know close to nothing.” I agree wholeheartedly. When you begin by asking the right questions, you have a chance of finding out the answers. Another point they agree on is that there’s no single cause of any NDD. There are multiple factors that contribute; finding out what they are may help develop effective treatments by focusing on a potential cause.

For those of you who want answers, whether about what I’ve written or about the many other things covered in the podcasts, I’ll write more as time goes on to satisfy that “What should I do now?” question. Obviously, you’ll want to keep your microbiome as healthy as possible (a search for the term microbiome on drchet.com will point you in the right direction); beyond that I have questions I need answers to before I can provide more answers for you. I’m on it and when I know, so will you.

What are you prepared to do today?

        Dr. Chet

How Science Works, Part 2

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How did you enjoy the first video? If you’re like me, there were some surprises and a whole lot more questions.

The second video is another interview with Dr. Jay Lombard recorded this year. Just like the other video, it isn’t an ad for a product but it does contain ads as do all YouTube videos. While the interviewer is different, the video demonstrates several things, none of which I’m going to tell you. The assignment is for you to learn how science really works. Listen closely to Dr. Lombard. If you want, send your thoughts and questions to drchet@drchet.com.

Here is the link to the second video: https://youtu.be/aCTTpFnSsD0

We’ll finish this look at how science works on Saturday.

What are you prepared to do today?

        Dr. Chet

How Science Works, Part 1

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If there’s one topic we’re all interested in, it’s making sure that we keep our minds clear and able to learn and recall things every day we’re alive. That’s confirmed by checking the number of people who read last week’s Memos on EAAs and brain health.

A long-time reader sent me a link to a video called “Doctor Thinks He Knows What Causes Alzheimer’s, Parkinson’s, and ALS!” I decided to listen to it while I worked out on the bike. It was interesting, so I listened to another podcast with the same doctor two years later. It was at that point I decided to make this a project for you.

Assignment 1 is to listen to a video podcast from Dr. Mark Hyman, a well-known physician who treats the entire patient, not just the symptoms. He interviews Dr. Jay Lombard, a neurologist, on current ideas as to the possible causes of a variety of conditions including depression and Alzheimer’s disease.

When you’re done, write down a couple of things that you learned or had questions about. Enjoy the first video—pay close attention to the last five minutes: https://www.youtube.com/watch?v=ETKZS5e33VA

Tomorrow, I’ll send you a second link to another video. If you listen and watch these videos, I think you’ll begin to learn how science works.

What are you prepared to do today?

        Dr. Chet

Should You Increase Your Essential Amino Acids?

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The question from Tuesday was this: how did the essential amino acids affect the transgenic tau mice on the low-protein and normal-protein diets? The addition of EAA to the transgenic mice on either diet appeared to neutralize the impact of the genetic mutation. The brain scans appeared to mimic the scans of the control mice fed either type of diet. There were positive changes in the genes impacted by the EAA supplementation as well as on neurotransmitters and other biochemicals.

Before we get too excited, a couple of facts.


Mice Are Not Humans

The results of this study are exciting when we consider brain health, but this was a study on rodents—the applicability to us as humans may be limited. What is encouraging is that when the same research group did a study on humans with EAAs, they found improvement in attention and cognitive flexibility. They’re now doing a study specific to the aging brain in human subjects similar to this one on rodents. It will be interesting to see what happens when it’s published.


EAAs Are Not All Equal

The EAA blend in this study was slightly different than what is typically offered. The company providing the EAAs for the study included high amounts of phenylalanine, almost the same amount as leucine which seems to always be found in the highest amount. Does that make a significant difference? Phenylalanine is important in the manufacture of signaling proteins. Might that be important for neurological benefits? We just don’t know yet. On top of that, there’s a small percentage of people with a genetic inability to process phenylalanine very well, so they would probably have to avoid higher amounts.


The Bottom Line

While this research update is interesting, there’s still a lot to learn about the use of EAAs for neurological benefit. I’ll keep an eye on it.

However, the research on EAAs and increasing muscle is solid; there’s little question about the benefit of keeping protein intake higher to retain muscle mass as we age. The critical factor is to be consistent, because digestive issues and satiety issues can sometimes derail good intentions. If it helps our brains as well, that’s a bonus at this point.

Tomorrow is the last day of the 25% off sale on Supplementing Your Diet as either a download for yourself or CDs to share with others, and that’s in addition to Member and Insider discounts.

What are you prepared to do today?

        Dr. Chet

Reference: Science Advances. Oct 2021. (7) 43. DOI: 10.1126/sciadv.abd5046

New Research Links EAAs and Brain Function

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I’ve talked about essential amino acids in the past as it relates to increasing muscle mass in those of us 50 and older. A recently published study may give us another reason for taking essential amino acids: it may reduce, delay, and perhaps reverse neurological signs of dementia.

To understand the research, you have to know about tau: it’s a structural protein found in nerve cells that help stabilize them, and deterioration of tau is associated with the development of Alzheimer’s disease. Researchers in Japan examined the response to normal and reduced protein intake both with and without supplemental essential amino acids in mice susceptible to developing high levels of tau (rTg4510 mice) along with control mice. They used a variety of tests to determine outcomes including brain scans, biochemical analysis, and genetic expression.

Because the data from the brain scans are so visual, they’re the easiest to assess. In the controls, there was very little impact of the 5% versus 20% protein diet in the cortical area. However, in the tau mice, there was evidence of decline in brain matter with normal protein intake, but the decline was much greater in those with reduced protein intake.

We’ll examine the impact of supplementation with essential amino acids in Saturday’s memo. One thing is certain: it’s important to increase protein intake to at least 20% of calories as we get older. Regardless of your age, it might be a good idea to monitor your protein intake by all sources this week.

Reminder: you have the rest of this week to take advantage of the 25% off sale on Supplementing Your Diet as either a download for yourself or CDs to share with others, and that’s in addition to Member and Insider discounts.

What are you prepared to do today?

        Dr. Chet

Reference: SCIENCE ADVANCES. Oct 2021. (7) 43. DOI: 10.1126/sciadv.abd5046

It’s All About the Calories

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The paper advocating the carbohydrate-insulin model (CIM) for explaining the obesity pandemic, not only in the U.S. but throughout the world, was written by the leading experts in endocrinology and nutrition. There were experts who’ve conducted some of the major nutritional studies that you’ve heard about over the years, from the Women’s Health Initiative to studies on the ketogenic diet. This is an expert group.

I agree with their desire for more research in this area. They’re trying to find out what would constitute their definition of cause: what increases appetite? Does palatability drive food choices? What hormones impact how much a person eats? And more. Where I disagree is in their lack of acknowledgement of the energy balance model (EBM) as valid. I outlined a written response to send to the journal that would have been about five pages long. Here are my two primary arguments.

Prior Research on Weight Loss

The authors talk about prior research showing that a low-fat diet doesn’t work long term; one of the authors was heavily involved in the weight loss study on a low-fat diet in the Women’s Health initiative. Their analysis was incorrect. The objective of that study was to compare a group of normally fed women eating the typical American diet of close to 40% fat with a group who was going to lower their fat intake to 20%. In the analysis, there were no differences in weight loss over the course of the study. The results suggested that a low-fat diet doesn’t work.

Here’s the problem: looking at the data from that study, what you see is that the women who were supposed to achieve a 20% fat intake couldn’t get below 28%. That doesn’t meet the goals of the study and thus doesn’t support their conclusion.

The Minnesota Starvation Experiment

My primary argument goes back to the research done on conscientious objectors during World War II. I’ve talked about this fascinating study many times, but here’s the short version: for a period of six months, 36 men who were conscientious objectors had their caloric intake cut by 25%. Their physical activity was also increased; they had to walk up to 22 miles per week.

What was unique was that they were weighed every week and their caloric intake adjusted based on weight loss or weight gain. If they did not lose the required amount, they were given less food. If they lost too much, they were given more food.

What makes that study even more consequential is the types of food that they were given to eat. The menu was very low fat and had virtually no protein; it consisted of breads and starches from root vegetables. In the CIM, that would be just about the worst types of food to eat to lose weight. But remember, the purpose of that study was to feed people foods that would be available after the end of the war. Every subject lost weight and lost it on a linear basis; most emerged looking emaciated. That’s the only study I’ve ever seen where people lost weight in a linear fashion over that period of time, and they did it eating an almost 100% carbohydrate diet.

The Bottom Line

There are many other aspects of the paper that I could comment on, but those are my two strongest points. I do believe that insulin is the most powerful hormone in the body; it does help store food as fat if someone overeats for an extended period of time. That makes it more difficult to sustain weight loss until the body is retrained to lose weight and keep it off.

But let me be clear: it always was, it is, and it always will be about the calories regardless of the source. Eat too many and you gain weight. Eat fewer and you lose weight. For sure, make better choices on the selection of the food that you eat and move more. But it’s all about the calories. Period.

What are you prepared to do today?

        Dr. Chet

Reference: AJCN. 2021. doi: https://doi.org/10.1093/ajcn/nqab270.