Podcast Episode 82. {Music}

Transcription

1 Page!1 {Music} Host: Welcome to PMR, Radio, where we bring you Paleo nutrition, exercise and lifestyle perspectives, from both the experts and the every day. PMR is brought to you by, the first and only print magazine dedicated to the Paleo lifestyle and is hosted by Tony Federico. The other day, I walked into a GNC and it had been a little while since I d been in there, but I couldn t help but look at this huge advertisement for some sort of testosterone-boosting supplement and it was packaged in such a way that it looked very clinical and it used a lot scientific jargon and it cited scientific-looking studies that seemed to back up the evidence that this thing would boost your testosterone levels by 100%, 200%, 300%, and that would lead to crazy games and of course, this product costs $100 and I guarantee you, people are buying this thing left and right. And what it made me think of was how much misinformation there is, especially out there regarding supplements. The supplement industry isn t very well-regulated. It s kind of a free-for-all and so, there s tons of people out there on the Internet, in stores, in magazines, making claims about supplements that are blatantly false. And worse off, some of these things can actually be harmful to your health, so how do we cut through all this clutter? How do we cut through all this misinformation?

2 Page!2 Well, fortunately, Examine.com was created. This is a site dedicated to 100% unbiased information. They don t have any sponsors. They don t have any advertisers. The only money they make is through guides that are research digests. This is the only way that they can really remain free of any sort of connotation of influence or anything like that. So, they re the only site out there that is doing this. They re really the only source of information that is completely unbiased about supplements. So, I m really happy to have an old friend of mine, Kamal Patel, who just so happens to be now the Director of Examine.com, which is totally awesome and we re going to talk about this and we re going to go over some of the information in one of their research digests and of course, these are available at their website, but the bigger picture point of all this is that information about supplements, good information, is hard to find. Examine.com offers a way to get that information on a regular basis. It s a really useful website, so of course today, we talk all about that. And speaking of useful, the second half of today s show is about getting off the couch. So, hopefully you re not sitting down right now. If so, this might make you feel a little bit self-conscious, but Adam Farrah and I, in another installment of Big Picture Paleo, dive into his experiment, getting rid of a couch. What happens? What happens when you don t have that big, comfortable place to sit and what do you do? And that s what we re talking about today, supplements and anti-couch surfing. I hope that you enjoy this episode standing up, walking around, doing something active. I m Tony Federico, Radio starts now.

3 Page!3 {Music} All right, everybody. Welcome back to another episode of Radio. I m here with Kamal Patel. He s been on the show before. The last time he was talking about the Ancestral Health Symposium, but this time, he s here to talk to us about Examine.com. Kamal is actually the Editor-in-Chief of the Examine.com Research Digest, as well as the Director of Examine.com itself. Welcome, man. It s good to have you back. It s my pleasure. So, tell us a little bit about Examine.com. So, if somebody has never been to the website, they have no idea what it s about, what would they expect? Why should they go there? So, I was a user of Examine.com before I started working there and I would go there because there s so many websites with opinions and research on nutrition. A lot of them are really good, but there s nothing really like Examine where it s just studies. There s only research. There s no objective, really, other than to list all the research possible. So, the first time I ran across it was back in the days of PaleoHacks. I mean, I guess it s still around, but back in the days when The heyday, I guess you could say. Yes, the old-school PaleoHacks where I met a lot of my Paleo friends and when you would want to make an argument about a certain nutrient or a certain supplement, then you can pick any two or three studies to show almost

4 Page!4 anything about any nutrition issue, but it really takes systematic reviews, meta-analyses and that kind of pooling of data and that s what Examine has. So, I just got more involved in talking to them and eventually, I started working there and now, we re growing the site out to the point where at some point this year, we re going to have all the micronutrients, all the most important phytonutrients, and most of the main performance-enhancing supplements. So, let s say, for example, I pull up Examine.com on my computer. I can learn about whey protein. I can learn about creatine. I can learn about vitamin C. If somebody has an inquiry about a specific nutrient, Examine.com is a place where they can get unbiased research. Yes. So, for example, if you go to the creatine page, I think there s 734 references on creatine. I didn t read all of them, but collectively, we read all the full texts of the papers, which is important because almost no paper stands alone. It s really in the context of a bunch of other studies and you don t really get this kind of manpower, often, to read all the studies on a given topic. So, that s our job and all the information is free on the website. And you re not sponsored by any big supplement manufacturer. You re not sponsored by anybody that has a vested financial stake in any particular supplement being shined in a particular light. No. We have to run a pretty tight ship financially because we don t accept ads or partnerships of any kind, so we only make our money by selling our research information projects, which are just some extra research and some

5 Page!5 more specific details about studies. Other than that, it s just the website, so we don t really rake in a ton of cash. It s just all information. Now, I like something that you said in your there s like sort of an editor s letter in the front of the recent Research Digest, which I think is the fifth volume. You said, Examine.com is the Switzerland of the nutrition and supplement world. So, you mean you re sort of neutral territory, I guess you could say. Yes. We are as neutral as you can get. The philosophical argument is if you say anything, it s taking a position, but we only relay the evidence, so for example, the meal frequency debate, or if it fits your macros, or animal foods versus plant food issues, we don t really have a stake in any of those issues, so we just report what studies on different sites say. And that way, it s nice because we don t need to take a position and we don t have to get involved in arguments, hopefully. Sort of like the old stand-by. You re interested in the truth, whatever that may be. Yes. We don t lay a claim to the truth because the research does change and we also make mistakes. My favorite quote at least for the past few months is, Teach thy tongue to say I do not know and thou shall prosper, or advance or something and that s really what s behind Examine.com. A lot of things are really not known. There s like two studies on a certain supplement, so take it if you think it works for you, otherwise don t.

6 Page!6 Well, and something that you said and I liked your letter to the editor, so I m going to quote something else you said, We don t claim to know for sure what you should eat for optimal health, and then, a little bit later on, you say, We want people to be better-informed and we want to help people foster their sense of curiosity over niggling details and methods, as well as the big picture, and I like that because you re embracing the uncertainty, which is our current body of knowledge and understanding of nutrition and supplements. But you could really extend that out to the human body, as well, and I just think there s too many actors in this world who kind of get up on-stage, whether it s on social media or online and claim to know the truth with a capital T, and then, when I say that you guys are seeking the truth, I think you re wading into that uncertainty and you re acknowledging that uncertainty and you re I think another phrase that you mentioned a little bit later on is trying to get things to gleam with accuracy, so it s refinements with the understanding we re never really going to get there. We might constantly be refining and trying to put a little bit of extra shine on what we think we know, but that s going to be the process of our species indefinitely. Yes and I know you ve been on Internet forums and comment sections and just the nutrition area, conferences, for a long time. Arguments come up every single day about both huge issues and very pedantic, specific issues. Like we ll try to make our information as accurate as possible, but even if we bring an issue up, people will yell at us. Like we brought up a recent article about the accuracy of the BOD POD, body fat measurement against DEXA and we weren t saying that one is bad and one

7 Page!7 is good. It s just the results of this study show that in different BMI categories, the BOD POD could have different accuracy. So, man, we got s from both sides. People who own BOD PODs, or random, would say, How can you mercilessly attack the BOD POD? On the other end, people would say, BOD POD s not accurate at all. How could you even bring it up? There s no way to win. It s like religion and Exactly. Even bringing the issue up to the surface can be taken as an offense by somebody who s got a pretty particular interest. Yes and I appreciate that. People get very curious and very into their own diets and routines, but at a certain point, it s really not worth our invitation. And I do think that s smart that you guys avoided taking sponsors or running ads to really kind of keep your hands clear of any accusations that you are taking sides and especially as the site gets bigger and has more of an influence in disseminating information, that s certainly going to be important. It was actually a really tough choice. Like at the very beginning, we ve been in the red for a long time and the first year or two, we were like, Maybe we should use these Amazon links, which I personally have nothing against. So, if you have a website, you need to pay the bills and you need to pay for your time when you re writing. Unless you do something where you re sponsored by anonymous donors, it s really hard to make that productive. So, we had Amazon links for just a few months or a year, but then, we thought let s just cut down costs as much as possible because we re the only site, really, that has the capability and the really good domain name to do this.

8 Page!8 And just in case somebody s not familiar in Amazon link, you mean like an Amazon affiliate link where if somebody clicks on the product, they buy it through Amazon. com, but whoever provides you the link gets a small commission. Yes and that could be just for no specific product, just, These are creatine supplements, or, These are vitamin K2 supplements. It s not necessarily evil. It s just one more level that we cut away. Let s dive in a little bit to the current Research Digest. I think this is Volume 5. I have a printed out, partial copy here in front of me, so if anyone hears any pages flipping by, that s me literally flipping pages. It kind of feels good to have something printed out. I actually brought it out to the pool today and was reading through some of the studies. A couple of them we ll be discussing here in a moment about pistachios and fish oil, specifically, but this is a pretty hefty volume, as much as my printer got through before it ran out of paper, but I think the whole thing, what s the entire length that we re looking at? Maybe? It s 79 pages. Seventy-nine pages, so this is a pretty stout compilation of material and just from like a surface level, a couple of things that people might be interested in, you certainly have an editorial team that includes yourself, as well as a few other individuals, a pretty distinguished list of researchers and contributors, lots of PhDs on that list, as well as some people in the reviewer category that individuals in the Paleo community might recognize, such as Sarah

9 Page!9 Ballantyne, The Paleo Mom, and Stephan Guyenet, whose name I ve always purported, if you could pronounce his name, you will have either been to AHS or PaleoFX because I don t think anyone outside of that Yes. Even if you re announcing his name at a conference, you re fairly likely to get it wrong. Right. It s sort of like if you can pass the Guyenet test, then you re in. Yes. I think I read a journal article about the Guyenet test. Was it a double-blind, placebo-controlled study? In fact, it was. Again, big picture, reading through this, it s very digestible and I m not trying to make a pun. The information is presented in a way that I don t think somebody who lacks a scientific background should necessarily be intimidated. I feel like you really have made an effort with the reviewers who are helping to put this together to make the information clear and understandable. I think sometimes people might hear, Oh, it s a research digest. I can t read research, and they might feel intimidated. Is that something that was really intentional on your part from the Examine.com team? Can you talk a little bit about how you actually put this information together when you re compiling a Research Digest?

10 Page!10 So, you actually hit the nail on the head there. Our biggest issue is that we know that there are some people who are MD-PhDs who get the Examine.com Research Digest every month and use it for their practice. On the flip side, there s grandmas and grandpas who only just now heard maybe you don t have to take fish oil every day or maybe a different way of eating could help their heart health. So, then, they read this. They obviously can t understand all of it, but they want to get some takeaway, so we want to address both of those and everybody in-between and it s really hard to do so. You can t have your cake and eat it, too. If you have something detailed, it s going to be over some people s heads at certain points, but what we did is we ve improved it every issue so that we take the feedback. We make little tweaks and at this point, we used to have one infographic per review. So, we d take eight of the most important peer-reviewed articles from the past two or three months and we d tear them apart and we look at it from different angles with a bunch of different reviewers. But we only one infographic originally and people were getting really lost in the text. So now we have three infographics for every review and they re kind of those cool-looking I mean, I just love infographics, even if they re not always totally accurate, I just like looking at them because the color is neat and you can understand things really easily and remember the layout. So, we re including more of those, so you could just browse the summaries and the graphics and get a gist of what s going on, but we also have like sidebars about, Does the P value really matter? What is Bayesian statistics? and that kind of thing and that can help people who are more into research issues. So, we re still not perfect, but we re trying to make it so that

11 Page!11 everybody benefits and we re coming on our seventh issue. Hopefully by one year, we ll strike a pretty good balance. Let s dive into a couple of the specific topics that were addressed in Volume 5. Now, the title of this section is, Can you go too nutty over pistachios? Influence of pistachios on performance and exercise-induced inflammation, oxidative stress, immune dysfunction and metabolite shifts in cyclists, a randomized crossover trial. Now, that sounds like quite a mouthful, but I think if you boil it down, it s just whether or not pistachios make you better at going long distances at a high intensity. It s do they improve performance is really the bottom line there. Yes. Now, Examine.com isn t Paleo, per se, but a topic such as this, I think is of interest to the Paleo community where nuts are certainly found in most peoples Paleo diets I know certainly my own and there s some things that I was surprised about. Could you tell us a little bit just kind of from a broad perspective about this particular study? Sure. These researchers, they re in a research group that every year or two, they do a different study on a different food and endurance athletes, particularly cyclists. So, they did bananas before and now they re doing pistachios. And what they do is they do a trial in an actual race situation and they do a metabalomic study where they look at metabolites in the gut, like hundreds of them, and see which metabolites are different in the pistachio group versus the group that didn t eat pistachios.

12 Page!12 So, there are some different strengths and weaknesses of this kind of study, but it s a cool study type. I mean, metabolomics, it s interesting because years ago, there was no way you could have done this study because you wouldn t be able to detect these metabolites, but now, not only can you do this, but the flip side is, I don t know if anybody s ever heard of like outcome fishing or result fishing? Sometimes people do studies where instead of having just one primary outcome and some secondary outcomes, there will be like 10, 20, 30 outcomes, especially like psychological studies, there can be all these different scales used. So, the negative of this type of study is let s say there s 150 different metabolites that are found in higher levels in the pistachio group. What does that mean? Just because there s a difference in one or two of these metabolites doesn t necessarily mean anything because the body works inconcert. All of these things are involved in mechanisms that are intertwined, so if there s different levels of some metabolites, that doesn t necessarily say anything about actual effect. But this study did have a primary outcome of performance and it was pretty well-conducted and it did show that the group that ate pistachios had worse performance in an endurance race, which was not their original hypothesis. Their hypothesis was because pistachios are nutrient-packed, they might decrease inflammation and oxidation and help you perform better. That didn t really work out.

13 Page!13 This is a situation where they thought one thing was going to happen and something else happened, but I think it s worth getting into and this is really the strength, I think, of these Research Digests. It gets into why even though the result, like you said, was decreased performance, that s not the end of it. That s not as simple as it may seem because somebody might hear that and be like, Oh, I shouldn t eat pistachios. Well, that s not exactly what it s saying. The one takeaway, I d say, from the past six months of reading these studies like five or 10 times over and talking about them with a bunch of different reviewers is if you read the abstract, which is what most people do because you don t really have access to the full paper unless you have a university account, that tells like 10% of the story, which is unfortunate because the write who writes the abstract, they have to put in certain things for the journal. Every journal has a different way to present their abstract. But those are just results. If you look at the methodology, for example, for this study, what you ll see is that they gave pistachios to one group for two weeks leading up to the race and then, they also had them eat pistachios before the race. The other only had water before the race and they didn t have pistachios in the two weeks leading up. So, first of all, the pistachio group ate a lot more fat and a little bit more protein every day, but they somehow ended up eating a lot more calories, so not just 400 or 500 more calories. They ate like 800 or 900 more calories, so what does that mean? Does it mean that pistachios made them eat more? Does it mean that they didn t record well? I don t really know. It doesn t really fit together and the other thing is, they combined two different interventions. So, one intervention is eating the

14 Page!14 pistachios for two weeks before the race. The other one is eating the pistachios right before the race, so can you really say that this shows you that eating pistachios before a race isn t good? No because it combined two different interventions. So, you really have to look at the details to figure out if this applies to you and I know a lot of endurance athletes and they ll say, Should I not eat pistachios? I like pistachios, and I love pistachios. I think they re my probably second- or first-favorite nut and luckily, you usually have to shell them. If they re not shelled, then, I would just take scoops and throw them in my mouth. They do sell the pistachio meats already shelled. It s dangerous. I know. I try to forget that, so don t bring that up again. Never mind. You can only buy them in shells. Good. So, people wonder, Should I not eat them during a race or should I just not eat them in general? No. I think really what this study says is try it yourself and start with eating versus not eating right before a race and then, see whether chronic consumption affects anything. But don t take the abstract for its word. You really have to read the whole thing. Well, and I think what you said about there being two interventions, kind of layered on top of each other in here is really key. And one of the things that s noted in the Digest is that, Extended and intense exercise can cause increased intestinal permeability, aka leaky gut. Now, just having food in your gut

15 Page!15 when you re exercising at an intense level could have caused some of these metabolites to get into the bloodstream at higher levels and they said that this is something that could certainly happen with other foods, as well, other nuts and then, some legumes. Exactly. So, in designing trials, the biggest issue is the placebo group, or the control group and I remember in my old job, I worked at an evidence-based practice center where the government hires you to do reviews of different topics and then, they use that for guidelines. So, my first research project was the vitamin D guidelines and we provided the systematic review for that. So, I remember at that time, when we were doing the vitamin D review, the placebo for vitamin D is really easy. It s just a pill that it doesn t have vitamin D in it. But at the same time, we were doing a review of fibromyalgia and rheumatoid arthritis treatments and the people in the section below us in our building, they were doing a trial of tai chi for fibromyalgia and I remember the control group I probably shouldn t say who it is because I m sort of criticizing them but the control group for the tai chi randomized trial was education. It was education about exercise and nutrition and stuff. So, if you re going to do a trial comparing tai chi to something to see if tai chi works for a pain condition, then wouldn t you want to have the control group be something where the person is moving? Or at least standing for 20 minutes or something. Yes, not like sitting in a chair and learning. So, that article was published in The New England Journal of Medicine and it was a huge deal and they were like, Tai chi rules. Tai chi does rule, but it s not because of that and I think

16 Page!16 that trial was a little bit misleading. So, in this case, in the pistachio trial, maybe the control group should have had some food, or just something or a different type of nut because (sounds like: rapenos) is possibly the key ingredient in pistachios that caused this increase in gut permeability. It s in high levels in other nuts, almonds, cashews, whatever. There s also vegetables that have similar components, so you really have to do a lot of thinking about if the control group was correct or not and if not, then does the trial mean anything? I don't know. And I like how you guys summed it up, Put simply, don t eat 500 calories of pistachios before going out to ride your bike as fast as you can. I think that that s something that we can least agree upon. Probably should eat 500 calories of peanut butter or a whole host of other things right before you engage in intense exercise, either. Yes. Probably eating a ton, not a great idea. All right. So, let s move onto the other study. This is one that is about fish oil and this is, again, something that s highly talked about in the Paleo community because of the omega-3 fatty acids found in fish. There s a lot of talk about trying to balance omega-3 and omega-6 fatty acid intake in your diet. So, that s the whole thing about reducing industrial seed oils like canola and soy bean oil and other high omega-6 oils and increasing your consumption of fish and potentially supplementing with fish oil. So, this is a study that looked at the label claims of different fish oil supplements. This was done in New Zealand, but because of the way that global trade works, the results could be extrapolated to other fish oil products

17 Page!17 found in other regions such as potentially North America, as well. So, although this is a New Zealand study, it could also be true for fish oil supplements that you buy at your local GNC or Vitamin Shoppe or whatever. Um-hum [affirmative]. So one of the things that they were really trying to drill down on is do the claimed levels of omega-3s, so DHA and EPA, match up to what s actually in there and then, what portion of the omega-3 acids are oxidized. So, can you tell us a little bit about this? Sure. So, there had been a few studies before on this similar topic, but they were either very small in that they sampled just a few supplements on the shelf, or they were very old, which isn t good because manufacturing practices change. So, this is the newest big study on fish oil label claims and oxidation and like you said, this is going to apply pretty much anywhere because certain waters, like around South America, provide a lot of the fish oil for the world and, I d say a lot of your listeners are in the know about omega-3s and 6s. So, in my head, when people on the train are arguing about fish oil, I m like, Oh, I m too cool for school. I don t need fish oil because I came from the Paleo world. You don t take a supplement just for the h--l [expletive] of it. There has to be a reason why if it s missing in modern man s diet. So, it actually is a big issue because even if you don t take fish oil, probably either your parents do or your friend or coworker. Multivitamins, fish oil, those are two of the highest-selling supplements and it affects people that you know, so it s good to know this kind of stuff. And it turns out that only three

18 Page!18 out of the 32 fish oil supplements and they looked at every single fish oil supplement that was on the shelf at that local store in New Zealand only three of them met their label claims for EPA and DHA. So, that means that in general, you can t be expected to know whether your fish oil quality is good or not unless you do some research ahead of time. So, there is an organization, IFOS, International Fish Oil Standards, maybe. That sounds about right. Yes. If it s not that, it should be that. So, some companies, manufacturers, will voluntarily send products over for batch testing to this organization and some of the more well-known names like Carlson, Nordic Naturals, have their fish oil there, but there is a ton of products that are not there. So, aside from that and a couple of other examples, you don t really know what s in your fish oil. There s some debate about whether that really matters or not because some people which is okay some people are alarmists and they say, If fat is a little bit rancid, that s bad. Don t eat it. There s some grain of truth and there s some uncertainty in that because there really hasn t been very much study in what the impact of oxidized, pre-oxidized, not in our body, but oxidized oils are as far as long-term effects. In fact, in healthy people over the course of weeks or months, there is shown to be no effect. Of course, they didn t study every outcome, but it s probably true that if you take fish oil every day in low amounts, even it s a little bit oxidized, it s not that bad. But my concern is that fatty acid turnover in adipose tissue takes

19 Page!19 two-to-three years. So if you re taking something every day, it won t be for months. It ll be for years on end and you could be getting other oxidized fats in other parts of your diet and you could get oxidized cholesterol products from cooking. So, when you add all of that up, I think it s playing with fire a little bit to be taking an oxidized supplement and that s why this study really shines light on you need to know what you re taking every day, whether it s fish oil or anything. And an important thing to mention is that they didn t see a big difference between the more expensive brands in terms of accuracy. Yes. So, in terms of oxidation, there was no link between cost and oxidation, so a more expensive product can t be expected to be better. However, there was a slight association between EPA and DHA content and cost. Some of that could be controlled by the fact that more expensive oils had a higher concentration. They just put more to begin with? Yes. So, in order to make high EPA-DHA fish oil, you have to take the natural triglyceride form, convert it to the ethyl ester form and then, convert it back to the triglycerides. So, they ll still call it the natural triglyceride form, but at that point, it s been subject to hexane, whatever other solvents, so nothing is really natural.

20 Page!20 The point is that cost isn t a good indicator, nor was geographic location. So, if it was sourced from Scandinavian countries or from South America, it doesn t really matter. They are usually all kind of sucky. So, fish oil Equally sucky. Yes. Now you do mention in here a couple of strategies that people can employ to make their fish oil less-sucky, like keeping it in the dark and keeping it in the refrigerator. That s just going to inhibit further oxidation, but it could very arrive with a pretty significant amount by the time you even buy it. Yes. So, if there s any oxidation that started before you buy it, it s not going to stop because it s an auto-oxidation process. You really can t stop it. What interests me even more than the fish oil supplements is cooking. So, the first time I found out the effects of cooking fish on oxidation, or cholesterol oxidation products, was from Prof. Dr. Andro at SuppVersity. I think there s an interview, isn t there? Yes. So, we interviewed him for this past issue and he s going to be a reviewer starting in our next issue onward. So, he s a really sharp guy and he reads a ton of articles and he reviewed something a year or two ago about oxidized cholesterol in ghee and butter and different saturated fats. It also had a little section about cholesterol oxidation products in steamed fish versus fried fish and it turns out that cholesterol oxidation products are higher in

21 Page!21 steamed fish than even if you fry the fish in corn oil. I don t mean deep fry. I mean just pan fry. So, that s kind of counter-intuitive, but it s because the steaming takes a little bit longer and it s really the length of time you cook it, rather than the method, so much. So, unless you re eating sushi, I guess, there s going to be some proportion of oxidization happening? Yes. So, I still don t know, maybe because the research isn t extensive, but I don t know what the best way approach cooking fish is, and I eat fish a ton, so I just eat it in the way that I think it tastes good and I love fried food, like deep fried, but I try not to eat tempura too much because it s just logical that it wouldn t be great to eat that too much. But it s probably not great to get worked up about every single instance of eating. It could cause extra stress, so it s probably better just to generally eat healthy. Now, trusting your tongue might actually make good scientific sense and you mention that in here because rancid or oxidized, highly-oxidized fish oil is the same thing as rancid fish oil, would taste pretty bad. So using a tongue test, does it taste good, might actually be a not-too-unscientific way to determine the oxidative load in your fish oil or in your fish, in general. Yes, and some people have punctured their fish oil capsule and tasted it. You can sometimes taste a little bit of rancidity, but I worry that certain fish oils have a little bit of flavor, or something in the taste, so it s not 100% accurate and it s probably more important to find out actually what the oxidation levels are. But that being said, I think it s cool that people come up with these

22 Page!22 strategies because there hasn t been research on these topics. You just kind of have to figure it out. So, another thing, too, that is mentioned in here, alternatives to fish oil that might be worth investigating and you kind of put out non-fish sources. So, vegetable sources of omega-3s, but the problem with that is that they re not really a form that our body can use and to convert it to a form that our body can use, requires an enzyme which is not particularly efficient. So, non-fish sources, or more specifically vegetarian sources, aren t necessarily going to be the best option. But there might be some animal sources, even marine animal sources like krill, that could be a better option because of naturally-occurring antioxidants. Yes. So, krill is an interesting one because krill products are growing very rapidly as an alternative to fish oil. Krill comes prepackaged with astaxanthin, an antioxidant, which means these oxidation issues might not be so prevalent in krill oil. Another thing is that krill oil is better absorbed than fish oil, so krill oil is in the phospholipid form rather than triglyceride form and it s usually better than fish oil in overall reduction of lipids. So that being said, krill oil is much, much more expensive than fish oil, so if you re looking to temper your spending and save your wallet at all, krill oil, I d say, is probably not worth it, but if cost is not an issue, then krill oil might be worth it. On the other hand, if you re even thinking about supplements, you should probably think about what you re eating in the first place and some people, when they and I used to be this way some people when they buy fish, only buy salmon because it has a lot of EPA and DHA. I don t know if that s a great strategy because if you think about it in a Paleo context, a lot of our

23 Page!23 ancestors were from equatorial regions and where would they have access to all these cold-water fish? Deep-water, cold-water fish. Yes. That s not really happening. There s a lot of other fish that is not so high in EPA and DHA, but people would have eaten. So, white fish tastes good. A lot of white fish is low in toxins and just because you re not getting a ton of EPA and DHA every day, it s no big deal and in fact, I d say maybe you don t want to get a ton of EPA and DHA every day because there hasn t been that many long-term, well-controlled trials of fish intake. The whole reason why the EPA-DHA supplement markets came about is the studies in Greenland, Inuit in the 1970s, and those might not have been very accurate because they thought that the Inuit didn t have high levels of cardiovascular disease, but that was only based on stats given by the government, but there weren t very many physicians in the Inuit areas, so they probably did have a lot higher heart disease than we thought. So, maybe eating fatty fish every single day is not a great idea. It might be better to balance your diet. And I think that that s a way to kind of segue back into the whole Paleo world, which is thinking of the ancestral template is a good sort of filter for making a lot of these decisions because I think it s so easy to get wrapped up in a study and every week, there s a new study that comes out. Eggs, I think, are the best example where one week, they re great, one week, they re terrible. One week, they re great, one week, they re terrible. And it literally flip-flops like that and it s been doing that for years and years.

24 Page!24 If we think about our ancestral environment, would anybody be eating a dozen eggs every day? Would anybody have these huge quantities of really any nutrient without any sort of seasonal variation, without any sort of fluctuation from day-to-day, to week-to-week. So, if we look at our ancestral model, which is that there s a seasonality to food, that you re going to have things at some point in the year and you might not at another time, you re going to have access to things that you could potentially catch with your hands, or dig up with your hands. I think that that can really help shape our nutritional choices in a sane way. So rather than chasing the latest research paper, which like we ve explored today, may not even be very clear in what it s recommending. There might be much more nuance than originally is evident when you read the headline, which might say, Eggs kill you, or Pistachios destroy athletic performance, or All fish oil is terrible and oxidized and is trying to give you lipid whiskers, which I just want to mention. I think that s the best name for a scientific model that I ve come across in a long time. So anyone who s hearing that and wondering what the heck I m talking about, you ve got to get the Examine.com Research Digest where they talk about the lipid whisker model. But I think we can chase these studies and really kind of get ourselves too wrapped up in a kind of hype or fear or whatever the case may be, but if we go back to, What would my ancestors have done? What did my grandparents do? What did people do a few hundred or a few thousand or a few tens of

25 Page!25 thousands of years ago? that can kind of help bring us back to our senses a little bit. Yes, and I d say for me personally, when I first started getting in Paleo, then my questions specifically on PaleoHacks were often about variability and I think one of my very first questions was about eggs. Is it natural to eat a dozen eggs a day or have them all the time? And then, meat. It seems like everybody on PaleoHacks back then ate meat at least twice a day, every single day of their life. Like I don't know. Is that necessary or preferable and my fairly recent ancestors at least from the past 500 or 1,000 years didn t eat meat at all and we had fairly long life spans. So a lot of people got angry. I actually ended up getting suspended on PaleoHacks before I was a moderator, so I understand that people like their own diets, but like I said, if you teach yourself how to say, I do not know, then a lot of things open up and what I don t know and I m most interested in right now is even less so, specific nutrition studies, but other Paleo influences on life style, to me, seem to be, as a whole, a lot more important than specific nutrients. So, like changing position fairly frequently, being able to sit in a full squat, light exposure, those sorts of things, and we try to include one of those every issue or so, just so that you have some context and you re not always micro-managing your nutrients, but you re thinking about the big picture. Yes. You don t want to get a myopic nutritional focus where everything else falls away and you forget about the life style. Great point, man. I think that s a good stopping point for today. I like everything that you re saying, man. I m glad that we had a chance to talk. Certainly an enlightening discussion on

26 Page!26 the nuances of scientific studies, how we can incorporate them into our life styles without letting them run our lives and then, certainly bringing awareness of Examine.com as a, really, I think the only unbiased source of nutrition information out there because there s so much biased information out there, that it s really hard to kind of wade through it and find out what s marketing and what s real. So, I appreciate you guys doing the work that you re doing to cut through the hype and try to find maybe truth with a lowercase T and clear up some of the confusion that people have out there. Yes. It was my pleasure to be on here and for anybody that s listening who s a nutrition information junkie, if you run across studies and you think they re interesting, then let us know. Just contact us. We ll try to include it on our pages. We like talking to people because we really came from people on the Internet who needed information who didn t know where to get it. So, we continue to rely on people talking to us about nutrition supplementation. Awesome. Thanks again, man. My pleasure. That was nutrition researcher and Director of Examine.com, Kamal Patel. Coming up next on the show, Adam Farrah in Big Picture Paleo. I m Tony Federico and you are listening to PMR. {Music} I can t believe it. I got rid of that freaking couch and it s like I already feel better. I can t believe it.

27 Page!27 You ditched your couch. Is that the only couch you had? Yes. You have no couch in your house. There s a little one in the living room that s my mom s that nobody ever really uses, but no. As far as my little corner of the house here, there s no more couch anywhere. It s a couch-free zone. Now what inspired you to ditch the couch? Well, I guess from a practical standpoint, I mean, there s not a lot of room out here and it was a relatively big couch that had come from my old house that was three times the size. So it took up a lot of space. What would happen is I would sit on the freaking thing and get stuck sitting on it, hunching over my laptop. Yes. You get attached to it and you get in that kind of crunched up, couch position. Yes and the first thing I was finding is that I kept having all these back problems, hip problems, ab strength problems. Like all these weird problems that I never had really dealt with before and really shouldn t have been having. And so, I started really paying attention to stuff and after awhile, I isolated it to every time I sit on the couch, working on my laptop, everything starts to hurt and then, I was watching and I d get up and like I could feel my

28 Page!28 hip flexors just so tight and my hand strength so tight. So there was that side of it. And then, the other side of it was I had had that couch since probably I got sick in 2004, so I spent a bunch of years like sick on that couch. Oh, man, so bad associations. Yes and I didn t necessarily I don t think consciously I associated it, but I just said, I ve got to get rid of this freaking thing. I don t want this thing in here anymore and there s too much, probably, energy attached to it. Then, this funny little side note with this, I had started reading this book called, Letting Go of the Person You Used to Be, and I lost it. And I started cleaning. Back to that clutter thing, cleaning and everything else, but I lost this book. Don t tell me it was in the couch. It was under the couch. Of the hundreds of books that passed through my hands every week, just about, the one I lost was as soon as I moved the couch, there it was, Letting Go of the Person You Used to Be. There s your sign. Yes, yes. But yes, man, already, it s just I have all these pillows. I ll figure something out. I ll have to get a bunch of cushions or something, or maybe I ll get some kind of a chair, but

29 Page!29 So, tell me a little bit about what you re doing. So, you got rid of the couch and it s kind of a revolutionary thing because we Americans, it s a couch and a TV and that s our jam. That s kind of how we roll. We eat there. We socialize there. Yes. I m glad I m not the only one because I don t know. No, I mean, that s the thing. That s the thing to do. Everybody does that. So, how are you coping? Were you feeling a little bit lost initially? How are you kind of navigating this transition? I ve just been glad to be rid of the d--m [expletive] thing. Really? Yes, and so I ve been like laying on my stomach. It reminds me, actually, of a couple of years ago, I did a week-long instructor prep course for Harris International jujitsu and there was like 12 of us and we re all sort of just laying around on these mats, listening to You re just in the gym, no chairs, nothing? No chairs. Just laying around on the mats. Everybody had foam rollers and everybody had different kinds, so we were like trying each other s foam rollers and Roy Harris was showing us different stretches and stuff and it worked so well and I remember thinking at the time, God, this is the right place to be, because what it have been like? Can you just imagine you re in

30 Page!30 a corporate meeting room and you just get up and lay down on the floor and start foam rolling. Yes, you know, that s funny, man, because in personal training, continuing education courses and different sort of situations that I ve been in for my professional life as a personal trainer, that s the (sounds like: ujj), that people are either squatting or they re laying down or they re on a foam roller or grabbing a squirrely ball or doing something and I ve just found that you kind of flip-flop. You re in different positions. You re kind of half-squatting. You re squatting. You re, like you said, on your belly, so you re in a much more dynamic state, even though you re relatively stationary versus a couch. It just sucks you in and you just sit there and you can stay literally in the same position for hours, if not days, or more. You start to actually grow roots, I believe, at some point. I think your body adapts. Look at it this way. You re spending let s be conservative you re spending six hours a day in like the same position and it s a position your body really shouldn t be in. Right. There s no natural adjunct for a couch position. Maybe, I don't know, I ve seen some hunter-gatherer types in the Amazon that sort of have like a hammock-type set-up. But even so, it s nothing like what we re rocking. Yes, no. I was actually thinking of bringing some large rocks in and just sitting on the large rocks, making it like a cave, you know? A little stump of wood.

31 Page!31 Yes, yes. Hey, why not, man? Did you ever see that I don t know if you re into cartoons at all but the Ren & Stimpy, they used to run the log. So it s like everyone wants a log and it s just like a log and all the kids are all stoked to do the log, man. I don t know if I ever saw that one. I used to watch Ren & Stimpy, but I don t remember that one. Oh, man. I m going to send you the YouTube clip for the log commercial and I ll make sure to post the link on the show notes for this episode, as well. They did it jokingly. This might be serious. Right, right. Time will tell, but I ve got all sorts of cushions and foam rollers and pillows and wedge. I ve got a memory foam wedge. I ve got all sorts of crazy stuff. That sounds kind of decadent, actually. Yes. Well, yes, it s like those big mansions in Hollywood with the depressed living room, that lowered living room with all the pillows, like a A very hedonistic sort of experience. Yes. If anything you see on Instagram starts looking like a swinger s pad, you can

32 Page!32 Relax, everybody. I just got rid of my couch. This is totally normal. Yes. Hey, they say that the forces applied to your spine in a sort of crunched-up, hunched couch position are three times greater than that when you re standing up, more so, even than when you re laying down, so you re better to lay down flat, to stand up, but when you re in that position, you re really compressing the spine. I actually had recently some serious low-back issues that I attribute to the kind of office chair style seat. Was doing a lot of writing in one of those. Have since transitioned more into a kneeling chair. I think I m going to kind of go to the standing work station next. But yes, man, I think all that sitting down, it s compressing the spine, compressing the disks. That is unhealthy. We need that dynamic movement to keep our spines grooving. So, I commend you for making that big step, man. That s a courageous move and I hope that it inspires other people to ditch their couches, as well. Maybe we ll see a wave of couch revolutionists. Yes. We need a hashtag, like #DitchYourCouch or something. Let s think about this. #NoCouch, of course. No couch. #DitchYourCouch, #KillYourCouch. #KillTheCouch. I like it. #KillTheCouch. Nice, man. There you go.

33 Page!33 Yes. That s it. Well, there it is, man, there it is. I need another hashtag cluster for Instagram. Can you really ever have too many hashtags? I think actually they limit you to 20 or 30. So, 21 is too many hashtags. Right. Okay, so as long as we re under that number, we re okay. Yes and I think it changes, but I ve definitely heard that it s somewhere in the 20 or 30. There is a limit. So, I guess somebody had to say, Enough is enough. #EnoughIsEnough. Well, because Twitter, you don t have enough room, so you can only two or three at the most. But then, Instagram, it s like if there s no limit, man, let s just load this thing up. Oh, man, yes, and sometimes it does get pretty bad, too.

34 Page!34 Yes. Hashtag killed a hashtag. Right. Well, hey, man, thanks for stopping by. I appreciate these opportunities to talk Big Picture with you, man. Appreciate it. Yes. Absolutely, man, you, too. All right, nation, that s going to do it for today s episode. Coming up next time on the show, our PaleoFX show wrap-up. I was busy all during PaleoFX recording interviews with some of the top names in Paleo, as well as some people that you maybe have never heard of before, to really give you a nice, diverse set of opinions and perspectives about what exactly happened at the event, what was the most important takeaway, what are the biggest things that you should know about PaleoFX and what it means for the Paleo movement in general. So, here s a little sample of what s instore next time. Hi, PaleoFX. We are seeing hundreds of exhibitors who are entering this marketplace with products that will enhance people s lives, so I have to say right now, that s what I m most excited about. Now, if you didn t recognize that voice, that was Mark Sisson of Mark s Daily Apple, and author of The Primal Blueprint. Now if you want to find out what exactly has Mark so excited, you re going to have to listen to next week s