Fork U with Dr. Terry Simpson Terry Simpson

Seed Oils, Omega 6, and InflammationJust about everyone in the low-carb community is talking about how bad seed oils are. They claim the medical community has it wrong. The conspiracy-minded folks claim doctors want to keep people sick. Thus dependent on medicine for pills and surgery. Hence, seed oils are the new evil part of the picture.
The New Sugar ConspiracySeed oils, hydrogenated oils, and omega-6 fatty acids have replaced sugar as the new reason for ill health in America.
Their logic goes like this:
Seed oils are high in omega-6 fatty acids. They claim that high Omega 6 fatty acids are pro-inflammatory. Therefore, if you have more seed oils in your diet, you will have more inflammation. Inflammation is the root cause of heart disease.
Their argument is logical, partially true, and the conclusion is incorrect.  They are selling you snake oil (well, usually supplements).
It is Peanut ButterThe keto crowd will say how "real" peanut butter is made with peanuts and salt. Claiming this peanut butter is "candy" or "full of garbage" and isn't fit to be eaten. But is it? Let's break this down.
Added SugarFirst, the added sugar, which according to the label is 3 grams per serving (two tablespoons), so the whole thing is 190 calories, of which 12 of those calories come from sugar, the rest from fat.
Here is the label from Sprouts Pure Peanut Butter. Nothing but ground peanuts. No salt, no oils, no sugar. There are 200 calories from two tablespoons.
Of the 200 calories from all peanut butter, with no added sugar, you get the same number of calories from the peanut butter with sugar in it. How much sugar? Well, about 3 grams per serving of sugar. How much is that? Not much.  To exceed the recommended dose of sugar from the American Heart Association, you would need to have more than 6% of your calories.  In Skippy, it is 1.5% added sugar.
Low Carb Sugar ConspiracySugar was the "evil" that low carbohydrate folks said caused obesity. If you read their literature from twenty-plus years ago, it blamed sugar for obesity. Not just sugar, but any carb that was sugar, they claimed, would become fat. They even had their alternative view of history of obesity in the country.
They stated that the world was not obese until Ancel Keys blamed heart disease on fat. Then the US government promoted a low-fat diet. The result was obesity bloomed because they replaced fat with sugar. That evil food pyramid caused people to turn away from fat, substituting sugar. That sugar substitution led to obesity.
It sounds so logical. If you ever go on a low-carb diet (Atkins, South Beach, Paleo, Keto, Carnivore), you stop eating junk food and eat steak. You feel satisfied eating lots of meat.  Then you get tired of steak. You lose weight because you are in a calorie deficit, not because of ketosis. But that weight loss leads to confirmation of the theory that sugar made you fat.
You go off the restrictive diet. Now you gain weight. You gain weight because you are eating more. But you blame the slice of bread. What you forget is now you are eating more steak because you have more flavors in your mouth. That slice of bread is 100 calories, but you think an 18-ounce Porterhouse (1260 calories) is a diet food? So you blame the bread or the lava cake. But not the extra calories.
Where It Falls ApartBut something about your low-carb diet doesn't make sense. You notice that obesity has increased in the United States. But...

Implementing the Mediterranean Diet: VegetablesThe increase of vegetables in the diet is one way to reduce inflammation.
Vegetables are an important part of the Mediterranean diet, providing essential nutrients. A diet rich in vegetables that contain antioxidants. As a result, the Med diet reduces the risk of heart disease, cancer, dementia, and anti-inflammatory diseases.
Vegetables are low in calories, but high in nutrient density. In addition to providing high nutrient value, they provide satiety. Thus making vegetables the cornerstone for weight loss and maintenance.
How Much is a Serving?One serving of vegetables is 3 ounces (85 grams) of raw or double that cooked. Three servings of vegetables a day is the daily goal. Without a doubt, the more vegetables, the better.
Meal IdeasBreakfast ideas for vegetables include what you might put in an omelet:  tomatoes, spinach, onions, and chives. Even the breakfast bites can have multiple vegetables in them.
While salads are great for lunch, filled with kale, radishes, and carrots, don't forget that you can pile a sandwich with lettuce, cucumbers, sprouts, and tomato.
Need a snack during the middle of the day, plan on carrots for the afternoon and for the drive home. You can't fall asleep while chewing on carrots.
Broccoli might be a great snack before dinner. Raw, even if you have a bit of ranch dressing. Buy packets of dry ranch dry ingredients and add to Greek yogurt.
Don't forget that dinner salad. Make it large and beautiful.
Supplements Are Not the SameVegetables contain nutrients that your body needs. They are rich in magnesium, potassium, and folate.
There is no supplement that can replace vegetables.
Do Vegetables Have Anti-nutrients?Every study has shown that an increase in vegetables decreases heart disease, cancer, and inflammation.
People who sell supplements often point out that vegetables have anti-nutrients in them. I have talked about this in a previous podcast and post (here). Of the various supplement salesmen out there, from the self-described Carnivore and his business partner Liver King to Dr. Gundry.
LectinsLegumes like beans and lentils are nutrient-rich, protein-, and fiber-rich foods whose benefits outweigh any lectin.  High doses of lectins, when fed to animals, lead to diarrhea, inflammation, and other problems. These problems have never been seen in human studies with normal foods. The main lectins are destroyed by cooking, soaking, sprouting, fermenting, boiling, and canning.
All human trials show that diets rich in legumes, and whole grains, lead to better health.
OxalatesOxalates can be absorbed from the gut, bind to calcium, and cause calcium kidney stones. They will also bind other minerals, such as zinc. This has led some to avoid healthy foods like spinach, swiss chard, amaranth, taro, sweet potatoes, beets, rhubarb, and sorrel.
Cooking greatly decreases the oxalate content. In addition, cooking increases the nutrients of the vegetables available for absorption. The higher the vegetable content, the higher the mineral content of the diet, the fewer kidney stones are formed.  People who consume a DASH diet have a 40-50% decreased risk of kidney stones (reference). The DASH diet is the American version of the...

Do You Need A Liver Cleanse?Fatty liver disease is the most common reason for liver transplantation. Fatty liver disease replaced alcoholic liver disease a decade ago.
The rise of obesity has contributed to fatty liver disease, and fat, like alcohol, is deadly to your liver.
So can you clean out your liver?  Simple answer - no. But that doesn't stop the world from making dubious claims.
History of Liver ScamsThe most famous was Carter's Little Liver pills. They promised to increase the flow of bile in the liver. This would rid the body of toxins.
Even when it was marketed in 1868, it was known as a "patent" medicine. Thus a medicine without merit was sold by quacks.
In 1959, the name was changed to "Carter's Little Pills." The FDA, in 1951, filed suit that the pills had nothing to do with the liver.
The phrase "Someone has more (fill in the blank) than Carter has pills" comes from this product.
The Master CleanserStanley Burroughs, a lumber salesman, invented the "master" liver cleanse. The formula was tea or lemonade with cayenne pepper and maple syrup. There was no clinical data this ever worked. In spite of the lack of evidence, it continues to be recycled in the pseudoscience world.
Burroughs first published the book in 1946, "The Master Cleanse," and re-released it in 1976 under the title "The Master Cleanser".
Burroughs was convicted of manslaughter in California and fined for practicing medicine without a license.
This "juice" or "liver cleanse" or liver detoxification program keeps coming around with different ingredients. Some of the latest include olive oil.
Gallbladder FlushThe gallbladder flush is the same formula.  People will defecate small round balls of fecal material. Then they are told that these represent gallbladder stones, but they are not. Thus, the flush is useless.
The Liver's JobAll the blood from the stomach and small bowel is filtered through the liver. Hence, the liver can be considered a filter.
Once the food you eat is broken down and digested by the gut, those nutrients go to the liver.  Then the liver determines if you need to use the nutrients, store the nutrients, or get rid of the nutrients.
The liver gets the first pass at the medicines you take.  Many medicines require the liver to process them to be effective. Those drugs are called "pro-drugs." Aspirin, for example, is a drug whose active ingredient is salicylic acid.
Liver and AlcoholThe liver can also take harmful substances and render them harmless.  In spite of the liver's ability to deactivate harmful products, a person can overcome the liver's ability to detoxify substances. The classic case is alcohol.
Once alcohol is ingested, the liver begins to change it into acetaldehyde. Acetaldehyde is both toxic to the liver and responsible for most hangovers. Acetaldehyde is metabolized into harmless products.
If a person consumes more alcohol than the liver can metabolize, they will become intoxicated. In addition, they will develop both acute fatty liver and chronic fatty liver. A fatty liver can lead to cirrhosis and liver failure.
Milk Thistle and The LiverSince there are multiple complex metabolic pathways in the liver, there is no one agent that will fix the liver.
Supplements touted to help the liver include:
Milk Thistle.  The active ingredient is silymarin. Silymarin has been extensively studied in alcoholic liver disease, fatty liver disease, hepatitis, Tylenol poisoning, and...

Erythritol and Heart Attacks: Is It Hype?Does the artificial sweetener erythritol increase the risk of heart attacks? In fact, some say that this is just hype.
The article abstract can be found here.
Erythritol is an artificial sweetenerIt has been used for years in food as a "non-nutritive sweetener." Erythritol is used in many processed foods, replacing the calories from sugar. The Food and Drug Administration considers erythritol a food additive (GRAS). As a food additive, erythritol has never been tested for its toxicity or long-term use.
The case for artificial sweetenersWhile artificial sweeteners decrease calories, do they decrease obesity? They have been shown to decrease obesity among teenagers (ref here). By reducing calories, it seems obvious that obesity would decrease. And yet, this has not been a consistent result
A study showed that increased erythritol led to increased obesity. And that was just the erythritol your body makes.
But your body makes erythritolSince your body makes erythritol. Does that mean it must be safe?
The human body produces many toxic substances. For example, formaldehyde. Humans produce about 1.5 ounces of formaldehyde a day.
Acetaldehyde is a breakdown product of ethanol. Drink too much alcohol, and you will produce enough acetaldehyde to kill you.
The case against artificial sweetenersThere have been a number of peer-reviewed journal articles showing that artificial sweeteners have adverse consequences:
Weight gain and obesity  (ref)Insulin resistance (ref)Type 2 Diabetes (ref)Stroke, heart disease, and all-cause mortality (ref)Increased heart deaths in women (ref)
How much we makeWe have about ten micromoles per liter of blood. That would be the baseline level. Blood levels with 1000 times as much erythritol are found in people who consume it as a sweetener.
One study showed that erythritol led to improved blood vessel function after drinking erythritol for a month (ref). But this was in healthy young adults. What about people with underlying heart disease?
It's not hype - the studyThe Erythritol study was done by the highly regarded Cleveland Clinic and published in the journal Nature Medicine. It was peer-reviewed, meaning many other scientists looked at that data and concluded the study was worthy of being included in this prestigious journal.
What this study examined was the correlation of erythritol with people prone to heart disease. They studied people at risk for heart disease. Such as those with high blood cholesterol, diabetes, obesity, or hypertension. They looked at the blood levels of erythritol. Data divided the patients according to how much erythritol was in their blood. What they found was that those with the highest levels of erythritol had the highest incidence of heart disease, strokes, and cardiac...

Don't Fear the Fruit, Enjoy ItAre you afraid that eating fruit will cause your blood sugar to spike? Let us bust that myth right now.
Only ten percent of adults eat enough whole fruit daily despite the clear benefits of fruit.
Eating fruit and Living Longer My 98-year-old dad eats fruit with breakfast for as long as I have known him. We would have grapefruit every morning. We even had those cute grapefruit spoons to wrestle the goodness out of the half grapefruit.
Now, dad enjoys a mixed bit of fruit.
In 28 studies with over 1.6 million people, each serving of fruit led to a 5% lower incidence of death (reference).
Each serving of fruit8% less risk of heart disease
3% lower risk of cancer
200 grams (7 ounces) showed the lowest risk of cancer rates and deaths from cancer.
Even the Low Carb Community is coming aroundThirty years ago, the low-carb community advised against whole fruits. Their rationale was that fruits spiked blood sugar, which caused insulin to rise, which caused fat storage. They even cautioned against eating carrots for the same reason. But now, even the most extreme members of that community proudly eat fruit.
What 5 servings looks likeBreakfast with 1/2 cup of blueberries
Morning snack of one medium banana
Lunch with one apple
Afternoon snack of 1/2 cup of grapes (about 16)
Evening snack of 1 clementine
Don't forget the tomatoThe tomato is a fruit. Yes, the Supreme Court said, for taxation purposes, it is a vegetable, but it isn't.
Other Benefits of Fruitpromoting long-term weight managementreducing the risk of heart diseasereducing the risk of type 2 diabetesdecreasing the risk of colon and lung cancerlowering the risk of depressionsuccessful aging (like dad)higher bone mineral densitydecreasing incidence of seborrheic dermatitisless constipationless irritable bowelless inflammatory bowelless diverticular diseaseless hemorrhoidsless stress
Fruit is not the enemy - but it is one of the easiest of the nine food groups to add to your Mediterranean Diet and one of the easiest and most delicious to add to the DASH diet.
 
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Salt: Toxicity is in the DoseFor the human body, salt is both an essential metal and toxic at a high dose.  The most common form of sodium comes from sodium chloride, a salt.  However, too much salt and arteries become stiff, and the risk of heart disease and cardiovascular disease increases. The majority of dietary salt comes from processed foods.
Salt Toxcity DeniersProbably the most famous book is The Salt Fix.  A rambling book claiming low salt is responsible for everything from lower sex drive to insulin resistance. The book is logical and simplistic, with abundant citations taken out of context. In summary, the book is almost completely incorrect.
Salt and HypertensionOne of the classic studies about salt and hypertension is the DASH sodium study. In these studies, the study participants were fed the diet with varying amounts of salt. These studies are expensive and often not done, but powerful. Additionally, the lower levels of salt, the lower the blood pressure. In fact, a low-sodium DASH diet led to a reduction of blood pressure equivalent to one blood pressure pill.
In contrast, "The Salt Fix" states that decreasing levels of salt led to increasing blood pressure and heart disease. The Salt Fix explanation is that lower salt leads to increased levels of renin, angiotensin, and aldosterone (hormones that would increase blood pressure). His conclusion is the opposite of hundreds of articles and much analysis. Such as here, here, and here.
Salt and CholesterolAnother false claim, "The Salt Fix," stated the DASH study showed an increase in LDL, cholesterol, and triglycerides.
The DASH diet showed no significant impact at all.
More of "The Salt Fix" MisinformationOur ancestors ate more saltThe primitive argument for which there is no proof. Since our ancestors ate mostly plants and no processed foods, this is easily debunked. Meat eaters know that a one-pound chicken contains about 150 mg of salt. A double patty of hamburger has 500 mg. He makes up numbers that don't make sense.He states our ancestors ate from salt licks, but there are few in Africa (he makes up stuff)Other countries have higher salt intake and lower heart diseaseHe cites Korea (which has 50% hypertension or pre-hypertension), Japan (highest incidence of stomach cancer related to salt), and France (hypertension is high, but low levels of heart disease related to the Mediterranean diet practiced by most).Salt doesn't lower blood pressure by a significant amount and makes food bland.The DASH diet studies show significant reductions in blood pressure, and the food is not bland.Lower salt leads to increased death.The opposite has been shown. Increased levels of sodium in the diet show increased levels of death.Lower salt leads to lower iodine levels.Iodized salt was introduced in the US because of the low iodine