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Posts Tagged ‘JD Moyer’

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How Do You Prevent Heart Disease? (Vitamin D might not help, but there’s plenty you can do)

Monday, January 28th, 2013
Today we feature a new article from, JD Moyer of the blog Systems for Living Well: Recently one of my favorite bloggers, Ferrett Steinmetz, had some chest pain, and as a precautionary measure went to the ER to get checked out. His initial tests came back normal, but the chest pain continued, and his blood work showed abnormal results. Ferrett had experienced a heart attack, and was immediately scheduled for surgery.

It got me thinking about heart disease.

Heart disease is incredibly common. It’s the leading cause of death in the United States.

So what can we do to prevent it?


For years the medical establishment told us that eating a low-fat, low-cholesterol diet was the best thing we could do to prevent heart disease. Even my last doctor tried to peddle this advice. I changed doctors.

Cardiologists who have been paying attention to the research now associate heart disease with factors like lack of exercise, diets high in refined carbohydrates, poor blood sugar control, inflammation, and sedentary lifestyle (lots of sitting — see infographic below). Dietary cholesterol doesn’t matter so much, and a moderate intake of saturated fat is probably not harmful (though monosaturated fats like olive oil may be preferable). Healthy fats (butter from grass-fed cows, olive oil, coconut oil, fatty fish) are a more “heart-healthy” source of fuel than grain products (even whole grains).

Bill Davis (author of Track Your Plaque and Wheat Belly) is one such forward-thinking cardiologist. Davis recommends a wheat-free, no refined vegetable oil (corn/sunflower/soy/canola), low-carbohydrate diet, as well as certain supplements (which he also sells) including vitamin D, fish oil, niacin, and coenzyme Q10. He also recommends foods such as olive oil, garlic, and tea (all associated with lower heart disease). Is he peddling products? Sure … but his approach is still leagues ahead of the conventional wisdom on heart disease.

Ferrett had to undergo triple bypass surgery. Thankfully, he survived, and is now recovering at home.


Cholesterol and Genetics tracks fifteen SNP’s that are related to an increased or decreased risk of coronary heart disease (if you have a 23andMe account you can click here to see your heart disease risk profile).

The most significant SNP is rs3798220 (snpedia/23andMe). People carrying the C allele produce higher levels of lipoprotein(a), and have more than a twofold increased risk of heart disease. I feel fortunate to carry TT, but C carriers get a compliment from Dr. Davis. He calls them the “perfect carnivores” in this post, and claims this variant is more resistant to dehydration, tropical disease, and is more likely to be intelligent (I’m not sure what Davis is basing these claims on, but they’re interesting).

AG or GG at rs10455872 is also associated with higher Lp(a) levels and increased risk of coronary heart disease. 23andMe users can see their genotype for this SNP here.

Heart disease risk for rs3798220-C carriers can be somewhat mitigated by low-dose aspirin therapy, at least in women. Estrogen HRT also lowers lipoprotein-a/Lp(a) levels. Among Bantu fishermen, higher fish intake was also associated with lower Lp(a).

Why are elevated Lp(a) levels associated with coronary heart disease? Lp(a) is similar to low-density lipoprotein (LDL), which is more likely to stick to arterial walls and clog them up (while the big HDL molecules bounce around harmlessly).


Environmental Risk Factors

In addition to genetic risk, these environmental risk factors are pretty well established. Unlike diet, there is little controversy around these risk factors for coronary heart disease:

We’re stuck with our genes, but these factors are avoidable. Don’t buy a house next to a freeway. If you smoke, making quitting a priority (if you’re under 40, the damage may be largely reversible). And get a standing desk (or convert — I added eight 12″ dowels to my IKEA desk — now it’s a standing desk).


Dietary Fat and Cholesterol

For decades, both fat intake and lipid cholesterol levels were associated with heart disease, but neither has been shown to be causative. The most famous high-fat diet correlation turned out to be Ancel Keys cherry-picking data for one of his presentations (though Keys may have been unfairly maligned by the paleo community, as this post explains).

What about cholesterol? As of 2010, the U.S. government was still recommending that we consume no more than 300mg of cholesterol a day (2 eggs contain about 370mg), even though a large body of research has failed to find any connection between dietary cholesterol and coronary heart disease. We’ll see if the 2015 guidelines update this recommendation.

Chris Kesser has written a number of articles debunking the idea that dietary cholesterol and saturated fat cause heart disease. I recommend his site.

Still, certain types of lipid cholesterol measurements are associated with an increased risk of coronary heart disease, specifically LDL-P (low-density-lipoprotein particle number). We don’t want large numbers of tiny cholesterol particles floating about in our bloodstreams — they tend to clog up the works.

What raises LDL levels? While Lp(a) levels (discussed above) are related primarily to genetics, LDL levels are highly influenced by diet. High carbohydrate/high sugar diets seem to be the main culprit.


Cholesterol, Vitamin D, Sunlight, and Nitric Oxide

Some researchers believe that high cholesterol levels are merely a biomarker for coronary heart disease risk, and don’t cause heart disease at all. Chris Masterjohn explains how cholesterol is converted to vitamin D, and that sunlight is necessary for this process. So high lipid cholesterol might simply indicate that you aren’t getting enough sun, and that your vitamin D levels are too low. Low vitamin D levels are associated with a higher risk of coronary heart disease.

So all we have to do is take supplemental vitamin D, and we should reduce our risk of heart disease, right?


Not so fast.


In terms of heart disease, blood levels of vitamin D may be a red herring biomarker, just like high cholesterol levels.

Dermatologist Richard Weller has done some fascinating research in this area. He found that people from northern latitudes with less sun exposure generally experience more heart disease. Even after controlling for smoking, diet, and socioeconomic factors, people from sunnier areas experience markedly less heart disease.

Weller discovered that the skin stores large amounts of nitrates and nitrites, which are converted to nitric oxide by exposure to sunlight. Nitric oxide released into the bloodstream lowers blood pressure and dilates (relaxes and opens) blood vessels. Weller showed that this effect was not related to vitamin D levels; the amount and intensity of sunlight (about 30 minutes of sun in Edinburgh, during the summer) was not sufficient to raise vitamin D levels. But it was enough to convert skin nitrates and nitrites into nitric oxide, and lower blood pressure.

It’s not that vitamin D isn’t good for you. We know vitamin D increases calcium absorption, prevent rickets, and reduces the risk of many cancers (especially colon cancer). But in terms of heart disease, low vitamin D may just be a biomarker for low sun exposure, and therefore low plasma nitric oxide levels.

How does nitric oxide prevent heart disease? In addition to lowering blood pressure, nitric oxide inhibits the oxidation of low-density lipoprotein, which is a known risk factor for heart disease.

What about skin cancer risk? Weller, a dermatologist, points out that heart disease is a much bigger killer than skin cancer (by a factor of 100). And thirty minutes of Scottish sunlight is probably not going to cause much skin damage.

I live in the Bay Area and we get plenty of sun, but I’m rarely in it. My calves are British-schoolboy white. Moving forward, that’s going to change. According to Weller, even ten minutes of California winter sunshine is enough to activate nitric oxide (NO) release. I won’t be sporting a tan anytime soon, but I might be moving into a light beige.


Other Ways To Raise Nitric Oxide Levels

What if sunlight exposure isn’t an option, either due to latitude or lifestyle?

There are other ways to boost nitric oxide. The primary one is exercise, which has shown to be heart-protective.

Dark chocolate also boosts NO levels and reduces blood pressure.

So does red wine.


So there are options to boost nitric oxide levels. And more than heart health is at stake; adequate NO levels are vital for sexual response in both men and women.


What About Supplements and Medications?

Which supplements and medications have the best evidence for protecting against heart disease?

Niacin has a decent track record, though a large trial by Merck combining statins and niacin showed no benefit. Personally I can’t tolerate large doses of niacin — the flush response is too much, and it messes with my digestion. Niacin may be especially effective for rs3798220-C carriers who produce higher levels of Lp(a), but low-dose aspirin is also effective.

Statins are often prescribed, but show no benefit for people who don’t already have coronary heart disease. Low-dose daily aspirin is just as (or more) effective, and much cheaper. Both statins and low-dose aspirin can have serious side effects, including internal bleeding and increased risk of macular degeneration for the latter.

Coenzyme Q-10 may be heart protective, and can help lower blood pressure. Oily fish like salmon is a good source, but since levels decrease with age, those of us over 40 might consider taking supplemental CoQ10. Statins tend to lower levels of coenzyme Q-10, and supplemental CoQ10 may protect against some of the side effects of statins.

Of all the supplements I have considered, vitamin K2 (found in fermented foods, aged cheeses, poultry liver, and grass-fed dairy products) seems to be the most promising in terms of actually preventing coronary heart disease. This study found an inverse relationships between dietary vitamin K2 and heart disease in older women.

I eat most of those foods, and recently I also started taking 50mcg of vitamin K2 (the Mk-7 form, derived from nattō) several times a week (I’ve tried actually eating nattō, but I can’t stand the taste).

Vitamin K2 controls where calcium goes in the body via modulation of the hormone osteocalcin. How exactly does this process work? Here’s a excerpt from this article.

The possible role of vitamin K2 in preventing coronary plaque development has emerged from observations of its effects on several bone proteins, whose main function is to keep calcium where it belongs in the body.

Osteocalcin is a calcium-regulating protein that is controlled by vitamin K2. When vitamin K is present, osteocalcin normally undergoes a process called carboxylation, which binds osteocalcin to the mineral portion of bone. However, in vitamin K2 deficiency, osteocalcin cannot perform this function, resulting in unrestrained calcium resorption (removal) from bone tissue that leads to osteoporosis.

The opposite situation seems to occur in the arteries. Calcium is deposited because another protein called matrix GLA-protein, which is a calcification inhibitor and is also K2-controlled, cannot undergo the process of carboxylation in a vitamin K-deficient state. Because only carboxylated matrix GLA-protein inhibits calcification, undercarboxylated matrix GLA-protein has been found to occur in unusually high concentration at the edge of calcified and atherosclerotic plaques, suggesting it plays an active role in depositing calcium in plaque.4 Impairment of the function of osteocalcin and matrix GLA-protein due to incomplete carboxy-lation results in an increased risk for developing osteoporosis and vascular calcification, respectively.

So if you want your arteries to remain uncalcified, you should absolutely make sure you are consuming enough vitamin K2.

What about fish oil? Consuming fatty fish multiple times a week is clearly associated with reduced risk of coronary heart disease, but it’s less clear if supplemental fish oil is beneficial. I do both, but use a lower dose of fish oil (only 2-3g on most days).

Linus Pauling hypothesized that arterial plaque is only created in the absence of adequate vitamin C levels. Researchers at the Linus Pauling Institute make a strong case for raising the RDA to 200mg a day (high enough not only to prevent scurvy, but to reduce mortality from a wide range of diseases). Other research has shown that vitamin C supplementation lowers levels of C-reactive protein (CRP is a biomarker of inflammation that is linked to heart disease). Population studies in the 1990′s found that vitamin C supplementation is associated with increased longevity, specifically from reduced cardiovascular disease. I’ve taken vitamin C for decades (though I no longer megadose, as very large doses of vitamin C can reduce copper absorption).



Heart disease is the biggest killer in the United States, and most other developed countries. We can reduce our risk by doing the following:

  • - reduce sitting (get a standing desk and limit TV couch time)
  • - exercise daily (long walks and taking the stairs count)
  • - get some sun on your skin daily (but don’t burn)
  • - eat dark chocolate and drink red wine
  • - eat a low-grain, low refined vegetable oil, low-sugar diet (not necessarily low-carb; some foods containing carbohydrates like whole fruit and properly cooked beans probably have more benefits than drawbacks)
  • - eat “good fats” including olive oil, butter from grass-fed cows, coconut oil
  • - get enough dietary vitamin K2, and consider supplementing up to 100mcg/day
  • - eat oily wild-caught fish multiple times a week (canned salmon is a less expensive source)
  • - eat green leafy vegetables to supply nitrates for NO production
  • - consume at least 200mg of vitamin C a day from food and supplements
  • - have impeccable dental hygiene; periodontal disease is strongly linked to heart disease (brush and floss daily and thoroughly, don’t eat sticky carbs and acidic juice, chew xylitol gum, consume fat soluble vitamins [D, K2, A], and see a dentist on a regular basis — I’ll do a detailed post on this topic in the coming months)

Did I miss anything? May you all live long and prosper!



What Your Doctor Is Not Thinking About (Dragging Medical Professionals Into the Modern Era)

Wednesday, February 29th, 2012

Today we feature a new article from, JD Moyer of the blog Systems for Living Well:

The other day I came across this alarming video of what it’s like to drive in Poland. My first thought after watching the clip was “What’s the Toxoplasmosis gondii infection rate in Poland?” T. gondii is a brain parasite easily acquired from eating undercooked meat, or contact with cats, and is associated with a six-fold increase in traffic accidents (this association has been replicated a number of times, in different countries). Well, I looked it up, and found that the latent infection rate in 2003 was around 41% (at least among pregnant women). That’s quite high — in the U.S. the infection rate is only about 11%.


Is there anything to my hypothesis that terrible driving in Poland is related to the relatively high T. gondii infection rate? Probably not. The accident fatality rate in Poland is relatively high for a modern industrialized country. But France has a very low accident fatality rate, and a much higher rate of T. gondii infection. So while T. gondii might be a contributing factor, it’s probably not the most important variable.

I’m fascinated by latent/chronic biological infections, and how they affect human health and behavior. T. gondii in particular is linked to changes in personality, and even schizophrenia.

What’s shocking to me, as shocking as the driving in Poland video above, is that so few medical professionals are considering latent infections as part of their diagnostic process. The research is here, and so are the diagnostic tests. So why aren’t medical professionals taking advantage of them?

The Future Is Here, It’s Just Not Evenly Distributed -William Gibson

The above quote definitely applies to the medical profession. How many general practitioners are doing the following?


  • a detailed dietary questionnaire (cost: $0, benefits: insights into common subclinical nutritional deficiencies, including vitamins C, D, B12, K2, magnesium, iron, zinc, copper, and chromium, as well as information re: macronutrients — is the patient eating enough protein and omega-3 fatty acids? or consuming too much fructose/sucrose/alcohol?)
  • a personal genetic profile (cost: $200, benefits: insights into disease risk for common health problems, and precise genotype information re: less common genetic conditions)
  •  antibody testing for a full range of common viral infections (HSV1, HSV2, CMV, HPV, etc.) (cost: a few hundred dollars, benefits: insight into diseases that are linked to multi-decade viral infections, including heart disease, dementia, many types of cancer, etc.)
  • an enterotype panel

I’m hoping that in ten years or so, the above practices will be commonplace. Spit in a tube, piss in a cup, prick your finger, and twenty minutes later get a full genome analysis, a full spectrum nutrient level analysis, a metal and chemical toxicity report (lead, mercury, bisophenol-A, etc.), an extremely wide antibody report (for hundreds or thousand of viruses), a complete bacterial panel (blood, gut, and mouth), testing for protozoan parasites like T. gondii, etc.

Why isn’t this happening already?

Gibson didn’t anticipate cheap genome sequencing.

In some cases cost is prohibitive. While a genome SNP test has come down to $200, micronutrient testing like the kind Spectracell offers is still quite expensive. I suspect that we’re on the cusp of (or in the midst of) a rapid advance in portable diagnostic technology, so testing costs may change quickly. It remains to be seen how quickly HMO’s will take advantage of the new technologies as they come online.

Another reason is that your doctor isn’t necessarily thinking along these lines, because when she was in medical school, you couldn’t get an accurate micronutrient panel, or a genome analysis, or an enterotype panel. These tests just weren’t available.

Educate Yourself, Test Yourself, Take Preventative Measure

It’s irritating to me that the medical profession hasn’t caught up with medical research and diagnostic technology. For most people, it’s probably worth taking the following diagnostic and preventive measures:

  1. If you can afford it, get a full micronutrient profile from Spectracell or another reputable vendor. I’m putting this at the top of my list because I haven’t actually done it yet (but I’m going to). At the very least, get a vitamin D test. If your levels are suboptimal, you’ll probably need to supplement, and also consider vitamin A and K2 levels.
  2. Get your genome analyzed, from 23andMe or a similar service. Find out what your risks are. One way to think about it is that reading your genome is like reading your death sentence. Another way to think about it is that reading your genome will give you possible clues into improving your quality of life, and possibly extending your life for a decade or more if you take the appropriate preventative measures.

What about prevention? Some measures are common sense. Others, like implementing a general viral suppression protocol, perhaps less so.

  1. Diet – get most gluten, casein, fructose, and refined vegetable oil (canola, corn, soy) out of the diet to drastically reduce your risk of IBS, autoimmune diseases, heart problems, and diabetes. Eat nutrient dense whole foods, mostly those available during the paleolithic era (for which we are genetically best-adapted to). This would include seafood, grass-fed meat, eggs from free-roaming birds, vegetables, low-sugar fruits, and nuts/seeds. For the research, please see Mark Sisson’s site.
  2. Reduce your carcinogen/toxin load (lead, mercury, bisphenol-A, air pollution, tobacco, hard alcohol, narcotics) to reduce risk of cancer, reproductive, and neurological problems.
  3. Ramp-up autophagy (clean out cellular debris) with both intense exercise and intermittent fasting. This will help ward off cancer, dementia, and suppress chronic viral and parasitic infections (which we all have after age 2 or so, unless we live in a bubble).
  4. Consume chemicals that kill cancer cells and interfere with viral replication. A short list would include curcumin (turmeric/yellow curry), garlic, resveratrol/grapeseed extract/red wine, and coconut oil. The links all go to research or articles about research.
  5. Reduce artificial light in the evenings to encourage natural sleep patterns. My post about giving up artificial light for a month has seen a spike in traffic since this recent BBC article (I was also on The Doctors about a month ago discussing the experiment).

I think the clinical research is there to back up all these claims. But are you going to get any of this advice from your doctor? Probably not. Your doctor is going to tell you to eat a low fat diet, but won’t distinguish good fats (olive oil, coconut oil, fats from grass-fed meats and wild fish) from bad fats (refined vegetable oil, fats from grain-fed animals). He will probably not mention vitamin D, vitamin K2, or the beneficial effects of polyphenols and flavonols. Your doctor is going to ask about your family history, but he’s not going to recommend that you actually look at your genome. Sugar and carbohydrate consumption won’t be mentioned unless you already have diabetes. Viral infections won’t be identified unless they have very specific symptoms (like chicken pox or cold sores), and no recommendations will be made to suppress chronic viral infection to prevent cancer or dementia twenty or forty years later.

I’m not against going to the doctor, or taking medical advice from someone who is better educated and informed than myself. But we should push our medical professionals. We should drag them (even if they protest, kicking and screaming) into the modern era.

The future is here … please help spread it around.

To Bean Or Not To Bean, That Is The Question (Legumes, Lectins, and Human Health)

Tuesday, January 31st, 2012

Today we feature another blog post form our first guest contributor, JD Moyer of the blog Systems for Living Well:

These days, many people across the world are wondering if they should eat beans, or not.

Right now, this very minute, there are two powerful, but opposing, dietary trends speeding towards a potentially explosive head-on collision.

On the one side the paleolithic (or “Stone Age“) style of eating, a dietary/lifestyle system that eschews grains, legumes, sugar, and all processed foods in favor of quality meats, poultry, fish, vegetables, fruit, and healthful fats.  This is the anti-bean side.

On the other side is the fad-diet du jour, Tim Ferriss’s “slow-carb diet” as described in the bestselling The 4-Hour Body.  Ferriss unabashedly recommends legumes.  Indeed, he suggests eating beans or lentils with every meal (but forbids grains, fruit, and dairy products — except on the once-per-week “binge day,” during which all foods are allowed).

Ferriss must be acknowledged as a cultural force in his own right; he is a master marketer with legions of supportive blog readers (myself among them).  His efforts have propelled both of his books to the #1 spot of the New York Times nonfiction bestsellers list.  He has recently appeared on both The View and Dr. Oz pushing his slow-carb diet, sleep gadgets, and anatomically precise better-sex tips.

Especially among the California/Silicon Valley/San Francisco/young techy professional set, 4-Hour Body is extremely influential.  Just the other night at Ignite SF, a friend mentioned she was “going home to eat some beans.”  When Ferriss says eat beans, people eat beans.  Ferriss constitutes the current vanguard of the pro-bean side.

Before we evaluate the evidence for and against legumes, let’s see who all is taking sides:

Pro-bean Anti-bean
Tim Ferriss (4-Hour Body)
Dan Buettner (Blue Zone)
Andrew Weil (
Pythagoras (Ionian philosopher)
Loren Cordain (The Paleo Diet)
Robb Wolf (The Paleo Solution)

Each link goes to a discussion of the health advocate’s recommendation for or against legumes.

Other health gurus take a more nuanced stance.  Mark Sisson, from whom I take my own dietary cues, is generally against eating beans and legumes, but acknowledges possible health benefits from eating nattō (a fermented soybean paste with is extremely high in vitamin K2).  PāNu blogger Kurt Harris, M.D., another advocate of the paleolithic diet, suggests eliminating beans but gives it a low priority (#11) on his 12 steps to improving health.

The Evidence Against Beans

Contrary to conventional dietary wisdom, paleo diet advocates say you should NOT eat beans.  Why not?

1.  Beans are hard to digest (the musical fruit).
Beans that are not properly soaked, drained, boiled, drained-again, and slow-cooked can result in severe digestive stress.  Even under the best of circumstances, beans can you make fart more.

2.  Beans can aggravate auto-immune diseases.
All legumes (beans, but also tofu, soy-milk, peas, lentils, and peanuts) contain lectinsSome of these lectins are implicated in IBS, Crohn’s disease, arthritis, multiple sclerosis, peptic ulcers, allergies, and Type 2 diabetes.

3.  Beans are high in starch and carbohydrates.
Beans are a starchy food, high in carbohydrates.  Eating significant amounts of beans may interfere with weight loss.

4. Beans contain estrogen mimics, which can be harmful to health.
Beans, especially soybeans but also fava beans and other beans, contain phytoestrogens — weak estrogen mimics that can interfere with hormone function.  Phytoestrogens evolved in plants as a defense mechanism, a way to disrupt the reproductive success of predators.  Red clover (a legume) has been shown to disrupt reproduction in animals.

Male infants and toddlers are probably the most vulnerable to the negative effects of a high legume diet, as is discussed in this article by Kaayla Daniel of the Weston Price Foundation.  From the article:

Every week I get agonized letters from parents who fed their sons soy infant formula and who report estrogenized boys who are flabby, lethargic, high strung and/or embarrassed by breasts and underdeveloped genitals.   These parents want to know, “What can we do now?”

Disturbing.  Do not feed your infant soy formula.

5. Beans can shrink your brain.
An even more heinous side-effect of eating soybean products frequently may be brain shrinkage.

I kid you not.  One study looked at autopsies of nearly 4000 Hawaiian men, and compared brain weight results with dietary habits.  The men who had eaten the most tofu and soy had smaller brain sizes and a higher chance (more than double) of developing Alzheimer’s disease.  The linked article mentions a possible mechanism; phytic acid in soybeans interferes with vitamin B12 absorption (which is independently associated with brain shrinkage and dementia).  In most beans, phytic acid can be greatly reduced by soaking, draining, and boiling, but soybeans retain high amounts even when cooked.

6. Lentils might make you fat.
Tim Ferriss recommends eating generous portions of legumes as a part of his “slow carb” weight loss diet.  In The 4-Hour Body he mentions lentils as being one of his favorite legumes.

But can lentils make you fat?  There is some evidence that the lentil lectin binds weakly to the insulin receptor, setting cells to “always on” for fat production.  That’s Peter J. D’Adamo’s hypothesis in Eat Right For Your Type.  Though many of D’Adamo’s ideas are speculative and not supported by the evidence, he should at least be credited with bringing lectins into the public consciousness.

7.  Many brands of canned beans have bisphenol A in the can lining.
People who eat beans don’t necessarily have the time or inclination to properly soak them, drain them, boil them, drain them again, and then slow-cook them.  Canned beans are the logical alternative to time-consuming preparation.

The problem with canned foods is that the plastic can linings often contain bisphenol A (BPA), a powerful endocrine disruptor.  BPA is strongly associated with heart disease, prostate cancer, breast cancer, miscarriage, erectile dysfunction, and abnormal reproductive development in children.  We should all be staying away from the stuff.  For most people, canned food, soda, and plastic bottles/cups are the main sources of BPA.

Trader Joe’s states that their canned beans are BPA-free (though their canned tomatoes and soups do contain BPA).  Eden Organic beans are also BPA-free.

The Evidence in Support of Beans

1.  Beans are high in protein and fiber.
Not everyone enjoys a high-meat diet.  For people who prefer to not consume animal protein at every meal, beans provide a decent amount of protein.  Because they’re high in fiber, they’re also quite filling.

2.  Beans provide a steady source of glucose for energy.
Consuming high amounts of fructose (the sugar found in fruit, corn syrup, and agave nectar) is associated with gaining belly fat, poor insulin sensitivity, increased risk of heart disease, and higher LDL levels.  Table sugar is not exempt — sucrose is half glucose and half fructose.

Ferriss recommends eliminating fructose entirely (except on cheat days), and using legumes as a carbohydrate source.  The starch in beans breaks down into glucose.  Too much glucose can still make you fat, but the fat will be subcutaneous (under the skin) fat, which isn’t associated with disease as much as abdominal fat.

Ferriss claims his “slow-carb” diet has a high rate of compliance, and that one reason for this is the steady energy provided by legumes.  It’s true that switching too quickly to a low-carb diet can result in energy crashes; the body needs a few weeks to adjust to using different kinds of fuel (including dietary fat, stored body fat, glycogen, and even lactic acid).

However, most “carb withdrawal” has nothing to do with blood sugar levels.  Except in cases of diabetes, the body regulates blood sugar within a tight range, via insulin and glucagon.  Most “carb withdrawal” symptoms are in fact exorphin withdrawal symptoms.  Beans, which do not contain food opioids, will not protect you from the aches, fatigue, and flu-like symptoms some people get when giving up wheat and dairy.

3. Beans are high in folate and iron, and have appreciable amounts of magnesium, manganese, copper, selenium, molybdenum, and antioxidants.
Beans are not nutritionally empty.  Depending on the legume, beans can provide decent amounts of a few vitamins and many minerals.

As for the anti-nutrients, phytic acid and lectins, most can be soaked/drained and cooked out.  If you don’t mind having a frothing bowl of beans on your counter (I do), then you can effectively remove most of the anti-nutrients.  Soaking is most effective for getting rid of phytic acid, and boiling is most effective for reducing lectin levels.  Do not slow-cook beans without boiling first.  Slow cooked kidney beans and red beans (often in the form of chili) lead to dozens of cases of lectin poisoning in the U.S. every year.

4.  Beans are associated with reduced risk of colon cancer.
If the evidence holds up, this is a pretty big win for beans.  Colorectal cancer is a relatively common, very serious disease (second only to lung cancer in lethality).

One clinical trial that looked at over 2,000 adults with precancerous colon polyps found that those people who ate more beans over a four year period had fewer “advanced” polyps and less cancer.  Those that increased fruit and vegetables in their diets, but not beans, did not enjoy the same protective effects.

If eating beans actually does reduce the chance of colorectal cancer, what’s the mechanism?  One theory is that the nondigestible carbs in beans are broken down (by gut flora) into the short-chain fatty acid butyrate, which has anti-inflammatory and anticancer properties.  Various phytonutrients in beans may act synergystically to prevent cancer in other ways.

One interesting possibility, for which there is strong evidence, is that a lectin in broad beans forces colon cancer cells to differentiate.  Could it be that not all lectins are bad?

Beans vs. Meat

I think some members of the “paleo community” are guilty of unsophisticated categorical thinking (meat is GOOD — grains & beans are BAD).  Instead of looking at the evidence regarding specific foods and the possible benefits of drawbacks of those foods (from all perspectives, including health effects, ease of preparation, taste and culinary possibilities), they eliminate entire food groups and exalt others.

Take bacon, for example.  Love for bacon has reached fetishistic heights among paleo bloggers.  Mark Sisson and Kurt Harris are both on the pro-bacon bandwagon (otherwise, I agree with 90+% of what both these guys recommend).  This salt and nitrite-laden meat-product is delicious, but please don’t try to claim that it’s good for you.  Processed meats (including bacon) are implicated in colon cancer and other diseases.  While saturated fats are not to be feared, nitrites, and to a lesser extent salt, should be.

Unprocessed red meat may also slightly raise the chance of colon cancer, but the risks are less than those incurred by obesity or lack of exercise.  And before you smack me in the face with your copy of The China Study, please read this detailed critique by nutrition blogger Denise Minger.

Maybe the solution is to eat some beans with your bacon.

Beans vs. Fruit

Back to fructose for a minute — Ferriss’s book recommends cutting out all fruit.  While it makes sense to limit fructose, let’s consider how many blueberries a person would have to eat to get the same amount of fructose delivered by a regular 12oz can of Coke (36g carbs mostly from HFCS).  By my rough calculations, that’s about the same as two cups of blueberries.  Three whole grapefruit would also do it.  I really don’t see a good reason for not eating half a cup of blueberries or a half grapefruit with breakfast — it’s just not that much fructose, and both fruits are high in vitamins and other phytonutrients.  On the other hand, a large banana, or 12oz of orange juice, delivers about as much fructose as the can of soda.

For steady weight-loss, Ferriss may be on to something when he recommends beans over fruit.  But you’ll probably get the same benefits if you eat some beans and some less-sweet fruit (tart apples, berries, grapefruit, kiwis, etc.).

The Bottom Line — Who Should Eat Beans

The way I see it, there’s no reason to fear properly cooked beans.  There is also no reason to force yourself to eat them.

If you don’t like beans, but still want to avoid colon cancer (who doesn’t?), there are many ways to reduce risk.  Stay lean, exercise regularly, don’t eat processed and cured meats, keep your vitamin D levels high, and eat broccoli, cauliflower, and cabbage.  Raw sauerkraut may be especially beneficial.

Nobody should eat large amounts of soy, in any form, though tiny cubes of tofu in miso soup won’t hurt you.  Red beans and kidney beans are risky unless you know how they’ve been prepared.  Canned beans may come with an unwelcome dose of BPA.

Anybody who has Crohn’s, ulcerative colitis, IBS, multiple sclerosis, or arthritis should avoid beans.  Lectins can tear up the intestinal lining, causing “leaky gut.” Leaky gut, in turn, leads to autoimmune problems.  In terms of lectins, dairy products, grains, peanuts and nightshade vegetables (tomatoes, potatoes, eggplant, peppers), are potentially as problematic as beans.

Beans and lentils aren’t an ideal fat-loss food unless you get lots of exercise, both because of starch content and possible lectin-insulin problems (at least with lentils).  But properly prepared (soaked, drained, boiled, and slow-cooked) beans are probably a better choice than bread or bananas.

For many people, one of the joys of the paleo diet is that they don’t have to eat beans (or oatmeal, or any of a long list of bland, boring foods).  Conventional wisdom (and Tim Ferriss), push beans as a kind of wonder food, but that’s just not the case.  You don’t have to eat beans to achieve vibrant health.  Many people, like this woman, respond very well to cutting out both grains and beans, but keeping some fruit in the diet (Mark Sisson’s “primal” diet).

Food Avoidance and The Great Carb Debate

I’m fascinated by how food affects health, but I also just enjoy eating.  I hope to never get cancer or heart disease, but chances are very good that something will kill me eventually (ideally it will be something exciting, like a genetically engineered dinosaur, or a falling disco ball, or lightning, or an orgy).  Dying from complications due to eating too many lectins, gluten, nitrites, or fructose does not strike me as a good way to go out, so I try to limit my intake of those substances.

I do eat beans once in awhile, usually canned pinto or black beans from Trader Joes, or white butter beans in a salad.  If I go out to Mexican food I’ll usually eat some meat and refried beans but skip the tortillas and rice.

Dr. Kurt Harris writes the popular Archevor blog.

I agree with Kurt Harris that consuming some carbs is easier on the body than consuming zero carbs or lots of carbs.  Going into ketosis now and then won’t hurt you, but long-term ketosis can deplete calcium and selenium, give you bad breath, cause a metallic taste in the mouth, and lead to mental dullness and sluggishness.  It’s easy to stay out of ketosis by consuming some carbs.  Wheat products, syrups, desserts, and sweet fruits are not ideal choices.  Vegetables, berries, properly cooked beans, and even dark chocolate are good choices.  Some rice is probably also fine for people who exercise a great deal.

I find the whole notion of avoiding carbohydrates altogether to be faintly ridiculous … somewhat akin to avoiding nitrogen or carbon.  Avoiding a specific class of chemicals, like lectins, makes more sense, but even then you may be throwing out the baby with the bathwater.  Some lectins may be good for us.

On the whole, I agree with the premises of the paleolithic diet — we’ll be healthier if we eat high quality meats, poultry, fish, eggs, vegetables, and nuts than if we eat “neolithic” foods (processed foods, sugary desserts, grains and legumes, fruit juice, etc.).  What I’m skeptical of is the idea that observing any set of dietary rules strictly will make us healthier.  We did, after all, evolve to be adaptable creatures, with a robustly flexible digestive system.  We’re more like rats than we are like panda bears (who eat only bamboo), koala bears (who pretty much just eat eucalyptus), or lions (who just eat meat).

On the other hand, I’ve noticed that my enjoyment of food has only increased with a slightly more restrictive diet.  The less sugar and fruit I eat, the sweeter all food tastes.  Same thing goes for salt.  Our palate can quickly adjust to a new “normal.”  And since I’ve cut out grains for the most part, I eat a much wider variety of meats and vegetables, mostly cooked in pastured butter.  It all tastes damn good.  A more restrictive diet doesn’t necessarily correspond to less enjoyment of food.

J.D. Moyer blogs at about health, nutrition, psychology, self-improvement, creative work, and “systems for living well.”

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