Understanding Diet Issues

Disclaimer & acknowledgements: This information is based on information Dr Andre’ Hugo has obtained from the literature listed below. It is shared because of his concern for the epidemic of obesity and associated poor health, which is becoming a feature of our society.

Dr Hugo does not claim to be an expert in the field of nutrition - anyone who follows this advice does so at their own risk. Prior to taking this advice, everyone, and especially people with compromised health, should consult their doctors or dieticians.

BASIC PHYSIOLOGY OF DIETING

The only healthy way to reduce weight & keep slim and healthy is to keep your blood insulin levels low (1- 11)
To keep blood insulin levels low one must restrict carbohydrate intake (even low GI carbs) to 20-50 g per day, because carbohydrates trigger high blood insulin levels and insulin keeps fat trapped in the cells (4)
Carbohydrates, especially refined carbohydrates, sugars and fruits are the main cause of high insulin levels. The more refined and sweeter they are the more insulin is secreted (1- 11)
High blood glucose is toxic to all organs, not least the brain and excess glucose results in inflammation and produces excessive & damaging free radicals in our tissues (12)
Even before you eat (especially carbohydrates), the blood insulin level is raised in anticipation to protect your brain from too much glucose (1)
Insulin removes this excess blood sugar (glucose) from the blood, partly by trapping glucose in fat cells and this makes you fat (2)
Hormone dependant lipase (HPL) can extract glucose out of the fat cells for energy, but only in the presence of low insulin levels in the blood so to burn fat insulin levels must be kept low (2)
Carbohydrates do not suppress the hunger hormone ghrelin and also do not trigger the satiety hormone leptin, so you tend to overeat on carbohydrates (2)
Carbohydrates do not give you lasting energy – they steal your energy and make you tired and ill from diabetes (3)
Carbohydrates especially sugars are addictive – they attach to the same receptors in the brain as cocaine and heroin (3)
Like all addictions, often the best way of recovering from them is to go “cold turkey” – so no carbs at all while losing weight (except minor amounts found in green, leafy vegetables ie. those growing above ground) (8)
Even yellow vegetables like corn, butternut etc should be restricted. Small amounts of carrots and pumpkin are fine because they have a lower carbohydrate content.
One should eat lots of green leafy vegetables like spinach, broccoli, cabbage etc (4)
Tim Noakes provides 3 very useful lists of foods: A list of those which are beneficial and can be eaten freely (green list), another list for those which should be limited and their carbohydrate content monitored (Orange list) and also a list of foods that should be avoided (Red list) because they are toxic or very high in carbohydrates (4)
A similar and very informative list is provided by Dave Asprey in the Bulletproof diet (6)
Fruit spikes your insulin levels more than any other food – insulin then drops your blood sugar and you feel hungry. The only fruits you should eat every day are 1 small avocado and up to 4 tomatoes per day
Interestingly, tomatoes are more beneficial when sautéed in grass fed animal fat or organic butter, because this makes the anti-cancer agent lycoprene in tomatoes more biologically accessible (4)
Dairy contains quite a lot of carbohydrates (about 33%) and is one of the most common food allergies/intolerances – so, to lose weight, eliminate milk and yoghurt, and don’t have too much cheese (3)
Unfortunately anything sweet spikes your insulin so drinking sweet tasting diet drinks or using sweeteners in your tea and coffee, are no help at all and even if they have no calories, they disrupt your metabolism and make you fat (1)
Only drink when thirsty (5). Drink sparkling or still water during the day, and, in the evening, make your sparkling water more interesting with, for example, low cal lem-lime (not sweet), a slice of lemon, lots of ice and a strip of lemon grass
If you drink tea (rooibos is better because it contains anti-oxidants) or coffee, have these without sugar, sweetener or milk for 1 week, and you will probably prefer always to drink it this way. No more than about 4 cups per day of either. Drink decaffeinated coffee after lunch to make sure you have 8-9 hours (3) sleep a night.
Bulletproof coffee for breakfast containing a tablespoon of organic grass fed butter (eg Kerrygold) and a tablespoon of coconut cream or Medium Chain Triglyceride oil is an excellent way to start your day – This gives you an energy boost and keeps hunger away (6)
All alcohol is high in calories and also disrupts your satiety centre – This includes white alcohol and dry wine. Once you have reached your goal weight, enjoy no more than one small glass of wine (125 ml) with your food (4)
Spirits like whiskey, vodka and gin contain no carbohydrates so are not fattening but they are still toxic and disrupt your satiety centre and should be avoided or restricted (4) to no more than one tot per day
Alcohol should not be taken every day as it inhibits the uptake of vitamin B12 which is necessary for the maintenance of a healthy nervous sysem
Some people who are at their ideal body weight, have optimal health & do not have insulin problems can eat moderate amounts of carbs and fruits (50 -100g per day)
Calorie counting is not important. If you don’t eat carbohydrates you will not be hungry so you will not eat too much
Calories are not equal. 2000 calories of carbohydrates a day for example could make you fat but you could lose weight on 2000 calories of fat and protein
There are no essential carbohydrates so you will not suffer any nutritional deficiencies by eliminating them from your diet (3)
There are however essential amino acids obtained from protein and essential fatty acids obtained from animal fats(3)
In the early 1990’s, the National Institutes of Health undertook the largest most expensive diet trial ever done namely The Womens Health Initiative (WHI), which showed that after 6 years on a low fat diet in a sample of 49 000 women, there was no beneficial effect on heart disease, stroke, breast cancer, colon cancer, or, for that matter, fat accumulation. In fact there was no observable beneficial effect at all when eating less total fat and saturated fat, and replacing fatty foods with fruits, vegetables and whole grains
Between 1943 & 1952 Stanford, Harvard & Cornell Medical Schools independently published their diets for obese people, recommending that carbohydrates should be avoided but not limiting amounts of meat, fish, birds, all green vegetables, eggs and fruit (excluding grapes & bananas) – These guidelines are now generally accepted but limiting the fruit intake because of the high fructose (sugar) levels in fruit
In spite of these recommendations the USDA adopted the Food pyramid in 1997 (1) which promoted as the healthy way to eat, a diet with largest lower 1/3 of the food pyramid being carbohydrates, the middle third fruit and vegetables and the smallest, upper 1/3 proteins & fats
Most of the medical world bought into this fallacy, resulting in ever increasing levels of obesity, heart disease and cancer (1). The basic message of Atkins in 1972 (Dr Atkins’ Diet Revolution) has been proven to be correct and numerous studies notably one by researchers from Stanford university in 2007 have proved that eating a diet high in protein and fat and low in carbohydrates is the best way to lose weight and keep it off (8)
The high carb diet has been amazingly profitable for fast food, soft drink and sports drink companies as well as sectors of the agricultural, medical and pharmaceutical industries. Unfortunately it has not been kind to our friends, family and co-workers (2,3)
Type 2 diabetes occurs because your cells are so used to receiving the signal from insulin to urgently remove glucose from the blood that they become resistant to the signal (insulin resistance) and the pancreas has to produce ever higher levels of insulin to protect your brain
Alzheimers and most cancers are associated with metabolic syndrome, obesity and diabetes and these are now thought to be caused by high blood sugar and high insulin levels - some researchers refer to Alzheimers as type 3 diabetes (1)
Living with constantly high levels of insulin causes the body huge stress - your body responds to stress by producing cortizol and chronically high levels of cortizol destroy your metabolism
High stress levels destroy your libido and fertility because cortizol production competes for the same hormone production pathways that produce sex hormones
Insulin also causes Sodium retention by the kidneys which causes high blood pressure
Insulin inhibits the excretion of urea so gout is commonly associated with metabolic syndrome
Cortizol and insulin work together to leach the Calcium from our bones, leading to osteoporosis. Some of this Calcium is excreted (risk of kidney and ureteric stones) and some is deposited in the lining of your arteries leading to atherosclerosis (hardening of the arteries) (3)
Calcium supplementation is known to increase the risk of stroke and heart attack but magnesium supplementation is better because magnesium works synergistically with calcium reducing the calcium requirement. Magnesium also relaxes constricted arteries, lowering blood pressure while providing the right building materials for healthy bone (3)
Poor sleep (less than 6-8 hours) stimulates the hunger hormone ghrelin (1)
Keep your sleep cycle normal: You must have a pitch-dark room so that your body can form melatonin, which enables sleep.
You should have a naturally higher cortizol level in the morning, to get you up and hyped for the day (aided by caffeine). Cortizol naturally drops to medium levels by mid-day, dropping to low levels at night. Stress, insulin and keeping irregular hours disrupts your sleep and spike belly-fat creating cortizol (11)

PROTEIN AND FAT

The good news is that you can eat almost as much protein and fat as you want - but not transfats like sunflower oil and margarine
Protein and fat trigger the satiety hormones leptin and suppress the hunger hormone, ghrelin. Protein and fat are therefore appetite-suppressants so it is difficult to overeat. Because of their slow sustained energy release proteins and fats do not spike your insulin levels (1-8)
Eating animal fat even lard actually lowers your blood cholesterol and increases the good cholesterol fraction (HDL & fluffy type LDL) but only if you do not eat also eat carbohydrates (1)
Eliminating carbohydrates to lose weight is not a new concept. In 1861 a Harley Street surgeon Mr William Harvey successfully treated a corpulent London undertaker, Mr William Banting with a low carbohydrate diet
The Harvey/Banting diet was well recognized as the effective way to lose weight that in time it was introduced into the English language: The term to ‘bant’ refers to the use of the low carbohydrate diet for weight loss
In 1918 a New York cardiologist, Dr Blake Donaldson, successfully used this approach to treat 17 000 obese patients. This approach was accepted as common knowledge from 1920’s until the 1960’s when the focus shifted to the fatty (cholesterol) accumulations lining the coronary arteries of heart attack victims (during post-mortem examinations)
Dietary fat was mistakenly blamed for these fatty arterial plaques and low fat diet became an obsession, promoted by medical world and the United States Department of Agriculture (USDA) - However, it is now known that it is the carbohydrates in our diet which raise our cholesterol and not the fat
The Cochrane Collaboration assessed the value of eating less fat in 2001 and the authors concluded that there is only limited and inconclusive evidence of the association of dietary fat (total fat or saturated, monounsaturated, or polyunsaturated fats) on cardiovascular morbidity and mortality
Fats should be obtained from a diet with more or less equal quanties of good fats and so-called bad fats (7)
So called good fats are from plant and fish oils called unsaturated and polyunsaturated fats eg. Salmon, avocado and raw nuts.
Eat fish like hake, salmon, pilchards, sardines or shellfish at least once a week but large fish like tuna or swordfish no more than once a week because large fish like tuna have higher concentrations of mercury, which is toxic (3)
The supposedly bad fats are called saturated fats and are from animal products such as the fat on red meat & chicken, dairy products and a small amount in eggs
This good fat, bad fat concept has been discredited and even saturated fats with low toxin levels have been shown to be very beneficial. In fact fats are considered by authorities such as Noakes and Asprey to the preferred dietary source of energy (5,6,7)
Since toxins that animals are given (antibiotics and steroids) are concentrated in their fat, one should choose organic animal products and red meat should be from grass fed and grass finished animals to obtain healthy saturated fat in your diet (6)
A diet with only saturated fat which is not balanced with an equal quantity of unsaturated fat could cause the lipid layers in the nerve cell walls to become too dense for correct nerve function – the acetylcholine release into the synapse could be inhibited in some people, leading to disruption of nerve transmissions and leading to or aggravating conditions such as Huntington’s chorea and Multiple Sclerosis
A third category of fats are trans-fats which are artificial fats made by hydrogenating plant fats and are now universally regarded as extremely toxic eg. Margarine

CHOLESTEROL AND TRIGLYCERIDES

Blood lipids are referred to as either good cholesterol which is beneficial to cardiovascular health and bad cholesterol and triglyderides which are harmful (7)
Good blood lipids are HDL (High density lipids) and also the large fluffy component of LDL (low density lipids) (1) and a naturally high level of HDL is the most single most reliableindicator of longevity
Bad lipids are the small dense fraction of low density lipids (LDL) and triglycerides which both increase when eating a high carbohydrate diet (7) and these will cause high blood pressure and narrowing and hardening of the arteries
Surprisingly, eating any fats (except transfats) increases the good cholesterol portions and lowers the bad lipid portion (4,7) so healthy fats that we eat are good for us and should be the main source of energy in a healthy diet (4,7)
Be careful of foods labeled “low fat” as these invariably have a higher carbohydrate content which is more fattening and damaging to your health (8)
Avoid salad dressings even balsamic vinegar, as these are high in carbohydrates. Olive oil is possibly the only salad dressing which you should use while losing weight
Ketones are produced in the liver from fat that we eat and from fatty acids mobilized from our fat tissue. Ketosis is a natural state during the metabolism of fat with ketone levels before breakfast of 5mg/dl or the 5-10 mg/dl during a carbohydrate restricted diet. Mild ketosis is a desirable state since the brain and nervous tissues run more efficiently on ketones than they do on glucose
Ketoacidosis on the other hand is a pathological state as in uncontrolled diabetes with ketone levels exceeding 200 mg/dl
You should never experience hunger while losing weight. The best way to switch off hunger is to have 1-2 tablespoons of organic butter and 1-2 tablespoons of coconut oil, milk or cream in coffee (6)
The fat in organic butter and coconut oil, milk or cream are excellent sources of energy and if taken for breakfast keep your body in fat-burning mode (ketosis) (6)
MCT (medium chain triglycerides) oil is an extract of coconut oil and contains the more beneficial elements of coconut oil – a tablespoon of this can be added to the butter coffee mentioned above (6)
One can also snack on grass fed biltong and almonds, pecans, macadamias or small amount of cheese (if you are not lactose intolerant)

EXERCISE AND WEIGHT LOSS

People on a diet who are prescribed bed-rest lose more weight than people on a diet who are prescribed exercise (1)
People who spend an hour in the gym tend to be less active the rest of the day and are much more likely to reward themselves with food like a muffin - One and a half hours on the treadmill in the gym burns roughly the same amount of calories as the muffin
A hormone, LPL (Lipoprotein lipase) works to make us (and our fat cells fatter), whereas Hormone sensitive lipase HSL works to make us (and our fat cells) thinner
Insulin switches on LPL and switches off HSL and also works to create new fat cells
When you exercise LPL (lipoprotein lipase) decreases on our fat cells and increases on our muscle cells. This releases fat from our fat cells so we can burn it in our muscle cells. Unfortunately this reverses when we stop exercising and LPL activity on the fat cells shoots up to restock whatever fat they lost during the workout
After exercise we get hungry because the muscles crave protein after exercise to restock glycogen, fat and protein for rebuilding (1)
Exercise is essential for good health but generally exercise sabotages your diet, because it makes you hungry so don’t try to lose weight by exercising. As you lose weight you will naturally become more active
For those fortunate few, who can successfully exercise and control their appetites, will lose weight faster with exercise because as the muscle mass increases one burns more energy even when not exercising (3).
For optimal cardio-vascular exercise you should push your heart rate up to 85% of it’s maximum(220 beats per minute - your age). Intense exercise stimulates fat burning growth hormone and releases feel good endorphins.
A good general principle is that one should not embark on an exercise program that you are unable to sustain long term, because the muscle you build will turn to fat when you stop exercising. Exercise need not be strenuous, for many people 2 hours of Yoga per week, and a few kilometers of walking or cycling are sufficient to maintain reasonable body tone and this intensity of exercise is generally sustainable indefinitely. 20-30 minutes a day of walking has been shown to reduce heart attacks and stroke by as much as 30% (3,4).

INFLAMMATION AND DIET

High insulin levels increase the LPL activity on the fat cells especially those around the abdomen, so pre-diabetes, diabetes type 2 and insulin resistance make you fat
Fat accumulated around the intestines (omental fat) acts as an endocrine organ, producing hormones called adipokines. This contributes to metabolic disorder by leading to a chronic sub-inflammatory state that could play a central role in the development of insulin resistance and type 2 diabetes, and the increased risk of cardiovascular disease (12,13)
Metabolic disorder exists when an obese person has type 2 diabetes, insulin resistance and high blood pressure. When your metabolic disorder is cured, you will feel more energetic and you will be much more inclined to have some exercise
Many people with weight problems have got food intolerances so it’s safer to eliminate the major causes of food intolerances/allergies - these are grains, dairy and legumes. Nuts can also be a problem but most people with nut allergies know about them (3)
Leaky gut syndrome: Can be caused by food allergies, nutritional deficiencies, stress, stomach flu, antibiotics, and just about anything that irritates the gut lining. Leaky gut refers to an abnormal permeability of the stomach and intestinal wall, allowing incompletely digested proteins to enter the blood stream. These proteins trigger an immune response and increase the likelihood of additional food allergies (12)
It is a misconception that grains are necessary for normal gut motility or that carbohydrate restricted diets cause constipation – there is plenty of fibre in vegetables (3)
One of the features of our modern diet is a disturbance in the omega 3: omega 6 fatty acid ratio. This ratio should be 1:1-1.5 but our modern western diet results in a 1:6 ratio, because of the poor oils we ingest like sunflower oil and margarine (transfats) (3)
Grass fed beef has a good balance of omega 3 to omega 6 and lower levels of antibiotics and hormones. If you cannot get grass fed beef, don’t eat a lot of the fat and take omega 3 supplements (3)
There is growing evidence that a diet high in pro-inflammatory omega-6 fatty acids is largely to blame for a shift in the ratio between Th1 and Th2 immune cells causes increased production of IgE and certain cytokines, predisposing people to allergies (12)
Trans fats are extremely bad for you and are associated with heart disease and cancer – these are produced when good unsaturated fats are partially hydrogenated to extend their shelf life (cookies, crisps, cakes, muffins, doughnuts) or to make them solid at room temperature for eg margarine
Trans-fatty acids sit like cement in the body, clogging up arteries and impeding hormone production, and replacing good, necessary fats (Omega 3s and 6's) with something harmful. You can't do anything with trans fatty acid except burn it off as calories; basically, its function is to poison your system and generate abnormal biochemistry.
Inflammation from food allergies/intolerances is thought to play an important role in atherosclerosis, arthritis, IBS (Irritable bowel syndrome as in Crohn’s disease and Ulcerative colitis) and a host of other health problems (12)
When bacteria from the intestinal tracts of thin mice are given to obese mice, these fat mice become thin, triglycerides were lowered, insulin sensitivity was reduced by 300% and mitochondrial function was improved (6)
Eating butter from grass fed cows has been shown to increase the healthy bacteria in the gut – the beneficial substance in grass fed butter is butyrate and it has been shown to reduce inflammation and keeps toxins from penetrating the gut lining (6)

FASTING

Intermittent Fasting or Alternate Day Fasting is recommended by many people as being beneficial for weight loss and optimum health (17)
It works well to eat your meals within a 6-8 hour window (13:00 and then again at !9:00) and fast in between those hours
Dave Asprey has contributed a very useful addition to the concept of fasting. He advocates drinking so called bulletproof coffee in the morning so that one remains in ketosis without feeling hunger until your first meal of the day at 13:00 (6)
Fasting inhibits Insulin-Like Growth Factor IGF-1, which causes obesity, senility, aging & cancer (17)
Fasting stimulates phagocytosis, which speeds up repair & reduces inflammation (arthritis)
Fasting promotes BDNF (Brain derived Neurotropic Factor), which promotes the conversion of Stem cells to Nerve Cells in the Brain Stem & Hippocampus (improved learning @ memory) (17)
BDNF is also a feel good hormone, which is an anti-depressant (17)
Fasting + Exercise results in improved muscle protein synthesis & better anabolic response to post exercise feeding. Also results in a greater % of fat being burned instead of recently consumed carbohydrates (17)
Fasting triggers hormesis - when the body is exposed to the right level of trauma or toxins it responds at a cellular level by repair & strengthening by activating a stress response & switching on genes that protect & repair (17)
Fasting before chemotherapy slows down the metabolism of normal cells but not cancer cells so fasting increases the efficacy of chemotherapy drugs against a variety of cancers (17)
Cheat day: Tim Ferris believes that you should have a cheat day, the same day each week, when you can eat whatever you like. This has psychological advantages to counter feelings of deprivation for foods that you love (like fruit or even junk food). There are also physiological advantages because the basic metabolic rate slows down on a diet and according to Tim Ferris, cheat day elevates the metabolic rate to a higher level (10)

COMPLETE AND INCOMPLETE PROTEINS

An essential amino acid or indispensable amino acid is an amino acid that cannot be synthesized de novo (from scratch) by the organism being considered, and therefore must be supplied in its diet. The amino acids regarded as essential for humans are: histidine, isoleucine, leucine, tryptophan, lysine, methionine, phenylalanine, threonine and valine (Help In Learning These Little Molecules Proves Truly Valuable)
It is thought to be possible (although extremely difficult) to maintain good health on a vegetarian diet (4). A lot of knowledge and regular blood tests are necessary to ensure that you do not suffer nutritional deficiencies. Plant proteins do not contain the essential amino acids so these have to be taken by vegetarians as supplements
Pregnant or lactating mothers and growing children can almost certainly not thrive on a vegetarian diet and will invariably suffer from nutritional deficiencies, which could have dire consequences (4,6)
Cysteine (or sulphur-containing amino acids), tyrosine (or aromatic amino acids) and arginine are always required by infants and growing children. Essential amino acids are "essential" not because they are more important for protein synthesis or general homeostasis than the others, but because the body does not synthesize them. If they are not uptaken through diet, they will not be available for protein synthesis.
Arginine, cysteine, glycine, glutamine, proline, serine & tyrosine are considered conditionally essential, meaning they are not normally required in the diet, but must be supplied exogenously to specific populations that do not synthesize them in adequate amounts. An example would be with the disease phenylketonuria (PKU). Individuals living with PKU must keep their intake of phenylalanine extremely low to prevent mental retardation and other metabolic complications. However, they cannot synthesize tyrosine from phenylalanine, so tyrosine becomes essential in the diet of PKU patients (11)
The distinction between essential and non-essential amino acids is somewhat unclear, as some amino acids can be produced from others. The sulfur-containing amino acids, methionine and homocysteine, can be converted into each other but neither can be synthesized de novo in humans. Likewise, cysteine can be made from homocysteine but cannot be synthesized on its own. So, for convenience, sulfur-containing amino acids are sometimes considered a single pool of nutritionally equivalent amino acids as are the aromatic amino acid pair, phenylalanine and tyrosine. Likewise arginine, ornithine, and citrulline, which are interconvertible by the urea cycle, are considered a single group (11)
Monogastric animals (single stomach) such as primates, poultry, pigs, fish, dogs & cats cannot get all the amino acids they need vegetable matter, whereas Multi-gastric animals such as ruminants (multi-chambered stomachs) can get all their nutritional requirements from plants, but have to spend almost all day eating to do so (12)
Even other primates previously thought to be exclusively herbivorous such as Gorillas need to get protein from eating grubs and insects (13)
Scatophagia or Cropoghagia is another way that gorillas and chimpanzees augment their diets to improve the absorbtion of vitamin B12, protein from intestinal parasites and nutritive elements made available from the re-ingestion of seeds. By eating their own or the faeces of other gorillas or chimpanzees, they are effectively getting the enhanced digestion of a second stomach (13)

SOYA

Limit Soya consumption to no more than 25 g per day, since higher levels have been shown to be associated with hypothyroidism. So Soya, which was previously recommended as a good source of protein for vegetarians, should only be eaten in moderation (1 soya patty is 80g)
Soy is a phytoestrogen, and therefore acts in the body much like a hormone, so it's no surprise that it interacts with the delicate balance of the thyroid's hormonal systems. High consumption of soy products are also proven to cause goiter (7)
Soya is 30 percent protein by volume but incomplete, whereas fishmeal is 52 percent protein and complete

FLY LARVAE

The fish and krill of the oceans are being depleted at an alarming rate to satisfy the human population explosion – 204,000 more people sit down for supper each evening each needing their RDA of 46-56 grams of complete protein which is equivalent to one small steak or tin of tuna
Fish farming needs 2.3 kg of wild-caught fish to produce I kg of farmed fish, only 30% of which is consumed by humans – the rest ends up as waste
About 30% of wild caught fish ends up in pet food or being fed to chickens, pigs, prawns, shrimp and other fish
In 2006 it took one litre of diesel to catch one kg of fish. Now it takes 2 litres of diesel and our global fishing capacity is 4 times greater than is sustainable
The larvae of the humble housefly, Musca domestica is now being farmed on an industrial scale by AgriProtein Technologies in the Western Cape
Rearing fly larvae on waste nutrients, effectively recycling them into high-quality natural feed – it is what chickens in the field and fish in the streams naturally eat
In due course the fly will join fish, pigs, chickens, sheep and cows and the 6th and most numerous industrially farmed animals on the planet.

USEFUL MEASUREMENTS

Body mass index: Weight in Kg divided by length in metres squared. A value of 25+ indicates that you are overweight (ideal weight plus 10%) and a value of 30+ says you are obese (ideal weight plus 20%) (1). BMI doesn’t account for all body types – heavily built muscular individuals will be incorrectly indicated as overweight
Waist to hip measurement: Take the average of 3 measurements of the narrowest part of your waist usually above the belly button and divide it by the measurement around your hips. In males this should be 0.9 with 0.95+indicating a weight problem. In females this should be 0.7 with 0.8+ indicating a problem (1)
Absolute waist measurement: Regardless of your build, you are considered obese if you have a waistline measurement of 100 cm or more
Height to waist measurement: The most reliable indicator of body mass – If any man or woman has a height less than twice his/her waist measurement they are deemed to be overweight (3)

SUPPLEMENTS

Age and sex specific multivitamins: Dave Apsrey however believes that these do not contain enough of the nutrients we need. See link below for his recommendations.
Vit D: Even though we live in a sunny country, we avoid the sun because of skin cancer concerns and most of us are severely vitamin D deficient.
Vit D is critical for a host of metabolic functions like Fat metabolism, cancer prevention, autoimmune control, fertility, cardiovascular disease, has an anti-inflammatory action and counters insulin resistance & diabetes types 1&2
Vit D deficiency has been shown to play a role in almost every major disease and is a possible trigger for Multiple Sclerosis
Vit D test: Correct test is called 25 OH(hydroxy) vitamin D. Range for optimum health is 50-80 ng/ml.
Vit D3 dosage: - Above 45 ng/ml take 2000 IU daily if fair & get more sun, but 4000 IU daily if older, darker and get less sun - 35-45 ng/ml: 5000 IU of vit D3 daily for 3 months under doctor’s supervision then recheck - Less than 35 ng/ml: 10 000 IU of D3 daily for 3 months under your doctor’s supervision then recheck
Vit D is best taken in the morning (6).
Omega 3 fatty acids: Most of us need at least 1000mg per day to restore the Omega 3: Omega 6 ratio. Our diets are too high in Omega 6.
Age and sex related hormone supplements may be recommended by the appropriate medical pracitioner

Dave Asprey has very comprehensive advice on supplements and believes almost everyone should take the first ten nutrients in the list below (6)

1. VITAMIN D

Role in Health: Acts on over 1000 different genes, substrate for testosterone, oestrogen and growth hormone, regulates immune function, inflammation & calcium metabolism
Sources: Cod liver oil has vitamin D and humans can produce enough of it if we are naked in a hot climate
Recommended form: D3 or Calciferol
Daily Dose: D3: 1000 IU/ 12 kg body weight so 6000 IU for 70 kg person
Calciferol: 1 tab weekly equiv to 50 000 IU
When to take: Morning
SA Brand: D3: Solal
Calciferol: Lennon Strong (script required)
Recommended Form: Calciferol
Dose: 1 tab weekly equiv to 50 000 IU
When to Take: Morning
Brand: Lennon Strong (script required)

2. MAGNESIUM

Role in Health: Plays a role in over 300 enzymatic processes. Deficiencies cause heart arrhythmias, tachycardia, headaches, migraines, muscle cramps, nausea, metabolic syndrome, cardiovascular disease, diabetes, asthma, anxiety disorders, and PMS
Sources: Due to soil depletion and poor farming practices, it’s almost impossible to get enough magnesium from your diet
Recommended Form: Citrate, malate, glycinate, threonate, or orotate
Dose: 600-800 mg per day
When to Take: Before bedtime
Brand: Slow Mag capsules

3. VITAMIN K2

Role in Health: Vitamin K2 is a fat soluble vitamin involved in calcium metabolis, strengthens bones & prevents atherosclerosis and heart attacks.
Sources: Grass fed meat & raw (unpasteurised) milk. Grass-fed ruminants like cows & sheep convert K1 from grass into K2 efficiently
Recommended Form: MK-4 & MK-7
Dose: MK-4: 2,000mcg / day MK-7: 100mcg / day
When to Take: With vit D in the morning
Brand: Solal

4. VITAMIN C

Role in Health: Vitamin C is needed for collagen and connective tissue formation. It’s used to manufacture the powerful antioxidant glutathione, it enhances immune function & reduces tissue damage by free radicals.
Sources: Some fruits and vegetables and high in vitamin C but it is difficult to get enough vitamin C from food and 30 % of people are deficient
Recommended Form: Ascorbic acid crystals or time-release capsules
Dose: 1-2 grams per day
When to Take: Morning and evening but preferably not after exercise
Brand: Dis-Chem

5. IODINE

Role in Health: Iodine is essential for good thyroid function and metabolism. It also enhances immune function and prevents brain damage. Iodine deficiency is common.
Sources: One can get some iodine from seafood, kelp & Iodised salt, but probably not enough
Recommended Form: Kelp powder or potassium iodide capsules
Dose: 1 mg per day
When to Take: Morning or evening
Brand: Vital (Kelp)

6. EPA / DHA (KRILL OIL)

Role in Health: Krill oil reduces inflammation, improves brain function & enhances muscle growth
Sources: Grass fed meat or wild caught fish
Recommended Form: Krill oil
Dose: 1000 Mg per day
When to Take: With meals
Brand: Best 4 Brain Power

7. VITAMIN A

Role in Health: Vitamin A is an important cofactor for numerous metabolic reactions and bodily functions
Sources: Cod liver oil or organ meats like beef liver, kidney, and heart. Plants such as carrots don’t have vitamin A, they have beta-carotene, which is poorly converted into vitamin A
Recommended Form: Retinol
Dose: 10,000-15,000 IU / day
When to Take: With meals
Brand: Biogen

8. SELENIUM

Role in Health: Selenium is a heavy metal which boosts immune function, prevents cancer, neurodegenerative disease, and protects against thyroid dysfunction.
Sources: Grass fed meat or wild caught fish
Recommended Form: Selenium Methyl Selenocysteine or selenomethionine
Dose: 20 mcg per day
When to Take: Morning or evening
Brand: Vital

9. COPPER

Role in Health: Copper is needed for proper vascular and heart function
Sources: Beef & lamb liver, dark chocolate, cashews and lobster are good sources of copper but most people consume less than 1 mg per day making them more susceptible to heart attacks
Recommended Form: Capsule
Dose: 1 mg per day
When to Take: Morning or evening
Brand: Solal

10. VITAMIN B12 & B9 FOLINIC ACID

Role in Health: B12protects against dementia, megaloblastic anaemia, improves immune function, maintains nerves, and regenerates cells. B12 lowers endothelial damaging homocysteine and protects against atherosclerosis, its necessary forrepairing DNA and preventing cancer. Folate and B12 are both required for mental function, and a deficiency in one produces a deficiency in the other.
Sources: Vitamin B12 : liver, beef/lamb, chicken, pork/ham, fish, whole egg, milk; cheese; yoghurt
Folate & Folinic acid are naturalforms of vitamin B9: Liver, kidney, egg yolk, chicken, almonds, fruit and green vegetables
Folic acid is a synthetic form of vitamin B9added as a processed food supplement and is potentially harmful
Recommended Form: Capsule
Dose: At least 5mg of methylcobalamin or hydroxycobalamin.
At least 800mcg of folate (5-MTHF or folinic acid, NOT folic acid)
When to Take: Morning or evening. Alcohol inhibits absorbtion
Brand: Solal

11. CO ENZYME Q10

This and it’s more easily utilisable form Ubiquinol is the most effective antioxidant and best membrane stabilizer in nature, coenzyme Q10. Minimum dosage recommendations are 60 to 100 mg per day for healthy individuals, and up to 200 mg or more per day for persons with health-compromising illnesses or those taking statin drugs.

12. GLUCOSAMINE & CHONDROITIN SULPHATE (21)

Role in Health: Claims: Reduces pain and inflammation, improves joint function and slows progression of osteoarthritis (OA).
Believed to enhance the shock-absorbing properties of collagen and block enzymes that breakdown cartilage. Helps cartilage retain water and may reverse cartilage loss when used with glucosamine.
Sources: Glucosamine is a natural substance that is found in the covering of shellfish. Glucosamine is also available in synthetic forms. The body absorbs glucosamine well.
Chondroitin can come from natural sources, such as shark or bovine cartilage, or it can be made in a lab
Recommended Form: Capsules, tablets or powder. It appears that glucosamine and chondroitin are safe and have few side effects, but an analysis of studies for osteoarthritis in the hip or knee did not show that these supplements slow joint destruction or relieve pain
Dose: Our diets contain very little cartilage so we are probably deficient in these substances. Chondroitin sulphate: 800 mg to 1,200 mg daily in two to four divided doses. Often combined with glucosamine. Allow up to one month to notice effect.
When to Take: Morning and evening
Brand: Arthrochoice advanced

13. CALCIUM (22)

Role in Health: Ca is required for vascular contraction and vasodilation, muscle function, nerve transmission, intracellular signaling and hormonal secretion, though less than 1% of total body calcium is needed to support these critical metabolic functions. The body uses bone tissue as a reservoir for, and source of calcium, to maintain constant concentrations of calcium in blood, muscle, and intercellular fluid. Hypocalcemia results primarily from medical problems or treatments, eg. renal failure, surgical removal of the stomach, and use of medications such as diuretics. Hypocalcemia causes numbness and tingling in the fingers, muscle cramps, convulsions, lethargy, poor appetite, and abnormal heart rhythms. Left untreated, calcium deficiency leads to death.
Sources: Milk, yogurt, and cheese are sources of calcium. Non-dairy sources include vegetables, such as Chinese cabbage, kale, and broccoli. Spinach provides calcium, but its bioavailability is poor. 99% of the body's calcium supply is stored in the bones and teeth where it supports their structure and function [1]. Bone undergoes continuous remodeling, with resorption and deposition of calcium into new bone.
The balance between bone resorption and deposition changes with age. Bone formation exceeds resorption in periods of growth in children and adolescents, whereas in early and middle adulthood both processes are relatively equal.
Recommended Form: Most people get enough calcium from their diet. Vitamin D improves Ca absorption. Foods with Phytates (eg. spinach) and oxalates (eg. grains), bind to calcium and inhibit absorption. The main calcium supplements are Ca carbonate & Ca citrate. Ca carbonate is inexpensive & absorbed most efficiently when taken with food, whereas Ca citrate is absorbed well with or without food
Inadequate intake of dietary calcium produces no obvious symptoms in the short term. Aging adults, particularly postmenopausal women often need supplemental Calcium because bone breakdown exceeds formation, resulting in bone loss that increases the risk of osteoporosis. Lactose intolerant people, amenorrheic women and the female athlete triad are also at risk.
When to Take: With vit D but not with foods like spinach or grains. Take Ca carbonate with food, & Ca citrate anytime
Brand: Osteochoice, Menacal

14. ECOTRIN (acetylsalicylic acid - ASA)(23)

Role in Health: The American College of Cardiology & the American Heart Association recommend that individuals at high risk for myocardial infarction should take low-dose ASA daily if recommended by their primary health care provider as long as there are no contraindications.13,14 The American Heart Association also recommends that patients who have had a heart attack discuss the use of low-dose ASA therapy regularly to decrease the risk for or prevent another heart attack.
Sources: Because the risks and benefits of ASA therapy vary from individual to individual, all patients should be encouraged to consult with their primary health care provider before initiating a low-dose ASA regimen to ascertain the appropriateness of therapy
Recommended Form: Buffered, enteric coated or chewable
Dose: 81 mg daily
When to Take: After meals or with food. Don't lie down for 30 minutes
Brand: Ecotrin 81 mg

15. SAW PALMETTO (24)

Role in Health: Saw palmetto is best known for its use in decreasing symptoms of an enlarged prostate (benign prostatic hypertrophy, BPH). According to many research studies, it is effective for this use.
Saw palmetto is used for treating certain types of prostate infections. It is also sometimes used, in combination with other herbs, to treat prostate cancer.
Some people use saw palmetto for colds and coughs, sore throat, asthma, chronicbronchitis, chronic pelvic pain syndrome, and migraine headache. It is also used to increase urine flow (as a diuretic), to promote relaxation (as a sedative), and to enhance sexual drive (as an aphrodisiac).
Saw palmetto doesn’t shrink the overall size of the prostate, but it seems to shrink the inner lining that puts pressure on the tubes that carry urine
Sources: Saw Palmetto is a plant. Its ripe fruit is used to make several forms of herbal medicine
Recommended Form: tablets
Dose: 267 mg daily
When to Take: Not recommended for children or during pregnancy. It decreases the effectiveness of estrogen products such as birth control. Stop before surgery because it increases bleeding time
Brand: Prostacare

REFERENCES

Why we get Fat and What to do about it: Gary Taubes
Good calories bad calories: Gary Taubes
The Paleo Solution: Robb Wolf
The Real Meal Revolution: Tim Noakes
Challenging Beliefs: Tim Noakes
The Bulletproof Diet: Dave Asprey
The Big Fat Surprise: Nina Teicholtz
Dietary fats: Knowing which types to choose: http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/fat/art
Huntingtons outreach project for education, at Stanford: http://web.stanford.edu/group/hopes/cgi-bin/hopes_test/?s=dietary+fats
The 4-Hour Body: Tim Ferris
The Battle of the Weight Loss Diets. Presented on YouTube by C Gardner, director of Nutrition Studies at the Stanford Prevention Research Center
Master your Metabolism: Jillian Michaels with Mariska van Aalst
Anti-oxidants and Free Radicals: Steven Sinatra: https://heartmdinstitute.com/diet-nutrition/antioxidants-and-free-radicals/
The Inflammation Syndrome: Jack Challem
Inflammation and Insulin Resistance: Steven E Shoelson, Jongsoon Lee and Allison B Goldfine
The Wahls Protocol: Terry Wahls, MD
The Fast Diet: Dr Michael Mosley & Mimi Spencer
What are the effects of Alcohol on Vitamins & Minerals: Leah DiPlacido: http://www.livestrong.com/article/375909-what-are-the-effects-of-alcohol-in-vitamins-minerals/
Anti-thyroid isoflavones from soybean: isolation, characterization, and mechanisms of action, Divi RL; Chang HC; Doerge DR, National Center for Toxicological Research, Jefferson, AR 72079, USA, Biochem Pharmacol, 1997 Nov, 54:10, 1087-96)
Lectins: Their Damaging Role in Intestinal Health, Rheumatoid Arthritis and Weight Los. Carolyn Pierini, CLS (ASCP), CNC
Rose WC, Haines WJ, Warner DT, Johnson JE. The amino acid requirements of man. The role of threonine and histidine. J Biol Chem. 1951;188(1):49-58The Story of the Fly: Jason Drew and Justine Joseph
The Story of the Fly: Jason Drew and Justine Joseph
Coprophagy by the semi-habituated chimpanzees of Semliki, Uganda: C.L.R. Payne1, T.H. Webster1,2 and K.D. Hunt3 | 1. Leverhulme Centre for Human Evolutionary Studies, University of Cambridge | 2. Departments of Anthropology and Zoology, Miami University | 3. Department of Anthropology, Indiana University
Antioxidants and Free Radicals: Dr Stephen Sinatra Sinatra https://heartmdinstitute.com/diet-nutrition/antioxidants-and-free-radicals/
Glucosamine and Chondroitin - Topic Overview: http://www.webmd.com/arthritis/tc/glucosamine-and-chondroitin-topic-overview
Calcium: Dietary supplement fact sheet: https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
Low-Dose aspirin therapy and Cardiovascular health: http://www.pharmacytimes.com/publications/issue/2014/december2014/low-dose-aspirin-therapy-and-cardiovascular-health
Saw Palmetto Overview Information: http://www.webmd.com/vitamins-supplements/ingredientmono-971-saw%20palmetto.aspx?activeingredientid=971&activeingredientname=saw%20palmetto