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[post_content] => Most people’s health goals could be simplified to something like:
a long life and the good health to enjoy it. And long life we have. The biggest-ever jump in life expectancy, which occurred from around the mid 1800s to the mid 1900s, can be mostly attributed to the reduction in deaths by infection. Infectious disease has been well managed by improved hygiene, better quality of food and water, antibiotics, vaccines, and more effective emergency medical care. Now that infection is a relatively minor concern in the developed world, it’s worth looking at the factors that degrade health in our later years. These factors – things like diabetes, obesity, and the cardiovascular disease that goes along with them – can be dramatically influenced by diet.
Unfortunately, the mainstream medical world is plagued by some very significant misunderstandings about human nutrition, and it barely recognizes the profound psychological factors involved in how we feed ourselves. It’s time for a revolution in nutrition … and luckily, it’s well on its way.
A few months ago, Marc David, founder of the Institute for the Psychology of Eating asked me if I would be one of 50 thought leaders to be interviewed for an online conference called The Future of Nutrition. I am honored to be part of this – and in the company of some very impressive researchers. I strongly encourage you to check it out. It’s free.
Note: This is an old article and the recordings of this event are no longer available. However, all of what I discussed in my interview and much more can be found in my online course
How to Eat.
Be well,
Dr. Peter Borten
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Over the past few decades we’ve seen a number of trends in popular supplements and so-called “superfoods.” First there was ginseng and echinacea, then ginkgo and St. John’s wort, then green tea, glucosamine, kombucha, fish oil, chia, maca, bone broth, magnesium l-threonate, vitamin D, and so on. Often, there’s a widespread hope that this substance is going to give us vibrant health, make us happy, perhaps even solve all our problems.
Turmeric has been on the charts for some years now, so I wanted to write about its uses and limitations – and why we need to take a broader view on health and supplements. First, it’s important to state that there’s some value to nearly all of these substances. Sometimes it’s a rather modest value for a fairly small subset of the population (like kombucha, most of which is essentially an overpriced mildly-caffeinated acidic soda with a little probiotic activity), other times it’s a significant value for a larger portion of the population (like vitamin D and magnesium). A food or supplement doesn’t need to be life-changing for everyone in order to be important; the key is that we’re realistic about what it can do and knowledgeable about who stands to benefit from it.
For several years, turmeric has been hot stuff in the West, though it has been used for at least 4000 years in Asia. Native to India, it’s a prominent herb in Ayurvedic medicine, though it’s even better known for its place in Indian cuisine and its use as a dye. Its particular yellowish-orange color is almost synonymous with Indian culture. It probably appeared in Traditional Chinese Medicine (TCM) about 1500 years ago, but has always been a relatively minor herb in that system.
In both Ayurveda and TCM, turmeric is almost never taken as a single herb. Rather, it’s utilized in a formula of multiple herbs that’s prescribed by a trained practitioner, based on the specific constitution and presentation of the person who will be consuming it. However, as with many adopted herbs, Americans generally take it on its own, without any understanding of its traditional application or the diagnostic framework of the systems that have utilized it for so long. Consequently, many probably conclude that herbs aren't very effective medicines.
This is really the crux of what limits Westerners in their use of herbs – lack of context. The systems through which herbs have been historically defined and applied include methods for determining when and how and with whom to use them. One of the things that makes Ayurveda and TCM so special is that their diagnoses and their interventions utilize the same philosophical framework and terminology. That is, there’s a seamlessness between diagnosis and treatment. For example, for a TCM diagnosis of liver Qi stagnation, the treatment is clear because there are herbs and acupuncture points that specifically unblock stagnant liver Qi.
In contrast, knowing the Ayurvedic properties of turmeric – a pungent vipaka, a heating virya, a light, dry guna, which enters the digestive, circulatory, respiratory, and female reproductive srotas – is meaningless if we’re working from a Western biomedical diagnosis such as lung cancer, because the languages and philosophies don’t match. We can only guess at equivalencies.
For any given symptom presentation, there might be half a dozen or more possible diagnoses of the actual cause. When we take an herb without a diagnosis, it has a limited chance of working as we hope, because we may or may not have the underlying disease pattern that this herb addresses. It might even make things worse.
When we take an herb based on properties revealed by modern research – such as antibiotic, diuretic, or anti-inflammatory – it might work if we’ve correctly identified that we have the biomedical diagnosis corresponding to this biomedical terminology. But we miss out on accessing the body of wisdom developed by the traditions that have utilized the herb for centuries. It’s more like taking a brand new, poorly-understood drug, usually with very little human research behind it.
Years of discussion and trial-and-error in traditional plant-medicine systems reveals important nuances, and synergies with other herbs. Without that context, however, scientists were able to discover that turmeric possesses anti-inflammatory properties. Hooray! People started taking turmeric by the handful. But it didn't work as well as predicted. Later research revealed that unless the inflammation was in the digestive tract itself, the herb (specifically a compound called curcumin) wasn't likely to reach its target. Absorption into the bloodstream, it turned out, was very poor.
Eventually, researchers discovered that with absorption-enhancers, they could get more curcumin into the bloodstream. They came up with two main devices. The first is to combine it with a compound called
piperine that helps it pass through the lining of the digestive tract. The second is to attach it to a form of fat known as a
phospholipid, that's what our cell membranes are made of. This helps it move into cells more readily. Interestingly, equivalents of both strategies were utilized for centuries (if not millennia) in India. Piperine is a constituent of black pepper and a similar herb called pippali (long pepper), with which turmeric has been traditionally combined. And turmeric is also routinely taken with ghee (clarified butter) which happens to be rich in phospholipids!
In TCM, turmeric is called jiang huang, which means “yellow ginger.” Based on its primary function, it’s categorized as an herb that promotes blood circulation. Therefore (through that handy-dandy seamlessness of diagnostic and therapeutic terminology), it is used to treat conditions of stagnant blood. When we have a condition of blood stagnation, often the tongue takes on a slightly purple color and the veins on the underside of the tongue become more prominent and blue or purple. The pulse at the wrist feels “choppy” or “wiry.” The complexion often becomes dark. In women, the menstrual blood might be clotty and dark. And most obvious, there is usually pain – often sharp, stabbing pain in a fixed location.
Also, low grade blood stagnation – essentially impaired circulation – is thought in TCM geriatrics to be an almost inevitable part of the aging process. Whenever we see an older person with cold and/or purplish feet, hardened skin of the lower legs and feet, prominent purple and blue veins, and perhaps a history of cardiovascular disease and/or diabetes, it’s likely that a TCM practitioner would make a diagnosis of blood stagnation. Biomedically speaking, it’s probable that such an individual has chronic inflammation, and we could therefore think of the herbs that address stagnant blood as likely possessing anti-inflammatory properties, like those ascribed to turmeric.
In such cases, an herb like turmeric might be utilized, but if we look at the actual practice of TCM, we find it’s not especially popular among the herbs in its category. That’s probably because there are about thirty other herbs in this category, and thousands of years of tradition have shown that other herbs do just as good of a job – if not better than turmeric.
In addition, with a palette of thirty herbs to choose from, we have a great deal of specificity available to us. There are blood movers with an affinity for the head, or the abdomen, or the shoulder (one of turmeric’s affinities), or the legs, or the arms, or the back. There are mild blood movers and strong blood movers. There are blood movers with an ability to break up masses or to heal broken bones. There are blood movers that soften tight muscles and tendons and promote healing of unhealing wounds. And there are ways to combine them in order to make them exponentially more effective; to direct them to certain parts of the body; to prevent side effects, and so on.
Since I’m lucky enough to have all these herbs at my disposal (and the training to know how to use them), turmeric isn’t exceptional to me. It’s just an herb that got noticed by Westerners. There are thousands of others that are equally impressive. But don’t get me wrong – I love it, as I love all herbs, and I do occasionally recommend it.
If you don’t have training in traditional herbal medicine and you don’t have access to a practitioner who can help determine if it’s good for you, at least it’s a very safe herb. You can try it, and if it doesn’t work, you’re unlikely to do yourself any harm (though I still recommend checking with your doctor).
If you’re going to take turmeric, be sure to take it in a form that’s going to be well absorbed (unless you’re meaning to target your digestive tract). That means combining it with black pepper, long pepper, or piperine (and a little ghee may help, too); or using a brand that binds curcumin with acetylcholine (such as Meriva); or a brand that utilizes very small particles (such as Theracurmin).
Because I don’t have the ability to teach you traditional diagnosis through this format, we're actually best off banking on what the research shows. And while there's a lot of hope that it does many things, the only thing that it's been really clearly proven to do (on its own) is alleviate inflammation and some of its expressions. Pain, swelling, arthritis, and even hidden inflammatory processes will usually improve with ongoing consumption of turmeric/curcumin (assuming you’re using an absorption-enhancer). The degree of improvement varies. Sometimes it’s dramatic, other times subtle. Just remember that because you may or may not have the underlying diagnostic pattern that makes you a good candidate for turmeric/curcumin, it might not work.
I’d like to finish by discussing some broader measures for reducing the “stagnant blood” (and accompanying inflammation) that we’re prone to in our elder years. First, there’s exercise. Ideally, this isn’t the exercise of going to a gym and using weight machines (though if that’s what you like, keep doing it) – it’s the exercise of walking to the store, riding a bike to work, digging in the garden, shoveling snow, and above all, playing.
Second, reduce your sugar intake. If there’s one part of our diet that provokes inflammation and thickening of the blood more than any other, it’s sugar. By sugar, I mean caloric sweeteners of all kinds (and also white flour). If you’re up for improving your diet, you’d also do well to reduce or eliminate processed meats, deep fried foods, and margarine. Meanwhile, increase your consumption of fresh fruits and vegetables, nuts (dry roasted or raw), and oily fish. Third, if you smoke, quit. Smoking is terrible for circulation.
Finally, the best way to keep blood (and energy, and life itself) flowing is to be light-hearted. The circulatory system is an extension of the heart, and a light, open, joyful heart is best able to pump blood to all parts of us (much in the way it’s open to people and experiences of all kinds). Meditate (metta or lovingkindness meditation is especially good for this purpose). Laugh. Find ways to de-stress. Breathe deeply. Engage with community. Accept. Forgive. And love. Love yourself, love your family, love your environment, just love as much as you can. Even if you were to drop dead tomorrow, this is the stuff your soul wants you to prioritize.
Be well,
Dr. Peter Borten
[post_title] => I’ve Been Taking Turmeric for a Year But Still Haven’t Found My Soulmate!
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This month’s theme is nutrition, and I started the series by explaining that, while we have greatly improved humans’ odds of surviving childhood, we haven’t made as much progress in prolonging the lives of older people. Old people tend to die of conditions that are long in the making, and there aren’t many ways to intervene in these processes near the end of life. The biggest value in life extension comes from adopting good habits earlier, such as healthy eating, exercise, and a spiritual or meditative practice.
Last week I compared the body to a car, and asserted that fuel quality isn’t everything. We always hear about what we should and shouldn’t eat, but how our fuel is introduced to the body is as important to our health as the fuel itself. (You can read part one and part two.) Previously, we looked at food preparation and the vital role of the mouth; now let’s travel a bit further down the rabbit hole. (Note: the gastrointestinal tract is not an actual rabbit hole; we do not condone swallowing live rabbits.)
Food goes in your mouth, travels down a tube called the esophagus, and pushes through a ring of muscle known as the lower esophageal sphincter (or LES) to enter your stomach. The LES is vital for keeping the top of your stomach closed, so food doesn’t back up and stomach acid doesn’t burn the lining of your esophagus. When you overfill your stomach, at least four bad things happen – it stretches the stomach, it promotes weight gain, it compromises digestion, and it puts lots of back pressure on the LES.
A stretched stomach is a feature of every overweight person. Fullness of the stomach is not a healthy way to gauge when to stop eating. If you routinely fill your stomach to capacity, it will inevitably expand, and you’ll need to eat more to get that full feeling. There’s a perceptible difference between enough and full, and enough is usually much less than full. Okinawans, known for their longevity, have a cultural practice of eating to just 80% of capacity. At 80% full, you will not be hungry, although you may convince yourself that you are, being used to that full stomach feeling. Undereating promotes longer life.
If the stomach is packed, it’s like an overly full washing machine. The clothes don’t circulate – they just get damp and wrinkly. Likewise, we don’t digest our best when the stomach is filled to capacity. A history of overeating tends to deplete the stomach, which can result in insufficient acid secretion. We need lots of acid to digest food (especially protein, minerals, and vitamin B12), to stimulate emptying of the stomach, to quickly dismantle potential allergens, and to kill bacteria and viruses that may have entered the GI tract. Low stomach acid is very common among older adults. I usually give patients hydrochloric acid in a form called betaine hydrochloride, though I’ve encountered many who have gotten good results from using apple cider vinegar in capsules or taken in some water.
If we frequently cram the stomach, the LES tends to become less competent at staying tightly closed. Especially when combined with shallow breathing, low stomach acid, sitting a lot, frequently wearing a tight belt or seat belt, and having a big belly, the result is acid reflux – AKA heartburn or gastroesophageal reflux disease (GERD). I don’t know if you’ve noticed, but a lot more people get acid reflux than in the past. When I began my practice, I didn’t encounter it that much. Now it seems every other patient is on an acid blocking drug. One reason is that portion sizes have increased and mealtimes have gotten shorter and less relaxed, so we eat both more and faster.
Sometimes a person with a history of acid reflux will develop pre-cancerous changes in their esophagus known as Barrett’s Esophagus, and in these cases, an acid blocker might be prudent (though I still recommend fixing the cause of the reflux). For everyone else, they are a bad idea except for occasional use. Over time, all of the functions of stomach acid I mentioned above can be expected to become compromised – nutrient absorption, killing of pathogens, breaking down allergens, etc. We’re already starting to see unusually high rates of uncommon infections in people on these drugs. There are lots of better and more natural approaches for relief, such as d-limonene, which comes from orange peel oil, and soothes and protects the esophagus. But the best thing you can do is to eat less food, do it slowly, prepare it as I explained in the last article, and chew thoroughly. It will not only improve your health, it will also bring you back to specialness that is the ritual of nourishing yourself.
Be well,
Dr. Peter Borten
P.S. After years of teaching people about nutrition, I recently decided to create an online video-based nutrition course called How to Eat. If you’re interested in learning more about nutrition, including both Eastern and Western points of view, I encourage you to check it out. My goal is to have participants gain a lifelong, intuitive understanding of how to feed themselves, and to learn how to eat for optimal energy and weight. You can check it out here.
[post_title] => The Difference Between Stomachs and Balloons
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[post_content] => Most people’s health goals could be simplified to something like:
a long life and the good health to enjoy it. And long life we have. The biggest-ever jump in life expectancy, which occurred from around the mid 1800s to the mid 1900s, can be mostly attributed to the reduction in deaths by infection. Infectious disease has been well managed by improved hygiene, better quality of food and water, antibiotics, vaccines, and more effective emergency medical care. Now that infection is a relatively minor concern in the developed world, it’s worth looking at the factors that degrade health in our later years. These factors – things like diabetes, obesity, and the cardiovascular disease that goes along with them – can be dramatically influenced by diet.
Unfortunately, the mainstream medical world is plagued by some very significant misunderstandings about human nutrition, and it barely recognizes the profound psychological factors involved in how we feed ourselves. It’s time for a revolution in nutrition … and luckily, it’s well on its way.
A few months ago, Marc David, founder of the Institute for the Psychology of Eating asked me if I would be one of 50 thought leaders to be interviewed for an online conference called The Future of Nutrition. I am honored to be part of this – and in the company of some very impressive researchers. I strongly encourage you to check it out. It’s free.
Note: This is an old article and the recordings of this event are no longer available. However, all of what I discussed in my interview and much more can be found in my online course
How to Eat.
Be well,
Dr. Peter Borten
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