The Cold War

On Fat

A Scientific Breakthrough

in Fat Loss

Jocelyn & Wayne Hayes, Ph.D.

“The lifeblood of a democracy is your ability to understand and act upon a problem once the facts are presented to you...and then you as individuals and citizens of a democracy must take action.”

U.S. Surgeon General Dr. Thomas Parran, 1946

“Drug therapy for obesity has hit the skids. It seems incredible that in the face of the relative lack of efficacy of lifestyle interventions, the ever-expanding knowledge of the physiology of energy balance, and a veritable gold mine for successful candidates, most pharmaceutical companies have closed their obesity research programs."

Robert H. Lustig, M.D., M.S.L., in Fat Chance (Plume, 2013)

Disclaimer

The material in this book is for informational purposes only. As every individual is different, you should use discretion and consult your medical healthcare professional before starting any new diet, exercise, cold exposure, or health regime. The authors disclaim any liability for any adverse effects that may result from the use or application of information contained in this book.

The Cold War on Fat. Copyright © 2014 by Jocelyn and Wayne Hayes. All rights reserved. Printed in the United States of America. No part of this book may be used or reproduced in any form whatsoever without written permission except in the case of brief quotations.

Contents

Authors’ Preface

Introduction

PART I: DIET AND EXERCISE:

ILLUSIONS AND THE NEW REALITY

Chapter 1– Fat Facts – The situation is grave - the dramatic increase in obesity; half-ton mom;

childhood obesity; risk of diabetes increases with weight; big boned? “Your excuse is invalid”.

Chapter 2 – How did we (supposedly) get this way? - calories in, calories out; what’s really in a calorie? food

labels; cooking food and big brains; dietary fat is not the culprit (except for trans fats); get your vitamins from food, not pills; hydrogenated fats are evil.

Chapter 3 – Biology 101: Digestion - carbs and sugars start to digest in your mouth; other

foods take longer, which is a good thing.

Chapter 4 – The insulin and carbohydrate link - if it tastes sweet, it’s a simple carb; simple carbs (sugar,

glucose, fructose, lactose) cause your insulin to rise sharply; raised insulin locks your fat inside your fat cells; eat whole fruits, not just juice; veggies have more than

enough vitamins---fruit is not necessary; zero calorie sweeteners---if it can fool your taste buds, it may fool your insulin.

Chapter 5 – Insulin, diabetes, obesity & cancer - the Inuit (Eskimo) eat almost no veggies, and have low

obesity and almost no cancer; cancer cells need insulin to survive; dairy can cause insulin spikes; two of the world’s leading cancer researchers are afraid of sugar and don’t eat it.

Chapter 6 - Cut out carbohydrates? What about the food pyramid?

- evolution of USDA food guidelines over the past century; grains are a recent addition to our diet---we did not evolve to eat them; grains inhibit vitamin absorption.

Chapter 7 – Obesity, exercise and political agendas - you can’t outrun your fork; exercise helps you build

muscle, but does not help you lose weight; an hour in the gym only burns a few cookies; exercise is not a ticket allowing you to eat badly; corn is in almost everything; corn subsidies: a good idea at the time, but we’ve outgrown the need for it; shopping in the war zone.

Chapter 8 – Enough doom and gloom. How do we fix it? - getting insulin under control; beating sugar addiction is

just as hard as quitting smoking; slow carb diets; binge days: psychologically and metabolically advantageous.

PART II: THE COLD WAR ON FAT:

THE NEW SCIENCE OF

COLD EXPOSURE AND WEIGHT LOSS

Chapter 9 – So where does cold exposure come in? - when you are cold, you must burn calories to stay warm;

shivering vs. non-shivering thermogenesis; brown fat vs. white fat; the low insulin requirement; you can’t spot-reduce fat

Chapter 10 – The Cold War on Fat: Principles & strategy - BMR includes temperature; types of thermogenesis;

irisin may increase brown fat; exercise is not a fat-loss strategy, but a muscle-retention (or building) strategy; cold exposure works best for weight loss on an empty stomach

Chapter 11 – Adrenaline and Thermogenesis - adrenaline/epinephrine is tightly controlled;

supplements can have nasty side-effects; supplements are unregulated by the FDA; nothing worth having comes easily

Chapter 12 – Individual variability in non-shivering thermogenesis

- body composition; gender; age; fitness level; cold adaptation; genetics

Chapter 13 – Harnessing cold exposure for weight loss - winter walks; swimming in warm or cold water; ice

baths; cold showers; ice bags & frozen peas; cooling the palms of the hands; The Cold Shoulder weight-loss vest

Chapter 14 – Cold exposure testimonials

- Mike Sirak, Robert Camille, Nick Hamilton, Jocelyn, and Wayne tout The Cold Shoulder

Chapter 15 – Additional cool benefits (pun intended) - improved sleep; improved immunity; improved mood;

overcoming being a wuss

Chapter 16 – Other hormones you should know about - ghrelin; leptin; adiponectin; Human Growth Hormone;

Chapter 17 – Advice from a gal - if I don’t have chocolate I’ll kill someone; I love XXX too

much, and you want me to give it up? Sabotaged by friends; can’t I take a pill rather than being cold?

Chapter 18 – Advice from a guy - booze; cooking; yes it’s cold---don’t be a pussy

Chapter 19 – Advice from a couple - foods we gave up (except perhaps for cheat days);

adverse affects of greatness; relationship friction; be aware of how your actions affect those around you

Afterword

Sources and further reading

Appendix

Authors’ Preface

Weight loss is not about “dieting”. It’s about eating habits. If you’re fat (let’s not mince words), then you need to made fundamental, permanent changes in your eating habits. You’ve been eating incorrectly, and it’s time to change that. This book will guide you in that quest, providing practical advice, a bit of science (not much---we’ll keep it simple), and a new tool in the war against fat.

Why should you listen to the advice in this book? Because between the two authors, we’ve tried a whole lot of ways to control our weight, and finally found a few things that work. We’ve also kept the weight off now for several years. Here’s a list of what we’ve tried (most of it didn’t work):

Diets

Fasting

3 day apple diet

Meal replacement shakes

Heartbreak diet (this was unintentional but definitely qualified as a 5 day fast)

Juice fast

“Cleanse” diets

Restrictive diets

Calorie controlled

Low fat

No dairy

No wheat

No gluten

More veggies

Vegetarian

Eggs for breakfast, vegetables for the rest of the day

More meat

Eat Right 4 Your Type – blood type O

4 Hour body slow carb diet

Paleo

Atkins

Supplements

Appetite suppressants

Hoodia

Apple cider vinegar pills

Metabolism boosters

Green tea pills

PAGG stack

Pre-workout stimulant shakes

Raspberry ketones

Protein supplements

Vegan protein powder (pea & soy)

Protein powders/bars (whey & soy varieties)

Paleo protein powder

Vitamins

Iron pills

Chlorophyll

Vitamin D pills

Calcium & vitamin D chews

Multivitamin

Cod liver oil

Exercise

Cardio

Badminton

Aerobics

Ballroom dancing

Rowing

Swimming

Cycling

Gym machines Toning

Body Conditioning

Yoga

Ballet

Ballet Pilates

Weights

Other

Electrical toning belt

Cold showers

Cold exposure

As you can see, we’ve had a fair go at a good chunk of the

options available on the market today, and for the most part,

we were left wanting.

In this book we aim not just to tell you what you can do to

become healthier, but also why you should do it. We believe

simply telling someone to do (or not do) something isn’t a very

effective method of bringing about real change. In order to truly

change the way you think and act you need to know the reasons

why. Some of the information we came across while

researching this book shocked us. We were stunned it wasn’t

common knowledge. And it’s altered our behaviors

permanently. We hope we can motivate you to be healthier

(and slimmer) too.

Several people have read early drafts of this book and provided

comments. We would like to thank Jeremy Goodwin (“Chef

Jeremy”), Ken Liu, ….

<insert digital signatures>

Introduction

When one speaks of the “cause” of obesity, it helps to distinguish between the “proximate” cause, and the “root” cause. A “proximate” cause (root: “proximity”) refers to the most immediate cause; the immediate cause usually has a cause, which has another, etc.; when you trace back the sequence of causes, you usually come to one that is in some sense the “root” cause. Of course one can always try to trace back as far as possible, but there’s usually a natural stopping point. For example, when somebody dies of a bullet wound to the heart, the proximate cause of death is the bullet wound causing massive blood loss. The root cause is whatever made the shooter decide to pull the trigger. It could be a domestic dispute between spouses, or a police officer shooting a violent offender in order to protect innocent bystanders (including himself).

As Gary Taubes explains at length in Why we Get Fat, or Robert Lustig argues in his book Fat Chance, the proximate cause of obesity is high insulin levels, because high insulin levels cause individual fat cells to get bigger. But that doesn’t explain the root cause. To find the root cause, we have to trace backwards.

The high insulin levels are the body’s response to high blood sugar levels---especially large upward spikes in blood sugar. A sharp rise in blood sugar comes when we’re digesting more food than we can immediately use. Any kind of food will do it---eat too much protein, and the result will be high blood sugar followed by an insulin spike. However, the problem is worst when we eat food that is too quickly and easily digested. The foods that tend to be digested most easily and quickly are foods called “simple carbohydrates”.

Thus, the root cause of obesity is that we, as a culture, eat way too many calories derived from simple, refined carbohydrates--- things like sugar, chocolate bars, bread (especially white bread), pasta, French fries, potato chips, etc. Even so-called meal replacement bars can be a problem if their calories are derived mostly from sugar. The problem is made worse by the fact that simple carbs don’t fill you up very well in proportion to their enormous calorie count, so we tend to eat way more than we need, especially if it’s our primary source of calories.

Rather than tracing proximate cause backwards to root cause, let’s look at the process in forward time. It goes like this:

1. fast carbs are cheap and easy to acquire in modern society---they’re everywhere from grocery stores to gas stations

2. fast carbs are very high in calories 3. they are too-easily digestible, causing a surge of blood

sugar because the energy is pumped into your blood stream faster than your body can use it (unless you’re doing strenuous exercise at that moment)

4. your body responds to the blood sugar spike by spiking your insulin, which tells your fat cells to start storing the energy1

5. the energy gets stored into your fat cells, and is then locked there because high insulin literally locks fat inside fat cells

6. you suddenly get exhausted (sugar crash) because there’s no more energy available---you’ve digested what you ate, and the energy is now out-of-reach.

7. go to step 1 above.

1 See the previously mentioned books by Taubes or Lustig for more detail on the biology.

That post-lunch snooze we all want is caused by the fast-carb sandwich, pasta, pizza, and soda you had for lunch. Fast carbs are also “empty” calories, in the sense that they typically don't even have much in the way of vitamins or minerals.

Although it is interesting to learn about the science that links the root cause to the proximate cause, fixing the problem requires us to address the root cause. To go back to the bullet analogy, you can't fix the problem once the bullet is flying through the air towards the victim. You need to stop the shooter from pulling the trigger in the first place; you need to fix the root cause.

Once you accept the root cause of our cultural obesity (eating too many fast carbs), the solution is simple: we all need to eat less in the way of refined carbs. That's it. That's the solution to the obesity epidemic. Eat fewer fast carbs---far fewer. Instead of eating empty calories, eat “full” calories, which means more unrefined carbs (read: whole fruits and veggies), more protein, and yes, more fat. These sources are vitamin-rich. Even more importantly, they make us feel full. The end result is that we tend to eat fewer calories, because unrefined calories make us feel more satiated.

Of course, you still need to watch your calories: unlike Dr. Atkins would have you believe, you can't eat infinite amounts of protein and fat, and hope to be slim. That's a pipe dream. You still need to have some self-restraint. Even if you eat protein, fat, and whole veggies, you can still over-eat. Even Dr. Atkins himself has admitted this: people who try high-protein/fat diets and fail to lose weight are advised to eat less (duh).

The Japanese have a saying that you should only eat until you feel 2/3 full. This is wise advice, and there is also the point that

you should eat slowly, because it takes about 20 minutes for the “I’m full” signal to propagate from your stomach to your brain.

In the end, it’s all about calories. If you want to lose weight (or more specifically, burn fat), you need to eat fewer calories than you’re using. The first half of our book explains our take on diet as a means of weight loss.

The second half of our book introduces a new tool in the fight against fat: mild cold exposure. In a word, mild cold exposure forces your body to burn calories to stay warm. And before you run away screaming that you don’t like being cold, consider all the other crazy stuff you’ve done in an effort to lose weight: dangerous or questionable pills, starving yourself, sweating it out in the gym…. Is a little bit of mild cold exposure all that bad in comparison, especially if it also has other benefits?

PART I: DIET AND EXERCISE:

ILLUSIONS AND THE NEW

REALITY

“My favorite example of this thinking came from a well-respected exercise physiologist, a co-author of a set of physical-activity and health guidelines that were published in August 2007 by the American Heart Association and the American College of Sports Medicine. This fellow told me that he personally had been ‘short, fat, and bald’ when he first took up distance running in the 1970s, and now he was in his late sixties and was ‘short, fatter, and still bald.’ In the intervening years, he said, he had gained thirty-odd pounds and run maybe eighty thousand miles-equivalent to running three times around the Earth. He believed that there was a limit to how much exercise could help him maintain his weight, but he also believed he would be fatter still if he hadn’t been running.

“When I asked him whether he really thought he might be leaner had he run even more, maybe four times around the planet instead of three, he said, ‘I don’t see how I could have been more active. I had no time to do more. But if I could have gone out over the last few decades for 2-3 hours a day, maybe I would not have gained this weight.’ And the point is that [more running would not have helped], but he just couldn’t wrap his head around that possibility. As sociologists of science would say, he was trapped in a paradigm.”

- Gary Taubes, Why we get fat (Anchor Books 2010)

Chapter 1 - Fat Facts – The

situation is grave (pun intended)

Unless you’re about five years old it’s socially inappropriate to ask, “Why are there so many fat people?” But the five-year-olds are right to ask. There are significantly more fat people now than there were a few decades ago, and that’s not just someone lamenting, “Back in my day...” It’s an actual fact; our generation is much fatter than our parent’s and grandparent’s generations. More than 72 million adults today in the U.S. are obese, and in 2012, U.S. surgeons performed over 103,000 gastric bypass surgeries. So it’s hardly surprising that within the healthcare system, studies have suggested that obesity is accountable for between 17% and 21% of all U.S. medical costs.

But it’s not just the scale of the problem that’s so alarming; it’s the age that it starts. Today we have five-year-olds who are fat. And while we accept that kids are often a bit chubby, they shouldn’t be waddling at the age of 14 or look like mini sumo wrestlers, with cheeks so pudgy you wonder how they manage to see. Young teenagers have even started going under the knife for stomach reducing surgery. Yes, you read that correctly: teenagers as young as 14 years old are having bariatric surgery as a result of being obese. And these types of surgeries are not cheap: they can cost up to $40,000. So despite the social stigma of pointing out the obvious, we really should be asking: “Why are we so fat?” Unless we want to end up like the humans in the film Wall-E (huge blob-like things that are so obese they can’t even walk) then it is imperative that we answer this question.

If we compare statistics from the 1950s with today we can clearly see a dramatic change. In 1950s, only about 10% of U.S.

adults were classed as clinically obese. By the year 2000, the U.S. obesity rate had more than tripled to 30.5%, while a further 4.7% were classified as severely obese.

The change is most clearly seen in our waistlines. In the 1950s the average waist size for a middle-age woman was 28 inches; today it’s 34 inches. One possibility for why there has been such an increase is that women today eat about 350-400 more calories per day than women did in the 50s. However, it’s not just the calorie count that has changed. The type of food we eat today is also very different, and probably just as (if not more) important as the calorie increase. In the 1950s, our diet consisted mostly of home-cooked whole foods (whole in the sense that it wasn’t pre-processed), while prepared and processed food was considered a treat. Today the situation has reversed, with processed and prepared foods being our staple diet, and home-cooked food considered a luxury.

Another dramatic change from the 1950s is childhood obesity. Ask your parents and grandparents how many obese kids there were at school, the answer will likely be “very few”. Nowadays it’s a disturbingly common problem: in 2011, somewhere between 16% and 33% of U.S. children and adolescents were classed as obese. Obesity is fairly easy to diagnose: if you get up from your chair and the chair remains wedged to your bottom, then you’re probably obese. Fixing it is harder, however: despite being pretty well aware of the problem (the media make sure you know about it), obesity rates are still rising, and this is likely to continue because overweight kids are much more likely to become overweight adults, and overweight adults are, in turn, more likely to have overweight children. It’s a vicious cycle resulting in obesity-related issues that cost the U.S. between $100 billion and $300 billion annually, depending upon what you count. Such costs include: Medicare / Medicaid costs, medical costs from private insurance, costs to the parents of

childhood obesity, estimated loss of productivity in the workplace… one study even suggests we’re spending an extra $3.4B a year in gasoline due to the extra weight of the obese person who’s sitting in the driver’s seat.

The scale of obesity now is bordering on ludicrous. We see toddlers that look like they’re made from strings of sausages. For adults, new categories have been created: morbidly obese and super morbidly obese. There are documentaries on TV like the super morbidly obese “Half-ton Mom.” These people can’t walk, or even fit through the door of the house. So firemen must carry them out through huge holes custom-cut through the walls and transport them to hospital to get stomach reducing surgery. “Why can’t you stop eating that bag of cookies?” we yell at the TV, outraged by their apparent gluttony. (As we’ll see later, our ability to stop eating has been hampered by foods that are as addictive as cocaine.)

We are not supposed to be so fat that we can’t get out of the front door, or so dependent on the medical profession for problems related to our weight, or so out-of-breath that we can’t play with our children. How did we get to this state, where human beings have to be fork lifted and weighed on Zoo scales designed to withstand the weight of adult rhinos? Surely, you ask, these people know the risks to their health from being so overweight?

The risks are indeed great, and they’re no secret. It’s fairly well known that being overweight goes hand-in-hand with contracting Type 2 Diabetes. It’s also well known that being overweight puts you at an increased risk of hypertension, high blood pressure, cancer, infertility and heart disease. No one is trying to stuff these facts into a folder labeled “Top Secret.” The facts are out there for anyone to find, from your doctor or from Google.

Figure: Weight and diabetes, courtesy of Dr. Joel Fuhrman and DiseaseProof.com. Used with permission (*** still to check ***)

There’s another risk of being overweight, and it’s not physical. For children, being bullied about their weight at school can lead to a lifetime of psychological problems such as depression, low self-esteem and eating disorders. The pressure during teenage

years to be “like everyone else” is huge and the stigma for being “different” can be very damaging. But bullying is not just reserved for teenagers; adults can be just as cruelly targeted. And unlike the physical effects of being overweight, the mental effects cannot always be so easily reversed. Despite the mantra, “sticks and stones may break my bones but words will never hurt me,” psychological wounds can be harder to diagnose and cure than physical ones.

You will often hear excuses for being overweight such as: “I’m just big boned.” But as these pictures clearly demonstrate, it’s not the bones that make someone fat, it’s what’s around the bones that make you fat.

Figure: Comparing the bodies of two individuals. Note their skeletons are pretty much the same size. Image courtesy of 9gag.com.

All healthcare professionals agree that being overweight is bad for us (and we’re pretty confident that all the non-healthcare professionals agree on this too). However, there seems to be some disagreement as to what caused us to get to this state. For everyone who says, “It doesn’t matter how I got this way, just fix it!” we politely disagree. It absolutely matters how we got this way. We need to know and understand how we got to this state in order to know what we can do to truly fix it. In order to find a lasting solution, we need to address and fix the root cause of the problem instead of just treating the symptoms. Surgical solutions and crash diets just address the symptoms of being overweight. If we do not address and fix the root cause of what is making us overweight, then obesity will recur in individuals, and continue to plague society as a whole.

Points to take away

We’re fatter than ever, and the problem just keeps getting bigger (pun intended).

We need to understand what caused the problem and fix it. Surgery and crash diets aren’t a viable long-term solution.

Chapter 2 – How did we

(supposedly) get this way?

Calories in, Calories out

Despite what you may have heard otherwise from various sources, weight loss all boils down to calories-in, calories-out. The science is very, very clear on this point, and I’ll get to the proof in just a few pages. I can hear the growns already… “Really? I need to count calories??? Arghhhhh!”

No. The good news is that you don’t actually have to count calories, because if you eat the right type of food, then you will naturally feel full at about the right time that you should stop eating. As long as you have the self-control to stop when you feel full, you should be fine. If you’re a glutton, then… yeah, you may need some help.

The “right” type of food is what we’ll call whole food. A food is a “whole” food if it’s basically something that you could pick up from the ground as a hunter-gatherer, and eat it either raw, or after cooking. Basically the only processing allowed is cutting with a knife, and cooking. Some people would call this “Paleo”, but we don’t want to put a label on it. Raw vegans eat whole foods; a steak is also a whole food---except, to be truly a whole food eater, you need to be willing to eat anything and everything from an animal---skin, liver, stomach (haggis, anybody?), heart, even eyeballs and brains---because some of the best vitamins are found in the fatty, “non-choice” cuts of meat. Rice and potatoes are whole foods, but bread is not, so this is not necessarily a “low carb” diet.

When you eat a whole food, it will make you feel full quite quickly, without a huge dose of calories. Thus, you will feel satiated long before you’ve eaten so many calories that you’ll get “fat”. This is the reason that people can go from 500 lbs to 200 lbs very quickly by “going Paleo”. They’ve really switched to a whole food diet---although most “Paleo” people will tell you that potatoes and rice are not “Paleo”.

The reason why obesity is such a problem today is that whole foods are not easily accessible outside of a large grocery store, and most of us don’t spend much time in large grocery stores. Instead, most of us spend time in gas stations, fast-food restaurants, or a workplace without a refrigerator. Most of us are eating the foods that are cheap and easy to acquire in such an environment. Highly processed foods are cheap, don’t spoil, and available everywhere. The problem with highly processed foods is that they are very high in calories, but don’t make you feel full. What do we mean by “highly processed foods”? You know what we mean: typical examples are a bag of chips, a chocolate bar, a pastry, a bowl of pasta or cereal. Basically if it’s gone through a machine that does anything other than cut it up with a knife or change its temperature (to freeze or to cook), then it’s “highly processed”. Bread? That’s gone through tons of machines that remove the grain from the plant, pulverize it, and mix it together with a bunch of other stuff that, if you read the ingredients list, you mostly can’t pronounce. No, bread is not a “whole food”---not even “whole wheat”. The name “whole wheat” is a misnomer. It’s not the whole wheat plant, it’s only whole grain, and the grain is just a small part of the whole plant. If you ate the whole plant, then yes, you’d be eating a whole food, and you’d be getting lots more fiber, and a lot fewer calories, and you’d feel full with far fewer calories than eating just the grain. Pasta is also highly processed.

Processed foods taste great, they have tons of calories, and none of them make you feel full for very long. The result? You end up being hungry again very soon afterward. And guess what? The next thing you eat is likely to be the same thing---cheap, easy to acquire, full of calories, and not satiating for very long. The result is an upward spiral of hunger, weight gain, as well as lack of vitamin and minerals, and in the long run, a host of health problems.

The solution is simple: eat whole, fresh foods---like fruit, vegetables, and meat. They’re hard to get ahold of, but they make you feel full, and you’ll stop eating when you’ve had enough, without the huge hit in calories, and you’ll stay feeling full a whole lot longer. Result? You’ll eat fewer calories, without having to actually count them. And you’ll get lots of great vitamins and minerals.

Of course, you may say, “but whole, fresh foods are hard to come by on the road”. True---and tough. Live with it. On the other hand, we’re not saying that you can’t ever eat a bag of chips or a chocolate bar, or a bowl of pasta or cereal. But don’t make it the norm, and don’t make it in huge portions. Make it the exception---only in emergencies, or as a small side dish. (Once you get into the habit of eating healthy food, “emergencies” can actually become fun. Wayne sometimes conjures up an “emergency” to satisfy an ice cream craving. Yes, that’s right. An “ice cream emergency”. You know what I’m talkin’ about. Just keep it rare, and in small portions, and you’ll be fine. In fact we’ll discuss entire “cheat days” later in the book.)

What is a calorie, and how is it measured?

We’re all familiar with the term “calorie” but not many of us know how the figures we see on food labels came about. Technically, a calorie is a measure of energy. The “calorie” seen on food labels is actually a kilocalorie (abbreviated kcal), but we’ll call it a “calorie” to keep with the common usage. The scientific definition of a “calorie” (kcal) is the energy required to raise the temperature of 1 kilogram of water (about a quart) by 1 degree Celsius (about 2 degrees Fahrenheit). But you can also measure how much energy it takes to do some other form of work, like lift a heavy object up certain distance, or push an object along a path, or heat up a steak enough to cook it (or digest it).

Originally, food calories were determined by placing food in a sealed container surrounded by water, and then literally burning it to see how much energy was released by measuring the rise in water temperature. However, burning the food in a bomb calorimeter (that’s the real name of the equipment, we’re not making it up) is no longer used today, because it’s incredibly simplistic in its approach. In particular, we don’t literally burn food inside our bodies---combustion is a different chemical process than digestion, except perhaps for jalapeños2.

Nowadays calories on food labels are calculated according to the nutrient components in the food (protein, carbohydrates, and fat) as specified by The Nutrition and Education Act of 1990, which states what information must be presented on food labels. Today most researchers use the Atwater system to determine the caloric content of foods. This system doesn’t burn food to determine the energy content but rather it uses a mathematical approach, calculating calorie contents by adding

2 That was a joke, in case you missed it.

the calories provided by the proportions of the protein, carbohydrates, fats and alcohol of the food (and subtracts the fiber portion of carbohydrates as often this is indigestible---a good example of the simplistic approach of the bomb calorimeter, since fiber can burn but does not digest). However, the figures that the Atwater system uses (4 kcal/g for protein and carbohydrates, 9kcal/g for fat, and 7kcal/g for alcohol) were also derived by burning and then averaging the results of these nutrients.

While it’s true that burning food until it’s a black cinder in a specially designed oven isn’t the same process as digestion, the fact is that it’s pretty much impossible to exactly measure how much energy we get from digesting foods. There’s simply no way to measure it exactly. What would you suggest? Even if we were to place a person in a sealed container, feed them precisely measured foods, precisely measure what they excrete, precisely measure the heat they generate and the exercise they perform… how do you measure how much energy remains in the excreted material?3

The point is: yes, there is a little bit of uncertainty as to the exact energy content in food. That doesn’t mean that the “calories-in, calories-out” theory is nonsense. The numbers in the Atwater system are pretty darn close, and there have been tons of rigorous scientific studies to support that.

3 TMI warning: yes, we’re saying here that you can burn poo and it will release energy, so clearly the process of digestion did not extract all the available energy in the food we ate. So how much energy is left? How would you measure it? Answer: you can’t, at least not precisely.

Calories-in, calories-out works in long term experiments

So how do we know that calories-in, calories-out is all there is to weight loss? It’s easy. All you have to do is lock a person in a room for a month, and feed them a certain number of calories of protein, and measure their weight loss or gain over that month. Then, for the next month, feed them the same number of calories, but this time make it fat. Then measure their weight loss or gain over the second month. Then in the third month feed them only carbs, but the same number of calories again.

Believe it or not, people have volunteered to participate in experiments similar to the above. (Not exactly like the above, but similar.) It’s been done dozens of times in the past few decades, all around the world, by various scientists. And the results are uniform and conclusive. If weight loss is your only consideration, it doesn’t matter what type of food you eat. As long as all other variables are held constant (like exercise and the temperature of the room), your weight depends only on the number of calories you eat, minus the calories you expend.

Yup. It’s just calories-in, calories out. End of story.

However, note I didn’t say anything about how happy the inmates were during these experiments. Yes, they volunteered, but other things were measured as well, such as satiety, how much they were satisfied, etc. Things like satiety and misery matter in the real world, so let’s do a “thought” experiment.

Imagine that you’re on a strict 1,500 calorie-per-day diet. Now imagine we change one variable---the type of food you’re eating to get those 1,500 calories. In one case, you eat only table sugar, all day, every day, totaling 1500 calories. In the second case, you eat only steak. And in the third case, you get your 1,500 calories per day as chopped celery.

In the first case, you get to eat 100 teaspoons of sugar, spread throughout the day. Do you think you’ll ever feel full? The answer is no. You will feel ravenously hungry the whole time. Pass the sugar, please.

In the second case, you get to munch your way through an enormous, 36 ounce steak, throughout the day. Will you feel full? Yes, you’ll feel quite full, even though you’re eating the same number of calories as 100 teaspoons of table sugar.

In the third case, you’d need to eat 100 cups of chopped celery throughout the day. Will you feel full? You betcha. You may not be happy, eating cup after cup of celery. You may get bored. You may not even want to finish all that celery. But you will feel full. Absolutely stuffed. Oh, and by the way… you’ll also have gotten 70 grams of protein from those 100 cups of celery. Yes, celery has protein. Not much per celery stick, but it's there. And the point here is that, if you eat 1,500 calories of whole food, even if it’s just celery, you’ll easily fulfill your recommended daily intake of protein.4

Get it? Calories in, calories out; just choose whole foods, and you’ll be fine.

4 We’re taking bets on how long it’ll be until some quack reads this and starts touting the “100 cups of celery diet”. Any takers? C’mon, it’s at least as good as the Maple Syrup Diet, the Apple Diet, or much of the other quackery you’ll find out there. To be clear: we are not recommending this diet. For one thing, celery has lots of Vitamin A, and eating 100 cups of it will way-overshoot your recommended daily intake of Vitamin A. This is just a thought experiment, not a real one.

To cook or not to cook – is it a calorie question?

Historically (meaning, when we lived wild and free as hunter-gatherers tens of thousands of years ago), food was always scarce. Until we started growing our food, it had to be hunted and gathered, and that required work. Each and every time you got hungry, you had to go out and find or hunt your food. That’s hard work, and it basically means that you spend most of your time being hungry. In the wild, calories are scarce, and nobody who lives in the wild would be willing to put in the amount of work that would be required to become obese. In fact, in the wild, calories are so hard to come by that it’s advantageous to find ways to enhance the caloric value of food.

There is evidence that the usable caloric value of food is significantly enhanced when it’s cooked. Richard Wrangham, an anthropologist at the Harvard University, has been arguing for some time that cooking has enabled us to evolve to where we are today, and that we actually cannot thrive (note, we said “thrive” not “survive”) in the wild on raw food since it’s just not nutritious enough.

Evolutionary digression

If we look at our evolutionary timeline, fossil evidence suggests that smaller monkeys diverged from the great apes about 28 million years ago and that we (Homo sapiens) diverged from other great apes about 6 million years ago (bear with us, you’ll see how this is related to cooking shortly). Genetically speaking, there is only a 7.3% difference between monkeys and great apes, and only about a 1.6% difference between us and chimpanzees. We share a common ancestor with chimpanzees and it is for that reason that chimpanzees are often studied with the aim of trying to gain insight into the mind of our earliest human ancestors. Such research does of course make the

assumption that there has been little evolutionary change to the mind of the chimpanzee in the last 6 million years. While we may not be able to speculate on the evolution of the inner workings of a chimpanzee’s brain over the last 6 million years, we do know that the brain size of the chimpanzee has remained constant for that time, and thus is similarly-sized to that of our early human ancestors.

Humans, on the other hand, have changed significantly in the last 6 million years. Most notably, our brain size tripled, most of that increase having occurred in the last 2 million years. Interestingly, according to archaeological evidence, 2 million years ago is also about the time we started cooking our food. Professor Wrangham hypothesizes that the extra nutrition available in cooked food, compared to raw food, may be a major factor in what fueled our brains to grow so large so quickly.

A recent study by Carmody, Weintraub, and Wrangham (2011) has shown, for the first time, that when food is cooked you actually get more energy (i.e. more calories) from it than if you eat it raw. By cooking our food (without overcooking) we increase the energy content available to our digestive system.

What about raw food diets?

When considering the nutrition of cooked and uncooked food for humans, it is important to remember that, while we share a common ancestor with other monkeys and apes, that occurred a long time ago. When we branched off from that ancestor, we evolved in different ways. So all the people who say, “Gorillas and chimpanzees don’t eat cooked food so neither should we,” should bear in mind that we did not evolve from gorillas and monkeys, but from a common ancestor. Thus, it doesn’t make

sense to directly compare ourselves with our ape counterparts today when we’ve had over six million years to evolve away from each other. So far as we know, gorillas don’t ponder the laws of relativity or create stories about alternate universes. Our brains have developed very differently from those of the other great apes, and our diet has developed differently too. In fact, one other recently published book (Grain Brain, by David Perlmutter, M.D.) posits that our brain has started to shrink again ever since we started eating diets high in grains and other carbs, rather than the cooked meat our ancestors have eaten over the past 2 million years.

Now we’re not suggesting that people who eat a lot of uncooked vegetables will have smaller brains and stay in the dark ages, blindly hitting their fridge door with a head of broccoli trying to work out how it opens. It’s totally fine to eat raw food if you’re watching your weight but if, for example, you’re suffering a deficiency somewhere (one of the authors personally suffers from anemia) then you should consider cooked food over raw food in your effort to correct any imbalances. Similarly, for those trying to put on weight, and especially for growing children, a raw diet may not do you any favors.

So, to answer the question as to whether cooking your food is a calorie question, we say it is. The difference in caloric value between cooked and raw food is important, as all the calorie contents you find on food packets are based on figures derived from cooked food---obviously, since it’s burned in order to measure the caloric value! If you eat a raw diet then your calorie numbers won’t add up correctly---if you choose to count calories at all.

The “fat is bad” movement

*Notes on Ancel Key’s 1953 paper, 6 countries: over the age of about 45, and in men more than women, increasing blood cholesterol is correlated with increasing risk of degenerative heart disease. Blood cholesterol, however, is not related to dietary cholesterol intake, but instead with the intake of fat. There is a very strong correlation across countries demonstrating this link: namely that increased dietary intake of fat is associated with increased risk of degenerative heart disease. This 1953 paper makes no claims about anything related to weight or obesity, only to degenerative heart disease. It also makes no distinction between saturated and unsaturated fats.]

The next theory as to why we are fat is that “we are eating too much fat.” Again, it seems quite blindingly simple, almost as though our muffin tops are directly formed from the sticks of butter we have consumed. With apologies to those who believe the phrase “you are what you eat,” it turns out that eating fat doesn’t actually make you fat (unless it’s eaten in gross excess). Another favorite saying is “a moment on the lips is a lifetime on the hips” (women are probably more familiar with that one than men).

There is lot of hot air being blown around by many, many people, about what you should eat. High carb, low carb, slow carb, high protein, low protein, meat-based, plant-based… it’s very difficult to know what’s right. What’s more, even the scientific community doesn’t have a broadly accepted recommendation on what’s best to eat for health.

To take one high-profile example, we’ll look at the controversy revolving around dietary fat. A good place to start is Ancel Keys and his study, published in 1953, about dietary fat and heart

disease. One would think that, since this study was done more than 50 years ago, there would be a clear consensus on whether he was right or wrong. Not so.

Ancel Keys and the heart disease epidemic

In 1953, Keys presented a study to the World Health Organization, in which he studied 18 countries, and focused on six5 . The study was concerned mostly with the causes of degenerative heart disease, and specifically the difference in rates of degenerative heart disease among those countries. The paper goes into depth into blood cholesterol levels, and comes to many very interesting conclusions:

- rates of degenerative heart disease is highly correlated with blood cholesterol levels. This conclusion still stands today.

- blood cholesterol levels have almost nothing to do with cholesterol that you eat. This conclusion is still pretty much supported by the scientific literature today, although it is widely misunderstood by the general public. In other words, go ahead and eat your egg yolks along with the whites. Keys was correct on this point.

- instead, blood cholesterol is strongly correlated with fat that we eat.

Keys went on to demonstrate a strong correlation between the amount of dietary fat eaten, on average, in a country, and that country’s rate of degenerative heart disease. Much has been written about this correlation, even today, because Keys focused mostly on 6 countries, rather than the full set of 18 that he studied. However, he had good reason, and he even

5 Not to be confused with the “seven-country study”, in which 22 countries were studied with a close focus on seven. That study was published in the 1970s.

explained it in the paper: “So far,” he wrote, “it has been possible to get fully compatible dietary and vital statistics data from 6 countries.” In other words, the other countries either didn’t have reliable death records, or didn’t use similar enough death classifications, or that data was not readily available. The idea that he somehow “cherry-picked” the data, although widely suggested, is false. In any case, Keys showed a very strong correlation among 6 countries that were chosen based on the reliability of their death records. However, even among the full set of 18 countries, with less reliable or less comparable death records, the correlation doesn’t go away---it’s just not as prominent as in the 6 countries for which reliable data was available at the time.

Keys’ 1953 study focused on the correlation between degenerative heart disease and dietary fat---without differentiating between saturated and unsaturated fats, or trans fats, which we now know is an important distinction. His later study, published in the 1970s, is the (in)famous “Seven Country Study”, in which 22 countries were studied, with a focus on seven. Again, he had good reasons to focus on those particular seven, and it wasn’t just cherry-picking.

We will not go into any more detail about Ancel Keys here, because there’s a wider point to be made. The wider point was made in the 1960s, by XXXXXXXXXXXXX, and it is this: while it is true that dietary fat strongly correlates with degenerative heart disease, it’s not like that’s the only reason people die. People die for many other reasons, and once you account for all those other reasons, the importance of dietary fat becomes less of an issue. Keys focused on degenerative heart disease because that particular cause of death was on the rise in the U.S. in the mid-20th century, so it was reasonable to ask why. The problem was not that Keys was wrong, or that he was cherry-picking countries, or that he was misleading people with regards to the

link between degenerative heart disease and dietary fat. He was correct on all those counts. The problem is that people die for other health reasons too, and it was naïve to ignore all the other reasons people die just to decrease the rate of degenerative heart disease. Furthermore, there were other, equally valid correlations (such as with sugar consumption, discussed later) that Keys ignored.

Another, independent issue to keep in mind is the quality of diagnosis today vs. in the past. As with many statistics, the number of cases of something today may appear to be higher than for our ancestors, until we take into account that people live a lot longer these days and are more likely to be accurately diagnosed by doctors as having certain conditions. It may have been that our ancestors would have also developed heart disease had they lived long enough to develop it, and had someone correctly diagnosed incidences of heart disease and recorded it. Diagnosis today is far better than it was previously, and even record-taking is far better today than in the past. So we cannot definitively say the rate is really higher today than it used to be because we are not comparing equal sets of data.

Sugar: the overlooked correlation

Another fact that really hits home is that, out of all the countries studied, Japan and Italy had the lowest rates of saturated fat consumption and heart disease. BUT they also had the lowest rates of sugar consumption. Wait. What? Why wasn’t sugar also implicated in the “heart disease epidemic”? Well, despite the fact that sugar rates also correlated with heart disease, Keys didn’t think sugar was an issue. He explained it away in his report as, “The fact that the incidence rate of coronary heart disease was significantly correlated with the

average percentage of calories from sucrose in the diets is explained by the intercorrelation of sucrose with saturated fat.” Well, that’s true, and the confounding factor is probably that rich countries tend to have better access, compared to poor countries, to both fatty foods and sugar. Basically, Keys just reckoned sugar correlated with heart disease because where you tend to find fat you also find sugar (think cake, biscuits, ice cream, etc. – they all contain both fat and sugar). So sugar was overlooked and fat remained the villain, without a good argument as to why sugar should be eliminated from blame.

Fat is the villain: how myth became “fact”

Many researchers questioned Keys’ theory against dietary fat, and in 1957 the American Heart Association declared that the evidence showing that dietary fat is correlated with heart disease “does not stand up to critical examination.” This may or may not have been true, but again, we contend that the problem was that they were concentrating too hard on heart disease, without regard to other causes of death. Thus, just 3 years later, the American Heart Association changed its mind, stating that “the best scientific evidence of the time warranted a lower-fat diet for people at high risk of heart disease.” Note the caveat at the end: for people at high risk of heart disease. This is probably good advice, but it doesn’t mean that the advice should apply to everybody. That’s the problem: the advice became gospel, taken out of context, and suddenly fat was the villain.

The new report put Keys on the cover of Time magazine, which ran a four page article singing Keys’ praises and only made a fleeting reference to the fact that his diet advice was “still questioned by some researchers.” The media clung to the

purported evidence from the article, ignored the nay-sayers, and by the 1970s the “fat is bad” theory really took off. This was, in part, thanks to a committee, led by Senator George McGovern, who issued a report to the American public advising them that in order to reduce their risk of heart disease, they must reduce their intake of dietary fat. The major problem with the report was that it was written by politicians, not scientists. They were unaware that the “fat is bad” theory was at all controversial within the scientific community, and based their report on information from just one Harvard nutritionist named Mark Hegsted (that’s right, they based a nation-wide policy decision on one opinion without getting a second).

The report then caught the attention of Carol Tucker Foreman, an assistant agriculture secretary, who then hired Hegsted to create dietary guidelines for the US. These guidelines, recommending a diet low in fat, were issued to the general population in 1980. And it was thus that the “fat is bad” theory became properly established in the American psyche, despite the original scientific recommendation being restricted to those at high risk of heart disease.

Innocent until proven guilty, or not?

However, the lack of evidence for this theory did not go unnoticed. Shortly after the USDA published its guidelines, the National Academy of Sciences (NAS) objected to the advice being generally applicable. Not to be deterred by facts, the politicians swiftly gave the NAS a slap on the hand for denying the existence of a very real threat that had already been endorsed by the American Heart Association, McGovern’s committee, and the USDA. The USDA used its status and muscle power to shut down the argument against the “fat is bad”

theory, and the recommendatios propagated without serious opposition.6

But the skeptics were rightly skeptical. In clinical trials testing the “fat is bad” theory, the results kept coming back negative. In 2001, an enormous and comprehensive meta-analysis of all the available clinical data was published by the Cochrane Collaboration, and still found no significant effect of dietary fat on mortality rates, when applied across the general population. (They didn’t question the applicability of the advice for people at risk for degenerative heart disease, just the applicability of the advice for the general population.) McGovern (stay with us here, he’s a “fat is bad” advocate) responded by saying that his low-fat recommendations were endorsed by 92% of “the world’s leading doctors” (he didn’t quite say who these doctors were though). It rather begs the question: is this a case of the blind leading the blind? After the earlier put-downs of opposing scientists, were the pro-fat scientists really in a position to disagree with the UDSA and McGovern committee when the latter apparently had a plethora of world class doctors on their side?

What’s the current stance on fat?

Recent research from Cambridge University, UK, yet again confirms that fat has been unfairly demonized. The Cambridge team conducted a meta-analysis of 72 studies involving 600,000 participants in 18 countries. A key finding was that total saturated fat levels showed no association with heart disease. The lead researcher, Dr. Rajiv Chowdhury, said, “These are interesting results that potentially stimulate new lines of

6 A class-action lawsuit of biblical proportions awaits.

scientific inquiry and encourage careful reappraisal of our current nutritional guidelines.”

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, which co-funded the study, also commented: “This analysis of existing data suggests there isn’t enough evidence to say that a diet rich in polyunsaturated fats but low in saturated fats reduces the risk of cardiovascular disease.” In other words, there is no evidence to suggest that saturated fats are bad for you, unless you have a predisposition towards heart disease.

London cardiologist Dr. Aseem Malhotra commented on the Cambridge study saying,

This huge and important study provides even more evidence that our focus purely on saturated fat as the number one dietary villain in causing heart disease has been misplaced when we should be focusing on food groups. Our over-consumption of processed food is what is driving much of the increasing burden of chronic disease currently plaguing the Western world. Poor diet is responsible for more disease than physical inactivity, alcohol and smoking combined. Furthermore, nutritional supplements have no proven benefit for the vast majority of people. It’s better for the body to gain essential nutrients from just eating real food.

Did you read that? A cardiologist said, “Supplements have no proven benefit for the vast majority of people.”

Further note on vitamins: About half of U.S. adults take vitamins and other supplements daily, spending over $25 billion yearly on dietary supplements. To Quote David B. Agus, MD, “Why, in this age of plenty, do we need to rely on manufactured

pills to get our vitamins and other nutrients?” (The End of Illness, 2011). Unless you have a genuine, bona fide deficiency then you should be looking to get all your nutrients from food. Not from a pill. Want more omega 3? Try eating some actual fish rather than taking a fish oil supplement. A multivitamin cannot make up for a poor diet.

What does this mean? It means (at least according to the Brits, who appear to be ahead of the curve in comparison to America) the butter can stay. What you really need to avoid is the trans fats (also known as hydrogenated fats).

Top Tip: A word on cholesterol. We’re sure you’ve read the above section and are now thinking, “Yeah, but saturated fat still raises my cholesterol levels. Isn’t that bad?” Saturated fat will indeed raise your cholesterol levels. But providing the saturated fat you eat comes from grass fed animals (as opposed to corn and soy fed animals) then it will raise your “good cholesterol” levels and not your “bad cholesterol” levels. It’s the bad cholesterol you need to worry about. That’s the stuff that sinks into your arteries and hardens them (bad news). What raises your levels of “bad cholesterol”? Carbohydrates do---in particular, refined carbohydrates. More on that later…

What are trans fats and where do they come from?

Trans fats are made from a process called hydrogenation, whereby hydrogen is added to vegetable oil. Hydrogenated fats are a synthetic form of fat that you won’t find in nature. We made them because hydrogenated fats don’t spoil on the shelf as quickly as some other fats do (you can probably guess where this is going). The manufacturing industry went in for trans fats

in a big way because trans fats help processed food have a longer shelf life. Trans fats are also preferred for deep frying because they give foods a less greasy texture than regular fats (which means you can eat more donuts and fries than other fats before you start to feel sick).

We now know that trans fats are bad news. So bad, in fact, that some European countries have banned them outright: Denmark in 2003, followed by Switzerland in 2008. The FDA and the food industry in the U.S. have both acknowledged the dangers of trans fats, but they have yet to ban them. However, they are making an effort to remove them from our diet and any products that contain trans fats must clearly state so (so make sure you check the labels of your food for them).

Where are you most likely to find trans fats? In processed food, fast food, baked goods, margarine and candy bars. You should check the label of anything that’s designed to sit on a store shelf for any length of time, and you should be wary of anything deep fried.

Points to take away

Energy in vs. Energy out doesn’t add up.

Saturated fat isn’t the bad guy you thought it was.

Calories are not as straightforward as they seem.

Food is a better source of nutrition than supplement pills.

Hydrogenated and trans fats are bad.

Chapter 3 – biology 101:

Digestion

As the previous chapter explains, neither the energy imbalance nor the “fat is bad” theory adequately explain why we are now so overweight. We’ve been counting calories and reducing our dietary fat since the USDA gave out it’s guidelines in the 1980s and yet we’ve not been getting thinner, we’ve been getting fatter. Could it be that fat isn’t the culprit and that it’s not a simple case of doing the math? Clearly something is going on inside our bodies that is affecting our weight and we need to go back to our biology for the answers.

The first thing we need to understand is what happens when we eat different types of food. We’re sure you learned the basics of digestion at school, but for some of you that may have been a while ago. So here’s a reminder of how it works.

The short version:

Digestion is a mechanical and chemical breakdown of food into components that are useful for your body. Mechanical digestion starts in the mouth as your teeth break food into pieces that are small enough to swallow (no, you’re not supposed to inhale you food, no matter how hungry you feel). Mechanical digestion continues as food passes down your throat using muscular action which pushes food along the gastrointestinal tract.

Chemical digestion happens all the way along the digestive system and involves enzymes and a few other things that help break down food into smaller molecular parts so that it can pass into the bloodstream via the small intestine and be transported to where it is required. Whatever is left over is passed through the colon and out of the rectum.

The long version:

You’ve probably heard the phrase “you eat with your eyes” on some patronizing cookery program where they tell you to make your carrots look like swans. Ironically they are right even if swans are not involved: sight and smell are where digestion first starts. The sight and/or smell of yummy food informs your brain that “food time!” is nigh, resulting in the following actions:

Your mouth starts to water (increasing saliva).

You get hunger pangs (your brain is worried you might ignore the food).

Your intestinal glands start to secrete digestive chemicals in anticipation.

Once you actually put food in your mouth, the show starts. Your teeth grind up the food and saliva is released to make food mushy. The enzyme amylase, which is present in saliva, starts to break down carbohydrates. That’s right, carbohydrates start to be digested the moment you put them in your mouth. Then you swallow and pass the food into your esophagus where it is moved down to your stomach by waves of muscle contractions called peristalsis in the esophagus, stomach and intestines. Once food reaches the bottom of the esophagus, the lower sphincter opens to let food through and then shuts to prevent acid reflux.

In the stomach, the food is swooshed around by the stomach muscles, a bit like clothes in a washing machine, and is broken into even smaller pieces. The stomach contains digestive enzymes and hydrochloric acid which further help to break down food. At this point whatever you ate now looks like a

sloppy, gloopy soup. When the stomach has done its bit this goop is passed into the small intestine.

The small intestine is where the majority of digestion and enzyme action happens. When food enters the small intestine, the pancreas secretes a very powerful cocktail of digestive enzymes and it is here where the full digestion of lipids (fat), carbohydrates, proteins and nucleic acids happens with the following enzymes:

Lipase – breaks down lipids (fat) into fatty acids

Amylase – breaks down starches into monosaccharides (simple sugars e.g. glucose)

Nuclease – breaks down nucleic acid (found in almost all foods) into nucleotides

Protease – breaks down protein into amino acids

A few other extra things are thrown into the mix such as an alkaline secretion from the pancreas that neutralizes the food after the acidity of the stomach, and bile from the liver which emulsifies7 fats and makes them easier to digest.

Once all the enzymes have done their job, the nutrients (assuming all is working well in your body) will have been broken down into simple parts: fatty acids, simple sugars, amino acids and nucleotides. It is at this point that nutrients can pass through the wall of the small intestine, into the bloodstream, and are transported around the body to do useful stuff.

TMI Point

It is worth stressing that nutrients can only pass through the small intestine into the bloodstream when they

7 An emulsion allows two liquids to mix that don’t usually mix. For example, milk is an emulsion of fat and water.

have been broken down into these small components. If something along the way isn’t working properly or you don’t chew your food properly, then the body will struggle to break down the food and the nutrients will not be able to get into the bloodstream as the molecules will just be too big to pass through the wall of the small intestine. So, if you see half-digested food in your poop then you should seriously consider chewing your food more before you swallow it. (Except for indigestible things like the wrapper around corn kernels.)

After the small intestine has taken all the nutrients it can, the remaining sludge is passed into the large intestine (aka the colon) where any water in the sludge is reabsorbed into the body. Whatever solid waste remaining is then passed down and out of the body.

Understanding how the body processes food is important when trying to understand why we have gotten so fat. You need to understand and know how the fundamentals work before you can diagnose and fix more complex problems. Otherwise you’re like a guy standing over the hood of a modern engine going “I think it must be the wishy-whizz bolts that are broken” (i.e. you’re just blindly guessing what’s wrong). What’s most clear from the biology lesson is that because carbohydrates start to be digested as soon as you close your lips they’re a faster source of fuel when compared with other food groups. And when it comes to weight control, it turns out that fast digestion is not a good thing. This is an important point to remember for the next chapter where we talk about insulin and its role in weight control.

Points to take away

Digestion is a complicated process.

The body processes different nutrients in different ways.

Carbohydrates start to be digested as soon as you put them in your mouth.

Chapter 4 – the Insulin and

Carbohydrate link

New York Times best-selling author Gary Taubes sums up the insulin and carbohydrate link aptly in his book, Why we get fat (Anchor Books 2010):

First, when insulin levels are elevated, we accumulate fat in our fat tissue; when these levels fall, we liberate fat from the fat tissue and burn it for fuel. This has been known since the early 1960s and has never been controversial.

Second, our insulin levels are effectively determined by the carbohydrates we eat – not entirely, but for all intents and purposes. The more carbohydrates we eat, and the easier they are to digest and the sweeter they are, the more insulin we will ultimately secrete, meaning that the level of it in our bloodstream is greater and so is the fat we retain in our fat cells.

“Carbohydrate is driving insulin is driving fat,” is how George Cahill, a former professor of medicine at Harvard Medical School, recently described this to me.

The word “carbohydrate” came about because a glucose molecule consists of six carbon atoms (the “carbo” bit) and the elements of six water molecules (the “hydrate” bit). There are two types of carbohydrates; simple and complex. You will see this on food labels, where it says “carbohydrates” and then below that “sugars”. The carbohydrates bit refers to complex carbohydrates and the sugars bit refers to simple sugars or “fast” sugars.

Simple Carbohydrates (Sugars)

Glucose is a simple sugar found in most plants, as it is one of the products of photosynthesis (photosynthesis is the process by which plants gain energy from sunlight. The chemical reaction is: carbon dioxide + sunlight → glucose + oxygen).

Fructose is the simple sugar found in fruit, which the liver converts into glucose.

Sucrose is the simple sugar you find on your kitchen table that looks just like salt. It consists of one glucose and one fructose molecule, bonded together.

Lactose is the simple sugar found in milk, consisting of one glucose and one galactose molecule (the liver also converts galactose to glucose).

Simple sugars all taste sweet and are digested very easily and quickly (which, it turns out, is usually not a good thing). The acid test (sugar test?) as to whether something is a simple sugar or not is easy: if it tastes sweet, it’s a simple sugar.

Top tip: Food labels fail to distinguish between the sugar that is found naturally in food and added sugar. You actually have to read the ingredient list to see if there is additional sugar in the food, over and above what you’d naturally expect to find. There are a lot of names for added sugars other than “sugar”. We include a list in the appendix to help you avoid being caught out by sneaky sugar.

Complex Carbohydrates

The other carbohydrates you hear about are complex carbohydrates (a.k.a. starches). These are formed of chains of glucose molecules (rather than single glucose molecules). Assuming you eat your vegetables you will likely already be getting the glucose your body requires to function because plants store glucose as starch. As mentioned above, plants produce glucose via photosynthesis, and when the glucose isn’t immediately required, they join the glucose molecules into chains and store them as starch molecules. During digestion the body breaks down these starch chains into individual glucose molecules, which are then passed through the small intestine into the bloodstream. However, it takes a lot longer to digest a starch than it does a simple sugar. And this is why broccoli won’t give you a sugar rush like white bread or candy will. (If you’ve ever had a “broccoli high” we want to hear about it.)

Almost everyone today knows that complex carbohydrates are better than simple ones and this quote from the Yale Guide to Children’s Nutrition explains why:

If complex carbohydrates are broken down to monosaccharides8 in the intestines before they are absorbed into the bloodstream, why are they better than refined sugar or other di- or mono-saccharides?9 To a great extent it has to do with the processes of digestion and absorption. Simple sugars require little digestion, and when a child eats a sweet food, such as a candy bar or a can of soda, the glucose level of the blood rises rapidly. In response, the pancreas secretes

8 Monosaccharide - any of the class of sugars (e.g., glucose) that cannot be hydrolyzed to give a simpler sugar. 9 Di-saccharide - any of a class of sugars whose molecules contain two monosaccharide residues (e.g., sucrose and lactose).

a large amount of insulin to keep blood glucose levels from rising too high. This large insulin response in turn tends to make the blood sugar fall to levels that are too low 3 to 5 hours after the candy bar or can of soda has been consumed. This tendency of blood glucose levels to fall may then lead to an adrenaline surge, which in turn can cause nervousness and irritability... The same roller-coaster ride of glucose and hormone levels is not experienced after eating complex carbohydrates or after eating a balanced meal because the digestion and absorption processes are much slower.

Out of all the food groups we digest, carbohydrates have the most extreme impact on the body (with simple sugars arguably having a detrimental effect). As we’ll soon see, an elevated insulin level, especially if it’s chronic, leads to all sorts of problems, eventually ending in---say it with us---getting fat.

What does insulin do?

According to the Encyclopedia Britannica,

Insulin helps transfer glucose into cells so that they can oxidize the glucose to produce energy for the body. In adipose (fat) tissue, insulin facilitates the storage of glucose and its conversion to fatty acids. Insulin also slows the breakdown of fatty acids. In muscle it promotes the uptake of amino acids for making proteins. In the liver it helps convert glucose into glycogen (the storage carbohydrate of animals) and it decreases gluconeogenesis (the formation of glucose from non-carbohydrate sources). The action of insulin is opposed by glucagon, another pancreatic hormone, and by epinephrine [adrenaline].

As you can see, the primary function of insulin is to regulate blood sugar levels and get energy to the body. But we want to draw attention to two things from this definition. The boldface in the above quote is ours.

1) The first boldface part basically tells us that insulin makes fat cells fatter.

2) The second boldface part tells us that insulin locks fat into fat cells even if your body needs the energy.

That second point deserves emphasis: even if your body needs energy, high insulin levels will lock energy inside your fat cells, so your body is forced to go find energy elsewhere---such as breaking down and digesting your own muscle. Yup, you read that right: when you eat too much sugar, it leads to your body digesting your own muscle tissue to get energy once the sugar has been stored away as fat, because the insulin is still in your bloodstream even when the sugar is gone.

Carbohydrates & insulin spikes

As far as hormones go, insulin is, in many ways, a fairly straightforward one. So the line, “I didn’t know that bag of sweets would make my blood sugar levels yo-yo,” isn’t going to fool anybody. Insulin has a direct relationship with the carbohydrates you eat. The more simple carbs there are in your diet, the more insulin there will be in your system. It is that simple.

When there is too much sugar in the blood (remember simple carbohydrates are all quickly converted into glucose) your insulin starts to behave like a 5 year old that just drank three espressos. It runs amok, messing up the body’s ability to do its job properly and it stops you from being able to break down

stored fat for fuel. Only simple carbohydrates have this effect on insulin levels; protein, complex carbs, and dietary fat do not.

Keep that in mind next time you look longingly at that chocolate bar or that big, sugary dessert. The sugar gives you a rush... and then once the sugar has been used up or stored, you can’t access the energy in your fat cells because it’s locked there due to high insulin levels. At that point you essentially have no energy available anywhere. The result is commonly called a “sugar crash.” Your body does have energy, but it’s locked in your fat cells, unable to escape due to high insulin levels. So you run on fumes, feel exhausted, and reach for more sugar. It’s a vicious cycle, and one that is all-too-familiar to too many of us.

Insulin & fat storage

Not only does insulin regulate your blood sugar levels, it also coordinates the storage and use of both fat and protein. When there is glucose in the bloodstream, our insulin levels are high. This gives us an immediate energy boost (good), but unless you use that energy immediately, it needs to go somewhere. The surplus goes mostly into our fat cells (bad), with small amounts getting stored as glycogen in the liver and muscles.

In order for fat to get into our fat cells, it must enter through the cell membrane as a small molecule in the form of a fatty acid (recall from Chapter 3 that during digestion fats are broken down into their smallest components, fatty acids). Once inside the fat cell, fatty acids are converted into large, immobile, storage molecules called triglycerides. Triglycerides are too big to exit the fat cell, and can only leave when they are broken back down into fatty acids again.

How are carbs keeping your fat cells fat?

Insulin blocks the conversion of triglycerides into fatty acids, effectively locking the triglycerides into your fat cells.

It’s worth emphasizing this point a third time, because it’s so important: insulin locks fat into your fat cells. And if you eat carbs, you’re going to have insulin coursing through your veins.

It goes like this: the hormone directly responsible for breaking down triglycerides into fatty acids is hormone-sensitive lipase (HSL). Insulin suppresses HSL, thus inhibiting the breakdown of triglycerides. Alarmingly, the amount of insulin required to shut down the flow of fatty acids out of fat cells and into the body is a very small amount, so even just that one cookie may be enough to stop HSL in its tracks, locking your fat inside the fat cells.10

To summarize once again: insulin directs fat from the bloodstream into the fat cells while simultaneously preventing stored fat from leaving fat cells. This is very bad news if you’re a guy on the hunt for six-pack abs, or if you’re a girl trying to fit into that tight pair of jeans.

10 Wayne has a personal story about that: when I first tried Tim Ferriss’s “Slow Carb Diet”, I eliminated all sugars except one: I couldn’t give up my one spoon of maple syrup in my morning coffee. Annoyingly, I didn’t see any weight loss for the first few weeks. Then I thought, “Could that one spoon of maple syrup really be all that important?” Yes, Virginia. Yes, it is. I eliminated it and bam, my weight started dropping. The insulin resulting from one lousy spoon of maple syrup per day made the difference between allowing fat to escape my fat cells, or not. Believe it: cutting sugar completely out of your diet will not be easy, but you will be astounded at the results. (But stay tuned: cheat days will be your saving grace. I live for cheat days.)

Take an insulin lesson from the type 2 diabetics

For anyone that needs further confirmation of how damaging simple carbohydrates are on our insulin levels, you need only look to those that suffer from Type 2 Diabetes. People who suffer from this disease must rigorously watch what they eat in order to keep their insulin levels low, because for them, high insulin levels can lead to a plethora of issues such as problems with vision (in extreme cases it can lead to blindness), foot ulcers or even gangrene (which occasionally results in limb amputation). Since there is no cure for Type 2 Diabetes, all they can do is manage the condition by frequently monitoring their blood sugar levels and controlling what they eat. Unlike the general population, type 2 diabetics are well aware of the worst insulin-spiking offenders.

The foods most commonly avoided by type 2 diabetics (because they can spike insulin levels) include: anything highly processed (especially white foods, such as sugar, bread, pasta, fries), refined grains, cereals, chips, biscuits, cake, sweets, jam, soda, ice cream, etc. You get the picture. Basically whatever tastes sweet and yummy isn’t allowed. If you want to stabilize your insulin levels but don’t know where to start, then follow the type 2 diabetics’ diet, and cut out the carbohydrate-based insulin spiking foods.

Top tip: Don’t be fooled by “healthy” sugars either, such as the ones labelled fruit sugar (that’s fructose) or agave (also contains fructose). They’re all still sugar, and therefore bad news for your insulin, your health, and your six-pack.

Fruit & the vitamin misconception

Prepare yourself for a shocking statement: you do not need fruit every day.

<Gasp>

Fruit is full of sugar (fructose) and there is no evidence that you really need fruit more than once a week or so. It certainly wasn’t available regularly to our ancestors; even just 200 years ago it wasn’t available all year round. Fruit is seasonal and we would have only eaten if from local sources when it was in season. The fact that you can get it all the time now is not natural. So relax, you do not need it every day. You can get pretty much all the vitamins you need elsewhere. Given that getting your RDA of vitamin C is the most common argument for a “need” for fruit we list alternative sources of Vitamin C in the appendix.

Your orange juice argument is invalid: Quick fact: 100g of broccoli contains as much vitamin C as 100g of kiwi fruit, and almost twice as much as 100g of oranges. And if you hate broccoli, then red bell peppers contain even more: almost 3.5 as much times (per 100g) as oranges.

Fructose & fat storage

Whether you were aware of it or not, over-indulging in fructose is likely contributing to your weight problems. Research from the University of Texas Southwestern Medical Centre found that fructose was converted to fat faster than all other sugars. More worryingly, they found that when fructose was eaten along with fat, the fat was more likely to be stored than burned. “Our study shows for the first time the surprising speed with which humans make body fat from fructose,” said lead researcher Elizabeth Parks, PhD.

That’s right, if you eat fat with fructose, not only does the fructose get converted to fat faster than had you eaten glucose, but the fat you eat along with it is also more likely to be stored than burned.

Why is this so shocking? Because fructose is in almost everything now! The very sugar on your kitchen table contains fructose (sucrose is one glucose molecule bonded with one fructose molecule). Every time you cook a cake or a cookie, you are cooking with both fructose and fat (and that’s not even getting started on the amount of things that contain high fructose corn syrup. More on that later). What did we just learn from Dr. Elizabeth Parks? When you consume fructose along with fat, the fat is more likely to be stored than burned.

Fruit juice: fructose overload

Tragically, fruit juice, although it may seem like a healthy choice, is fraught with problems. First, fruit juice is a highly concentrated form of fructose, meaning that you’re getting way too much sugar. Second, it’s in pure liquid form, which means it gets absorbed into the bloodstream very quickly, resulting in a huge insulin spike. And we know by now that that means “fat cells get fatter.”

Instead of drinking fruit juice, eat the fruit whole. The fructose in a piece of whole fruit is okay (now and again) because it also contains fiber. The fiber helps to slow down the rate at which the sugar is digested, thus slowing the entry of sugar into the bloodstream. Even freshly pulverized juice is bad, because the juicing process destroys the delicate fibers in the whole fruit. What’s more, juice often has added sugar on top of the naturally present sugars. Juice does not grow on trees. If you’re

trying to eat a Paleo diet (discussed later), fruit is Paleo but juice is not.

Top tip: If you don’t like the taste of your water, buy a water filter. If you still find your water boring, add a slice of lemon or 100% lemon juice. Lemons have very little sugar in them, and are one of the few exceptions to the “no juice” rule.

Reducing your fructose intake

Whether your fructose comes from a high fructose corn syrup snack or from a glass of orange juice we recommend you cut your consumption of it way back. In fact cut out the juice and high fructose corn syrup products completely and just have the occasional whole piece of (fresh, not dried) fruit instead.

A final word on fructose: if you’re thinking that simply cutting out fruit will eliminate fructose from your diet then think again. As mentioned before, the very sugar in your cupboard contains fructose. That’s right. We’re talking about the white granulated stuff in the cupboard that you put in your coffee and cakes. What you commonly refer to as “sugar” (technically called sucrose) is actually a mixture of 50% glucose and 50% fructose. In order to cut down the fructose levels in your diet then you’ve got to cut out the white powder (you can leave the apples on the table).

What about “diet” sugars?

Just to further bum you out, picking “diet” or “sugar free” versions of things may not do you many favors either. As Gary Taubes explains (again in the September 2013 edition of Scientific American), some recent research has suggested that our bodies (and thus our insulin responses) are as fooled by artificial sweeteners as our taste buds. In other words, if fake sugars fool your taste buds into thinking something is sweet, then it’s not unreasonable to believe that the rest of your body will also be fooled. Result: elevated insulin levels even in the absence of calories.

This is particularly bad news for those with a Diet Coke addiction (like one of the authors – who is working on giving it up). It turns out that diet soft drink sales are falling as people become more wary of artificial sweeteners. “Diet everything” became a huge thing in the 1970s as we attempted to reduce our sugar intake. However, the catch is that while diet versions of things don’t contain the calories of their sugared counterparts, they may well have a similar effect on insulin levels. Research into the effect of artificial sweeteners on insulin levels is pretty scarce but preliminary results seem to suggest that at least some fake sugars may raise insulin levels much like actual sugar does. So while you’re not ingesting any calories, you are likely still keeping your fat locked in your fat cells by raising your insulin levels, which is also bad news for the six-pack/flat stomach quest. 11

So where does that leave us?

11 Try a little stevia instead (initial research suggests stevia does not raise your insulin levels like some sweeteners do).

It seems pretty clear that eating fat isn’t what’s causing us to store and keep fat in our fat cells. The cause is predominantly high insulin levels, which are preventing us from slimming down by keeping fat firmly inside our fat cells. So, for everyone that is sick of seeing that roll of fat that spills over your jeans whenever you sit down, it’s fairly obvious that the simple and refined carbohydrates and high quantities of fructose need to go. By eating fewer simple carbohydrates (or fast sugars) we should be able to normalize insulin levels and allow the body to use fat for fuel when it needs energy.

Points to take away

Starchy carbohydrates are merely chains of glucose molecules.

Dietary fat is not making you fat. High insulin levels are.

Fructose is bad news. Cut it out in all forms except the odd bit of whole fruit.

Some fake sugars may be as bad for your insulin levels as real sugar. Be wary of them until more research has been done.

Chapter 5 – Insulin, diabetes,

obesity & cancer

It’s no secret that an added bonus to obesity and diabetes is an increased risk of cancer. The connection between these diseases first came to light in 2004 from large scale studies conducted by the World Health Organization’s International Agency for Research on Cancer. The studies simply showed that you are statistically more likely to get cancer if you have diabetes or are obese.

Cancer seems to be a more frightening word than obesity or diabetes because it evokes a fear of death. When you say “obesity” or “diabetes” to someone they usually think “fat” or “lazy” and that you just need to lay off the cookies and you’ll be okay. But throw “cancer” into the mix, and suddenly people sit up and listen. It’s different. It’s a scary word. Sadly, this link is not yet widely known. Until obesity comes with a well-publicized warning of its link with cancer---until it is advertised as a life or death situation---the obesity epidemic will just continue to seem like just an inconvenience. Cigarettes come with hefty warnings of the dangers they pose to your health. The day may not be too far off that sugar will, too.

Are western diets & lifestyles to blame?

There are two further observations to back up the hypothesis that a good portion of cancers are a direct result of our Western diet and lifestyle. The first observation is that cancer death rates have increased significantly from the mid-19th century to now,

which correlates perfectly with the rise in diabetes rates. While this doesn’t necessarily imply that sugar is the cause of cancers, it does suggest that something is probably relating the two, at least indirectly. The relation may even be coincidence. For example, cancer rates may be increasing simply because people live longer today, and cancer is a disease of the old---nothing to do with diet. In addition, diagnostic tools have been getting better. Cancer is currently not easy to diagnose without a physical sample of tissue cells to test (from someone alive or dead), so better tools mean that when somebody gets sick, we more often discover that it’s cancer that’s the problem. However, even when all of this is accounted for, the World Cancer Research Fund International and the American Institute for Cancer Research stated, “it was apparent that age-adjusted death rates from cancer were rising in the U.S.A.” Meaning, the rates really were going up, and not just because people were living longer and doctors were getting better at diagnosing cancer.

The second observation that suggests diet is related to cancer is that malignant cancer is rarely seen, if not non-existent, in populations that don’t live Western lifestyles and don’t eat Western diets. In the 1950s, cases of malignant cancer in the Inuit populations were so rare that individual cases would be published in medical journals when they arose. Since the Inuit diet used to consist almost entirely of fat and protein---you don’t see many bananas growing in the Arctic---carbohydrates are immediately suspect, while fat is exonerated.

In 1984, thirty years’ worth of cancer incidences in the Inuit population were published by Canadian physicians. And while the research showed a “striking increase in the incidence of cancers of modern societies” such as lung and cervical cancer, the physicians noted there were still “conspicuous deficits” in breast-cancer rates. Astonishingly there was not a single case of

breast cancer in an Inuit patient prior to 1966, and only two cases between 1967 and 1980.

What changed so dramatically in the 80s? After the 1980s, the Inuit diet became westernized like ours, and breast cancer rates steadily grew. And while their rates are still lower than the rates in other North American ethnic groups, it seems fairly clear that the variable that changed was their diets. Once their diet changed, the rates of breast cancer started to go up, as did their rates of diabetes. This makes it pretty clear that diet can impact your health in ways that are beyond your weight.

What does insulin have to do with cancer?

So, now that diabetes and obesity are linked to an increased risk of cancer, the next question should be, “How does cancer relate to insulin?” Before getting there, we need to define a couple new terms. Insulin resistance is what happens to your cells when they get tired of always being immersed in high insulin levels: they start to say, “Ho hum, more insulin. Sigh.” They start to resist the effects of insulin. The result? Your pancreas says, “Oh yeah? Watch this!” and pumps out more insulin. This leads to a deadly cycle of increasing insulin levels, causing more insulin resistance. Insulin resistance is common in the obese, and is also a symptom of diabetes.

Note for later: insulin sensitivity is the opposite of insulin resistance, and it’s what you want in your cells. You want your

cells to be sensitive to insulin, so that only a small amount is needed to trigger the things insulin is supposed to trigger.12

Cancer researchers now believe that high insulin levels and insulin resistance (along with something called insulin-like growth factor, IGF) promotes the growth of many cancer cells.

Let’s say that again, in case you missed it. Insulin resistance, which is what you get when you eat too many fast carbohydrates, promotes cancer.

Craig Thompson, president of the Memorial Sloan-Kettering Cancer Center in New York, has performed much of the research on insulin and cancer. He explains that many cancer cells become dependent on insulin to provide them with their fuel (glucose from the blood) and the relevant things they require to grow and multiply. Insulin and insulin-like growth factor basically give the green light for cancer cells to grow. The more insulin there is, the more the cancer cells thrive. In fact, some cancers mutate in a way that specifically allows insulin to have a greater influence on cancer cells, whereas others just take advantage of the high levels of insulin present in people who are diabetic, obese or just plain have insulin resistance. Some cancer cells even do both. Insulin is effectively handing over food to the enemy so it can grow strong enough to invade and take over your body.

Why are we characterizing insulin as the bad guy instead of cancer? Well, Thomson believes that pre-cancerous cells might never mutate into malignant tumors without the presence of

12 This is because, ancestrally, our insulin levels have been low due to a lack of easily available fast sugars in the wild; ergo, we evolved to be insulin sensitive, not insulin resistant, and our bodies work best in that regime.

insulin which allows them to take up and metabolize increasing levels of glucose. It appears that elevated insulin (or insulin-like growth factor) signaling is a necessary step in many human cancers, in particular cancers such as colon and breast cancer.

Shocking fact: Breast cancer cells can be kept alive in a petri dish in a laboratory as long as you provide them with both glucose and insulin. The shocking bit is that if you remove the insulin and leave them with only sugar, they die. This suggests that if you reduce your own insulin levels, it may be harder for cancer cells to thrive inside you.

Lewis Cantley is the director of The Cancer Center at Beth Israel Deaconess Medical Center at Harvard Medical School. According to him, up to 80 percent of all types of human cancers grow because of mutations or environmental factors that either increase or imitate the effect that insulin has on developing tumor cells.

Most of the researchers studying the link between insulin and cancer are doing it primarily with the view of finding a drug to suppress the effect that high insulin levels have on cancer cells.13 They hope to develop one, but that’s a long, long way off---years, decades, or maybe never. Furthermore, most of this research is based on the assumption that chronically elevated insulin levels and insulin resistance are a result of being fat (for the most part this is correct) and many of these researchers recommend we exercise more in order to maintain a lean weight (this is an incorrect piece of advice, since exercise does not lower your insulin levels – you have to lower the carbohydrates in your diet).

13 We think it may be wiser to simply avoid the insulin spikes in the first place. Just sayin’.

However, some researchers, such as Cantley and Thompson, suggest that there’s a deeper explanation to the cause of insulin resistance than just “being fat.” They suggest that diet, and specifically sugar, is the cause. Their advice (which we really, really recommend you follow) is to avoid sugar. You certainly won’t find either of these men eating sugar or high-fructose corn syrup unless it absolutely cannot be avoided:

“I have eliminated refined sugar from my diet and eat as little as I possibly can because I believe ultimately it’s something I can do to decrease my risk of cancer,” Thompson said in an interview with Gary Taubes. When Cantley was interviewed he simply phrased it: “Sugar scares me.”

Insulin-like growth factor and dairy products

Due to the fairly clear link between insulin and certain cancers

we highly recommend you consider cutting out or lowering your

commercial dairy intake as well as your sugar intake14. The

hormone insulin-like growth factor (IGF), which behaves a lot

like actual insulin, is often found in milk products and this

hormone has been tied to cancers such as prostate cancer.

We do want to quickly note the difference between commercial

dairy and raw, grass-fed dairy products. In this section we are

referring to commercial dairy products. Grass-fed dairy products

14 Milk from grass fed cows or goats may be exempt from this warning; the jury is still out, but certainly grass feed is healthier for the cows themselves, and happy cows are better for both us and the cows.

(in particular, goat’s milk products) have been associated with a

decrease in metabolic syndrome15.

A lot of people use the argument that they need dairy products

for the calcium. However, you can in fact get all the calcium you

need from leafy greens, nuts and seeds. (We list alternative

sources of calcium in the appendix.)

If lowering your risk of cancer isn’t a good enough reason to kick

the commercial dairy then perhaps the fact it could be making

you fat is. While most dairy products are low on the glycemic

index scale they do produce a high insulin response (and as you

now know, low insulin levels are key for weight loss). So kicking

the dairy may well help you lose weight faster, as well as

lowering your cancer risk. There are many alternatives to dairy

out there and we recommend you try almond or coconut milk

instead (we don’t recommend soy as soy can raise your

estrogen levels – not good for men at all, and not good for

women’s hormonal balances).

A final aesthetic argument against dairy is the effect it has on

your skin. If you’ve never suffered from acne then you’re a very

lucky person indeed. For everyone else fed up of bad skin days

then we urge you to quit the dairy products pronto.

15 Metabolic syndrome is defined as a cluster of biochemical and physiological abnormalities associated with the development of cardiovascular disease and type 2 diabetes.

How is commerical milk related to acne?

The hormone IGF-1. This is found in milk because baby

cows need it to grow. But you’re not a baby cow. You’re

done growing. All it appears to achieve in humans is

growing pimples. IGF-1 is a contributing factor to the

characteristic redness and swelling of acne.

Dairy products cause an insulin spike. Insulin spikes are

bad news for your skin. It’s no secret that the first

advice you’ll get from a dermatologist about reducing

acne is to cut out sugar and dairy.

Dairy products make your skin more oily (you produce

more sebum) which leads to more clogged pores and

thus more acne. (Wayne has first-hand experience with

this; my face is far less oily after giving up dairy.)

There are at least five studies that confirm the link between

milk and acne. The more you consume the worse your acne will

get. We don’t think you should need any more reasons to kick

the white stuff.

Points to take away

Two of the world’s leading cancer researchers are afraid of sugar and avoid it like the plague.

Obesity and diabetes put you at an increased risk of cancer.

There were almost no cases of breast cancer in the Inuit populations until a Western diet high in sugar was adopted.

Many cancer cells need nsulin (or Insulin-like growth factor) to grow. Breast cancer cells die without it.

Dairy isn’t doing your waistline or your skin any favors.

Chapter 6 - Cut out

carbohydrates? What about the

food pyramid?

We are proposing that you cut out most conventional fast carbohydrates in order to lower your insulin levels, and switch your body’s energy stores from glucose to stored fat. Doesn’t this mean that we are going against what everyone currently believes is correct? Well, yes and no. Most people are familiar with the food pyramid and the U.S. Plate example of what we are supposed to eat and in what proportions. However, the current advice is not the advice we have always been given. Since 1916, the U.S. has issued several different nutritional guidelines. Let’s have a look at how they have changed over the years.

1916 - Food for Young Children

"Food for Young Children" along with the sequel "How to Select Foods," was the first dietary guide issued by the USDA that contained detailed recommendations. It suggested, in order: (1) milk, meat, fish, poultry, and eggs; (2) bread and other cereals; (3) butter and other “wholesome fats”; (4) vegetables and fruits; (5) simple sweets.

1943 - The basic 7

The National Academy of Sciences developed the first-ever recommended daily allowances of nutrients and, armed with these new figures, the USDA created new dietary guidelines embracing the recommended RDA’s. The result was the “Basic Seven”, designed to make sure everyone got adequate levels of necessary nutrients. It’s worth noting that while the 1946

edition provided serving sizes it didn’t go so far as to define how much a serving should be (a small portion of meat or half a cow on your plate?). Also, contrary to what is commonly believed today, one of the seven groups of foods considered essential in this model was butter. Fat was considered essential. And indeed it is---for example, there are certain vitamins, like vitamin K, that can only be absorbed in the body in the presence of fat.

1956 - Essentials of an Adequate Diet

"Essentials of an Adequate Diet" revised the guidelines to a more concise basic four food groups: dairy; protein; fruits and vegetables; and grains. These guidelines were still focused on making sure people got enough to eat.

1979 - Food

In the somewhat unimaginatively named 1979 guidelines “Food,” the USDA sought to address the link between food and disease. In addition to the four basic food groups, this edition added a section about “fats, oils and sweets,” and advised people consume these in moderation.

1992 - Food Pyramid

This is when the well-recognized food pyramid was introduced. The pyramid was designed to visually simplify the USDA guidelines so it would be easy to know what proportions of what foods should make up your diet. Food groups like fat and sugar, which the USDA deemed should be limited, were put at the top of the pyramid in the smallest section. However, this edition made no distinction between good fats, such as avocados, and bad fats, such as trans fats. All fats were tarred with the same negative brush.

2005 - MyPyramid

The pyramid got a facelift in 2005 and went online. However it was not a very successful move. Feedback on the online model was that it was vague and unclear. No one knew what the wedges were supposed to represent. So this edition was a bit like a facelift that went bad.

2011 – The Plate and the Moon

In a move away from the pyramid model the USDA decided to use a plate as a visual aid instead. The plate consisted of the four basic food groups. Lacking space on the plate for dairy, they decided to have a dairy “moon” orbiting the plate (a clever reference the Moon being made of cheese?).

Clearly, the guidelines have changed quite a bit over the last 100 years and, until the relatively recent pyramid model, we were not advised to have the vast majority of our diet consist of grains. But out of all the guidelines that were issued by the USDA, this seems to be the message that has stuck the most, and has now become so ingrained (pardon the pun) into our beliefs that it’s controversial to argue otherwise. If you tell someone that they shouldn’t eat so many whole grains (or any type of grains) you’re likely to be met with incredulity, much as you would by trying to offer a steak to a vegan.

Going against the grain

We’re going to go one step beyond suggesting you cut all fast carbohydrates out and also suggest you cut out grains from your diet. There may be economic reasons to choose grains as a food group, especially when we consider that the generation that promoted grains grew up during the Great Depression:

grains are cheap and easy to produce, much cheaper than meats and vegetables.

In fact, the “cheap and easy to produce” argument goes back about 10,000 years, back to the time humanity started to farm in the first place. Grains entered our diet at least 40,000 years ago, but when you gather wild grains you can’t possibly gather very much of it (the grain itself is tiny, and it’s the only part you eat, so in the wild you can’t get much). However, with the advent of agriculture about 10,000 years ago, grains became a big part of our diet because they’re easier to domesticate than other plants: they are easy to grow, harvest, store, and carry-over to the following year using seed grain. So as we moved from a hunter-gatherer lifestyle to one of farming, grains became a much larger part of our diet than previously. Grains also provide a modest amount of protein. That, along with the carb-based calories provided by the grain, allowed a settlement to subsist almost on farmed grains alone.

While it is true that we can subsist on a diet primarily consisting of grains, the real question today is whether grains are the healthiest food group on which to base the majority of our nutrition. Yes grains are cheap, but are they healthy?

The evolution of the human diet

To answer this question, we need to go back further than 10,000 years. From an evolutionary perspective, 10,000 years is actually a short time. Recall that as a species, Humans started cooking food about 2 million years ago. To put into perspective the difference between 10,000 years ago, and the 2 million years that came before it, we turn to the documentary film The Perfect Human Diet (Thompson Hunt Media, 2012). In that film, producer, writer and director C.J. Hunt presents a football field

analogy. Along with him is Loren Cordain, Professor of Health & Exercise Science at Colorado State University and author of The Paleolithic Diet. In this analogy, the past 2 million years is made analogous to a 100-yard football field. The 100-yard line represents 2 million years ago. During the vast majority of that 2 million year period, our diet consisted mostly of meat that we hunted, augmented by a small amount (calorie-wise) of gathered fruits and vegetables. Grains did not appear until 10,000 years ago, which represents the ½ yard mark. That means for 99½ yards of the football field there were no grains in our diets. (See Figure.)

Another point that one may argue from the above paragraph is the phrase, “our diet consisted mostly of meat.” How do we know that? Well, we didn’t---until very recently. Professor Mike Richards is head of the Archaeological Science Group at the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany. Dr. Richards studies long-lived isotopes in the bones of humans and animals, trying to discern what they ate, and how their diets evolved.

Until the advent of techniques developed by Dr. Richards, all diet evidence was circumstantial, based upon tools found together with the bones of animals presumably eaten by those who made the tools. However, it was impossible to know how much of our diet consisted of meat. Dr. Richards’ methods have allowed us to compare the diets of various animals to each other. He’s found that the Neanderthals (our closest recent relative before the advent of farming) were getting virtually all of their protein from animal sources. This doesn’t necessarily mean they were carnivores; they may have been getting much of their calories from plant sources, but the protein was from meat as opposed to, say, grains (which have some protein).

Modern diets: ignoring our ancestry to our own detriment?

Dr. Richards’ group has measured thousands of Paleolithic human bones from all over the world, and they have yet to find a vegetarian or vegan from Paleolithic times. When the Neolithic period came about (with the advent of farming), our diet switched to mostly plant-based protein. Furthermore, it is only in these later farming communities that you start to see diseases that plague us now, that did not exist in Paleolithic times.

Professor Loren Cordain, Professor of Health & Exercise Science at Colorado State University, points to the 0.001 yard line of a 100-yard football field representing the 2-million year evolution of humans since we split from the other Great Apes. The 0.001

yard line represents the time at which processed foods were introduced, about a century ago. Just half a yard back from there is 10,000 years ago---when grains were introduced. Compare that half a yard to the 99½ yards before it, during which we were eating mostly meat, augmented by what meagre fruits and vegetables we could scavenge. Dr. Cordain believes that our primarily cooked-meat diet over the past 2 million years is the single most important reason that our brains managed to grow as much as they did in the past 2 million years. Image courtesy of Hunt Thompson Media’s The Perfect Human Diet. Used with permission.

Why are we giving grains such a hard time?

To answer that question we’re going to have to take a closer look at grains. When we say “grains” we’re referring to domesticated grasses such as wheat, rye, barley, oats, spelt, millet, rice, etc. These are all grasses that we have domesticated over the last 10,000 years to become a major source of food.

In nature, many systems are either co-dependent or independent. For example, we need to eat, and fruit bearing plants need to spread their seeds. Our relationship with fruit is a long-standing co-dependent system: we eat it to stay alive and when we excrete the seeds elsewhere we fulfill the fruit bearing plant’s need to reproduce. This is a win-win situation where we can peacefully exist with each other. Each party gets something from the interaction. Grains on the other hand, gain nothing from being eaten. Cereal grains are distributed by the wind. Their reproductive system is wholly independent of us. They do not want to be eaten by us because that is not how they reproduce, and if we digest them they’ve got no chance whatsoever of reproducing. The result is that grains have evolved a mechanism to deter animals (like us) from eating them. Such mechanisms are common---for example, we all

know that you shouldn’t eat wild mushrooms because some of them are poisonous. Mushrooms evolved this mechanism because being eaten offers them no advantage. The same goes with grains, except grains are not quite as poisonous; basically if you’re not used to eating grains, they can give you severe gastro-intestinal problems which will deter you from eating them again. However, if you introduce them slowly and never eat them in large amounts, then your body can “get used” to them; but it doesn’t mean they’re the healthiest way to eat, or that you should eat them in large amounts.

How to grains defend themselves from being eaten?

Grains contain a variety of proteins, some of which cause havoc in our digestive tracts. The gluten-containing grains often irritate our gut the most, but even the non-gluten containing grains, such as oats and corn, can irritate us. Our bodies often mistake some of the proteins in grains as foreign invaders (such as bacteria) and this provokes an immune system response.

And it gets worse. When the body launches an immune response against these grain proteins it produces antibodies. Antibodies are created specifically to fit the shape of a particular foreign invader. They attach to the invader and attack it. This is great when the invader is a bacterium or a virus cell. However, the shapes of the grain proteins that end up in our intestine often look a whole lot like the proteins in our own bodies. When the body launches an immune response against grain proteins, the antibodies not only attack the grain protein, but often end up attacking the body too.

That’s right. Your body is mistakenly attacking your own cells as well as the grain proteins. Why is this happening? Because grains do not want you to eat them. By eating them you messed

up their reproductive plans---and they’ve had millions of years to develop this defense mechanism, just like you’ve had millions of years to learn not to eat them. By starting to eat copious amounts of them just recently, we’ve made everybody miserable---us, and the grains.

Whole grains & vitamin deficiencies

We’ve already made our argument against refined grains (they spike your insulin and should be avoided). Our final argument against whole grains is: they are vitamin inhibitors. Most notably, whole grains affect vitamin D, iron and zinc levels. High consumption of whole grains has been shown to alter vitamin D metabolism and it has long been known that excessive consumption of cereal grains can induce vitamin D deficiency in a wide range of animals, including primates and humans.

Top tip: It is worth bearing in mind that most of the human population is already vitamin D deficient due to insufficient sunlight exposure. So by eating a diet high in grains, you could inadvertently be making the problem worse.

It is also well known within the medical profession that whole grains inhibit iron absorption. Iron deficiency affects 2.15 billion people worldwide, with a further 1.2 billion people severely deficient enough to be classed as having anemia. Jocelyn is one of those 1.2 billion. For years she was given strong prescription iron pills and on the labels of those iron pills the instructions stated she should not consume milk, dairy, tea, coffee, eggs or whole grains 1-2 hours either side of taking the iron supplement because those substances would inhibit her absorption of the iron.

Side note on iron pills: Jocelyn hated every iron supplement she tried and no longer takes iron pills due to their unpleasant side effects. Instead, she has cut out grains, black tea, coffee and

eggs16 from her diet and just eats more liver and dark green vegetables. She does this because the iron from food is more easily absorbed in the body and comes with next to no side effects. Get your nutrients from food.

There is evidence that by fortifying (artificially adding) iron to whole grains (such as cereal and bread) we can override their vitamin inhibiting properties. But we ask, “Isn’t it better to just get your iron from a bioavailable source?” (I.e. why don’t we get our iron from food that contains iron in the first place and from food that doesn’t inhibit our absorption of key vitamins?)

Lastly, similar to iron, whole grains impair zinc absorption. Animal studies on primates, as well as zinc supplementation trials in human children, have shown that zinc deficiencies can limit skeletal growth. When you compare the bioavailability of zinc in whole grains to that of meat, the zinc in meat is 4 times more easily absorbed than the zinc found in whole grains.

Moral of the story

Given that grains only started to feature in our diet so recently in evolutionary terms, it makes sense that our bodies do not

16 While eggs are high in iron they also contain some substances that inhibit iron absorption. The instruction leaflet of the very first iron pills Jocelyn was prescribed stated, “Do not consume: tea, coffee, milk, whole grains or eggs 1-2 hours either side of taking an iron supplement pill.” So, in order to maximize iron absorption, Jocelyn doesn’t eat eggs. They’re probably fine for most people; Jocelyn just can’t be bothered to keep track of the math. As she tries to eat high iron foods at most meals, it would mean she could only have eggs as a snack. So she doesn’t bother. To a certain degree, the same applies to spinach.

react well to such great quantities of carbohydrates---and especially not to refined ones like sugars and flour.

To be fair, grains are not pure evil. In fact, without grains, it’s arguable that humanity would never have developed civilization. Compared to many other domesticable plants and animals, grains are easy to grow and harvest, and they do provide enough protein and nutrients for us to survive and even thrive. In his wonderful book Guns, Germs, and Steel, Jared Diamond explains exactly why grains were crucial to the development of civilization over the past 10,000 years: grains were (and still are) the primary output of farming. Without farming, you can’t build cities, and without cities, you can’t develop a civilization. Cities allow the development of trade, manufacturing, education, political systems, armies, and eventually, ships that can sail across the ocean. Grains made farming and cities possible, and for that we can be grateful. But they’ve served their purpose. Civilization is here (hopefully to stay), and we now have the farming technology to get back to eating what we evolved to eat. It’s time to ditch the grains and eat healthy.

It is important to know that dietary guidelines change as scientific knowledge changes. What we thought was correct, even just 20 years ago, may well be proven incorrect today. We all used to believe that the earth was flat until it was proven otherwise. Given that our health and waistlines are at stake, we need to stop blindly clinging to past nutritional guidelines as food gospel. Carbohydrates and grains are not the saints they were (and still are) believed to be. The food pyramid isn’t even the most recent edition of the USDA guidelines. The USDA has revised their guidelines so that the portion size of fruits and vegetables is larger than that of grains. Let the pyramid go. It’s out of date.

Points to take away

Grains were not part of our diet for 99.5% of our evolutionary history.

Food guidelines have changed a lot over the last 100 years, and not necessarily for the better.

It’s important to embrace new guidelines as new knowledge arises.

The food pyramid format is out of date. Let go of it.

Chapter 7 – Obesity, Exercise

and political agendas

We’d like to burst a myth bubble here. Exercise does not help you lose weight, nor does it mean you can eat whatever you want and lose weight <popping sound>. We have been force fed the notion that you can eat whatever you want and not gain weight as long as you burn off the equivalent number of calories you consumed. This approach also suggests that exercise alone can cause you to lose weight, that by burning off more calories than you need to function at your basal metabolic rate (BMR) you can create a calorie deficit and thus lose weight. This advice ties straight back into the energy imbalance theory, which, as we outlined earlier has never been properly tested or verified (and doesn’t add up).

While we admit that a dramatic deficit in calories will cause you to lose weight, most people cannot create a dramatic deficit from an hour at the gym. For a person of average fitness, an hour of cardio at the gym will burn only a few hundred calories---equivalent to a few medium-sized chocolate chip cookies, or one of those huge ones (you know, the ones in the cafe that you could hide a baby behind). Even a very fit person can burn only about 1,000 calories in an hour at the gym---about one slice of decadent chocolate cake. Instead, many people still think that because they went to the gym they are entitled to polish off a whole tub of chocapocalypse ice cream, because they “earned it.”

Exercise is an important part of maintaining lean mass17 and cardiovascular health (we didn’t evolve to sit in front of a desk all day long, we are designed to be mobile) but if you are eating the wrong things then exercise alone will not make you lean. It will help you maintain cardiovascular fitness, but it will not make you thin.

Why do we believe that exercise absolves us of our food sins?

Well, because once again we were told so by The EstablishmentTM. To be honest we’re not quite sure who The Establishment is, or if there’s actually any conspiracy... but certainly something’s gone wrong somewhere with our ideas on diet and fitness. To fully understand why the establishment tried to push the message that it was a lack of exercise making us fat, and that the food we were eating had little to do with it, we need to take a short historical digression.

Government policies: feeding the nation

In the U.S. it used to be that a lack of food was a main concern of the government rather than the abundance of food. In 1862 the Department of Agriculture was founded by Abraham Lincoln and it was considered so important that it was only surpassed in size by the Army and Navy. Its mission was to preserve the vast fertile farmland in the US. However, it wasn’t really until after World War II that food became a serious priority. Providing

17 Also known as fat-free mass, i.e., muscle, bones, connective tissue etc. Exercise helps you keep your muscle; it does not help you lose much fat.

enough food for the population at a reasonable price moved to the top of politician’s agendas and quantity, rather than quality, became the main objective.

The government wanted to ensure that its citizens had enough to eat, which is a reasonable enough concern to have. At this point it was decided that the food industry should head towards large conglomerates rather than small localized producers, in order that it could be better controlled. Farming became a corporate matter, where massive yields were the goal. In 1970, farmers were famously told by Earl Butz to “get big or get out” and that “what we want out of agriculture is plenty of food.” Farmers were paid for each bushel of corn they produced, which established the importance of quantity over quality. And yes, it was predominantly corn that farmers were producing.

Everywhere you look: corn

Due to government subsidies that were (and still are) provided to corn farmers, corn is now in everything---even our gasoline. 30% of U.S. farming land is used to farm corn. Well, the plan to have plentiful food worked, but today, rather than having a food deficit, the U.S. has more corn than it knows what to do with. Yet farmers still receive subsidies for growing corn whether we need it or not.

We (the authors) don’t originally hail from the U.S. and when we moved here the prevalence of corn and high fructose corn syrup shocked us. It’s in practically everything; sweets, soda pop, gum, sauces, cheese, canned fruit, soups, juice, salad dressing, jelly, coke, vitamins, dog food... Even meat contains corn because the animals are fed corn. (Try grass fed beef instead of corn fed beef. It’s both healthier and tastes better.)

Whether you are aware of it or not, you are likely eating a lot of highly processed corn. Take a look at the labels next time you go food shopping. But beware, corn can come under many different names (we have included a list of many of these names in the appendix).

Shopping has become a war zone between us and the pushers of highly processed food. But we’re at a disadvantage. Most of us don’t have lots of money to burn and therefore one of the major reasons as to why we eat so badly is because it’s a lot cheaper to eat highly processed food than freshly prepared, organic food. The cost of an entire package of cookies is the same as a single cucumber, which is ridiculous. There are more money saving deals on junk food than there are on fresh fruits and vegetables. This is because the U.S. is just swimming in corn, and the abundance of corn means corn based products are very cheap to produce. And where do “subsidies” come from? Answer: your tax dollars. Yes, that’s where (a significant portion of) your tax dollars are going: to make you fat through the miracle of processed corn.

What really compounds the problem of trying to eat more healthily is that we are bombarded with bad food everywhere we go. We challenge you to find a food product “on the go” that isn’t highly processed and doesn’t contain corn. Finding an apple or some almonds on the road is rather like going on a treasure hunt, whereas you can easily find a cookie, a chocolate bar, or corn-based chips within arm’s reach wherever you go. We (again, the authors) are constantly disappointed with how small the fresh and frozen vegetable sections are in most supermarkets in comparison with the rows and rows of bread, cereals, cookies, cake and sweets. Everywhere you turn there’s another high fructose corn syrup or sugary product in your field of view.

So for anyone trying to be healthy, walking into the food store is really like shopping in a war zone. More often than not, you walk through the door and are hit with a full on assault of cookies and chips “on special” before you’ve so much as gotten your trolley. Trying to ignore the tsunami of marketing of junk food, and shop healthily on a budget, is well-nigh impossible for many people. It’s a war between your willpower and the massive marketing effort of junk food corporations. For our part, the authors, we just put blinders on until we get to the fresh food section. Ignore, ignore, ignore the advertising is our mantra. But it’s hard. Sometimes one of us has to rein the other in so we don’t give in to the temptation of a cookie.

Top tip: Don’t go shopping when you’re hungry. Your willpower will crack. Eat before you go, make a list and don’t get anything that’s not on the list.

Avoiding the issue: “We just need to exercise more”

So why doesn’t the U.S. government just change the food regulations so that there’s less corn and less junk food? Well, it’s a question of economics. Let’s not forget that corporations spend significant money in campaign “donations,” and they also spend significant money to maintain a large lobbying presence in Washington. Thus, they have more influence than they probably should have when it comes to food guidelines, and their main concern (as is the case with most companies) is their bottom line. As a result, politicians are unlikely to endorse advice that would damage a major source of campaign support for the next election.

While we’re on the subject, why doesn’t the government stop the corn subsides if we don’t need the corn? Well, because Iowa is the main producer of corn. Why is this important? Iowa is a

swing state. If they upset the corn producers in Iowa then they’ve lost a key voting state in the presidential run. Cutting the corn subsides and changing the regulations so there is less corn is not something many politicians are likely to do if they actually want to get re-elected. If we want less corn on the market then it’s up to us to stop buying corn products. The politicians aren’t going to fight this one any time soon. The ball is in the consumer’s court. The only way to reduce the corn-based product supply is to reduce the demand for them.

It’s fairly ironic that what started out as good intentions by the government, to provide us with enough food so we don’t suffer from starvation or malnutrition, has now turned into the exact thing that is making us ill: overfeeding on the wrong sorts of food. However, rather than admit that previous policies are no longer doing us any favors, the politicians and corporations appear to have decided that the reason Americans had gotten so obese was due to a lack of exercise. This is the advice that you will still hear touted, that we just need to “exercise more” in order to control our weight.

We now know this is a cop-out in terms of advice. Exercise alone will not help you maintain or reduce weight (unless you’re exercising like an Olympian). You must, first and foremost, eat correctly. Just remember the fact that an hour in the gym only burns off a few cookies. The advice issued by George W. Bush, a fitness fanatic, and his party---that we simply need to move our butts more---smacks of a lack of understanding of the underlying causes of obesity, as well as a lack of courage to stand up for the greater good and change the food policies.

If we are going to beat the obesity epidemic then ultimately the sales of the foods that are making us fat are going to have to fall. Someone is going to have to take a hit, and it ought to be

the sales of candy bars (and the like) that take that hit, not our lifespans.

You’ll never hear a doctor tell a diabetic that they can eat whatever they want as long as they burn off the calories in the gym. And the reason you’ll never hear them issue that advice is because exercise does not control your insulin levels. And keeping insulin levels low is key to fat loss.

Points to take away

Exercise does not absolve you of food sins with regard to insulin. You can’t outrun your fork.

Exercise aids in general health, but should not be considered an effective way to burn excess calories.

Listen to science rather than political agendas. Science has less of an agenda.

Chapter 8 – Enough doom and

gloom. How do we fix it?

Time again to quote Dr. Thomas Parran, the 1946 U.S. Surgeon General:

The lifeblood of a democracy is your ability to understand and act upon a problem once the facts are presented to you...and then you as individuals and citizens of a democracy must take action.

We’ve now presented the facts to you of how we, as a nation, got fat. If you picked up this book then you have the will to act. So let’s get to it. What do you do?

Immediate action

The very first action you must take is to wipe out that nagging voice in your head that says “fortified bread is good for you; go on, have a bagel.” The guidelines that you’re clinging to are the equivalent of “the earth is flat” theory. We know they’re not correct. You’ve read the previous chapters, and if you didn’t already know that maintaining low insulin levels is key to weight loss, then you do now. Ignorance is no longer an excuse.

Start by going through your cupboards and throw the worst offenders in the trash. Get rid of the cookies, the chips, the soda pop, the white bread, and anything that has sugar or high fructose corn syrup (HFCS) as the first or second ingredient on the label. Eventually we’ll want to get rid of pretty much everything with sugar or HFCS anywhere on the label... but let’s start small. Start by getting rid of anything that will cause a huge

insulin spike within minutes of eating it. That’s a huge first step. Even potatoes (especially fries) and white rice are suspect---throw those out too if you have the guts.

Go ahead. Read the above paragraph again if you must, and then do it. Go ahead, we’ll wait. Really.

<Pause while elevator music plays for half an hour as you rifle through your cupboards, lamenting the cookies, cake, chips, and soda, throwing them all in the garbage.>

Now, take the trash out. No going back. No fishing in the garbage can for that package of cookies. Spray them with cleaning products if you must, but make sure they’re gone and unsalvageable.

<Another pause while, with a forlorn look, you wheel the trash bin outside to the curb or toss it down the garbage chute.>

Did you do it? Are your cupboards now bare of sugar and HFCS products? If not, then lather, rinse, and repeat the above few paragraphs.

Okay! Well done <pat on the back>.

Quick fix warning

Now that you’ve decided to join us on the road to fitting into that pair of jeans you haven’t fit into for years, we want to issue a quick warning about quick fixes. It’s human nature to be impatient. The computer can never load fast enough, the barista can never get your coffee fast enough, and queues never move fast enough. After your carbohydrate and sugar binning victory you are no doubt saying, “I’m going to change right now for the better,” and we applaud that wholeheartedly. You are

changing right now. But you’re unlikely to see visible changes immediately. It’s going to take days, weeks, months, to get yourself into healthy eating habits.

Keep in mind that nothing worth having comes quickly or easily, so don’t get discouraged and go reaching for the quick fixes like “meal replacement” bars and shakes. They’re often misleading and counter-productive. If you don’t believe us, have a look at the first few ingredients of a meal replacement bar or shake. We’d bet serious money that you’ll find that the first or second ingredient is sugar. Yes, sugar. Pretty damn stupid, right? You’re trying to lose weight, and yet the very products advertised to help you are the exact things that are making you fat in the first place–fast sugar leading to high insulin levels. The same story of sugar high followed by a sugar crash, depression, hunger, cravings etc.

Image courtesy of icanhazcheesburger.com

Don’t go there, you’re smarter than that. Avoid sugar, even in those “diet” meal bars and shakes. Eat real food.

What “diets” should you follow?

In this section, I (Wayne) am going to switch to first person, to tell you a bit about my story. I’m going to lead you through the story of how I got a refresher on my diet knowledge, by following the path that I took to get here. Why should you care? Because I have lost significant weight over the past few years, and kept it off. And at a moment’s notice I can lose 5-10 lbs in less than a month to expose my abs, on a whim, if I suddenly decide to take a beach vacation. Yes, you read that right: I can choose to lose 5-10 pounds in a month, and succeed, without much pain, whenever I want. I’ve done it, and you can too. And I do it by eating steak, bacon, eggs, butter, fat, and lots of fresh green veggies, while avoiding sugars, starches, potatoes, rice, and grains. How did I get here?

For many years I followed a supposedly sensible diet of meat, vegetables and complex carbohydrates (lots of whole wheat bread sandwiches---I’ve never liked white bread). Furthermore, for several years I went to the gym 3-4 times a week for intense cardio, burning 500-1000 calories per day on a rowing machine. However, my stubborn belly fat never went away, and my abs remained hidden. Clearly something was amiss, and if exercise wasn’t working, then it must be diet. You don’t have to be a scientist like me to come to that conclusion---although it did take me awhile to clue in...

On the assumption that I was clearly ignorant about how best to lose weight, I did what any good scientist would do: I decided to read up on the issue. Problem? When confronted with the “diet” section of the local bookstore, there seemed to be no

clear consensus as to how best to lose weight. In fact, there were books that sat side by side on the shelf, contradicting each other. It was like an old fashioned duel: “steak knives versus celery sticks at dawn”. Each book seemed to be screaming “pick me! The rest don’t know what they’re talking about!”

I left the bookstore feeling more confused than when I went in. And then it struck me. I’m a big fan of thinking about evolution, and how evolutionary processes have shaped us. And most modern hunter-gatherer societies who are still on their traditional diets are not fat. Clearly, they are eating what we evolved to eat. Furthermore, I didn’t want to become one of those bores that ruins dinner parties by saying, “How many calories are in that?” The answer was obvious. I just needed to go back to basics. We didn’t have chicken nuggets or soda 20,000 years ago, so why was I eating them now? In fact (as a guy) I decided in that moment to make my life as simple as possible. I would enact the following rules:

1. If I can’t hunt it in the wild - don’t eat it.

2. If I can’t pick or gather it in the wild - don’t eat it.

3. If the label has anything I can’t pronounce or sugar of any form - don’t eat it.

4. If it’s been processed or turned a color you wouldn’t see in nature (as far as I know there are no bright blue foods anywhere) - don’t eat it.

“Ha!” I laughed (which elicited a few weird looks from strangers around me in the supermarkets). I had just created the shortest diet book anywhere. And without wanting to stereotype too much, for me (a guy), there was a direct relationship between

the length and complexity of diet rules (or rules of any sort) and my ability to remember and follow them.

Later on I found that there already exist diets that pretty much follow similar rules:

1. The Paleolithic Diet (think caveman).

2. The “slow carb” diet, made famous by Tim Ferriss in his book, The Four Hour Body.

3. A low GI (Glycemic Index) diet (this is a good option for vegetarians and vegans).18

What do all these diets have in common? They are all what’s known as “slow carb”. They avoid all fast sugars and therefore they never raise your insulin levels very high. The Paleo Diet is the strictest of the three as it eliminates all processed carbohydrates and grains of any sort (vegetables still have some carbohydrates in them and those are allowed in whatever quantities you want – just not sugary ones like corn, carrots, potatoes or beets). That diet (Paleo) is actually my favorite, because it’s so simple: if it’s an unprocessed animal product (eggs, meat, fish) or a plant that has simply been picked and/or cut (and been vetted against being poisonous), you can eat it, otherwise not.

Fruits are borderline on a Paleo diet because most fruits have been bred to be far sweeter and far bigger than wild fruits (compare the size of a regular store bought apple with a crab apple). If you must eat fruit, be sure to eat the whole fruit, not

18 If you are interested in using the glycemic index/load, we’d recommend getting an app for your phone. There are several good ones, including ones to help you track your glycemic load over time.

just drink the juice. You can’t pick fruit juice off a tree, so it’s definitely not Paleo. While the other two diets allow things such as beans, lentils, and whole grain breads, I personally find that these foods make me rather unpleasant company a few hours later once the digestion has... um... gone astray. So I personally avoid those.

Top tip: If you are vegetarian or vegan do not automatically assume your diet is fine. If you are replacing the meat in your diet with refined carbohydrates (such as white bread, pasta, white rice etc.) then you are eating more simple sugars than those who eat meat. Sitting there and smugly thinking, “I’m fine because I don’t eat meat,” isn’t going to fly. You’re just as susceptible to insulin spikes as the rest of us and you too need to pay attention to the amount of sugar and refined carbohydrates in your diet. Beans and lentils are great calorie-dense options for you.

Moving forward: changing your diet

From a dietary standpoint, you know what you need to do. Cut out the things we’re not really supposed to eat because we didn’t evolve to eat them: the potato products, rice, sugar and grains; the weird ingredients you can’t pronounce; the neon colored foods that don’t exist in nature; and all things sugary. Sometimes when we read the ingredient list on a supermarket item we think, “I wouldn’t even feed this stuff to my pet... so why am I eating it?” We have, in fact, read the labels on pet foods and wondered why they seem to be of a better quality than what we’re eating. In many instances, your cat’s dinner is of a higher nutritional standard than your own.

One very good way to think about it, as espoused by Dr. Lane Sebring, M.D., is that there are two types of food: food that is fit

for human consumption, and other stuff that is not fit for human consumption, or as he refers to them, “human food” and “non-human food.” We recommend Googling his clinic, or watching the movie, The Perfect Human Diet for further information (which includes interviews of many other eminent researchers including anthropologists, archaeologists, and Paleolithic chemists who study the biochemistry of the bones of ancient humans in order to figure out what they ate – we’ll give you a hint, it wasn’t anything beige).

We’re not going to give a big list of “allowed” foods and “forbidden” foods in this book (some other useful information in the appendix). Diets like that frequently fail, because they require you to memorize a big list and stick to complicated rules.

We all know the things we really shouldn’t eat. In fact we call them “guilty pleasures” or “comfort food” for that very reason. If you follow the same four rules as us then it will be difficult for you to go wrong:

1. If I can’t hunt it in the wild - don’t eat it.

2. If I can’t pick or gather it in the wild - don’t eat it.

3. If the label has anything I can’t pronounce or sugar of any form - don’t eat it.

4. If it’s been processed or turned a color you wouldn’t see in nature (as far as I know there are no bright blue foods anywhere) - don’t eat it.

We’re advocating a shift in your mindset. Go back to the basics of how we were designed to live. It’s your health, so don’t

compromise. Check the labels for sneaky ingredients---if you can’t pronounce it, it’s probably not fit for human consumption. Ask about your meat: did your beef come from a grass fed cow (good) or from a corn fed cow (not so good)? Where did your eggs come from: battery hens or free range hens? You are smart enough to make the judgment call as to what should be deemed edible and what should not.

Fail to prepare and prepare to fail – confronting your sugar addiction

The Paleo diet (the principles of which apply to vegetarians and vegans too) is the one we (the authors) follow, but any diet that removes blood sugar spikes is a step forward from what you’re eating now. We’re not pretending that giving up carbohydrates and sugar is easy. It’s not. Sugar is addictive and somewhat destructive, in that withdrawal can be about as unpleasant as caffeine or nicotine withdrawal. It’s going to take a fair bit of willpower to quit it, but it is worth knowing that you’re effectively battling an addiction. It’s easier to confront the problem once you realize that it’s not just a matter of you being too greedy to stay out of the cookie jar. Sugar is an addiction, literally. And you’re going to have to fight to kick the habit.

People get hooked on sugar like they do caffeine and various other (not so legal) drugs. However, no one seems to take sugar addiction that seriously. We all know someone who stands in the kitchen at work eating a cookie as they smugly tell you how bad a caffeine addiction is for you, and how they would never do such a thing to their body. But studies on rats have shown that they behave the same way to junk food as they do to cocaine – they were unable to stop consuming it even in the presence of pain. (We’ve all been there, to quote Louis C. K.,

“The meal isn’t over when I’m full. It’s over when I hate myself.”)

We suggest you approach giving up sugar much like how people approach quitting smoking. Do not assume it will be easy. Some people find giving up sugar just as hard as quitting smoking. Be prepared. Remove temptation from your house and find a support buddy to talk to when your willpower starts to fade.

Once you stop viewing candy and it’s counterparts as “food” you’ve won the willpower battle. Just use your common sense, we know you have it. Say no to junk.

Binge days/cheat days – the light at the end of the tunnel

There’s going to be some dietary bumps. You’re going to crack at some point, have a bag of cookies, or ice cream, or cake. No problem. An occasional lapse is fine. In fact, some diets (such as the “slow carb” diet espoused by Tim Ferriss in his Four Hour Body, as well as many other modern Paleo/Slow Carb type diets) actually recommend a weekly lapse, called a “binge day”.

On a binge day (also called a “cheat” day), you’re allowed, even encouraged, to eat anything your heart desires: sweets, chocolate bars, chips, ice cream, cake, cookies, pancakes with maple syrup, croissants, donuts... anything at all (unless, like Jocelyn, you are gluten sensitive, gluten intolerant or have celiac disease – we include some suitable “cheat” recipes for in the appendix for people with these conditions), and in any amount (but it’s best to stop before you feel sick). And the greatest thing is that the binge may actually help you lose weight.

How is that possible? In a nutshell, if you deprive your body of calories for too long, your body may downshift into a slower metabolism, in which it starts to hoard calories and it becomes more and more difficult to lose weight. By “hitting” your body with a huge surge of fast calories once a week, you avoid this downshift, keeping your metabolism running at high speed.

The excess calories on binge day are more than offset by your “clean” diet the other 6 days a week. However, be careful: you really have to restrict your food to avoid fast carbs for the other six days. No small cheats on non-cheat days. Cheat day is cheat day; the other days you must refrain from all the cheat foods, or it won’t work, because even the slightest amount of sugar will cause your insulin to rise, locking those fats into the fat cells. (Remember my story of that one spoon of maple syrup in my morning coffee!)

If you plan to do a cheat day then only ever have cheat foods around on cheat day. Keep them out of the house for the other six days of the week. Don’t torture or sabotage yourself unnecessarily. Remove temptation from your home on all days except for “cheat” day.

Points to take away

You have a brain so don’t be afraid to use it.

If you consider the paleo-type diets a fad then it’s a 2 million year old fad and probably a fad worth following.

Start viewing items as “food” and “non-food.” Anything with weird ingredients, colors, or a long list of things you can’t

pronounce, or added sugar, should be considered non-food.

Sugar blips should only happen on “cheat days.” No exceptions.

PART II: THE COLD WAR

ON FAT:

THE NEW SCIENCE OF

COLD EXPOSURE AND

WEIGHT LOSS

Cold and altitude are a potent anti-obesity combination. Take the difference between Switzerland and Germany. Switzerland eats virtually the same diet as Germany, … But Switzerland is high, cold, and thin (only 8 percent obesity), while Germany is low, less

cold, and fat (16 percent obesity).

- Robert H. Lustig, Fat Chance (Plume 2013)

Chapter 9 – So where does

cold exposure come in?

It’s a good question. Why have we spent the first half of the book talking about diet? Well, diet is a key part of the weight loss equation. And as it turns out, what you eat will affect how effective cold exposure will be as a weight loss tool.

In the beginning: “The Ice Age”

We (the authors) gained much of our diet knowledge from trial and error on ourselves, based at least in part on a (sometimes flawed) view on the state-of-the-art knowledge. Like you, we were confused. We’d tried most of the diet fads out there over the years (including a few stupid ones). After many attempts at achieving a “beach worthy body” we happened upon The Four Hour Body by Tim Ferris.

Apart from the fact that Tim’s a cool dude, we liked him because his advice was, for the most part, spot on for us. He advocates a “slow carb” diet, which essentially means meats, fish, and non-starchy vegetables, and beans/lentils (although we prefer Paleo, which disallows the latter). However, for us, it was one of his further chapters that truly caught our attention. For those wanting an extra tool to shed the pounds, Tim recommends cold exposure as a method for fat loss. There’s a whole chapter in Tim’s book on the subject, called “Ice Age.”

How does cold exposure cause weight loss?

The idea behind cold exposure induced weight loss is simple: when you are cold, you must burn calories as heat to stay warm. The physics is undeniable: your body must maintain a constant temperature of 98.6F (37C) to function properly, so if your body experiences some cold---even mild cold---it must burn calories to stay warm. The same phenomenon, in more extreme form, occurs for arctic explorers and Everest climbers. They eat an enormous number of calories to stay warm---up to the point of eating a pound of butter a day just for the calories. In retrospect it’s obvious, but until we read Tim’s chapter on cold exposure and weight loss, we never put two and two together and realized that anybody can use the idea to burn extra calories.

Thermogenesis is the technical word used to describe the process of heat production within your body. As long as you have a pulse, thermogenesis is happening in your body. Mostly it’s just a by-product of the everyday workings of your body. When we are in an environment with a comfortable temperature, called the “thermo-neutral zone,” the normal heat production of your body is enough to maintain your core body temperature. However, when we are exposed to a temperature below our thermo-neutral zone (i.e., when you feel cold) it is forced to burn extra energy as heat.

Turning up the internal thermostat

There are two interesting questions at this point: (1) what process produces the extra heat? And, (2) where does the energy for extra heat come from?

1) Shivering and non-shivering thermogenesis

In answer to the first question, there are two processes that your body can use to generate heat. You’re already familiar with one of them: shivering. When your body gets too cold and immediately needs warmth, it triggers your muscles to start contracting involuntarily. This mimics exercise, and the friction in your muscles generates heat. This process is technically called shivering thermogenesis (yeah, scientists are an imaginative bunch when it comes to naming things). However, there are two problems with shivering thermogenesis. First, it’s terribly uncomfortable and disruptive. And second, it turns out to be a terribly inefficient way to create heat. So your body only uses it when absolutely necessary: either when you’re really cold and there’s no other option, or if the second process (below) hasn’t started yet. Shivering is your body’s first and last line of defense against cold. Luckily, there’s another, less drastic, option in the middle.

The second process doesn’t involve shivering. So, scientists being the imaginative bunch they are, call it nonshivering thermogenesis. Nonshivering thermogenesis occurs in a type of tissue call Brown Adipose Tissue (BAT for short), also variously known as “brown fat”, “fat burning fat”, or “good fat.” When it comes to extra heat, we like to say “BAT is where it’s at.”

A closer look at fat

When we say “fat,” most of us think of that white, wibbly stuff that we wish would stop accumulating around our stomachs and thighs. This familiar type of fat, like the marbling of a steak, is called White Adipose Tissue (WAT for short), or variously “white fat”, “bad fat”, “energy-storing fat”, “love handles”, “muffin top”,... you get the idea. WAT is a fairly inactive storage depot for energy, like a battery. On the other hand, BAT is

active fat that, when needed, burns energy to keep you warm. It was actually calculated around thirty years ago that as little as 50g of activated brown fat in humans could have a positive impact on weight loss. BAT is activated when it is stimulated by a synaptic cue such as feeling cold, or by an adrenal cue (usually from a pill).

When was BAT discovered?

The reason you’ve probably never heard of BAT before is because it wasn’t until relatively recently that it was surreptitiously discovered in adult humans. We’ve known for decades that small mammals have extensive BAT, because small animals lose heat quickly to the environment, and often need back-up measures to keep warm. Animal researchers were mainly interested in BAT’s function with regard to hibernation. Several studies showed that there was a 6-fold increase in BAT activity after an animal had been exposed to cold. This led some scientists to view BAT as an animal’s “electric blanket,” a method of keeping warm by burning stored fat during winter hibernation (which explains why hibernating animals stuff themselves silly before dozing off for the winter).

It was known that human babies (being small mammals) possessed BAT. However, it had been mostly assumed that our BAT disappeared as we grew into adulthood. Then, in 2007, during a routine PET scan for another purpose, researchers in Stockholm, Sweden, noticed some mysterious dark regions in the neck, back, and shoulders of a patient. These dark regions on the PET scan were only apparent when the room was cold; if the room was warm, the tissue disappeared from the scans. After some investigation, they realized it was BAT that was becoming active as the room got cold. They published their discovery in the American Journal of Endocrinology and Metabolism in May, 2007.

a) b)

Two images reproduced from by Nedergraard et al. (2007) showing known locations of Brown Adipose Tissue. (a) PET scan highlighting areas in the neck, shoulder, and spine areas. The other dark areas are not BAT and are not of concern to this application. (b) Schematic diagram of the locations of BAT. Black areas appear to be in all adult humans; gray areas appear only in some adult humans. “Supra-clavicular” means above the clavicle, i.e., the front of the shoulder.

Oddly, this was not the first discovery of BAT in adult humans. Autopsy studies on human cadavers in the 1970s by Heaton had found BAT present in adults up to eighty years old. This led to a brief boom in research on BAT in the 1970s and 1980s. But it was early research, and was restricted to examining BAT depots near the adrenal beds that were accessible in live patients during abdominal surgery. While this allowed researchers to view BAT in living humans, it gave a very narrow view of the scope of BAT. At the time, scientists could not confirm that BAT definitely played a role in the metabolism of energy, and they stated that it would “continue to be controversial until a method for quantitative non-invasive measurement of total BAT

thermogenesis was developed.” It took another two decades before we had the technology necessary in the form of PET (positron emission tomography) scans to conduct conclusive metabolic imaging studies to confirm the existence of active BAT in adult humans.

2) Where does the energy come from for extra heat?

This brings us to the second question: when your BAT gets activated, where does it get its energy from? The answer depends upon whether you’ve eaten recently or not. If you’ve eaten recently, then there is glucose in the bloodstream, and your BAT will simply extract glucose from the bloodstream and burn it. This has the advantage that such energy doesn’t end up in your white fat, but it doesn’t help you lose your existing white fat.

On the other hand, if there is no readily available energy source already in your bloodstream, then your white fat cells will start pumping energy into the bloodstream in the form of fatty acids as an energy source for your BAT. Et voila: your white fat is now being burned in order to keep you warm, and you start to lose weight.

In other words, nonshivering thermogenesis that occurs while your blood glucose levels are low causes you to burn (white) fat—as long as your insulin is low! Because if you have high insulin levels---say it with me, you’ve read the first half of this book---your fat stays locked in your fat cells. So avoid the carbs!

Points to take away

When you are cold you must burn calories to stay warm

The body uses either shivering thermogenesis or nonshivering thermogenesis to create heat

Non-shivering thermogenesis occurs in brown adipose tissue (BAT/brown fat)

The existence of BAT in adult humans was only recently confirmed

Cold exposure can cause the body will burn white fat to stay warm, but only if your insulin level is low.

Chapter 10 – The Cold War on

Fat: principles & strategy

We are interested in a thermogenic approach to weight loss, a cold war on fat, where thermogenesis is a new weapon in the arsenal against fat.

Cold exposure should not be viewed as just another “fad” or “quick fix,” since it is based on very solid science. In order to maximize its effect, however, a holistic approach needs to be taken. There’s more to thermogenesis than just cold exposure and brown fat.

When losing weight we want to manipulate the body’s total energy expenditure. Your total energy expenditure includes the total heat your body produces, commonly measured over a 24 hour period.

Total energy expenditure is made up of four things:

1) BMR – basal metabolic rate: the basic energy needed to keep the body running when you are doing nothing in particular.

2) DIT – Diet induced thermogenesis: heat produced from the processing of food.

3) Exercise – heat produced from muscular activity. 4) Cold Exposure – heat generated from activated BAT or

shivering.

Together these four components control how much energy your body burns, and therefore they have an effect on your fat levels. Now let’s take a more in depth look the first three; cold exposure is covered in more depth in the next chapter.

Basal metabolic rate (BMR)

Basal metabolic rate---also known as resting metabolic rate (RMR) or Resting Energy Expenditure (REE)---is the largest part of your total energy expenditure. The notion of BMR was initially developed as a means of comparing the metabolic rates of animals. In the twentieth century, metabolic rate measurements became of interest to those investigating the relationship between bio-energetics and growth.

Calculating metabolic rates

The metabolic rate of an animal can be calculated by measuring a combination of variables such as oxygen consumption, carbon dioxide production, heat production and food intake versus food excretion. However, the metabolic rate of an animal can vary widely in response to a range of things, so scientists found it necessary to create a defined set of conditions under which a more stable metabolic rate could be established. Enter BMR.

Definition of BMR

BMR is defined as the metabolic rate of an animal at rest in a thermo-neutral zone. The BMR thus represents the minimal cost of just existing. The explicit reference to being in a thermo-neutral zone (i.e., a comfortable temperature) emphasizes the importance of the temperature of the environment when it comes to your energy expenditure.

Ambient temperature & BMR

In fact, it is only at the lower end of our thermo-neutral zone that BMR is actually responsible for producing the minimal heat we require to maintain our core temperature. Normally, at regular ambient temperatures (like room temperature – still within the thermo-neutral range) we produce more heat from

our body processes than we need to keep our core at a constant temperature. In these cases our body needs to dispose of the extra the heat, and does so through our breath as we exhale, and through our skin: our capillaries widen (vasodilation) and more blood passes by our skin, enabling a greater expulsion of heat from the skin into the air.

How is BMR determined?

Nowadays, we can calculate BMR levels using some rather fancy mathematical equations (we suggest you use an online calculator rather than try to do the math yourself), but levels still vary widely from person to person. There are also devices designed to measure BMR in real-time, called “indirect calorimeters”. Most measure the breath you exhale, in order to measure how much oxygen you’ re using and how much carbon dioxide you’re producing. These measures directly correlate with the energy your body is expending in real time. However, such devices are large, expensive and cumbersome, and are mostly available only in weight loss clinics. Unless you are on good terms with your local weight loss clinic, an online calculator is probably the way to go.

What affects your BMR?

The main thing that seems to most affect the variation seen between BMR levels is what’s known as fat-free mass. Fat-free mass is the sum of all of your body parts minus the fat. Most of us will be more familiar with the term “body fat percentage”, which is the opposite: your fat levels minus all the rest of your body. There are limits to what a healthy fat-free mass range is for men and women. You do actually need some fat to stay healthy. Some fat is necessary to support your organs and provide energy. According to the book “Exercise Physiology,” if

you go below the defined acceptable range of essential fat you can seriously and adversely affect your normal bodily functions.

Men need at least 3% body fat and women need an absolute minimum of 4-7% to function properly. However, there are also more gender-specific fat requirements on women in that they require fat on their breasts, hips, etc. And therefore the more accepted lower limit for a woman is around 12%. But don’t worry... most people, even models and Olympic athletes, would find it extremely difficult to hit (and maintain) such a low level of body fat.

The more fat-free mass you have, the higher your BMR is likely to be, because only fat-free mass (with the exception of BAT) metabolizes energy. So, one way to burn more energy is to increase your fat-free mass (easier said than done since it generally requires exercise to build muscle). Dieting is another way, as we all know, to lose fat. However, one must be careful: if you only diet and do not do any exercise, you may end up reducing your fat-free mass (which you don’t want to reduce) as well as your fat. For each pound lost, a typical individual on a diet who does not do any maintenance exercise will lose around 0.45 pounds of fat-free mass along with 0.55 pounds of fat loss. This is bad news, as you want to maintain your fat-free mass level or, even better, increase it. The higher your levels of fat-free mass, the greater your BMR---and your BMR burns calories all day, every day, even when you’re sleeping.

The relationship between fat-free mass and BMR levels would seem to explain why the super buff gym dudes seem to be able to eat like a horse and apparently not put on weight: all those extra calories are going towards their higher BMR, maintaining the lifeblood of their copious muscles even when they’re not in the gym. However, most regular folk do not have such muscles, and would like to eat normally rather than having to reduce our

portions to that of a four year old in order to lose weight. Don’t worry, though: you don’t need to hit the gym for two hours a day like the über buff friend (we all have one of those – the one that bores you talking about protein powder). You just need to be aware that some exercise is necessary to improve or maintain your BMR and that dieting alone won’t do that.

Diet-induced thermogenesis (DIT)

Researchers Roswell and Stock in the 1970s noticed that BAT was activated when animals ate a high fat diet, just as if they had been exposed to cold. This introduced the idea of diet-induced thermogenesis.

Diet-induced thermogenesis happens during the breakdown and digestion of food. Although it only makes up about 5-10% of your overall total energy expenditure, it’s nothing to be sniffed at, as every little bit helps when trying to burn fat.

The effect of various food groups on DIT

The below graph demonstrates the effect of different food groups on your rate of energy expenditure following the ingestion of various types of food. As you can see, the human body creates more heat while digesting proteins than it does for carbohydrates and fats. In other words, it requires energy to digest all foods, but proteins require the most energy, so that the net calories (energy ingested minus energy used) from eating protein is less than for fats and carbs.

Increase in BMR after eating various foods. From an article by L. Gross et al. (American Journal of Clinical Nutrition, vol. 79 (2004)). Reproduced with permission.

The generally accepted values for the thermic effect of foods are:

Protein: 20-35% of calories burned through processing.

Carbohydrates: 5-15% of calories burned through processing.

Fats: 0-5% of calories burned through processing.

Therefore, to maximize your fat loss from diet-induced thermogenesis, you should eat more protein. In addition, you should get the majority of your carbohydrates from low-GI vegetables (see previous chapters for our arguments against grains and other fast carbohydrates).

Exercise and Thermogenesis

Spontaneous physical activity such as walking, running or even just fidgeting, accounts for about 8-15% of your total energy expenditure. This comes from heat generated by your muscles. Most people are aware of the heat generated from exercise because... you get hot while exercising.

Irisin: A hormone to increase BAT

Apart from keeping you fit, there’s another benefit that exercise provides in thermogenesis. In January 2012, the research team led by Dr. Bruce Spiegelman at the Harvard Medical School published a study in Nature showing that mice who exercised produced a hormone called irisin. This hormone was found to increase brown fat levels. That’s right: exercise may increase the amount of BAT that you have, which in turn may help increase your calories burned via thermogenesis even when you’re not exercising.

"Irisin travels throughout the body in the blood, and alters fat cells," explains Dr. Komaroff, one of the researchers in Spiegelman’s team at the time. "Body fat is stored inside fat cells. Most of these fat cells are called white fat cells, and their function is to store fat.” However, we also have brown fat cells, which burn fat. You don’t have to be a Harvard researcher to come to the conclusion that if you want to lose weight then you want more brown fat.

Irisin was found to increase BAT levels in mice. While the research by Dr. Spiegelman and his team was done on mice, he did later also verify that humans produce irisin. It is likely that irisin has a similar effect on humans as it does in mice, namely to increase brown fat levels.

Exercise: Lowering your diabetes risk

In addition to “browning” white fat cells, a regular, moderate exercise routine has been shown to reduce the risk of developing Type II Diabetes by almost 60%. This is more than any medicine yet created. It’s possible that irisin may have something to do with this, by helping prevent or overcome insulin resistance, which is one of the factors leading to Type II Diabetes, but this is yet to be confirmed.

Irisin: A cancer fighting hormone?

Irisin may also help fight certain cancers and other disorders that have no cure but appear to improve with exercise. Quoting Dr. Spiegelman again, "Another potentially important aspect of this work relates to other beneficial effects of exercise, especially in some diseases for which no effective treatments exist." Furthermore, "The clinical data linking exercise with health benefits in many other diseases suggests that irisin could also have significant effects in these disorders,” said Dr. Spiegelman.

Exercise is not a fat loss strategy

Once again we stress that exercise (and irisin) alone will not make you lean. Even the American College of Sports Medicine and the American Heart Association acknowledge this in their physical activity guidelines in 2007:

[Although] it is reasonable to assume that persons with relatively high daily energy expenditures would be less likely to gain weight over time, [the] data to support this hypothesis are not particularly compelling.

Exercise and irisin will help you lower your white fat levels providing you are also eating correctly. Exercise is not a magic wand than can be waved over your brownie to undo its insulin spiking effect on your

body

Points to take away

Thermogenesis occurs in four ways:

1. BMR – basal metabolic rate, heat produced from keeping the body running.

2. DIT – Diet induced thermogenesis, heat produced from the processing of food.

3. Exercise – heat produced from muscular activity. 4. Cold Exposure – heat generated from activated BAT.

Exercise produces irisin, which may increase your brown fat levels.

Cold exposure causes the most weight loss on an empty

stomach, and in any case only if your insulin is low. So avoid the sugars to make effective use of cold exposure!

Chapter 11 - Adrenaline and

Thermogenesis

BAT-generated thermogenesis is triggered by one of two things; an adrenal cue (adrenaline) or a synaptic cue (from feeling cold).

Adrenaline & its effects on the body

Most of us know the hormone adrenaline (also known as epinephrine) as the “fight or flight” hormone. Adrenaline exists in the body as a highly regulated hormone that coordinates the release and burning of fat for fuel. It can also contribute to appetite suppression. Exercise, in particular interval training, is an effective way to trigger adrenaline’s appetite suppression properties. Interval training means perform short spurts (a minute or so) of extreme effort exercise (for example, sprinting as fast as you can, or lifting heavy weights), followed by a minute of rest---and then repeat a few times. These one-minute periods are called intervals, although the suggested timings can vary depending on your health and which exercise you’re performing in the interval.

I’m too lazy to exercise. Can’t I take a pill for that?

Now, being realistic, many people may find interval training too difficult, despite the benefits that would come from the resulting increase in adrenaline. So once more we are going to refer to quick fixes. There are artificial sources of adrenaline and

adrenaline-like substances on the market, but such sources must be treated with caution. For example, one common source is Ma Huang, an herbal supplement made from a desert shrub. This supplement contains ephedrine, which triggers adrenaline receptors in the brain. It is for this reason that it is such a popular diet supplement and is so easily available on the internet. It stimulates the adrenaline receptors, thereby suppressing appetite and stimulates the thyroid to increase body temperature and burn more calories via thermogenesis. So far, so good.

People have indeed lost weight this way, and you may be thinking “Awesome! I can lose weight by taking this without exercise and without cold exposure!” However, tricking the body with the use of supplements to induce thermogenesis may not be a good idea in so far as your health is concerned.

FDA unapproved supplements

Adrenaline, as a drug, is very tightly regulated and can only be obtained with a prescription. However, due to a loophole in the U.S. FDA guidelines, supplements such as Ma Huang are not regulated.

The FDA has in fact tried to ban Ma Huang, but they have so far been unsuccessful because Ma Huang is classified as a “dietary supplement” rather than a drug. The difference, essentially, is that a drug makes explicit claims to cure or treat some disease, whereas a supplement is not allowed to make such claims. Whereas new drugs must be proven safe before they are allowed on the market, no such tests are required for supplements. Instead, the burden of proof lies with the FDA to prove the supplement is dangerous before it can be banned. This was not always the case, but in 1994, due to heavy

lobbying on the part of supplement companies, a law was passed in the U.S. that put supplements out of the FDA’s regulatory reach, as long as they didn’t claim to treat any disease (this is why when you look on the back of a supplement bottle it doesn’t tell you what it’s for).

The risks of adrenaline-like supplements

Ephedrine (which stimulates the release of adrenaline) from Ma Huang can raise blood pressure and heart rate, make you dizzy, and also cause insomnia and headaches. The FDA proposed that there should be limits placed on the supplement and recommends that it shouldn’t be taken for more than a week. They also specified that it should come with a warning that overdosing of this supplement (in excess of 25mg/day) could lead to seizures, heart attack, stroke or death. However, no strict clinical trials have been done on the supplement, and because of the 1994 law, the FDA cannot ban ephedrine that exists in supplements even though drugs containing ephedrine are tightly regulated.

Adrenal induced thermogenesis & sleep

Finally, having any sort of stimulant in your bloodstream, be it caffeine, adrenaline, or ephedrine, does not bode well for your sleep. One of the authors (Jocelyn) has actually tried Raspberry Ketones, which is designed to increase metabolism. She subsequently had difficulty sleeping while taking that supplement, even though she had simultaneously reduced the amount of caffeine she had been drinking (trying to kick the habit, she proudly went from 6 cups a day to less than one---

which helped her sleep immensely, until she tried these other metabolism-increasing supplements).

Synaptic induced thermogenesis & sleep

Mild cold exposure, on the other hand, can actually help your sleep. So which would you prefer: increased metabolism and risk of severe health effects (including death) and lost sleep, or the same increased metabolism without the risk of severe health effects, and better sleep?

Nothing worth having comes easily

Quick fix supplements that mimic the effects of prescription drugs should be treated with great caution because, unlike prescription drugs, supplements are not tested or regulated as strictly. It is for this reason that the authors believe in using non-intrusive weight loss aids. After all, would you really want to put something in your body when no one really knows what it does to you in the long term (or the short term for that matter)? We all want to be slim, but at what risk?

Remember what Grandma said: if something sounds too good to be true then it probably is. We champion good ol’ exercise as the best way to get your adrenaline running. The excuse “I hate exercise” is not really acceptable since there are so many different types of exercise out there these days that there will be one you like. And if all else fails... jump in bed with your partner more frequently; pretty much everybody enjoys that exercise.

Points to take away

Be wary of supplements: they are unregulated and often have bad side effects.

Pills are not a substitute for exercise.

Thermogenesis is safest when done naturally: through food, exercise, or cold exposure.

Chapter 12 – Individual

variability in non-shivering

thermogenesis

Non-shivering thermogenesis (NST) is the primary mode of heat production in mammals, and is vastly more efficient (and less disruptive) than shivering thermogenesis. Shivering is a last resort of heat production, and can occur in conjunction with NST, or when you’ve exhausted your ability to generate heat from other means.

Since non-shivering thermogenesis is both more efficient and less disruptive than shivering, and since brown fat is the primary tissue involved in non-shivering thermogenesis, it makes more sense to use BAT-driven, non-shivering thermogenesis when looking at cold exposure for the purpose of weight loss.

However, not everyone may get the same weight loss results from cold exposure. It turns out that cold-induced NST metabolic levels can vary from person to person in response to the following factors.

Body Composition and Gender

The rate that the core body cools is related to our physical properties such as our ratio of surface area to body mass, our overall mass, and internal fat levels.

Most of us know that white fat, in addition to storing energy, serves as insulation against cold. Yes, that’s why whales and dolphins have a layer of fat (blubber) just under their skin. Unfortunately, it turns out that brown fat levels are negatively

correlated with white fat levels, so the more white fat you have, the less brown fat you tend to have. But don’t despair, when people lose weight and become thinner their brown fat levels increase (and irisin produced from exercise may help speed this conversion of white fat to brown fat).

Note, however, that even though women typically have higher levels of white fat than men (don’t worry, it’s normal), no well-controlled studies have yet been done to see if there’s a significant difference in non-shivering thermogenesis between men and women. Certainly both authors (one male, one female) have successfully used non-shivering thermogenesis to induce fat loss.

Age

Pound for pound, babies have hugely more BAT than adults. In fact, 5% of a newborn’s body weight is made up of brown fat, and this percentage drops steadily with age. Part of the reason that babies have such a high percentage of brown fat is probably because they can’t just get up and move to a warmer place if they feel cold. Furthermore, babies don’t shiver. (Weird, right? But we don’t recommend you go staring at some stranger’s baby next time it’s cold to see if they shiver. You’ll probably be mistaken for some creepy weirdo). As adults, high levels of brown fat enable humans and other mammals to last longer in a cold environment before they start to shiver or develop hypothermia.

Physical fitness

There is evidence to suggest that thermoregulatory responses to cold exposure can be affected by training under specific climate conditions and by the type of exercise performed. There is also evidence that fatigue can dull the body’s synaptic response to cold temperatures (NST is triggered by either a synaptic or adrenal cue). However, these studies failed to distinguish between the effects of fitness on shivering or non-shivering thermogenesis. So, not very helpful until more studies are done, but if you train in one of those huge room-sized beer refrigerators in your local supermarket, then you can probably assume that your thermoregulatory responses will be different from the average person.

Cold adaptation

Cold adaptation is defined as physiological change intended to reduce the strain placed on the body from consistent cold exposure (such as in those that live in very cold climates). There are very few studies on the effects of cold adaptation on NST. However, we’ll take quick tour around the very small number of torture tests (on willing subjects) that have been done.

A recent study on winter swimmers showed that frequent swimming in cold water (1 hour at 13° C) produced increased levels of vasoconstriction (your blood vessels near the skin contracting to reduce heat loss through the skin), lower core body temperatures and higher levels of NST during cold exposure episodes in comparison to those that were not cold adapted.

For extra fun, try spending two hours naked in a cold room (10° C or 50° F). In addition to goose bumps and erect nipples, you’ll also eventually get reduced levels of norepinephrine (a neurotransmitter related to adrenaline) during subsequent cold

exposure. In other words, your body is adapting itself to not be too worried about the cold exposure. Additionally, subjecting yourself to such torture over 11 days causes skin temperatures to drop, so that your body is trying to adapt towards working less hard at keeping you warm.

Finally, mild cold exposure (3 hours at 15 ° C – clothed) showed no differences in core body insulation (such as vasoconstriction) or risk of hypothermia, but it did show an increase of 8% in NST in winter months versus summer months in a temperate climate. In other words, your body knows that it’s cold outside in winter, and is more ready to turn on non-shivering thermogenesis as a response to mild cold exposure, than in summer months.

Extreme cold exposure (such as cold water swimming) produces insulative, hypothermic and hypermetabolic responses in the body, whereas mild cold exposure produces predominantly only a metabolic response. It is for this reason (and the fact that full body cold exposure is… unpleasant, shall we say) we recommend mild cold exposure over full body extreme cold exposure. We want to trigger an increase in NST without producing hypothermic effects in the body.

Genetics

Several comparative studies have shown physiological adaptations between different races and populations in their responses to cold exposure. The adaptations appear to have evolved as a survival advantage, such as reduced core body temperatures in those living in harsh conditions, such as in the Australian aborigines (it’s a desert climate so, despite sometimes being hot during the daytime, it gets damn cold at night).

In the past, these adaptations were advantages since they enabled individuals to conserve energy in cold climates. However, in today’s society, where we all have central heating, these adaptations could be a contributing factor to the rising obesity levels recently seen within these genetically adapted populations. We have no need for our body to burn energy via NST when we keep our homes warm all the time, and so the mechanism of cold exposure is not being used by your body to burn calories. Our aim is to fix that problem, and do it without too much discomfort.

Points to take away

Non-shivering thermogenesis burns calories with only mild discomfort.

Adaptation to mild cold exposure increases NST without producing insulative or hypothermic effects (you only want to

produce a metabolic response, no more).

Your responses to cold exposure may vary depending on your age, gender, genetics, cold adaptation and physical fitness.

Chapter 13 – Harnessing cold

exposure for weight loss

People do some pretty crazy things to lose weight; pretty uncomfortable things. Restricting calories, counting calories, and any of a number of extreme diets that are not fun; nor is wearing a girdle, undergoing surgery, undergoing colonic irrigation, pumping yourself full of artificial hormones, and electrocuting yourself with belts designed to stimulate your muscles. Exposing yourself to a bit of cold seems almost tame in comparison.

Let’s quickly review how it works. When your body is cold, it must burn energy to stay warm. This is the fundamental principle behind using cold exposure to burn calories, and it’s impossible to deny. And the great thing about it is that you don’t have to feel too cold in order for the mechanism to work. Sure, to make it work wonders, you can immerse yourself in an ice bath. But such extreme measures are not necessary to get decent results, and it’s not as uncomfortable as you may think.

In this chapter we offer specific suggestions for how to harness cold exposure for weight loss. Keep in mind that this is still a relatively new area of research, so things may change. You should keep abreast of the facts as they change. One way to do that is to consult our blog, The Cold Blog, which can be found at www.TheColdBlog.net. (Not TheColdBlog.com, that’s something entirely different.)

There are many ways to get cold exposure, some obvious, some not-too-obvious.

Go for a cold walk outside in winter

This is not possible for those who live in places like California, Florida, or Texas, but for those who actually live in a climate that gets cold in winter, you can go for a winter “chill walk”. Ray Cronise, a former NASA employee who has been doing research on cold exposure since about 2008, recommends this. He suggests that you want to keep your extremities warm, since cold extremities are a signal to the brain to get worried. So you should wear gloves, shoes, and ear muffs or a headband or a hat to keep your ears and head warm. If the temperature is below freezing or it’s windy you should probably also wear long sleeves and long trousers. But other than that, you could go with just a T-shirt, or even shirtless, and with shorts. You should start with limited time walks: start with 5 minutes or less, and see how your body reacts. Slowly increase the time up to 20-30 minutes, at most once a day, at first.

Swimming in warm water

You don’t need to swim in cold water to get the benefits of cold exposure. Even swimming in a nice, heated pool (78F or about 24C) will cause your body to burn extra calories. This is because water is about 25 times more heat conductive than air, which means that water extracts heat from your body 25 times more quickly than air of the same temperature. So swimming in water at 80F will have the same effect as a very cold winter chill walk, without the discomfort. Swimming in such balmy water could burn 500-1000 calories per hour. And if you actually swim rather than just float, you’ll also get the benefit of exercise.

Swimming in cold(er) water

Of course, swimming in colder water will have an even greater effect on calorie burn than swimming in warm water. Swimming in the ocean without a wetsuit, swimming in an unheated pool or river or lake, or being a member of a “polar bear club,” are all options here. However, extreme caution is warranted here since if you’re not careful, hypothermia may result. If you try this, do not try it alone and consult your doctor beforehand.

Start with very short swims, 2-3 minutes at most, until you ascertain how your body reacts. Use your common sense. The last thing we want to hear is that somebody read our book and went swimming in freezing water with tragic consequences. Be careful, and don’t do anything stupid. One of the authors (Wayne) has tried swimming in an unheated pool in California in winter. The water was bloody cold, although he didn’t bring a thermometer to measure it. He couldn’t even put his head under. He resorted to breast stroke, head above the water, for about 10 minutes, before getting out and shivering. It was not fun, and he only tried it twice. No thanks... In addition, recall that full body immersion in cold water increases ghrelin, so expect to come out feeling hungry. Not a good sensation if your goal is to lose weight. (Of course you could follow the freezing swim with some interval training to reduce the feelings of hunger… but that’s only if you’re truly desperate to burn fat fast.)

Immersion in an ice bath

Of course, cold water will induce even more calorie burn than warm water, but it’s far less comfortable. Tim Ferriss, in The Four Hour Body, suggests 20-minute ice baths in which you

slowly immerse yourself over the 20-minute span, starting with just your legs for the first few minutes, then your torso for a few minutes, then up to your neck for the last 5 minutes, and then your hands for the last 1-2 minutes. (Immersing your hands is the hardest part, because your palms are connected directly to your inner core body and immersing your hands causes a quick heat transfer from your core body---more on that below.)

Of course, full-body immersion in ice water takes... ahem, well, it takes balls. Most people---and that includes the authors of this book---have not tried it and probably never will. And, just like swimming in cold water, expect to come out feeling hungry. Again, not a good thing if your goal is weight loss.

Taking a cold(-ish) shower

This actually isn’t as bad as it sounds. Although only one of us has tried this (Wayne), Wayne actually takes a 10 minute cold shower pretty much every morning now. It takes a bit of a Zen-like state for about the first 30 seconds, but after the initial shock it’s really not so bad (“Yeah, right,” Jocelyn says sarcastically). It takes about 30 seconds to wet your entire body. Then you spend most of the time with your upper back in the cold stream, as you lather up your head and body with soap. Within a minute or two you hardly notice the cold water on your back. Once you turn around to rinse the soap off, it can be a bit cold on the front of your body, but again not too bad. Wayne is usually done with rinsing after about 5 minutes, and then he just stands in the cold stream for an additional 5 minutes, for a total of 10. Sometime’s he’ll wrap his Kindle in a Ziploc™ bag and read under the cold shower.

And of course the definition of “cold” water from the tap varies depending upon where you live. In California, the “cold” water tap in summer is really just tepid, hardly qualifying as “cold”. In winter it’s colder, but still not really all that cold. If, however, you live in Canada, or the UK, or any place where there’s snow outside in winter... expect the water coming out of the “cold” tap to be bloody freaking freezing. In this case it really does take a bit more balls to stand in the stream of freezing water for 10 minutes, as the water is so cold your back will start to go numb by the end of it.

However, it’s a great way to wake up without coffee. I guarantee you’ll be wide awake after your morning cold shower. In addition, if you do it before breakfast, on an empty stomach, your insulin levels will be very low and your fat cells will be more willing to give up their energy to be burned as heat. So, it’s best recommended to have a cold shower in the morning before breakfast, if your goal is weight loss.

Put some ice in a bag in a towel on your neck or back while sitting down.

This method is recommended in Tim Ferriss’s book The Four Hour Body. He recommends putting a bag of frozen peas, or ice, in a towel, and then sitting down on the couch for 30 minutes, 5 times a week. This is best done on an empty stomach (when your insulin levels are low), so either in the morning before breakfast, or perhaps in the evening either before dinner or several hours afterwards. Tim finds that 30 minutes of ice on the back of the neck, 5 times a week, is about 60% as effective as 20-minute ice baths three times a week. In other words, it’s 40% less effective, but much less painful. Not a bad return for a much less painful investment.

Don a special garment designed for cold exposure

Here we shamelessly recommend our own ice vest, called The Cold Shoulder (www.ColdSh.com). We designed it specifically for weight loss, because we found all the other options (above) to be less convenient, less comfortable, or too time consuming. If you don’t have a swimming pool nearby, or you live in a warm climate, or if you don’t have the balls for an ice bath or cold shower, or if you are too impatient to sit immobile on a couch with an ice pack on your neck for 30 minutes, then an ice vest is a much better option.

The Cold Shoulder specifically targets brown fat in your shoulder, back, and neck, and initial tests suggest that it burns about a chocolate bar’s worth of calories per wearing. So it’s not a miracle worker, and it’s best worn at the same times you’d take a cold shower: in the morning before breakfast, or before bed, when your insulin is low. In addition to fat loss some users have reported that it improves their sleep and helps relieve sore muscles in the neck, back, and shoulders.

There are many cold vests on the market, but most are designed for keeping workers cool in a warm environment, not for weight loss. (Think of the poor dude wearing the full-body Mickey Mouse suit at Disneyland when it’s 90 degrees F outside.) These ice vests are not very fashionable, and furthermore they do not target brown fat, and so are probably not optimal for weight loss.

In contrast, The Cold Shoulder is comfortable and fashionable enough that you can wear in a formal office setting, over your collared shirt and under a business jacket. It’ll make your business suit look like a 3-piece for the 60-90 minutes you wear

it. And in any case, dressy vests---known as “waistcoats” in the UK---are making a fashion comeback anyway. When the ice has warmed up to your body temperature, just take it off and throw it back in the freezer. One of our testers works in a bank and he wears it on his morning commute work and for the first 30-60 minutes in the bank. That’s how fashionable it is.

FAQ: “Won’t an ice vest just make me lose weight from my shoulders?” In a word: no. You cannot “spot reduce” fat. Fat loss is a systemic thing (i.e. happens over the whole body). Unless you have targeted fat loss treatments such as liposuction then you cannot choose where you lose fat from. Once your BAT is activated, your body quickly moves the energy from your white fat tissue (on your tummy, hips, whatever) to where it’s needed, within minutes, via your blood. So no, you won’t just lose fat from the places where the cold packs are located.

Cooling the palms of the hands

It turns out that the palms of your hands and the soles of your feet are very efficient radiators of heat. The blood vessels in your palms go directly to the heart, and so if you cool the palms, it’s an efficient way to move heat out of the core body quickly. This is one reason why, if you take an ice bath, you don’t want to immerse your hands until the very last point, and only for a minute or two: there is a risk of hypothermia when your entire body is immersed in water, and that risk is increased when the palms of your hands are also immersed. (The soles of your feet are in from the first second, so you’re already cooling the core body that way, but your feet are a lot further from your core than your hands, and so the blood warms a bit as it passes through the legs before getting to your core. With your hands... not so much.)

There are several ways to cool your hands: put them in a sink full of cold water, hold a bag of ice cubes in your palms... Stanford University has developed a special glove that costs $900 and has ice water running through it, attached to a machine that pumps the water and cools it. It’s for professional athletes, and has been shown to increase athletic performance by quickly extracting heat from the body of an athlete in the midst of a heavy workout. However... it costs $900, and the cooling contraption is about the size and weight of a bar fridge. Not very economical, fashionable, or portable. A much cheaper option is a hand-held sphere of ice or frozen gel. Our company, The Cold Shoulder, is currently developing such a gel that can be strapped to your palm and provide cooling. It’ll be useful both during workouts, to cool your body, and for weight loss, by activating brown fat if you’re not working out.

Points to take away

There are many ways to get cold exposure:

- Take a cold shower (requires guts) - Go swimming, warm (nice) or cold water (again, guts) - Take an ice bath (real guts) - Go for a walk outside with minimal clothing (be careful

to avoid frostbite)

- Wear a garment specifically designed for weight loss via cold exposure, such as The Cold Shoulder---for the less brave among us (e.g., the authors)

Chapter 14 – Cold exposure

testimonials

We would like to be upfront here and say that each of the testimonials here focuses on cold exposure with our ice vest, The Cold Shoulder. These testimonials are based on a 4 week program. Testers followed a calorie controlled program for the entire 4 weeks. For the first 2 weeks they did not use The Cold Shoulder, and then started wearing The Cold Shoulder for the second two week period. The goal was to isolate the effect wearing The Cold Shoulder, compared to not wearing it. The results are unanimous and speak for themselves; everyone lost more weight when cold exposure was added to their routine.

Each of the following sections are written in the first person, by the author of the trial. You can also find these testimonials on our blog, TheColdBlog.net.

Tester – Mike Sirak

In the beginning

Let me be blunt. There are few people who would describe my body as anything other than overweight. As of December 8th, 2013, I was carrying about 50 lbs. too much body fat, which was confidence-depleting, with my cardiovascular health closely following. I was slowly becoming sluggish both mentally and physically. It was clear I had to make a change, but lacked any kind of motivation to do so. That was until an acquaintance of

mine created a product to help people lose weight: The Cold Shoulder.

I'd like to point out at this early juncture that this isn't some magic weight-loss scheme, a magic pill, or any loosely veiled repackaging of a resistance training regime. This is a product to help you burn calories by making your body produce extra heat.

The Cold Shoulder is essentially an ice pack for your body, and it's great for a number of reasons.

Let there be fright

The idea of wearing a full torso ice pack sounds quite scary. Firstly, we've all stepped into the shower while the water is still freezing and we know it's not a pleasant experience, so you may think that an ice vest is probably going to be much worse. Secondly, the very thought of deliberately making yourself cold sounds almost entirely unlike a good idea. However, the ice vest, when worn with a T-shirt underneath, is far less shocking to your system than stepping into cold water. And while it may not seem a good idea as far as comfort goes, in weight loss various studies and individuals (see the “Ice Age” chapter in Tim Ferriss’s Four Hour Body) have shown that the effects of short periods of cold exposure are positive in more ways than one. There's a great write-up of the history and benefits over at Chest Sculpting.com, but it essentially boils down to this: Your body wants to be warm; if you get cold, you turn available energy into heat. The colder you are, the harder your body must work to generate warmth.

Separate from darkness

By agreeing to complete a four week test cycle for The Cold Shoulder, I had to create a meal plan and stick to it, I had to note the calories of any and all snacks, and I had to track changes in my levels of body fat and my overall weight. Being forced to do this served as excellent motivation for a few reasons. One of the reasons was the motivation to not screw up a trial of a new product, but that motivation quickly gave way to a new motivational factor of not wanting my graphs to start showing an upward trend. I wanted an even graph of calorific intake and a downward gradient in fat and weight loss.

Bringing into the light a number of metrics is a brilliant visualization of your progress. Simple numbers can be plotted on graphs, graph trends can be understood at a glance, and any potential issues can be quickly spotted and acted upon.

My advice to anybody else doing such a trial: write everything down.

Everything.

Let dry ground appear

Now the muddy waters had cleared and I had my motivation. I stood on firm hard ground for this trial, which I will now explain.

The purpose of the trial was to measure the difference in fat loss between two weeks of not using the product, followed by two weeks of using the product. By keeping fluid and food intake constant over the two week period, any additional fat loss in the second two week period could, more or less, be attributed to The Cold Shoulder. It is worth noting at this point

that this was not a fully controlled clinical study, and outside effects such as weather or different physical demands throughout the weeks may have played a role, however minor, in any losses or gains throughout the trial.

To begin with, I started on week zero. I didn't weigh myself because I didn't want to go in with any preconceptions. I started eating the same as I would be for the following four weeks, but this week would serve to let my body adjust to the new regime and negate the effects of water weight on the initial two week period.

Mankind in our image

In order to sculpt this new body, I needed a few things. Initially I needed to scope out my Resting Metobolic Rate. At a stout 6 foot 1, weighing in at a frankly ridiculous 112.7 kg or 248 lbs (ok, so there's some muscle mass), as 28 year old male the RMR for my sedentary lifestyle was calculated as 2,581 calories per day. Ignoring the fact that I can eat that many calories in one sitting, I went on to prepare two set meals which would serve as my evening delights. Breakfast and lunch were kept the same for convenience throughout, and because I already have a routine.

Meal One - 200g Chicken Breast. 344 calories, 0g carbs, 18g fat. 195g Brown Rice. 216 calories, 45g carbs, 1.8g fat. 25g Powdered Curry Sauce. Approx. 25 calories, 1g carbs, 1g fat. 25g Spinach. Approx. 6 calories, trace carbs, trace fat.

For a grand total of 591 calories, this is a god damn delicious meal, and one of my favorites.

Meal Two - 200g Chicken Breast. 344 calories, 0g carbs, 18g fat. 100g Red/Pink Lentils. 353 calories, 60g carbs, 1.1g fat.

25g Powdered Curry Sauce. Approx. 25 calories, 1g carbs, 1g fat. 25g Spinach. Approx. 6 calories, trace carbs, trace fat.

At a hefty 728 calories, this is similar to my favorite meal of all time, only with a bucket load more fiber and not quite as delicious.

Breakfast - 60g Protein shake, 240 calories, 10.7 carbs, 4.7 fat 100g Spinach blended with 1 medium red apple, 120cal, 28.6 carbs, 0.7 fat

Total 360 calories.

Snack - 93g Hoi Sin Duck Sushi, 150 calories, 25g carbs, 3g fat.

Lunch - Sweet Chili Chicken Wrap, 438 calories, 60g carbs, 13g fat.

Total calories for the time I'm at work was 738. This is comprised of a mid-morning sushi snack, a mid-day lunch, and a mid-afternoon snack.

My fixed daily calories between breakfast and when I finish work totals 1098. This made tracking very easy, because I only had two choices of evening meals. I broke these down into: Meal Day 1 (591 calories of Meal One, plus every day 1098 calories) 1689 Meal Day 2 (728 calories of Meal Two, plus every day 1098 calories) 1862

So, on I went. On I went with a strict diet, writing details in a notebook, completing the same exercise routine. It became almost therapeutic:

Wake up at 6:30. Cold Shoulder for 30 minutes. Breakfast. 10 minutes of stretching. 40 squats. 2 mile walk to work. Large cup of green tea. Couple of hours of work. Snack. Large glass of water. Couple of hours of work. Lunch. Large glass of water. Couple of hours of work. Snack. Green tea. Couple of hours work. Home. Cold Shoulder for 90 minutes (until melted and warmed) while preparing meals, reading or gaming. Shower. Cold shoulder for 15 minutes. Sleep at 10:30.

Knowing exactly what you're going to consume during the day really does seem to reduce decision fatigue and keep your mind fresh. Or maybe it was the amount of water and green tea I was consuming, who knows.

It is worth pointing out that I had a cheat day in the first two week period, and a cheat day in the second two week period. Both were roughly equal in terms of calories, with the second one maybe edging ahead (it was Christmas, after all).

And he saw that it was good

So it all boils down to the numbers. In a single month I lost 7.7kg (17lbs) The first two week period without The Cold Shoulder, I dropped 3.5kg (7.7lbs) The second two week period with The Cold Shoulder, I dropped 4.1kg (9.2lbs)---an extra 1.5 lbs lost in 2 weeks.

My second favorite benefit from wearing The Cold Shoulder was that my sleep improved. I wore it for a few minutes before bed every night and slept much more soundly than I had done for months.

Tester – Robert Camille

Background

Like many I first heard about cold exposure therapy through Tim Ferriss from his book The 4 Hour Body (hereafter 4HB), as well as Joel Runyon from IMPOSSIBLEHQ and his cold shower therapy. I am a big advocate of cold exposure for reducing body fat, and I have been enduring 5 minute cold showers for 345 out of 365 days last year (and still going). Using the advice in 4HB, backed by my own research, I attempted to target the areas of the shoulders and neck to maximize the fat burning effects of cold exposure therapy. I did see results (never recorded) but it was very impractical to actually target these areas – I tried cutting my own ice packs, wearing an ice backpack, taping packs to my body and even just using frozen peas applied straight to the back of my neck while watching TV (the peas solution actually remained the longest!). I lasted a couple of weeks before I had enough because it was just too impractical. So obviously when I came across Wayne’s product – The Cold Shoulder – I once again got excited.

Design

Opening up the package for the first time I was impressed in the quality of the product – it actually looks as nice as a formal suit vest. It is well-stitched and a great fit to my body type (I have broad shoulders and it’s nicely snug in a fitted way). The Velcro is strong and allows you to adjust the tightness of the vest to get most comfortable. The locations of the ‘ice pockets’ are laid out well to target the correct areas. I am happy with the design. I will say that the Velcro on The Cold Neck wrap does have sharp corners that can scratch a little now and then – using a smaller patch of Velcro so there is more material around the edges

would easily solve this. It’s hardly a complaint but I want to be thorough in this review. [Note from the editor: we’re getting rid of that Velcro on The Cold Neck, so the scratching will no longer be an issue going forward.]

Ease of use/Practicality

You can either take out the ice packs after each session to put them in the freezer, reinserting them on next use – or you can do like I did because I am lazy and just leave the packs in all the time and place the whole garment in the freezer. The ice packs freeze quicker if you take them all out, but this wasn’t an issue for me in my very cold freezer.

You can easily put it on like a regular vest. However, now and then, an ice pack might fall out of its pocket and you have to pop it back in. Note that this never happened while actually wearing the garment! *Editor’s note: we’re adding Velcro to the pocket closures, so this won’t be an issue either, going forward.+ Given that the packs freeze quicker out of the vest I can understand why they weren’t designed that way.

Wearing the garment – in the month that I have worn it every day to work – no one has noticed (of course I don’t wear The Cold Neck tie while out in public). The vest is undetectable under a regular button up shirt or regular fit polo/t-shirt so unless you are wearing very tight clothes, giving lots of hugs or getting lots of pats on the back for all the weight you’ve been losing – no one is going to know you’re wearing it. At home I’m happy to just wear it around with nothing else over the top/underneath. [Editor's note: we recommend wearing a shirt underneath The Cold Shoulder, but Robert is brave...]

Performance

I used The Cold Shoulder on my bare skin without any undershirt. It’s almost unbearably cold at first, but after a couple of days your skin gets used to it. Now I actually enjoy the sensation unless it’s really freezing outside, but in the Australian summer it’s a refreshing delight.

The ice packs cool effectively even with bare skin contact – I get about 30 minutes before they turn to liquid again, but they definitely stay cold for another 30-60 minutes until I take it off. If you want them to melt slower you can wear an undershirt. In terms of cold performance I couldn’t ask for more than this – the ice packs I’d bought previously didn’t stay frozen as long. I have had The Cold Shoulder for a few months and none of the ice packs have leaked.

Results

Being an avid body tracker/hacker, I wanted to chart the performance of this product. I have nothing to compare it against directly (IE. The peas) but I did compare wearing vs. not wearing. I tracked my weight and approximate diet for 2 weeks without and then another 2 weeks with the garment, wearing it for at least 60 minutes first thing in the morning, and then again for 30 minutes before bed in the evening, replicating the same diet and activities as much as practical.

Looking at the results I did not see a significant effect on weight loss/gain (but see below!). I did note something minor – a greater rate of decline from my peak weight cycle (day after cheat day) – back down to my average baseline weight.

More significant were my body fat results. My body fat levels have remained stable for ~6 months at around 9% plus minus 0.2%. After just 2 weeks wearing The Cold Shoulder it was clear

that my body fat percentage reduced by another 0.5%. This does not seem like much BUT given I have little body fat to start off with – it is a loss of approximately 5.5% of my total fat which IS significant. A loss like this for effectively doing nothing is excellent. Furthermore my body fat percentage has reached a new low than ever previously – and I believe my trial clearly shows that it was a result of The Cold Shoulder.

Back to what I mentioned earlier about my weight remaining unchanged – my best conclusion is that whatever weight was lost in fat, I have gained approximately in muscle. I have no proof or statics of this but it makes sense and also agrees with the cold exposure studies.

Overall

The Cold Shoulder is a high quality product that I would definitely recommend to anyone wanting that extra edge in toning up and reducing body fat percentage. It is comfortable and easy to use, and has definitely produced results for me with effectively zero effort!

Tester - Nick Hamilton

I was introduced to the idea of intermittent cold exposure when I read The Four Hour Body by Tim Ferriss. In the book, Tim chronicles Ray Cronise’s experiences with cold water exposure and how it pushed his metabolism into overdrive causing him to lose 4.77 lbs. of fat per week, which is quite impressive. You should definitely read The Four Hour Body for the full details of

Ray and Tim’s cold exposure experience and especially so if you are keen on self-experimentation.

As an overly-analytical engineer and fitness enthusiast, I am quite the self-experimenter. I love designing trials to test specific variables from supplementation to new training modalities and their effects on my overall health and well being. I keep track of my health and contributing factors by having my blood work done quarterly, counting calories during experiments, getting body scans to determine body fat, etc. Needless to say, Wayne was excited to send me his prototype as he knew I would apply a rigorous testing protocol to it. The idea was simple – controlling for calorie input and expenditure, would The Cold Shoulder have any effects on my metabolism?

The Cold Shoulder is a brilliant execution on a simple idea. Tim pointed out in The Four Hour Body that cold exposure applied directly to your upper shoulders/back/neck had the same metabolic effects as full immersion ice baths – an excellent point to note if you have ever taken an ice bath. The Cold Shoulder prototype showed up at my doorstep just in time for me to include it in the last 4 week cycle of a 16 week workout program I have been focusing on. As with any prototype, it was ugly, but it fit and it worked. [Editor’s note: Nick was using our very first prototype vest and, yes, it was ugly—it looked like a beige fisherman’s vest. The ones we’re now shipping are much prettier—snazzy black with silver pockets.-Wayne.] I immediately shoved the vest into my subzero freezer to ensure I could start wearing it the next morning. I then went to my computer to log my weight and calories for the day.

My Protocol

Being in the last 4 weeks of my workout program, I was curious what would happen when I introduced a new variable. During the previous 14 weeks, I had gained 5.5 lbs and increased my strength significantly, but my body fat had maintained at an approximate 13% and some change.

My eating during this last 4 week period consisted of 206g/120g/171g of Protein/Fat/Carbs on workout days and 171g/115g/69g on non-workout days. This equals 2592 calories and 1992 calories, respectively. I could post the logs of my food here, but to keep this simple, I’ll just tell you that I came strikingly close to these goals every single day. I use a scale the measure my food, and the logs are precise. The workouts for the last 4 week phase were lifting sessions 4 days a week. My feeding period (for intermittent fasting) was 12pm – 8pm daily.

Enter The Cold Shoulder

If you have never put ice packs against on your skin directly after waking up, you are missing out. I wake up at 6am daily and The Cold Shoulder became the first thing in my morning routine. The vest is easy to quickly slip on and Velcro closed. On the first day, putting the vest on caused me to gasp for breath and wince immediately, but the sensation faded rather quickly. After about 5 minutes of feeling chilly, my upper body began to warm up quite a bit – I could actually feel my temperature rising. One of the corollary benefits to this protocol is shocking your brain into an alert state first thing in the morning – I didn’t even need coffee. I went off to do my morning writing and forgot that I was wearing The Cold Shoulder. At the one hour mark, my alarm dinged and I realized all of the ice was melted, so back in the freezer it went.

In the evening, I would wear The Cold Shoulder from 8pm-9pm, just after my last meal of the day. This was a convenient time for me as I cut all artificial light exposure to relax from 9pm-10pm before going to sleep. I generally wrapped up my work day at this point or played with my daughter as the ice packs melted against my skin. Putting this thing on at night is about 100 times easier than in the morning. On the first evening my neck popped and cracked quite a bit which is a huge relief for me as I carry a lot of tension in that region due to an old injury.

Getting into the routine, the mornings became easier and I noticed that my body started heating up quickly following the cold exposure. I could actually feel my skin getting hot. My back began to crack, move and loosen up following each 45-60 minute session with The Cold Shoulder, which was a completely unexpected side benefit. At night, I began falling into a deep sleep around 9:30pm every evening, completely unable to hold my eyes open while reading. During this two week period, the latest I managed to stay up was 9:45pm. From my light research, this is in line with other people’s experiences of cold exposure and its effects on their sleep. I love these unexpected, but welcome, side benefits…

Regardless of my strict protocol, I did take a break from The Cold Shoulder to attend an evening wedding a few hours from home. The hotel didn’t have in-room freezers, so I missed the next morning as well. I assumed that two sessions missed out of 28 wouldn’t affect my results that much, but travelling with the vest wasn’t an option for such a short trip.

The Results

Over the two week period that I wore The Cold Shoulder, I noticed my weight slowly creep up and actually began to worry

that this wasn’t working. At the end of the two weeks, my weight came in at 161.4, about a pound heavier. I was still getting stronger during my workouts, so this wasn’t completely unexpected and, being somewhat lean already, I really didn’t expect to cut a lot of weight.

I was mildly surprised when I picked up my body scan results and saw 12.78% body fat. That put me at 20.6 lbs of body fat, a full 1 pound less of fat in two weeks, all while simultaneously gaining Lean Body Mass. The most exciting thing about this result is that my body fat had basically maintained for the first 14 weeks of this program. To see such a drastic change in a short amount of time could only be attributed to the new factor in my routine, The Cold Shoulder.

So, the entire 16-week program looked like this (italic=before The Cold Shoulder, bold = including The Cold Shoulder).

16 Week Program

Body Fat % Weight Fat (lbs) LBM (lbs)

0 weeks 13.83 154.8 21.4 133.4

4 weeks 13.65 155.4 21.2 134.2

8 weeks 13.72 156.6 21.5 135.1

12 weeks 13.58 159.2 21.6 137.6

14 weeks 13.46 160.3 21.6 138.7

16 weeks 12.78 161.4 20.6 140.8

The results are even more apparent if you plot a graph:

Figure: Nick Hamilon’s Body Fat Percentage remained roughly constant for 14 weeks before using The Cold Shoulder. When he added The Cold Shoulder, his body fat percentage quickly and

sharply dropped.

Verdict

The Cold Shoulder makes experimenting with cold exposure simple, portable, and allows you to easily move around and function while wearing it. I’ll continue using it intermittently through two or four week cycles to see what other benefits I can edge out of it and to hopefully continue the impossible task of leaning out while still adding LBM. My goal is to hit 10% body fat, and I’m hoping The Cold Shoulder will be the key to helping me get there.

Tester - Jocelyn

I had never heard of cold exposure for weight loss until Wayne

showed me the Ice Age section in Tim Ferriss’s The Four Hour

Body. And, just like everyone else, I said, “No thank you!” Why?

I don’t like being cold. Most people don’t. However, I’m game to

at least try most things. So I did try having a cold shower, twice

(one of those times was somewhat involuntary, the hot water

heater wasn’t working). I found both experiences to be

somewhat traumatic. My hands went a strange purple color

(and didn’t go back to normal for a good half an hour). I

shivered a lot and was generally just pretty miserable. That was

the end of my cold exposure, or so I thought.

Like almost all girls (and most guys) I hate the idea of being cold.

And yet, it struck me that over the years I had done far worse

things to myself in an effort to lose weight. Once, I had eaten

almost nothing for 3 days, to the point of feeling faint. I’d tried

supplements that made me feel jittery for hours. I’d spent hours

punishing myself with exercise until I was so tired I could barely

move. I’d gone on countless fad diets that left me hungry and

obsessed with food. And, though I hate to admit it, I’d even

crossed over into eating disorder territory by taking laxatives in

an attempt to flush all food from my body. In my effort to lose

weight I had done things to my body that were far worse than

simply making myself a bit cold. So, when Wayne presented me

with his ice vest (The Cold Shoulder) I reluctantly resolved to

give cold exposure another go *Wayne’s note: she looked at me

like I was nuts.]

It wasn’t so bad the second time around. You don’t wear the ice

vest directly on your skin. You wear it over a T-shirt, which

makes the whole thing a lot more tolerable. Secondly, the ice

only covers your back, neck and shoulders. It doesn’t freeze

your hands, feet, or other sensitive areas. This, again, makes it a

lot more tolerable. I’ll admit, the first few times I wore it, it was

pretty darn cold and I didn’t wear it until it melted fully. I just

wore it for an hour. But after a few days it didn’t feel so cold

anymore. And towards the end of the two weeks I was

purposefully wearing the thinnest T-shirts I had underneath the

vest, because it didn’t feel very cold anymore.

The results? If we’re honest this is all anyone really cares about.

I’ll be upfront and say that I used the ice vest like a regular

person would, not like a fanatic. I mostly only wore it only once

a day, not twice. Sometimes I wore it until it melted; sometimes

I took it off after an hour. I tried to remember to wear it in the

morning before I ate but that didn’t always work. Sometimes I

didn’t wear it until the evening. I didn’t count calories (I never

have); I haven’t changed the way I eat for a long time. I eat a

low GI, Paleo diet, and my weight had remained pretty constant

for a year. I didn’t weigh myself before and after I started.

However, I did take my measurements with a tape measure.

After two weeks of wearing The Cold Shoulder I had lost an

inch from around my ribcage. Seeing as nothing else in my life

had changed, I attributed the weight loss to The Cold Shoulder.

In my opinion, an inch in two weeks isn’t bad.

The best part for me though, was its effect on my sleep. I’m a

very troubled sleeper and I sleep best when the room is super

cold and I’m snuggled in a nice warm bed. However, super cold

rooms are hard to come by in California. But The Cold Shoulder

seemed to make up for that. Of the times I wore it before bed, I

fell asleep faster. In fact, on one occasion I almost fell asleep in

front of the TV while wearing it (which hasn’t happened since I

was about six years old).

Another thing I really like about The Cold Shoulder is how

natural it is. More and more I’ve begun to care about what I put

inside my body. I care about what I’m doing to my insides. The

fact that this vest gave me results without me having to ingest

anything was great. It’s a wonderfully easy, natural solution for

those wanting a weight loss aid. What’s more, it leaves you in

control. When you’ve had enough, you take it off. The same

cannot be said for a supplement. Once something is inside you,

if you don’t like the effects, there’s nothing you can do about it.

Furthermore, it never “runs” out. I don’t have to buy another

one every month as I would do with supplements or meal plans.

Do I still wear it? Not right now. I have no further ambition to

lose more weight at the moment. However, when I eventually

have kids I fully intend to use The Cold Shoulder again to help

me drop the inevitable baby-related weight gain.

Have I put the weight back on since I stopped using it? No. But

that’s because my eating habits have also stayed constant. I

already ate well before and continue to do so.

I don’t believe that cold exposure is something you’d need to do

forever (unless you want to use it every night to improve your

sleep). It can boost your results so you can get to where you

want to be faster, and as long as you maintain a healthy diet

and lifestyle once you reach your weight loss goals, then you

should be able to stop if you want to.

Tester – Wayne

Like most other testers here, I first heard about cold exposure

for weight loss from Tim Ferriss’s book, The Four Hour Body. I

was most impressed with the results from Ray Cronise, who

basically tripled his rate of weight loss by introducing many cold

exposure mechanisms all at once: drinking a gallon of ice water,

sleeping without sheets, winter shiver walks, cold showers, and

ice packs. I started with cold showers and frozen peas on the

back of my neck… that was about 2010 or 2011, living in London

where the cold water is really cold from the shower. I didn’t

record my weight or any other results.

I built the first prototype of The Cold Shoulder in the Spring of

2013. I bought a tight-fitting polyester T-shirt, took a white bed

sheet and some ice packs to a tailor in Pasadena, and asked her

to cut the sheet into pockets and sew them onto the inside of

the shirt so that they’d hold the ice packs over my shoulders,

and on my back; in addition I designed a neck-wrap that could

also hold the ice packs and she constructed it for me, out of that

white bed sheet.

I used the new T-shirt version of The Cold Shoulder for quite a

while just blindly, measuring my weight, and watching it go

down slowly, until I realized that I didn’t really know if it was

having any effect. I had to be more formal, and use my

scientific training to see the effect. So I stopped using it for

awhile, then did my own trial just like the others (more recent

testers above) did: I wrote down a diet (it was a slow-carb diet

as expounded in 4HB), counted all the calories, and measured

my weight every day, without using the The Cold Shoulder

prototype. Then after 2 weeks of this, I repeated everything

again but this time I wore the prototype (with neck wrap) for 90

minutes in the morning, and again for 90 minutes in the

evening. Result? I lost an extra 1.5 lbs in the second two weeks

compared to the first. This corresponds to about an extra 5,000-

6,000 calories burned in 2 weeks (assuming the rule of thumb

that 1 lb. is worth about 3,500 calories). Interestingly, this is

roughly consistent with the actual heat capacity of the ice that

is in The Cold Shoulder, combined with the amount of extra

calories your body has to burn in order to melt the ice. (Your

body is not 100% efficient, so it actually needs to generate more

calories than one would strictly need in order to melt the ice in

The Cold Shoulder).

I did not find any improvement in my sleep, because I already

sleep like a baby. Typically I’m asleep within 3 minutes after my

head hits the pillow---much to the chagrin of my sleeping

partner, who often takes much longer to fall asleep.

More recently I have managed to gain the trust of a local

medical weight loss doctor in Pasadena, who has allowed me

almost unrestricted use to a calorimeter. This is a device that,

in real time, measures your metabolic rate. You breathe into

the device, and it measures the ratio of oxygen to carbon

dioxide as you exhale. Oxygen is required for any burning of

calories in your body, and the rate at which you use oxygen

changes very quickly---within seconds or minutes at most---as

your metabolism speeds up and slows down with whatever

activity you’re performing. It’s really cool to be able to sit

absolutely still for a few minutes and see your metabolic rate

stabilize (my resting rate is about 1700 kcal/day), and then

watch what happens if you do something as simple as stand up:

your metabolism has to work a bit to pump the blood into your

standing (rather than sitting) body, and to feed your muscles

that are required to get you, and hold you, in a standing

position. It increases your metabolism by about 20%, just

standing up compared to sitting.

In any case, I wanted to see the effect of wearing The Cold

Shoulder. I’d sit, breathing into the device for about an hour

without The Cold Shoulder, to get a good baseline measurement

of my resting metabolic rate. Then I’d don The Cold Shoulder

and wait. Typically it would take 10 minutes before my

metabolic rate would increase (because it takes some time for

the ice to extract heat from your body before your body

recognizes it’s getting a bit cold), but then for the next hour or

more, while wearing The Cold Shoulder, my metabolic rate

would increase about 20-30%, just while sitting down and

wearing, while reading or using my laptop.

So, all told, all the results we see here---both mine, and the

results of others---are consistent with losing about an extra 1-2

lbs of fat in 2 weeks, by wearing The Cold Shoulder. Not a bad

return for sitting on your butt and doing nothing for 3 hours a

day, wearing a vest and neck wrap that you basically forget

about once you put it on, and that can be worn anywhere: in

the car, while shopping in the grocery store, at a nice

restaurant, or at a workplace with formal attire.

And yes, once you wear it a few times, you’ll totally forget

you’re wearing it. Burn extra calories while doing nothing. Not

bad, huh?

Points to take away

Wearing The Cold Shoulder twice a day can help you burn away

about an extra 1-2 lbs of fat every 2 weeks

It works whether you are overweight, or even if you’re in good

shape and just want to accelerate your path towards having six-

pack abs

Chapter 15 – Additional cool

benefits (pun intended)

While this section of the book is primarily about cold exposure as a weight loss tool, there are other benefits to going cold. We outline some of them here.

Improved immunity

It is a misconception that cold exposure increases your chances of contracting the common cold. In fact this misconception is likely why the disease is even called “a cold” in the first place. There is little data to support the hypothesis that cold ambient temperatures are related to a suppressed immune system and an increased susceptibility to infection. In fact, it’s likely that it’s not actually the cold air itself that’s the problem. Although much of the research on cold exposure and immunity has been done on animals, it’s likely that what we learn from animals applies to humans as well. That’s why we use animals to study disease in the first place (well, duh).

There are a number of reasons why people think that cold exposure increases their risk of getting colds and flus:

- Misinterpretation of symptoms – breathing cold air can elicit symptoms similar to respiratory infections, such as shortness of breath.

- Increased pathogens in the air – cold air is friendlier than warm air to some pathogens and microorganisms. (Note that cold air has nothing to do with cold exposure, if your cold exposure comes from a piece of clothing.)

- People seem to “catch” colds and flus more frequently in winter.

The U.S Army Research Institute of Environmental Medicine reviewed the scientific literature and concluded “there is no support for the concept that cold exposure causes depressed immune function” (2002). And we can be pretty sure that they’re right, since the U.S. Army would want to know if their soldiers had an increased risk of infection from cold exposure. If they say it doesn’t affect your immune system then they’re probably right.

It’s more likely to be what’s in the air than the air temperature itself. In 2008, Dr. Peter Palese and his research team at the Mount Sinai Hospital in New York published a paper describing the two main reasons that the influenza virus is more prevalent in winter. Both reasons have to do with the low humidity that occurs in winter, especially indoors. First, when somebody who is already infected sneezes, the virus can be found in the water droplets that are expelled from their nose and mouth. In a warm and humid climate, those water droplets tend to fall to the ground before they can infect anybody. But in a cold, dry climate, the water droplets evaporate quickly while still floating, allowing the virus, which is very light, to linger and float around in the air ready to be passed to the next person who breathes that air. And second, the same dry, cold air causes our nasal passages to be dry, so that the mucous membrane usually protecting them is absent. The dry nasal passages then crack, allowing the virus to more easily enter the body. Neither of these reasons have anything to do with cold exposure weakening our immune system.

Additional evidence against the “weak immune system” hypothesis comes from studies on mild cold water immersions and immune function. These studies found that repeated cold

water immersions (three times a week for one hour at 14 degrees Celsius over a six week period) produced a small but significant positive effect on the immune system.

Research in this area is rather scarce. But for now it is certainly safe to say that cold exposure is unlikely to weaken your immune system, and may in fact help strengthen it.

Sleep

If you’ve never suffered from sleeping problems then you’re very lucky. Those that have will understand the frustration, exhaustion and exasperation that come with not sleeping well (not to mention latent homicidal thoughts towards whomever is sleeping soundly next to you). One of the authors (Jocelyn) has suffered sleeping problems for about eight years and it has gotten to the point where she no longer remembers what it feels like to sleep for eight hours uninterrupted. And it seems she is not alone.

Millions of Americans battle with insomnia every year and there is no real treatable, underlying cause. For most people the only answer is sleeping pills. Jocelyn has always tried to avoid these as they can be highly addictive (at least the prescription ones are) and one quickly develops a tolerance, reducing their effectiveness. This is why doctors are unlikely to prescribe more than a week’s worth. It’s not a long term solution at all.

Furthermore, sleeping pills don’t produce the same result as real sleep does. Previous studies have shown that only 25% of people who use sleeping pills were actually satisfied with them. They also come with a whole host of side effects, such as being completely out of it in the morning, feeling somewhat hung-over---not to mention developing a dependence on pills.

If you ask around for advice on sleep, some of the advice you’re likely to get is:

- Exercise more. This can help, but not always. Jocelyn‘s worst sleeping problems occurred at a time in her life during which she had plenty of exercise.

- Consume less caffeine. This is difficult to do, especially considering that if you slept badly the night before then caffeine may be your only saving grace to make it through the day. Cutting back may not be an option---a terrible Catch-22.

- Have a glass of warm milk. Not much help for those who are lactose intolerant or don’t like milk.

- Have a warm bath. Ironically, a cold bath may help better (see below).

- Read before bed. Again, it can help, but not always. - Listen to something boring. Jocelyn finds that even

cricket radio commentary, which is incredibly boring, doesn’t put her to sleep.

- If you don’t fall asleep in 20 minutes then get up. Not particularly good advice as it can lead to a yoyo schedule all night long.

- Reduce stress levels. Right. As if stress is something you choose to have.

Although many of these suggestions may work for some people, it turns out cold exposure can help. Research presented at the Sleep 2011 Conference showed that cooling of the brain (with a space-age, dunce-like, cooling cap worn on the head in which cool water circulates) helped 11 insomniacs to fall asleep and keep them asleep. When given the highest intensity treatment, those who suffered insomnia were able to fall asleep in 13 minutes, which was even better than the 16 minutes it took the non-insomniac control group. The effectiveness of this

treatment was found to be dependent on the frequency and intensity of the use of the cooling cap.

The results of this study have provided researchers with a good basis for further investigation into temperature and sleep quality. “When you get into the neurobiology, insomnia is a disorder of hyperarousal,” explains Eric A. Nofzinger, a psychiatrist at the University of Pittsburgh School of Medicine, who worked on the study. That is, it’s primarily a disorder of the brain.

Further studies have found that the ambient temperature of your bedroom may affect sleep quality, with the optimal sleep temperature being 60 to 68 degrees Fahrenheit (15-19C). Temperatures within this range appear to help lower the core body temperature that initiates sleepiness (if you didn’t already know, your body temperature drops slightly during sleep). This drop in body temperature is an important fact for insomniacs because researchers have observed that insomniacs tend to have warmer core body temperatures before bed than those who do not have insomnia. It is hypothesized that this leads to heightened arousal and difficulty falling asleep. (Wayne finds that he falls asleep faster if he starts bedtime with no sheets or blankets; later, when you wake up cold, just put the sheets back on and fall back asleep.)

This all makes sense to Jocelyn, since she’s always been a fairly “exothermic” person, meaning she gives off a lot of heat. When she was young, her sister used to climb in bed with her when she was cold, only to get out ten minutes later because “it was too hot”. So this finding gives hope to troubled sleepers that don’t want to take sleeping pills (like Jocelyn). However, for those that don’t want to wear a cooling cap on their head, there are other options. Keep the house cool when it’s time for bed, or take a cool bath or shower before bed. Others, like our

testers from the previous chapter, have found that wearing a cooling vest (such as The Cold Shoulder, www.ColdSh.com) before bed helps them to fall asleep more easily. Finally, you can lower your thermostat and place a hot water bottle on your feet to dilate your blood vessels and increase heat loss from the body.

Improved mood

Eric A. Nofzinger, who worked on the cooling cap sleep study discussed above, expressed his hopes that such a treatment might also be useful to those who suffer from anxiety and mood disorders, as these are also disorders of the brain. Although research into cold exposure and mood is fairly scarce, a few studies have been done in relation to depression, which is listed as one of the top disabilities in the world. Depression presents with somatic, emotional and behavioral symptoms and carries with it a high risk of suicide.

One study looked at cold showers as a potential long term treatment of depression. Cold exposure activates the sympathetic nervous system, increasing beta-endorphin and noradrenaline levels in the blood. And yes, endorphins are the “feel good” neurotransmitters. Cold exposure also floods the brain with electrical impulses from the cold receptors in the skin (when you’re screaming “damn that’s cold” so is your brain). The researchers tested a small group of individuals whose symptoms were not quite severe enough to be clinically classed as “depression” and found cold exposure helped relieve their depressive symptoms.

The reason cold exposure helps with depression may be linked to its effects on endorphins, which are the body’s natural

painkillers. Just as certain drugs can have side effects, endorphins can produce a range of effects other than just killing pain. Some researchers believe that depression and mood swings may be caused by a lack of endorphins, so the enhanced endorphin production that comes with cold exposure may account for the mood improvements found above.

Beta-endorphins also happen to be released when you’re excited and can therefore enhance mood. Many alternative therapies, such as acupuncture, work by trying to stimulate the release of beta-endorphins. It is believed that some people who self-harm may do so to experience the positive feelings induced by the endorphins they get as a result of the pain they inflict on themselves. For people such as this, who need an endorphin rush to feel better, cold exposure would be a good source of endorphins since it poses little risk to the individual and is easily available in the form of a cold shower.

A second study, on people who suffered from things such as tension, memory, fatigue and negative mood, found that four months of winter swimming caused them to feel better. They had more energy, and had a significant reduction in their symptoms of tension, fatigue, poor memory and negative mood. Winter swimming was also found to improve symptoms of rheumatism, fibromyalgia and asthma within those subjects.

Cold exposure seems to be a safe, natural treatment with no known side effects (other than---duh---you’ll get cold), and probably has little risk of dependence (as would come with anti-depressant pills). Certainly it’s an area worthy of further research, and is a treatment that can be self-applied immediately to anybody willing to try a cold shower. And for those without the wherewithal to stand in a cold shower, there are more comfortable options, like wearing a cold vest such as The Cold Shoulder.

Points to take away

Evening cold exposure may help you sleep better.

Cold exposure may help with immunity.

Cold exposure may improve your mood.

Chapter 16 – Other hormones

you should know about

Ghrelin

Sounds like a gremlin doesn’t it? It’s actually an appetite hormone produced primarily in the stomach that tells the brain “I’m hungry”. We like to call it the “hunger gremlin”.

Ghrelin increases as you get hungry, and decreases after you eat. Those trying to lose weight would thus want to maintain low levels of ghrelin. However, the only current method of beating down the hunger gremlin is to eat. If you try to not eat, the hunger gremlin raises its head (i.e., ghrelin increases). If you dig in your heels and don’t eat, ghrelin acts like a belligerent child and also digs in its heels, increasing even more. Eventually the gremlin wins, and you eat, sometimes too much, making it difficult to lose weight.

How do we deal with our inner child? We trick it of course. What we want to do is keep the hunger gremlins feeling “full” for as long as possible and we can do this by what we eat rather than how much we eat. Studies suggest that the macronutrient content of food affects how satiated we feel and that protein is the most effective strategy against high ghrelin levels.

So again we see that a diet high in protein is an effective strategy for weight loss, not only because it helps with diet-induced thermogenesis, but also because it helps keep the hunger gremlins at bay. So you may want to consider changing your breakfast from bagels and croissants to a higher protein and fat option. Bacon and eggs, steak, fish, chicken, or even a

standard English Breakfast (minus the bread) serve nicely to squash your inner child, and prepare your body for the beach.

A quick side note on the relationship between ghrelin and cold exposure. One might think that, since cold exposure burns calories, a great way to burn lots of calories is full-body immersion in cold water (like winter swimming). The problem is that full-body immersion in cold water can cause a great increase in ghrelin levels, making you very hungry. This is why we recommend mild cold exposure instead.

Leptin

Leptin is produced by fat cells when they feel “full”. They try to tell your brain to eat less and burn more calories. However, the more body fat you have, the more leptin your fat cells release in an effort to use up stored fat. When there is too much leptin in your system the brain stops picking up on the “burn calories” message and becomes about as deaf as somebody blaring loud music through tiny ear buds. This is called leptin resistance.

Leptin resistance is in many ways similar to insulin resistance. Both use common signaling pathways in the brain and both seem to occur together in overweight people, but with one gender difference. Overweight men show higher levels of insulin and overweight women show higher levels of leptin. This may be to do with the difference in where men and women store fat, with men mostly storing fat around the mid-section and women storing fat more evenly across the body.

Although there is currently some scientific debate about how leptin resistance actually works, it’s clear from the results that past a certain point, too much body fat screws up your leptin mechanisms. But don’t lose faith. It’s not the point of no return.

It is possible to re-sensitize and maximize your leptin responses in the body by making sure you get enough sleep and eat lots of leafy green vegetables. Losing weight also has a big effect on leptin sensitivity: the more weight you lose, the more effective your leptin signals become. So, once you get the weight loss ball rolling, the brain should come out of its stupor and once again get the “burn the fat!” message.

Unfortunately for fruit juice lovers, some studies have shown that too much fructose may induce leptin resistance. The best way to avoid this is to eat the whole fruit, rather than just drinking fruit juice. (This is one of those finer points about the Paleo diet. You may think that a fruit juice is Paleo, but it’s not. You can’t pick juice off a tree.) Those packages of fruit juice that say, “Made with the juice of 6 oranges!” really shouldn’t be so proud of all those oranges: our bodies were not designed to withstand the onslaught of fructose from 6 modern, gigantic, super-sweet oranges all at once. Instead, we evolved to eat the whole fruit of probably just a few wild oranges, which are much smaller and much less sweet. The whole fruit contains fiber, which helps you to feel full. Without the fiber, you’ll drink way too much juice, get way too much fructose (and also way too many calories), and end up with leptin resistance. We’ve said it before and we’ll say it again: for those on a quest for the vitamin C provided in orange juice, it turns out that you can get your RDA of vitamin C from a single serving (1 cup) of broccoli. Your mother was right. Eat your vegetables.

Adiponectin

Adiponectin is another hormone secreted by fat cells. It seems that fat cells do quite a lot other than just sitting there being fat, and occasionally pissing you off. However, unlike leptin, you

produce more adiponectin when you are lean. Adiponectin is a nifty little hormone that regulates the metabolism of lipids (fats) and carbohydrates (sugars). It improves your muscle’s ability to use carbohydrates as fuel, boosts your metabolism, increases the speed at which the body breaks down fat and also curbs your appetite.

Woo hoo! We like the sound of this hormone. Even better, adiponectin has anti-inflammatory effects on the cells that line the walls of your blood vessels, and thus, high levels of adiponectin have been associated with a reduced risk of heart attacks. So it’s an all-round good’un.

The best ways to increase your adiponectin levels are to be active, maintain a lean body and replace the carbohydrates in your diet with good fats such as olives or avocadoes. Mmm.... guacamole! Yum.

Growth Hormone

Human growth hormone (HGH) is produced in the pituitary gland in the brain. HGH levels are at their highest during our teenage years when we have our “growth spurts” into adults and then they lower off as we get older. In adults, it controls bodily functions such as tissue repair, muscle growth, metabolism and brain function.

Studies have shown that HGH levels are lower in obese individuals than in individuals of a normal weight. This suggests that perhaps an increase in HGH might help with weight loss. When scientists administered an HGH injection to patients that suffered HGH deficiency as a result of a pituitary gland disease, they found it improved the patients’ body composition by

increasing the bone and muscle mass and reducing the fat stores.

However, when this was tested in obese individuals it did not produce a significant effect. “Our results showed small improvements in body composition, a small reduction in body fat and increase in muscle mass, but on balance, weight did not change,” says Nicholas Tritos, M.D., who co-authored an analysis investigating the effectiveness of HGH as a weight loss aid for obese people. “More notable changes are seen when an individual is deficient in growth hormone from true pituitary disease,” he said. The American Association of Clinical Endocrinologists also warns that HGH is not recommended as a treatment for obesity.

HGH has garnered more interest for its muscle-building properties. As a supplement, HGH is banned in the Olympics and other sports. Growth hormone allows you to better use the protein in your diet to build muscle. It improves cell growth and thus helps you to grow muscle mass (hence why it’s banned, it would be considered an unfair advantage for those who injected with growth hormone compared to those who did not).

If you want to naturally make the most of growth hormone you can increase your levels through methods such as making sure you sleep well, doing high intensity exercise, not eating before you work out and fasting in the morning (people who aren’t “breakfast people” will rejoice at this). If you are a guy and interested in knowing more about hormones, including HGH, and how to naturally balance them and become superman, we recommend the book Man 2.0: Engineering the Alpha, by John Romaniello and Adam Bornstein.

Points to take away

Ghrelin is the hunger gremlin. Try to keep levels low by eating enough protein.

Too much leptin leads to leptin resistance, making it hard to burn fat.

You want high levels of adiponectin, since it has myriad benefits; so eat lots of protein and moderate amounts of good fat, and get plenty of sleep. (And remember… sleep improves

with mild cold exposure before bedtime.)

Growth Hormone may help you build muscle but it’s not a solution for obesity.

Chapter 17 – Advice from a gal

This chapter is written by Jocelyn, in the first person.

Problem: It’s my period and if I don’t have something sweet I’ll kill someone

We recommend (and follow) slow carbohydrate diets. However, we’re human and fully admit to the occasional sugar cravings. We try to go a week between sugar blips but if you’re at risk of carving your frustration into the kitchen table then it’s sometimes best to give in to a craving before a week is up.

If you MUST have cake (we’ve all been there) then you can have it. In terms of flour, you don’t need to use flours based on grains (wheat, spelt, corn, etc.) Instead, try coconut or almond flour, or even hazelnut flour. They are low in carbs, instead being high in (good) fats. Add a bit of stevia (but never, ever try eating one of the pills – we learnt that the hard way, yuk!), and you can make some pretty amazing low-carb cookies and cakes. We include a few recipes in the Appendix.

We ought to warn you though that coconut flour doesn’t behave like any flour you will have used before. It behaves like someone that has just woken up after a massive night out drinking; it soaks up huge quantities of liquid, and still can’t “hold together”. So you really won’t need to use that much of it. A little goes a long way.

If you want to avoid adding any sugar (recommended) then we suggest you cook with fruit (the whole fruit and not just

powdered fructose/fruit sugar), as it contains natural sugar and fiber that is better for you than the white kind you find in a bag.

We like almond and cinnamon pancakes as well as pear and almond cake. Happy baking

Top tip: cinnamon actually dulls your insulin response (helps prevent insulin spikes), so it’s great for damage control. Cinnamon works really well with apples and tastes great in cookies.

Problem: I love bread/pasta/<insert carbohydrate of choice> too much

Yeah, I used to love bread too, and pasta, and cake and cookies. Wait, I still love the taste of them, ooh and the smell of them. However, I find it pretty easy to avoid them now because I’m almost entirely certain that I’m gluten intolerant and probably have celiac disease. For a long time I suspected I was either wheat or gluten intolerant, or possibly both. I gave up almost all sources of wheat and gluten about three years ago, just to see what would happen (random spur of the moment “I wonder what if...” type thing). I have never taken them back up. I also gave up dairy in a similar experiment. I never took that back up either.

“But bread is so yummy!” I hear you say. Well, I have good reason to not eat it anymore. On the few occasions I have eaten bread since I gave it up it has given me sharp, stabbing stomach pains, and on both of the last two times I tried to eat oatmeal I promptly vomited afterwards. I took this as fairly conclusive evidence that these things didn’t agree with me, and so it’s fairly easy to avoid them with those sorts of consequences.

While I don’t think everyone reacts quite so violently to a bowl of pasta I do think there are a lot of people that are in fact intolerant to wheat or gluten that simply haven’t put two and two together yet. So while you may love your bread or pasta I urge you to give it up for a short while (2-4 weeks at least) and then see what happens when you try it again. You may find, like me, that you have a fairly solid reason to avoid it forever. And even if you don’t react badly, you may notice you just feel better in general when you don’t eat it.

So, what is gluten anyway? It’s a protein found in most grains as well as many food additives. It’s what makes baked things chewy and sauces gloopy. It would be easier to list items that don’t have gluten rather than the items that do because it’s in so many things.

The most extreme response to gluten is found in people that have celiac disease. When they eat gluten they can suffer from damage to the small intestine, poor uptake of nutrients into the blood, stomach pains, bloating, fatigue, anemia and diarrhea. Not a great list huh? How’s that cookie looking now?

According to a 2003 study from The University of Maryland Center for Celiac Research, celiac disease affects about one in 133 people (that’s a lot!). There is no cure for celiac disease. The only thing you can do is cut out gluten from your diet forever (this is what I have done and I feel much better for it).

If you’re one of those people thinking, “Well I don’t get the runs each time I eat cake so I must be fine,” you may want to think again. You may not have full blown celiac disease but you could be “gluten-sensitive” (we include a gluten intolerance symptoms checklist in the appendix). So, if after eating your favorite treat you look like you’re suddenly pregnant with a “food baby” then it may be worth getting yourself tested to see

if you are intolerant to wheat or gluten. Or, you can just do what I did. Cut it out just to see what happens. If you feel better then you’re probably doing what’s best for you.

Oh, and just a side note, I personally find the “gluten and wheat free” versions of things still upset me, so I tend to approach them with a cynical view rather than just assuming that they’ll be fine as an alternative (after trying many gluten free options I came to the conclusion that I felt better when I consumed no grains at all, whether they were gluten free or not).

I certainly don’t intend to never ever eat cake, cookies or ice cream again. I do eat those things BUT I don’t eat the standard ones in the shops. I eat almond flour cake, almond or coconut flour cookies and coconut milk ice cream (unsweetened). I also like almond milk (again, unsweetened), so I can still have an almond-milk latte if I want. There are enough alternative options out there that you can still (occasionally) have your cake and eat it too. And almond cake with stevia is delicious. (See recipes in the appendix.)

Problem: My female friends/colleagues are trying to sabotage me

The chances are they’re not really trying to sabotage you. They just live differently and perhaps haven’t had a “diet epiphany” yet to cause them to look at their own way of eating. However, I’ve been there, at work, it’s someone’s birthday and you don’t participate in the cake eating. This automatically prompts disapproval amongst your colleagues and whisperings of you being “uptight, vain, a bad sport” you name it and it’s probably been said.

I personally find it easiest to say that I can’t eat wheat or any grains because they give me very bad stomach problems. If you’re not yet sure if you’re gluten or wheat intolerant or sensitive then you can just say you’re on an elimination diet to test for intolerances. When you avoid things for medical reasons people don’t seem to treat you quite so unkindly. Even if you’re not intolerant you can always tell a white lie and say you might be in order to avoid an unpleasant situation.

When going to parties or if it’s your own birthday at work then I suggest making some almond flour cake or some appropriate snacks to take with you which you can eat. I was always taught that it was bad manners to show up to a party empty handed anyway. So it’s a perfect excuse to bring something you can actually eat, and introduce to others so they can see that “eating healthy” can be quite yummy.

Dinner parties are a slightly more difficult gig and I’ll admit, I sometimes end up breaking my own rules (such as the dairy – I refuse to compromise on the no grains rule) in order not to offend someone I don’t know very well. If your close friends take issue then they’re not very good friends and it might be time to find some new ones. Just pass on the bread and anything you reasonably can and try not to stress out too much if you break a rule or two if there’s a food you just can’t avoid. You don’t want to be one of those dinner party bores, we all know that people hate having vegan guests because they’re hard to cater for. So if it’s unavoidable just relax, no one can be perfect all the time.

Problem: I don’t like being cold. Can’t I just take a pill for that?

No. If you’ve picked up this book it’s because you care about your body. Regardless of the fact that there are almost no successful anti-obesity pills out there on the market, taking pills is not a true route to health.

Let food be thy medicine – Hippocrates

You’re going to have to make some major changes to your mindset here. The notion that you can take a pill and erase years of bad eating is bullshit. I’m sorry, but that’s how it is. You did the crime (me too) now you do the time (you lose weight safely, naturally and at a reasonable rate).

Ask yourself, what have you done to your body in a quest for a flat stomach? Seriously, write a list of what you’ve tried and whether it really worked. I’ll bet your list looks a bit like our list (which can be found in the introduction section of this book). Now ask yourself whether being a little bit cold is so terrible in comparison. Would you really rather follow a 500 a day calorie diet or consume nothing but juice rather than be a teeny bit chilly for an hour? Really?

All those articles and adverts you read that say “drop 10 pounds in two weeks” are unrealistic (unless you’re very large to start with and go on a very calorie restricted diet). An average of 1-2 pounds of weight loss per week is what the professionals (the doctors) consider normal and safe. Assuming you stick with it as a routine, what cold exposure can do is add roughly an extra 1 pound of weight loss a week (it will vary slightly from person to person). In case you missed it, that means cold exposure can almost double your rate of healthy weight loss. To someone who is addicted to diets that claim to “drop 10 pounds in two

weeks”, an extra pound a week doesn’t sound that impressive. But from a realistic and healthy weight loss perspective, it is. An extra pound from doing essentially nothing really is significant---just see our testimonials chapter.

Girls, I get it. Being cold sucks. But this isn’t getting into a cold shower, nor are you freezing your entire body. I’m fairly wussy when it comes to being cold. I see girls who go out on a Friday night in December in a tiny little dress and I’m like, “How is she not freezing her butt off?!” I’m always the one wearing trousers and a coat. So, when I tell you that I managed to wear The Cold Shoulder ice vest, and it really wasn’t so bad, then I reckon pretty much every other girl can handle it too. In fact, towards the end of my two weeks, after about ten minutes, it barely felt cold anymore.

If you’re sick of being taken for a ride by the weight loss industry, sick of recurring cost of supplements or weight loss plans, sick of fad diets, sick of punishing gym routines, sick and tired of feeling sick and tired, then I recommend you follow our diet advice, change the way you eat for the better, and if you want a tool to speed up your weight loss, then I urge you to give cold exposure a go. I was the least likely advocate for cold exposure. But in comparison to everything I’ve tried before, it was the least painful weight loss method I’ve ever tried (and that’s a sentence I never thought I’d say).

Chapter 18 – Advice from a guy

This chapter is written by Wayne, in the first person.

Problem: What? Give up booze? Really?!

It turns out that different types of alcohol behave differently in your bloodstream. Pretty much any white wine, and most spirits, and definitely beer, can all spike your insulin the same way that sugar does. They also have a large number of calories, so even just from a calorie standpoint they’re not great. After all, alcohol is a sugar. So you should avoid beer, white wine, and spirits, on all days except binge days (if you choose to do them). On binge days anything goes. You can have the sweetest, most girlish cocktail with an umbrella in it if you want to.

During non-binge days red wine, especially dry ones, seem to be best for avoiding an insulin spike. Furthermore, red wine has what are called “tannins”, which have an anti-oxidant effect in the blood. So, if you want to have alcohol and stay slow-carb, pick red wines. My favorites are Malbec, Syrah, and Pinot Noir. Merlot is fine too. Cabernet Sauvignon, however, always gives me a headache.

The obvious no-no but common love of men is beer. I’m sorry but this isn’t going to help you lose weight. There are a lot of calories in beer, but worse, it has a very high carbohydrate content because it is made from cereal grains. It’s a no-go.

Here’s a quick refresher on where various types of alcohol come from:

Beer: grains. Read “carbs”. No-no. Vodka: grains, potatoes and sometimes fruits and sugar. Again, definitely a “no-no”. Gin: grains, potatoes and sometimes grapes. Nope. Rum: sugarcane by-products, such as molasses. Yup, Sugar. Not allowed. Sorry. Tequila: blue agave plant. The same thing that agave syrup (aka, another type of sugar) is made from, so it’s another no. Besides the consequences of too much are a nasty headache and amnesia. So probably not a good idea anyway. Wine: grapes. White grapes are some of the most sugar laden of all the fruits. White wine is definitely a no-no; red, if it’s dry, is okay. For those that are gluten intolerant or gluten sensitive then you may want to consider discarding alcohol derived from grains and if you must have spirits then go all Captain Jack Sparrow instead. “Where’s the rum?” However, with regard to weight loss it would seem that red wine is your best option as it’s relatively low in sugars and carbs, and is derived from fruit rather than grains, potatoes, sugars, or any other fast carbs. I know there are people out there saying “I can’t possibly drink red wine as it gives me a headache.” Yeah, that used to be me too but I found out that it’s actually only some red wines that do that and I can usually tell within a few sips whether the glass I’m holding is a headache inducer or not. Cabernet is definitely out for me. And finally, to state the obvious, no one uses fake sugar in alcohol, so if it tastes sweet then it’s probably high in actual sugar. Stick to dry red wines on all but binge days.

Problem: Cold showers are... cold!

Yeah, no shit, dude. They’re cold. That’s the point. Man up and take it (or quit whining and wear an ice vest instead).

A cold shower in the morning gets you going, gets the blood flowing. There’s even evidence that it boosts testosterone, especially if you also have one before bed. I certainly know that my libido is enhanced by cold showers. They’re also great after a workout, to help ease the muscle aches and help cool you down.

When I first started taking cold showers, I felt like Shrek in that scene in the first movie where he’s fighting the knights in the stadium. When he’s done, he just adopts a body-building stance, and says, “Grrrrr! Yeah!” He’s loving it.

Nowadays, I prefer a different approach (and one less likely to wake up the neighbors). I step into the shower, turn on the water, and then close my eyes for a moment. Breathe deeply and slowly, and adopt don a Zen-like calmness. Imagine what the cold is going to feel like a few seconds hence, and just accept it. The trick is to know and psychologically prepare for the cold stream. Then step into the stream of water, while maintaining the slow, deep breathing and calmness. Yes, it’s cold on your skin. Don’t try to ignore it. Instead, concentrate on the sensation of cold on your skin. Concentrate hard on it. Just take it in, accept it. Keep breathing slowly and concentrating on the sensations. Turn around and douse your entire body in the stream. Keep breathing slowly. Within 30 seconds you’ll be fine, and be able to just start lathering up.

Trust me. It’s really just the first 30 seconds. Once you’re in, you’ll be fine.

Problem: I can’t cook

The excuse “I can’t change the way I eat because I can’t cook” isn’t going to fly here. Can you follow a list of instructions? Yes? Then you can cook. It really is that simple. Especially considering that we live in the golden age of technology. If you don’t know how to do something there is a YouTube video out there to teach you how to do it. I learned how to make a 3-minute delicious microwave scrambled-eggs breakfast from Tim Ferriss’ video on YouTube. You can too.

I too used to claim an inability to cook. My idea of cooking was to shove something in the microwave and nuke it. I have only recently discovered how easy it is to use a frying pan (still working on the oven part). But it’s really not as hard as it seems. You do not have to be able to cook a cordon bleu five-course meal in order to better your eating habits. You only need a grasp of the fundamentals.

Let me show you the cooking skills required for my typical day:

Breakfast: Bacon, scrambled eggs and nuked vegetables. Skills: Place steam bag of vegetables in the microwave and turn on. While the veggies are cooking, fry bacon in a pan (turkey or real bacon, doesn’t matter). When done, leave the fat in the frying pan. Break eggs directly into the pan, add salt and pepper to taste, and stir the eggs around until they are cooked (if you skipped the bacon, a bit of butter helps to stop the eggs sticking to the pan). Place on a plate and eat. Sometimes I’ll skip the eggs and, once the veggies are nuked, pour them into the pan and fry them a bit in the bacon fat, for just a bacon-and-veggies meal. You have not been in heaven unless you’ve tried bacon-fried asparagus. (Butter works well too here.) Yum. Lunch: Chicken and salad

Skills: Cut raw chicken into strips and fry until cooked (I don’t tend to use any oil but, if you must, I recommend macadamia nut oil rather than olive oil). Chop lettuce and tomatoes (and whatever else) up and place on a plate. Plonk chicken on top of the salad, add a bit of oil for dressing and eat. You can also nuke frozen chicken breasts instead of cutting and frying. This saves time but isn’t quite as yummy. Dinner: Beef mince with vegetables Skills: Add salt and pepper to beef and stir around in a frying pan until cooked (it won’t be pink anymore). Add a tablespoon or so of sauce (make sure it doesn’t contain sugar on the ingredient list) and stir. Either steam vegetables in a pan or place another steam bag in the microwave. Place all on a plate and tuck in. As you can see, it’s hardly rocket science. For those of you still not sure you can handle cooking then I recommend The Four Hour Chef by Tim Ferriss. He too believed he couldn’t cook, until he learnt how. If you need any further reason to learn how to cook then you should do it to avoid the washing up. In our house whoever cooks doesn’t have to wash up. And if there’s one thing men hate more than cooking, it’s tidying up.

Chapter 19 – Advice from a

couple

This chapter is written by both Wayne and Jocelyn, in the first person

Problem: giving up foods is too hard Jocelyn: The other day I was standing at a traffic light and the man behind me turned to his companions and said, “Life isn’t worth living if you can’t have bread, beer and ice cream.” I almost felt like turning around and saying, “Oh, well I guess I’ll just go cry in a corner about how empty my life is with my steak, bacon and red wine.” The point is we are not asking you to give up everything enjoyable and just eat cardboard for the rest of your lives. Wayne: We’re also not pretending it will be easy. We also found it hard to give up the foods we loved. Here’s a list of what we struggled with the most:

Wayne Jocelyn

Chocolate ice cream Vanilla lattes

Pecan turtles Peanut butter sandwiches

Popcorn White wine

Marzipan Cookie dough ice cream

Chocolate chip cookies Cupcakes

Anything with maple syrup Chocolate

Pizza Potatoes (all forms)

We’ve both found our own way of dealing with having to give up the foods we were so attached to. We now limit ourselves to one day off a week (many diets recommend a sugar blip every 7-10 days to keep your metabolism from getting complacent). Jocelyn has just altered recipes and substituted the ingredients she can’t have (grains, dairy and gluten) with other ingredients that she can. And we both watch each other’s backs to make sure we don’t fall off the wagon. Changing your diet, and in particular battling a sugar addiction, is hard. It’s much easier if you don’t do it alone. Sometimes we need someone to tell us, “No, you can’t have that cake. Here, have an apple.” Jocelyn: There is another reason we recommend you try to make dietary changes as a couple, and as a family. When you drastically change the way you eat it can affect the people around you in ways you didn’t expect. Let me give you a prime example from the internet:

The guy was just trying to work out and get healthy, so why was his wife reacting so negatively? Well, this response to the above picture answers that question:

When looking at the user comments to these memes19 they perfectly outline the situation. Here are two examples:

honeysucklelips (this user is a girl)

No, no, his wife is worried he is already cheating on him. For a

man already in a steady relationship/marriage, the greatest

motivation to get his appearance into order is for another

woman. The same applies of course for women, except that in

general women always try to impress by their looks so the

changes in appearance are usually more subtle.

zarosch (this user is a guy)

19 For the uninitiated, a “meme” in this context refers to a particular photo, on a website such as 9gag.com or imgur.com, where users add their own text for humorous purposes.

All this generalization. For example, I started to work out

because my girlfriend gives me a reason to take care of myself; a

feeling I haven't felt for a few years. Still she doesn't seem to be

happy about it....

As you can see, whether you like it or not, if you suddenly

change the way you behave and start to look better as a result

your partner is going to wonder who you’re making the effort

for (because you didn’t previously make that effort for them).

Wayne: We’re now straying into psychology rather than just

dieting, but if you want to live harmoniously then you do

actually need to be aware of the psychology of it all. What you

do affects the people around you. Talk to your partner. Try to

make it really damn clear that you’re changing the way you eat

for health reasons.

Jocelyn: It never hurts to use the line, “I want to be with you as

long as possible, so the healthier I am the longer I get to enjoy

life with you.”

Also, try to get your partner to change with you. However, if

you are a guy trying to get your female partner to change their

diet with you then you’ve got to be VERY careful how you

phrase things.

Here are just a few things I have banned boyfriends from saying

to me:

“You ate ALL that?”

“You’re STILL hungry?”

“Wow, you ate that fast.”

“Are you sure you should eat that?”

And here are a few things I have banned boyfriends from saying

around me:

“It’s amazing how I’m so full on this new diet.”

“I’m not hungry.” (Said at both breakfast and lunch)

“Fasting is so easy.”

“How many calories were in that?” (After I’ve spent ages

cooking)

Girls are particularly prone to eating issues (some guys are too,

I’m not denying that) and because we generally have an

emotional attachment to food it can be a sensitive issue. By all

means make changes for the better, just be mindful of how you

go about it, or you’ll likely end up making your partner feel

guilty about not eating the way you do, and resentful towards

you for making them feel bad.

Wayne: I’ll give you two example situations of potential friction

despite good intentions.

Example number 1

I went on a strict diet at one point for a month where I ate eggs

at breakfast and then nothing but veggies for the rest of the

day.

Result?

I upset Jocelyn by saying, “It’s amazing how filling veggies are

and how great I feel just eating this.” Jocelyn has anemia. She

can’t survive very well on just veggies. I made her feel bad for

needing to eat more than me and needing to eat a whole lot

more protein than me. Why did she feel bad about it? Well, we

all know that men generally get to eat more than women

because we’re bigger. So when I started eating less than her she

felt like something was pretty wrong.

Also, Jocelyn is 5’6 and I am 5’8. Previously she tended to

gravitate towards men who were over 6’0 tall because they

made her feel dainty and petite (but she went for me because

I’m just so amazing). However, while Jocelyn is by no means fat,

the smaller I got the larger she felt in comparison next to me,

especially when you consider the size difference she was used

to with previous partners. She felt under pressure to also lose

weight so she would still feel feminine next to me.

Solution?

I’m working on building up my muscle mass so she’ll still feel

feminine even though I’m thinner.

Example number 2

I tried a diet that involved fasting until the afternoon (or

sometimes until dinner) because it’s claimed to help with

muscle building. (Yes, I’m talking to you, John Romaniello.)

Result?

My not eating for long stretches of time drastically aggravated

Jocelyn’s teenage eating issues. She felt guilty for eating at all

and turned from the confident woman I knew to a very insecure

one. She couldn’t do what I was doing as we reckon she has

hypoglycemia, whereby she would almost faint if she didn’t eat

regularly.

We also grew up differently. In her family mealtimes were “a

family time” where everyone sat down together and ate as a

family and chatted about their day. The fact that I wasn’t eating

at all “robbed” her of something she considered to be quality

time together.

Solution?

I compromised to eat lunch and dinner with Jocelyn (unless I’m

away, then I can do as I please).

Jocelyn: So what’s the moral of the story? Your actions affect

those immediately around you. If you’re going to drastically

change your diet then get your partner and family on board.

Remember to talk it out and be flexible towards your partner’s

personal sticking points and insecurities. Otherwise you might

just find you lose the pounds only to gain a load of relationship

problems. Most of all: be gentle with yourself and each other.

Afterword

We’ve introduced the idea of cold exposure and weight loss. It’s not a magic bullet. You can’t just keep eating cookies and cake and use cold exposure and expect to lose weight. You need to adopt a whole new attitude towards eating; the exercise is optional, although highly recommended if you want to maintain muscle mass. The diet, however, must be part of the equation for weight loss. That’s why we spent the whole first half of the book talking about diet, insulin, etc. Without understanding diet and insulin and everything else we discussed, cold exposure isn’t going to get you anywhere. Weight loss is at least 75% diet; the other 25% are exercise and cold exposure.

Cold exposure is just the way to turbo-charge your diet-induced weight loss. Keep that in mind, and you’ll be well on your way to a six-pack (if you’re a guy) or fitting into that tight dress (if you’re a girl).

Sources and further reading

Here we provide a (slightly) annotated, non-exhaustive list of references about diet and cold exposure.

Books

The Four Hour Body, by Timothy Ferriss. Published by Vermilion (2011).

The 100, by Jorge Cruise. Published by William Morrow (2013).

Man 2.0: Engineering the Alpha, by John Romaniello and Adam Bornstein. Published by Harper One (2013).

Why We Get Fat, by Gary Taubes. Published by Random House (2011).

Fat Chance, by Robert Lustig. (2013, Plume)

Films

The Perfect Human Diet. Hunt Thompson Media (2012).

King Corn. Mosaic Films (2007).

Fat, Sick, and Nearly Dead. Us & Us Media (2011).

Killer at Large. Snag Films (2008).

]

Websites

Rather than a huge list of long URLs that you’ll find maddeningly annoying to type correctly anyway, just go to our website, http://www.ColdSh.com, and click on the “Science” link.

Selected Scientific References (warning: technical)

Here is a non-exhaustive list of academic articles on diet, brown fat, cold exposure, weight loss, obesity, diabetes, etc. Most of these articles are rather technical in nature; proceed at your own risk. Furthermore, although the abstracts should all be readable, in some cases the full article may require a paid subscription (or one-time payment) to read.

Articles are listed in no particular order.

On cooked food and our increase in brain size: “Energetic consequences of thermal and nonthermal food processing.” R.N. Carmody, G.S. Weintrauba, and R.W. Wrangham. Proceedings of the National Academy of Sciences 108:48 (November 29, 2011). doi: 10.1073/pnas.1112128108.

A nice review article: Ravussin E, Kozak LP. “Have we entered the brown adipose tissue renaissance?” Obesity Reviews. 2009 May;10(3):265-8. doi: 10.1111/j.1467-789X.2008.00559.x. Epub 2009 Jan 19.

Cold exposure treats depression: Rymaszewska J, Ramsey D, Chladzinska-Kiejna S. "Whole-body cryotherapy as adjunct treatment of depressive and anxiety disorders." Arch Immunol Ther Exp (Warsz). 2008 Jan-Feb;56(1):63-8. doi: 10.1007/s00005-008-0006-5. Epub 2008 Feb 5.

More on cold exposure treating depression: Shevchuk NA. "Adapted cold shower as a potential treatment for depression." Med Hypotheses. 2008;70(5):995-1001. Epub 2007 Nov 13.

Evidence that cold exposure boosts the immune system: Jansky L, Pospísilová D, Honzová S, Ulicny B, Srámek P, Zeman V, Kamínková J. “Immune system of cold-exposed and cold-adapted humans.” Eur J Appl Physiol Occup Physiol. 1996;72(5-6):445-50.

Two articles about cold exposure increasing g adiponectin

levels (as long as you don’t eat carbs). Note that adiponectin

can aid lean muscle gain; this mechanism is still not well

understood, but suggests that cold exposure may lead to

increased muscle gain. Ray Cronise certainly noticed it, as

explained by Tim Ferriss in the Four Hour Body:

Imbeault P, Dépault I, Haman F. "Cold exposure increases adiponectin levels in men." Metabolism. 2009 Apr;58(4):552-9. doi: 10.1016/j.metabol.2008.11.017.

Takayuki Masaki, Seiichi Chiba, Tohru Yasuda, Tetsuo Tsubone, Tetsuya Kakuma, Iichiro Shimomura, Tohru Funahashi, Yuji Matsuzawa and Hironobu Yoshimatsu. "Peripheral, But Not Central, Administration of Adiponectin Reduces Visceral Adiposity and Upregulates the Expression of Uncoupling Protein in Agouti Yellow (Ay/a) Obese Mice" Diabetes. September 2003 vol. 52 no. 9 2266-2273. doi: 10.2337/diabetes.52.9.2266.

Recipes – By Jocelyn

Microwave Vanilla Almond Cake

Cake was one of the first things I gave up when I gave up wheat.

But it meant that I could never have birthday cake, cupcakes or

steamed cakes again. But, when I discovered almond flour I

gleefully realized that cake could be mine again. Microwave

almond flour cake is almost instant cake. It’s so good that I’ve

almost had to ban almond flour from the house due to a lack of

self-control (now we only get one packet at a time and don’t

always have it in the house). It’s a great winter warmer,

comforting treat.

Ingredients

60g or half a cup of almond flour

10g (1 Tbsp) of Stevia baking blend (we use truvia)

Half a teaspoon baking powder

1 egg

Half a teaspoon vanilla essence

1 Teaspoon of water or almond milk (unsweetened)

1 Tablespoon of chocolate chips or raisins or cranberries

or whatever (all optional)

Instructions

1) Combine the almond flour, stevia and baking powder in

a big mug or a small tupperware box (or you could use a

pyrex jug – whatever’s nearby).

2) Add the egg and stir in.

3) Add the vanilla essence.

4) Add about a teaspoon of water or almond milk and stir

until all the ingredients are mixed in.

5) Put in the microwave and gently cover (but do not seal)

6) Cook for approximately 1 minute (it may take up to a

minute and a half) or until a knife inserted comes out

clean.

This cake also tastes good with a few chunks of ripe pear or

apple in it. Or you can put a few dark chocolate chips in and

have choc-chip cake.

Almond Pancakes

My mother is American so I grew up with pancakes. But when I

kicked the wheat it meant no more pancakes for me (Boo!).

However, now that almond flour has become easily available on

the market I get to have pancakes again. These make a great

Sunday morning brunch and I highly recommend them with

bacon.

Yields approx. six small pancakes

Ingredients

60g or half a cup of almond flour

10g of Stevia baking blend (we use Truvia)

Half a teaspoon baking powder

1 egg

Quarter cup or 50ml almond milk

Instructions

1) Combine the almond flour, stevia and baking powder in

a bowl

2) Add the egg and stir in

3) Add the almond milk and stir until all the ingredients

are mixed in

4) Heat a frying pan on a medium heat with either some

oil or some butter

5) Pour a small amount of the mixture into the pan. I

recommend you pour a blob no bigger than the palm of

your hand. Almond flour has no gluten and it can be

tricky to turn the pancakes if you make them too big.

Keep them small or they’ll break.

6) When you see bubbles all over the pancake turn it over

and cook the other side.

These pancakes also taste great with half a teaspoon of

cinnamon in them.

Fake brownies

Sometimes you’ve just got to have chocolate. Certainly Wayne

can’t go without it. For those occasions these fake brownies

should hit the spot. They contain no flour of any kind, so make a

nice change from cooking with almond flour. If you replace the

nuts with some dried cranberries or raisins, and the almond

milk with coconut milk, this can make a great recipe for those

with nut allergies.

Ingredients

For the brownies:

2 cups walnuts, pecans or a mixture of both (I like 1 cup of each)

40 dates, pitted 8 tablespoons cocoa powder (100% cocoa – not drinking

chocolate) 1 tsp pure vanilla extract

For ganache frosting:

1/4 cup unsweetened almond milk 4 tablespoons butter or coconut oil 9 oz. dark chocolate, chopped or chips 1 tsp pure vanilla extract

Instructions

1) Place the nuts in a freezer bag and bash them with a rolling pin until they’re coarsely ground.

2) Either chop the dates until they become a pulp or process in a food processor until they’re a sticky paste.

3) Add the dates to the nuts and mix with your hands (the mixture is too stiff to use a spoon).

4) Add the cocoa and vanilla and knead until combined. 5) Transfer the mixture to a square pan and press down

firmly. Refrigerate until cold 6) As you wait for the brownie to chill, make the ganache

frosting: in a small saucepan, heat the almond milk, butter/coconut oil until the butter has melted and the almond milk just comes to a boil.

7) Remove the saucepan from the heat and add the chopped chocolate. Stir until the chocolate melts. Add the vanilla extract and stir. The ganache should be smooth and glossy.

8) Spread the ganache evenly over the chilled brownie and refrigerate until set.

9) Cut into squares and store in the refrigerator.

Almond honey cookies

Sometimes we all just want a cookie, and the need for cookies

tends to kick in around 3 or 4 pm. I’m not a fan of overly sweet

cookies and that preference holds still when using almond flour.

If you use a lot of sweetener with almond flour it ends up

tasting like marzipan. So these for me are just sweet enough to

satisfy my cookie craving but not so sweet that I scoff the lot or

start to feel sick.

Yields 6 small cookies

Ingredients

1 cup or 120g almond flour

1 egg

2 tablespoons honey

10g melted butter (basically just a small blob)

Chopped nuts of your preference to go on top (I use

brazil nuts)

Instructions

1) Pre-heat the oven to 325 fan or 350 gas.

2) Mix the egg and butter into the almond flour.

3) Add the honey.

4) Combine all ingredients but try not to over-stir .

5) Line a baking tray with parchment paper.

6) Use spoons to measure out six balls of cookie dough.

7) Wet your fingers and gently squash the balls into flat

disks (wetting your fingers stops the dough from getting

stuck to your hand).

8) Top with chopped nuts.

9) Bake for approximately 10 mins.

10) Leave to cool completely and eat.

If you find these aren’t sweet enough for you then you could try

adding a sprinkle of some stevia baking blend to the top of the

cookies before they go in the oven.

Almond Pear cake

This cake is done in the oven rather than the microwave. It

won’t rise as much as a normal cake but it still tastes delicious.

You can use apples instead of pears but they may take a bit

longer to cook (unless they’re really ripe). The benefit of using

almond flour rather than normal cake flour is that is makes for a

very moist cake that keeps well. Having said that, the last time I

made it for my family it only lasted an hour.

Ingredients

2 cups or 225g almond flour

1 teaspoon baking powder

2 eggs

2 tablespoons or 25g butter

1 ripe pear

Quarter cup or 4 fluid oz water

Instructions

1. Add all the dry ingredients in a bowl.

2. Beat the eggs in with the dry ingredients.

3. Melt the butter and add to the bowl .

4. Add the water and mix.

5. Peel the pear, chop it up and add it to the batter.

6. Line an 8 inch baking pan with baking parchment.

7. Put the batter in the baking pan.

8. Bake at 325 fan or 350 gas for 20 mins or until a knife

comes out clean.

If this isn’t sweet enough for you then consider using riper

pears. Alternatively you can sprinkle a little stevia and cinnamon

on the top when the cake is cooked.

Fake Spaghetti Bolognaise

When I found out I couldn’t tolerate gluten I felt pretty sad that

I had to give up all those family staple meals, such as spaghetti

bolognaise. That is, until I discovered spaghetti squash. Now

spaghetti bolognaise is back on the menu and I couldn’t be

happier.

Ingredients

Fake spaghetti:

1 Spaghetti squash

Sauce:

1 onion (The yellow ones - the white ones have no flavor)

About half a pack of bacon (I cut the super fatty bits off)

1 lb beef mince

1 small packet mushrooms

1 jar of pasta sauce (You can choose your favorite but try to pick ones that don't have sugar in the ingredients, or at least have it really low down in the ingredients)

Half a glass of red wine

Instructions:

1. Cut a spaghetti squash in half and roasted it in the oven for about 45 mins (325 fan or 350 gas) or until a knife inserts easily (if it feels hard then it’s not cooked yet).

2. Make the sauce while the spaghetti squash cooks. 3. Chop and fry the onion in olive oil. 4. When onion looks soft and a bit translucent chop and add

bacon (keep the heat on low to medium - you don't want the onion to go brown).

5. Add the meat and stir until cooked. 6. Add the sauce and simmer for about 5-10 minutes. 7. Add the mushrooms and the red wine and simmer for about

5 minutes longer. 8. Once the spaghetti squash is cooked take it out and drag a

fork across it. It should peel away in ribbons that look just like spaghetti.

9. Serve and eat.

Pasta-free meat lasagna

I usually make a double batch of the fake spaghetti bolognaise

sauce and then use the rest for pasta-free lasagna. If you want

superior flavor then I recommend you make this in advance and

leave it in the fridge overnight. This is a great dinner party food

because you can make it all the day before, meaning you can

spend time with your guests instead of being stuck in the

kitchen.

Ingredients

Sauce:

Make one batch of the fake spaghetti bolognaise sauce

Pasta replacement:

4-5 zucchinis (you may need more or less depending on the size of your dish)

Topping:

Good quality cheddar cheese (if you’re avoiding dairy you can omit this)

Instructions

1) Cut around 4-5 zucchinis into thin strips lengthways. 2) Layer the bottom of the dish with zucchini.

3) Cover with sauce. 4) Another layer of zucchini strips . 5) Repeat layers until you reach the top of the dish, the top

layer should be sauce. 6) Grate some cheese on top (being English I'm a cheese snob,

so extra mature cheddar was what I used. Good cheddar should almost "flake" when you cut it. It should not be at all rubbery in texture).

7) Bake at 325 fan or 350 gas for about 40 minutes (or until

you can insert and knife and feel that the zucchini is soft).

Cauliflower soup

This is something I make when I want some comfort food. It’s thick, warming and rich. It’s super easy to make and freezes well. Even if you don’t usually like cauliflower you should give this a try. I’m not sure Wayne really knew what a cauliflower was before I made this and now it’s become one of his favorites.

Ingredients:

1 large cauliflower

1 cup or 8 fluid oz water

6 tablespoons butter

2 teaspoons salt

1 teaspoon nutmeg

Instructions

1) Cut the greens off the cauliflower and place in a steamer pan with the water (the greens go in the liquid to give it more flavor).

2) Chop the white cauliflower florets into small chunks and place them in the steamer part (the pan section that sits above the water).

3) Put the lid on and steam for approx. 10 mins or until you can insert a knife and feel the cauliflower is soft.

4) Strain the greens from the liquid (you don’t want these in the soup – but don’t throw them away, they’re perfectly fine to eat).

5) Add the cauliflower to the liquid. 6) Add the butter. 7) Add the nutmeg and salt. 8) Either transfer to a blender or use a hand held blender and

blend until everything is smooth.

You may be thinking that there’s a lot of butter in this recipe, but the original recipe called for milk and cream too. However, since I don’t recommend you consume those, I simply removed them from the recipe and added a bit more butter instead.

If you find this soup is too thick for you then you can add a bit more water at the end.

Appendix

Gluten Intolerance Symptoms Checklist

Emotional Symptoms

Do you frequently feel irritable for no reason? Do you often feel depressed or do you suffer from

clinical depression? Are you prone to mood swings? Do you suffer from adult Attention Deficit

Disorder/Hyperactivity? Do you frequently have anxiety?

Physical Symptoms

Do your joints/bones ache frequently? Do you suffer from inexplicable exhaustion and fatigue,

no matter how much sleep you get? Do you have anemia? A calcium deficiency? Another nutritional deficiency? Do you show signs that may indicate a nutritional

deficiency, including hair loss, dull hair and skin, weak nails, or exhaustion?

Have you had unexplained weight loss or (less likely) weight gain?

Migraines? Frequent falls or broken bones? (a symptom of

osteoporosis)

Gastrointestinal Symptoms

Have you been diagnosed with Irritable Bowel Syndrome?

Do you have frequent gas and/or bloating? Diarrhea? Constipation? Irregular bowel movements? Stomach pain? Acid reflux/heartburn?

Visible Symptoms

Do you exhibit eczema or psoriasis? Unexplained skin rashes? Dental decay, tooth enamel discoloring, frequent

cavities or other dental problems? (which could indicate a calcium deficiency)

Other Diseases or Disorders Linked to Gluten Intolerance The following diseases and disorders are often linked to gluten intolerance. In addition to treating these diseases, your doctor should perform gluten intolerance tests.

Hypothyroidism/hyperthyroidism Osteoporosis Rheumatoid arthritis Chronic Fatigue Syndrome Fibromyalgia Other autoimmune disorders

Gluten Intolerance Symptom Checklist for Children Gluten intolerance may show up differently in infants, toddlers, and school-age children. Some of the more common signs of gluten intolerance in children include:

Diarrhea Constipation Stomach ache Gas/bloating Colic (in infants) ADD/ADHD Learning disabilities Asthma Eczema Nutritional deficiencies, which show up in blood tests or

in lethargic behavior Bed-wetting Behavioral problems

If you exhibit many of the symptoms in this gluten intolerance

symptoms checklist, it’s very likely you have gluten sensitivity,

gluten intolerance or celiac disease. Bring the checklist to your

doctor and ask for the appropriate tests.

Food Sources of Vitamin C

Food Sources of Vitamin C ranked by milligrams of vitamin C per standard amount; also calories in the standard amount. (All provide ≥ 20% of RDA for adult men, which is 90 mg/day.)

Food, Standard Amount Vitamin C

(mg) Calories

Guava, raw, ½ cup 188 56

Red sweet pepper, raw,

½cup 142 20

Red sweet pepper, cooked, ½

cup 116 19

Kiwi fruit, 1 medium 70 46

Orange, raw, 1 medium 70 62

Orange juice, ¾ cup 61-93 79-84

Green pepper, sweet, raw, ½

cup 60 15

Green pepper, sweet,

cooked, ½ cup 51 19

Grapefruit juice, ¾ cup 50-70 71-86

Vegetable juice cocktail, ¾

cup 50 34

Strawberries, raw, ½ cup 49 27

Brussels sprouts, cooked, ½

cup 48 28

Cantaloupe, ¼ medium 47 51

Papaya, raw, ¼ medium 47 30

Kohlrabi, cooked, ½ cup 45 24

Broccoli, raw, ½ cup 39 15

Edible pod peas, cooked, ½

cup 38 34

Broccoli, cooked, ½ cup 37 26

Sweetpotato, canned, ½ cup 34 116

Tomato juice, ¾ cup 33 31

Cauliflower, cooked, ½ cup 28 17

Pineapple, raw, ½ cup 28 37

Kale, cooked, ½ cup 27 18

Mango, ½ cup 23 54

Source: Nutrient values from Agricultural Research Service (ARS)

Nutrient Database for Standard Reference, Release 17. Foods are from

ARS single nutrient reports, sorted in descending order by nutrient

content in terms of common household measures. Food items and

weights in the single nutrient reports are adapted from those in 2002

revision of USDA Home and Garden Bulletin No. 72, Nutritive Value

of Foods. Mixed dishes and multiple preparations of the same food

item have been omitted from this table.

Non-Dairy Food Sources of Calcium

Non-Dairy Food Sources of Calcium ranked by milligrams of calcium per standard amount; also calories in the standard amount. The bioavailability may vary. (The AI for adults is 1,000 mg/day.)a

Note: fortified means the nutrient was artificially added and does not occur naturally in the food.

Food, Standard Amount Calcium

(mg)

Calories

Fortified ready-to-eat cereals

(various), 1 oz 236-1043 88-106

Soy beverage, calcium fortified,

1 cup 368 98

Sardines, Atlantic, in oil,

drained, 3 oz 325 177

Tofu, firm, prepared with nigarib

, ½ cup 253 88

Pink salmon, canned, with bone,

3 oz 181 118

Collards, cooked from frozen, ½ 178 31

cup

Molasses, blackstrap, 1 Tbsp 172 47

Spinach, cooked from frozen, ½

cup 146 30

Soybeans, green, cooked, ½ cup 130 127

Turnip greens, cooked from

frozen, ½ cup 124 24

Ocean perch, Atlantic, cooked, 3

oz 116 103

Oatmeal, plain and flavored,

instant, fortified, 1 packet

prepared 99-110 97-157

Cowpeas, cooked, ½ cup 106 80

White beans, canned, ½ cup 96 153

Kale, cooked from frozen, ½ cup 90 20

Okra, cooked from frozen, ½ cup 88 26

Soybeans, mature, cooked, ½ 88 149

cup

Blue crab, canned, 3 oz 86 84

Beet greens, cooked from fresh,

½ cup 82 19

Pak-choi, Chinese cabbage,

cooked from fresh, ½ cup 79 10

Clams, canned, 3 oz 78 126

Dandelion greens, cooked from

fresh, ½ cup 74 17

Rainbow trout, farmed, cooked,

3 oz 73 144

a Both calcium content and bioavailability should be considered when

selecting dietary sources of calcium. Some plant foods have calcium

that is well absorbed, but the large quantity of plant foods that would be

needed to provide as much calcium as in a glass of milk may be

unachievable for many. Many other calcium-fortified foods are

available, but the percentage of calcium that can be absorbed is

unavailable for many of them.

b Calcium sulfate and magnesium chloride.

Source: Nutrient values from Agricultural Research Service (ARS)

Nutrient Database for Standard Reference, Release 17. Foods are from

ARS single nutrient reports, sorted in descending order by nutrient

content in terms of common household measures. Food items and

weights in the single nutrient reports are adapted from those in 2002

revision of USDA Home and Garden Bulletin No. 72, Nutritive Value

of Foods. Mixed dishes and multiple preparations of the same food

item have been omitted from this table.

Food Sources of Dietary Fiber

Food Sources of Dietary Fiber ranked by grams of dietary fiber per standard amount; also calories in the standard amount. (All are ≥10% of AI for adult women, which is 25 grams/day.)

Food, Standard Amount Dietary

Fiber (g) Calories

Navy beans, cooked, ½ cup 9.5 128

Bran ready-to-eat cereal

(100%), ½ cup 8.8 78

Kidney beans, canned, ½ cup 8.2 109

Split peas, cooked, ½ cup 8.1 116

Lentils, cooked, ½ cup 7.8 115

Black beans, cooked, ½ cup 7.5 114

Pinto beans, cooked, ½ cup 7.7 122

Lima beans, cooked, ½ cup 6.6 108

Artichoke, globe, cooked, 1 6.5 60

each

White beans, canned, ½ cup 6.3 154

Chickpeas, cooked, ½ cup 6.2 135

Great northern beans, cooked,

½ cup 6.2 105

Cowpeas, cooked, ½ cup 5.6 100

Soybeans, mature, cooked, ½

cup 5.2 149

Bran ready-to-eat cereals,

various, ~1 oz 2.6-5.0 90-108

Crackers, rye wafers, plain, 2

wafers 5.0 74

Sweetpotato, baked, with peel,

l medium (146 g) 4.8 131

Asian pear, raw, 1 small 4.4 51

Green peas, cooked, ½ cup 4.4 67

Whole-wheat English muffin, 1 4.4 134

each

Pear, raw, 1 small 4.3 81

Bulgur, cooked, ½ cup 4.1 76

Mixed vegetables, cooked, ½

cup 4.0 59

Raspberries, raw, ½ cup 4.0 32

Sweetpotato, boiled, no peel,

1 medium (156 g) 3.9 119

Blackberries, raw, ½ cup 3.8 31

Potato, baked, with skin, 1

medium 3.8 161

Soybeans, green, cooked, ½

cup 3.8 127

Stewed prunes, ½ cup 3.8 133

Figs, dried, ¼ cup 3.7 93

Dates, ¼ cup 3.6 126

Oat bran, raw, ¼ cup 3.6 58

Pumpkin, canned, ½ cup 3.6 42

Spinach, frozen, cooked, ½ cup 3.5 30

Shredded wheat ready-to-eat

cereals, various, ~1 oz 2.8-3.4 96

Almonds, 1 oz 3.3 164

Apple with skin, raw, 1

medium 3.3 72

Brussels sprouts, frozen,

cooked, ½ cup 3.2 33

Whole-wheat spaghetti,

cooked, ½ cup 3.1 87

Banana, 1 medium 3.1 105

Orange, raw, 1 medium 3.1 62

Oat bran muffin, 1 small 3.0 178

Guava, 1 medium 3.0 37

Pearled barley, cooked, ½ cup 3.0 97

Sauerkraut, canned, solids, and

liquids, ½ cup 3.0 23

Tomato paste, ¼ cup 2.9 54

Winter squash, cooked, ½ cup 2.9 38

Broccoli, cooked, ½ cup 2.8 26

Parsnips, cooked, chopped, ½

cup 2.8 55

Turnip greens, cooked, ½ cup 2.5 15

Collards, cooked, ½ cup 2.7 25

Okra, frozen, cooked, ½ cup 2.6 26

Peas, edible-podded, cooked,

½ cup 2.5 42

Source: ARS Nutrient Database for Standard Reference, Release 17.

Foods are from single nutrient reports, which are sorted either by food

description or in descending order by nutrient content in terms of

common household measures. The food items and weights in these

reports are adapted from those in 2002 revision of USDA Home and

Garden Bulletin No. 72, Nutritive Value of Foods. Mixed dishes and

multiple preparations of the same food item have been omitted.

Vegetables vs. Meat Nutrient comparison table

This table compares the nutrients of 100 calorie portions of broccoli, sirloin steak, romaine lettuce and kale. What’s most clear is that the three vegetables are packed with nutrients. Of course, you’d need to eat much bigger portions of the vegetables to get a 100 calorie portion than you would for the sirloin steak.

Broccoli Sirloin Steak

Romaine Lettuce

Kale

Protein 11.2 g 5.4 g 7.5 g 11 g

Calcium 322 mg 2.4 mg 374 mg 470 mg

Iron 3.5 mg 0.7 mg 7.7 mg 5.8 mg

Magnesium 74.5 mg 5 mg 60.5 mg 97 mg

Fiber 4.7 g 0 4 g 3.4 g

Phytochemicals Very high 0 Very high Very high

Antioxidants Very high 0 Very high Very high

Folate 257 mcg 3 mcg 969 mcg 60 mcg

Vitamin B2 710 mcg 40 mcg 450 mcg 320 mcg

Niacin 2.8 mg 1.1 mg 2.2 mg 2.1 mg

Zinc 1.04 mg 1.2 mg 1.2 mg 0.55 mg

Vitamin C 350 mg 0 100 mg 329 mg

Vitamin A 7750 IU 24 IU 10,450 IU 23,407 IU

Vitamin E 26 IU 0 32 IU 34 IU

Cholesterol 0 5.5 mg 0 0

Weight 307 g 24 g 550 g 266 g

(10.6 oz) (0.84 oz) (19 oz) (9.2 oz)

All the 304 names (so far) of sugar project20

From Chef Jeremy Goodwin: “This is the list of the ingredient names for sugars that you find on packages in the USA and Canada. Some of the sugars are really artificial sweeteners, but have a high calorific value, high enough to be considered an artificial sugar.” These are 304 names (and the list is growing) of the names for various types of sugar. The criteria for inclusion in this list is that it should include anything with a high glycemic index. In other words, all of these ingredients will cause your insulin levels to rise, as well as having effects on your endocrine system. Consider them all as “bad” in your six-pack quest.

1. Agave nectar (Often with HFCS) 2. Agave syrup (Often with HFCS 3. All natural evaporated cane juice 4. Amasake 5. Amber liquid sugar 6. Anhydrous dextrose 7. Apple butter (Usually with HFCS) 8. Apple fructose 9. Apple sugar 10. Apple syrup 11. Arenga sugar 12. Azucar morena 13. Bakers special sugar 14. Barbados Sugar 15. Barley malt 16. Barley malt syrup 17. Bar sugar 18. Berry Sugar

20 This list is Copyright 2011-2014 Jeremy Goodwin, Single Man's Kitchen (singlemanskitchen.com). Used with permission.

19. Beet molasses 20. Beet sugar 21. Beet sugar molasses 22. Beet syrup 23. Birch syrup 24. Blackstrap molasses 25. Blonde coconut sugar 26. Brown rice syrup 27. Brown rice malt 28. Brown sugar 29. BRS 30. Buttered syrup 31. Candy floss 32. Candy syrup 33. Candi syrup 34. Cane crystals 35. Cane juice 36. Cane juice crystals 37. Cane juice powder 38. Cane sugar 39. Caramel 40. Carob syrup 41. Caster sugar 42. Castorsugar 43. Cellobiose 44. Chicory (HFCS) 45. Coarse sugar 46. Coconut nectar 47. Coconut palm sugar 48. Coconut sap sugar 49. Coconut sugar 50. Coconut syrup 51. Coco sugar 52. Coco sap sugar

53. Concentrate juice (Often with HFCS) 54. Concord grape juice concentrate (Often with HFCS) 55. Confectioner’s sugar 56. Corn sugar (HFCS) 57. Corn syrup (may contain some HFCS) 58. Corn syrup powder (may contain some HFCS) 59. Corn syrup solids (may contain some HFCS) 60. Corn sweetener (HFCS) 61. Cornsweet 90 ® (really HFCS 90) 62. Creamed honey (Often with HFCS) 63. Crystal dextrose 64. Crystalline fructose 65. Crystallized organic cane juice 66. Crystal sugar 67. D-arabino-hexulose 68. Dark brown sugar 69. Dark molasses 70. Date sap 71. Date sugar 72. Decorating sugar 73. Dehydrated sugar cane juice 74. Demerara sugar 75. Demerara light sugar 76. Dextrin 77. Dextran 78. Dextrose 79. D-fructose 80. D-fructofuranose 81. D-glucose 82. Diastatic malt 83. Diatase 84. Disaccharide 85. Dixie crystals 86. D-mannose

87. Dried corn syrup 88. Dried evaporated organic cane juice 89. D-xylose 90. ECJ 91. Evaporated organic cane juice 92. Evaporated corn sweetener (HFCS) 93. Ethyl maltol 94. First molasses 95. Florida Crystals 96. Free Flowing 97. Free flowing brown sugar 98. Fructamyl 99. Fructosan (may contain HFCS) 100. Fructose (HFCS) 101. Fructose crystals (HFCS) 102. Fructose sweetener (HFCS) 103. Fruit fructose (HFCS) 104. Fruit juice (Often with HFCS) 105. Fruit juice concentrate (Often with HFCS) 106. Fruit sugar (Often with HFCS) 107. Fruit syrup (Often with HFCS) 108. Galactose 109. Glucodry 110. Glucomalt 111. Glucoplus 112. Glucose 113. Glucose-fructose syrup (HFCS) 114. Glucose solids 115. Glucose syrup 116. Glucosweet 117. Gluctose fructose (HFCS) 118. Golden molasses 119. Golden sugar 120. Golden syrup (GMO beet)

121. Gomme syrup 122. Granulated coconut nectar 123. Granulated coconut sugar 124. Granulated fructose 125. Granulated sugar 126. Granulated sugar cane juice 127. Granulized cane sugar 128. Grape sugar 129. Grape juice concentrate (Often with HFCS) 130. Gur 131. HFCS 132. HFCS 42 133. HFCS 55 134. HFCS 90 135. High dextrose glucose syrup 136. High-fructose corn syrup 137. High fructose maize syrup (HFCS) 138. High maltose corn syrup (Often with HFCS) 139. Hydrogenated starch 140. Hydrogenated starch hydrosylate 141. Hydrolyzed corn starch (Often with HFCS) 142. Honey 143. Honey comb 144. Honey powder 145. HSH 146. Icing sugar 147. Inulin (HFCS) 148. Invert sugar 149. Inverted sugar 150. Inverted sugar syrup 151. Invert syrup 152. Icing sugar 153. Isoglucose (HFCS) 154. Isomalt

155. Isomaltotriose 156. Isosweet 157. Jaggery 158. Jaggery powder 159. Lactitol 160. Lactose 161. Levulose 162. Lesys 163. Light brown sugar 164. Light molasses 165. Liquid dextrose 166. Liquid fructose (Often with HFCS) 167. Liquid fructose syrup (Often with HFCS) 168. Liquid honey (Often with HFCS) 169. Liquid maltodextrin 170. Liquid sucrose 171. Liquid sugar 172. Maize sugar 173. Maize syrup (HFCS) 174. Maldex 175. Maldexel 176. Malt 177. Malted barley syrup HFCS) 178. Malted corn syrup (HFCS) 179. Malted corn and barley syrup (HFCS 180. Malted barley 181. Maltitol 182. Maltitol syrup 183. Malitsorb 184. Maltisweet 185. Maltodextrin 186. Maltose 187. Maltotriitol 188. Maltotriose

189. Maltotriulose 190. Malt syrup 191. Mannitol 192. Maple Sugar 193. Maple syrup (Sometimes with HFCS) 194. Meritose 195. Meritab 700 196. Milk sugar 197. Misri 198. Mizuame 199. Molasses 200. Molasses sugar 201. Monosaccharide 202. Morena 203. Muscovado sugar 204. Mycose 205. Mylose 206. Nigerotriose 207. Nipa sap 208. Nipa syrup 209. Oligosaccharide 210. Organic agave syrup 211. Organic brown rice syrup 212. Organic cane juice crystals 213. Organic coconut nectar 214. Organic coconut sugar 215. Organic coconut palm sugar 216. Organic granulated coconut sugar 217. Organic maple syrup 218. Organic palm sugar 219. Organic rice syrup 220. Organic sucanat 221. Organic sugar 222. Organic raw sugar

223. Orgeat syrup 224. Palm sap 225. Palm sugar 226. Palm syrup 227. Panela 228. Pancake syrup (Often with HFCS) 229. Panocha 230. Pearl sugar 231. Piloncillo 232. Potato maltodextrine 233. Potato syrup 234. Powdered sugar 235. Promitor 236. Pure fructose crystals (HFCS) 237. Pure cane syrup 238. Pure sugar spun 239. Raisin syrup 240. Rapadura 241. Raw agave syrup 242. Raw sugar 243. Raffinose 244. Refiner’s syrup (Often with HFCS) 245. Rice bran syrup 246. Rice malt 247. Rice maltodextrine 248. Rice malt syrup 249. Rice syrup 250. Rice syrup solids 251. Raw honey 252. Rock sugar 253. Saccharose 254. Sanding sugar 255. Second molasses 256. Shakar

257. Simple syrup (Often with HFCS) 258. Sirodex 259. Soluble corn fiber 260. Sorbitol 261. Sorbitol syrup 262. Sorghum 263. Sorghum molasses 264. Sorghum syrup 265. Sucanat 266. Sucre de canne naturel 267. Sucrose 268. Sucrosweet 269. Sugar 270. Sugar beet syrup 271. Sugar beet crystals 272. Sugar beet molasses 273. Sugar cane juice 274. Sugar cane natural 275. Sugar glass 276. Sugar hat 277. Sugar pine 278. Sulfured molasses 279. Sweetened condensed milk (Often with HFCS) 280. Sweet sorghum syrup 281. Syrup Syrup 282. Table sugar 283. Taffy 284. Tagatose 285. Tapioca syrup 286. Toddy 287. Treacle 288. Trehalose 289. Tremalose 290. Trimoline

291. Triose 292. Trisaccharides 293. Turbinado sugar 294. Unrefined sugar 295. Unsulphured molasses 296. Wheat syrup 297. White crystal sugar 298. White grape juice concentrate (Often with HFCS) 299. White refined sugar 300. White sugar 301. Wood sugar 302. Xylose 303. Yacon syrup 304. Yellow sugar

Where is corn hiding in your food?21

Ingredients that definitely contain corn: Corn alcohol Corn chips Corn gluten Corn extract Corn flakes Corn flour Corn fritters Corn oil – corn oil margarine Corn meal Corn puffs cereal Corn starch Corn sweetener Corn sugar (dextrose, Dyno, Cerelose, Puretose, Sweetose, glucose are all possibilities) Corn syrup Corn syrup solids Corn Popcorn Corn meal Cornstarch Corn flour Corn tortillas Grits High fructose corn syrup Hominy Hydrolyzed corn Hydrolyzed corn protein Maize

21 Copyright Gluten Free Society (2014) (*** permission spending ***)

Modified corn starch Polenta Tamales (coating) Taco shells Vegetable oil Zea mays Zein

Ingredients that may contain corn. Not all of these terms are definitively derived from corn, but they can be. Use with caution: Acetic acid Alcohol Alpha tocopherol Artificial flavorings Artificial sweeteners Ascorbates Ascorbic acid Aspartame (Artificial sweetener) Astaxanthin Baking powder Barley malt Bleached flour Blended sugar Brown sugar (typically the caramel color) Calcium citrate Calcium fumarate Calcium gluconate Calcium lactate Calcium magnesium acetate (CMA) Calcium stearate Calcium stearoyl lactylate Caramel and caramel color

Carbonmethylcellulose sodium Cellulose microcrystalline Cellulose, methyl Cellulose, powdered Cetearyl glucoside Choline chloride Citric acid Citrus cloud emulsion (CCS) Coco glycerides (cocoglycerides) Confectioners sugar Crosscarmellose sodium Crystalline dextrose Crystalline fructose Cyclodextrin DATUM (a dough conditioner) Decyl glucoside Decyl polyglucose Dextrin Dextrose (also found in IV solutions) Dextrose anything (such as monohydrate or anhydrous) d-Gluconic acid Distilled white vinegar Drying agent Erythorbic acid Erythritol Ethanol Ethocel 20 Ethylcellulose Ethylene Ethyl acetate Ethyl alcohol Ethyl lactate Ethyl maltol Fibersol-2

Flavorings Food starch Fructose Fruit juice concentrate Fumaric acid Germ/germ meal Gluconate Gluconic acid Glucono delta-lactone Gluconolactone Glucosamine Glucose Glucose syrup (also found in IV solutions) Glutamate Gluten Gluten feed/meal Glycerides Glycerin Glycerol Golden syrup Honey Hydrolyzed vegetable protein Hydroxypropyl methylcellulose Hydroxypropyl methylcellulose pthalate (HPMCP) Inositol Invert syrup or sugar Iodized salt Lactate Lactic acid Lauryl glucoside Lecithin Linoleic acid Lysine Magnesium fumarate

Maize Malic acid Malonic acid Malt syrup from corn Malt, malt extract Maltitol Maltodextrin Maltol Maltose Mannitol Methyl gluceth Methyl glucose Methyl glucoside Methylcellulose Microcrystaline cellulose Modified cellulose gum Modified food starch Molasses (corn syrup may be present; know your product) Mono and di glycerides Monosodium glutamate MSG Natural flavorings Olestra/Olean Polydextrose Polylactic acid (PLA) Polysorbates (e.g. Polysorbate 80) Polyvinyl acetate Potassium citrate Potassium fumarate Potassium gluconate Powdered sugar Pregelatinized starch Propionic acid Propylene glycol

Propylene glycol monostearate Saccharin Salt (iodized salt) Semolina (unless from wheat) Simethicone Sodium carboxymethylcellulose Sodium citrate Sodium erythorbate Sodium fumarate Sodium lactate Sodium starch glycolate Sodium stearoyl fumarate Sorbate Sorbic acid Sorbitan Sorbitan monooleate Sorbitan tri-oleate Sorbitol Sorghum (syrup and/or grain may be mixed with corn) Splenda (Artificial sweetener) Starch Stearic acid Stearoyls Sucralose (Artificial sweetener) Sucrose Sugar Talc Threonine Tocopherol (vitamin E) Treacle Triethyl citrate Unmodified starch Vanilla, natural flavoring Vanilla, pure or extract

Vanillin Vinegar, distilled white Vinyl acetate Vitamin C Vitamin E Vitamin supplements Xanthan gum Xylitol Yeast

Use caution with the following foods, which may include sources of corn from various products, such as cornstarch, corn syrup and corn/vegetable oils: Commercial soups Peanut butter Various meats (cold cuts, ham, hotdogs, sausages) Breaded or fried foods Cheese Chili Chop suey Chow mein Cheese spreads Fish sticks Mixed vegetables (frozen, canned) Succotash Pork and beans Creamed vegetables Breads dusted with corn meal Graham crackers Baking mixes Pancakes (certain mixes) Pancake syrups English muffins

Gravy (thickened with corn starch, for instance) Salad dressings Canned or frozen fruits sweetened with corn syrup Dates and other fruit confections Ice creams, sherbets Chocolate milk, milk shakes, soy milks, eggnog American wines, whiskey, gin, beer, ale Carbonated beverages such as Coca-Cola, 7-Up, etc Lemonade Instant coffees Powdered sugar Jams and jellies Candies Catsup Chewing gums Sauces White distilled vinegar Monosodium glutamate Baking powder Cake yeast Bleached flour Gelatin capsules