Nutrition Science Initiative (NuSI) and Multiple Alternative Hypotheses

Right off the bat, I have both positive thoughts and expectations, as well as some reservations about the Nutrition Science Initiative (NuSI), co-founded by Peter Attia, M.D., and Gary Taubes: billed as The Manhattan Project to End Diet Fads. I met Peter for the first time at AHS in Boston, introduced by Sisson, and had a fun chat with Gary. I'll bet they must have been just bursting at the seams about all of this, so close to its launch.

I initially got wind of it via Tim Ferriss, clearly someone instrumental in rallying some of the initial sponsorship and funding. Good moving & shaking, Tim. Rather than go into specifics about how the institution is designed, set up, etc., just see the link at Tim's place (and the two slide decks especially), as well as Dr. Stephan Guyenet's take on the whole thing.

In short, Stephan's reservations echo my own (while I remain very positive and enthusiastic overall). But I'll explain mine differently. Before I do, here's Peter Attia's 3-minute launch video.

The criticism I like the best about me is that I don't usually dig into "teh science" first hand, very often. It's true. I do sometimes, and I generally don't much care for posting on studies unless I can get my hands on the full text (abstracts are marketing and press releases). As a recent example of digging into a study first hand, exchanging email with the lead researcher, then synthesizing various takes on it: Synthesis: Guyenet, Colpo, Calories Count, Food Quality Matters, Macronutrient Ratios are Qualitative. But mostly, I'm about integrating everything out there with some basis, and then attempting to synthesize that integration into the widest possible context for an overall sum greater than the constituent parts...too often counted like beans.

I'll start at the beginning and that beginning starts with Gary Taubes, Good Calories, Bad Calories, and one of his lectures after his best-selling book hit the scene. I called that January, 2008 post 180 Degree Errors.

...But in the sense it implies that eating more causes children to grow, it's completely false. In fact, the reverse is true. As children, we don't eat more so we can cause ourselves to grow bigger than we already are. We grow bigger than we are, and the effect is that we eat more in order to sustain our larger base metabolism. Growth hormone causes growth. Food is just the raw material.

The reason this error is so easy to make is because it's self evident that if we don't eat at all, we'll starve and die, and in fact, malnutrition can cause stunted growth. But that's because the minimum necessary raw materials aren't present. Let's draw an analogy in the form of building a skyscraper. If you don't have the minimum amount of concrete and steel, then the building is not going to be built to its full height. But what if you pile up two times the amount of concrete and steel required to build to plan? Is that going to cause it to be built, or built bigger than plan, or faster? No, you need the "growth hormone" to build it: construction workers. They use the raw material, build with it, which creates the demand for additional raw material; but it is the act of building that is the cause for the increased demand for "feeding."

To stretch my analogy even further, one might describe those construction workers as being hungry for raw materials. Even further, what happens if their hunger for those raw materials goes awry, is no longer integrated with the plan? We'll, then, perhaps you end up with something akin to the Winchester Mystery House.

What I have always believed Gary Taubes to be right about is that "you eat too much" doesn't say anything important. That's an indictment of character, and I'm sorry, but we're animals, and animals—contrary to ancient fantasies—are not imbibed of Original Sin. We don't have inherent design flaws. Why we eat too much is the question to ask, and if you pay attention, calories do matter. Or:

  • Calories Count...BUT
  • A Calorie IS NOT a Calorie

Sounds self contradictory, eh? But in fact, this is where the modern science that looks only at calories or Taubsian Doctrine [smiley] come together, if you stop thinking in binary terms...that either Taubes is right or modern obesity researchers are right (or both wrong). Me? I think they both have pieces of the puzzle, and they both lack pieces of the puzzle. To me, when Gary says that fat accumulation is a hormonal disregulation, it's a priori—you don't even need to get up off the couch to know it's true.

But there are other pieces to the whole puzzle. Who has another piece? Brad Pilon and Martin Berkhan, pioneers both in using fasting or intermittent fasting (IF). But they don't do studies. They practice. ...Fast forwarding a year, to January 2009, I did a short post on Hunger.

The longer I go down this path of paleo-like eating, the more I am convinced that hunger is the key. I tell people, now: ultimately, this is not a battle of the bulge, fat, or weight. This is a battle over hunger and ultimately, your hunger is going to win in the long run unless you simply have the rare constitution to be miserable all the time -- like many of the calorie restriction folks do.

I didn't actually mention IF in that post but in retrospect, I have to wonder if that wasn't really it, mostly. You see, over the years I've seen both Brad & Martin field tons of success stories under a general paradigm of dietary agnosticism, i.e., the fasting outweighs all, whether you include grains, sugar...whatever—so long as there's some sensibility to it. If so, what could be going on there? Is it that calories count, or that hunger normalization counts more, or both?

What I found in fasting and working out fasted was what I called "high resolution into hunger." That is, I could get on a leg press with lots of weight in a fasted state, do reps, and make myself ravenously hungry to not hungry at all inside of a minute or two, from one extreme to the next, back & forth. In short, I found fasting to be a solid means of getting a handle on hunger and what you're going to do about it. Fasting is like practicing hunger for fun.

So where are we so far? Well, to my mind, I don't see the right questions being asked by very many. Let's look at Food Reward. Again, definitely a factor, definitely part of the big picture. But to put it in a wide perspective, how often do you say or think "I need a reward," as opposed to "I'm hungry?" Naturally, there's a fooling one's self overlap, but we're human animals. We generally get hungry every day. Do we get hungry because we're really feeling hungry, or, is it a perpetual fooling of one's self? I doubt it. It's probably both, but what's dominant in the equation?

Or, how about economics and scale and doing more with less? Food is cheap, now, relatively speaking. But how can that confounding variable be accounted for in any study? McDonald's offers a reasonably "balanced meal" at very low cost, especially if one retroacts to the earlier days of McDonald's, with something like the Mini Meal. That was the Big Meal back in the day and in current dollars, was probably three or more times as expensive while being half of the calories.

To put it another way, who doesn't think that the macarons et chocolats du Pierre Hermé, Paris, are not about the most rewarding things on the planet? But you'll pay way, way more relatively than you will for just about any other frivolous thing. Not to take anything away from those studying food reward: I realize that most likely, cost is part of the overall picture. It's an integrated "more for less" calculation. How many times have you heard someone describe the food at a (crappy) restaurant being "great" exclusively in terms of the huge portion sizes (talk to old folks)? Getting "a lot" for one's money seems to have been disconnected from any sense of hunger or need.

Now let's move onto the biggest confounder of all: micronutrient nutrition. ...It's almost too bad (not really) we don't live still in an age where things like rickets, scurvy, pellagra and other such conditions were so commonplace that everyone had a constant reminder of how important it is to get nutrients. Let me, right here, give a shout out to my friend Kurt Harris, MD, who was right: There is no such thing as a macronutrient.

To cut to the chase, there are: NUTRIENTS. Nutrients include vitamins, minerals, lipids, amino acids, starches, sugars and whole hosts of things...in....FOOD. And of course, anyone paying attention must have to ask: how come the government always recommends the most nutrient vapid food (grains, vegetables, fruit)? It's really a huge story that ought to fill a book, but when everyone was poor as dirt and the cheapest calories were grains and sugar (still are), and people made sure to get some dairy because it had good nutrition, what happened? "Fortification," an awfully dishonest, misleading moniker. It gives the impression that that recommended industrial food (hint) was good and that adding nutrients just made it better (yea!). Nope. What it did, only, was to target staple foods like wheat and milk, to have added into, enough nutrients to barely prevent the aforementioned nutritional deficiency diseases, because that's what everyone was eating (and the government it totally efficient when it comes to public health :). Real food needs no "fortification," especially when you include plenty of food-chain animals.

To integrate something even more, Julia Ross has a couple of books out and has also gained some acclaim in clinical settings for her success rates in getting people to overcome substance addiction. How? It's not by feeding them protein (macronutrient). Rather, she targets a specific range of supplemental amino acids (nutrients). Get it?

So we don't really know what optimal levels are in terms of nutrients (Laf: we can't even stop arguing about 3 "macro" nutrients). ...It's always been focussed on minimums of specific nutrients to prevent woeful in-your-face deficiency.

...A while back, I wrote a post about how I suspect the root cause of obesity is malnutrition:  Malnutrition –> Health Degeneration –> Obesity & Other Diseases of Civilization.

The idea, simply stated, is that perhaps the very root and fundamental cause of obesity and other "diseases of civilization"—obesity being a good ill-health marker—is malnutrition. But, because food is plentiful and we're not talking about malnutrition in terms of chronic caloric deficit, the malnutrition is subclinical, i.e., no obvious micronutrient deficiencies such as would usher in rickets, scurvy, and other well-documented, easy-to-spot diseases arising out of micronutrient deficiencies like vitamin D, C, or others. Or, to put it another way, sufficient or even excess macronutrient nutrition in the face of mal-micronutrient-nutrition.

A few whom I corresponded with got the wrong idea about that. I was not trying to assert that malnutrition was a direct per se cause of obesity—but going back to Taubes, Hunger, Food Reward: the thing that gives all of these "ideas" a stage, front & center.

  • Taubes: Hormonal Disregulation leading to adverse fat storage (seems more likely if malnourished, even if calorically replete)
  • Unbridled Hunger (seems more likely if malnourished, even if calorically replete)
  • Guyenet: Food Reward leading to overconsumption (seems more likely if malnourished, and...even if calorically replete)

But here's the rub...and now I get to my own reservations about this project, and I wish to frame these reservations as constructively as I can.

It strikes me as just a competing paradigm of calories count vs. carbohydrates count, as simply as I can state it. And I think that sort of binary thinking is wrong, on both parts. Furthermore, I expect to learn more over the years, but as it stands, no more than I already suspect, I suspect.

We're creatures of volition and unique in the animal kingdom. We have invented means in human civilization by which a single individual of its making...using mind, accumulated capital and cooperation, can produce values for millions—just as single individuals have been known to oversee the torture and massacre of millions. This will never be accounted for in any study, but dollars count a lot, and they count every day and for a lot of people individually.

Individual true hunger vs. a reward mentality—and faking of hunger, and its overlap—will never be satisfactorily accounted for in a study. Too complex. Too individual.

There are tons of vitamins and minerals and other essentials and so-called phytonutrients (a word that really means: we don't know what the hell it is) in food. Food contains nutrients. "Macro" nutrients are a mere abstraction, a grouping together by type. For that matter, so are nutrients in general, because we can always deconstruct to the chemical or even atomic properties. "Phytonutrients" are the stuff we have no fucking idea of, but some may be essential. We don't know. At this point, deconstruction perhaps needs some deconstructing. In the end, we're all protons, neutrons, and electrons—or, are we quarks, Higgs Boson, and other sub-atomic and sub-sub-atomic particles? Who knows? Just eat real food?

Back from the ridiculous, I just hope this isn't a project intent on ushering in just another, new set of confounding variables in an effort to "prove" that low carb was right all along, and those who look at calories primarily were wrong. I think you're both wrong—and right—frankly. There's pitfall in looking at anything so complex as human behavior so simplistically, when you are dealing with the economics, the mass of production, the industrial interests, the nutrients at base, teenage girls, and the fact that people get hungry every day no matter what.

...Or, a sweet potato is not the same as a Big Gulp...nor is a Sandwich Jambon Beurre the same as a Hot Pocket!

Here are a few off-the-top-of-my-head suggestions.

  • State your study limitations (confounders), always. See above.
  • Go ahead and give the macronutrient breakdown, but also the MICRONUTRIENT breakdown of the foods consumed (has ANYONE ever done that?).
  • Learn more from the successes of your opponents than you do from their failures.
  • Integrate widely. Synthesize wider contexts as a matter of routine operation and base ethic.
  • Have fun.

It's no secret, given the foregoing, that I'm hugely enthusiastic about any sort of study that can attempt to drill down into how replete full NUTRITION from real food (beef liver, people—the most nutritious, and don't forget oysters, clams, mussels, eggs, etc.) effects hunger and indeed, behavior in that context. When I was thinking of this post, I had in mind a bunch of ideas and suggestions as to how to design such a study but you guys are the experts in that regard.

Everyone knows I have a little book. What I'm most proud of is doing a bit of original work—I think it's chapter 3—in terms of comparing nutrients in various foods. I spent more time there than on anything else. When I went to AHS, I saw Matt Lalonde do basically the same thing in his presentation, my favorite of the whole conference.

A calorie is most certainly not a calorie, while calories do matter for fat accumulation and loss. This is what I would like NuSI to integrate, above all else.

If you find this post to your liking, please do socialize it with the buttons right below. Spread it around. I mean this to be constructive and I care a great deal about all of it. Make sure everyone sees it who ought to see it.

 

Comments

  1. Richard, can you see a scale emerging in the future measuring the nutritional density of different foods compared to their caloric values?

    • Hmm, that’s a funny question on a number of levels as it strikes me, and I’ve never considered it.

      Get this. We live in a world where you are regularly bombarded in media, even TV, even fucking Oprah (well…), about SUPER FOODS. Tell me the last time any of them was animal origin? And yet, I can teach a 1st grader in a couple of hours how to blast it out of the water with a number of far more nutrient dense foods.

      But hey, I’m a total sucker for leapfrogging.

      • Paleophil says:

        Rip wrote: “Richard, can you see a scale emerging in the future measuring the nutritional density of different foods compared to their caloric values?”

        Well said, Rip. My dream is unit price labels on foods based on cost per nutrient instead of cost per pound, but it would have to be based on the nutrient analysis of knowledgeable folks like the Kraken, rather than the USDA. I hope someone in the Paleo world creates such a list.

        @Richard: I commend you on having the courage to express a perspective that differs a bit with LC god, Gary Taubes and to publicly express where you agree with Stephan Guyenet (horror of horrors ;-) ).

        Richard wrote: “…about SUPER FOODS. Tell me the last time any of them was animal origin?”

        Right on, Richard! The best animal foods are some of the world’s best “superfoods,” but you rarely see them portrayed that way, because it’s not considered “politically correct” by folks like Oprah.

        Richard wrote: ‘how often do you say or think “I need a reward,” as opposed to “I’m hungry?” ‘

        Minor quibble–my understanding of “food reward” (aka “brain reward”) is that it acts at an unconscious/subconscious biochemical level, so that you don’t say to yourself consciously “I need a reward.” Instead, your brain/body generates signals saying “eat this, EAT THIS,” and then “EAT MORE OF IT, MORE, MORE!” and the message even seems to come from the food itself. The potato chips cry out to you from the cupboard “Eat me, Eat me! Don’t worry, you’re wife isn’t watching, you’ll get away with it!” ;-) When the reward signals are super-strong, you eat until you get sick. How many of us have eaten candy and other junk foods at some point in our lives until our stomachs are bloated and we feel ill? It’s a seemingly irrational behavior that now has a plausible rational explanation.

        Food reward is the label scientists give to why it’s nearly impossible to eat just one potato chip, but not difficult to eat just one chunk of boiled potato. Scientists don’t understand every detail of how it works, but you don’t need to understand every reductionist detail to know that it’s difficult to eat just one potato chip (ie, that food/brain reward is real).

        I think Dr. Harris called it the Pringles effect, and that was a particularly good example, because it’s not about gourmet food–quite the contrary, it’s generally about cheap, crappy food that you nonetheless find yourself inexplicably wanting to eat more of, despite not planning to. You open a can of el-crappo Pringles, intending to eat just one handful, and the next thing you know, you’re tilting the can for just one more handful and the can is empty, and you ask yourself, “Why did I do that?” That’s food/brain reward. Boiled potatoes don’t generally produce it, but you won’t tend to hear Gary Taubes or Ron Rosedale talking about that (though they have done a very good job in other areas, such as pointing out the insanity of demonization of animal fats and that there are “good calories” as well as “bad calories”).

        The best thing about NuSI may be that Taubes and Guyenet have put the macronutrient wars aside and joined forces to promote science and health. Best of luck to both of them.

      • PeePhil :)

        Ha, just having fun. I actually completely agree with you and both J Stanton and I, in out interview and over hours, agree with a lot of that food reward stuff. How is it you can’t eat another bite of ribeye that you love, but you’ll keep at the Pringles until the can is gone, and let’s hope there isn’t another in the cupboard.

        On pure basis of the length a detail of the post and wanting it to be accessible to as many as possible, I cut corners. With unlimited space, I’d have gone on to say that what I’m really talking about is that food reward doe not explain why we eat and perhaps only marginally explains why we overheat. In other words, FW is a convenience, closely related to the economics and of course, there’s the food engineering, closely related to cigarette engineering.

        Food reward is interesting, but look at it this way. When you’re NOT hungry, at all, what effect does FW have? My argument is simply that hunger and non hunger is by far the dominant force.

        ….and, thanks. Going into more depth is what comments are for.

      • Paleophil says:

        Richard wrote: “On pure basis of the length a detail of the post and wanting it to be accessible to as many as possible, I cut corners.”

        Yes, that’s partly why I wrote that it was a minor quibble.

        Richard: “food reward doe not explain why we eat and perhaps only marginally explains why we overeat. In other words, FW is a convenience, closely related to the economics and of course, there’s the food engineering, closely related to cigarette engineering.”

        I think food reward is abbreviated as FR and the term seems to turn a lot of people off, so I’ll try referring to it mainly as the Pringles effect (TPE) going forward, where it won’t cause confusion (I hope), and FR otherwise. Do you mean that FR is a convenient term used to explain complex multiple factors? That’s quite possible. Food engineering is supposed to be part of the FR phenomenon, right? FR and TPE may even turn out to be misleading terms and a poor explanation for multiple complex factors. What does seem to the be the case is when people act as though something called “food reward” is a factor, such as via a simple, easy Shangri-La-type approach, they report that their levels of hunger diminish and that they lose body fat, at least in the short term. Questioning the importance of TPE would have more oomph if a Shangri-La-type approach were first put to the test.

        My own issue re: body weight is more one of having to put effort into keeping my weight up on a Paleo-type approach, so I’ve employed TPE in reverse–using higher-reward foods, combinations and some cooking/processing to stimulate increased caloric intake–and have had some success, though I don’t employ it with the most pathological foods and processes, so I still have far less body fat than I did on a SAD.

        Richard wrote: “Food reward is interesting, but look at it this way. When you’re NOT hungry, at all, what effect does FW have?”

        That is when TPE reveals its true power and partly explains why some moderners continue to eat long after they have consumed more than humans in older societies generally did, and why records of individual and societal obesity have been recently set. We don’t need Pringles or ice cream to avoid starvation, but people eat them anyway. Even when you think you’re completely stuffed, someone says, “Do you want dessert?” and by some miracle you find there is still room for dessert, only now some scientists think they have some new insights into how this works.

        Richard: “My argument is simply that hunger and non hunger is by far the dominant force.”

        Hunger and TPE are not discrete opposing hypotheses–hunger is part of the TPE model. Lowering hunger is an integral part of TPE approaches. Stephan Guyenet reported (http://wholehealthsource.blogspot.com/search?q=food+reward+hunger) about a case where a “grossly obese” volunteer consumed a starvation-level of calories on a low-reward diet and yet “never complained of hunger” (http://www.ncbi.nlm.nih.gov/pubmed/5216999). Other obese volunteers “rapidly lost a massive amount of fat and reduced calorie intake dramatically without hunger.” As you may recall, Seth Roberts’ Shangri-La diet works by reducing hunger.

        Stephan also wrote about the impact of hunger on alliesthesia and food reward: ‘Alliesthesia is the phenomenon whereby the pleasantness of an external stimulus depends on the internal state of the organism. It sounds more complicated than it is. One example is that entering a hot tub feels better when you’re cold than when you’re already hot. The pleasantness of the stimulus (hot water) depends on your internal state (temperature of the extremities). Another example is that food tastes better when you’re hungry than when you’ve just eaten a large meal (“hunger is the best sauce”). Again, the pleasantness of the stimulus (food) depends on your internal state (hunger).’ http://wholehealthsource.blogspot.com/2011/08/food-palatability-and-body-fatness.html

        While TPE or any other single model doesn’t completely explain chronic obesity, where is the evidence that traditional societies governed by natural hunger and alliesthesia rather than by biochemical stimulation from selectively-bred, engineered and processed foods are prone to unwanted chronic obesity, even when food is plentiful, including even carby traditional foods? Everyone is prone to hunger, but not everyone becomes obese. Even Pringles don’t fatten everyone, but they seem to do a better job of it than boiled potatoes. Plus, it’s reportedly easier to lose weight by eating with the nose clipped than not. Hunger is important and integral to TPE, of course, but how does hunger alone explain the Pringles or noseclip effects?

        Richard: “….and, thanks. Going into more depth is what comments are for.”

        You’re welcome! Thanks for the courageous blog post.

      • Phil

        Thanks for all of that. Yea, FR, not FW. Brain fart.

        My overall point is that of everything, hunger is the essential key. Yes, sometimes we eat high reward foods when not hungry but for most, I don’t think it’s pathological.

        I want to see a focus more on why a person feels hungry when in terms of calories and fat mass, they are not. Yea, leptin and such, we all know that I suppose. But I’m not seeing nutritional quality being integrated, just calories.

        For example, it would be interesting to do a crossover study as follows (this being only one way of design, probably many others, probably better)

        For one month, everyone eats ad libitum, but one group eats a super nutritionally demise diet with plenty of liver, oysters, clams, mussels, eggs, etc. the most nutritious foods on the planet while the other group eats processed and fast food. Compare caloric intake, ad libitum. Then crossover and go to a ward setting where everyone eats 300 calories per day less than maintenance, but one group gets the nutrient dense food and the other gets the crap in a bag. Compare weight loss and subjective feelings of hunger, stress, antagonism, well being, etc.

      • Paleophil says:

        Richard wrote: “I’m not seeing nutritional quality being integrated, just calories.”

        I am. For example, Stephan Guyenet has discuss nutrient density and broader food quality multiple times:

        “The nutrient density of a diet may influence obesity risk, as I speculated in my recent audio interview and related posts (5, 6, 7, 8, 9).” http://wholehealthsource.blogspot.com/2010/06/low-micronutrient-intake-may-contribute.html

        “I think it’s likely that refined carbohydrate and sugar can contribute to obesity, but by what mechanism? Insulin is not a compelling explanation. Food reward/palatability is an alternative possibility that fits the evidence better. Another plausible hypothesis is reduced fiber and micronutrient density.” (http://wholehealthsource.blogspot.com/2011/08/carbohydrate-hypothesis-of-obesity.html)

        “As I discussed in the last post, micronutrient deficiency probably plays a role in obesity, both in ways that we understand and ways that we (or I) don’t.” http://wholehealthsource.blogspot.com/2010/01/body-fat-setpoint-part-iv-changing.html

        “French people fiercely defend the quality of their food. … generally we are far behind in assuring food quality and transparency.” http://wholehealthsource.blogspot.com/search?q=quality

        “allow yourself to eat quality food until you’re no longer hungry.” http://wholehealthsource.blogspot.com/2010/01/body-fat-setpoint-part-iv-changing.html

        I see nutritional quality and micronutrient density as complementary to FR, rather than opposed.

        Your proposed study would help determine how much overweight is due to excess calories vs. nutrition, though it wouldn’t factor out the FR aspect, as the low-nutrition foods also tend to be high-reward foods. It would be easier to do a single-factor study that tests the FR concept, because one could use the Shangri-La diet technique of just adding a small additional snack in between meals of bland refined coconut oil or MCT oil, or of any high calorie food (like roast beef and butter, as Seth Roberts was doing the last I noticed) with the nose clipped.

        Shangri-La is so simple and easy that I’m amazed more people haven’t tried it. It’s the only completely nonrestrictive diet I can recall coming across.

      • Galina L. says:

        There are so small details that could matter, I don’t see how it could be all addressed in studies.

      • Paleophil

        We agree, basically. Limitations of comment threads I suppose. In terms of addressing micronutrients, I meant in formal studies. Indeed, Stephan is the first around way back when to address quality and his being half French and me knowing very well how the French regard quality food is one reason I have more links to WWS on my blog than to any other. Some of his past stuff on traditional preparation methods and societies are gold.

        My proposed study isn’t intended to wash out FR but rather to pit FR against nutritional density head to head. See which one perhaps has the greatest effect. One could also do an ad libitum study with zero food restrictions and then compare food logs, calculate micronutrients and calories and see if there’s a strong correlation between eating more quality, dense, and a caloric intake closer to what the individual ought to be eating.

        My hypothesis is that over time, eating high quality and density washes out FR.

      • Oh, about Seth & Shangri-La. Seth is a friend, but I have never looked into it. Perhaps one of these days.

      • Paleophil says:

        Thanks for clarifying that you meant formal studies, Richard. Drs. Lindeberg, Sebastian and others (especially Dr. Lindeberg, who seems to be all about DOING, rather than talking) have done some studies that did produce fantastic findings for nutrient-dense quality foods, but we could certainly use a heck of a lot more to make a dent in the mountain of misinformation that the entrenched powers vomit out. We can all do our part by doing quantified self experiments and reporting on the results in blogs like yours, Seth Robert’s, Stephan G.’s, …. I think the future lies mainly with self experimentation anyway. This tool can help: http://www.quantified-mind.com.

        Hmmm, that brings to mind an idea…If you want to pit FR against nutritional density and you think that quality/density will kick FR’s pussy ass (good gracious, you’re rubbing off on me! ;-) ), then I suggest that you man up, lay down the gauntlet, and challenge your friend Seth Roberts and his wimpy Shangri-La ;-) . One set of people could do Seth’s doomed noseclipped snack method, with Seth providing instructions on what to do, and the other set could follow your brilliant he-man guidance, and then maybe switch. It would be a Paleo smackdown! Two approaches from the Paleo/traditional community tested against each other in a battle to the death, or, erm, health. ;-) You’d need to agree on how to score the results (maybe which approach reduces waist size or % body fat the most) and determine the winning approach. Maybe a third party like Stephan could be the ref and judge.

        Wish I had thought of this earlier. Enough of the whining and arguing and personal attacks on blogs and forums–let people get in the ring and bare their fists and prove what’s best! As a matter of fact, we should do this with LC vs. moderate carb too and everything else, after this is done, instead of talking things to death–let’s DO stuff. Let’s put things to the test and try to settle the arguments. I know, not likely, but maybe SOME people might PARTIALLY accept the results and the bitchiness might tone down a notch or two? More importantly, maybe we’d all learn something?

        Yeah, yeah, I can already hear the critics and naysayers: “It’s not the perfect gold standard of a double-blind, placebo-controlled clinical study.” Kiss mi rass! Who cares. It’s real people putting things to the test instead of just talking about it, and if that’s not good enough for the critics, so be it–I’m not talking about trying to get a study published in a peer-reviewed journal, after all.

        Unfortunately, I’m not looking to lose weight, so I wouldn’t be a good participant. I guess my contribution is the idea, if you think it’s any good, and moral support.

      • PaleoPhil

        I’ve been experimenting with how daily doses of the grassfed liver pills from Universal I previously blogged about reduce cravings, allowing one to take off weight slowly. It’s my own thing. Not ready to blog about it yet but hopefully soon.

  2. You should be on the NuSI board of advisors!!

    • Agreed! Having a bunch of eggheads doing the science is all fine and well but they need someone impartial in there to keep them honest, and to interpret the results with some common sense.

      • Petter Attia and I will have dinner soon, probably do a skype interview. I’m using some connectins to hopefully do a VC presentation or two. Checking the Rolodex now. I’ve done many in the past, on Sand Hill Rd and SF.

        I’m going to be working on a slide deck to help the effort.

      • Galina L. says:

        It is great to have a front seat.

  3. wilberfan says:

    “I’m about integrating everything out there with some basis, and then attempting to synthesize that integration into the widest possible context for an overall sum greater than the constituent parts…”

    The Ken Wilber of the Paleosphere! ;-)

    • I sincerely take that as a complement, sir, because I have a slight inkling of your paradigm and set of assumptions, which I stand under, in order to understand.

      Curious minds want to know, chiefly mine. Did you view that Kimura video, and what did you think?

      • wilberfan says:

        Oh, yeah… forgot about that. Oops.

        Just watched it, and I Grok what he is saying, and I agree. I think a Ken/Yasuhiko Venn Diagram would overlap a lot… Based on this, I think you’d really enjoy Ken’s Stuff…

  4. Here’s a thought: FTA Grass Fed Liver Pills. Nutrient density is your thing. Outsource production, distribute via Amazon.

    • GC

      Glad to see I didn’t piss you off in our last exchange. Every new thread is a new thread.

      Actually, Universl already makes grassfed liver pills. And they’re fucking cheap! Search the blog! (just staying one step ahead, always)

  5. Just FYI, Tim Ferriss had nothing to do with how this project originally got off the ground; it was rather because John Arnold approached Gary Taubes after hearing a lecture.

  6. I think you really said a mouthful here! I do think that focusing a ton of attention on the particular nutrient profile of individual foods will ultimately turn out to be not that useful in terms of maintaining health. Several different cultures, including the always-canny Japanese, place a distinct mandate on simply eating a wide variety of foods. My mom, who hails from a small fishing village on the coast of Thailand, always evaluates any plate of food based on whether it has enough different colors to please her eye. I recently heard from somewhere that the Japanese approach is to try to eat 30 different ingredients every day. So, I realize that this is a non-scientific sampling of anecdotal evidence, but that’s the takeaway: ancient cultures that enjoyed profound good health on a diet of whole foods also advocate seeking out as varied a diet as possible. This wisdom seems so obvious that it hardly needs stating; but look how easily we’ve managed to turn away from the traditional wisdom of our ancestors lately. Eat seasonally. . . eat real food. . . eat a big variety of whatever is available. . . not rocket science yet people seem to have a tough time getting the picture.

    I haven’t followed the whole Food Reward thing at all. But I look at it this way. As you and others have noted, when we eat health-promoting whole foods, we don’t feel much need to gorge. Suspiciously, only super-crappy foods seem to do that thing where it’s like they talk to you and you feel illogically motivated to eat them even when you are not hungry at all, maybe even when you are actually already uncomfortably full. I don’t know what causes that, but I know that when I feel it happen, I make a note to try and never eat that food again. That gotta-gorge feeling is the clearest signal I know of that I should avoid a certain food.

    And in conclusion, I will say this. Liver pills? Why would I want that? The whole point is to eat the actual, yummy liver. Real food can not be reduced to pill form. NO THANK YOU.

    • Rachel B.

      Thank you. That was great. Having lived in Japan 5 years and spent many months in Thailand in the 80s, those people would have uniformly scoffed at “dietary recommendations for all”.

      Real food, indeed.

    • LeonRover says:

      Rachel,

      “whether it has enough different colors to please her eye”

      I see that Terry Wahls, Mitochondrial Health,

      http://freetheanimal.com/2011/12/dont-listen-to-me-listen-to-dr-terry-wahls-cured-from-debilitating-multiple-sclerosis-ms-on-a-paleo-diet.html

      came to a similar description of her recommended variety of vegetable and plant foods, thus:

      “Eat a wide variety of fruits and vegetables. Include red, blue, yellow and green . . . (one third) dark green, (one third) intensely colored – red, orange, blue, purple, black – and (one third) should from others. Do NOT count white potatoes, corn rice or grain in the . . . vegetables and fruit.”

      (I use a blender and make a “gazpacho” – Mediterranean “liquid salad” – Leon, not Terry!)

      Slainte

    • Paleophil says:

      Rachel B. wrote: “only super-crappy foods seem to do that thing where it’s like they talk to you and you feel illogically motivated to eat them even when you are not hungry at all, maybe even when you are actually already uncomfortably full. I don’t know what causes that, but I know that when I feel it happen, I make a note to try and never eat that food again.”

      Precisely! You don’t have to understand the scientific details of how it works to benefit from avoiding modern foods that do that, though the science may give us further clues about which foods/processing to try an elimination/reduction trial of, and which foods/processing we haven’t tried before to test, and also about potential longer-term effects that are difficult for an individual to test.

  7. LibertarianMan says:

    Hey Richard,

    This is a bit off track, but I wanted to thank you for your book. I pirated it off the internet this week and it is really good so far!

    • LM

      Thanks. As for the pirating, neither I nor the publisher worry about that. The word is, it actually helps sales. In fact, there are a few authors that have specifically set up “pirating” sites for their books with great results in increased sales.

      • Amazing what can happen when you play with people instead of playing against them, eh?

      • Piracy is a very effective two tiered pricing system. Chances are a pirate will almost never pay for anything digital – ever. If pirates are locked out of your market you don’t actually gain any revenue – they were never paying for anything anyway. However, you do lose the cross promotion that you would have gained from a pirate.

        Pirates may find this hard to believe, but there are people like myself who actually have enough money not to be bothered looking for the “free” version. My time is worth more than a couple of bucks. However, most digital pirates I have met are poor people – very, very poor indeed.

      • GC

        And then there are those like me who like feeling good about themselves and while knowing I can get it for free, shooting a few bucks out makes me feel even better about it all.

        Pirates make me feel better.

      • Speaking of shooting a few bucks about (or dimes in this case) – I just tried to buy a copy of the Julia Ross book you mentioned in your article, but it’s not listed in your Amazon store. I’ll buy it from Amazon anyway, but it would have been nice to throw a dime (or two?) your way in the process….

      • Hey G, thanks for the thought. Perhaps the cookie will work.

        You know, I don’t mind at all the hundred bucks or there abouts Amazon sends me every month, but it’s play and laugh money and I love anyone who would toss me a dime or buy me a drink.

        To me, it would be far too expensive to ever give the impression I do this for money. It’s the thorn in my side.

  8. You positioned yourself as a person that is a person that supports doing.

  9. You are sceptical, Richard? Fine, as that’s the position NuSi is starting from at baseline.

    From what I understand, Taubes et al are not proposing that CICO is the to be proved or disproved with NuSI at all. Their mission is to fund research to find out which way of eating (not to use the word diet) is the healthiest – and of course as a bi-product of that, to help stem obesity. I see from their site that many of the researchers they have attracted are sceptics from the git-go. That should put to rest that only Taubes’ dog is in the hunt. He has said this over and over in all his writing: “for heaven sake let’s find out!”

    Point being that public policy has been up to now based on not much of anything. NuSi hopes to at least discover some real science for future policy to be based on.

    • Barbara

      Agreed. No problems. I emphasize that my enthusiasm outweighs my reservations. Got an email from Peter Attia and he liked the post. I wanted to be positive but not all fanboy, if you know what I mean.

      • Yes, I do know what you mean.Better to laud their efforts to really find out what the science tells us about what the heck we should do about our health problems, than follow Taubes, Sissons, or whomever because we like his butt!!!

  10. I don’t see the point of eating a wide variety of fruits and vegetables, what the hell good is that going to do for you?

    Pick the ones that you think best suit your goals and eat those. Leave out the ones that are unsuitable for your goals.

    If on a scale of 1 to 10, with 1o being the best, a vegetable scores 3, why the fuck would you eat that vegetable, instead of eating more of the vegetable that scores an 8?

    That is utterly irrational.

    • Rob, given that non starchy veggies are not calorically dense, there’s not much in the way of crowding out nutrients, so it’s not a big anyway. So they can be rated ffor flavor, texture, crunch, color, etc. Starchy ones may be a different story but the amino profile of potatoes is pretty decent.

  11. Scott Miller says:

    Phytonutrients (and polyphenols) merely means nutrients from plants. It’s surprising that we do not have the equivalent for animals, like alisnutrients (alis is latin for animal).

    Macronutients has always been a bad way to categorized foods, because there are both good and bad proteins, good and bad fats, and good and bad carbs.

    Studies that are controlled for specific nutrients will make never give a good slice of the truth, because nutrients work in concert, and it will be very hard to know what the cascading effects are. This is one reason why the medical establishment has a hard time grasping the importants of nutrients, because they are not meant to be silver bullets (like drugs)–instead nutrients work like a broad shotgun blast, each pellet does a piece of the work.

    All of these NuSI studies need to take a more thorough range of health stats, such as VLDL, CR-P, A1c, homocysteine, and other key markers that most studies completely miss.

    Finally, why there’s a lot of evidence supporting the idea that carbs (glucose-based carbs, more specifically, versus fructose, for example) are not as unhealthy as some people consider, I’m still convinced a lower-carb diet is healthier because it leads to [1] less metabolic waste and damage, and [2] less build-up of AGEs (advanced glycation end-products) — two areas that we in the longevity community pay a lot of attention too, but seems to be a blind spot for the general paleo and nutritional communities. I hope that NuSI takes the right measurements to hone in on these areas, too.

  12. I think Petro is hot on the trail that fat is superior at the cellular level…. and i agree

  13. While I agree with a good bit of what you wrote, Richard, I think this level of: ‘hey y’all! You’re not parsing the science finely enough!” is (way!) too early. Right now? If NuSI can get even a simple majority of folks to modify their diets — it’s a HUGE win! If NuSI funding well-done studies, done today, trying to address the ‘common complaints’ against not-so-well-done studies, can help move more docs and others over into the light, super!

    If NuSI gets caught up in trying to track down the smallest particles of nutrient, determining if 100 mg of magnesium is less-good than 110 mg of magnesium; and pill form is less-good than transdermal, and sprayed-on transdermal is less-good than a bath-tub immersion transdermal… then they’re wasting time and money. Sure, tracking nutrient (macro, micro, whatever) is a goal. But it’s not the first goal!

    TRIAGE! The ‘body-politic’ is bleeding to death! Let’s stop the bleeding before we worry about lesser wounds!

    • Galina L. says:

      I hope the main result from NuSI studies will be not the finding all details of a perfect diet for everyone, but the giving LC diets a green light for a wide practical applications. Usually practice allows to identify small important things that matter.

  14. I wish somebody would clarify this issue for me.

    Mr. Colpo has mentioned numerous metabolic ward studies in which there was no significant difference in weight loss even though the macronutrient ratios varied among the subjects.

    A Kansas State professor went on a ding dong diet and loss weight as long as he had a caloric deficit. Same thing with another guy with a potatoes only diet.

    I will accept that the individual will feel different (hungrier, satisfied, etc.) if he eats more or less of a certain macronutrient (i.e. refined v. complex carbs).

    I will accept that the body needs a determined amount of certain nutrients to perform maintenance and repair functions (i.e. protein to build muscle).

    But once the food is ingested, isn’t it “equalized” inside the body to lowest common denominator – carbs, fats, proteins), and processed by the body accordingly?

    • Josef

      You are right,

      And here’s what needs to be solidly taken into account. Under eating calories ALWAYS leads to fat loss so far as we know. That’s important and establishes something. What it establishes for me is that if you are going to tell me that calories are irrelevant no matter how many, so long as fat or protein calories, then the onus of proof and bar is very, very high.

      But my overall point is: how about if people are micro nutritionally repleate? How do they behave then?

      Behavior is the most fundamental key.

      • I concur with your overall point. As s matter of fact, Dr. Jaminet makes the same point and he presents volumes of research evidence. I must confess I haven’t gone through it nor read his book. But his (and yours) explanations seem plausible.

    • The dysregulation of a multivariable system can occur differently without making its difference readily manifest. Even in a system where we know a lot of the relevant variables (e.g. the electric wiring in your house), different problems can manifest the same symptom (a light goes out: does this mean a dead bulb, a short in the wiring, a blown fuse?). The human body is not incomprehensible, i.e. not so complex that we have no idea how it works at all, but we are still figuring it out. (If I am hearing the eggheads right, understanding hormonal regulation is a lot like doing astrology at this point: we know enough to point at variables, but not really enough to know precisely what they mean; all we can say for sure is that people get sick round about the time their chemistry goes haywire in ways that we have not sorted into simple chains of cause and effect.) My sister and I can have the same symptom (e.g. irritable bowel, or even better, the nebulous Metabolic Syndrome) manifest for different causes (Celiac disease for her, something else for me). Different doctors are going to recommend different approaches to treatment, especially if they are dealing with something whose pathology is unclear to the community at large (e.g. something like Metabolic Syndrome). Treatment is a gamble, always, and there is no such thing as a silver bullet (despite idiotic lawyers who drive our health insurance premia up by demanding that doctors lay claim to Platonic expertise that the best ones are too intelligent and/or honest to believe they have).

  15. excellent post Richard –

    reminds me of when I was in Netherlands and they were smearing butter all over their cold cut sandwiches . . .pretty damn tasty-

    in fact I’m now craving a crispy baguette w/ ham and butter right now

  16. Paleophil says:

    “You open a can of el-crappo Pringles, intending to eat just one handful, and the next thing you know, you’re tilting the can for just one more handful and the can is empty, and you ask yourself, “Why did I do that?” ‘

    I wonder if salt plays a big part in that scenario . . .for instance I but dry roasted unsalted almonds from Trader Joes- and hand full or two and I’m done . . .not sure I could do that if it was Blue Diamond brand

  17. Mike Gilmore says:

    Wouldn’t it be crazy if they found out that all you have to do is lower your calories, and it doesn’t matter what you eat as long as you eat a variety of stuff. The first time I was ever successful losing weight was when I tracked my calories, but i didn’t care what I was eating, as long as the calories where within my goal intake. I went from 281 to 175 and did not struggle to get there. I was even full twice a day on a diet because I would only eat two meals a day, skipping breakfast. There is a mental aspect to all of this, and there would be the true breakthrough if ever found. The problem may be that the mental aspect might be different for everyone. Thanks

    • Longtime Reader says:

      It sure would be crazy, since “lower your calories” has been the advice since the McGovern commission went all-in on high carb.

      I’m old enough to remember the ubiquitous diet plates in the 60’s: cottage cheese and a bare burger patty. That’s how people dieted back then. It was not even up for debate; it was simply how it was done.

      And, ironically, no one was fat.

      Go figure.

  18. ladysadie1 says:

    “…Or, a sweet potato is not the same as a Big Gulp…nor is a Sandwich Jambon Beurre the same as a Hot Pocket!”

    Amen to that, but then why does a pop-tart count as a serving of grain and why do hotdogs and chicken nuggets count as proteins according to our loving government overseers? Could it be that “eat real food” is all we really need to know and the science is just a means to explain that simple concept?

  19. I like those who can synthesise some ‘principles’ on optimal eating habits and give it a broad spectrum base to work from and you make your decisions from there. This link has some interesting things to add to the discussion, I link to two articles:

    http://www.paleostyle.com/?p=2076

    http://www.paleostyle.com/?p=2098

  20. Sometimes, understanding the problem is much more complicated than implementing the solution. That’s the case here in my humble opinion.

  21. If you eat a wide variety of food – esp. fruit and vege – you are ultimately probably just getting your gut bacteria pissed off at you. If you look at healthy populations, they don’t eat a hundred different foods.
    Why are there so many allergies, FODMAP intolerances, and such? Might it be that in some cases, we ate stuff we really had no call for? No matter how “healthy” it is, maybe if it’s surplus to requirements – whether in calories, or fibre, or phytonutrients, or plant toxins or whatever – it’s potentially problematic.

    • http://www.youtube.com/watch?v=RSlTri0R-_4

      I think I may have gotten this link from Richard, but I can’t remember. Anyway, they are basically talking about what you just said.

      Personally, I would like to see more about pH levels of food and the effects they have on us. I haven’t run across any info, but I’m thinking there is quite a bit of significance with food pH.

    • Hardtack, salt pork and a pint of rum kept the British Navy healthy

      /except for the scurvy

  22. The trouble with food pH theory is that people load their prejudices onto it. Fats are either pH neutral or have an alkalising effect by producing less CO2, but are often demonised as acid foods.
    The “alkalysing” vege foods are high in potassium, magnesium etc, minerals you body needs to help alkalyse pH; whereas wheat is higher in phosphorous, which contributes to the acid part; but really pH is something your body does, and any excess either way goes into urine or breath. All it takes is not being deficient in electrolytes, and not overdoing alcohol or aspirin.
    If it was all about pH, baking soda would be the top selling-supplement. It does have its uses.

  23. Rob Beyerlein says:

    Back to the realm of science (the fluffy warm blanket of my soul), i dig it. I think part of the discussion has to be about the pursuit of health versus the pursuit of look good naked. Using fasting, calorie restriction at times and lifting weights can give you abs regardless of whether you do it low carb, paleo or “if it fits your macros” (which is basically code for eat whatever regardless of micronutrient content if you hit your p/f/c numbers). But, you can be ripped to shreds with a junk immune system and an endocrine atomic bomb.

    There have already been several discussions in this thread about calorie quality versus thermodynamics. If we look at just the microcosm of the paleo community, we see all the little infighting bullshit about carb levels and these “sugar detoxes” that people are making loads of money off of. Expand that to society at large with all of the opposing viewpoints and money being thrown around and its not hard to see why the answer is so cloudy “people with money and power fucking lie so you’ll buy their food so they get rich and their doctor friends get rich too when you get sick off their food”. I know you’ve said much of this already, but my conscience felt the need to bitch about those damn sugar detoxes, and you graciously allow me to drop f bombs.

    The one extra thing i would add to your criteria for a good study is to isolate by indigenous population and also the “mutts”. As someone mentioned above, some cultures have eaten the same food for thousands of years and then all of a sudden globalization throws a bunch of new stuff in their diet and the enzymes and proteins molded over generations are now like WTF. We need to know how to adjust diet based on genetic coding, not just “endo, ecto, meso” somatypes.

    Great topic for discussion

    • Thanks Rob. Having put this up Friday afternoon because I couldn’t wait, I’ve wanted to keep it at the top of the blog in hopes discussion might intensify a bit come Monday morning. Thanks for jumping in.

  24. Dear Richard,
    I must say I think you are onto something here. I am the author of a new paleo blog that hopes to marry paleo food with regular fasting practices. I recently wrote a piece on hunger and appetite. Actually I would value your opinion on it. please see http://paleofast.co.uk
    I completely agree with you that nobody is either completely wrong or completely right although I think Gary Taubes has really reigned in a lot of truth.
    I am aware of body builders pratices like Leangains and Martin Berkhan and i know that although some of them strive to eat so called healthy they know that once they have achieved leanness they can eat almsot anything and stay that way.
    I also think that appetite even more so than hunger plays a major role. Even before becoming a regular of 20/4 fasting I knew that I could easily control hunger i.e. I could stop myself from initiating eating but once I start eating it is VERY hard to stop even more so after a fast. I cannot describe the overwhelming need to continue eating ad libitum. So the problem is appeatite nad I bet you that many of us who were or are overweight have what you may define BIG or strong appetites i.e. perhaps since childhood we could eat ourselves stupid and still have room for more. As a woman I noticed something really amazing. for various reasons last year I was put on artificial menopause. During that time it has been very easy for me to diet (Conventional calorie restriction) and lose some 25 kgs (over 3 st). As my hormones were allowed to return to normal over a period of 6 months I could feel the urge to eat a lot come back to me. How to maintain the most amazing weight loss of my life? Paleo came to rescue but even that was not enough and some weight (7 kg ~ 14 lbs) did come back.
    So yes hunger can be controlled by fasting but how to control appetite because at some point you will have to break the fast and once you start eating… Look forward to your opinion
    thank you

    • Hi Paleofast.

      Looks like a good blogging effort. Feel free to link to specific post you have here or elsewhere whenever something seems relevant.

      • Ehi Richard thanks a lot…by the way I have jsut seen your declaration of independence…neverthe less benchmarks will be benchmarks! Thnaks for the endorsement! Keep being yourself

  25. Hi Richard,

    Interesting post! I particularly think your word of warning here is astute — “it strikes me as just a competing paradigm of calories count vs. carbohydrates count…. And I think that sort of binary thinking is wrong.”

    Perhaps the gulf between the FW camp and the carbs-insulin-taubes camp is in some sense overstated. Maybe the problem is how we’re defining terms. For instance, we in the low carb/paleo world tend to talk about the carbs-insulin hypothesis and Bergman and Bauer’s lipophilia idea as if they were one and the same. But I’m not so sure that’s the best way to frame things. Especially in light of your comment that “when Gary says that fat accumulation is a hormonal disregulation, it’s a priori—you don’t even need to get up off the couch to know it’s true,” I’d be curious to see what you think of the following post:

    http://www.caloriegate.com/carbs-insulin-hypothesis/how-are-we-ever-going-to-resolve-the-carbs-calories-debate-a-new-perspective

    Thanks!

    Adam

    • Hey Adam:

      Very pressed for time so I have not looked solidly at your link.

      Let me state where I’m at: I think Guyenet with reward and such best explains how obesity gets started. I think Taubes best explains how it perpetuates way past when a person should say whoa!

      I look forward to the continuing debate but I do take comfort that I think some things are converging and coming together.

Trackbacks

  1. […] Nikoley shares his thoughts on the new Nutrition Science Initiative everyone on the paleosphere is talking about. Anthony Jonhson also wrote up his thoughts on this […]

  2. […] sceptical. Here are a few voices:Tim FerrissChris KresserRobb WolfStephan GuyenetYonee FreedhoffRichard NicholeyPersonally I’m very much in favor of NuSI and I think it may accomplish great things. But […]

  3. […] Here are a few voices:Tim FerrissChris KresserRobb WolfStephan GuyenetYoni FreedhoffJimmy MooreRichard NicholeyPersonally I’m very much in favor of NuSI and I think it may accomplish great things. But […]

  4. […] mer skeptiska röster:Tim FerrissChris KresserRobb WolfStephan GuyenetYoni FreedhoffJimmy MooreRichard NicholeySjälv tror jag att NuSI har stora möjligheter. Men jag är inte den bästa personen för att […]

  5. […] I put up my first post about NuSi (Nutrition Science Initiative), I've had various correspondence with co-founder Peter Attia, MD […]

  6. […] there's the multiple hypotheses approach: Nutrition Science Initiative (NuSI) and Multiple Alternative Hypotheses and Dr. Peter Attia and NuSI (Nutritions Science […]