Fork U with Dr. Terry Simpson
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Turmeric: It Can Kill You
Fork U with Dr. Terry Simpson
11/22/23 • 10 min
Turmeric: It can kill you
Turmeric is from the root of a flowering plant (Curcuma longa of the ginger family Zingiberaceae), known for being anti-inflammatory. Because of its anti-inflammatory nature, turmeric is one of the most common supplements I am asked about during my TikTok live sessions. This is because people like a "natural" anti-inflammatory supplement rather than over-the-counter medications.
Supplements
Supplements are excluded from "black box warnings." Those warnings you see in the package inserts in pharmaceuticals. This article is meant to provide references for those interested in doing more research about Tumeric to realize it is not benign.
Turmeric has many potential applications for cancer, brain injury, and many other diseases. The key is knowing what dose of turmeric is toxic, what dose is effective, and what dose is ineffective. We also need to know how to mitigate potential dangers.
Contrast with Aspirin
Aspirin is a known anti-inflammatory agent with many uses. Since aspirin is regulated, we know the dose effect of aspirin. If you have a headache, the 81 mg dose of aspirin will not relieve your headache. But the 325 mg dose will decrease headache. And you know that taking two hundred tablets of aspirin is a toxic dose.
A single aspirin can cause a bleeding ulcer, which may lead to death. Some people are allergic to aspirin, and an allergic reaction can lead to death.
What we don't know is the effective dose of Turmeric or the lethal dose of it in that supplement bottle. But we know that turmeric, curcumin can lead to liver injury and death.
Turmeric and Liver Injury
Toxicity is always in the dose. High curcumin levels, the active ingredient in turmeric, have caused liver damage (Ref 1-13). To quote from one of the references:
Liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. (2)Turmeric and Cooking
There is no danger in using turmeric as a spice in cooking. First, because your intestines do not absorb turmeric well. Unlike a supplement, which has high doses of curcumin. In addition, supplements also have black pepper, which increases absorption. Since turmeric has a mild anti-inflammatory component, this might have limited benefits as part of a healthy diet.
Tumeric belongs in the cabinet, not in a capsule.
TEXT FROM THE PODCAST
You probably have some turmeric in your herb and spice drawer.
You’ve probably heard that Turmeric’s active ingredient Curcumin has anti-inflammatory properties and has been used for centuries as an “ancient” medicine.
That yellow powder comes from the root of the Curcuma longa plant, a member of the ginger family.
Turmeric has a warm, bitter taste, and I use it in Paella, curry, and add it to salads, rice, or other starches like pearl barley.
But what you haven’t heard is that too much Turmeric can kill you.
Today we will make sense of the madness surrounding Turmeric. From its promise as an anti-cancer agent to its toxicity, and who should avoid it for daily use.
FORK U
I’m Dr. Terry Simpson, and THIS is FORK U
Fork University
Where we make sense of the madness
Bust a few myths!
And teach you a little bit about food as medicine.
Inflammation
Inflammation is a complex biochemical, physiological, and even pathological process. Inflammation is the basis of our immune system, and acute inflammation allows us to rid our bodies of cancer, viruses, bacteria, yeasts, mold, and parasites. Without the inflammatory process, we would end up being a pile of goo in twenty-four hours – dead as dead can be. Inflammation allows us to repair our body from injury, anything from burning our hand by spilling coffee to major trauma from an automobile accident.
Chronic Inflammation
Chronic inflammation can make certain illnesses much worse - from arthritis, heart disease, inflammatory bowel disease, psoriasis, and may even play a part in premature aging.
So we want some inflammation, but not too much.
You've Had Inflammation
Did you ever have the flu and have muscle aches and a fever, only to take an aspirin and feel better in 24 hours? Those muscle aches and fevers were not the result of the virus but of your body fighting it – and fighting it to where you felt poorly. So you added a bit of anti-inflammatory agent – aspirin – and felt better.
Science and Inflammation
Science is always looking for anti-inflammatory agents, and curcumin has attracted a lot of interest among legitimate scientists.
Curcumin has been examined for a potential role in cancer treatments or with inflammatory bowe...
Cholesterol and Heart Disease
Fork U with Dr. Terry Simpson
09/19/24 • 12 min
Apolipoprotein B (apoB) is the causative agent in atherosclerosis. If your apoB is low, you will not develop atherosclerosis. However, if your apoB is high, you could die young.
We know this because of genetic studies of people with different levels of apoB and their health outcomes.
What is Atherosclerosis of the heart?
Atherosclerosis is a progressive laying down of "plaque" in the wall of the coronary arteries. Since the coronary arteries feed the heart, this can lead to three outcomes:
- The plaque impinges on the artery. Thus, the plaque will decrease blood flow to the heart. This can lead to angina or a poorly working cardiac muscle.
- The plaque can rupture (burst) into the artery. Next the body repairs this by clotting the blood. Thus, the blood flows to that portion of the heart is stopped. Without blood flow, the heart muscle starves, and if the flow isn't restored, that part of the heart will die. This is a heart attack or myocardial infarction.
- The plaque can have no result. Meaning, it isn't stopping blood flow to lead to angina, and it doesn't occlude the artery.
What is in the plaque?
In the above artery, you can see the yellow cholesterol in the wall. This is a "soft" plaque, like porridge.
The plaque is not inside the vessel. The artery is lined by a layer called the intima. So how does cholesterol get from the inside of the blood vessel to behind the layer?
The Process of Atherosclerotic Plaque Formation
Lipoprotein Entry into the Arterial Wall: The process begins when ApoB-containing lipoproteins pass through the endothelial layer of arteries. Normally, this layer acts as a barrier, but factors like high blood pressure or inflammation can make it more permeable, allowing these particles to accumulate beneath the endothelial cells.
Retention and Modification: Once inside the arterial wall, ApoB lipoproteins are trapped by proteoglycans (components of the extracellular matrix). These retained lipoproteins undergo modifications, such as oxidation, which makes them more likely to trigger inflammatory responses.
Inflammatory Response: The modified lipoproteins activate endothelial cells and attract immune cells like monocytes. These monocytes enter the arterial wall and transform into macrophages. Macrophages engulf the modified lipoproteins, turning into foam cells, which are a hallmark of early atherosclerotic plaque.
Plaque Development: Over time, foam cells accumulate, leading to the formation of fatty streaks in the arterial wall. Smooth muscle cells migrate into the intimal layer of the artery, contributing to the formation of a fibrous cap that covers the plaque. This cap consists of connective tissue, calcium, and cholesterol deposits.
Progression and Complications: As the plaque grows, it narrows the artery and restricts blood flow. If the fibrous cap ruptures, it can lead to the formation of a blood clot (thrombus), which may block the artery entirely, causing a heart attack or stroke.
Preventing Plaque Formation
Understanding how ApoB-containing lipoproteins contribute to atherosclerosis underscores the importance of managing blood cholesterol levels. Lifestyle changes such as diet, exercise, and medications like statins can reduce LDL levels, lowering the risk of plaque formation and subsequent cardiovascular events.
Atherosclerosis is a gradual process that starts with the seemingly harmless entry of ApoB lipoproteins into arterial walls. By addressing the risk factors that promote lipoprotein retention and inflammation, the progression of atherosclerosis can be slowed or prevented.
LDL particle size
LDL particles can vary in size, and it was previously believed smaller, denser LDL particles were more atherogenic than larger, buoyant ones. However, research has shown that the number of LDL particles, regardless of size, is a more significant determinant of cardiovascular risk. Studies indicate that the concentration of LDL particles is more closely associated with atherosclerosis than the size of the particles themselves.
The ApoB Factor: Why It's a Big Deal
ApoB is a protein found on the surface of atherogenic lipoproteins, including LDL, VLDL, and IDL. Each of these particles contains one ApoB molecule, making ApoB a direct measure of the number of atherogenic particles in the blood. This measurement is crucial because it provides a clearer picture of the atherogenic burden in the bloodstream than LDL-C alone.
Why ApoB is the Star Player
Direct Measure of Risk: ApoB directly measures the number of atherogenic particles, providing a more accurate assessment of cardiovascular risk.
Indep...
Ultra-Processed Food Myths
Fork U with Dr. Terry Simpson
02/12/25 • 10 min
What Are Ultra-Processed Foods?
Ultra-processed food (UPF) might sound like something concocted in a secret laboratory, but it simply refers to foods that are significantly altered from their original state. These often contain additives like emulsifiers, preservatives, and stabilizers—ingredients you wouldn’t typically find in a home kitchen.
This category includes everything from convenience-store hot dogs to plant-based meat alternatives. Yes, even your favorite vegan nuggets fall into this group.
Common Myths About Ultra-Processed Foods
Myth #1: They’re Toxic and Will Kill You Instantly
If ultra-processed foods were as lethal as some claim, most of us wouldn’t have survived past childhood. While some contain high amounts of salt, sugar, and fat, they aren’t inherently poisonous. The key is moderation. A diet loaded with neon-colored cheese puffs and soda? That’s a health disaster. But an occasional indulgence won’t do you in.
Myth #2: Twinkies Last Forever
Twinkies have a long shelf life, but they aren’t immortal. The idea that they’ll outlast civilization comes from misunderstood experiments on old snack cakes. In reality, they’ll go stale and unappetizing over time—just like any other food.
Myth #3: If You Can’t Pronounce an Ingredient, It Must Be Bad
Complicated words don’t necessarily mean something is harmful. For example, cyanocobalamin is just vitamin B12, an essential nutrient for your nervous system. Even dihydrogen monoxide sounds ominous—but it’s just water.
The Real Issue with Ultra-Processed Foods
Many ultra-processed foods are designed to be hyper-palatable, meaning they activate your brain’s reward system. Ever wonder why it’s so easy to eat an entire bag of chips in one sitting? It’s not just about willpower—these foods are engineered to be irresistible.
Additionally, ultra-processed foods tend to be calorie-dense but nutrient-poor. They can crowd out healthier, more nutrient-rich options, leading to deficiencies over time.
Can You Eat Ultra-Processed Foods and Stay Healthy?
Absolutely! The key is balance. If 80% of your diet consists of whole foods—fruits, vegetables, lean proteins, and whole grains—you can enjoy processed indulgences in moderation. The problem arises when ultra-processed foods dominate your meals.
Final Thoughts: Should You Fear the French Fry?
No. Fear misinformation more than the occasional processed snack. The goal isn’t to live on a diet of raw kale and regret—it’s about making informed choices.
Enjoy your guilty pleasures in moderation, but don’t let them replace nutrient-dense foods. Science, not fear, should guide your eating habits.
For more food science insights, follow me on TikTok and Instagram at @drterrysimpson. And remember—eat smart, not scared!
Apple Watch vs. Oura, Whoop, and Withings
Fork U with Dr. Terry Simpson
02/22/25 • 9 min
Apple Watch vs. Oura, Whoop, and Withings
Health wearables have exploded in popularity, promising better sleep, fitness, and recovery tracking. But with so many options—Apple Watch, Whoop, Withings, Oura, and Ultrahuman Rings—which one is actually worth your money?
More importantly, do these devices improve your health, or are they just expensive digital trophies?
In this breakdown, we’ll compare features, accuracy, HRV (Heart Rate Variability) and “strain” tracking, battery life, hidden costs, and privacy concerns—so you can make the best choice for your lifestyle.
We have come a long way since the pedometer - which I used to buy and give to my post op surgery patients to encourage them to walk.
What Do These Devices Track?
Most modern wearables track heart rate, sleep, HRV, activity levels, and even blood oxygen and temperature. More than just steps - which they all track, but each device has its strengths:
- Apple Watch – Tracks HRV, ECG (FDA-cleared for atrial fibrillation), and fall detection. However, cellular models require a monthly subscription for full use, and it no longer tracks blood oxygen (SpO2) due to a patent dispute.
- Whoop – Focuses on recovery, strain, and sleep—but requires a costly subscription and has no screen.
- Oura Ring – A discreet ring tracking sleep stages, HRV, and body temperature.
- Withings – The only one besides Apple to be FDA-cleared for atrial fibrillation detection, with a focus on medical-grade tracking (smart scales, blood pressure monitors, and sleep mats). Unlike Apple, Withings still tracks blood oxygen (SpO2). Withings also tracks heart rate continuously during sleep, and thanks to its long battery life, it can be worn at night for weeks without interruption. No subscription required.
- Ultrahuman Ring – A newer ring with a focus on metabolic tracking and recovery.
Scientific Insight:
A 2020 Nature Digital Medicine study found that wrist-based devices overestimate activity but underestimate calories burned, while rings tend to be more reliable for sleep and HRV.
HRV and Strain: What Do These Metrics Really Mean?
What is HRV (Heart Rate Variability)?
HRV is the variation in time between heartbeats—a measure of how well your autonomic nervous system is functioning.
- Higher HRV = Better recovery, lower stress, and improved cardiovascular health.
- Lower HRV = Fatigue, overtraining, stress, or even illness.
However, HRV is highly variable based on factors like hydration, sleep, and time of day.
How Wearables Measure HRV:
- Apple Watch, Whoop, Oura, Withings, and Ultrahuman all track HRV, but accuracy depends on when and how it’s measured.
- Whoop and Oura measure HRV during deep sleep, which is considered more stable than spot-checks.
- Apple Watch and Withings measure HRV periodically throughout the day, which may be less reliable due to external factors.
💡 Bottom Line: HRV is useful for tracking trends over time, but daily fluctuations can be misleading.
Dr. Terry Simpson's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
What is “Strain” and Is It Useful?
Strain is Whoop’s proprietary score that estimates how hard your body works based on HRV, heart rate, and activity levels.
- High Strain = More exertion, requiring longer recovery.
- Low Strain = Your body is well-recovered.
🚨 The Problem?
- Strain scores don’t account for individual fitness levels—what’s high strain for one person may be normal for another.
- External factors like caffeine, stress, and dehydration can artificially raise strain scores.
💡 Bottom Line: While strain tracking can help athletes fine-tune training, it’s not always meaningful for the average user.
GLP-1 Guide to Healthy Habits and Success
Fork U with Dr. Terry Simpson
01/01/25 • 20 min
Navigating GLP-1 Medications and Building a Healthier You: A Fork U Guide
Introduction: The Revolution Starts Here
Welcome to Fork University, where science meets sarcasm, and healthy eating gets a reality check. Today, we’re diving into the world of GLP-1 medications, like Ozempic and Zepbound—those little injections making waves in the weight loss and metabolic health scene. Spoiler alert: Even if needles aren’t your thing, this advice is gold for anyone looking to improve their relationship with food (yes, even you, cereal-at-midnight enthusiasts). So, grab a cup of tea (ginger if you’re nauseous), and let’s get started.
Breaking Free from Diet Culture: Goodbye, Guilt
Ah, diet culture. That pesky little voice whispering, “Carbs are evil,” or “You’re only worthy if you can squeeze into those jeans from 2012.” Here’s the deal: Diet culture sucks, and it’s time to boot it out of your life. Here’s how:
- Focus on Health Over Appearance
- “Strong, not skinny” isn’t just a gym bro mantra. Celebrate wins like better blood sugar control or climbing stairs without feeling like you ran a marathon.
- Neutralize Food Labels
- No food is inherently “good” or “bad.” (Except maybe that mysterious gas station sushi. Proceed with caution.) All foods can fit into a balanced diet—just maybe not all at once.
- Ditch Unrealistic Media
- Swap those Instagram influencers with body-positive accounts. Life is too short for filter-fueled comparisons.
Taming Side Effects: Fiber, Hydration, and the Art of Not Overeating
GLP-1 medications are game-changers, but they come with their quirks. Here’s how to navigate the rocky road of side effects:
Constipation: The Fiber FixFun fact: Only 10% of Americans eat enough fiber. No wonder our colons are grumpy. Fix that with:
- Whole Grains: Brown rice, quinoa, oats—because white bread is so 1990.
- Legumes: Beans, chickpeas, lentils—fiber heroes and fart-inducing legends.
- Supplements: Citrucel or Metamucil work in a pinch, but food first!
Hydration: Sugar-Free Isn’t Always Your Friend
Not all hydration packets are created equal. Skip the sugar-free gimmicks and opt for options like Pedialyte. Bonus points if you grab the popsicles—because who doesn’t love reliving childhood?
Nausea: Avoid the Grease TrapHigh-fat foods + GLP-1 = a stomach rebellion. Swap fried chicken for grilled and save yourself the bloat. Greek yogurt and peppermint tea are your new besties.
Building Healthy Habits: Small Steps, Big Wins
Forget the “eat less, move more” mantra. Here’s what actually works:
- Mindful Portions
- At restaurants, box up half your meal right away. Or embrace the kids’ menu—yes, you might even score a toy.
- Protein with Purpose
- Greek yogurt, beans, and protein shakes are your go-tos. But don’t let diet culture trick you into thinking protein is the only macronutrient that matters.
- Celebrate Non-Scale Victories
- Fitting into old jeans? Amazing. Cooking a new recipe? Even better. Toss the scale if it’s ruining your day—you’re more than a number.
Long-Term Success: Sustainable, Not Perfect
GLP-1 medications are tools, not magic wands. They’re here to help you build a healthier relationship with food, not to police your every bite. Remember:
- Moderation Wins: That scoop of ice cream isn’t your downfall. Balance it out with nutrient-rich meals.
- Be Patient: Rapid initial weight loss (thanks, glycogen, and water) will slow, but consistency pays off. A pound a week equals 52 pounds a year. Do the math and cheer yourself on.
Conclusion: Fork U’s Final Wisdom
GLP-1 medications are here to support you, not define you. Focus on health, ditch the guilt, and enjoy the journey. And don’t forget: Consult a real, western-trained physician and a dietitian. Chiropractors and green juice influencers don’t count. Ok, I sometimes drink some green juice.
Why You Should Ditch Your Gas Stove
Fork U with Dr. Terry Simpson
02/03/23 • 10 min
Why you should ditch your gas stove
Did you ever wonder what the controversy is about gas stoves? There is no controversy. Gas range tops are responsible for high levels of indoor pollution. But what should we do? The answer, change to an induction cooking top
Types of Indoor Cooking
You can imagine the first time cooking was brought indoors. Probably a fire inside a cave. It turns out that wasn't all that safe. The particulate matter from the wood not only increased the risk of lung disease, but also increased the transmission of respiratory illness.
Community houses, like this one for the Tlingit Nation from Southeast Alaska, had a fire pit in the center of the house. Your status in the community determined how close you would sit by the fire.
While the opening in the roof provided some ventilation, it was not enough.
Particulate Matter and Disease in Native Americans has been well studied. The lung damage from particulate matter predisposed Native Americans to pneumonia, tuberculosis, influenza, and smallpox.
Wooden Stoves
The use of wooden stoves with a chimney, and contained fire, were the most popular stoves in America until after the Great Depression.
America was excited to go electric. But there is something primal about gas and electric cooking.
Cooking with Gas
The phrase cooking with gas was from the gas companies competing with electric companies for the new kitchen. The idea that gas was less expensive, faster, and you could see the flame became the basis for their campaign.
They were trying to compete with "clean electric"
Indoor pollutants with gas range tops
Products from indoor gas ranges are highly toxic to lung tissue. Those products
- Nitrogen dioxide
- Carbon dioxide
- Methane emission
- Benzene
Even with the range off, gas escapes and pollutes the air indoors. Good ventilation decreases the exposure to gas. Most people do not like continuous fans. In addition to the methane, there is also benzene that escapes.
Culture Wars
As soon as the United States Consumer Product Safety announced it was considering regulations for indoor gas cooking the vitriole started.
A Wall Street Journal Editorial stated "Don’t believe for a second Consumer Product Safety Commission member Richard Trumka Jr.’s slippery claim that they aren’t coming for your stove." She also went on to state that the research was paid for.
Jim Jordan, the Republican Congressman from Ohio tweeted, "God, Guns, and Gas Stoves."
Sean Hannity, that famous high school graduate stated that "Biden is coming for your gas stove."
On my tiktok channel I had lots of people parrot this.
I never knew so many old white men knew where the stove was? Let alone what it used for fuel
Research
We have known about the dangers of nitrogen dioxide since the 1960's. (see here, here, here). Experimental data showed it cause lung damage in animal models, then it was associated with human studies. None of these researchers were concerned about climate change.
What can you do?
Even ventilation to the outdoor with a powerful hood may not decrease the nitrogen dioxide enough. And often you won't have the ventilation fan on when the stove is not on.
Converting to induction stovetop might be expensive, although there is currently a government tax incentive to do so.
Even though I just bought my house, and it came with a lovely gas stovetop, I am changing to induction. Until then, I am using my induction hotplates (I have two) for most cooking.
Implementing the Med Diet - Part One
Fork U with Dr. Terry Simpson
09/16/22 • 9 min
Do you think you eat enough plants in your diet? How many plants do you eat in a week? Not refined grains, but plants. You can cook them, boil, bake, microwave, roast them or even eat them raw. How many? Further, it's not just eating more volume of plants, it's diversity.
Mediterranean Diet and PlantsAdherence to the Mediterranean diet depends more on plants.
- Vegetables
- Fruits, Tree Nuts, Seeds
- Legumes
- Whole Grains
- Olive oil
When it comes to plants, more is better. But not just in quantity of plants, but also diversity.
Think about this: there is no one plant that can provide all the micronutrients and macronutrients a person needs. We tell vegetarians to use several plant sources for complete proteins, the same is true for any nutrient.
Gut Bugs and PlantsYour gut contains a trillion bugs. There are more of them than of us. But what do they eat? It turns out, most of what they eat are the things we don't. Gut bugs eat plant parts. Without them eating those plant parts, we would be far worse off. Thus, the gut microbiome is an exciting research field.
Guts break down fiber to chemicals shown to:
- Decrease the risk of colon cancer
- Lower cholesterol
- Decrease blood sugar spikes
- Decrease depression
- Allow absorption of polyphenols
Fiber is an Essential Nutrient
Plants provide vitamins, minerals, macro and micronutrients. A single source of plants cannot provide the nutrients a person requires, which has been the main reason we recommend a diversified diet. Fiber is also a nutrient, an essential nutrient, one that humans cannot make, but without it there is clearly an increase in disease. While those on the extreme of low-carb diets will disagree, the literature is unambiguous.
MythFiber supplements are not a substitute. Some are expensive, one selling for over $150 a month. But no supplement gives you the diversity of nutrients that you can get from your diet. Mother Nature gives you a better deal. So, eat your fiber, don't buy a supplement.
Now begin to chart your diversityToday's assignment is simple: begin to chart the diversity in your diet, so that you increase the sources of your plants. One of my favorite dieticians, Dr. Megan Rossie, suggests a person has 30 plant-based foods per week. Sound impossible? Let's try it using the Meditereanean Diet.
Why 30?It isn't that difficult to implement, but consider that you want to consume the vitamins, minerals, antioxidants, and other nutrients, and there is no one plant that does this. But many will.
Vegetables:One Mediterranean diet point is achieved by consuming 9 ounces of vegetables per day. Run through the list of vegetables that you can add to your diet in any given week.
- Asparagus
- Beets
- Bok Choi
- Broccoli
- Brussels Sprouts
- Cabbage
- Cauliflower
- Carrots
- Celery
- Cucumbers
- Eggplant
- Jicama
- Kale
- Leeks
- Lettuce
- Onions
- Parsnips
- Peppers
- Spinach
- Squash
- Tomatillos
- Zucchini
Fruits:
- Apples
- Apricots
- Avocado
- Bananas
- Blueberries
- Cherries
- Coconuts
- Dates
- Grapes
- Grapefruit
- Jackfruit
- Kiwi
- Lemon
- Lime
- Mangos
- Melons
- Nectarines
- Peaches
- Pears
- Pineapple
- Pomegranates
- Plumbs
- Prunes
- Oranges
- Tomato
- Watermelon
Legumes:
- Black beans
- Butter beans
- Chickpeas
- Green beans
- Kidney beans
- Navy beans
- Pinto beans
- Navy beans
- Lentils
- Peanuts
Whole Grains:
- Barley
- Brown Rice
- Buckwheat
- Bulgur
- Corn
- Millet
- Oatmeal
- Whole wheat
- Red rice
Nuts:
- Acorns
- Almonds
- Brazil nuts
- Cashews
- Chesnuts
- Hazelnuts
- Macadamias
- Pecans
- Pine nuts
- Pistachios
- Walnuts
Seeds:
- Chia
- Flax seeds
- Hemp
- Pomegranate
- Poppy seeds
- Pumpkin
- Sesame seeds
- Squash seeds
- Sunflower
These provide a diversity of micronutrients, macronutrients and fiber.
All of which provide a healthy diet.
But let's not forget one of the most important plants:
Perhaps the most important part of the Mediterranean Diet is this plant.
Breakfast ideas...
Continuous Blood Glucose Monitors for Non-Diabetics
Fork U with Dr. Terry Simpson
07/21/22 • 5 min
If you don’t have diabetes, should you even consider a blood glucose monitor? Well, here is the science behind this new tiktok trend and why these Continuous Blood Glucose Monitors (CGM) are here to stay and what we know about them.
The device
First, the device – a continuous blood glucose monitor is a device that you place on your body and it measures the blood glucose level and reports that data typically to an application on your phone. The first blood glucose monitors were used to help patients with type 1 diabetes regulate their blood sugar. They were revolutionary, but expensive, not covered by many insurance companies, and cumbersome. As the technology has improved, the price has decreased, the comfort level has improved, and the accuracy of the monitoring has improved. As with most technology, blood glucose monitors are now less expensive, better, and widely available.
You can read more about the history of the blood glucose monitor here.
Most diabetics use a fingerstick to see what their blood glucose is, and use that information to determine the medicine they need to help regulate their blood glucose. The CGM allows real-time data which can be checked against food logs to allow a person to see impact of their diet on their regulation of food. As the epidemic of diabetes grows, about 55 million predicted with diabetes by 2030, we know that the less variability in glucose, the better long-term outcome (reference here) and here.
Variability in blood glucose with non-diabetics
It turns out that even people who are not diabetic, have wide variations of blood glucose (reference here). Further, the variations in blood glucose have real time effects and we should care about those effects. For example, high glucose spikes lead to inflammation of the arteries, even in non-diabetics, which lead to atherosclerosis, heart disease, strokes and peripheral vascular disease (click here). A study published in Journal of the American Medical Association (here) concluded “Providing individuals with tools to manage their glycemic responses to food based on personalized predictions of their PPGRs may allow them to maintain their blood glucose levels within limits associated with good health.”
What is best?
Avoiding the large variability in blood glucose is clearly important to health whether one has diabetes or not. Trying to predict what variability will be based on fasting blood glucose or hemoglobin A1C cannot be done.
Using a healthy diet like the Mediterranean or DASH diet – this has been found in studies with CGM on young people with type 1 diabetes (reference )
Even variations of the Mediterranean Diet and CGM have found improvement in glucose variability.
Economies of Scale
Continuous Glucose monitors are getting less expensive, more accurate, and more comfortable to wear. This is good news for patients who have diabetes, and as demand raises among all to use these tools the price will drop further. The economies of scale work with medical devices. Consider the pulse oximeter that you can purchase from a local pharmacy for $25 – they used to cost over $900 and were used to manage patients with lung disease. Now, for less than a copay, you can have one of these devices and they not only help manage patients with lung disease, but also keep people with COVID out of the hospital when they are doing well, or provide a warning to get patients into the hospital.
The original pulse oximeters were large, expensive and cumbersome. The modern pulse oximeter is available at any pharmacy for $25.
These are another tool in our toolbox.
Disclosure: I received a continuous glucose monitor from Nutrisense. They do not manufacture the device ...
Vitamins and Supplements for Prevention of Heart Disease and Cancer
Fork U with Dr. Terry Simpson
07/05/22 • 3 min
The US Preventative Task Force updated their recent recommendations about vitamins and supplements in The Journal of the American Medical Association - reference here.
Their conclusion was: "Conclusions and Relevance Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer."
We have published about how misleading labels of supplements are before - click here.
The appeal of vitamins and supplements is the ability to extract the vital chemicals (like vital amines) antioxidants, and anti-inflammatory ingredients, place them into a pill so you can avoid having a healthy diet. Trust me, a healthy diet is clinically proven to work but it is a lot easier to eat a burger and pop a pill than to remember to eat some vegetables (I like Habit Burger).
[caption id="attachment_9745" align="aligncenter" width="640"]V Yes, I do love a good burger - Habit is my favorite[/caption]
But let's go back in history for a second and let you know that surgeons love vitamins. If you haven't listened to one of my favorite stories- listen to this about the first vitamin - click here. And let us not forget that the first evidence based study in the history showed that citrus fruits prevented scurvy - who was that person that showed that - was it a "nutritionist" or was it a surgeon? Oh yes, it was Dr. James Lind - a surgeon.
Why the appeal of vitamins, besides my fantasy about eating burgers and popping a pill?
First there is the "natural" fallacy - I don't know, I think natural is more eating fruits and vegetables than pills. People tend to think of vitamins as "good" or healthy, and they are. They seem to think of a vitamin as "natural" even though they were brought to us from the golden age of biochemistry. It is clear that the vitamin and supplement companies have taken advantage of that and use terms like "support gut health" or "support immune function" or "good for cardiovascular health, " - even if those statements are meaningless.
Second, it is easier to think of things we believe we understand. Heart disease and cancer are complex topics (not that the true chemistry of vitamins aren't but they seem easy). We want to make things easy - like take vitamins and supplements for prevention or cure of cancer or heart disease, because if we start talking about scary statins or chemotherapy not only are there real side-effects but bad press. Of course with vitamins and supplements there can be real side effects - check here. My aunt's son, a Ph.D. in nuclear physics, died after taking a supplement that was to help him be "fit."
But the simple truth is this: however the polychemistry there is in fruits, vegetables, legumes, whole grains, as well as balancing dairy, meats, fats and alcohol has proven effect - we call that the Mediterranean Diet (for more see here)
[caption id="attachment_9746" align="aligncenter" width="640"]i Instead of vitamins and supplements from a pill - eat this[/caption]
For whatever reason, eating a Mediterranean Diet or DASH diet continue to be the proven way to maintain your health.
References
1.
Mishra S, Stierman B, Gahche JJ, Potischman N. Dietary Supplement Use Among Adults: United States, 2017-2018. NCHS Data Brief. National Center for Health Statistics; 2021. doi:10.15620/cdc:101131
2.
North America dietary supplements market report, 2021-2028. Accessed May 26, 2022. https://www.grandviewresearch.com/industry-analysis/north-america-dietary-supplements-market
3.
Arnett DK, Blumenthal RS, Albert MA, et al 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11). doi:10.1161/CIR.0000000000000678Google...
Inflammation and the Mediterranean Diet
Fork U with Dr. Terry Simpson
09/02/22 • 5 min
The Mediterranean Diet is the most anti-inflammatory diet studied.
The inflammatory response is the body's mechanism to fight infection, repair itself and rid itself of cancer. Inflammation is a coordinated response to trauma, infection, and cancer. Without inflammation, we would be dead within twenty-four hours.
Too little or too muchToo much inflammation results in wanton destruction of tissues, pain, fevers, and misery. It is associated with heart disease, cancer, aging. It is that delicate balance of inflammation we need.
Does diet play a role with inflammation? The answer is "sort of."
Short Course about InflammationInflammation is involved in:
- Wound healing, removing dead cells - breaking them down into components so they can be recycled
- Removing and destroying bacteria
- Inactivating and eliminating viruses
- Destroying cells that have changed into cancer cells
- Repairing injury from infection
- Destroying parasites
- Removes toxic chemicals
- The immune system is one branch of the inflammatory response.
Five Signs of Inflammation
The five signs of acute inflammation and their Latin names:
- Redness - in Latin this is called rubor.
- Swelling - in Latin this is called tumor.
- Fever - in Latin this is called calor
- Pain - in Latin this is called dolor
- Secretion - in Latin this is called fluor
Medical school teaches inflammation as one of the first series of lectures.
Simple InflammationYour finger was hit with a hammer. You have an injury to your finger. Some cells are injured. The cells send a distress signal, and immediately white blood cells begin to swarm into the area to help the injured cells. All that extra blood flowing to the area will lead to redness (rubor) and swelling (tumor). Soon, the finger will feel a bit hot (calor) and will have pain (dolor).
Some cells are so badly injured that they are no longer viable. Your inflammatory reaction breaks down these cells, removes the debris, and recycles the parts to create new tissue in the area.
Unwanted InflammationI love nature walks but like to avoid Poison Ivy.
Sometimes, we want to decrease the immune response. Inflammation is the response of our skin to poison ivy. We reduce the immune response by reducing hives and itching.
Rheumatoid arthritis is another example of unwanted inflammation. Rheumatoid arthritis is an auto-immune disease. The resulting inflammation leads to pain, fever, and joint destruction. The aim of the treatment is to reduce the inflammatory response that saves joints and improves well-being.
The inflammatory response of COVID, influenza, or the common cold is reduced by the use of non-steroidal anti-inflammatory drugs, such as aspirin or Motrin.
Acute Disease and InflammationHeart disease is partially the result of inflammation. When you have a heart attack, the coronary arteries are blocked. As a result, a part of your heart muscle is without oxygen. The cells send out inflammatory signals, and you begin to feel pain (dolor). If the blood flow is restored, your cells can heal, but if it takes too long, some of those cells will die. Then your body will get rid of those dead cells and replace them with scar tissue. The result is that your heart becomes less effective.
Cardiovascular disease and inflammationPlaque formation in the arteries is the result of genetics, diet, and inflammation. The increased cholesterol, either from the genetics or from a diet high in saturated fat, is deposited in the arteries. When cholesterol enters the artery wall, the body's inflammatory response tries to get rid of it, causing inflammation in the arteries. Did you know that 18-year-olds already have signs of early plaque formation in their arteries?
Chronic InflammationChronic inflammation is when your body continues to send inflammatory signals, even when there is no acute injury or danger. This is what happens in rheumatoid arthritis, lupus, long Covid, and is involved in diabetes, obesity, dementia, and premature aging.
Western Diet and InflammationIt is easy to obtain calories in western societies. In human history, we have gone from people on the verge of starvation to being overfed. We have also increased lifespan because of sanitation, vaccination, clean water, availability of food, and modern m...
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FAQ
How many episodes does Fork U with Dr. Terry Simpson have?
Fork U with Dr. Terry Simpson currently has 75 episodes available.
What topics does Fork U with Dr. Terry Simpson cover?
The podcast is about Health & Fitness, Nutrition, Medicine and Podcasts.
What is the most popular episode on Fork U with Dr. Terry Simpson?
The episode title 'Whole Grains Reduce Obesity' is the most popular.
What is the average episode length on Fork U with Dr. Terry Simpson?
The average episode length on Fork U with Dr. Terry Simpson is 11 minutes.
How often are episodes of Fork U with Dr. Terry Simpson released?
Episodes of Fork U with Dr. Terry Simpson are typically released every 12 days, 15 hours.
When was the first episode of Fork U with Dr. Terry Simpson?
The first episode of Fork U with Dr. Terry Simpson was released on Sep 20, 2021.
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