ApoE, cholesterol and alcohol revisited. An N=1 experiment appears to pay off.

"I'm under doctor's orders to drink every day" -- me, starting in late January 2014.

It's a line that got laughs, especially because, just a little while earlier -- as of early August 2013 -- I hadn't been drinking alcohol at all. (In fact, hell, I was so happy with not drinking that I did a blog post about it).

But then, in January, my visit to the paleo doc revealed a bizarre twist: every available measurement of my LDL cholesterol -- small dense LDL, particle number (LDL-p), plain old regular LDL (LDL-c) -- was up forty percent in just under six months, the same "just under six months" that I hadn't been drinking. It was downright weird, and there was only one thing I could point to as a dietary/lifestyle difference over that time: I had quit alcohol entirely. Everything else was exactly the same. I had been paleo for years without an LDL issue. And these LDL numbers were suddenly high. Very high. I wanted to do something.

So I did some research. Then I did a really detailed blog post about that research. The bottom line of all that reading was that I am in a rare (10% or so) genotype called ApoE-2 which appears to get a (sometimes very significant) lowering of LDL cholesterol from regular consumption of alcohol. The genetics behind all that aren't terribly complicated, but I have laid them all out for you previously in that old blog post so there's no point in repeating it here. Let's just say that when I talked to the doc about my results, we both agreed that an experiment was in order because of my ApoE-2 status. "Have a drink every day -- not three drinks, not six drinks, and not beer because of the gluten... just one drink a day -- for a few months and then we will retest you," my doc said after I presented him with the Framingham Offspring Study. He hadn't heard of it before. "This is fascinating," he said. "Cheers, doc," I replied, and off I went to buy some wine. **

Really. I went straight to the liquor store.

I am not a man plagued by hesitancy.

But when one is non-hesitant and goes from six months of teetotaling straight to daily alcohol consumption, one's body initially gets a little uppity about it and doesn't fully cooperate. My ethanol of choice was either red wine (white wine grosses me out), hard cider (but it gets really sugary and heavy, so not so often), or either whisky or tequila. And, Jesus Christ, my gym performance took a hit for about three to four weeks. I was fairly sure something like that was going to happen -- after all, I was always the guy telling people that if they wanted a cheap way to up their weightlifting numbers, just quit drinking for a month -- so I just accepted the reverse effect as the cost of doing the lipid/alcohol experiment, but seriously... I was awful in the gym for most of February. But my body eventually adjusted. And I started lifting heavier, eventually nailing some deadlift and snatch PRs by the time May rolled around. And I even got back my aerobic capacity as well. But it took some time.

I was also careful not to overdo things in the alcohol department. So yeah, from late January to late May (now), I had one drink every day. There were also maybe at most a handful of two-drink nights, and I think one or two three-drink evenings, but never more than that. In other words, I never got anywhere close to drunk. I also doubled down on my mindfulness practice during that time. One of the things I really don't like about alcohol is that its depressant qualities can make me think more gloom-and-doom/catastophically than usual. I can get into a sludgy/discontented mental haze if I am not careful. So, knowing that going into this thing, and also realizing how much I dug the "clean" feeling of the six months of teetotaling, I decided that I was going to do my best to meditate every day. Sometimes that was straight-up stare-at-the-wall Zen meditation. Other times I would get out my EmWave2 and work on cognitive training via heartrate variability. But, no matter what, I tried to be really aware that if I was going to pour in some ethanol on a daily basis as part of a "health" experiment, I needed to take extra care to manage my mind and mood.

So, you ask, "What was the result of this lipid/alcohol experiment, Mr. Drummer?" Well... I had blood drawn last week and just got my results back. My first worry was that daily alcohol might somehow screw something up, but no. My HDL is still high, my triglycerides low and every marker of inflammation is lower than ever (and they were already great). Paleo for the win. But, even better, LDL -- in all its permutations, most notably the scarier measurements of LDL-p and small dense particles -- went down to levels even slightly better than I had gotten in my August 2013 tests. In other words, four months of daily alcohol for this ApoE-2 guy and I completely reversed the 40% LDL increase that almost six months of teetotaling had caused, and then I even did a little better than that.***

So now what? It seems pretty clear to me that I get a lipid-profile benefit from a little daily alcohol and that that same alcohol does not cause me an inflammation issue. The most interesting remaining question is whether that benefit has peaked and it is now just a matter of maintaining my current status, or are my current numbers merely a snapshot of today and am I still actually improving? For now, I am willing to say a big "Who cares?" or "Time will tell." In the meantime, it's Genetic Mutant Happy Hour for this ApoE-2. Cheers.

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**I can't overemphasize that this advice would not be given to most of you. As that previous blog post underscores, I am in a 10% genotype (ApoE-2) where the Framingham Offspring Study indicates that alcohol consumption significantly lowers LDL (for men; women are not so clear). No other genotype gets that benefit, and ApoE-4s actually end up with higher LDL if they drink alcohol (and there are more ApoE-4s out there than ApoE-2s, if you were wondering). The point of this footnote: I am a genetic anomaly with regard to this, and you probably aren't. Sorry. You'll have to take solace in the fact that you are probably younger and quite possibly better-looking than I am.

***By the way, don't interpret this post as an acceptance of the notion that high LDL, especially that standard LDL-c measurement that often is the only one you ever get on your standard blood tests, equals a health problem. I am a firm believer that low-inflammatory/low-stress eating/living is the most important factor in health. But very high measurements of LDL-p and of small dense LDL particles are at least minimally correlated with cardiovascular problems. When I got measurements like that in January, I decided it was time to try an experiment, even though my other cardiovascular risk factors are very low (low triglycerides, low inflammation, high HDL).

#100HappyDays: silly fluff, or a secret Zen trick?

Mostly it struck me as a pretty ridiculous idea.

I got an email about something called #100HappyDays. The idea was to "be happy for 100 days in a row." And to prove your commitment to the venture, the email said that, for 100 straight days, you are supposed to post a reference to a thing that made you happy that day to Facebook, Twitter or both -- preferably with a pic -- with the #100HappyDays hashtag.

Apparently 71% of people fail the challenge because they "run out of time." That stat alone made me want to participate just as a matter of Henry-Rollins-esque personal discipline. "For fuck's sake, people...." I crabbily crabified (yes, I just verbed), "I will defeat you, you 71% of weak-willed individuals who probably would also fail a paleo challenge on Day One crying into a slice of half-eaten pizza. Bring it on, happymeisters!"

So I signed up, citing Facebook, specifically the Paleo Drummer FB page, as my platform of choice,  checking off "curmudgeonly bastard" as "occupation," and providing "defeating the weak-minded" as my "reason for joining the challenge."

Let's say that my participation did not indicate that I was really sold on the actual concept.

I mean, come on now.... happy for 100 days in a row? I took it, at first, to mean 100 consecutive days of answering "Yes" to the question: "Did you have a good day today?" And that seemed preposterous.

Let's be clear: no adult human being has a predominantly good day 100 days in a row, unless you define "good day" as "still alive" and "bad day" as "dead." Even if your name is Happy McHappyson, and you live with your happy family on Happy Street in Happy Valley, you cannot string 100 mostly good days in a row. Something is going to screw that up.

And then I had one of those not-so-happy days, and, somewhere in the midst of competitively refusing to fail the challenge and posting some small tidbit of a scrap of something (a dog walk, I believe) that actually brought me joy on my otherwise craptastic day,  I suddenly "got it":

The #100HappyDays challenge isn't about actually having 100 great days in a row. It's not even about the personal discipline of invoking your inner Rollins to follow through on a commitment for 100 days in a row. It's about finding the joy in life, even on a lousy day.

Especially on a lousy day.

See, my life is pretty great. And sometimes I think that spoils the hell out of me and I let the dumbassery of the modern world drag me down too easily. And this silly, even seemingly inane, little "challenge" has done its bit to change that. Because at some point every day (if nothing else to avoid failure -- because failure will not happen... we're clear at least on that, right?) I have to search the memory banks for something cool that happened that day. Most days, it's easy. Like I said, my life is pretty great. I have a job I like, a family and friends that I love, and, most days, finding something "fun" is like shooting fish in a barrel. Until it isn't. It's on those days that I truly love this goofy little exercise.

It's yet another Zen spin on "perspective." And there may be nothing more important than perspective.

Maybe, just maybe, sometimes some of us are a little out of hand? (Sunday night thoughts and rambles....)

By and large, I don't do a lot of paleo "stunts" or "bio-hacks" (or whatever the going phrase of the day is), but I do dabble in a few of them. You know... eating/drinking excessive amounts of _____ because, you know.... If a little bit of ____ is good for us, then a whole giant effing boatload of it must be the key to general awesomeness, right?

Right?

I am beginning to wonder.

I had an interesting conversation today with a regular reader of my Facebook page. He showed me an article that wasn't a hit-piece on paleo by any means. But it was questioning a common breakfast-y trick that he and I both do pretty often. And I don't want to pick on any one stunt, so I am not going to name it, but let's just say that it necessarily involves me consuming a quantity of butter and coconut oil that is just not "normal" in any sense of the word.

And I got to thinking: if all (ok, most) paleo folks who are "in the know" shun exercise-y things like steady-state cardio at overdone durations that most of our ancestors just wouldn't have done, why are sizable numbers of us seemingly overdoing it in certain areas of the food/drink department in ways that said ancestors wouldn't have embraced either?

On one hand, I fully agree with the standard paleo dogma that says that, for instance, the government recommendations/warnings on saturated-fat intake are comically overblown, and probably even dangerously low. But is it possible that some of us are going overly wild in the opposite direction by doing things like adding fat in such quantities to our food on a daily basis that we have surpassed any reasonable levels that our ancestors would have regularly eaten?

I don't know. I really don't. I am not a paleo professional. But I am wondering about it out loud, anyway, because as I consumed a fairly obscene chunk of butter this morning in just a few minutes, there was a thought that consumed me: "Who the hell actually did this every morning in the paleolithic world?"

While I firmly reject the mantra of "moderation in all things" because some "things" (modern wheat and industrial seed oils, for example) are just spectacularly bad for you in any quantity let alone "moderate" ones, could it be that the time-honored path of The Middle Way applies, generally speaking**, to "the good stuff" in our paleo template?

It's just a thought, and I think I am going to follow it to see where it goes for a little while, because The Middle Way always gets my head in the right place, and it works pretty damn well for my exercise regimen too. Could it be that, dietarily speaking, there is a Paleo Middle Way that can be even better for my body than the Paleo Plus Stunts approach that I have been doing?

Time will tell.

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**Note that I say "generally speaking." There are very good reasons (brain injuries and the like) why more extreme paleo templates are necessary for some folks.

Book Review: Sexy By Nature

The smart paleo books these days don't just focus on food.

The even smarter ones are so global in their approach to health, and so broadminded/non-dogmatic about food, that it's often hard to pigeonhole them as solely "paleo." With some, it's even tough to find the word "paleo" on the cover**.

And the super-smart/one-percenter paleo books focus on the missing link in so many people's lives: happiness.

Stefani Ruper's Sexy By Nature is a super-smart/one-percenter kind of paleo book.

Like every author in this ever-expanding genre, Ruper would, of course, like to see you to eat clean and exercise smart. But, more than anything, she wants you to be happy and confident. And she wants you to understand that happiness and confidence come primarily -- almost exclusively, as a matter of fact -- from within.

The payoff is huge, because happy and confident equal sexy.

That's the principal message of Sexy By Nature, which provides women a step-by-step template -- through food, exercise and stress reduction like a lot of those other paleo books, but also through attitude adjustment and a strong focus on happiness and confidence -- for reaching a simple goal: sexiness through a positive body image.

Yeah, this book is specifically for women. It's not that a Y chromosome necessarily acts as a talisman against all negative self-image issues, mind you, but Ruper narrows her focus to the gender that's clearly suffering the brunt of the damage when it comes to both societal norms in, as she calls it, "the way we do sexy these days" and basic body-image concerns. Put differently, a lot more women than men need this book.

In Sexy By Nature, Stefani Ruper delivers the goods to meet that need.

It begins, like a lot of paleo books, with a sick author. A few years ago, Ruper had beaten herself down with vegetarianism and over-exercise into a low BMI, but also into polycystic ovarian syndrome (PCOS), hypothyroidism and hypothalamic amenorrhea (yeah... I had to look that one up too; don't feel bad). Oh, and acne too.

The answer to all of that was to put into practice a simple realization: "The more I give my body love, the more my body loves me back."

"Love" in that sense translated to a broad prescription of paleo/primal food choices, smart exercise, and stress-reduction techniques, like you would expect, and in those respects, Sexy By Nature is no surprise to anyone who has ever delved deep into the popular paleo tomes of the day.  But there are two significantly heavier angles being explored here that are geared specifically toward women: loving one's body no matter what, and turning that self-love into a new, empowered attitude of confidence.

Ruper writes: "If [women] reject the idea of a common, ideal body type and instead take pride in our own unique shapes, then we don't have to vie against each other in the race for beauty and love. We can, instead, celebrate our differences." In fact, the "sexiest thing of all is to be unashamedly you."

So she sets forth "old rules" -- like beauty conformity, dietary restriction to the insane point that food asceticism turns into an aesthetic of its own, and "unquestioning ignorance" -- that need to be replaced by "new rules" like celebrating each woman's uniqueness, obtaining nourishment from whole foods and "investigation" instead of ignorance.

The food section is precise in its recommendations (which amount, by and large, to a paleo/primal template) and equally exacting in its polite, but pointed, attacks on some of the more culpable players in the rise of food-driven disease. The dangers and nutritional inadequacies of grains, legumes, soy, seed oils and even vegetarianism are dealt with firmly and intelligently, and Ruper is clear that when it comes to the age-old paleo debates about the proper ratios of macronutrients (carbs, protein and fat) in a whole-food diet, the quality of those macronutrients is far more important than their quantities and ratios. There is even a balanced, non-judgmental treatment of the pluses and minuses of dairy consumption, and a plea to embrace the consumption of good fats, while shunning calorie-counting.

Stress and exercise all fall under the banner of "Live" in Sexy By Nature. Ruper provides not only detail on the affects of stress on digestion, on female hormones and on inflammation, but also a long list of stress-management tips that will be familiar to readers of this blog. (I think the only one she may have missed is flotation, and we know how I feel about that....) Her exercise recommendations (Stand; don't sit! Lift! Sprint!) share space with other lifestyle suggestions (Sleep! Sex! Sunlight! Explore your "spiritual" side in whatever way works for you).

Then there's the section called "Overcome" which addresses problems like fixing sleep, restoring proper thyroid function, stabilizing blood sugar, losing fat and beating skin/acne issues. And, no surprise, most of the suggestions in "Overcome" amount to ditching processed food, eating natural food, reducing stress, eating when hungry and until full, etc.

You could get the (correct) idea that all this food, exercise, stress stuff is deeply interrelated.

The "Overcome" section also directly addresses menopause, fertility, PMS, cramps and mental health. And while often the recommendations regarding those issues are even more detailed and specific than the more general food/exercise/stress-management portions of the book (for instance, the menopause chapter discusses how fasting and low-carb approaches may work better for women who are past their reproductive years) many of the "fixes" bear a lot of similarity to one another and to what preceded them in the book, as well they should: eat well, exercise smart, be happy and stress-free.

But as wonderful and detailed a manual for smart, healthy living as Sexy By Nature is all through its first almost 300 pages, it's in the final section of the book -- entitled "Strut" -- where Stefani Ruper really hits the peak of her stride. This is the place where, in a series of truly inspiring and detailed chapters, Ruper tells women how to get their groove back. Self-love isn't just emphasized; it's ordered as the prescription of the day, week and month with specific recommendations to ultimately result in a high level of "self-determined sex appeal." And Ruper means every aspect of self-love: physical (love your body), non-physical (love your mind, personality and talents) and even existential (love and respect your inherent self-worth, no matter what).

Ruper not only tells the indisputable, but often-overlooked, truth that the "only thing you have to do to be sexy is to feel it, believe it, and embody it"; she gives a long series of detailed tips on how to get there. The most important of those? "Be yourself." The second most important -- and I love this because it's so true: "Fake it 'til you make it." Translated: no one knows a damn thing about your self-doubt... unless you let them in on the secret. So don't.

It's one thing to write a great paleo/primal guide to food, exercise and stress/happiness. Stefani Ruper's undoubtedly done that with Sexy By Nature. But there is so much more here than just clean food, smart movement and mindfulness. This is a manual for personal empowerment. and really, what's sexier than a confident, empowered woman?

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**Ok, technically the word "paleo" appears once on the back cover of Sexy By Nature. I'll let you play "Where's (Caveman) Waldo?" to find it....