Anyway, his November 2011 issue contained a question from a reader who stated that his doctor was concerned about his cholesterol levels being high and was considering putting him on a statin. This reader stated how he follows Alan’s recommendations and hopes its not the three eggs per day and whole fat milk that is giving him such “high” cholesterol. The quotations are mine and you will see why in a moment.

Well Alan proceeded to ask this reader what his actual numbers were, and here is what he got (I have slightly rounded, by just a few points, to avoid any HIPAA issues):

HDL: 110 mg/dL

LDL: 105 mg/dL

Triglycerides: 25 mgdL

Does anybody see what is wrong with this picture? His doc is concerned because his total cholesterol is elevated, but this is simply because his HDL (considered good cholesterol) is through the roof! A level above 60 is desirable, and he is far above that, which significantly reduces his risk of cardiovascular disease.

In addition Alan astutely points out that the ratio of total cholesterol to HDL is a better predictor of heart disease risk than total cholesterol or LDL cholesterol (often called bad cholesterol, though that is somewhat misleading) alone. In men a ratio of 5 is average risk, while a ratio of 3.4 cuts your risk in half. This guy’s ratio is 2!

Alan also points out that a recent study stated that the triglyceride to HDL ratio is the “single most powerful predictor of extensive coronary heart disease among all the lipid variables examined.” It was found to be even more powerful than the aforementioned TC/HDL. The goal of the triglyceride to HDL ratio is 2 or lower. The reader’s score was 0.2!

As you can clearly see this guy’s doctor is missing the forest for the trees. Where he only sees high total cholesterol, the numbers actually show that this guy has an excellent cholesterol panel (from what these numbers show us anyway) and absolutely, positively does not need a statin.

For a more detailed breakdown of this scenario, and just for consistently good breakdown of current and past research, do yourself a favor and subscribe to Alan’s Research Review, you will be glad you did.

Clearly 3 whole eggs and whole milk were not a problem for this guy! The point of all of this was to encourage you to educate yourself prior to seeing your doctor. Doctor’s are smart people, but that doesn’t mean they know everything. It is ok to gather data and be an informed patient. In fact I think it is imperative because if you are not an advocate for yourself, who will be?

There is another fish oil product that I have never mentioned on this site that is spectacular, but you certainly pay the price for it. Nordic Naturals Ultimate Omega is the market leader when it comes to fish oil, however it costs $20/month compared to Carlson’s $10. In terms of absolute quality this product has stood head and shoulders above the rest.

That has all changed.

Athletic Greens has recently launched their own fish oil, Athletic Greens Omega 3, where their sole aim was to match or exceed Nordic Naturals in all categories, and yet be affordable for the average consumer, and they did so with flying colors!

While much has been made of their Athletic Greens multivitamin/mineral/greens supplement, and I do think it is a good product, I personally still prefer Innate Response One Daily (Men’s and Women’s) due to its vitamin and mineral content actually being derived from food, no synthetics whatsoever. However, this fish oil product is absolutely fantastic and it just blew me away.

It is made from small, wild, sustainably-caught fish, is third-party tested for contaminants, is ultra-concentrated (you only need 2 capsules), has no fishy after-taste and it too will only cost you $10/month!

As a matter of fact I was surprised to see that Carlson’s does not source from wild, sustainably-caught fish. I guess I had just always assumed this was the case. From now on my default fish oil recommendation is going to be Athletic Greens Omega 3. Check it out for yourself and let me know what you think.

Seriously.

Orange produce – carrots, pumpkin, sweet potatoes, oranges, etc – were all on the Not To Be Eaten list. The rationale was that they are digested too quickly and therefore will exacerbate the pre-diabetes issue. This is such a misunderstanding of the science it is utterly scary.

So this “expert in diabetes” is telling me that if I am pre-diabetic that eating a serving of baby carrots (which we will say is 10 of them, close enough anyway) is going to harm my pancreas/increase my insulin resistance? Does this make any semblance of sense? Do you see the ridiculous of this assertion? I understand carrots have a relatively high GI for a vegetable, but that test requires 50 grams of digestible carbohydrate. That takes 1.5lbs of carrots! No one eats that in a sitting and it is utterly irrelevant to every day intake.

This type of advice is nutritionism at it’s worst. It’s just like telling someone to not eat eggs because they contain cholesterol. Focusing on one aspect of a food to the exclusion of all others is just asinine, and is missing the forest for the trees. Carrots are a lot more than their GI value, just like eggs are a lot more than their cholesterol content.

Do you judge an engagement ring simply on cut? No! You look at size, color, clarity, price, etc.  Odd analogy I know, it just popped into my head and I think it works nicely.

The point is that whether or not you eat carrots or sweet potatoes is not in anyway going to affect your diabetes risk. Losing weight, quitting smoking, exercising more, decreasing stress, getting adequate sleep, and eating a nutrient-rich calorically balanced diet are your best weapons against most diseases, including diabetes. Avoiding orange produce is not.

Check it out —> Nutrition Interrogation with Brian St. Pierre <—

If you are unfamiliar with Rick he is the creator of the Muscle Imbalances Revealed DVD/Seminar Series (Upper Body and Lower Body) featuring the likes of Bill Hartman, Dean Somerset, Tony Gentilcore and more.

Q. Brian,

I wanted to get your expert take on fish oil vs. krill. Which is better in your opinion? I’ve been on the fish oil bandwagon for years . Which is the better of the 2?

Thanks as always for your blog and the great info. It’s appreciated!

A. I think this is a good question, however I am not sure there is a clear cut answer.

In my opinion both are good, but in comparison to fish oil there isn’t nearly as much data on krill oil. The data that is coming out is quite positive, however much of it has been supported by Neptune Technologies, the company that owns the patent on the process of removing the oil from the krill.

Now that isn’t to say the research is invalid, it simply means I would like to see more independently conducted research before I draw any conclusions. Now having said that, people still want answers, and my answer is this:

For now I still recommend fish oil (I like 1 tsp of Carlson’s The Very Finest Fish Oil for most people). It has mountains of data supporting its efficacy in a plethora of capacities. It is cost-effective. And finally, it has been around long enough to have been found to work in real life, not just the lab.

Krill oil is an incredibly promising supplement that may one day supplant fish oil. With it’s phospholipid form of omega-3′s (rather than fish oil’s triglyceride form), astaxanthin (a powerful antioxidant), phosphatidylcholine (a potent source of choline, which I have written more about here), as well as some fat-soluble vitamins it certainly appears to be a wonderful thing. However, in comparison to fish oil it is not cheap. Yes you can allegedly take less to get the same result, but not enough to make up the cost difference.

For now with fish oil’s far longer track record it is my go source for marine lipids, but I am certainly keeping krill oil on my radar. If you choose to take krill oil that is certainly fine, just be willing to pony up a few (up to 5x more) extra bucks!

I guess the answer is yes. So with that in mind here is my Stuff You Should Read for today.

Stuff to Read While You’re Pretending to Work: 1/5/12 – by Tony Gentilcore. Thought I would start this off right by giving you guys a link to a bunch of great articles that Tony linked to! Topics include chicks getting good at pullups (works for guys too), a rant against calories, being awesome and the like. Good stuff as usual.

What Causes Insulin Resistance Part IV - by Stephan Guyenet. As usual Stephan provides riveting yet easy-to-read information on the causes of insulin resistance. For those of you not well-versed in science this is probably one of his easiest to understand posts as it’s not too technical.

The 80/20 Principle for Program Design – by Dean Somerset. Dean is a guy who’s stuff I have been meaning to read and just haven’t done enough of it yet. Well I made a decision to read this post and I am glad I did. Simple, to the point and easy to apply. It is quite long though!

Enjoy!

In other news I went down to Cressey Performance for the day yesterday, which was a most welcome change of pace. I even gave the staff in-service in the morning before clients arrived, which was aimed mainly at teaching the 6 new interns the basics of working with high school athletes. We also had a Q & A after where Eric, Tony, Chris and others asked questions on different topics. It was more of an impromptu off-the-cuff talk than anything formally prepared, but I think it went really well. We recorded the talk, so I will keep you updated if we do anything with it.

Continuing the CP theme it was good to get back in the trenches and coach people again. Though there are a lot of new faces and plenty of new exercises that I had to ask a few questions on, the coaching aspect was like riding a bike. Coaching trap bar deadlifts, med ball work, core exercises, and my favorite for newbies – Glute Ham Raises was an absolute blast and I hope to do it again sometime soon. It was great to catch up with everybody and marvel at the speed at which Cressey Performance continues to grow.

I also had EC eval me as my left shoulder/trap/upper back area has been cranky as of late and not responding as I would have liked to some of my attempts at treating it. While it has gotten better, it wasn’t great, so I had Eric check me out. He basically concluded that I have downward rotation syndrome and jacked up levator scapulae, essentially my upper traps have been too neglected and I need to work on overhead shrugs and a few other similar exercises.

As we talked he mentioned that he has started to notice this issue more and more with guys when he assesses them, due to a seemingly over-emphasis on the “down-and-back” cue, near total avoidance of using the upper traps in addition to poor upper body posture (mainly anterior scapular tilt and excessive internal rotation – mostly from sitting too much). Looking back I can definitely see how I have not trained by upper traps/uppward rotators to the same degree as my downward rotators, not too mention the fact that I have been sitting a ton more since I left CP. We also both felt there was accumulated wear and tear on the area from years of baseball/lacrosse/hockey/rugby that certainly isn’t doing me any favors, but with some appropriate soft tissue work and corrective strategies I should be good to go.

This really speaks to the fact that the hardest person to train is yourself. As much as I know about appropriate training modalities, proper exercise execution, and corrective strategies, when training yourself it can be easy to continue to work on what you are good at and neglect areas that are weak. Doing a little more research myself I stumbled across a fantastic article by Mike Robertson and Bill Hartman that outlines the downward rotation syndrome and provides some excellent corrective strategies that I will certainly put to use – Push Ups, Face Pull, and Shrugs.

Lastly, I also wanted to mention to keep your eyes peeled for some audio interviews I did for Rick Kaselj of ExercisesForInjuries.com and Medhi of Stronglifts.com recently. They should be going up within the next month or so, and I will let you guys know when they do.

Q. Hi Brian,

I’ve been meaning to shoot you an email to thank you for a while.  I purchased your nutrition information from Eric Cressey’s Show and Go product.  It’s some of the most well thought out and realistic nutrition information I’ve ever read.  I think you have a real knack for simplifying what others can make very complicated but at the same time educating and providing people with important reasons why their nutrition matters so much.

I wanted to ask you was in your guidelines I know you refute the commonly held belief that saturated fat is bad.  In your shopping list though is lean meats.  Is that just in case the meat is conventional and there are more antibiotics or hormones stored in the fat?

A. First off, thank you for the kind words, much appreciated. I like to think of that as my skill set as well!

The reason for relatively lean meats is because excess fat and calories is still excess fat and calories. While I don’t think saturated fat is the devil, far from it, the goal isn’t to eat as much of it as possible either! Eating lean meats allows you to decide what fat sources you want with that meal. Do you want olive oil, butter, avocado, nuts, or maybe you want fattier meat? In addition it’s not like I am recommending 99% lean ground meat either (which tastes awful), I think 93% is a good compromise. Eating fattier meat will decrease the protein content and make it harder to hit your macronutrient needs within your caloric needs. Granted, if you know how to fit it in then go for it.

For example lets say you want to make a burger – going with say an 85% lean patty makes it more difficult to add other things to it if you like cheese or avocado with your burger, or you wanted to saute up some veggies in olive oil or something like that. Going with 93% allows for more flexibility without sacrificing much in taste.

Again just general recommendations. If you know what you are doing you can easily consume a higher fat steak, just have something like a sweet potato and some steamed veggies with it. With the lower fat options you just more flexibility to add other components and not be jacking up the calories crazy high. Choosing a higher fat cut of meat is not inherently bad, it just tends to limit your side options is all.

Your point at the end about the hormones and antibiotics is a valid question as well, and if you are choosing conventional meat it might be a wiser idea to go with a leaner option.

Make sense?

I would love to hear your thoughts and comments below.

Let’s use lung cancer as an example. It is well established that smoking significantly increases your risk for lung cancer, and people will often state that smoking causes lung cancer. Then someone will come along and point out that their grandfather smoked a pack per day for 70 years, lived until he was 95 and never developed lung cancer. Another person will come along and point out that their relative never smoked and died from lung cancer at 55. Though these example seem to defy the initial stated theory, the simple fact is there are other ways to develop lung cancer than through smoking, and smoking is not guaranteed to lead to lung cancer. It is all about managing risk. However their examples do not disprove the fact that smoking is the major (but not only) cause of lung cancer, and that quitting or never starting in the first place significantly decreases your risk of developing cancer. Just like using your seat belt will significantly decrease your risk of dying in a motor vehicle accident, but it isn’t guaranteed.

You may be wondering where I am going with all of this, but bare with me. Stephan Guyenet has been writing a lot recently about the flaws of the insulin-causes-obesity theory and the strong support for hyper-rewarding food being a dominant factor in obesity. He has also stated that obesity is a major cause of insulin resistance, and not the otherway around as Gary Taubes would like to have us all believe. He has received A LOT of resistance from low-carb advocates who will use their own personal story of going low-carb and losing a ton of weight as the definitive reason why he is wrong. Many are also pointing out that there are thin people who develop diabetes too.

What these people fail to recognize is that just because there are exceptions to the theory does not make the theory false, it simply means there are other ways for the process to happen. For example we all know that 2+2=4, however there is more than one way to get to the number 4. 3+1=4. 5-1=4. 2×2=4. NONE of those equations make 2+2=4 false. The point is that for MOST people obesity leads to insulin resistance and diabetes, however this does not mean there are not other pathways for the disease to develop, it simply means it is the most common way.

People need to open their minds to the possibility that their experience is not the defining explanation for disease development. A “study” where n=1 should not convince anyone of anything. As Stephan calmly points out there are other environmental and genetic contributions to disease development, he is simply summarizing what the data shows as a major cause of obesity(and something that we can control), not the only cause.