Category: Health Tips

Dr Pete Sulack writes:

Hi Tom,​

After my cancer diagnosis, I stopped looking at food in terms of calories and started looking at it in terms of biology.

Every meal creates a response in the body. Blood glucose and insulin change, your gut microbiome is affected, and you’re supplying your cells with fats, amino acids, vitamins, minerals, and thousands of naturally occurring plant compounds.

That’s why diet became one of the five pillars of my approach and something I became extremely intentional about.

In today’s blog, What Are You Feeding Your Cells?, I break down:

• The research on ultra-processed foods and cancer risk
• Why cancer metabolism changed the way I thought about glucose
• Why I personally used therapeutic ketosis, and why I don’t recommend everyone copy me
• Why a Mediterranean-style diet is one of the first approaches I’d look at for most people
• The foods I intentionally eat for compounds being studied in angiogenesis and other cancer-related pathways
• Where I would start if changing your entire diet feels overwhelming

Keep reading: https://www.drpetesulack.com/untitled-3/diet-blog-post

Despite fasting increasing in popularity across the last 5 years or so, many are still perplexed by its purpose and true utility.

Fasting – How it works

Fasting can be described as a dietary strategy that consists of small periods of eating separated by larger periods of not eating (fasting). The absence of calories (in such periods) can encourage alternative forms of cellular energy production (i.e., gluconeogenesis) and for cells to become more energy efficient. This physiological cascade can trigger additional processes such as autophagy (cleaning out damaged cells and regenerating others) which is why fasting grew in popularity rapidly despite the body of research on the topic still in its preliminary stages.

In recent times, the proposed goal of fasting has drifted drastically, with many adopting fasting as a purported fat loss aid as opposed to longevity enhancement. With the explosion of fasting across the fitness community, fasted training quickly followed suit.

Why fasted weight training?

There are 3 main reasons why one would prefer to train in a fasted state.

Religion (i.e., Ramadan): Some religions prohibit followers to eat or drink anything between dawn and sunset for a period of 29 days once a year.
Early training: Some individuals who train super early in the morning find that eating prior to training can be an inconvenience, or alternatively, they don’t have much appetite that early.
Low calories: During a fat loss phase, calories can be reduced substantially, which makes it difficult for individuals to adhere. Fasted training can be a tool for some to “save” calories for later in the day, allowing larger more satisfying meals in the PM.

What does the research say about fasted weight training?

Trabelsi and colleagues (2013) conducted a study with the purpose of evaluating the effects of resistance training in a fasted versus a fed state during Ramadan on body composition & metabolic parameters in a group of bodybuilders.

This study randomly allocated the bodybuilders into two groups (fasted or fed) during Ramadan. All individuals followed a hypertrophy-based training program at least 3 times per week for the entire duration of Ramadan (29 days). The researchers saw no significant differences on body mass or body composition between the groups of bodybuilders after 4 weeks. The researchers went on to conclude that resistance training did not significantly affect body composition nor immune or inflammatory markers when done in a fasted or a fed state.

Another study by Frawley and colleagues in 2018 examined the effects of a bout of resistance training in a fasted state compared to ingestion of a standardised meal on fat and carbohydrate utilisation. In this study they found that individuals who performed fasted resistance training did not perceive the training sessions to be any more challenging compared to a fed state. Moreover, the researchers determined that fasted training happened at a significantly lower respiratory exchange ratio (RER), indicating that during fasted training, individuals use more energy for fuel from fats than carbs to meet energy demands. Important to note, this doesn’t necessarily translate to greater fat loss since the body tends to compensate for substrate utilisation, using more of the other substrate that wasn’t used as fuel throughout the day!

While the above studies suggest that intermittent fasting is not superior nor worse than fed training for overall body composition change, it Is important to note that other research does show that training in a fasted state can at times hinder performance. Several studies conducted on elite athletes (judo & soccer players) have shown how performance capabilities (speed, agility, endurance) become significantly impaired during fasted regimes. According to a review paper by Zouhal and colleagues, “fasting can elicit negative effects on performance in some events, and hence modifications to the training schedules may be required to minimize such effects.”

Conclusion

For most people (i.e., gen pop), training in the fasted or fed state isn’t going to matter too much. You’re unlikely to burn more fat training fasted, but you’re also not going to lose any more muscle either, compared to training when fed. However, for the athletes among us, we should be weary of the performance detriment that has been observed when training in the fasted state. While it might not matter too much for people just wanting to look better naked…a 5% performance drop off from training fasted could be the difference between a 1st and 5th place for a high-level athlete.

So… if you love fasted training, go right ahead, this strategy won’t stop you from making progress (although it won’t enhance it either), but if you consider yourself an elite athlete and are looking to optimise the training process and your results, you might be better off having some food prior to hitting the iron!

https://www.bulknutrients.com.au/blog/weight-loss/fasted-weight-training-is-it-optimal

(Tom: I saw this ad on Facebook and thought it might help so am sharing it. I have no personal experience with it.)

My husband is a cataract surgeon. When my eyes were still bone-dry two years after my cataract operation, the first thing he did was hand me a regimen. Preservative-free drops four times a day. A nighttime gel. Warm compresses morning and evening, ten minutes each, timed. Omega-3s with breakfast. Everything measured and monitored.

I followed it perfectly. For five months. Set phone alarms for the drops so many times my daughter asked if I was “on some kind of medication schedule.” Microwaved the compress mask twice a day until the kitchen smelled like hot flaxseed, because my husband the eye surgeon said that’s what you do when your eyes won’t recover after surgery.

My eyes were exactly the same. Gritty every morning. Blurring by noon.

That’s when he wanted to start me on Restasis and put plugs in my tear ducts. He didn’t really ask. He scheduled it himself.

Two weeks before the appointment, I stopped the whole regimen. In secret. He still doesn’t know everything.

And the reason I’m writing this is that what I found in his own hospital’s medical library contradicts what he’s spent thirty years telling his cataract patients about why their eyes stay dry.

I need to be careful how I say this. Not because I’m afraid of the medical establishment. Because I’m afraid of what it means for my marriage.

I’m Ann, I’m 64 and I’ve been married to Robert for 34 years. Robert is a board-certified ophthalmologist and one of the busiest cataract surgeons in the state, on staff at two hospitals. He’s been named to the regional “Top Doctors” list nine years running. He has restored the sight of thousands of people. Many of them weep in his office.

I love my husband. I need you to know that before I tell you the rest.

For 34 years, I’ve been a doctor’s wife. And when you’re married to an eye surgeon, his career becomes your atmosphere. You breathe it. You learn the language without taking the classes.

I know what the tear film is. I know what the meibomian glands are. I can follow a conversation about corneal nerves and tear break-up time at a dinner party and know when to nod.

I’ve heard Robert on the phone with patients at 10 PM, reassuring them about their dry eyes after surgery. Calm. Confident. Authoritative.

“Some dryness is normal after cataract surgery.”

“Keep using your drops. It settles for most people.”

“If it doesn’t, we have Restasis and punctal plugs.”

I’ve heard those phrases so many times they became the background music of our marriage.

So when my own eyes wouldn’t recover after the cataract surgery — gritty at dawn, blurring by lunch, a bottle of drops in every room — I didn’t expect a conversation. I expected a regimen.

And that’s exactly what I got.

Robert was at the kitchen counter. Sunday morning. Coffee. Still in his bathrobe.

“Annie, this is just post-surgical dryness. We get ahead of it. Preservative-free drops, four a day. The nighttime gel. Warm compress, ten minutes, twice a day. Omegas with breakfast. I’ll write it all down.”

He didn’t ask what I thought. Because in his world there’s nothing to discuss. Dry eye after surgery means the standard regimen. That’s the algorithm. That’s the training. That’s the thirty years.

“Okay,” I said.

What else do you say? Your husband is the surgeon. The entire weight of his career, his authority, the authority you’ve deferred to at every dinner party for 34 years, is behind that sentence.

I followed it perfectly. Five months. The drops, the gel, the compress, the omegas. I skipped my granddaughter’s pool party because the sun and the chlorine and the glare off the water made my eyes stream so badly I couldn’t see her in the shallow end.

My eyes were exactly the same. Gritty. Blurring. The drops lasting twenty minutes and then gone.

Robert looked at my tear film test, frowned, and said it was time for Restasis twice a day and plugs in both lower tear ducts. Fifteen seconds. Scheduled.

I started the Restasis that night. It stung going in, both eyes, a hot burn that lasted a minute and made me grip the edge of the sink. Twice a day, every day. On top of the drops. On top of everything.

Except I wasn’t his next patient. I was his wife.

The burning never settled. Twice a day I’d stand at the sink with my eyes watering from the sting. The drops still wore off in twenty minutes. The mornings were still gritty. I was now doing more to my eyes than ever, and they were no better.

And here’s the part that started to scare me. My vision had begun to blur in waves. I’d be reading and the words would film over and I’d have to blink hard to clear them. Driving at night, the headlights smeared into streaks. A few times the whole room went soft for a second or two before a blink brought it back, and I’d feel a cold drop in my stomach, wondering if something was going wrong with my eyes that even Robert couldn’t fix.

I didn’t tell him. Because I knew what he’d say. I’d heard him say it a thousand times.

“The fluctuating vision is the dryness. The surface dries between blinks. It’s not the lens, the surgery was perfect. Keep using your drops.”

The dinner party was in March. Eight guests, all physicians and their spouses. Robert was holding court, telling a story about a patient that week.

“She comes in convinced her dry eye is cured. Convinced. ‘Doc, I started taking this supplement and my eyes feel completely different, I’m not using my drops anymore.’ So I run her tear film test. It had improved at her last visit and I told her it was measurement variability. People want to believe the supplement did it. The supplement didn’t do anything. Dry eye fluctuates day to day.”

The table laughed. Knowing nods. The ophthalmologist across from me said, “Every week. They all think the supplement is working.”

Robert smiled. “I told her to stay on her drops and we’d discuss Restasis. That’s the standard of care.”

I was sitting at the end of the table. Three feet from my husband. Restasis burning in my eyes twice a day. Drops wearing off every twenty minutes. Vision smearing in the candlelight. And my husband, the man I’ve loved for 34 years, was telling a room full of doctors that women like her are imagining it.

I excused myself. Sat in the powder room and pressed my palms against my eyes.

Because his patient was right. The improvement was real. The supplement was doing something. And I couldn’t tell him. Because if she was right, he was wrong, not just about me, but about the thousands of patients he’d reassured for thirty years, about the whole approach he’d built his identity on.

That’s not a conversation about eyes. That’s a conversation about everything.

So I said nothing. And for three more weeks I burned my eyes with Restasis twice a day and said nothing.

The medical library was my rebellion.

Robert has privileges at the university hospital. The medical library is on the third floor, wood-paneled, quiet. I went on a Tuesday. Told him I was going shopping. Walked through the lobby in my sunglasses like a woman having an affair. Which, in a way, I was. An affair with information my husband hadn’t authorized.

I sat at a terminal and typed: why do eyes stay dry after cataract surgery.

I read for an hour. And the floor shifted.

Because everything I’d been doing, every drop, every vial, every compress, worked on the surface of the eye. And the research kept saying the damage wasn’t on the surface at all.

“Can I help you find something?”

A woman about my age. Reading glasses on a chain. Her badge said ‘Margaret, Medical Librarian’.

She looked at my screen. “Are you reading about meibomian gland dysfunction after cataract surgery?”

I nodded. She pulled up a chair.

“I’ve catalogued this research for 24 years,” she said quietly. “It’s some of the most robust and most overlooked work in the field. Let me show you what the surgery actually does.”

And she walked me through it.

The surgical microscope used to illuminate the operative field produces intense, sustained light directed at the eye surface for the duration of the procedure. That light is warm. It is direct. And it causes measurable disruption to the meibomian glands, the tiny oil-producing glands that run along the margin of both eyelids and are responsible for the outermost layer of the tear film.

The surgical incision itself severs corneal nerves. Those nerves are responsible for signaling the lacrimal gland to produce tears and for regulating the blink reflex that spreads the tear film across the eye surface. When those nerves are severed, both functions are disrupted. The eye blinks less frequently. The tear gland receives fewer signals to produce. The surface becomes exposed between blinks in a way it was not before the procedure.

The post-surgical antibiotic, steroid, and anti-inflammatory drops prescribed after every cataract procedure, the drops every patient leaves with in that paper bag, contain preservatives. The most common is benzalkonium chloride, found in approximately 70 percent of ophthalmic formulations. Benzalkonium chloride is cytotoxic to the conjunctival and corneal epithelial cells that form the foundation of a healthy tear film. Applied multiple times daily in the weeks following surgery, it causes additional disruption to a surface that is already compromised.

These three things, microscope light, severed corneal nerves, and preservative-laden post-surgical drops, act together on the meibomian glands and the tear film simultaneously.

I sat there and thought about two years of drops on the counter. Two years of my eyes blurring while everyone told me my surgery had been perfect.

“So why didn’t any of it work?” I asked her.

“Because drops, gels, compresses, Restasis, plugs, they all work on the surface of the eye, or they trap moisture on the surface. And the glands that make the oil, the thing that keeps your tears from evaporating between blinks, the thing that keeps your vision from blurring, are buried inside your eyelid. You can treat the surface forever. It never reaches the gland.”

She opened another study.

“The oil layer cannot be restored by anything applied to the surface of the eye. It is produced by glands in the eyelids. Those glands are tissue. Tissue needs nutritional support from inside the body, through the bloodstream, to function properly. No drop, no matter how advanced, reaches those glands from the outside.”

She let that sit.

“They were all working on the surface. The glands producing the oil layer are not on the surface. They are in the eyelid tissue. They need to be fed from within.”

“Fed how?” I said.

She pulled up the research and counted them off.

GLA from borage seed oil travels through the bloodstream to the glands and tells them to start producing oil again. The signal that restarts the oil factory.

Hyaluronic acid hydrates the tear film from within. Not drops on the surface. Moisture built into the system through the blood.

CuminUP60 curcumin puts out the inflammation fire that has been running inside the tissue since the surgery. Calms everything down so the glands can recover.

Astaxanthin protects the gland tissue from daily damage so things stop getting worse while they get better.

“Four ingredients,” she said. “Four jobs. All delivered through the bloodstream to the glands that no drop has ever reached.”

My hands were shaking in my lap.

“Why doesn’t anyone—” I started.

“Tell patients this?” She smiled gently. “Because the current model is measurable and publishable. Drops are reimbursable. Plugs are a procedure. Restasis is a prescription. There’s no blockbuster in telling someone to feed the glands from the inside. The research is ahead of the practice. It usually is. Sometimes by decades.”

She asked, carefully, “Are you researching this for personal reasons?”

I hesitated. “I’m on Restasis. After five months of a drop regimen that did nothing. My husband prescribed it. He’s a cataract surgeon here.”

Her expression didn’t change. “I’ve seen this before. Physician families. The hardest patients to reach are the ones closest to the prescriber.”

She wrote on a notepad and slid it to me.

“It has to be built for the meibomian glands, not the retina. Most eye supplements are macular formulas, lutein and zeaxanthin, wonderful for the back of the eye and useless for the glands. And the doses have to be disclosed on the label, not buried in a proprietary blend. The one I’ve seen that meets all of it is Hydro Restore, by EYEMOS. Whole formula built for the glands. Every dose printed and third-party tested.”

I folded the paper into my purse.

“Come back anytime,” she said. “The library doesn’t require a prescription.”

I ordered it from my phone that night. In the bathroom. Door locked. While Robert watched a surgical webinar downstairs.

It came two days later. I intercepted the package and put the bottle in my bathroom drawer, behind the cotton balls, in the back where he never looks.

I stopped the Restasis that same day. Stopped the four-times-a-day drops. Just the capsules now, once every morning with my coffee. And the first thing I noticed, before it had done a single thing, was that nothing went in my eyes. After two years of bottles and a burning prescription, I sat at the table with a cup of coffee and a capsule and almost laughed.

I scored my own OSDI at the kitchen table that first morning, the standard dry eye questionnaire, zero to a hundred. I came out at 47. Severe. I wrote it in a little notebook I kept in the lining of my purse.

Week one, not much. I’d read enough to know the glands rebuild slowly, from the inside.

By week two, the mornings. My eyelids stopped sealing shut overnight. I came down one day having made the coffee before Robert was up, and my eyes had simply opened on their own.

Week three, the blurring waves got further apart. I read half the paper before the words filmed over, and even then a blink cleared them and they stayed clear.

I re-scored my OSDI every week in the hidden notebook.

Week two: 39.

Week four: 28.

Week six: 21. Out of severe. Into mild. I scored it three times because I didn’t believe it.

I was at the kitchen table staring at the number when the garage door opened. Robert, home early. I closed the notebook, put it in my purse, wiped my eyes. I hadn’t realized I was crying.

“Hey Annie. Good day?”

“Good day,” I said.

My follow-up tear film test was at eight weeks. Robert ordered it himself, standard after starting a patient on Restasis. He expected the Restasis to be holding the line. I let him order it. Let the tech run it. And waited.

The results came up on his iPad at breakfast.

He frowned. “Huh.”

“What?”

“Your tear break-up time is 9 seconds. It was 4 at your last visit. Your OSDI questionnaire came back at 18. Gland expression looks clearer.” He scrolled. “Annie, this is better than I’d expect on the Restasis. I almost never see this kind of improvement in the tear film this fast.”

He set the iPad down. Looked at me.

“Any trouble with the Restasis? Any stinging?”

This was the moment. Thirty-four years. Thirty years of his career. Everything balanced on what I said next.

“Robert. I stopped the Restasis. Six weeks ago. I stopped the drops too.”

The stillness in his face didn’t change. But something behind it did.

“You stopped,” he said. Not a question. A man doing math.

“I was burning my eyes twice a day and they were no better. My vision was still blurring. The same things your patients describe, the ones you tell them are normal.” I steadied myself. “I went to the medical library at the hospital. I didn’t tell you. I should have, and I’m sorry for that part. But I needed to understand it myself.”

“Annie—”

“Please let me finish.”

He was quiet.

“I found the research on what cataract surgery does to the meibomian glands. The light, the severed nerves, the preservative in the drops. And I found out why nothing we were doing worked. The drops are all on the surface. The glands are inside the eyelid. They have to be fed from the inside, through the bloodstream.” I pulled the notebook from my purse and slid it across the table. He didn’t reach for it. “I’ve been taking a supplement built for the glands. Four capsules every morning. Four ingredients, each at a real dose. That tear break-up time, the 9 seconds, that’s not the Restasis. I haven’t taken the Restasis.”

Silence.

“A supplement,” he said. Flat.

“GLA from borage seed oil, hyaluronic acid, a bioavailable curcumin, astaxanthin. Each one delivered through the bloodstream to the gland tissue, because that’s the only route that reaches it. The drops never could, Robert. You know they wear off in twenty minutes. That’s because they’re sitting on the surface while the glands underneath make no oil. The diet of drops reduces the dryness you feel for a few minutes. It never touches the thing that’s actually broken.”

He looked at the notebook. Still didn’t open it.

“My OSDI was 47 when I started. Severe. It’s 18 now. My eyes open on their own in the morning. My vision holds steady. I came back. Without the Restasis. Without the plugs you wanted to put in.”

Quiet. The refrigerator hummed.

“I’d like you to look at the tear film numbers,” I said, “the way you’d look at them for any patient. And read the studies. They’re in your own hospital’s library.”

He sat there a long moment with his hands around a coffee gone cold.

Then he picked up the iPad and read the numbers again. And he said, “I’m not going to place the plugs.”

And then: “I’d like to read those studies.”

I need to be honest about what happened next and what didn’t.

Robert did not become a convert. He did not throw away his prescription pad. He did not start recommending Hydro Restore to his patients.

He read the studies. He asked me questions, clinical, mechanism questions, the kind he asks drug reps. I answered what I could. For the rest I sent him to Margaret’s reading list. He was quiet about it for weeks. Doing what surgeons do with data that doesn’t fit their model, which is interrogate it harder than the data that confirms it.

Then one evening, three weeks later, we were doing the dishes. He was drying. I was washing.

“I’ve been thinking about that patient,” he said. “The one from the dinner party. The supplement.”

The woman he’d diagnosed with measurement variability in front of eight laughing doctors.

“What about her?”

He dried a plate. Set it down.

“I think she might have been right.”

Six words. He said them to the dish rack, not to me. But he said them.

That’s not a revolution. It’s a hairline crack in thirty years of certainty. But it started because his wife quietly stopped the drops, stopped the Restasis, fed the glands from the inside, and got her eyes back.

If you’re reading this, I think I know where you are.

You had cataract surgery and your eyes never came right. You’ve been told some dryness is normal, to keep using your drops, that you can always move to Restasis or plugs. You’ve done everything right and your eyes are still gritty every morning and blurring by afternoon, and maybe your vision has started fluctuating in a way that frightens you. And the person telling you to keep going is someone whose authority you don’t feel you can question.

Here’s what I learned in a medical library on a Tuesday afternoon.

The problem isn’t that you need a stronger drop. The drops work on the surface of your eye. The glands that make the oil layer, the layer that holds your tears in place and keeps your vision from smearing, are buried inside your eyelid, where no drop can reach. The drops reduce the dryness you feel for twenty minutes. They never touch the glands. And the glands are what the surgery damaged.

The only way to feed them is from the inside, through the bloodstream.

The brand is Hydro Restore by EYEMOS. Built for the glands, not the retina. GLA from borage seed oil, hyaluronic acid, CuminUP60 curcumin, astaxanthin, each at a disclosed clinical dose, third-party tested, made in the USA. Four capsules a day. Nothing goes in your eye.

Score your own OSDI before you start, it’s a free questionnaire you can find in minutes. Ask your eye doctor to run your tear break-up time. Start the capsules. Re-check at eight weeks. Watch the numbers move. Yours and your timeline may differ from mine. But that part won’t be a feeling. It’ll be a reading.

Ninety days of living with this won’t tell you anything a careful eight weeks won’t. It comes with a 60-day money-back guarantee. Feed the glands for two full months, and if your mornings aren’t easier and your numbers aren’t moving, you get every cent back. You risk nothing.

You’re standing where I stood five months ago.

One path: keep the drops, start the Restasis, place the plugs, keep treating the surface while the glands stay empty, and keep being told it’s managed.

The other path: feed the glands the surgery damaged, the one place every drop has missed, and give them an honest two months.

I chose the second. My OSDI is 18. My break-up time is 9 seconds and climbing. My eyes open on their own in the morning. My husband is reading the studies. And I found my answer in his own hospital’s library. The evidence was always there. It was just waiting for someone to look.

The link between saturated fat and LDL is debated, but is high LDL even harmful? A review of 19 studies with 68,000+ participants revealed those with the highest LDL levels lived the longest.

Click to view the video: https://www.facebook.com/share/r/1JyRbwVHpx/

Not smoking
Maintain a healthy body weight
Exercise
A healthy diet – limit processed meats and ultra-processed foods, enough fiber
Limit alcohol consumption
Limit UV exposure
Limit toxin exposure
Limit/eliminate stress
Get enough sleep/minimise Circadian rhythm disruption
Maintain adequate blood level of nutrients – Vitamin C, D, calcium, magnesium
Smokers need to not take too much of certain supplements

Click to view the video: https://www.youtube.com/watch?v=ZXjHGFRD6U8

Dr Berg says: DON”T TAKE THEM TO A PSYCHIATRIST!!! “The number one sign that your child is eating too much sugar is moodiness.