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optimal health explained

Hello and welcome to my site. I'm going to dive straight in and firstly give you the generally held consensus view of what optimal health is. Later on there with be room to consider the scientific view of optimal health and ways to influence it, including references to well conducted studies that show associations between certain behaviours and the incidence of preferred outcomes. Associative studies do not prove cause and effect but might give some indication of what is the best path to follow to achieve optimal health.

Hopefully I can present a range of suggestions to help you on your road to optimal health.

Stephen Thomas BSc (STEM)

Contact me with any questions here

What is health?

Here is a very general list of what most people would include as indication that they are near to optimal health. Remember that this list is simply opinion. As you go through the site you will see well referenced articles that offer signposts to what might be the best way to achieve your health goals.

If you can not tick all, or even one of those things on that list don't give up! 

Reaching optimal health appears to be achievable and there are  many strategies you can adopt to improve your life at any age.

The path to health

I believe that a good place to start when considering your health is examining what you are eating. What you eat will have an impact on your health. It really is that simple. Here are a few reasons why.

Take the last thing on the list above regarding strong bones. Bone density is important in many ways, one example being that it helps to reduce the incidence of fractures. In layman's terms, eating the most appropriate diet for your physiology can make a big difference.

Certain nutritional habits, such as eating animal-based protein seems to be associated with improved bone density compared to plant-based protein for example. (1) 

Here are the geeky 'sciencey' conclusions from the study. " These findings, along with the intriguing observation of a negative association between vegetable protein consumption and BMD, have significant implications for osteoporosis prevention strategies and warrant further investigation in elderly cohorts."

As you commence your journey towards optimal health consider how it will be manageable for your body and your lifestyle to adapt. 

For example, introducing some small changes that over time will add up and make big differences can make changing your ways easier. Many people seem to obtain 'instant success' improving their health by just reducing or eliminating sodas, sugary foods and processed-food-like products. I have not referenced this claim as it now seems common place in anecdotal evidence.

muscle mass

Lean muscle mass often referred to as skeletal muscle has two prime associations to optimal health;

Your metabolic rate is influenced by muscle due to the nature of its thermogenic tissue (i.e., energy consuming). For the majority of people this is the largest single contributor to daily energy expenditure. It seems to be for this reason that any decline in skeletal muscle mass is associated with an increase in body fat mass. 

In layman's terms this means that the more muscle you have the more energy you'll be using up, even when asleep. Muscle uses up energy just to maintain its mass. So good levels of lean muscle mass is associated with longevity and good health.

The geeky bit for those that want to know WHY this is...

"Because of its oxidative capacity (i.e., mitochondrial content) skeletal muscle is also a large site of fat oxidation, potentially playing a role in maintaining lipoprotein (cholesterol) and triglyceride homeostasis. Skeletal muscle is also, mostly by virtue of its mass, the primary site of blood glucose disposal; hence, maintaining skeletal muscle mass would also play a role in reducing risk for development of type II diabetes. Finally, the decline in maximal aerobic capacity with age, and with other muscular wasting conditions, including weight loss, has also been found to be due, to a large degree, to a decline in skeletal muscle mass and skeletal muscle quality." (2)

Hormones

Optimal hormonal balance seems associated with better long-term health outcomes. Understanding what hormones are and what they do could help you make better decisions regarding how to maintain your health. Studies suggest that most people believe chronic stress has a deleterious effect on health. Many participants in studies already knew that stress releases cortisol and adrenaline and that those hormones can cause various responses in the body. A hormone can be defined as 

Dietary factors as well as environmental influences can have impacts on the hormonal balance with the physiology of the human body. Various studies for different conditions have looked at lowering carbohydrate intake as a tool for better regulation of hormones, many with promising results. "Other potential benefits of carbohydrate restriction may include fat mobilisation and oxidation and reductions in the TG/HDL ratio, a marker of insulin resistance" (3)

restorative sleep and time restricted feeding

Sometimes optimising health is  not just about what you eat, it can also be about WHEN you eat. 

Fasting is basically not eating. 

When you are asleep you are fasting. 

The time between getting up and eating and when you finish eating for the day is called your 'eating window.' In recent times there has been a lot of studies on what is called 'time-restricted-feeding.' One study concluded, "We detected improved sleep, prevention of body weight gain, and deceleration of cardiac ageing under TRF, even when caloric intake and activity were unchanged." (4)

Basically if you start to eat at midday and finish by 5pm then your eating window is just 5 hours. Time restricted feeding "prevents excessive body weight gain, improves sleep, and attenuates age- and diet-induced deterioration in cardiac performance" (5)

fasting

Fasting is a practice that dates back centuries and plays a central role in many cultures and religions. Fasting is not eating all or some foods or drinks for a set period of time, there are many different ways of fasting. In general, most types of fasts are performed over 24–72 hours. Intermittent fasting, on the other hand, involves cycling between periods of eating and fasting, ranging from a few hours to a few days at a time. Fasting has been shown to have many health benefits, from increased weight loss to better brain function. 'Alternate day fasting (ADF) improved markers of general health in healthy, middle-aged humans while causing a 37% calorie reduction on average. No adverse effects occurred even after >6 months. ADF improved cardiovascular markers, reduced fat mass (particularly the trunk fat), improving the fat-to-lean ratio, and increased β-hydroxybutyrate, even on non-fasting days.' (6)

Cholesterol and lipoproteins

These are the notes from my recent Muscle and Health meeting regarding LDL, HDL and Triglycerides.

Firstly I wish to cover the basics and then talk about transport of fats and lipids around the body.

Triglycerides are the 'storage form' of fat-based fuel.

Triglycerides are found in fat cells (adipocytes) and inside lipoproteins.

To break them up you need the lipase enzyme. You get...

This goes back and forth.

When fasting

More free fatty acids (FFA) goes to tissues like muscle and more goes to liver and produces a higher production of ketones than when you are in the fed state (eating)This also means you see higher VLDL output.

What are the lipoproteins?

You need a 'shell' to encase fats / lipids, the shell is called a lipoprotein because it is a combination of lipid and protein. The body needs a way to transport fat and fatty substances around the body because fat and water don't mix so you can't simply allow fat to enter the bloodstream without a container that likes water. The bloodstream is typically an aqueous solution (water-like).

This molecule likes water on the outside but the inside is filled with fat.

Fat based cored cells only need a monolayer (as shown above)

Water based cored cells have a phospholipid bilayer (below)

The lipoprotein system of molecules is designed to do the following things

Lipoprotein is the 'container' that transports nutrients

Vitamins A, D, E and K are fat soluble vitamins they get transported around the body.

The liver is the starting place for all this to happen. There are many factors that influence the production of lipoproteins. For example, under eating conditions and with the influence of insulin the liver makes makes VLDL (very low density lipoproteins)

VLDL is relatively speaking a BIG molecule.

When you're eating the liver receives the nutrients and places all the elements in the 'container' we call VLDL. It places in this spherical container the following 'cargo.' vitamins, proteins, triglycerides and cholesterol.

Primarily the fat cells is the destination.

There is a protein on the outside of the 'container' which is the address of where it's got to stop. The liver has punched it into the 'protein sat-nav' and said 'go to the fat cells'

So these particular proteins are in the wall of the VLDL.

WHEN it sees a fat cell it will bond with it.

This bonding will in general release a little bit of triglyceride into the bloodstream. 

They are called non-esterified fatty acids (Non-esterified fatty acids (NEFA) are molecules released from triglycerides by the action of the enzyme lipase and are transported in the blood bound to albumin. They contribute only a small proportion of the body's fat; however provide a large part of the body's energy).

They get absorbed all over the body by different tissues. 

For example, your heart will obtain between 70% to 85% of its energy from those triglycerides.

Remember the remainder does go to some other organs and tissues. It is the majority of the VLDL content that gets into the fat cell for storage (mostly triglycerides and cholesterol)

The 'sat nav protein' is then removed and the receiving fat cell changes the 'protein sat nav' in the shell of the lipoprotein to a different location and by now the container is smaller and we call it an IDL (intermediate density lipoprotein) as it's now a smaller molecule. Not all becomes IDL as some others becomes LDL (Low density lipoprotein)

HOW DOES IT GET SMALLER?

The monolayer of phospholipids sees some break away and they go into the bloodstream. Most though go into making the receiving cells membrane larger! WOW, clever.

This 'docking' has a two-fold function. It is FILLING UP THE CELL WHILE INCREASING ITS CONTAINER TOO!

LDL size variation

LDL size varies dependent on the insulin status of your body.

Small particles of LDL are small and dense usually if insulin is high.

If insulin is low the body is more likely to be breaking fat down and more of this breakdown is put into the LDL and it becomes a big fluffy molecule. Therefore you have two types of LDL

SMALL DENSE LDL

OR

BIG FLUFFY LDL, which goes to all the cells in your body, including your brain, MOSTLY for energy, some for repair.

This is best when fat adapted as you use triglycerides and ketones together.

HDL (High density lipoprotein)

Not many people mention that there is variation in size of HDL. HDL plays a role in clearing up the body. For example, LDL eventually hooks up with HDL. The small LDL is in the bloodstream and combines with HDL (high density lipoprotein) the HDL transfers cholesterol mainly into the small LDL and the HDL adds a protein 'sat nav' telling it to go back to the liver.

For those that interested in the variation in size of the HDL please look at the formation of HDL1, HDL2, HDL 3 and HDL4 source material

https://pubmed.ncbi.nlm.nih.gov/212757/

(this paper is also handy for demonstrating the importance of lipoprotein lipase 'LPL', it is an in-vitro study)

Adipose tissue LPL activity is high in fed animals and low when fasted. In skeletal and heart muscles it is the reverse. Low in the fed state and high in the fasted. Anyway back to the story...

HDL is a scavenger molecule that has been acting throughout the body collecting cholesterol and lipids that have been trapped in blood vessels where it's been performing a repair function.

The small LDL gets back to liver where it's either reprocessed back into VLDL or it dumps the extra cholesterol into bile and you poop it out.

When insulin level is low the liver produces a lot of these HDL molecules. 

Small dense LDL can be looking to hook up with HDL but also has a protein 'sat nav' to an activated macrophage (part of your immune system)

Macrophages get trapped in blood clots in your blood vessels. So when there is an injury in your blood vessel you get this clotting cascade (fibrous clots, platelets, neutrophils, white blood cells and macrophages) 

The macrophages have proteins that are looking out for these LDL because the contents are used to smooth out blood clots.

So injuries to the cell wall from things like high blood sugar have a continued dumping of LDL contents to try and repair the damage.

Let's say the endothelial cells are repaired, there is still a little clot that has to be removed. Plasminogen breaks the clot down with assistance from antithrombin but the lipid still has to be picked up so HDL stops by and sucks up the cholesterol and the fat and goes back towards the liver, combining with LDL on its way and then it's back to the liver.

Bile

Not only does some bile end up in your poop but it also can head to the gut and when you eat a fatty meal the gall bladder squeezes bile into the gut, bile contains micelles (like little soap bubbles) which contains cholesterol and fat and these small little bubbles absorb fat from the food and the micelles get absorbed by the small intestine and dumped into the lymphatic system and we call that molecule a chylomicron.

They go to the tissues all over the body and any remnants go back to the liver 

FAT STORAGE

Is like golfballs in a net bag. If you could not open the bag you'd need to break the golf balls down into smaller bits to get them out. The fat cell is packed with amongst other things, a great deal of triglyceride. These have to broken down to leave the fat cell, you need an enzymatic lipase to do this.

Lipase

The heart is a major site of LPL synthesis and fatty acids provide over 70% of energy needs for the cardiac muscle.

Neither non-esterified fatty acids nor the compensatory increase in cardiac glucose metabolism can entirely replace fatty acids not provided by LPL in the heart.

doi:10.1152/ajpendo.90920.2008

https://journals.physiology.org/doi/full/10.1152/ajpendo.90920.2008

The heart seeks out fatty acids coming off LPL

In adipose tissue insulin increases the level of LPL mRN

Weight / Fat Loss Stall

Here are some reasons that are nor related to eating that might contribute to why you are experiencing a temporary stall of fat loss. Avoid Mobile Phones, TV screens and Tablets. I will explain why but firstly a little bit about hormones…

Melatonin is produced by the body and is designed to help induce a deep sleep.

It seems to be produced once nighttime approaches and the light outside diminishes.

One function of melatonin is to inhibit insulin production.

Insulin blocks fat burning. So far so good.

BUT...

Exposure to blue light before sleep 

For example, a PC, phone, tablet etc that light, especially the blue light, is going to block melatonin. 

So we have lost the insulin inhibition and therefore fat burning is switched off. 

This also means we might have disturbed sleep.

(Late night snacking will also stop fat loss because you’ve just bumped up blood sugar but due to the darkness of nighttime melatonin is inhibiting insulin so your blood sugars are going to go up!)

Stress

You need to sleep to lose weight, so here is how stress might be affecting the fat loss progress.

Stress starts production of the stress hormones such as cortisol, which is a glucocorticoid. ‘GLUCO’ means glucose.

It’s a glucose hormone.

Cortisol inhibits insulin.

It raises blood sugar because of this.

You are making sugar from gluconeogenesis to prepare you for a fight or for a flight away from the stressor. 


Protein

Protein is macronutrient that the body breaks down into amino acids.

There are 20 amino acids

Some we can make from other amino acids.

There are 9 essential amino acids and 6 conditionally essential.

Proteins are not all the same

Some proteins are either:

1. Glucogenic, broken down to become glucose.

2. Some are ketogenic

Get broken down make ketones 

3. Some proteins can do both.

Protein gets broken down and sent to the liver. Protein synthesis is part of a mechanism of rebuilding tissue.

Insulin governs protein synthesis.


Proteins are not all the same

Some proteins are either 

1. glucogenic, broken down to become glucose.

2. Some are ketogenic

Get broken down make ketones 

3. Some proteins can do both.

Protein gets broken down and sent to the liver. Protein synthesis is part of a mechanism of rebuilding tissue.

Insulin governs protein synthesis.