Inflammation is not the underlying root of any disease. It is a side effect of a deeper cause. Tinkering with inflammation is tinkering with the immune system. Buzzwords like “anti-cancer”, “anti-viral”, “anti-inflammation” and “immune-boosting” are misleading and offer no information about how various herbs, supplements and pharmaceuticals actually work. Desperate for relief, ill consumers are constantly duped by the supplement industry as they seek easy answers for complex diseases. When the mechanism of a supplement doesn’t match the underlying cause of the immune imbalance, short-term side effects commonly occur. An understanding the mechanisms of aging offers us a glimpse of the potential short-term and long-term side effects that can result from tinkering with the immune system.
When I began studying functional medicine 18 years ago, I was awakened to the then controversial hypothesis that inflammation was the primary driver of many of the diseases of aging. There were hundreds of studies demonstrating the correlation between inflammation and conditions like heart disease, obesity, diabetes, cancer and even aging. As I developed my practice, it was like having magical powers believing that the cause of heart disease was not cholesterol but, in fact, inflammation. Armed with supplements like fish oil, curcumin and boswellia, I felt like Wonder Woman, striking down interleukin 6, NF-kappa B, TNFα and other inflammatory signals that could lead to disease. It wasn’t until I began treating autoimmune and skin disorders that I came to realize that inflammation is not the underlying root of any of these diseases. It’s a side effect of a deeper cause. In fact, suppressing inflammation without understanding its cause is as insane as turning off the fire alarm and going back to bed while the house fills with smoke.
There are four core mechanisms that drive inflammation. This article will explore the most common; when the immune system recognizes something as an invader and launches an attack using inflammatory chemicals as weapons. In science we call this immune system activation by antigen recognition.
The other three (listed below) will be discussed in future posts.
- Over activation of NFKappaB through dietary signaling. Activity of NFKappa B is highly influenced by the presence or absence of insulin. In general, diet doesn’t cause inflammation; it simply acts like a volume control. It isn’t until grossly pathological changes develop through excessive insulin signaling and ROS production that we begin to see the out-of-control inflammation associated with diseases like obesity and diabetes.
- Deranged methylation and acetylation of DNA,. Basically methyl groups (from SAMe) and acetyl groups are stuck to DNA to turn it on and off.
- The healing response – the redness, pain and swelling that results from an injury is ultimately an immune response that drives healing. However, repeated injuries, like when high blood pressure repeatedly damages the arteries, will lead to thickening and scarring.
Much of inflammation is nothing more than a side effect of immune activity. A fundamental flaw in our current medical approach to inflammation is the false belief that the immune system is creating inflammation for no reason. As a result, we have an entire industry of herbs, supplements and pharmaceuticals built upon the idea that suppressing inflammation is somehow healing the body. All this despite several large studies demonstrating that conditions associated with inflammation like heart disease, diabetes and cancer are mostly driven by external factors. To be clear, unless a true autoimmune condition has developed, the immune system will not act unless there is something triggering it to act. Sometimes we don’t like the results. However, this ancient system that protects us from cancer and invaders is highly intelligent and tightly regulated. The immune system will launch an attack against any critters or substance that it identifies as an invader. These include bacteria, viruses, air pollutants, some metals, environmental contaminants and oxidized LDL cholesterol. It will also attack undigested food proteins like gluten from wheat and lectins from beans. Food sensitivity tests like the ALCAT and Mediator Release Test (MRT) regularly reveal that the immune system will attack virtually any intact food protein or microbe that escapes past the protective gut mucosa (gut lining).
As one example in an ocean of inflammatory immune signals, look at what happens if we tinker with TNFα.
T= “tumor” like cancer
N=“necrosis” like death
Fα=“factor alpha” as a signal category
TNFα is an inflammation weapon produced by certain immune cells to protect us from viruses and cancer. It helps transmit signals from outside a cell to inside a cell’s nucleus where more signals tell the cell to kill itself. In science we call this apoptosis. It is helpful for ensuring that cells that have become cancerous do not survive to divide and grow into a tumor. TNFα also “serve[s] as a first-line defense against influenza virus” and has “strong antiviral activity against many viruses including avian flu and swine flu2”. Upon first glance, it sounds like anything that will increase activity of TNFα can keep you from getting cancer and viruses. Woohoo! In fact, several medicinal mushrooms are promoted as having these anti-cancer and anti-viral properties. Cordyceps,, Maitake, Coriolus and Ganoderma, all contain chemicals that increase activity of TNFα*. While this approach can be transformative for someone with a weak immune response, what effects does artificially increasing TNFα have in a healthy person? We know that in high amounts, TNFα causes considerable collateral damage to tissues. It is one of the main participants in diseases like psoriasis, ulcerative colitis and rheumatoid arthritis. Moderately high levels are associated with Alzheimer’s disease and even cancer10.
*I suspect that these mushrooms cause an increase in TNFα, not because they have magical properties, but because the immune system sees them as invaders and launches an attack.
Over the long term, does artificially raising TNFα activity accelerate the same degenerative problems that we see with any chronic inflammation? Wouldn’t mildly elevated levels still increase cell turnover, damage tissues, accelerate shortening of telomeres, speed aging and ultimately lead to early senescence*?
(*Senescence is a term used in aging research to describe the end stage of the aging process of a cell, tissue or system. When a cell reaches senescence it can no longer function properly or divide to form new cells. As more cells reach senescence in a given tissue, the more that tissue shrinks and becomes dysfunctional.)
Unless there is a specific reason to artificially stimulate TNF-alpha, it is important to weigh the potential effects of taking any herbs or mushrooms that raise it. Other herbs that stimulate inflammation by raising TNFα include Cistanches, Dipsacus, Echinacea and Psoralea. I have personally seen several patients whose autoimmune conditions were severely exacerbated from taking medicinal mushrooms. They were duped by claims and promises that somehow their condition was a result of a “weak” immune system and that these mushrooms were their salvation. On the other hand, with proper diagnosis, these types of mushrooms can be used as an effective tool when the immune response is too weak. Poor wound healing and recurrent viral infections (like shingles and Epstein Barr) are often caused by a weak immune response. Another scenario where these mushrooms may have benefit is with cancer. I have worked with scores of patients who were doing well months after their doctor prescribed Maitake-D as part of a larger protocol to help the immune system kill cancer cells. (Notice I said “part of a protocol”).
In the ocean of herbs and supplements that are supposed to help us live longer and healthier, how do we know which ones are actually helping? With illness, when the mechanism of a supplement doesn’t match the underlying cause of an immune imbalance short-term side effects commonly occur. What are the less detectable the long-term consequences? Is it possible to accelerate the aging process by inappropriately stimulating the immune system?
 Kurtak, K. Dietary and Nutritional Manipulation of the Nuclear Transcription Factors, PPAR’s and SREBP’s,as a Tool for Reversing the Primary Diseases of Premature Death and Aging. Rejuvenation Research 17-2. April 2014. P 140-44.
 D. Bayarsaihan Epigenetic Mechanisms in Inflammation J Dent Res. 2011 Jan; 90(1): 9–17. doi: 10.1177/0022034510378683 PMCID: PMC3144097
 Stephen B Baylin DNA methylation and gene silencing in cancer. Nature Clinical Practice Oncology (2005) 2, S4-S11 doi:10.1038/ncponc0354. Received 16 August 2005 | Accepted 30 August 2005
 Prof Salim Yusuf DPhil,Steven Hawken MSc,Stephanie Ôunpuu PhD,Tony Dans MD,Alvaro Avezum MD,Fernando Lanas MD,Matthew McQueen FRCP,Andrzej Budaj MD,Prem Pais MD,John Varigos BSc,Liu Lisheng MD,on behalf of the INTERHEART Study Investigators Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study
The Lancet – 11 September 2004 ( Vol. 364, Issue 9438, Pages 937-952 )
 Dariush Mozaffarian, MD, DrPH; Aruna Kamineni, MPH; Mercedes Carnethon, PhD; Luc Djoussé, MD, ScD; Kenneth J. Mukamal, MD; David Siscovick, MD, MPH. Lifestyle Risk Factors and new Onset Diabetes Mellitus in Older Adults. Arch Intern Med. 2009;169(8):798-807. doi:10.1001/archinternmed.2009.21.
 Song Wu, Scott Powers, Wei Zhu & Yusuf A. Hannun. Substantial contribution of extrinsic risk factors to cancer development. Nature (2015) doi:10.1038/nature16166
Received 15 April 2015 Accepted 23 October 2015 Published online 16 December 2015
 From experience I have no doubt that many conditions that are diagnosed as “autoimmune” are nothing more than an appropriate immune reaction to an unidentified trigger that has grown out of control. This is commonly seen with leaky gut syndrome, SIBO and dental infections.
 Although there are hundreds of studies showing that oxidized LDL elicits inflammation from macrophages, it has never been shown whether this is an immune reaction or a healing response.
 Seo SH, Webster RG. Tumor necrosis factor alpha exerts powerful anti-influenza virus effects in lung epithelial cells. J Virol. 2002 Feb;76(3):1071-6.
 Test on mononuclear cells Lymphoproliferative, inhibited NK cell activity, phytohemagglutinin response raises IL2, raises TNF-alpha, IL-2 Kuo YC1, Tsai WJ, Shiao MS, Chen CF, Lin CY. Cordyceps sinensis as an immunomodulatory agent. Am J Chin Med. 1996;24(2):111-25.
 Jong Seok Lee, Eock Kee Hong. Immunostimulating Activity of the Polysaccharides Isonated from Cordyceps militaris. International Immunopharmacology. Vol 11, Isue 9, September 2011 Pp 1226-1233 doi:10.1016/j.intimp.2011.04.001
 Matsui K1, Kodama N, Nanba H. Effects of maitake (Grifola frondosa) D-Fraction on the carcinoma angiogenesis. Cancer Lett. 2001 Oct 30;172(2):193-8.
 Cheuk-Lun Lee, Xiaotong Yang, Jennifer Man-Fan Wan. The culture duration affects the immunomodulatory and anticancer effect of polysaccharopeptide derived from Coriolus versicolor. Enzyme and Microbial Technology. Volume 38, Issues 1–2, 3 January 2006, Pages 14–21
 Hung-Sen Chena, Yow-Fu Tsaia, Steven Lina, Chia-Ching Lina, Kay-Hooi Khoo, Chun-Hung Lin , , Chi-Huey Won. “Studies on the immuno-modulating and anti-tumor activities of Ganoderma lucidum (Reishi) polysaccharides”. Bioorganic & Medicinal Chemistry Volume 12, Issue 21, 1 November 2004, Pages 5595–5601
 Sands BE1, Kaplan GG The role of in ulcerative colitis.. J Clin Pharmacol. 2007 Aug;47(8):930-41. Epub 2007 Jun 13.
 VASANTHI, P., NALINI, G. and RAJASEKHAR, G. (2007), Role of tumor necrosis factor-alpha in rheumatoid arthritis: a review. APLAR Journal of Rheumatology, 10: 270–274. doi: 10.1111/j.1479-8077.2007.00305.x
 Swardfager W, Lanctôt K, Rothenburg L, Wong A, Cappell J, Herrmann N (2010). “A meta-analysis of cytokines in Alzheimer’s disease”. Biol Psychiatry 68 (10): 930–941. doi:10.1016/j.biopsych.2010.06.012. PMID 20692646.by
The net result of the interaction of an organism’s genes with its environment.
In 1953, Watson and Crick’s discovery of DNA was a beacon of hope for understanding what causes human disease. Since then science and medicine have invested billions in research and man hours under the premise and promise that understanding our genetic code would lead us to answers and cures for the leading causes of disease and death. To our surprise, the results have not been so straightforward. As we’ve gained more and more information about our genetic programming, we’ve discovered that genetics plays only a small role in the development of many of the leading causes of chronic disease and premature death. Our antiquated belief that we are destined to fall victim to a disease that ended the life of our parents and/or grandparents has given way to the sometimes difficult realization that we have more influence over the future of our health and our lifespan than we could have imagined.
As more and more research has come online, we’ve discovered that many human diseases are largely a result of external factors that are potentially under our control. A study published in 2004 in The Lancet followed over 15,000 people assessing risk factors for heart attack. The authors identified nine non-genetic risk factors that “collectively accounted for 90-94% of cardiovascular disease and had the potential to prevent the majority of premature myocardial infarction1”. These risk factors were composed of external influences that can all be eliminated including “Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity[i]”.
A study appearing in JAMA in 2008 on 4883 people over the age of sixty-five concluded that 90% of DM2 cases are preventable using 5 lifestyle changes. Diabetes-related risk factors include physical activity level, dietary habits, adiposity, alcohol use, and smoking habits[ii].
As our understanding deepens, it is becoming apparent that perhaps these are not diseases at all but in fact what we call phenotypes.
Since 1998, the statistics regarding cancer risk, which were studied separately by the NIH and WHO, have remained surprisingly steady. Despite thousands of new studies every year the figures stood at approximately 80% environmental (a scientific term for external factors) and 20% genetic. This was concurred in 2014 by The American Cancer Society saying, “environmental factors (as opposed to heredity factors) account for an estimated 75%-80% of cancer cases and deaths in the US[iii]. On January 2nd 2015 this assessment came crashing down with the controversial Science article by Cristian Tomasette and Bert Vogelstein titled “Variation in Cancer Risk Among Tissues Can Be Explained by the Number of Stem Cell Division”[iv]. This was an elegant, groundbreaking study that shined a light on the novel idea that some cancers simply occur because of random mutations during stem cell division. Suddenly, part of the 80% environmental aspect had to be redefined. The authors’ unfortunate choice to assign a new value to the environmental influence in the absence of adequate data parameters was incendiary across the media and scientific community. Six of the top eleven most frequently occurring cancer types were not included in this study. Interestingly, each of the excluded cancer types have a huge body of scientific evidence demonstrating that each of them is highly influenced by environmental factors. Among these cancers were prostate, breast, uterine, urinary bladder, kidney and Non Hodgkin’s Lymphoma, collectively, responsible for nearly 20% or 1/5 of cancer deaths in the US in 2014 and their incidence rate an even higher contribution3. The environmental factors that influence their development include infectious agents[v], endogenous[vi] and exogenous hormones, xenobiotic compounds[vii], certain heavy metals[viii], certain pharmaceuticals, specific industrial and organic chemicals[ix], alcohol consumption[x], glycemic control[xi], and aflatoxin[xii].
One reason the scientific community raised such a fuss about the “bad luck” cancer study was that an inordinate amount of funding and resources is already dedicated to the diagnosis and treatment of cancer. The same goes for many other “diseases” including heart disease and diabetes. After all, each one forms a massive economic base that generates billions of dollars annually. Research funding directed towards the understanding and true prevention of these diseases contributes very little to monthly recurring revenues. Instead, it represents an ominous threat to the economic base of the medical industry as well as any industry whose products might be identified as a risk. Despite the hurdles, advances in our understanding of the processes that create these “diseases” has accelerated so fast that it has created a growing chasm where science and medicine no longer overlap but have diverged. The statistics about the environmental influences on “disease” have been well known in the scientific community for at least 15 years. However, they are poorly acknowledged by the medical industry and, as a result, have remained clandestine to the general public. Chemicals aside, imagine if society truly understood how they could prevent diabetes or delay the onset of heart disease simply by adopting a regimen of glycemic control as described in the studies above. What if it was not based on a drug but was based on reducing their consumption of excess sugar? This one change would have massive reverberations through multiple industries. On one side, there would be reduced “need” for medical services that manage the entire sequela of diseases that are known to be caused by poor glycemic control. This would translate into reduced doctor visits, reduced “need” for pharmaceuticals, fewer hospitalizations, fewer surgeries, lower consumption medical supplies, reduced need for assisted living and in home care, reduction of insurance costs etc. On the other side the industrial farming and food complex would also be widely affected. This includes farming equipment, GPS equipment, chemical fertilizers, pesticides, herbicides, fungicides, GMO seeds, all sugar-laden products, packaging, transportation and distribution, fuel consumption etc. As you can see, a significant base of the economy relies on a mutualistic relationship between Big Farma and Big Pharma. The current medical paradigm actually benefits from environmental problems and generally relegates efforts to fix this to the realm of environmental fundamentalism and quackery.
At what point do we embrace our responsibility of removing the known causes of disease? There are already billions of dollars and man-hours wasted on researching and treating diseases that are created by humans literally poisoning themselves. What is the sense? To continue to protect economic interests cloaked inside a societal dietary lexicon that has been hijacked by mass manipulation of naturally occurring, animalistic addictions through marketing, food additives and advertising? We must focus on removing the factors that create these disease phenotypes. Once this illusion has been cleared we can direct our resources towards novel drugs and therapies that will do the most good. Image a healthy, thriving society where disabled life expectancy is a thing of the past. Where companies and organizations like SENS, Calico and Human Longevity Inc. create drugs that don’t depend on illness but address the factors that are not under our control to produce meaningful lasting advances in health and longevity.
[i] Prof Salim Yusuf DPhil,Steven Hawken MSc,Stephanie Ôunpuu PhD,Tony Dans MD,Alvaro Avezum MD,Fernando Lanas MD,Matthew McQueen FRCP,Andrzej Budaj MD,Prem Pais MD,John Varigos BSc,Liu Lisheng MD,on behalf of the INTERHEART Study Investigators Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study
The Lancet – 11 September 2004 ( Vol. 364, Issue 9438, Pages 937-952) DOI: 10.1016/S0140-6736(04)17018-9
[ii] Dariush Mozaffarian, MD, DrPH; Aruna Kamineni, MPH; Mercedes Carnethon, PhD; Luc Djoussé, MD, ScD; Kenneth J. Mukamal, MD; David Siscovick, MD, MPH. Lifestyle Risk Factors and new Onset Diabetes Mellitus in Older Adults. Arch Intern Med. 2009;169(8):798-807. doi:10.1001/archinternmed.2009.21.
[iii] [iii] ACS (2014). Cancer Facts & Figures 2014, Atlanta. American Cancer Society, 2014. Available at: http://www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf
[iv] Cristian Tomasetti, Bert Vogelstein. Variation in Cancer Risk Among Tissues Can Be Explained by the Number of Stem Cell Divisions. Science 2 January 2015 Vol. 347 no. 6217 pp. 78-81. DOI:10.1126/science.1260825
[v] Yidya Vedham Ph. D., Mukesh Verma Ph. D. Cancer-Assoicated Infectious Agents and Epigenetic Regulation Cancer Epigenetics Methods in Molecular Biology Nov. 8, 2014 Vol. 1238, pp333-354 Doi: 10.1007/978-1-4939-1804-1_18
[vi] Tim Key; Endogenous Hormones Breast Cancer Collaborative Group Steroid hormone measurements from different types of assays in relation to body mass index and breast cancer risk in postmenopausal women: Reanalysis of eighteen prospective studies. Steroids. Oct. 7, 2014. Doi: 10.1016/j.steroids.2014.09.001
[vii] Hye-Rim Lee; Kyung-A Hwang; Kyung-Chul Choi. The estrogen receptor signaling pathway activated by phthalates is linked with transforming growth factor-β in the progression of LNCaP prostate cancer models. International Journal of Oncology. May 22, 2014. Pp595-602 Doi: 10.3892/ijo.2014.2460
[viii] García-Lestón, J; Roma-Torres, J; Vilares, M; Pinto, R; Prista, J; Teixeira, JP; Mayan, O; Conde, J; Pingarilho, M; Gaspar, JF; Pásaro, E; Méndez, J; Laffon, B. Genotoxic effects of occupational exposure to lead and influence of polymorphisms in genes involved in lead toxicokinetics and in DNA repair. Environ Int, 2012 vol. 43 pp. 29-36
[ix] Guo, H; Bassig, BA; Lan, Q; Zhu, Y; Zhang, Y; Holford, TR; Leaderer, B; Boyle, P; Qin, Q; Zhu, C; Li, N; Rothman, N; Zheng, T. Polymorphisms in DNA repair genes, hair dye use, and the risk of non-Hodgkin lymphoma. Cancer Causes Control, 2014 vol. 25(10) pp. 1261-70
[x] Qian Zhong, Ganggang Shi, Yanmei Zhang, Lei lu, Daniel Levy, Shuping Zhong. Alteration of BRCA1 Expression Affects Alcohol-induced Transcription of RNA Pol III-Dependent Genes. Gene Vol 556, Issue 1, Feb. 1, 2015 74-79.
[xi] Juhyun Park; Sung Yong Cho; Young Ju Lee; Seung Bae Lee; Hwancheol Son; Hyeon Jeong. Poor Glycemic Control of Diabetes Mellitus Is Associated with Higher Risk of Prostate Cancer Detection in a Biopsy Population. PLOS Sept. 18, 2014. Doi: 10.1371/journal.pone.0104789
[xii] Xi-Dai Long; Dong Zhao; Xiao-Qiang Mo; Chao Wang; Xiao-Ying Huang; Jin-Guang Yao; Yun Ma; Zhong-Hua Wei; Min Liu; Li-Xiao Zeng; Jian-Jun Zhang; Feng Xue; Bo Zhai; Qiang Xia. Genetic Polymorphisms in DNA Repair Genes XRCC4 and XRCC5 and Aflatoxin B1–related Hepatocellular Carcinoma. Epidemiology Sept 2013, Vol. 24 Issue 5 pp. 671-81. Doi: 10.1097/EDE.0b013e31829d2744by
Here is a link to my presentation. SENS6 Karen Kurtak
Hello all! This is my first presentation at a major international conference. It’s very technical but there are pieces that clarify in non-biochemical terminology . Here I present an argument for why the primary diseases of aging are not “diseases” at all but, in fact, phenotypes. I also discuss how the ketogenic diet alters signaling of DNA through nuclear transcription factors to stop, and sometimes reverse, the processes that ultimately lead to the primary “diseases” of aging including diabetes, heart disease, cancer, Alzheimer’s Disease. It was a lot of information to cover in 15 minutes but it offers a rough outline of the biochemical mechanism of action of the ketogenic diet. This took me literally over 1000 hours of sorting through science articles and plugging in the pieces until it all began to make sense. Along the way I found multiple journal articles that were completely wrong that led me down frustrating rabbit holes. Grrrr! For more extensive information please see my article that will be published in Rejuvenation Research Journal. Ultimately, this is just one example of the amount of information we already possess that is independent of clinical trials. Since I was limited to 2000 words in the article, I will be discussing each of these points in more detail in the coming months.
Thanks to Bill Andrews, who in his quest to cure aging or die trying, asked me a question that I couldn’t answer. Thank you to Aubrey de Grey for your vision that has created a firm foundation of understanding of the processes that lead to disease and aging. Thank you to all the humans of the Earth who have dedicated time and money towards uncovering truth and knowledge through science. Thank you to journals who don’t limit access of knowledge by creating pay walls. Elsevier, you guys are self-serving hijackers of knowledge. Thank you Markdavis and mmkroll for your open access photos on Flickr. Thanks to Nick, Robyn, my parents, Doreen, Bob, Michelle, Jordan, Michelle, Cliff, Darcie, Paula, Randi, Sue, Beth and Lara who supported me through multiple meltdowns and temporary possession by the Demon of OCD. Thank you Rozyln, William, Bill, (Bill’s brilliant wife whose name has escaped me), Dr. Cai, and everyone else who cheered for me before or during the conference!!!
In November of 2013 there was a media feeding frenzy when a large study demonstrated that people who ate even small amounts of nuts had an overall “7% reduced risk of dying from any cause during the 30 year study.”(Health Day from Medline © 2013). It also revealed that the more nuts people ate the more they reduced their risk of dying peaking at a 20% reduction for the highest consumers. Previous studies have demonstrated that eating nuts reduces incidence and risk for diabetes, heart disease, memory loss and obesity. (I”m not referencing these because there are too many to sift through).
There are several possible explanations for this but only time will tell. Here are a couple. First, fats, unlike protein and carbohydrates, have a unique ability to signal fullness. Fats do this through a chemical called leptin. It’s possible that simply eating nuts helps to reduce overconsumption of other foods. Second, omega-9 fats, which are predominant in nuts, send signals that talk directly to your DNA to reduce inflammation and cholesterol production, and increase the effectiveness of insulin. As I discuss in my article in Rejuvenation Research Journal, this works through a switch on the cell’s nucleus called PPAR which we know is activated by omega-9 oils. doi:10.1089/rej.2013.1485
In conclusion, eat at least a handful of nuts per day. Not seeds, nuts. Olive oil also contains the same beneficial oils. Try eating nuts before dinner. Since the fats help to signal fullness, it may help to reduce overeating. Later, I will discuss the nuances of deriving maximum benefit from nuts.by