Health & Fitness

08/16/20

An online COVID-19 symptom tracking tool developed by researchers at Georgetown University Medical Center ensures a person's confidentiality while being able to actively monitor their symptoms. The tool is not proprietary and can be used by entities that are not able to develop their own tracking systems.

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Scientists identify the order of COVID-19's symptoms

Task force examines role of mobile health technology in COVID-19 pandemic

Is the COVID-19 virus pathogenic because it depletes specific host microRNAs?

Frequently used serology test may not detect antibodies that could confirm protection against reinfection of COVID-19, study shows

Pregnant mother's immunity tied to behavioral, emotional challenges for kids with autism

Children with autism born to mothers who had immune conditions during their pregnancy are more likely to have behavioral and emotional problems, a new study has found. Offspring sex may also interact with maternal immune conditions to influence outcomes, particularly in terms of a child's cognition.

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Frontline Nurse Speaks Out About Lethal Protocols

In this interview, retired Army combat veteran Erin Marie Olszewski, a nurse who for several months treated COVID-19 patients at the Elmhurst Hospital Center, a public hospital in Queens, New York — the epicenter of the pandemic in the U.S.

She has now written a book, "Undercover Epicenter Nurse: How Fraud, Negligence, and Greed Led to Unnecessary Deaths at Elmhurst Hospital,"¹ which details her experiences.

Olszewski was born in Michigan and raised in a small Wisconsin town and joined the military at 17. When 9/11 happened, she was in basic training. "I was only 18 years old so I grew up pretty quickly," she says.

Altogether, she was stationed in Iraq for just over a year. Upon her return to the U.S., she worked at the Special Operations Command in Tampa, Florida, before leaving the military and going into nursing. Just a bit over 20 years ago, July 2000, I read a study by Dr. Barbara Starfield² published in JAMA. It contained stats that identified physicians as the third leading cause of death.

I created that headline in July 2000, which took off as a meme and spread across the world. In a shocking follow-up to Starfield’s article, in 2012 her husband wrote a disturbing article in the Archives of Internal Medicine³ about her death, pointing to a drug she was taking as a possible contributor to it.

“Specialization, fragmentation, drug-orientation and profit-seeking help make American medical care the most expensive in the world, but not the safest or most effective,” Dr. Neil A. Holtzman wrote. "The lessons from Barbara’s death should be put in the perspective of the millions who cannot afford even basic services in our expensive system and suffer as a result.”

As if that's not egregious enough, newer death statistics reveal the situation has only gotten worse over the years, and Olszewski's experience during the COVID-19 pandemic demonstrates just how much more dangerous medicine has become.

"I did go into this profession to help people … [but] it did not take me long to realize that we're literally just pumping our patients full of medications. Most of my job was morning meds, afternoon meds, night meds ... [and] tests.

I've always had a passion for more of a natural approach to health and it was devastating to me to realize that I wasn't really helping these patients, I was contributing to the problem," Olszewski says.

"I always had that mindset as a nurse: How can I get these patients to look through these meds and talk to the doctors and advocate for them to get them off of all this?

I would hit a lot of roadblocks and so I ended up going to work at a private practice where doctors were more concerned about not so much profit, but the people. I always continued along those lines. Fast forward to this year, we were essentially laid off from our jobs.

In Florida, we did it right. We didn't ban any of the alternative treatments. They left it up to individual hospitals to make up their own minds, so that's why we were very successful, whereas New York was not."

Medical Negligence Was the Norm

As the COVID-19 pandemic progressed, New York, being a hotspot, was in desperate need for skilled nurses, so Olszewski ended up volunteering and went to work at Elmhurst in April 2020. "It was still extremely packed in these hospitals with pretty much every single person on a ventilator," she says.

Curiously, when she got there, she was told she'd have to wait days for her assignment. Normally, in times of war, you're expected to immediately get to work. This was the first red flag suggesting all was not as it seemed. Some of the nurses had waited in hotel rooms for 18 days before they received their assignments.

"Why weren't they utilizing their resources, complaining that they didn't have enough help when [there were] … 1,000, 2,000 nurses sitting around in New York waiting for an assignment? That was very confusing to me. If indeed this was essentially a war zone, people are literally dying left and right, why aren't they utilizing us?

I finally did get an assignment and they put me at Elmhurst Hospital … I got there and literally it took me one shift — 12 hours — to realize that this is absolute chaos, and not because we didn't have enough staff.

We were well staffed. It was because nobody cared. I literally felt like I was living in the twilight zone. And, just knowing what I know about our system anyway on a good day, this was just absolute negligence."

Clearly, when you go into the hospital, you are at great risk of medical mistakes that can accidentally kill you, and Olszewski's experience highlights one of the key problems: willful gross negligence. This is why it's so crucial to make sure you have an advocate with you around the clock who can speak for you, ask questions and ensure you're getting the appropriate treatment.

Due to COVID-19 infection concerns, family members were excluded from the process here. They simply weren't allowed in. To me, that was probably why so much of this abuse was able to occur. Olszewski agrees, saying:

"That's exactly right. On top of that, they created a liability-free environment. So now you have a liability-free environment where everybody knows that no matter what they do, they're not going to get in trouble for it. We have no family around putting us in check …

You've got doctors and nurses that, at that point, just didn't care because everybody was going to die anyway so what's the point? And then you have everybody on a ventilator. So, these patients can't even speak for themselves. They're at the hands of whoever is taking care of them.

How do you sit by and allow this to happen? I don't know how so many people knowingly knew this was going on and just chose to remain quiet. It's just really sad."

Routine Ventilation Was a Death Sentence

By the time Olszewski started working at Elmhurst in April, doctors around the world, including the U.S., had already started raising questions about the routine use of mechanical ventilation for COVID-19 patients. Within weeks, many started arguing that it appeared to be doing more harm than good.

That certainly proved accurate at Elmhurst. In a four-week period, Olszewski only witnessed one patient put on mechanical ventilation who survived, and that's because the sedation didn't quite take and he ended up extubating himself. The sad tragedy is he didn't have any medical indications warranting him being placed on a ventilator to begin with.

Essentially, being put on a vent is the kiss of death and, according to Olszewski, the staff at Elmhurst were aware of that. So, within her first week, Olszewski spoke to an attorney and began secretly videotaping her findings and interactions with the staff at Elmhurst. This was necessary so that the public would believe her story. She explains:

"Like I said, it didn't take me more than a shift to realize what was going on. I got back to my hotel room and just broke down in tears … I couldn't even believe it. I have a lot of nurse friends and I asked them to hop on a Zoom call with me and I just let it all out.

One of them is a nurse practitioner, and she ended up kind of being my proxy. She did a live video and it went pretty viral … She got gaslighted by everybody. She had death threats. Everyone said she was making it up.

So, I had contacted an attorney after a few days of seeing what was going on with her, just trying to get my message out. And I'm like, 'Listen. No one's going to believe what's happening here because they don't believe her … The only way the public is ever going to be able to take this seriously and believe what I'm saying … is with actual video.'

I had already tried to go up the chain of command and everybody would just tell you, 'Just be quiet or you're gone.' You were considered a troublemaker if you tried to advocate for your patients, and you were pretty much shunned … There were nurses sent home prior to me getting there, for doing the same things …

Ethics essentially just went out the window. My attorney actually ended up getting me a pair of spy glasses in order to videotape and they fit in with the rest of the PPE so it was never really questioned …

It was pretty terrifying, but at the same time I'm going in there, looking at my patients like, 'You know what? You guys deserve justice. This should have never happened, and I hope history never repeats itself ever again.' That was the mission.

People need to know the truth and those that thought this was OK need to be held accountable for these actions. In our profession, we're supposed to be there for the patients. We're supposed to act with integrity and compassion and none of that was happening."

Nurses Fired for Protecting Patients

As a general rule, nurses, who are in the trenches day in and day out, are far more knowledgeable about the practical details to optimize patient care than most physicians, who may understand the science better but typically fail to appreciate critical implementation variables.

Nurses who are in the trenches day in and day out typically know what works and what doesn't. I can remember many times during my own medical residency where nurses would correct decisions that, if implemented, could have harmed the patient.

So, skilled nursing staff are really crucial components that help keep patients safe. Unfortunately, in this case, nurses were routinely overruled and ignored. According to Olszewski, she had many conversations with her coworkers, all of whom said the same thing. They just couldn't believe what was happening.

"I actually recorded a lot of those conversations too just because I didn't want people to think it was just me," she says. "Really, everybody thought 'This is not OK.' But everybody was afraid to say something … There are a lot of upset people and they try to hurt you and silence you in any way that they can."

Olszewski was ultimately fired from Elmhurst for speaking out about the conditions there. There are also petitions to remove her nursing license. That, it seems, is a commonly used way to silence the opposition these days. Olszewski vows to fight to keep her license.

Medical Experimentation by Residents Killed Patients

Making matters worse, many of the doctors treating COVID-19 patients at Elmhurst were first-year residents, many of whom had never interacted with patients before. According to Olszewski, many had "zero bedside manner" and approached their patients as little more than "something to practice on." "There were not many of them that really had compassion for these lives," she says.

Typically, private hospitals do not have medical residents treating patients, and if they do, they're strictly supervised. Elmhurst Hospital, however, is a training hospital, and according to Olszewski, residents had virtually no supervision at all. "I very rarely saw an attending, so it was the residents running these floors," she says. Worse, the residents were not leaning on the expertise of the nursing staff.

"We couldn't even leave our patient's room because [the residents] would come in and dial the ventilators, they'd mess with our drips. We had to lock our pumps because they would just come in and change it. That's unheard of on a normal day. Physicians never touch our pumps or ventilators without letting us know."

When asked why residents would behave so inappropriately, Olszewski replies:

"A lot of ego, a lot of, 'They're going to die anyway so we just want to experiment and see what works and what doesn't.' There were a lot of errors being made and unnecessarily causing a lot of death. And I can't explain it. Like I said, [you had a] liability-free environment … [and] these residents weren't being monitored by the attending doctors …"

Lack of Segregation Led to Unnecessary Deaths

The refusal to segregate infected patients from noninfected ones also undoubtedly worsened the situation, placing lives at risk. In a perfect scenario, infected patients would have been isolated in negative pressure rooms, since the normal ventilation system can circulate the virus throughput the hospital.

Still, by rooming infected and noninfected patients together, you virtually ensure the disease will spread to noninfected patients being treated for other health conditions.

Nurses also were not changing their personal protective equipment (PPE) between patients. The same PPE was worn all day long. Elmhurst didn't even have regulations requiring fresh PPE between patients or when going from one room to the next.

COVID-Negative Patients Placed on Ventilation

Perhaps most egregious, COVID-negative patients were listed and treated as confirmed positive, and some were even placed on mechanical ventilation. One of them was a male patient admitted for high blood glucose, which is easily remedied and under no circumstance would require ventilation. Olszewski tells the story:

"They ended up giving him a lot of different psych drugs which, ultimately, just kept that blood sugar going up and up. And, instead of treating that, they ventilated him.

They put him on our COVID ICU floor, which is unheard of. And he's anxious, so they have him tied down to the bed in restraints, which makes anybody even more anxious. You can't have any family in there, there's a bunch of nurses telling you to be quiet. Anyone's going to fight in that type of situation. You're terrified to be there in the first place …

I was in there just trying to hold his hand, talk to him, calm him down, and one of the residents comes in saying 'If you don't calm down, we're going to have to put a tube down you to help you breathe.' I was just like, 'What are you doing? He doesn't need that.' Within five minutes of my leaving for the end of my shift, he was on a ventilator. That right there, that's just negligence."

New York Had Adequate Resources That Went Unused

The same medical fellow also refused to allow another patient to be resuscitated, even though he did not have a do-not-resuscitate (DNR) order. A fellow is someone who has completed their formal medical training, graduated medical school, internship, and residency, and is doing a sub specialty in some discipline of medicine. So, you'd expect a fellow to act more responsibly than that.

"At that point, nobody really cared anymore," Olszewski says. The doctors expected all patients to die anyway, and there was no liability for anything that was being done or not done. Unfortunately, there was a clear financial incentive for treating noninfected patients as COVID-19 patients, and placing them all on mechanical ventilation. As explained by Olszewski:

"They essentially turned Elmhurst into an all-COVID hospital … If they were going to admit somebody, they were either COVID positive or they were awaiting their test results. So, they would be admitted as 'COVID rule-out' and the hospital would still get the kickback. It was $13,000 to admit a patient to the floor.

Some of these people, like the one that was unnecessarily vented, he could have gone to the Navy ship Comfort, knowing he was negative for COVID-19. They knew that. But they still admitted him, got the $13,000 and then ventilated him for another $39,000. This was happening consistently.

There's no reason these patients had to be packed in like sardines when we had external resources that weren't being utilized. So why? … Maybe it was the financial incentive … That's just people just not caring and putting profit over these patients."

Death Rate Plummeted Once Treatment Protocols Were Exposed

While Olszewski has been largely ostracized by her nursing colleagues, most of whom likely fear losing their jobs if they openly side with her, the death rate at Elmhurst plummeted after Olszewski's undercover videos started making the rounds on social media.

Her hour-long interview in the "Perspectives on the Pandemic" series, which has 1.4 million views,⁴ was released to the public June 9, 2020. Daily death rates in New York City hospitals dropped dramatically after that.⁵

"I personally think that this has had an impact on the deaths in New York because after that video went out and they were outed on their treatment protocols, the death rate plummeted,” Olszewski says.

I think they're a lot more cautious about who they're admitting to these hospitals and how many people are being put on the ventilators [now]. In early April when I got there, I questioned a doctor that I also recorded and he admitted that not one patient had been successfully extubated.

So, by the time I got there, every single patient on a ventilator died. And they refused to try any alternative treatments even though we know a lot of alternative treatments existed. Their excuse was that they didn't work. And my question was, 'Listen, if you know the ventilators aren't working, then why not try [the alternatives]?'"

Government Should Not Interfere in Medical Decisions

The tragedy is that hydroxychloroquine with zinc likely would have made a significant difference if routinely used in the early stages of disease, and in suspected cases. It clearly was helpful in Florida, where some doctors have been using it.

Quercetin also works similarly to hydroxychloroquine. Both drive zinc into the cell, and quercetin, being a supplement, doesn't require a prescription and also has other effects, such as SIRT2 activation and decreasing inflammation, which actually make it a better choice. However, like hydroxychloroquine, quercetin must also be used with zinc — and administered very early in the course of the illness.

Still, considering asymptomatic patients were being roomed with those who had confirmed COVID-19, either of these options could have protected many of these patients. It's really incomprehensible that a treatment has been so badly maligned, to the point that pharmacy boards have refused to fill prescriptions for a drug that's been on the market for more than six decades.

"I think every patient has a right to try multiple different alternatives," Olszewski says. "High-dose IV vitamin C [has also] successfully treated patients in Asia and some people in New York when [the pandemic] first started. Why are these alternative treatments being frowned upon?

Has this caused even more deaths? Honestly, government shouldn't ever get involved in the doctor-patient relationship. People should be able to have a choice and the freedom to be able to have these alternative treatments available to them if they can save their life.

Autonomy and patient rights are just gone … Patients deserve to be treated like humans, and politics and profit should never be placed above human life, ever."

One of the most effective treatments to date in the hospital setting appears to be the MATH+ protocol, which includes high-dose vitamin C, steroids, thiamine and heparin. It has protocols both for early intervention and late-stage disease.

However, I plan on posting an update to the nebulized hydrogen peroxide video as I have modified the recommendation. I've had a number of people use it with very severe disease and recovered from the symptoms in a matter of hours. I had no idea this treatment was so effective.

Fortunately, since Olszewski started speaking out, others have braved the backlash and spoken out about medical mismanagement as well. One of them is featured in the video below. Warning though the video is very emotional and the nurse uses some understandable profane language.

On the downside, physicians at Elmhurst who were responsible for implementing orders that led to patients' deaths may or may not be held liable for their actions.

"There are some clauses in that order that gross negligence is liable," Olszewski says. "Families are coming forward and many of them are very upset, so maybe, hopefully, there will be a federal investigation and there will be accountability for these actions. I feel there should be."

To learn more about what went on at Elmhurst, be sure to pick up a copy of "Undercover Epicenter Nurse: How Fraud, Negligence, and Greed Led to Unnecessary Deaths at Elmhurst Hospital," slated for release August 18, 2020.

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Right Kind of Stress Can Make You Resilient to COVID-19

Dr. Mercola Interviews the Experts

This article is part of a weekly series in which Dr. Mercola interviews various experts on a variety of health issues. To see more expert interviews, click here.

Siim Land has written an excellent book called “Metabolic Autophagy: Practice Intermittent Fasting and Resistance Training to Build Muscle and Promote Longevity.”¹ It’s a valuable synergetic companion to “Fat for Fuel,” as it delves into some areas I did not cover. It compiles and presents all the basic science you need to know in a digestible format.

Here, we discuss his latest book, “Stronger by Stress: Adapt to Beneficial Stressors to Improve Your Health and Strengthen the Body,”² which came out July 26, 2020. It reviews the really important concepts of hormesis and antifragility.

“Part of the reason I wrote the book was to help people become more resilient and more robust, because the world we live in is full of unpredictable challenges,” Land says.

“Pandemics and viruses are part of them, but there's also other potential dangers like global warming or fluctuations in temperature, different kinds of physical challenges that have been a part of the human condition for eons.

The modern human has become somewhat more fragile towards those things, and this kind of goes to show why most people just overreacted to the coronavirus and were really scared.

The book itself was meant to create more resilient people in the face of these unavoidable challenges of life, because you can't really avoid them. You can't create this bubble society where everything is perfect. We all come across different kinds of stressors all the time.”

Stronger by Stress

As it pertains to COVID-19, evidence suggest if you can get two key variables right — a vitamin D level of at least 30 ng/mL (75 nmol/L) and metabolic flexibility — your chances of getting sick from SARS-CoV-2 infection is fairly remote. But improving your resilience against stress is also important.

“If your body is unfit or lacking key nutrients, then even the smaller stressors in your life are going to become more dreadful. You're going to experience chronic stress, and you're going to overactivate the sympathetic nervous system, even if you're stuck in traffic or if you spill a cup of coffee or whatever it is.

These small stressors can become really massive if your body is incapable of dealing with those stressors. On the other hand, if your body has been exposed to the right amount of stress at the right time, then it has also built up this higher level of stress adaptation and resilience. So, the small stressors are becoming literally meaningless. You have a bigger capacity to face even the larger stressors.”

What Is Antifragility?

Antifragility is a term coined by economist Nassim Nicholas Taleb in his book, “Antifragile: Things That Gain From Disorder.” The term describes a state that is the opposite of fragility. Antifragility describes how stress makes you stronger rather than breaking you down or apart.

“[Antifragility] isn't precisely the same thing as robustness or resilience,” Land says. “Something that is robust is something like a piece of stone or a metal. You can heat it, you can drop it on the ground. It’s not going to break, but it's going to stay the same, it's not going to change, whereas something that is antifragile is going to gain from the stress.”

Time-Restricted Eating Builds Antifragility

One of Land’s favorite tools for health and longevity is intermittent fasting, or more accurately termed, time-restricted eating, and one of the reasons for this is because it allows you to become metabolically flexible and insulin sensitive, which builds your antifragility.

“A [2019] study in the New England Journal of Medicine found intermittent fasting mimics a lot of the same effects of calorie restriction. It can actually be somewhat more beneficial because it not only has life extension benefits, but it also turns on certain key defensive mechanisms inside a body that make it more antifragile and also provide additional health benefits.

One of those things has to do with autophagy, but there's also things like increased glutathione, increased NRF2, sirtuins and NAD and many other longevity-boosting and immune-strengthening pathways that get activated when you're fasting that don't necessarily get activated when you are restricting calories.”

So, time-restricted eating is a great way to get the benefits of calorie restriction without experiencing the negative side effects from it, because extreme and prolonged calorie restriction can also leave you vulnerable and more fragile by triggering muscle loss, for example.

That will actually shorten your life span and make you more vulnerable to potential dangers in your environment, such as falling and breaking your hip. Intermittent fasting can sidestep these negative side effects.

Time-Restricted Eating for Muscle Building

A persistent question surrounding intermittent fasting is what the best strategy is. Should you eat just once a day, or can you get away with two or more meals as long as you eat it all within a certain time window? And, if so, how long can that window be? Land comments:

“I think there isn't inherently much difference between eating one meal a day or doing the 16-to-8 type of intermittent fasting where you eat twice a day within eight hours because, already, if you're fasting within one 24-hour period, then the fast itself isn't substantially different. The amount of autophagy wouldn't matter that much either in such a short timeframe, as long as you're still healthy.”

Now, if your intention is to build muscle, having two meals a day, within a six- to eight-hour window, would make more sense. Having just one meal a day is likely better if you are seeking to lose weight, but might be challenging.

This is likely for the simple reason that you’re only going to build muscle when you activate mTOR, and to activate mTOR you need to introduce protein and leucine or branched-chain amino acids, along with some healthy carbohydrates.

If you eat twice, six hours apart, you can activate mTOR twice a day, thus allowing you to get better muscle-building benefits. As explained by Land:

“What determines your muscle growth throughout the 24-hour period is the balance between mTOR stimulation and autophagy. So, if you're eating only once a day, then the amount of mTOR stimulation is relatively small compared to eating twice a day or three times a day.

That's why if someone has the goal of increasing their muscle mass, maintaining muscle mass or preventing sarcopenia, then for them it is much wiser to incorporate more frequent meals. For them I would say that a 16-to-8 type of fasting where they eat twice a day is perfectly suitable, and is actually better than the one meal a day.

It becomes increasingly more difficult to maintain muscle mass if you're already predisposed to sarcopenia and you're eating once a day, because there's a threshold of how much mTOR you can stimulate per meal, and how much muscle protein synthesis you can create per meal as well. It doesn't have to mean that you start eating six times a day. Increasing the eating window is generally a better idea.

For most people, I would say that the 16-to-8 type of fasting, where they fast for 16 hours and eat within eight hours, is a really good balance between getting a daily stimulation in autophagy, while at the same time also stimulating enough mTOR and being able to build muscle."

I found this advice personally helpful as I was pushing my eating window to four hours, but after Land related this commonsense strategy, I extended it to six to eight hours, which actually is easier on the kidneys. Also, as noted by Land, pushing your eating window to be excessively narrow can backfire and slow down your metabolism.

In the context of stress adaptation and antifragility, if your body becomes too accustomed to the fasting because you’re eating only one meal a day all the time, then that can eventually slow down your metabolism and lower thyroid functioning. This in turn makes you more prone to insulin resistance, which is exactly what you’re trying to avoid by eating just once a day.

Carbs Aren’t All Bad

While carbs have gotten a bad rap, they are still an important part of your diet. In fact, when you're seeking to stimulate mTOR, carbs may be just as important as protein, because insulin secretion is a powerful activator of mTOR.

I believe carb cycling can be highly beneficial in this respect. If you’re chronically low-carb, it will provide you with significant benefits initially, but long-term, it can backfire. Land explains:

“Carbs can be useful for muscle growth, but they're not a necessary part of it. You can stimulate mTOR and build muscle with protein only … but the insulin is still a very powerful anabolic hormone and it does help. It is possible to build muscle with a low carb or a ketogenic diet, but at the same time carbs can be also useful.

I do believe that chronic ketosis isn't necessarily the best solution either, especially for metabolic flexibility because there are a lot of studies showing that chronic ketosis can eventually lead to insulin resistance or some mild forms of it …

I believe a more flexible approach is better in the long-term because you're able to still use both. You're still able to become a fat burner while at the same time you don't become insulin resistant towards carbs either, and you can incorporate both.

In practice that would mean that people can do some form of cyclical keto diet, where they eat keto on some days but also incorporate some days where they eat more carbs to kick themselves out of ketosis, as well as break this mild insulin resistance that may develop. I myself like to eat keto on days where I'm not working out.

So, on my rest days where I don't have a lot of physical activity, then it's perfect to stay in ketosis and eat low carb because my body isn't burning that many carbs for fuel either, whereas on days where I do high-intensity training or some resistance training, or on days when I want to really stimulate mTOR, and on those days, I'll just have more carbs because the body uses carbs and glycogen during a workout.

If you eat carbs after a workout, then the body is already primed to use those carbs more efficiently instead of storing them as fat or instead of developing diabetes from it. So, it's a perfect time to strategize or time your carbohydrate intake around your exercise.

Your body is the most insulin sensitive after a workout because the muscle contractions activate the glucose transporter GLUT4. Then you don't even need insulin to shuttle carbs into muscle cells either. So that's why having some carbs around a workout itself won't necessarily be harmful as long as you are still metabolically flexible and you have metabolic health.”

Land’s explanation above caused me to change my own carb cycling to a more optimal schedule. While nothing is set in stone and listening to your body is important, if you are not insulin resistant, I believe cycling in carbs once or twice a week and remaining low-carb, below 50 grams per day, the rest of the week is a good strategy, as nutritional ketosis has so many profound metabolic benefits.

That said, if you’re already insulin resistant, as 90% of the population is, or diabetic, then adding carbs will be counterproductive, so it’s important to assess your individual situation. If your metabolic flexibility is already good, then being on a restrictive low-carb diet isn’t really necessary anymore.

Hydroxy Methylbutyrate

One excellent reminder in Land’s book is the importance of hydroxy methylbutyrate (HMB), a metabolite of the branched-chain amino acid leucine, which is the most potent stimulator of mTOR. To activate mTOR and boost muscle protein synthesis, you need a significant quantity of leucine, at least 3 grams.

I have a kidney damage from mercury poisoning that limits me from eating high amounts of protein. The beautiful thing about HMB is it doesn’t stress the kidneys. After reading “Stronger by Stress,” I started adding HMB to my breakfast as I wasn’t getting the minimum dose of leucine needed to activate mTOR. Since then, I’ve noticed a significant change in my body's ability to create more muscle mass. Land comments:

“Using leucine or HMB can be really useful for getting more protein synthesis from less protein. You can get away with eating less protein and still getting the benefits of the mTOR stimulation. But I would say that leucine itself could be better than HMB by itself.

HMB has some anticatabolic effects, but most of those effects are mediated by leucine and mTOR itself. You could use both, but if you want to get more benefits from the mTOR and muscle growth, then leucine is probably more important than HMB.”

The Benefits of Heat-Shock and Cold-Shock Proteins

“Stronger by Stress” also delves into the science of heat-shock proteins and cold-shock proteins, activated by exposure to heat and cold respectively. Heat-shock proteins repair misfolded proteins and RNA, increase glutathione and promote autophagy, among other things.

Cold-shock proteins also activate antioxidant defense mechanisms, and lower inflammation and oxidative stress. Born and raised in Estonia, Land is familiar with the cold, and embraces cold exposure for its physical conditioning and mental toughness benefits.

“If you are habitually engaging in cold exposure throughout the entire year, then the winter itself becomes a piece of cake. It becomes less stressful on yourself and it becomes less damaging. You're able to adapt to it faster than normal people.

If you're constantly using central heating or you're using the heating in your car and you're never really exposed to the cold for any longer than a few minutes, then you're missing out on the benefits of the cold shock proteins. You're also making your body more vulnerable and more fragile, back to the original point that we talked about.

So that's why I do it. The mental aspect is also really great. I used to take a cold shower every morning, and it really helped me develop more self-discipline and self-control.

The rationale for me was that if I'm able to start the day with a cold shower, then anything else for the rest of the day is going to be that much easier because I already climbed over this initial challenge.”

Muscle Building Is Essential to Avoid Sarcopenia

In the interview, Land reviews some of his recommendations for high-intensity resistance training, such as doing multiple sets, split training and other strategies that are also covered in his book. As noted by Land, maintaining muscle and keeping physically active is probably one of the best things you can do to extend both your life span and health span.

Age-related muscle loss, called sarcopenia, is a significant threat to health that virtually no one can escape. Use it or lose it applies here, and muscle is far easier to lose than gain, and its lost much faster than you can build it.

For this reason, I strongly recommend strength training for all ages, especially the elderly. The good news is you can effectively build muscle without risking injury from heavy loads by using blood flow restriction (BFR) training. In Japan, where the technique was developed, it’s known as KAATSU. You can learn more about the fascinating history of BFR in my interview with Steven Munatones, who brought this fitness system to the U.S.

It’s important to realize that sarcopenia is not just cosmetic, and it’s not just about frailty. Your muscle tissue, which makes up about half of your body’s tissues, is a metabolic organ, an endocrine organ. Your muscle tissue makes cytokines and myokines, and is a sink for glucose.

Insulin resistance and Type 2 diabetes accelerate sarcopenia, and research shows glucose fluctuations are independently associated with this condition. As noted in one 2019 study,³ “glucose fluctuations were significantly associated with a low muscle mass, low grip strength, and slow walking speed.”

The effectiveness of BFR for the prevention and reversal of muscle wasting is directly addressed in an April 2019 study⁴ in the Journal of Cachexia, Sarcopenia and Muscle:

“Muscle wasting leads to significant decrements in muscle strength, cardiorespiratory, and functional capacity, which increase mortality rates. As a consequence, different interventions have been tested to minimize muscle wasting.

In this regard, blood flow restriction (BFR) has been used as a novel therapeutic approach to mitigate the burden associated with muscle waste conditions.

Evidence has shown that BFR per se can counteract muscle wasting during immobilization or bed rest. Moreover, BFR has also been applied while performing low intensity resistance and endurance exercises and produced increases in muscle strength and mass.

Endurance training with BFR has also been proved to increase cardiorespiratory fitness. Thus, frail patients can benefit from exercising with BFR due to the lower cardiovascular and join stress compared with traditional high intensity exercises.

Therefore, low intensity resistance and endurance training combined with BFR may be considered as a novel and attractive intervention to counteract muscle wasting and to decrease the burden associated with this condition.”

BFR Summary

For a detailed discussion about the benefits of BFR and how it can be done, see “Build Muscle Faster, Safer and Easier With BFR Training.” In brief, BRF involves exercising your muscles while partially restricting arterial inflow and fully restricting venous outflow in either both proximal arms or legs.⁵

Venous flow restriction is achieved by using thin elastic bands on the extremity being exercised. By restricting the venous blood flow, you create a relatively hypoxic (low oxygen) environment in the exercising muscle, which in turn triggers a number of physiological benefits, including the production of hormones such as growth hormone and IGF-1, commonly referred to as “the fitness hormones.”⁶

It also increases vascular endothelial growth factor (VEGF), which acts as “fertilizer” for growing more blood vessels and improving their lining (endothelium).

I believe BRF is one of the best strategies available to address the epidemic of sarcopenia,⁷ and for most people who are not competitive athletes it may be the only form of resistance training they need. Land, like me, is a big fan of the KAATSU system,⁸ and uses it every day.

“If I'm not doing an actual workout with them, then I'll just use the KAATSU cycle, the on and off pressures. So even if I'm not doing an actual exercise with them, then I'll still do the cycle to pump more blood into the muscle and accelerate recovery.

On other days, I'll use [the bands while doing] biceps curls and pushups. With the legs, I'll do squats and lunges, or just regular walking. I really enjoy them and I find that they accelerate recovery. Even if it's not for the exercise performance, I think the cardiovascular effects are still worthwhile.”

Bad Fats Are Worse for You Than Sugar

Land also discusses the benefits and importance of omega-3 fats, and the hazard of vegetable oils and oxidized, rancid fats. It’s important to realize that both omega-3 and omega-6 oils are integrated into your cell membranes.

While omega-3s make your cell membranes healthier, omega-6 fats from vegetable oils wreak havoc with your cellular metabolism, and have a half-life of 600 to 680 days, as explained in my interview with Dr. Chris Knobbe. I firmly believe, as does Land, that harmful oils and fats are far more hazardous to your health than added sugar and grain carbs.

“The aspect of lipid peroxidation itself is also accelerating aging and causes carcinogenesis and also leads the creation or the accumulation of lipofuscin, which is this age-related wear and tear pigment,” Land explains.

“Lipofuscin also begins to cause cellular damage and inhibits autophagy. Again, once you have bad fats stuck inside your cell membranes, then burning fat itself also becomes an inflammatory act.

So, if you are fasting while you have bad fats inside your cell membranes, then you are leaching those same bad fats into your system, and that's why you may get a lot of detox symptoms. You may actually feel worse from fasting or ketosis just because you're burning the wrong fats that are stuck inside your body fat.”

One simple way to tell whether you might have a lot of bad fats in your system is to look at your skin. The dark so-called “age spots” or “liver spots” many have are caused by lipofuscin. Those spots can eventually disappear if you clean up your diet.

More Information

We cover a lot of ground in this interview, as we review many of the topics Land covers in his book. For example, we touch on the harmful impact of high iron, which in conjunction with lipid peroxidation is particularly disastrous; the importance of sleep and nose breathing; and how to avoid mouth breathing while asleep.

We also discuss senolytic therapies — strategies that remove senescent (old, damaged) cells, thus providing antiaging benefits. One of the most effective senolytic therapies, in Land’s opinion, is intermittent fasting. Cyclical ketosis also helps clear out senescent cells, and certain compounds, such as curcumin, EGCG, quercetin, resveratrol, sulforaphane and allicin have senolytic effects.

Because fasting is a powerful senolytic therapy, these compounds are best taken while you’re fasting. So, for example, provided you’ve eaten your last meal early enough in the evening, take your supplement right before you go to bed. That way, it can work for another several hours while you’re sleeping.

Land also discusses how autophagy and nutritional ketosis may help protect against EMF damage. To learn more about all of these topics that we’ve merely scratched the surface of here, be sure to pick up a copy of “Stronger by Stress,”⁹ which is a great follow-up to and continuation of “Metabolic Autophagy: Practice Intermittent Fasting and Resistance Training to Build Muscle and Promote Longevity.”¹⁰ Both are excellent and well worth reading. In closing, Land reminds us:

“It's important to engage in these small stressors that have a hormetic effect on a regular basis because they're not permanent. You're going to lose them if you don't use them. So, if you don't use the sauna, then you're going to lose your ability to tolerate heat. The same applies to exercise, to fasting.

Those things should be a part of your regular lifestyle. They are really beneficial for your overall longevity as well as just resiliency against stress. So, I personally feel that doing intermittent fasting, cold showers, heat exposure — all those things have helped me tolerate stress in other areas of life much better.

I'm able to tolerate stress from work, I'm able to tolerate stress from other people so I don't get triggered or I don't get angry at other people. I'm not stressed out from those things because my stress resiliency is much higher than it is in the average person.”

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