Category: testing

5. TRYING TO UNDERSTAND METABOLISM AND METABOLIC HEALTH (health project99+)

Inside a mosque in Samarkand/Uzbekistan

Dear reader,

Metabolism/metabolic health is a concept that all health experts use, but that few people really understand. Neither did I: all I knew wat that it was something to do “with food intake and energy”. And that good metabolism is important . 

1.Looking at metabolism from a disorder/disease point of view

I started to understand metabolism better when I looked at it from a disease point of view. Which diseases are caused by bad metabolism, and which have other causes? It turns out that most diseases are not related to metabolism but occur because of (for example) viruses. In the last para of this blog, I provide an overview of all non-metabolic disorders and diseases. It’s incredible how many diseases there are, by the way .

You can roughly divide metabolic diseases into two groups when we concentrate on them. There are plenty of these diseases as well. One group of disorders or diseases occurs wholly or partly because of your lifestyle. The second group is genetic and inherited. In the second group, you will find many rare diseases. The good news is that developments are progressing quickly. More and more diseases can be cured.

2.Definition of metabolism

After this “disease-focused” introduction, let us turn to the definition of metabolism. 

Metabolism refers to how your body converts food and drink into energy to keep you alive and functioning. Your body’s metabolism never stops — even when you’re resting or sleeping. It constantly sustains basic bodily functions. It involves all the chemical processes occurring in the cells of your body every moment of the day. These processes help you breathe, move, grow, and repair cells, manage hormone levels, regulate body temperature, and much more. If there are no issues, your metabolism is functioning well; if not, you may have a metabolic disorder. 

Metabolism consists of thousands of chemical processes within your cells that keep your body operating effectively. Your metabolism is healthy when all these processes work efficiently. However, if one or more processes do not function properly, you may experience metabolic problems. Consider this analogy: metabolism is like a car, and the various processes are its components. The car operates smoothly when all parts function well.

3.Indicators of a well-functioning metabolic function

A well-functioning metabolism is related to several factors.

  • Energy Production. A healthy metabolism efficiently converts carbohydrates, fats, and proteins from food into usable energy (ATP) while minimizing waste.
  • Nutrient Utilization. A functioning metabolism enables the body to effectively use nutrients. It also allows the body to store nutrients for various bodily functions. These functions include growth, repair, and everyday activities.
  • Metabolism plays a crucial role in weight management. A balanced metabolic rate helps maintain an appropriate weight relative to caloric intake and expenditure.
  • Metabolic health is closely linked to hormone function (e.g., insulin, thyroid hormones), which regulates how the body stores and uses energy.
  • Overall Health. A well-functioning metabolism supports many physiological processes. These include digestion, immune function, and energy levels. It contributes to overall health and well-being.

4.And what is metabolic rate?

Metabolic rate is the rate at which the body converts food into energy through biochemical processes. It reflects how quickly the body burns calories to support essential functions like breathing, circulation, and cell production. It also supports physical activity. 

Metabolism isn’t always functioning at the same “rate.”; this depends per situation and per person. Your body can use more or less energy during different times of the day and for various reasons. The metabolic rate can be influenced by factors such as age, sex, body composition, and levels of physical activity. 

Another term often used is the basal metabolic rate (BMR), which is the energy expenditure at rest. Your basal metabolic rate (BMR) indicates the number of calories your body needs to function at a basic level. Just as with the general metabolic rate several factors can influence your BMR, and the rate is different for everyone. 

Someone with a fast metabolism or fast basal metabolic rate (BMR) burns a lot of calories even while at rest. If you have a slow metabolism or slow BMR, your body needs fewer calories to keep it going. Your metabolic rate alone doesn’t determine your body size, and vice versa.

5.The two main groups of metabolic processes (catabolism and anabolism)

Catabolism is the breakdown of macronutrients (carbs, protein and fats) you consume into their simpler forms. For example, your body breaks down carbohydrates into glucose, which enters your blood as blood glucose (=sugar). These macronutrients are the basis of the fuel your body uses for all its cells.

Anabolism is the opposite of catabolism. Your body takes smaller units (like amino acids)  and puts them together to create bigger structures (like proteins). Anabolism is essential when you get an injury, and your body has to heal. It’s also essential for bone growth and building muscles.

6.How does metabolism affect weight?

Many people believe that metabolic problems are responsible for weight gain or loss. However, your metabolism naturally regulates itself. It meets your body’s specific needs. It is rarely the sole cause of weight fluctuations. In general, if your body uses more calories than you take in, you will lose weight (and vice versa). Nonetheless, several other factors affect how many calories your body requires—many of which are difficult to predict.

The commonly referenced figure of 2,000 calories for daily caloric needs is a very rough guideline. Individual requirements can vary widely based on factors such as age and gender. Activity level and overall health also play a significant role.

In summary, while metabolism is an important factor, it reflects how well your body functions. It measures energy production, nutrient utilization, and maintaining vital physiological processes. Additionally, lifestyle components such as diet, exercise, sleep, and stress significantly influence metabolic function. This underscores the importance of making healthy lifestyle choices to support metabolic health.

7.You often read about homeostasis as well? What is this?

Homeostasis is the process by which living organisms regulate and maintain a stable internal environment despite external changes. This includes the regulation of factors such as temperature, pH, and concentration of ions, ensuring optimal conditions for cellular functions.

8.What are metabolic disorders/diseases?

A metabolic disorder is a condition that arises from issues in processing energy. Your body may not process nutrients properly to function well. Metabolism involves a complex series of biochemical processes. Many different things can go wrong in these processes. This can lead to a wide range of metabolic disorders.

Metabolic processes are complex. Metabolic disorders can present with a wide range of symptoms. These symptoms vary significantly depending on the specific disorder and the individual.

9.There are two main groups of metabolic disorders

Metabolic disorders can be broadly categorized into two main groups: genetic (Inherited) metabolic disorders and acquired metabolic disorders. 

The genetic disorders are conditions that you are born with. They occur due to gene mutations. These mutations affect the metabolism of certain substances in the body.  Many of these types of metabolic disorders are endocrine system conditions and involve hormone imbalances. 

Acquired metabolic disorders are conditions that develop later in life. They are often (but not always) linked to factors such as lifestyle choices, diet, and other health conditions. Examples include type 2 diabetes, metabolic syndrome, and obesity. 

Some acquired metabolic disorders may arise due to other medical conditions, hormonal changes, or environmental factors. Additionally, they can result from damaged or diseased organs or autoimmune attacks on the body’s tissues. For instance, excessive alcohol consumption can lead to liver damage. This damage can result in metabolic dysfunctions related to the liver. One example is alcoholic liver disease.

10.Lifestyle: which factors are in your control?

Genetic and age-related factors significantly impact metabolic rate. Nonetheless, individuals can actively manage their lifestyle choices. This management can influence their overall metabolic health. Hence, it’s oversimplified to say that metabolism and metabolic rate are mostly out of one’s control.

  • Eat balanced meals regularly. Don’t skip meals. Your metabolism works best when it has a steady source of energy. Skipping meals or eating too few calories can slow down your metabolism.
  • Focus on nutritious foods. Choose fresh fruits and vegetables, lean proteins, whole grains and healthy fats.
  • Stay active. Exercise, especially strength training and resistance exercises, helps build muscle. Muscle burns more calories than fat, even at rest. This can boost your metabolic rate.
  • Get enough sleep. Quality sleep is essential for a healthy metabolism. Lack of sleep can disrupt your hormones and slow down your body’s ability to use energy efficiently.
  • Stay hydrated. Drinking enough water helps your body’s metabolic processes work properly. Even mild dehydration can slow down your metabolism.
  • Avoid extreme diets or long-term fasting. Drastic calorie cuts or prolonged fasting can slow your metabolism and cause your body to store energy.
  • Avoid stress.

11.Which factors are outside your control?

  • Your genetic makeup can influence your metabolic rate and how your body processes energy.
  • Metabolism typically slows down with age due to loss of muscle mass and hormonal changes.
  • Men generally have a higher metabolic rate than women, primarily due to higher muscle mass.

12.To test your metabolism. Is this possible?

Yes, you can, but not in all countries. The two most common tests are the basic metabolic panel (BMP) and the comprehensive metabolic panel (CMP). Several other types of blood tests and urine tests can assess many metabolic issues, as well.

13.As promised, some examples of non-metabolic diseases.

Metabolism plays a critical role in many bodily functions. Nevertheless, health problems can arise from a variety of other systems and factors. Here are some common categories of health problems that are not primarily metabolic in nature. At times there is overlap.

  • Infections caused by bacteria, viruses, fungi, or parasites can lead to diseases like influenza, pneumonia, tuberculosis, and HIV/AIDS. These conditions are not primarily related to metabolic processes but rather to the body’s immune response and pathogen interaction.
  • Conditions affecting the heart and blood vessels may arise from lifestyle factors. Such conditions include hypertension (high blood pressure), coronary artery disease, heart attacks, and strokes. Lifestyle choices can lead to these issues. Genetics and other non-metabolic factors also play a role.
  • Problems such as arthritis, osteoporosis, and injuries (e.g., fractures, sprains) are related to the musculoskeletal system and mechanical issues rather than metabolic dysfunction.
  • Conditions affecting the nervous system include epilepsy, multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease. These conditions involve neurological pathways and brain function. They are not primarily metabolic in nature.
  • Diseases such as asthma, chronic obstructive pulmonary disease (COPD), and lung infections do not originate from metabolic processes. However, they influence respiratory function.
  • Conditions like gastritis, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and gallstones affect the digestive system. These conditions do not necessarily qualify as metabolic diseases.
  • Mental health issues such as depression, anxiety disorders, schizophrenia, and bipolar disorder often have complex causes. These may include genetic, environmental, and psychological factors. They are not purely metabolic.
  • Diseases where the immune system attacks the body’s own tissues are not primarily metabolic problems. Examples include rheumatoid arthritis, lupus, and multiple sclerosis.

I hope you find this text useful. It helped me a lot to better understand the concept of metabolism. Now time for a long beach walk.

Take care and live a happy and healthy life!

Robert, your health friend

(2017) somewhere in Uzbekistan, in need of losing some kilos

20. A PLASTIC TSUNAMI ENTERING HUMAN BODIES

Courtesy Greenpeace, plastic in Kinshasa

Dear reader,

Summary: We consume more plastics than we think. Especially the smallest particles, the Nanoplastics, can have a bad effect on your long-term health. Science is working hard, much is still unclear, but signs are not good. Try to limit your contact with plastic significantly. Avoid using plastic bottles, plastic coffee and tea cups and chewing gum. See point 8 how to minimise your exposure to these plastic particles.

  1. Research only at its infancy/I am worried

I know research is ongoing and final conclusions will take years, but doesn’t this micro and nanoplastic stuff sound scary? Plastics might sound innocuous, but there are many types, some of which can cause cancer or other diseases. 

The effect of all these micro- and Nanoplastics entering our bodies is still unknown. The more I read, the more concerned I become. Plastics are a holistic concept, but when you break them down you enter a world dangerous additives. You also read about Nanoplastics as molecular pollutants that attach to fungus, algae and bacteria.

Writing this blog did not help, nor did these alarming headlines: “0.5% of the brain consists of Nanoplastics,” “Nanoplastics found in penises,” and “Nanoplastics entering individual cell structures.”

2, Most experts downplay the risk,

Experts claim that the public is overreacting. A quarter of the Dutch population believes that microplastics, and especially Nanoplastics, are among the top dangers to one’s health. The Dutch are perhaps exaggerating, but probably not. From what I have read this plastic future does not look all too good.

We do not know what interaction might occur between these smallest particles and living organisms. The idea that the tiniest particles can enter your individual cells is worrying. In reality, they do enter your cells. The increasing amount of plastic found in people’s brains is also not a good sign.

Dear reader, I don’t know about you. I am truly concerned. There seems to be no end to the plastic tsunami that overwhelms us. This news from the Netherlands is a bit off topic but related. It states that eggs from free-ranging chickens are too dangerous to eat. Can you imagine? Apparently, there is so much poison in the Dutch soil that it impacts the quality of food the chicken eat. This, in turn, affects the quality of the eggs.

There are actions we can take, such as avoiding these contaminated eggs. Or, in the case of plastics, minimizing their use as much as possible. Below are some tips in this blog.

For everything else, we must keep an eye on scientific developments.

3. Ok, what are micro plastics and Nanoplastics?

Microplastics are small plastic particles. They are usually defined as being less than 5 millimeters in size. However, they can be much smaller. They originate from the breakdown of larger plastic debris, like bottles and bags. They also include fragments of stabilizers, lubricants, fillers, and plasticizes. Manufacturers use these and other chemicals to impart desirable properties to plastics. Such properties include transparency, flexibility, and durability. Many of these chemicals have been classified by experts as toxic and harmful to human health.

Microplastics are widespread in the environment, found in oceans, waterways, soil, and even in the air. They pose increasing environmental challenges. Microplastics contaminate ecosystems and enter food chains, such as in fish. Animals and humans can ingest them, potentially causing harm over time.

Nanoplastics (sometimes calles nanoparticles, but this is a wider concept) are particles less than 100 nanometers in size. This size is less than 1/10,000 of a millimeter. They are much smaller than microplastics and more concerning because they can overcome certain barriers and enter human cells. They can be purposefully engineered in various scientific and industrial processes. For example, they are used for materials like carbon nanotubes. Alternatively, they may occur naturally in some processes. They can also result from the further breakdown of microplastics.

4. Just some plastic statistics

In 2020, approximately 367 million tons of plastics were produced worldwide. This amount is almost double that of 2000, which had an annual production of 200 million tons. Production is still growing on an annual basis.

Researchers estimate that the average person consumes between 78,000 and 211,000 microplastic particles every year. Plastic-based bottled water has a big role in these figures. Hot drinks in plastic cups can also contribute significantly. Together, they can make up to 50% of the intake. And remember, we talk about the micro plastics, the “big” particles, up to half a centimeter! every year through drinking water, foods contaminated by microplastics, and breathing microplastics-containing air. The number of Nanoplastics is infinitively more and can be 200.000 in one plastic bottle with water.

Fortunately, most, but not all leaves our body again the natural way.

In early 2024, a new study revealed that human brain samples collected at autopsy contained significantly more plastic. They had seven to 30 times more plastic than the kidneys and liver. Compared to 2016, this concentration represents about a 50% increase, indicating that, as of today, about 99.5% of the brain is brain tissue and the rest is plastic.

5. Not only plastic bottles and plastic coffee cups are of concern. Chewing gum as well.

A pilot study presented at the American Chemical Society’s spring 2025 meeting revealed that chewing gum can release hundreds to thousands of micro and nano plastic particles into saliva, which are then potentially ingested.

6. Dangers of micro- and nanoplastics

Microplastics and Nanoplastics have infiltrated ecosystems worldwide and have been detected in air, water and soil. Their small size allows them to enter the human body through ingestion, inhalation and dermal contact. Chemical additives like polychlorinated biphenyls and phthalate esters are added to microplastics during production. These additives typically exacerbate health effects. Microplastics are therefore recognized as an emerging environmental concern. They are also a public health concern. These concerns have the potential to affect both human well-being and the natural environment.

The much smaller parts, the Nanoplastics, can penetrate biological barriers. They enter cells and tissues, raising concerns about long-term health effects. It alarms me to learn that microplastic and nano plastic concentrations in brain samples are seven to 30 times higher. These concentrations are notably higher than those in kidneys and liver. As always with relative new developments, more studies need to be done to understand what the health implications are.

The mechanisms by which Nanoplastics enter the brain remain unclear. One hypothesis is that they travel with lipids ingested through food. Human brains are particularly rich in fat, which may help plastics cross the blood-brain barrier. Inhalation of airborne microplastics and ingestion through diet are considered primary routes of exposure.

7. Just one example how plastic pollution originates and affects us all

Biosolids, which are the treated water sludge generated from wastewater treatment, significantly contribute to plastic pollution in terrestrial environments. They are commonly utilized as fertilizers in agricultural land. This practice results in a considerable deposition of microplastics onto farmlands. In Europe, estimates vary between 63,000 to 430,000 tons of microplastics are deposited annually. In North America, the range is 44,000 to 300,000 tons. Consequently, agricultural soils serve as extensive reservoirs of microplastics. These particles are transported to the aquatic environment through various means. These means include rainfall, leaching, and irrigation.

8. First suspected links with diseases

There is ongoing debate over the health impacts of these microplastics within human tissues. These risks encompass inflammation, oxidative stress, and tissue damage. They have been found in vital organs such as the heart, liver, lungs, and even placenta. 

One study also found that individuals with dementia have more plastic fragments in their brains. The amount is three to five times higher than those without the condition. It was noted that dementia can impair the blood-brain barrier and brain clearance mechanisms, possibly creating a “sink” for plastics. Again, no definitive proof yet.

Some experts argue that nano plastics carry harmful chemicals. These chemicals are known to lead to reproductive issues. They cause hormonal imbalances by disrupting the endocrine function.

There appears to be a link between plastics and obesity.

9. What to do?

Summary: reducing exposure to microplastics and nano particles involves several lifestyle and consumer choices. Below some suggestions I summarized from reliable sources on internet.chapter

My own top 5 is: never heat anything in plastic, avoid drinks from plastic bottles (= no 1 tip), do not drink hot drinks from plastic, store in metal or porcelain, repack from plastic in metal, glass or porcelain, not cutting food on plastic cutting-board. I cut everything on an ordinary porcelain plate. And stop chewing gum.

Suggestions from internet

Filtering and boiling water.

Cutting back on plastic use when possible, for example, by using reusable containers

Boosting fiber intake involves two types of fiber. Fermentable fiber found in fruits and vegetables forms a gel-like substance in your gut. This helps trap microplastics and prevents them from entering your system. Meanwhile, non-fermentable fiber helps push these harmful particles through your digestive tract. It does this before they can be absorbed. In a world where microplastics are unavoidable, fiber could be your best defense

Not using single-use plastic over and over.

Avoiding heating plastic food packaging, as plastic particles can spread into the food.

Focusing on good sources for our food is essential. We should ensure our seafood is from sources that have less microplastics, for example.

Avoid foods that are ultra-processed, as there have been some reports of MNPs (=micro and nano plastics) in ultra-processed food.

Wearing natural fiber clothing — organic cotton or hemp — and avoiding those with synthetic fibers.

Vacuuming our homes more often, as microplastics can accumulate in household dust.

Being careful of environmental pollutants as high air pollution areas might have more MNPs in air.

Making sure our environment at home or work has a good air ventilation system.

This was a difficult blog to write. Too little is known about this topic, but from what we know one can only draw one conclusion: stay away as much as possible from plastics, but this will be hard to do.

Robert, your health friend,

traffic in Kinshasa, DRC. On a quiet day

5. INFLAMMATION IS TO BE TAKEN VERY SERIOUSLY (health project99+)

Dear reader,

Main conclusion: chronic inflammation is very serious. It can cause you to die prematurely. It can also make your life miserable for many years. There are several ways to test the level of inflammation. You have many options to prevent it. There are also various ways to cure it or at least reduce it substantially. Be careful about hypes, disinformation and pure nonsense when it comes to products that let inflammation disappear “overnight”.

1.Inflammation introduction

I started healthproject99+ in the first place to better understand myself the complexity of health issues. I share what I understand along with my own experiences. I do this not as a doctor (I studied international law), but as an interested party. A very interested party!

Take inflammation. It is not difficult to grasp the basic concept and see the difference between acute and chronic inflammation. The problems start with all the claims that certain products are anti-inflammatory. Fine, for all inflammations? For just a few? Is inflammation also good for you? Or should you be entirely inflammation free (the answer is no).

Acute inflammation is the easiest part; the difficulties start with chronic inflammation, from arthritis to cardiovascular issues. You can recognize it by symptoms like gut issues, eczema, and chronic fatigue. Other symptoms include brain fog, weight gain, allergies, chronic pains, and mood swings.

There is a hype about food and supplements that work anti-inflammatory. I tried to understand what the impact can be. I am sure that I miss out on certain points, but below my findings so far.

2. Inflammation (acute and chronic)

Inflammation itself is not an illness, but a natural response by the body’s immune system. Inflammation is part of how the immune system defends the body. It protects against harmful agents like bacteria and viruses. It also responds to toxic chemicals, chronic stress, and certain foods. Diets high in processed foods, fats, and alcohol can be among the main culprits of chronic inflammation. 

2a. Acute Inflammation

Acute inflammation is triggered by injury, infection, or exposure to substances. It presents itself as pain, redness, swelling, loss of function, and heat. It is usually beneficial and helps the body to heal by fighting off infections and initiating tissue repair.

2b. Chronic Inflammation.

The immune system sometimes continues to act as if there is a threat. This happens even when there isn’t one. Alternatively, it might react against the body’s own tissues. It occurs when the inflammation process persists over a longer period, and it can damage healthy tissues in the body. Chronic inflammation is associated with a range of diseases and conditions, such as autoimmune disorders (e.g., rheumatoid arthritis), cardiovascular diseases, allergies, certain chronic infections and metabolic syndrome ( = group of conditions that together raise risk of coronary heart disease, diabetes, stroke and other serious health problems). 

Chronic inflammation can happen when the immune system mistakenly attacks healthy tissues in the body. This response is different from the acute and beneficial inflammation the body uses to fight infections or heal injuries. It is prolonged and inappropriate.

3. Chronic inflammation can negatively impact longevity (a long list of illnesses that should worry everyone, it does me)

  • Persistent inflammation leads to ongoing production of inflammatory mediators and oxidative stress, which can damage DNA, proteins, and cellular structures. Over time, this can cause irreversible tissue damage and contribute to degenerative diseases.
  • Chronic inflammation is linked to a wide range of diseases. It includes cardiovascular diseases like atherosclerosis, diabetes, cancer, Alzheimer’s disease, and autoimmune disorders. These conditions are major causes of morbidity and mortality.
  • Chronic inflammation can accelerate the aging of the immune system, a scary phenomenon known as immune-senescence. This results in a diminished immune response to new infections and a decrease in surveillance against malignant cells.
  • Inflammatory cytokines can interfere with insulin signaling, contributing to insulin resistance and type 2 diabetes. They can also affect lipid metabolism and contribute to obesity-related complications.
  • Inflammation can create a pro-carcinogenic environment (= promotion of cancer). It induces DNA mutations, stimulates cell proliferation, and inhibits apoptosis (programmed cell death). It is often linked with specific types of cancer, such as colorectal cancer linked to inflammatory bowel disease.
  • There is growing evidence linking chronic inflammation with neurodegenerative diseases and mental health disorders, including depression. Inflammatory cytokines can affect the brain and lead to behavioral changes. Some research suggests that chronic inflammation might contribute to brain aging. It may also play a role in cognitive decline. This could be why you’re seeing references to inflammation making the brain appear biologically older.
  • Chronic inflammation can cause changes in blood vessels. It promotes hypertension. It also increases the risk of stroke and heart attacks due to its role in promoting plaque buildup within arteries.

4. Diving deeper into the concept of inflammation

  • At the micro level, it involves a series of cellular and molecular events primarily orchestrated by the immune system. Here’s a detailed look at how inflammation works at this level. 
  • Recognition of harmful stimuli The process begins when cells in the body detect harmful stimuli. Harmful stimuli are identified through pattern recognition receptors (PRRs). These receptors recognize pathogen-associated molecular patterns (PAMPs) from microbes. They also identify damage-associated molecular patterns (DAMPs) from injured cells.
  • Activation of immune cells Once harmful stimuli are detected, these immune cells become activated. They release signaling molecules called cytokines which orchestrate the inflammatory response. They also release chemokines that attract specific immune cells to the site of inflammation. These molecules help coordinate the inflammatory response.
  • Recruitment of Immune Cells Cytokines increase the expression of molecules on the surface of cells lining the blood vessels. This facilitates the movement of additional immune cells. These include neutrophils and monocytes. They move from the bloodstream to the affected tissue.
  • Increased Blood Flow and Permeability Blood vessels near the site of injury or infection widen (vasodilation) and become more permeable. This allows immune cells, proteins, and nutrients to pass more easily into the tissue to combat the harm.
  • Phagocytosis and Destruction of Pathogens Neutrophils and macrophages engulf and destroy invading microbes and debris through a process called phagocytosis. Inside these immune cells, pathogens are trapped in a vesicle and destroyed by enzymes and reactive oxygen species. Which is excellent of course!
  • Resolution and Healing Normally, inflammation is a self-limiting process. Once the harmful stimuli are dealt with, anti-inflammatory signals are released to suppress the inflammatory response. Macrophages start the cleanup of cellular debris. They promote tissue repair by secreting growth factors. These molecules facilitate healing.
  • 5. Tests
  • Inflammation can be measured in several ways, often through a combination of clinical assessments and laboratory tests. Here are some common methods used to evaluate inflammation. The first one is already very helpful.

5a. Blood Tests

  •  C-Reactive Protein (CRP) This is a protein produced by the liver in response to inflammation. High levels of CRP in the blood can indicate inflammation. A common target for hsCRP is below 1 mg/L. Levels between 1 and 3 mg/L are considered average. Levels above 3 mg/L might indicate a higher risk of cardiovascular problems due to inflammation. 
  • Inflammation can be a key factor in various health conditions. Monitoring hsCRP is a strategy to gauge inflammatory activity. It helps assess cardiovascular risk. However, hsCRP is just one of many markers. It should be interpreted within the context of overall health and other risk factors.
  • Erythrocyte Sedimentation Rate (ESR) This test measures how quickly red blood cells settle at the bottom of a test tube. A faster-than-normal rate may indicate inflammation.
  • Pro-inflammatory Cytokines We measure levels of cytokines like interleukin-6 (IL-6). We also measure tumor necrosis factor-alpha (TNF-alpha). These are involved in the inflammatory response.
  •  Fibrinogen Elevated levels of this protein, which helps with blood clotting, can also indicate inflammation.

5b. Physical Examination

  • Doctors assess signs of inflammation such as redness, warmth, swelling, and pain in specific areas of the body.

5c. Imaging Tests

  • Ultrasound or MRI These imaging tests can detect inflammation by showing swelling, fluid accumulation, and other tissue changes.
  • X-rays Though not directly showing inflammation, they can indicate changes in bones and joints that are often due to inflammation.
  • In some cases, tissue biopsies are taken to examine the presence of inflammatory cells under a microscope.
  • In some contexts, specific biomarkers are assessed for conditions, like antibodies in autoimmune diseases.

6. Management and treatment of inflammation

Identifying the underlying causes of chronic inflammation is crucial. These causes include infections, prolonged exposure to irritants, or genetic factors. Understanding them aids in management and treatment. Medical professionals typically employ a combination of lifestyle modifications, medications, and therapies to treat conditions associated with chronic inflammation. If you suspect chronic inflammation, it’s important to consult with a healthcare provider for proper evaluation and management. This is for sure no area for self-treatment.

Ultimately, you can’t (and shouldn’t) eliminate the body’s ability to mount an inflammatory response. However, the strategies below can help modulate and control chronic or harmful inflammation. For specific medical advice and a tailored plan, it’s best to consult with a healthcare provider.

6a. How to reduce chronic inflammation the natural way (lifestyle modifications)?

You may not be able to avoid chronic inflammation entirely. Still, you can take steps to reduce your risk. You can also manage it effectively if it occurs. Here are some strategies to help minimize the risk and impact of chronic inflammation. By incorporating these lifestyle changes, you can reduce your risk of developing chronic inflammation and improve your overall health. 

Focus on a balanced diet rich in whole foods, such as fruits, vegetables, whole grains, lean proteins, and healthy fats. Foods with anti-inflammatory properties include berries, fatty fish, nuts, olive oil, and leafy greens. Pay attention to your fiber intake, limit sugar and alcohol and reduce the Omega-6 to Omega-3 ratio.

Excess body weight, particularly around the abdomen, can contribute to chronic inflammation. Maintaining a healthy weight through diet and exercise can help reduce this risk.

Regular physical activity has been shown to reduce inflammation. 

Chronic stress can contribute to inflammation. Practices such as mindfulness, meditation, yoga, or deep-breathing exercises can help manage stress levels.

Poor sleep can contribute to inflammation. Aim for 7-9 hours of quality sleep each night.

Tobacco smoke and excessive alcohol consumption can increase inflammation. Quitting smoking and moderating alcohol intake can help reduce this risk.

Monitor and manage chronic conditions like diabetes, hypertension, and high cholesterol as they can increase inflammation.

Some dietary or environmental factors can trigger inflammation in susceptible individuals. Identifying and minimizing exposure to allergens or irritants can help reduce inflammatory responses.

Given these factors, reducing chronic inflammation could favorably influence health span and lifespan. This can be achieved through lifestyle modifications, such as diet and exercise. Stress management and using anti-inflammatory medications or supplements can also help. It is essential to maintain a balance where the inflammatory response effectively protects against disease without causing persistent harm.

6b. What about official medications?

Yes, there are several types of medications used to reduce inflammation. These medications vary in their mechanisms and are used based on the nature and severity of the inflammatory condition. 

The medications below are typically used based on the specific medical condition and individual patient needs. It’s essential to use anti-inflammatory medications under the guidance of a healthcare provider. This is important as they can have side effects. They may also have potential interactions with other medications. For example, long-term use of NSAIDs can lead to gastrointestinal issues. They can also cause cardiovascular problems and kidney damage. Prolonged use of corticosteroids can cause a wide range of side effects.

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). These are among the most widely used medications for reducing inflammation, pain, and fever. Common NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin. They work by inhibiting enzymes (COX-1 and COX-2) involved in the production of prostaglandins, substances that promote inflammation.
  • Corticosteroids. These are potent anti-inflammatory and immunosuppressive medications. Examples include prednisone, dexamethasone, and hydrocortisone. They mimic the effects of glucocorticoids produced by the adrenal glands. They reduce inflammation by suppressing the immune response. They also decrease the production of inflammatory substances.
  • Disease-Modifying Antirheumatic Drugs (DMARDs). Typically used to treat inflammatory autoimmune conditions like rheumatoid arthritis. Examples include methotrexate, sulfasalazine, and hydroxychloroquine. These drugs work by altering the underlying processes that cause inflammation or damage tissues.
  • Biologics. These are a newer class of drugs often used for conditions like rheumatoid arthritis, psoriasis, and inflammatory bowel disease. Examples include infliximab (Remicade), etanercept (Enbrel), and adalimumab (Humira). They target specific components of the immune system, such as tumor necrosis factor (TNF) or interleukins, to reduce inflammation.
  • Selective COX-2 Inhibitors. A subset of NSAIDs includes drugs like celecoxib (Celebrex). These drugs specifically target the COX-2 enzyme. They reduce inflammation with fewer gastrointestinal side effects than traditional NSAIDs.
  • Antihistamines While primarily used for allergic reactions, they can also reduce inflammation related to allergies. Examples include cetirizine (Zyrtec) and loratadine (Claritin).

6c. How to reduce chronic inflammation with the help of supplements?

  • Several supplements are known for their potential to help reduce chronic inflammation. Some for specific conditions, others for overall reduction of inflammation like ginger and green tea. 
  • Found in fish oil and flaxseed oil, omega-3s possess anti-inflammatory properties and are beneficial for heart health and joint conditions.
  • Curcumin, the active compound in turmeric, has strong general anti-inflammatory and antioxidant properties. Black pepper is often added to enhance absorption and impact.
  • Known for its general anti-inflammatory and antioxidant effects, ginger can be used in its natural form or as a supplement. Its benefits can be seen across multiple systems, supporting overall reductions in inflammation. 
  • Found in red wine, grapes, and certain berries, resveratrol has anti-inflammatory effects and may be beneficial for cardiovascular health. Myself I take because pterostilbene, that has a much longer half-life than resveratrol.
  • Rich in polyphenols like EGCG, green tea has general anti-inflammatory and antioxidant properties.
  • Boswellia Serrata, also known as Indian frankincense, is a plant extract. It has been used for its general anti-inflammatory benefits. It is especially beneficial for arthritis.
  • Alpha-Lipoic Acid is an antioxidant that helps reduce inflammation and may benefit metabolic health.
  • Adequate levels of vitamin D are important for immune role and inflammation control, and deficiency is linked to increased inflammation.
  • An enzyme derived from pineapples, bromelain has anti-inflammatory properties and may help reduce inflammation and improve digestion.

A long blog, sorry about that, but it took me a long time to understand the essence of inflammation.

Take care, live a happy and healthy life,

Some Dutch related heritage in Venezuela

15. TO DO AT HOME: TEST YOUR ENDURANCE, FLEXIBILITY AND MUSCULAR STRENGTH (health project99+)

Rare Kalahari desert lion

Knowledge about one’s health is essential, at least for me. When I was younger, I was always a bit hesitant because you never know what the results will be. Still, this is “ostrich politics,” burying my head in the sand to hide from danger.

Biomarkers, different types of heart rates, hormone tests, and blood tests are available. Some are more relevant than others. They give me a sense of confidence when everything appears normal according to the tests. And if something is wrong, you hopefully have time to make adjustments.

Some tests are cumbersome, some are expensive, but these days, more and more is possible. Your Apple Watch or any other health gadget is already a great help. AI is on its way to revolutionizing the way we deal with health.

This blog is dedicated to “easy-to-do” at-home tests for assessing your overall physical condition. They should give you a good idea of your health status, specifically your endurance, flexibility, and muscular strength. For longevity, it is crucial to keep muscle mass (fight against sarcopenia!), stay flexible, and not lose your balance. The good news is that exercise and willpower can take you very far. In most tests, I score in the 30-year-old bracket. I assure you that I am an average guy—not a top athlete. I am someone who is determined to stay fit and is willing to put in the work.

That means walking, biking (I am Dutch), and going to the gym. I should do more yoga and remain interested in resuming tai chi.

  1. Sit-to-Stand Test (30 seconds)

 Purpose: Tests lower body strength and endurance.

 How to Perform: Sit in a chair with your feet flat on the floor and arms crossed over your chest. Stand up fully and sit back down as many times as you can in 30 seconds. 

Age 30/Men 15–20 repetitions; Women 15–20 repetitions

Age 50/Men 12–18 repetitions; Women 12–18 repetitions

Age 65/Men 11–16 repetitions; Women 11–16 repetitions

I do 16 so that is fine. I read somewhere that the world record is 72 times, but to me that must be a mistake.

2. Push-Up Test 

 Purpose: Assesses upper body strength and endurance.

 How to Perform: Do as many push-ups as you can with proper form. 

Age 30/Men (15-20 = good, 30+ = excellent); Women (10-15 = good standard, 20+ = excellent).

Age 50/Men (10-15 = good, 20+ = excellent); Women (8-12 push-ups = good, 15+ = excellent).

Age 65/Men (6-10 = good, 15+ = excellent); Women (5-10 = good, range, 12+ = excellent).

I do 30, so I am very pleased with myself. It has been a long process to get so far. I started 1 ½ years ago, barely making 2 or 3 push-ups at a time, but slowly I improved. I can do 100 in short bouts of 20 each, with a limit of 30. After completing 30 I feel my arms, that is for sure.

3. Plank Test

Purpose: Measures core strength and endurance.

How to Perform: Hold a plank position (elbows and toes on the floor, body in a straight line) for as long as possible. Check your time and aim for gradual improvement. See Youtube for instructions.

Age 30/men 1.45; women 1.30.

Age 50+/men 1.15; women 1.00

Some say best approach is a small number of planks of 30 seconds each, but you can also go for a maximum time. My record is 4.30 minutes, on average I do 2.30. I never enjoy it though; it is a very hard exercise.

4. Sit-and-Reach Test

Purpose: Tests flexibility, especially in the lower back and hamstrings.

How to Perform: Sit on the floor with legs straight ahead. Then, reach forward as far as you can towards your toes, and measure the distance reached beyond your feet.

Flexibility is of all ages (or not). I know this is an important test, but only recently I made it. It requires 10-15 minutes of yoga style of exercises before I manage this. I honestly never managed, not in my 20’s or in my 50’s, but now in my 60’s I do. Four cm beyond my feet!

5. The Cooper Test

This is a physical fitness test developed by Dr. Kenneth Cooper in the 1960’s, used to assess aerobic endurance. It involves running as far as possible in 12 minutes, and the distance covered indicates aerobic fitness. 

Age 30/men (1900–2400 meters = average; 2400-2800 = good; 2800+ = excellent).

Women (1700–2100 meters = average; 2100–2500  = good;  2500+  = excellent).

Age 50/men (1700–2099 meters = average; 2100–2500 = good; 2500+ = excellent).

Women (1500–1900 meters = average; 1900–2300 = good; 2300+ = excellent).

Age 65/men (1500-1900 meters = average; 1900–2300 = good; 2300+ = excellent).

Women (1400–1700 meters = average; 1700-2100 = good; 2100+ = excellent).

6. Step Test

Purpose: Assess cardiovascular fitness.

How to Perform: Step up and down on a platform or step at a consistent pace for 3 minutes. After finishing, measure your heart rate for one minute to evaluate recovery.

Age 30/men and women (Heart rate recovering to 101-115 beats per minute = average; to 85-100 beats = good; below 85 beats per minute. = excellent).

Age 50/men and women (Heart rate recovering to 106-120 beats per minute = average; to 91-105 beats per minute = good; below 90 = excellent).

Age 65/men and women (Heart rate recovering to 111-125 beats per minute = average; to 96-110 = good; below 95 beats = excellent).

7. Standing on one leg 

This is a commonly used balance test that can show overall stability and balance abilities, which often decline with age. Here are some general guidelines for how long you should be able to stand on one leg based on different age groups:

Age 30/both men and women at least 50 seconds.

Age 50/both men and women at least 30 seconds.

Age 70/both men and women at least 25 seconds.

The longer the better of course. I do easily over 1 minute. I practice in the bathroom and doing exercises on one leg also helps.

Enjoy the tests and draw your conclusions!

Robert, your health friend

The Hague is beautiful

21. BERBERINE, A TRULY GREAT SUPPLEMENT (health project99+)

The city of Hoorn in The Netherlands

Summary One of my favorite supplements is Berberine. It has similar positive effects on blood sugar levels as the prescription drug Metformin, but without its side effects. However, I do not take Berberine for its blood sugar management and its other potential benefits. Berberine interests me mainly because it may play a role in slowing aging and extending life expectancy with years. Interesting research is ongoing (see point 9 of this blog).

Berberine is an herb extracted from several different plants, specifically shrubs called Berberis. Berberine originates from an ancient Chinese herb called Coptis Chinensis French. 

1. Six Categories for a Longer and Healthier Life

Nutrition, exercise, sleep, stress management, and social life are five key elements. These elements, if well managed, contribute to a healthier and longer life. Fortunately, expert recommendations across these categories often align. However, food and exercise can sometimes lead to debates and differing opinions.

Discussions on food and exercise are mild compared to the sixth category: supplements! Supplements are often controversial, with many unproven health claims and contradictory expert opinions. Yet, this is also the most exciting category because we are continually discovering the potential of new supplements.

We live in the age of AI. I am convinced, or at least hopeful, that AI will spur an exponential growth of new medicines, that it will also lead to the development of many new supplements and new ways to proof their effectiveness.

2. Weak Points of Supplements

Supplements generally have two weak points:

1. Their production is not officially regulated and controlled by health agencies, so it’s crucial to buy from reputable companies.

2. Many health claims are not scientifically proven.

3. The Importance of Remaining Critical

I try to remain critical. Take Resveratrol, for example. Fifteen years ago, it was heralded as a miracle supplement. Later, it turned out to be a false alarm. Its half-life is only about 1 hour. This makes any positive effects very short-lived. I took Resveratrol for a few years until I discovered this fact, and I consider it a waste of money.

4. Berberine (proven claims)

Berberine has been scientifically proven to lower blood sugar as effectively as Metformin. It helps in weight loss. It also improves heart health. individual users as Berberine.

I have been taking Berberine for a few years now. It offers similar benefits as the officially approved medicine Metformin. However, I stopped taking Metformin. I experienced side effects, such as bloating, nausea, and stomach cramps.

A combination of Berberine and metformin can enhance the effects of these two medications. Research has shown their combination can improve blood sugar control. Also, Berberine can make it easier to tolerate metformin with fewer metformin side effects. Therefore, if your doctor says it is okay to take both Berberine-metformin, you can go ahead and do so.

On YouTube, the comments sections of videos where doctors discuss Berberine are quite interesting. Generally, the comments are positive, and many emphasize the absence of side effects. Among the supplements I follow, few receive as many positive reviews from users as Berberine does.

5. Claims (Not proven but with interesting indications from several trials)

Berberine may reduce inflammation in various ways, suggesting it could be used to treat inflammatory conditions like arthritis. It may also offer additional benefits. It could potentially aid in treating conditions such as depression and nonalcoholic fatty liver disease. Some studies suggest it might even help reverse arterial plaque (if true this would be a true miracle) and address hormonal issues. All interesting, but not proven.

6. Safety

The “no-harm” approach is central for me when deciding to take any supplement. I take several supplements based on the hope and indicating they might provide certain benefits. However, I only take supplements considered completely safe and that do not interact with any medication.

7. Half-life time of Berberine

Berberine has a half-life of several hours. This characteristic makes it ideal to take at a dosage of 500 mg twice daily. It’s best taken with meals.

8. How long does it take for Berberine to lower A1C (that indicates your blood sugar level)

Most studies have examined Berberine’s effects over 90 days. We can assume that noticeable effects likely take about three months. In contrast, Metformin works much faster, typically yielding full benefits within 4-5 days. However, the overall impact is similar between the two.

9. A bit more on life extension potential of Berberine

Metformin (and Berberine) are believed to mimic some biological effects of caloric restriction. This is a well-studied method for potentially increasing lifespan. In animal models, Metformin-treated mice often showed signs of improved health span. They lived healthier lives with fewer age-related diseases. These improvements include better metabolic health markers and reduced instances of age-related conditions.

It’s important to note that what holds in animal models doesn’t always directly translate to humans. This is due to differences in physiology and dosage responses. Therefore, more research is crucial to validate these effects in humans. The TAME (Targeting Aging with Metformin) study is a significant clinical trial aiming to assess Metformin’s effects on aging-related diseases. It is anticipated that the results for Metformin will be comparable to those for Berberine.

Enjoy a happy, healthy and long life,

Robert, your health friend,

21. OMEGA-3 SUPPLEMENTS, OFTEN NO NEED TO TAKE THEM (health project99+)

Somewhere in the East of Venezuela

Summary: 1. Omega-3 fatty acids are important for your health; all your cells use them. 2. Most people are deficient, but the solution is easy for most (change of diet, not taking supplements). 3. Taking high amounts of Omega-3 fatty acids is recommended by many on internet, but this is something you really should check with your doctor. 4. Many supplements are of low quality and can work counterproductive. 5. Higher amounts of Omega-3 fatty acids can have unexpected health consequences like atrial fibrillation.

Your body needs the different Omega-3 fatty acids, especially the EPA, DHA and ALA types. They are essential for a broad range of health benefits. These benefits start with the heart and brain and extend to a healthy cellular structure and function. All your cells use them on a constant basis.

The good news is that you get enough if your diet includes fatty fish twice per week (herring, salmon etc) for the EPA and DHA. For the ALA flax seed or a handful of walnuts daily should be sufficient. The half-life ( = time a compound stays active in your body) of EPA and DHA is approximately 3-4 days. This is excellent. It explains why a few helpings of fatty fish per week give you sufficient Omega-3. This is as suggested by health authorities.

So do you need to take supplements? They are among the most promoted and sold supplements by the industry. However, just like vitamin C, they are easy enough to get through a balanced diet. Really think twice and look at your diet before you decide to take a supplement.

If you do not like fish or are allergic to nuts, supplements might be necessary. I say this with some caution. Omega-3s supplements can be of bad quality, and they often are. They might even cause unwanted effects like triggering attacks of heart rhythm issues. These issues include atrial fibrillation, which has happened to me. 

In blogs like these it is standard practice to refer the reader to his/her doctor. This is often done as part of one’s “cover your ass” policy. However, in the case of Omega-3, it is advisable to do so. Of course, we hope that your doctor is open-minded. We hope they look at supplements and other alternatives in a welcoming way. Which is not always guaranteed.

The Omega-3 index

Experts typically recommend targeting an Omega-3 index between 8% and 12%. Most Americans have on average 4%, much too low and up to 80% are below the 8%. The Omega 3 index is a blood test. It measures the amount of EPA and DHA found in the membranes of red blood cells. A test above 8% is desirable. The solution of course is not taking a supplement, but to improve one’s diet.

Recommended Intake of Omega-3 fatty acids

Various health organizations suggest around 250 to 500 mg combined EPA and DHA per day for adults. This supports heart health. Of course there are differences between children, men, women, patients etc. The figures I use are rough estimates only.

There is no established upper limit for EPA and DHA from dietary sources. However, supplementation guidelines often recommend not exceeding 3,000 mg (3 g) per day. This is to avoid potential side effects. Some go to 5,000 mg (5 g) per day.

Discuss with your doctor what “excessive” means in your case. Taking up to 5000 milligrams per day is considered safe for most people. However, it is definitely not safe for everyone. If you are like me and are susceptible to atrial fibrillation, more than 1000 mg of combined EPA and DHA per day might already be too much.

For ALA there isn’t a specific recommendation. However, on internet I see the following suggestion: 1,600 milligrams per day for adult men. For adult women, it is 1,100 milligrams per day.

Why take more?

Why should you take more than the recommended least quantities? There is a lot of interesting research going on that indicate (not proven!) that higher amounts of Omega-3 fatty acids can contribute to a longer and more healthy life.

One example from reliable internet sources

According to new research Omega 3 and Vitamins D and exercise slows biological aging by several months. Older adults who took 1 gram of polyunsaturated omega-3 fatty acids from algae slowed biological aging. They mixed it with vitamin D (2,000 international units per day) and 30 minutes of exercise three times a week. This combination slowed biological aging by approximately 2.9 to 3.8 months over 3 years.

While omega-3 alone reduced biological age, the combination of all three interventions had an even greater impact. A reduction of a few months in biological aging may seem modest. However, this could have meaningful public health benefits. These include a lower prevalence of certain age-related conditions.

Further research has also suggested that a combination of omega-3, vitamin D, and exercise may lower the risk of cancer.

But as always, approach these conclusions with caution as further research is needed. Very few claims are 100% scientifically proven. 

What I saw on internet are interesting discussions, a lot of promises, but little proven. Treatments are accepted to slow down aging at the molecular level. However, there is no 100% proof that this leads to a longer life. Similarly, there is no guarantee of better health. Still, many hopeful signs.

If you take Omega-3 supplements

Omega-3 supplements are best consumed with meals, particularly meals containing dietary fats, as this enhances absorption.

Check which brands are reputable. Many are not and the supplements they sell are often oxidized and can be damaging to your health. Preferably buy fish oil, not in capsules, in a dark bottle. Store the oil (or capsules) in the fridge, especially when open. You can do that only for 4 weeks. Fish oil is rich in omega-3 fatty acids, which can easily oxidize in heat, light and air

Oil tends to be absorbed better but can be very expensive. You rely on your digestive system to effectively break down the capsule before it can absorb the omega-3. Most brands use pork or beef gelatin, which is very tough and thus harder to break down.

Best sources for Omega-3s fatty acids.

Natural sources should suffice. For EPA and DHA especially cold water fish like herring and wild salmon. Also eggs can contribute. For ALA flax seed, chia seeds, walnuts.

As I said, it is important to know what was the food of the herring or salmon you eat. The nutrition of farmed salmon is very different from the food of wild salmon. As a result, it has much less EPA and DHA.

The same applies to eggs. Eggs from pasture-raised chickens contain 120 mg of DHA and 23 mg of EPA per large egg. This is more than six times the amount provided by the eggs of grain-fed chickens.

For herring (Atlantic), a 100-gram serving typically contains approximately 770 mg of EPA and 1,000 mg of DHA. For salmon (Atlantic, farmed), a 100-gram serving usually provides around 400-700 mg of EPA and around 700-1,000 mg of DHA.

All easy to calculate. Consuming 300 grams of fatty fish per week provides approximately 5,000 milligrams of EPA/DHA. This amount easily puts you above the minimum needed, which is approximately 2,000 to 3,500 milligrams for the week. Add a few eggs and one can be sure not to be Omega-3 deficient.

Half-life

I already mentioned the long biological half-life of EPA and DHA. This means the time it takes for half of a substance to be eliminated from the body. 

For EPA the half-life is estimated to be around 37 to 82 hours. Half-life of DHA is much longer ranging approximately from 72 to 144 hours.

Often you read about a preferred ratio of EPA and DHA of 2:1. Achieving this ratio is difficult, especially if you rely on natural sources only. However, it is more important to ensure adequate overall intake of both omega-3 fatty acids. This is more crucial than focusing on the precise ratio of EPA to DHA. The half-life of ALA is not known.

Bio-availability

The bio-availability of nutrients refers to the extent and rate at which they are absorbed and utilized in the body. For EPA and DHA Omega-3 fatty acids EPA and DHA the natural sources tend to have very high bio-availability. When consumed as part of whole foods, they are present in the form of triglycerides, which are well absorbed. (note: Triglycerides are a type of fat (lipid) found in your blood).

Potential Risks of Excessive Intake

Bleeding Risk: Doses at the high end of omega-3 fatty acids (over 3,000 mg per day) can increase bleeding risk. This is because of their blood-thinning effects. This is especially important for individuals taking anticoagulant medications. Like many people I take these.

Immune Function: Some studies suggest that very high doses of EPA and DHA might suppress the immune system. However, this is not typically reached through diet or normal supplementation. A dysfunctional immune response can lead to a viral or bacterial infection.

Gastrointestinal Effects: Not surprisingly excessive amounts may lead to gastrointestinal discomfort, such as diarrhea, indigestion, or fishy aftertaste. This is the case with many supplements.

Vitamin E and Oxidative Stress: High doses of fish oil may increase oxidation levels. This effect is because of EPA/DHA. This can deplete vitamin E. Some supplements include vitamin E to counteract this.

Pregnancy and Breastfeeding: Pregnant or breastfeeding women should be cautious with fish oil supplements to avoid excessive intake. They should also aim to meet recommended levels for fetal and infant development.

Interactions with Medications: Those on blood thinners, aspirin, or high-dose anti-inflammatory drugs should consult with a healthcare provider. Omega-3 can exacerbate their effects.

What is the use of EPA, DHA and ALA?

EPA (Eicosapentaenoic Acid) plays a crucial role in reducing inflammation and is involved in the production of signaling molecules called eicosanoids, which have various important effects on cardiovascular health and immune system regulation.

DHA (Docosahexaenoic Acid)  is a vital structural component of cell membranes, particularly in the brain, eyes, and nervous system, where it supports cognitive function, vision, and overall neural development.

ALA (Alpha-Linolenic Acid) serves as a precursor to EPA and DHA, providing an essential source of omega-3s in plant-based diets, and is involved in energy metabolism and various physiological processes, although its conversion to EPA and DHA in the body is relatively inefficient.

This is it. A long one, but it helped me a lot.

Enjoy a happy and healthy life and stay critical!

Robert, your health friend

When I still had to wear ties

9. FOUR DRINKS: (C) THE EVENING VEGETABLES SOUP (health project99+)

Summary: by turning solid vegetables into soup, for six years I now easily meet my daily vegetables target. And my body is grateful for it.

1. I don’t like vegetables...

I’ve never been a fan of vegetables. I would tolerate only peas and maybe some carrots. They had to be covered in Dutch apple sauce (which is not healthy because of its high sugar content). Potatoes and especially French fries got a pass. They might count as veggies, but peeled and fried, they do not offer much health benefit.

I have known all these years, of course, that vegetables should play a starring role in any healthy diet. My mother said a thing or two about it, if I remember correctly. Willpower is essential for any lifestyle change. The motivation to eat these green, red, orange and white things was just lacking. I will write about the importance of will power (and the lack of it) in another blog.

2. But…….

About six years ago, my wife decided she’d had enough of my veggie aversion. She started making vegetable soup, using fresh or frozen vegetables only. A blend of persuasion and gentle insistence managed to get me to eat it daily. It was a brilliant move and since then, I haven’t looked back. Vegetables are now an integral part of my diet, and the numbers from my annual health tests show the benefits. *(For context, biomarkers are biological molecules that indicate normal or abnormal processes or conditions in the body.)

3. More about vegetables

I enjoy incorporating a variety of vegetables into my meals. I include red beets, broccoli, spinach, carrots, cauliflower, pumpkin, and sweet potatoes. I like to spice things up with a bit of celery or leek—I would use onions, but I’m unfortunately allergic. Instead of combining all these vegetables at once, I prefer selecting a mix that suits my needs. Not always a culinary success, by the way, but that is part of the process. Healthy they always are!

Each vegetable brings its own unique benefits. For example, beets are touted for their potential health properties, including (unproven) anti-cancer claims. Broccoli and spinach offer around 3 grams of protein per 100 grams. Sweet potatoes are particularly impressive, containing 35% fewer carbs than regular potatoes and packed with vitamins and minerals. 

All these vegetables are excellent sources of fiber which is crucial for health. Good to know as it can be challenging to consume fiber in sufficient quantities, just as it is with protein. Life is unfair because if we compare proteins and fiber with sugar, there the opposite is true. Sugar, our common dietary foe is found in many forms in our food and very easy to overeat.

One caveat. Some vegetables have a surprising amount of sugar as well, so be careful. For example, carrots contain 6 grams per 100 grams, beetroot has 8 grams, and pumpkin 5. In contrast, broccoli contains only about 0.4 grams.

4. At home we have a diet that is 3/4 liquid

A. Lemon juice to start the day and as a drink in between (1 liter). https://shakethehealthtree.com/index.php/2025/02/25/5-lemons-and-limes-health-project-99/

B. A large smoothie for breakfast and lunch (up to one liter). I already wrote about this morning routine.  https://shakethehealthtree.com/index.php/2025/03/10/9-four-drinks-a-morning-afternoon-smoothie-health-project-99/

C. A fresh soup for the evening, with some carbs and proteins like fish, 0.4 liters. 

D. Two glasses of water/lemon juice with collagen and creatine (0.5 liters), one in the morning with added protein, and one in the evening without extra protein. 

5. Carbs, meat, fish

We aren’t against carbs. They just need to come in the form of whole food. We prefer these over white bread, white rice, or light pasta. We don’t eat much meat, and when we do, it’s mainly organic chicken. We consume fish more frequently, though less than before due to a variety of increasing concerns ranging from mercury to nano-plastics. And I already wrote about the (too) big role nuts play in my diet.

6. Preparation

I mostly use frozen vegetables for their health benefits, cleanliness, practicality, and affordability. When I buy fresh, I cook and freeze them for later use.

I start by boiling approximately ½ kg of frozen vegetables. After boiling for a few minutes, I transfer everything into a blender. I then add salt, pepper, two teaspoons of olive oil, and a generous amount of herbs. Once blended, voilà—a delicious vegetable soup is ready, although not always perfect! Too much cauliflower for example is not to my taste :).

Enjoy a happy, tasty and healthy life,

Robert, your health friend

Cool guys in the DRC, when times were more peaceful

3. FISH IS HEALTHY, BUT NOT TOO MUCH PLEASE (health project99+)

Summary: eating fish is healthy. However, due to an increasing number of foreign substances like mercury, one has to limit fish consumption. When I realized this I cut down my fish consumption by half.

Fish: great, but from now on a cautious “yes”

At home, we used to eat fish almost every day over the past five years. The health benefits of fish are well known. However, we neglected important dangers. Issues like PCBs, nano plastics, and mercury are truly concerning. Other heavy metals and antibiotics in farmed fish also worry me as an enthusiastic fish consumer. 

So I dived into this topic to see whether we could continue eating fish every day. The short and sad conclusion is “no”. It was already “no” to farmed fish. We should also avoid fish that is most likely to have high levels of mercury. PCBs and nano plastics are also concerns. This is all easier said than done. When buying fish, the amounts of mercury and other harmful components are not labeled. They probably never will be, as they are difficult to measure. With mercury it is more or less known which fish is mercury heavy and which not. When it comes to farmed fish, you can find out what is wrong. But what about other heavy metals? PCBs? Nano plastics?

2. Why take the risk?

To those who say that the Japanese eat fish almost daily, I admit I have no answer. They argue that Japanese are among the longest-living people in the world. Food and health are complex issues, as I have come to realize over the past few years. 

Not everything is scientifically proven. However, there are many indications of potential negative effects from eating fish more than a few times per week. So, why take the risk? Especially when you can maintain a very balanced diet without consuming fish daily.

3. Do you need fish for your necessary protein intake?

We humans have several other protein sources legumes, nuts, eggs, light French quark, soya milk, seeds, and plant-based proteins. In another blog I wrote that people tend to undereat protein, something that is very harmful especially if one ages. Eating fish helps. Chicken also helps. For us, fish is “just” one of the protein sources. It is an important contributor to a tasty meal.

4. Just to repeat the benefits of fish. It is an excellent source of high-quality protein. It also provides omega-3 fatty acids, especially in fatty fish like herring and salmon. Additionally, it contains vitamins such as vitamin D and B2. It also has minerals like calcium, phosphorus, iron, zinc, iodine, magnesium, and potassium. Omega-3 fatty acids are beneficial for heart health. They may lower the risk of heart attack and stroke. He/she who eats fatty fish a few times per week really should not take Omega-3 supplements. 

One portion of fatty fish can provide a significant amount of EPA and DHA. Fish like salmon, mackerel, sardines, or herring can offer approximately 250 to 500 mg of these nutrients. The exact amount depends on the type and size of the fish. This amount is typically recommended for maintaining overall heart health. Most sources I read talk about two portions per week of fatty fish.

5. Lean (white) fish typically contains much lower levels of omega-3 fatty acids. This is in comparison to fatty fish such as salmon, mackerel, sardines, and herring. Omega-3 fatty acids are primarily found in the fats of fish. White fish are usually much leaner, so they provide fewer omega-3s. They remain a healthy option as they provide high-quality protein, vitamins, and minerals. 

Some examples of lean fish include Cod, Haddock, Pollock, Hake, Flounder, and Sole. Tilapia (but see my critical remarks on farmed fish), Whiting, Bass, and Shrimps are also lean fish. The following white fish are, unfortunately high on mercury: Sea bream, Sea bass and Turbot.

All international health agencies recommend two portions of fish, with a maximum of three (150 grams). At least one portion should be fatty fish, like herring or salmon. The other can be white fish like cod. White fish lack however the all-important omega-3 with EPA (“eicosapentaenoic acid”) and DHA (“docosahexaenoic acid”),

6. Mercury: important to realize the potential impact on your health

In this blog, I delve a bit deeper into one of the dangers of eating fish: mercury. It is a hazardous heavy metal that we primarily ingest through eating fish. Once it reaches the brain, it can remain there for decades, accumulating and impacting the nervous system. Serious stuff. Other heavy metals, PCBs, and nano plastics might be just as dangerous. These topics will be discussed in other blogs.

(Note: PCBs, or Polychlorinated Biphenyls, are a group of man-made organic chemicals consisting of carbon, hydrogen, and chlorine atoms. They were widely used in various industrial and commercial applications. PCBs have been found to have significant environmental and health impacts; studies are ongoing.)

Some things are recent developments, like nano plastics. We know it is a developing health scare worldwide. Its consequences are not yet known. I cannot imagine that it is good for your body. Who wasn’t alarmed to read that the average adult brain now contains a spoonful of nano plastics? Also a topic for a future blog.

7. From mercury to methylmercury: a technical explanation

Mercury is a global pollutant. It enters water bodies for 1/3 through atmospheric deposition. This deposition results from natural events like volcanic eruptions. For 2/3, mercury enters through human activities such as coal burning and industrial processes. 

The legacy of human use of mercury has caused mercury to be released into the environment in enormous quantities. These releases amount to hundreds of thousands of tons. The levels of mercury in the atmosphere at the moment are up to 500 % above natural levels. In the oceans, the concentrations of mercury are about 200 % above natural levels.

Mercury can undergo chemical transformations once it is deposited to the landscape. Of greatest concern to fish, wildlife, and humans is mercury’s conversion to methylmercury. This conversion is most common in wetlands that are periodically flooded, where the bacteria that facilitate the process are abundant.

Fish absorb methylmercury from the water they live in and from the organisms they eat. Methylmercury is a highly toxic form that accumulates in fish, especially in long-lived and predatory species.

8, Bioconcentration (or biomagnification) refers to the process by which mercury concentrations increase as they move up the food chain. This process results in higher concentrations in higher-level predators such as fish, birds, minks, and otters. Through bioconcentration, mercury levels can increase by 100 to 1,000 times or more. As a result, even low concentrations of mercury in water can contaminate an entire food chain. This contamination makes fish unsafe for human consumption.

Mercury usage and emissions have been reduced in regions such as Europe and North America. Despite this, environmental levels of mercury are likely to remain high for a long time. This persistence is due to mercury’s long lifetime in the environment and increasing emissions in other parts of the world. These emissions can travel long distances. In fact, about half of the mercury deposited in Europe comes from outside the continent.

The biological half-life of mercury is estimated to be approximately 30 to 60 days in the body. The half-life of mercury in the brain is not entirely clear. However, it is estimated to be as long as approximately 20 years.

9. Fish with high or low mercury level

Mercury levels differ from one species of fish to the next. This is due to factors such as the type of fish, size, location, habitat, diet and age.

Fish that are predatory (eat other fish) are large and at the top of the food chain, and so tend to contain more mercury. This includes tuna and swordfish. Try to avoid them and go for wild salmon, herring, sardines etc.

10. Potential Health impact is serious

The health impacts of mercury are dose-related, but the main concern is its impact on fetuses and young children. Mercury exposure can occur in the womb due to a mother’s consumption of seafood, which can have significant and lifelong effects on a baby’s developing brain and nervous system. This exposure can affect memory, language, attention, and other skills. In Europe alone, it is estimated that more than 1.8 million children are born each year with mercury levels above recommended safe limits.

In adults, chronic mercury exposure can lead to neurological and developmental issues. Symptoms of mercury poisoning can include tremors, memory problems, and cognitive deficits. In severe cases, it can affect kidney function and the respiratory system. Mercury exposure can also potentially impact cardiovascular and immune health in adults.

11. Possible symptoms of methylmercury poisoning may include

Loss of peripheral vision; pins and needles” feelings, usually in the hands, feet, and around the mouth; lack of coordination of movements; impairment of speech, hearing, walking; and/or muscle weakness.

12. Testing

It is possible to measure the levels of mercury in your body through blood tests, urine tests, and hair analysis. The last method is particularly interesting. Measuring mercury levels in hair can provide an estimate of long-term exposure to methylmercury. Hair accumulates mercury steadily as it grows. This reflects exposure over months rather than days. This is useful for assessing chronic exposure.

13. My Experience

For years, we enjoyed our daily fish meals. However, preparing this blog made me realize my naivety during all those years. Yes, fish is healthy. However, it can also carry many harmful substances. These include heavy metals, PCBs, nano plastics, and antibiotics.

We ate tinned sardines and mackerel. We also had deep-frozen cod from the North Atlantic. Of course, we enjoyed sustainably fished fresh Dutch herring and the occasional wild salmon.

It proved to be almost impossible to get hard data on which fish carries which substances. It is probably too complex; I realize this. But, I have read too much worrying news from reliable sources to continue with my current level of fish consumption.

So we decided to cut down on fish. We enjoy Dutch herring once or twice a week. We have wild salmon once a week. Both are oily fish providing omega-3 fatty acids.

Additionally, I will do a hair analysis to check if mercury has accumulated in my body.

Time for dinner, but no fish tonight :). Enjoy a long and healthy life,

Robert, your health friend