When people use the contact form on the bottom of this site, maybe they should take a few seconds and think about two things I don't tolerate very well, which are

• packaged industrial products being sold under "real food" or "paleo" labels
• complete and utter misuse of history to sell a particular diet

Maybe don't send me that stuff, because I will post about it, and I will criticize it. Or maybe on the latter case, just leave the historical narrative out of your spiel if you can't waste more than an hour thinking about what it might actually imply. 

One thing I really regret is when I first got healthy by eating a paleo diet, I thought that if everyone just ate like me, they could have a slim body like mine. It didn't seem that hard to me. So I became a zealot about it. But that process of being a zealot forced me to talk with a wide range of people about their experiences with food and health- from relatives to people I met at paleo meetups in real life. What shocked me were the people who ate like me, some of them ate "better" than me, and yet they were struggling with their weight. I even met people who gained weight on diets like mine. It was eye-opening.

And then there was the process of me discontinuing my strict diet, once when I moved to Europe, and next after I was having low blood pressure issues. I was talking to a friend who lost a lot of weight on paleo successfully and now works...making pizza. We were both joking how we have worried that we were going to suddenly gain a bunch of weight. But it never happens. It's not like we returned to a junk food diet, but I'm not going to turn down some ice cream or homemade pizza. And yet there are people right now turning down the kinds of things who can't seem to slim down. And then there are are fair number of people who slim down on diets full of paleo demonized foods like legumes and whole grains.

Some of them realize that health is about more than being slim, and while gaining weight might be a bad sign, the fact that they can lose a little and feel healthier is more than satisfying. Others however give up, disenchanted with the promises of a slim figure, dismissing it as just another fad diet. 

Recently Jonathan Bailor sent me a contact email not once, but twice with his new "Slim is Simple" video to celebrate the creation of a non-profit devoted to distributing his educational material on healthy eating. I was surprised that so many got excited by this video. I criticized it on Twitter and some people were upset by that, saying it was a great educational tool and we need more such "simple" tools. No reason to be obsessed with scientific accuracy. Now I don't think I have that problem- I have recommended books that are quite imperfect on this blog many times from The Primal Blueprint to The Paleo Solution, but I don't recommend something unless I feel it has a useful and correct core.

Luckily I wasn't the only one who saw right through this video, Beth at Weight Maven, also posted a skeptical take on it. Evelyn has also written about Jonathan's other work before. I won't even get into his questionable calorie math that doesn't seem to bother with the fat that the correct equation takes maintence, which depends on body size, into account.

 But I also would love to see more books that simplify eating without bordering on inaccurate propaganda like this video. I felt like I was watching a cult indoctrination film. Not only that, but it would seem its bolsters didn't even notice he's recommending a diet that is pretty different from the one they recommend- a diet based on three pillars of protein, fiber, and water. Eat as much as you want of those three things (maybe it helps that if you eat too much of the first two, you'll get diarrhea). 

That's right- have as much protein as you want on this diet, have twice as much as normal, you'll be so satiated you'll supposedly forget about ice cream.I think this is exactly the kind of diet I coined the term "faileo" to describe (though sadly I feel this eventually contributed to a culture that somehow thinks you can guzzle as much coconut oil and bacon fat as you want, when I was kind of just trying to get people on board with more reasonable things like lamb shanks). The language is also exactly what many of us have tried to get away from, like the idea that we are "designed" for certain "clean" (an excessively moralistic word reminiscent of Kellogg and other health puritans) foods. Other foods, like starches and sugars (including most fruit- only citrus and berries are given a pass), will "clog our body." 

But then I gets weird, because he says "almost everyone stayed healthy and fit without even trying until very recently" and the visuals for this are very interesting:

So we have an early bipedal ancestor, and than an Egyptian, and Pioneer, and someone who looks like they are from the 40s or 50s. Oh and a rather curvy person, who we presumably don't want to be...if only we knew what those Egyptians did. But Egyptians ate diet rich in bread and beer. Wait, I thought all these foods were the ones the video describes as "unnatural" and are responsible for our modern "clogs"? Hmm, well maybe we'll see about the pioneer woman. American pioneers had access to much more meat and fat than the average Ancient Egyptian, but they also ate things like biscuits and hoe cakes. 40s to the 60s? Well I collect cookbooks from those eras and they are certainly not full of an austere cuisine of protein, fiber, and water. Even if he had used the typical types of people that paleo dieters hold up as examples- the Hadza, The !Kung, the Kitavans, and other modern peoples who still live foraging lifestyles and remain very healthy, it would not make sense, because their diets contain a large amount of starch and even simple sugars. 

Another use of history offender is Dr. Lustig in his new book Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease. Others are more qualified to comment on the biochemistry errors in this book, but the food history in this book is so inaccurate that I wonder if publishers even bother to employ fact-checkers any more. His take on food history involves dividing ancient people into "hunters" mythic fat-burning intermittent fasting meat-guzzlers who "didn't know what a carbohydrate was and they didn't need to." The modern remnants are the Maasai and Inuit. Then there were the "gatherers" who ate carbohydrates and protein in the form of fruits and vegetables, "this is the basis for today's vegan diet. It is practiced in multiple cultures around the globe, because if you grow your own food, that's what's available." Yes...the vegan tribes of India, oh wait, there is no such thing. And has Lustig ever raised his own food or visited a farm? Where do you think most farmers are getting fertilizer from? Hint: it's not vegan. 

And the Maasai, while they may sometimes be fat burners, are not a low-carb culture. As for ancient foragers, there is a reason they have been called hunter-gatherers, not hunters AND gatherers. In fact the vast majority of foraging peoples in the Ethnographic Atlas eat fairly mixed diets, the people who are primarily hunters or gatherers are exceptions.

But Lustig has to make up this false narrative so he can get to his all-encompassing theory of all our problems (and also because for some weird reason he wants to pander to both the Atkins and plant-based folks, a weird thread in this book), which is the "Omnivore's Curse"- "it wasn't until we became gourmets, eating fat and carbohydrate in the same meal, that our cells first felt the wrath of mitochondrial wear and tear." Apparently, with the advent of farming we started mixing fat and carbohydrates together in meals and thus we became diseased, because in nature there are no foods that have both things, which means somehow that we should take our lessons and cease our evil cooking of potatoes in butter. "This accounts for the appearance of metabolic disease with the advent of trade in the early seventeenth century; before that, food was still a function of what you killed or you grew yourself. Eventually, we became gourmands, eating fat and carbohydrate in the same food." 

Reminds me of my maxim not to take advice on food from people who don't actually seem to like it very much. My friends and I have a historical eating club and this Saturday is our dinner based on ancient Mesopotamia. I still have some mead (liquid carbohydrates mmm) left over from our Viking dinner, though we might have some ancient beer as well. For dinner I am making lard-rubbed goat leg with cumin, mastic, coriander, mint, and ginger. There will be sides of roasted barley and roots. Yes, I will be mixing carbohydrates, fat, and protein in one meal, which presumably people have been doing since they have been cooking. Pottery dates well into the Paleolithic, and before that people probably used other containers to mix things together. We know they were cooking because they left residues of grease and boiled fruits and all sorts of other things. Because humans are curious creatures and some of us really do like to play with our food (though as Gary Nabhan has pointed out, there may be some evolutionary reasons some cultures adopted things like spices).

Some people cook less than others- for example the Hadza don't seem to cook very many "recipes" though they do mix baobab (which contains both fat and carbohydrate) with honey for a drink sometimes. It's funny that Lustig later mentions that Ancel Keys in his heart disease study left out populations like those in Tokelau- in Tokelau their diet is starch and coconut. If mixing fat and carbohydrate were an issue, we would have been the way we are now for a very long time. Not that I think ancient people were perfectly healthy- for example, both Egyptian and Inuit mummies show atherosclerosis, though back then it may have been caused by constant infections and cooking smoke inhalation rather than food and there is no evidence it caused any mummy's death. Lustig does also make a good point that heart disease was a problem in the 1930s, back before the "obesity epidemic".

When I think of my very slim (though probably wearing a corset) great-great grandmother pictured here, I don't think of diets based on protein, fiber, and water. I think of people who ate reasonable natural homemade food. The same food I eat now. I doubt she would have touched things like the Slim is Simple Peanut Butter Pie (which contains ingredients I actually do try to avoid: low-fat dairy, industrial whey protein isolate, and extremely high omega-6 peanut butter, cooked almond flour...he recommends leaving the honey out of the crust, which is funny because it's probably one of the healthier ingredients) with a ten foot pole.

She didn't count calories, and neither have I. As someone who eats made-from-scratch foods that are highly variable it would be pretty pointless for me to count calories, as it would be inaccurate. I know when I'm losing weight I have a calorie deficit though, even if it is going to not be possible to quantify it accurately. Some people find success with trying to do the math, but I always found it easier to try things that have been shown in studies to subconsciously reduce the amount of calories eaten. One of these is to eat a lot of protein, which is funny because that's one of Bailor's main strategies. Though it certainly never made me stop thinking of other foods, and I had significant energy issues when I was on the very high-protein, low fat, high fiber kind of diet Bailor advocates. Frankly, I felt sick and catatonic, but I guess his diet works for some people, and not for others, the same way some weight loss diets work for some and not for others. Because nothing to do with the human body is simple. Slim is not simple. 

Obesity system influence map

Now and then I get an email asking about using Betaine HCL to heal from GERD. I first heard about this supplement through Robb Wolf's podcast. By the time I heard of it, I already did not have GERD. I bought a bottle to use as a digestive enzyme after large meals like Thanksgiving, but it didn't do very much for me and I kind of forgot about it. 

The use of acidic products to treat GERD is a common folk remedy. Back when I had GERD, I based my own treatment on both preliminary scientific research such as these studies on supplements and low-carb. But I also drew on some internet folk remedies that utilized harmless foods. At the time that was all that was out there, and the side effects of the Nexium I was on were so intolerable that I felt I didn't have much to lose. At the time one of the top Google results for heartburn remedies was this site advocating apple cider vinegar tonics. I started taking them after every meal. It was initially uncomfortable, but eventually I found relief. And a weird permanent craving from acidic foods that remains to this day and seems to drive my love for kombucha and sour beer.

There aren't any studies at all on acid supplementation and GERD. The folk remedy sites had two theories about it:

1. That GERD was actually caused by LOW stomach acid (I hear this a lot in the alternative health community and there are no studies that show this- consistently studies of people with GERD show high acidity, buts it seems to be more a disease of acidity at inappropriate times, inflammation, and of esophageal sphincter dysfunction). Taking acidic thing X is supposed to fix that somehow.

2. That introducing acidic things into the stomach causes a buffering action and lowers acidity after a meal. 

In the instance of apple cider vinegar, because it is a cultured food, there are all kinds of confounders like the phytochemicals from apples and the live bacteria and associated byproducts. Same thing goes for kombucha. There is some evidence that fermented foods can increase gastric acid secretion in the form of a nice glass of wine. Beer may have similar effects, and also stimulates GI motility. But sorry- not whiskey and other distilled beverages. Other things that are known to increase acidity include high-protein meals.

Maybe HCL does something similar? I don't know. I just know that some bloggers like Robb Wolf and SCDlifestyle promote a test for taking it which was to pop the capsules until you feel a warming sensation in the stomach. I've seen it lead to some pretty sad people taking dozens and dozens of these capsules with no effect and thinking they have low stomach acid because of it. It is even possible they are doing real harm to their stomach lining with these pseudoscientific tests- the burning/warming senasation might indicate irritation of the stomach lining, which means that the integrity of that lining is an issue, not necessarily the acidity of the stomach. 

The test is now on the page of Wolf and Kresser's new brand of "Paleo" supplements that is supposed to help people adjust to "paleo" diets:

1. Start with one 400 mg capsule of AdaptaGest Flex in the early part of each meal. You should begin to feel better digestive response following meals.
2. After two or three days, increase the dose to two capsules at the beginning of meals. Then after another two days increase to three capsules. Increase the dose gradually in this stepwise fashion until you feel a mild warming sensation.
3. When you feel this sensation, reduce the dosage to the previous number of capsules you were taking before you experienced it and stay at that dosage. This is your maintenance dose. You should notice significant improvement in digestion: less gas and bloating, better absorption, more regular and better-formed stools.
4. If you start feel a warming sensation at that dose, reduce again. Over time you may find that you can continue to reduce the dosage, or you may also find that you may need to increase the dosage.
5. After 90 days on your maintenance dose, try to gradually reduce the dose to zero. For some people, this will be possible. Others may need to take HCL indefinitely (this is especially true if you have a history of PPI or other acid-suppressing drug use).

I guess we'll have to take their word for it. Dr. Art Ayers, a laboratory scientist who sadly hasn't blogged in ages, has questioned Betaine-HCL:

The HCl in betaine-HCl, just means that HCl was used to neutralize the betaine. There is no HCl in betaine-HCl. Using betaine as a supplement will buffer your stomach and have no impact other than perhaps lowering acidity. Betaine is very bizarre stuff, so it may incidentally increase the production of stomach acid, but I know nothing about that.

In most cases, stomach acidity is not the problem. Typically the problem is with gut bacteria...

The confusion comes from the fact that betaine has two ionizable groups, like amino acids in water. The N, bonded to four carbons has a positive charge and the carboxylic acid loses its proton to have a negative charge. When HCl is added, the H+ reprotonates the carboxyl group and the Cl- forms an ionic bond with the positively charged quaternary amine to yield a salt.

There is no HCl in NaCl and no HCl in ammonium chloride and no HCl in betaine-HCl. All of those are salts.

Betaine-HCl cannot be claimed to increase stomach acid in over the counter medications, because there is no evidence to support the claim.

Thanks for the questions.

Whose word to take though? I'm going with Art because at the end of the day there simply is "no evidence to support the claim." Furthermore, think about his explanation- if you looked at the label of Zantac, which is an ANTI-ACID I used to take, it says Ranitidine-HCL.

Now regardless of whether it works, why would someone who is transitioning to a "paleo" diet need something like this? My own impression is that many such diets are excessively high in added fats and this is often a very sudden change for people, not giving their digestive system time to adjust to them. Very high fat meals may also lead to slowed gastric emptying for people who are not used to such foods (this might not be a bad thing always as it increases satiation, but you might feel bloated and have reflux if it's too pronounced). I remember low-carb coconut milk (common additives like guar gum might play a role here)-based meals that felt like they were a brick in my stomach. I wonder a bit if the Dr. Kruse fever that briefly swept "paleos" was a product of his suggestion that people eat a nice high-protein breakfast, which may have stimulated a more favorable gastric environment than the mostly fat breakfasts I often see, though it also included a lot of added fat and some people on forums noted they were bloated or had to force themselves to finish it. 

But honestly when you are doing a bunch of different things, it's hard to tell what is responsible for making you better. That's why when people say that Expert X knows that Something works because of "clinical experience," I don't take much stock in that. Few clinicians are recommending just one thing. And the placebo effect is a powerful thing.

Also a lot of Betaine HCL formulations are gelatin capsules- people might benefit from the gelatin rather than the stuff inside the capsule. I did not have any luck with betaine HCL, but I've added a lot of gelatin to my diet with great results. Also the betaine itself, though it's hard to comment on that because there doesn't seem to be much information on the type in the supplement, but studies on betaine have shown it can possibly affect digestion and gut integrity (mostly animal studies), as well as homocysteine metabolism. Like Ayers said, it's weird stuff. That GERD supplementation study I mentioned up thread used betaine (not betaine HCL, but if Ayers is right is should be about the same thing although this supplement publication suggests it will not work as well as betaine, but this livestock publication suggests they should work identically), melatonin, tryptophan, methionine, B12, B6, and folic acid. Most betaine-HCL is also bundled with the enzyme pepsin, which could also improve digestion though there are not many studies out there on supplementing it. So maybe it does work, but for not the reasons people think it does.

Overall though I think the most promising approach to issues like GERD is a

• low-carbohydrate high-quality (good grass-fed ruminant meats and fish) low-omega 6 fairly high protein diet (particularly low in fermentable carbohydrates likes starches, I actually found things that were not fermentable carbohydrates like honey in my tea did not have an impact)- you might need to restrict added-fats/mostly fat foods like butter, coconut oil, coconut milk, etc. until your body adjusts or at least not eat large amounts in one sitting. Naturally fatty cuts like grass-fed lamb shank never bothered me personally, it was things like coconut milk soups that were a problem. You could also try supplementing lipase. Some types of meat also seem to be more likely to trigger reflux such as smoked or cured meats- sometimes aged meats can be an issue as well. 
• fixing sleep issues- sleeping 8 hours a night in a dark room
• perhaps with some acidic fermented drinks like kombucha or wine with meals, and some supplements based on symptoms. Some ones I've played with based on preliminary research and had good results with include sea buckthorn (possibly helps heal stomach lining, mastic might also work too and I also just really like the flavors of these foods, but I think other similar berries that are more common in the US might have similar properties), gelatin (or from bone broths), bromelain, and probiotics. My general opinion of supplements is to avoid bundles because you are going to get a lot of stuff you don't probably need and you also won't be able to adjust dosages and ratios as easily.
• Stop taking NSAIDs like aspirin and ibuprofen. 
• Screen for H. Pylori and SIBO (small intestinal bacterial overgrowth), perhaps try a scientifically validated test like the Heidelberg test to see what your stomach acidity is like

This has worked for me, members of my family, and people who have corresponded with me. Maybe this surprises people because it's quite obvious I eat a higher-carbohydrate diet now, but I've always said low-carb diets can be therapeutic, I just never bought into the idea that you should eat them forever or that they were the optimal human diet.

I would not recommend the "test" of acid levels that involves taking more and more Betaine-HCL, I suspect people getting "acid damage" from that just are upsetting their stomachs. 

What do you think? Have you had any interesting experiences with supplements for improving digestion? 

 Today I saw the headline: Can vegans stomach the unpalatable truth about quinoa?

Which is appallingly stupid considering that quinoa is trendy among many segments of the health-conscious crowd. Like many articles of this genre, it also wants believe consumers have more power than they do. What would happen in Western health nuts stopped eating quinoa? Would this benefit the people there somehow? I guess it's more fun to blame trendy dieters than to face larger issues of water scarcity (and water pricing and allocation) and middlemen. It's the same faulty line of logic that many vegans use when talking about meat.

It is a bit amusing to consider how consumption of far away foods lets us turn a blind eye to their production (it's far), which is why I tend to advocate food systems that bring people closer to their food production- and its consequences. 

The article also details failed attempts to grow quinoa elsewhere. Interestingly enough, I was researching yesterday traditional foods of the Midwest, and I'm not talking about Chicago Hot Dogs, but about what people were eating and growing here in the 1600s and before. Turns out the form of agriculture indigenous to this region utilized a relative of quinoa - Chenopodium berlandieri. As a cultivated crop, only remnants remain and from what I can gather, nothing of the kind grown for seeds the way quinoa is grown now. A leaf-heavy version is eaten in Mexico as a vegetable.

But echoes remain. All those lamb's quarters growing out of your patio are ghosts of The Eastern Agricultural Complex- possibly feral ancestors of domesticated crops, which explains some of their tenacity as weeds. I would think it would be possible to re-domesticate through selective breeding. It already makes a fine salad. Wild food enthusiast Euell Gibbons found the grains even of the modern weed somewhat easy to harvest:

“In rich soil,” he said, “lamb’s quarters will grow four or five feet high if not disturbed, becoming much branched. It bears a heavy crop of tiny seeds in panicles at the end of every branch. In early winter, when the panicles are dry, it is quite easy to gather these seeds in considerable quantity. Just hold a pail under the branches and strip them off. Rub the husks between the hands to separate the seed and chaff, then winnow out the trash. I have collected several quarts of seed in an hour, using this method.

“The seeds are quite fine, being smaller than mustard seeds, and a dull blackish-brown color....I find it pretty good food for humans.”

I think this also brings me to question certain studies that have tried to estimate the amount of wild grains foragers could have harvested- the ones we encounter now might be feralized crops, not true wild seeds or grains. That might also be why many are less toxic than truly wild seeds/grains. It's probably worth soaking and rinsing though since like quinoa, it may contain high levels of saponins. 

Another former crop, Sumpweed, Jared Diamond says was abandoned because it was allergenic and smelled bad, but that didn't stop modern farmers from reshaping rapeseed, a crop that seems quite far from edible with its high levels of nasty erucic acid, into canola, which is now a novel and strangely unquestioned ubiquitous part of our food supply. Plenty of other foods that foragers and agriculturalists eat are toxic when harvested- that is often a feature, not a bug, as it keeps other competing pests away. Humans are smart enough to detoxify through soaking, rinsing, fermentation, and other technologies.

It's interesting how so many Americans look to afar for interesting foods while ignoring the ones in our backyards. 

There is also a legend that quinoa is "cursed" which is why North American production has been so difficult, but I find it more logical to think that the Chenopodium that is Quinoa is adapted to a specific environment that we can't offer. There is also some evidence that ancient northern Europeans cultivated a type of Chenopodium as well, remnants of that perhaps are seen in England's Pigweed.

 I was fairly young when I started having health problems. One of them was headaches. I had severe headaches and then migraines starting when I was maybe 9. By the time I was in high school, headaches, constant infections, fatigue, and stomach problems caused me to miss over a month of class every single school year. One thing that helped quite a bit was Excedrin Migraine, a combination of ibuprofen and caffeine. I popped those things like candy. I bought them all the time, taking the maximum dose for weeks at a time. 

When I was a senior in high school I was diagnosed with my first ulcer and given Nexium. I was diagnosed with another ulcer when I was a freshman in college. 

I don't know why doctors never thought to connect my excessive usage of Excedrin Migraine to my ulcers. 

I've eaten all sorts of things since I discovered evolutionary medicine. Some of those things were not probably the best things to eat. And sometimes I've had stomach aches, but I've never gone back to my original horrible messed up state. 

Except once. I was backpacking through Europe with friends. Let's just say I didn't sleep so well and I also drank my fair share of brandy, mulled wine, and beer. I came down with what was probably strep throat, but the trip was almost over and I didn't know how I could get treated in a place like Budapest. So I took the max safe dosage of ibuprofen for over a week, all through Hungary and Austria. By the time I got back to home base in Sweden, I was having heartburn again. It took a long time for me to get rid of that. It was extremely unpleasant to say the least, requiring a strict elimination diet to fix.

And at that time I did my research and found that NSAIDs could damage the gut lining. Some studies have connected NSAIDS to impaired intestinal permeability in IBS patients. I stopped taking them. 

Last year I purchased 23andme for myself and then I also got my dad a kit for Christmas. I ran both of our outputs through Promethease, a cool open-source program I've blogged about before. One thing that I noticed this time was genoset 191, which is related to poor NSAID metabolism. Being super lucky, I have CYP2C8*3 from my father and CYP2C9*2 from my mother. Several studies have shown this genoset is associated with gastric bleeding. Now that's an acute symptom, but you have to wonder it can cause more subtle chronic stomach problems as well. 

Both my parents were taking NSAIDS at the time I realized this. Both have a history of stomach problems. My mother discontinued them on my advice and she said it helped. 

But when you stop taking NSAIDs, you realize how much our culture depends on them. Last year I messed up my knee while exercising and was kind of sore for a couple of days. I rarely resort to pain killers, but it was affecting my ability to concentrate. The office first aid kit only contained NSAIDs- aspirin, advil, etc. I walked to the drug store in pain and bought tylenol. It doesn't work as well for me as NSAIDs, but it worked OK.

But not being able to rely on pain relievers also forces you to address the real source of problems you might cover up otherwise. It seems like at least once a year, I get bad neck aches. Ususally it's after a big project when I sit hunched over for too long, even though I know it will have consequences. Unfortunate Even a standing desk doesn't fix this for me. Apparently I can hunch while standing.

Usually yoga helps it, but my regular yoga teacher moved away. When I went to another level 1 yoga class nearby, that teacher was really pushy about inversions. Now, I think inversions can be safe, but I don't think they are safe for beginners or people with certain structural issues at all. That's not the way the human body evolved to move and you really need to have good core strength and flexibility (the latter which I do not have) to do them safely. And of course my neck got worse after that class, to the point where I started to get headaches. 

And the 8 Steps to Pain-Free Back stuff only helps so much when it's that bad. I can't maintain the recommendations in the book if my muscles are cramped and miserable. So I decided to try other things. I went to the chiropractor next door to my office. Now I am suspicious of a lot of chiropractic stuff, but when my neck is in such a state, it really does seem to help and I can chose to ignore the office woo about food/vaccines/etc. Which is kind of hilarious given how pushy some chiropracters are about getting x-rays, which increase risk for several cancers. They had a video playing in the office of the latest place I went that was about chiropractic care having been around for 2000 years or something. I wondered how it was ever possible it existed before x-rays considering how annoyed they were with me when I said I wouldn't sign off on them. 

The other thing I didn't like about the chiropractic stuff is that I didn't feel it was fixing the root causes, just treating the symptoms and frustratingly when I brought that up to the chiropractor, they just said I needed to come in more. When I dialed back on my appointments because I was busy, the pain came back. 

I started seeing a rolfing professional on a whim. Rolfing was pretty interesting- is it almost like a massage, but one that tries to correct your structure by interrupting dysfunctional fascia. It provided me relief and the rolfer provided some insight into some of the everyday imbalances that seemed to plague me. I got the book she recommended, The New Rules of Posture by Mary Bond, which I'm currently in the middle of. 

It's truly an interesting book in how it points out the potential sources of problems. For example, I was under the impression that I was doing the right thing in terms of my shoes and walking. I walk a lot and I wear flexible thin-soled shoes. Earlier this year I started having some annoying heel pain on my right food. The exercises in the book pointed out that this is my dominant foot, so that makes sense. Or does it? Turns out that dominant doesn't mean what you think it means, the drive for the act of walking according to Bond should be the buttocks and ball/toes of the non-dominant foot, rather than the heel strike, which is how I was driving.

Also the Bond and Gokhale books both pointed out that the fact that my dress straps on many of the sleeveless dresses slipping is not just a minor annoyance, it reveals that my shoulders have become rounded over time, probably from a mixture of hunching (I often put my elbows on my desk and lean onto my hands) and letting my shoulder muscles atrophy. There is also just a host of interesting information about posture in the Bond book, particularly that about posture reflecting mood and social structure. If you think about this it makes sense. How many times have you seen a timid animal hunch down with you tried to pet them? Or cats arching their backs when trying to menace another cat? Or a guilty dog hunch and look down at the ground when confronted? In humans you start to notice this as well, seeing the introverted child or overworked programmer hunching? Perhaps this explains why various studies have tied unhappiness to back pain. They always frustrated me because some used them to imply that back pain is psychosomatic, but in my opinion it seems more likely that unhappiness and unhappy situations can lead to poor posture and also that pain from that can lead to further unhappiness.

So for the new year I plan on finishing the Bond book exercises. And I'd like to try out Feldenkrais and the Alexander technique. More Rolfing too with some gentle yoga, and occasional visits to the chiropractor just to release tension. And perhaps instead of doing group workouts, focus on my own weight training with my own deficits in mind. Any other suggestions?